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Perceptual learning theory suggests that perceptual grouping in mathematical expressions can direct students' attention toward specific parts of problems, thus impacting their mathematical reasoning. Using in-lab eye tracking and a sample of 85 undergraduates from a STEM-focused university, we investigated how higher-order operator position (HOO; i.e., multiplication/division operators and the presence of superfluous brackets impacted students' time to first fixation to the HOO, response time, and percent of correct responses). Students solved order-of-operations problems presented in six ways (3 HOO positions × presence of brackets). We found that HOO position and presence of superfluous brackets had separate and combined impacts on calculating arithmetic expressions. Superfluous brackets most influenced undergraduates' performance when higher-order operators were located in the center of mathematical expressions. Implications for learning and future directions are discussed about observing eye movements and gaining insights into students' processes when solving arithmetic expressions.

Cigarette smoking remains a leading cause of preventable disease and death worldwide. Due to the devastating negative health effects of smoking, many users attempt to quit, but few are successful in the long-term. Thus, there is a critical need for novel therapeutic approaches. In these investigations, we sought to examine whether cannabidiol (CBD) has the potential to be repurposed as a nicotine cessation therapeutic. In the first study, male and female mice were trained to respond for intravenous nicotine infusions at either a low or moderate nicotine dose and then were pretreated with CBD prior to their drug-taking session. We found that CBD produced a significant decrease in the number of nicotine rewards earned, and this effect was evidenced across CBD doses and with both the low and moderate levels of nicotine intake. These effects on drug intake were not due to general motor-related effects, since mice self-administering food pellets did not alter their behavior with CBD administration. The potential effects of CBD in mitigating nicotine withdrawal symptoms were then investigated. We found that CBD attenuated the somatic signs of nicotine withdrawal and prevented nicotine's hyperalgesia-inducing effects. Taken together, these results demonstrate that modulation of cannabinoid signaling may be a viable therapeutic option as a smoking cessation aid.

Objective: To compare neurofunctional responses in emotional and attentional networks of psychostimulant-free ADHD youth with and without familial risk for bipolar I disorder (BD). Methods: ADHD youth with (high-risk, HR, n = 48) and without (low-risk, LR, n = 50) a first-degree relative with BD and healthy controls (n = 46) underwent functional magnetic resonance imaging while performing a continuous performance task with emotional distracters. Region-of-interest analyses were performed for bilateral amygdala (AMY), ventrolateral (VLPFC) and dorsolateral (DLPFC) prefrontal cortex, and anterior (ACC) and posterior cingulate cortex (PCC). Results: Compared with HC, HR, but not LR, exhibited predominantly left-lateralized AMY, VLPFC, DLPFC, PCC, and rostral ACC hyperactivation to emotional distractors, whereas LR exhibited right VLPFC and bilateral dorsal ACC hypoactivation to attentional targets. Regional responses correlated with emotional and attention symptoms. Conclusion: Aberrant neurofunctional responses during emotional and attentional processing differentiate ADHD youth with and without a family history of BD and correlate with relevant symptoms ratings.

Context.—Quantitative imaging is a promising tool that is gaining wide use across several areas of pathology. Although there has been increasing adoption of morphologic and immunohistochemical analysis, the adoption of evaluation of fluorescence in situ hybridization (FISH) on formalin-fixed, paraffin-embedded tissue has been limited because of complexity and lack of practice guidelines.Objective.—To perform human epidermal growth factor receptor 2 (HER2) FISH validation in breast carcinoma in accordance with the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) 2018 guideline.Design.—Clinical validation of HER2 FISH was performed using the US Food and Drug Administration-approved dual-probe HER2 IQFISH (Dako, Carpinteria, California) with digital scanning performed on a PathFusion (Applied Spectral Imaging, Carlsbad, California) system. Validation parameters evaluated included z-stacking, classifier, accuracy, precision, software, and hardware settings. Finally, we evaluated the performance of digital enumeration on clinical samples in a real-world setting.Results.—The accuracy samples showed a final concordance of 95.3% to 100% across HER2 groups 1 to 5. During clinical implementation for HER2 groups 2, 3, and 4, we achieved a final concordance of 76% (95 of 125). Of these cases, only 8% (10 of 125) had discordances with clinical impact that could be identified algorithmically and triaged for manual review.Conclusions.—Digital FISH enumeration is a useful tool to improve the efficacy of HER2 FISH enumeration and capture genetic heterogeneity across HER2 signals. Excluding cases with high background or poor image quality and manual review of cases with ASCO/CAP group discordances can further improve the efficiency of digital HER2 FISH enumeration.

