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Many children with autism spectrum disorder experience feeding difficulties that can lead to increased health risks (e.g., severe nutrition deficiencies, obesity-related illnesses) if left untreated. Intensive feeding programs that use behavior-analytic interventions have reported positive outcomes for treating challenging behavior associated with pediatric feeding disorders at discharge and up to 1 year post discharge. Whether these children achieve and maintain long-term goals is unknown. The purpose of the current study was to evaluate outcomes of behavior-analytic intervention for pediatric feeding disorders among children with and without autism spectrum disorder in an intensive feeding program post discharge. Caregivers of former patients reported on the positive and negative impact of the program and their child's growth and diet variety at follow-up. 85% of caregivers reported the program had a positive impact. Increases in height-for-age z scores were significant from admission to discharge from the intensive program, and progress in growth and diet variety remained the same or improved for most children at follow-up. Results suggest that behavior-analytic intervention in an intensive feeding program produced positive short- and long-term outcomes for children and their families.

The benefits of afterschool activity participation for youth development are well-documented. An interesting question dominating this field is whether there is a threshold at which point participating in too many activities (breadth) and spending too much time in those activities (intensity) is negatively associated with desirable outcomes. Using 9th grade student data (N=115,731) from three administrations of a state-wide school survey, we explore whether students' breadth and intensity of afterschool participation is associated with GPA and perceived family and community support. Findings corroborate prior research in demonstrating the association between breadth and intensity. Importantly, we extend the discussion, with three important observations. First, a linear model is insufficient for modeling these complex associations with outcomes. Second, there is a threshold at which too much participation has a negative impact in these outcomes. Third, variations in activities, time windows and indices have small or no influence in the association with outcomes.

Gifted education programs have facilitated educational segregation since their inception and recent research has determined these programs to be "the" most inequitable in the field. Although a substantial body of research has established that racial inequities in gifted placement practices exist, there is an existing gap in the research around how discriminatory placement trends have evolved over time. The present study examines longitudinal gifted program enrollment data from the Civil Rights Data Collection (CRDC) between 2011 and 2018 to compare participation rates between White and Black students over time. The analysis revealed that White students have consistently participated in gifted programs at a significantly higher rate than their Black peers over this timeframe. Moreover, despite a tendency to assume that although equity in gifted education programs has not yet been achieved, it is slowly becoming more equitable over time, the analysis also revealed that Black students have become even less likely to participate than their White peers since 2011. The need to adopt and widely implement effective approaches to diversify gifted education programs has become more dire over time, and this study serves as a call to action to ensure that educational opportunity is equitably distributed to students regardless of race.

Medulloblastoma is the most common malignant brain tumor in children. It has WNT-driven, SHH-driven/TP53 mutant, SHH-driven/TP53 wildtype, and non-WNT/non-SHH subgroups. MAGMAS (Mitochondrial Associated Granulocyte Macrophage colony-stimulating factor Signaling molecules) encodes a mitochondrial import inner membrane translocase subunit and is responsible for the translocation of matrix proteins across the inner membrane. We previously reported that a small molecule MAGMAS inhibitor, BT9, decreases cell proliferation, migration, and oxidative phosphorylation in adult glioblastoma cell lines. The aim of our study was to investigate whether the chemotherapeutic effect of BT9 can be extended to pediatric medulloblastoma.MethodsDAOY (SHH driven/tp53 mutant) and D425 (non-SHH group 3) were treated with BT9. For in vitro analysis, cell proliferation, death, migration, invasion, and metabolic activity were assessed using MTT assay, TUNEL staining, scratch wound assay, Matrigel invasion chambers, and seahorse assay, respectively. A D425 orthotopic xenograft mouse model was used to evaluate BT9 efficacy in vivo.ResultsBT9 treatment resulted in a significant decrease in cell proliferation (DAOY, 24 hours IC50: 3.6 μM, 48 hours IC50: 2.3 μM, 72 hours IC50: 2.1 μM; D425 24 hours IC50: 3.4 μM, 48 hours IC50: 2.2 μM, 72 hours IC50: 2.1 μM) and a significant increase in cell death (DAOY, 24 hours p = 0.0004, 48 hours p