Research and policy often focus on reducing attrition from educational trajectories leading to careers in science, technology, engineering, and mathematics (STEM), but many students change career plans "within" STEM. This study examined how changing career plans within STEM fields was associated with psychological indicators of career readiness. We conducted a large online survey of undergraduate students (N = 1,727) across 42 courses covering every major STEM discipline at a large U.S. research-intensive public university. Students reported about their career plans, whether plans had changed, motivation for those career plans, and satisfaction with and certainty of persisting with those plans. A trained team of coders classified whether students reported having STEM career plans at the time of the survey and at the beginning of college. Students who said they had changed career plans within STEM fields during college also reported lower motivation for their new career plans, satisfaction with those plans, and certainty of persisting in them, compared to students who retained consistent STEM career plans. With few exceptions, these associations held across students' gender, race, year in school, and STEM field of study. Within-STEM career plan changes were very common, reported by 55% of fourth-year STEM students. Women reported changing career plans within STEM fields more often than men. Results suggest that changing career plans within STEM is an important phenomenon to consider in preparing a qualified and diverse STEM workforce. Students who change career plans within STEM fields may need additional supports for their career motivation and satisfaction compared to students who do not change plans.

Despite the elevated importance of Data Science in Statistics, there exists limited research investigating how students learn the computing concepts and skills necessary for carrying out data science tasks. Computer Science educators have investigated how students debug their own code and how students reason through foreign code. While these studies illuminate different aspects of students' programming behavior or conceptual understanding, a method has yet to be employed that can shed light on students' learning processes. This type of inquiry necessitates qualitative methods, which allow for a holistic description of the skills a student uses throughout the computing code they produce, the organization of these descriptions into themes, and a comparison of the emergent themes across students or across time. In this article we share how to conceptualize and carry out the qualitative coding process with students' computing code. Drawing on the Block Model to frame our analysis, we explore two types of research questions which could be posed about students' learning. Supplementary materials for this article are available online.

Scaling up the use of evidence-based practice (EBP) for autism across service sectors and regions has presented a considerable challenge indicating a clear need for continued development. The California Autism Professional Training and Information Network (CAPTAIN) integrates implementation drivers into specific procedures and methodology as an implementation strategy to support statewide scale up. The current study was designed to evaluate the impact of CAPTAIN on provider-level outcomes including attitude toward, and knowledge, fidelity and use of autism EBPs, and overall classroom quality. Overall, results indicated variability across measures, with some significant differences between CAPTAIN-trained and non-CAPTAIN-trained providers. CAPTAIN-trained providers reported more openness to EBP. Significantly more CAPTAIN-trained direct service providers reported collecting fidelity of implementation data (X[superscript 2](2, N = 1515) = 10.95, p = 0.004), collecting student data (X[superscript 2](2, N = 1509) = 14.19, p = 0.001), and reported using their primary EBP with "most or all students" (X[superscript 2](2, N = 1514) = 11.41, p = 0.003) than providers not trained by CAPTAIN. In summary, these preliminary findings show promise for the efficacy of the CAPTAIN model to increase dissemination and implementation of EBP at the classroom level.

Group social skills interventions (GSSIs) are among the most commonly used treatments for improving social competence in youth with ASD, however, results remain variable. The current study examined predictors of treatment response to an empirically-supported GSSI for youth with ASD delivered in the community (N[subscript total]=75). Participants completed a computer-based emotion recognition task and their parents completed measures of broad psychopathology, ASD symptomatology, and social skills. We utilized generalized estimating equations in an ANCOVA-of-change framework to account for nesting. Results indicate differential improvements in emotion recognition by sex as well as ADHD-specific improvements in adaptive functioning. Youth with both co-occurring anxiety and ADHD experienced iatrogenic effects, suggesting that SDARI may be most effective for youth with ASD without multiple co-occurring issues. Findings provide important directions for addressing variability in treatment outcomes for youth with ASD.

As of March 31, 2023, more than 30,000 monkeypox (mpox) cases had been reported in the United States in an outbreak that has disproportionately affected gay, bisexual, and other men who have sex with men (MSM) and transgender persons (1). JYNNEOS vaccine (Modified Vaccinia Ankara vaccine, Bavarian Nordic) was approved by the Food and Drug Administration (FDA) in 2019 for the prevention of smallpox and mpox via subcutaneous injection as a 2-dose series (0.5 mL per dose, administered 4 weeks apart) (2). To expand vaccine access, an Emergency Use Authorization was issued by FDA on August 9, 2022, for dose-sparing intradermal injection of JYNNEOS as a 2-dose series (0.1 mL per dose, administered 4 weeks apart) (3). Vaccination was available to persons with known or presumed exposure to a person with mpox (postexposure prophylaxis [PEP]), as well as persons at increased risk for mpox or who might benefit from vaccination (preexposure mpox prophylaxis [PrEP]) (4). Because information on JYNNEOS vaccine effectiveness (VE) is limited, a matched case-control study was conducted in 12 U.S. jurisdictions,† including nine Emerging Infections Program sites and three Epidemiology and Laboratory Capacity sites,§ to evaluate VE against mpox among MSM and transgender adults aged 18-49 years. During August 19, 2022-March 31, 2023, a total of 309 case-patients were matched to 608 control patients. Adjusted VE was 75.2% (95% CI = 61.2% to 84.2%) for partial vaccination (1 dose) and 85.9% (95% CI = 73.8% to 92.4%) for full vaccination (2 doses). Adjusted VE for full vaccination by subcutaneous, intradermal, and heterologous routes of administration was 88.9% (95% CI = 56.0% to 97.2%), 80.3% (95% CI = 22.9% to 95.0%), and 86.9% (95% CI = 69.1% to 94.5%), respectively. Adjusted VE for full vaccination among immunocompromised participants was 70.2% (95% CI = -37.9% to 93.6%) and among immunocompetent participants was 87.8% (95% CI = 57.5% to 96.5%). JYNNEOS is effective at reducing the risk for mpox. Because duration of protection of 1 versus 2 doses remains unknown, persons at increased risk for mpox exposure should receive the 2-dose series as recommended by the Advisory Committee on Immunization Practices (ACIP),¶ regardless of administration route or immunocompromise status.

Background: Prior work has shown that middle school students struggle with algebra and that game-based educational technologies, such as DragonBox and From Here to There!, are effective at improving students' algebraic performance. However, it remains unclear which aspects of algebraic knowledge shift as a result of playing these games and what game design features support algebraic learning. Objective: Using the data from a randomized controlled trial conducted in the 2020-2021 academic year, we (a) examined students' relative performance on assessment items measuring conceptual knowledge, procedural knowledge and procedural flexibility in algebraic equation solving, and (b) identified changes in these aspects of algebraic knowledge after playing DragonBox or From Here to There!. Methods: Eight hundred eighty-seven seventh-graders were randomly assigned to playing DragonBox or From Here to There! for nine 30-min sessions throughout the school year. Students also completed a pretest, midtest and posttest measuring their algebraic knowledge. Results and Conclusion: First, prior to the intervention, students scored the highest on procedural knowledge and lowest on conceptual knowledge. Second, students significantly improved and maintained learning gains on conceptual knowledge throughout the intervention. Their performance on procedural knowledge and procedural flexibility items increased at midtest but decreased at posttest. Third, the pattern of results was consistent for students in the DragonBox and From Here to There! conditions, suggesting that both games may support students' conceptual understanding of algebra. The findings have implications for research and practice on supporting algebraic learning through game-based technologies during and beyond educational disruptions. [For the corresponding grantee submission, see ED628258.]

Prior research has shown that game-based learning tools, such as DragonBox 12+, support algebraic understanding and that students' in-game progress positively predicts their later performance. Using data from 253 seventh-graders (12-13 years old) who played DragonBox as a part of technology intervention, we examined (a) the relations between students' progress within DragonBox and their algebraic knowledge and general mathematics achievement, (b) the moderating effects of students' prior performance on these relations and (c) the potential factors associated with students' in-game progress. Among students with higher prior algebraic knowledge, higher in-game progress was related to higher algebraic knowledge after the intervention. Higher in-game progress was also associated with higher end-of-year mathematics achievement, and this association was stronger among students with lower prior mathematics achievement. Students' demographic characteristics, prior knowledge and prior achievement did not significantly predict in-game progress beyond the number of intervention sessions students completed. These findings advance research on how, for whom and in what contexts game-based interventions, such as DragonBox, support mathematical learning and have implications for practice using game-based technologies to supplement instruction. [For the corresponding grantee submission, see ED626412.]

Exposure to adversity (e.g., poverty, bereavement) is a robust predictor of disruptions in psychological functioning. However, people vary greatly in their responses to adversity; some experience severe long-term disruptions, others experience minimal disruptions or even improvements. We refer to the latter outcomes-faring better than expected given adversity-as psychological resilience. Understanding what processes explain resilience has critical theoretical and practical implications. Yet, psychology's understanding of resilience is incomplete, for two reasons: (a) We lack conceptual clarity, and (b) two major approaches to resilience-the stress and coping approach and the emotion and emotion-regulation approach-have limitations and are relatively isolated from one another. To address these two obstacles,we first discuss conceptual questions about resilience. Next, we offer an integrative affect-regulation framework that capitalizes on complementary strengths of both approaches. This framework advances our understanding of resilience by integrating existing findings, highlighting gaps in knowledge, and guiding future research.

Public programs have been charged with implementation of evidence-based practices (EBPs) to improve outcomes for children with autism. However, research indicates that scale-up of EBPs poses challenges. This study identifies perceived variables linked to effective statewide scale-up of EBPs in special education by exploring implementation climate and leadership across special education organization types (e.g., schools, districts, and regional consortiums). A simultaneous QUAL + QUAN mixed methods design was employed with the primary function of convergence and triangulation. Data were drawn from focus groups with 30 special educators and a statewide survey completed by 656 school personnel in one U.S. state. In general, perceptions of implementation climate and leadership are weak in special education organizations, with strengths at regional levels focused on special education and increased challenges at the school and district levels. Implications for practice and future research are identified.

Abstract Background More than 50% of dogs with protein‐losing enteropathy (PLE) fail to respond to standard therapies. Octreotide, a somatostatin analogue, is used in cases of intestinal lymphangiectasia (IL) in humans with some success. Objectives Describe the use of octreotide in dogs with PLE including reason for and details of prescription, adverse effects, and apparent response. Animals Eighteen dogs with PLE, 13 with histopathology available. Ninety‐two percent (12/13) had IL diagnosed on biopsy. All 13 dogs had intestinal inflammatory infiltrates noted. Methods Multicenter, retrospective, descriptive study. Cases were volunteered for inclusion by individual attending veterinarians who reported the use of octreotide in cases of PLE. Results In 16/18 (89%) cases octreotide was prescribed to PLE dogs with a clinical suspicion or confirmed diagnosis of IL that were refractory to standard therapies. Median serum albumin at the time of octreotide prescription was 1.7 g/dL (range, 1.0‐3.1 g/dL). The median dose of octreotide prescribed was 20 μg/kg, SQ, daily with a range of 4‐39 μg/kg, SQ, daily. Adverse effects were noted in 3/18 (17%, 95% CI [4%, 41%]) of dogs; discontinuation of the drug was necessary in 1 dog. Improvement in clinical signs was noted in 6/12 (50%, 95% CI [21%, 79%]). Conclusions and Clinical Importance Octreotide was most commonly prescribed to dogs with PLE and suspected or confirmed IL that had failed to respond to standard therapies. Though a benefit to PLE dogs cannot be confirmed, octreotide was well tolerated by the majority of dogs at the doses prescribed in this study.

The United States’ National Science Foundation (NSF) ADVANCE program awards funding to universities to improve gender equality in the faculty ranks in Science, Technology, Engineering, and Mathematics (STEM). Our team at East Carolina University is using our award to educate men in the university about implicit and explicit gender bias and how they can and should use their power to help disrupt these systems. The program, adapted from other universities with past NSF ADVANCE funding, is in its infancy at our university, but there are initial signs of progress. This essay analyzes early data, grounded in sociological theories of gender so as to understand and make progress on structural change in our academic institution. The timeline for action and initial outcomes, including three specific scenarios, are presented. A discussion regarding the impact of the program and how it can be expanded and strengthened is also presented. We reflect on gendered tensions, and explore the limitations of “bringing men in” to correct structural power imbalances that have disproportionately benefitted them.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a range of symptoms in infected individuals, from mild respiratory illness to acute respiratory distress syndrome. A systematic understanding of host factors influencing viral infection is critical to elucidate SARS-CoV-2-host interactions and the progression of Coronavirus disease 2019 (COVID-19). Here, we conducted genome-wide CRISPR knockout and activation screens in human lung epithelial cells with endogenous expression of the SARS-CoV-2 entry factors ACE2 and TMPRSS2. We uncovered proviral and antiviral factors across highly interconnected host pathways, including clathrin transport, inflammatory signaling, cell-cycle regulation, and transcriptional and epigenetic regulation. We further identified mucins, a family of high molecular weight glycoproteins, as a prominent viral restriction network that inhibits SARS-CoV-2 infection in vitro and in murine models. These mucins also inhibit infection of diverse respiratory viruses. This functional landscape of SARS-CoV-2 host factors provides a physiologically relevant starting point for new host-directed therapeutics and highlights airway mucins as a host defense mechanism.

Giant congenital melanocytic nevi are NRAS-driven proliferations that may cover up to 80% of the body surface. Their most dangerous consequence is progression to melanoma. This risk often triggers preemptive extensive surgical excisions in childhood, producing severe lifelong challenges. We have presented preclinical models, including multiple genetically engineered mice and xenografted human lesions, which enabled testing locally applied pharmacologic agents to avoid surgery. The murine models permitted the identification of proliferative versus senescent nevus phases and treatments targeting both. These nevi recapitulated the histologic and molecular features of human giant congenital nevi, including the risk of melanoma transformation. Cutaneously delivered MEK, PI3K, and c-KIT inhibitors or proinflammatory squaric acid dibutylester (SADBE) achieved major regressions. SADBE triggered innate immunity that ablated detectable nevocytes, fully prevented melanoma, and regressed human giant nevus xenografts. These findings reveal nevus mechanistic vulnerabilities and suggest opportunities for topical interventions that may alter the therapeutic options for children with congenital giant nevi.

We report high-precision measurements of the deeply virtual Compton scattering (DVCS) cross section at high values of the Bjorken variable x_{B}. DVCS is sensitive to the generalized parton distributions of the nucleon, which provide a three-dimensional description of its internal constituents. Using the exact analytic expression of the DVCS cross section for all possible polarization states of the initial and final electron and nucleon, and final state photon, we present the first experimental extraction of all four helicity-conserving Compton form factors (CFFs) of the nucleon as a function of x_{B}, while systematically including helicity flip amplitudes. In particular, the high accuracy of the present data demonstrates sensitivity to some very poorly known CFFs.

This study examined factors associated with 9-month outcomes of 78 preschoolers with autism spectrum disorder ([ASD]; 66 males, mean age = 44.8 [7.0] months) receiving preschool special education services. Use of recommended intervention practices was observed in each student's primary educational setting: autism-only (n = 28), mixed-disability (n = 25), and general early education (n = 25). Recommended practice use across setting types and developmental changes were compared using generalized estimating equations. Autism-only settings had the highest implementation of classroom structure, classroom environment, and curriculum and instruction. General early education had greater implementation of practices to support social and peer relationships. Supporting social and peer relationships was the largest predictor of gains, controlling for setting type; the association was greater for children with lower initial receptive language or developmental skills. These findings highlight the importance of supporting and promoting peer engagement in students with ASD across preschool placement types.

BackgroundRates of melanoma have increased dramatically in the United States over the past 25 years, and it has become among the most prevalent cancers for young adult women. Intentional skin tanning leads to a pattern of intense and intermittent UV radiation exposure that is associated with increased risk of melanoma. Frequent tanning is most common among young women and is linked to a variety of sociocultural pressures that negatively impact body image and drive appearance control behaviors. Unfortunately, there are no established interventions designed for frequent tanners. This intervention addresses this gap with unique content informed by body image and acceptance-based interventions. The intervention is delivered using Facebook secret groups, an approach designed to support behavior change and ensure scalability. ObjectiveThis study aims to describe the rationale and methodology of a randomized controlled trial of a melanoma prevention program targeting young women engaged in frequent indoor or outdoor UV tanning. MethodsParticipants are women aged 18-25 years who report high-risk tanning (ie, at least 10 indoor tanning sessions in the past 12 months or 10 outdoor sessions in the previous summer). After recruitment and screening, participants completed a baseline survey and were randomly assigned to receive the intervention or an attention-matched control condition. Both conditions were 8-week-long Facebook groups (approximately 25 members each) with daily posting of content. Follow-up surveys are administered at 3, 8, and 18 months after baseline. The primary trial outcome is the combined number of indoor and outdoor tanning sessions reported at the 8-month follow-up. Hypothesized intervention mediators are assessed at the 3-month follow-up. ResultsThis project was funded by a National Cancer Institute award (R01 CA218068), and the trial procedures were approved by the University of Kentucky Institutional Review Board in February 2020. Trial recruitment and enrollment occurred in 6 waves of data collection, which started in February 2022 and closed in May 2023. The study is closed to enrollment but remains open for follow-ups, and this protocol report was prepared before data analyses. As of February 2024, all participants have completed the 8-month follow-up assessment, and data collection is scheduled to close by the end of 2024 after the collection of the 18-month follow-up. ConclusionsThis trial will contribute unique knowledge to the field of skin cancer prevention, as no fully powered trials have examined the efficacy of an intervention designed for frequent indoor or outdoor tanning. The trial may also contribute evidence of the value in translating principles of body image and acceptance-based interventions into the field of skin cancer prevention and beyond. If successful, the use of the Facebook platform is intended to aid in dissemination as it provides a way to embed the intervention into individuals’ everyday routines. Trial RegistrationClinicalTrials.gov NCT03441321; https://clinicaltrials.gov/study/NCT03441321 International Registered Report Identifier (IRRID)DERR1-10.2196/56562

BackgroundPrevious latent class analysis of adults with acute respiratory distress syndrome (ARDS) identified two phenotypes, distinguished by the degree of inflammation. We aimed to identify phenotypes in children with ARDS in whom developmental differences might be important, using a latent class analysis approach similar to that used in adults.MethodsThis study was a secondary analysis of data aggregated from the Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE) clinical trial and the Genetic Variation and Biomarkers in Children with Acute Lung Injury (BALI) ancillary study. We used latent class analysis, which included demographic, clinical, and plasma biomarker variables, to identify paediatric ARDS (PARDS) phenotypes within a cohort of children included in the RESTORE and BALI studies. The association of phenotypes with clinically relevant outcomes and the performance of paediatric data in adult ARDS classification algorithms were also assessed.Findings304 children with PARDS were included in this secondary analysis. Using latent class analysis, a two-class model was a better fit for the cohort than a one-class model (p