INTRODUCTION 2054 I. SCOPING THE PRESIDENT'S CONSTITUTIONAL DELEGATIONS AND 2058 STATUTORY SUBDELEGATIONS A. Delegating Constitutional Powers 2059 B. Subdelegating Statutory Powers 2061 II. THE COSTS OF NATIONAL SECURITY DELEGATIONS AND [...], The President sometimes delegates important constitutional and statutory powers to use force or conduct other national security operations. Although these delegations are understudied, there may be reason for concern. Sometimes the President's national security subdelegations have been unfaithful to Congress's strictures. Sometimes the delegations are high stakes, as where President Eisenhower delegated to seven military officials the authority to launch nuclear weapons. Presidents sometimes even resist seemingly reasonable statutory limits on the power to delegate decisions that could lead the United States into armed conflict. National security delegations can be costly. They may diffuse political accountability for high-stakes decisions. The agent may fail to act in a way that reflects the principal's intent. Inferior officials are generally less sensitive to the full scope of foreign policy concerns that may operate at a given moment. And delegations of war-related decisions to actors below the Secretary of Defense shift control of war from civilian officials to military ones. Classified national security delegations-and congressional efforts to regulate those delegations-raise difficult legal questions, including the extent to which Congress may restrict or require reporting about them. Yet the pressure on the President to delegate authorities to respond to "hyperwar," and the coming autonomy revolution in which the President may delegate decisionmaking to artificial intelligence systems, will keep delegation questions at the fore. This Article analyzes the legal doctrine and historical practice surrounding presidential national security delegations, the costs and benefits of such delegations, and Congress's powers to constrain delegations and subdelegations. After identifying gaps in congressional and even presidential awareness of the full range of existing delegations, it proposes ways in which Congress and the President herself can more consistently surface and structure those delegations.

Limited quantitative research has examined similarities and differences between the academic achievement and discipline outcomes, including suspensions, of students with disabilities in rural and urban schools. Therefore, we leveraged a statewide longitudinal data set to explore academic achievement and discipline outcomes for students with disabilities in rural schools and compared those outcomes to students with disabilities in urban schools. We then followed up with analyses to evaluate differences by disability category. The full data set of students in urban and rural schools included 1,306,134 observations from 366,529 unique students with disabilities across 11 consecutive years. We used a series of linear mixed-effects models to evaluate academic achievement for students in Grades 3 to 8 and generalized linear mixed-effects models to evaluate two discipline outcomes, in- and out-of-school suspensions. Overall, we found that students with disabilities in rural schools had lower reading scores, fewer in-school suspensions, and more out-of-school suspensions. Unique patterns across disability categories also emerged.

Abstract Maternal asthma is associated with increased rates of neonatal lung disease, and fetuses from asthmatic ewes have fewer surfactant‐producing cells and lower surfactant‐protein B gene (SFTPB) expression than controls. Antenatal betamethasone increases lung surfactant production in preterm babies, and we therefore tested this therapy in experimental maternal asthma. Ewes were sensitised to house dust mite allergen, and an asthmatic phenotype induced by fortnightly allergen lung challenges; controls received saline. Pregnant asthmatic ewes were randomised to receive antenatal saline (asthma) or 12 mg intramuscular betamethasone (asthma+beta) at 138 and 139 days of gestation (term = 150 days). Lambs were delivered by Caesarean section at 140 days of gestation and ventilated for 45 min before tissue collection. Lung function and structure were similar in control lambs (n = 16, 11 ewes) and lambs from asthma ewes (n = 14, 9 ewes). Dynamic lung compliance was higher in lambs from asthma+beta ewes (n = 12, 8 ewes) compared to those from controls (P = 0.003) or asthma ewes (P = 0.008). Lung expression of surfactant protein genes SFTPA (P = 0.048) and SFTPB (P

Background and Purpose: Adverse childhood experiences (ACEs) have been linked with multiple adverse outcomes, including adolescent dating violence (ADV). ADV is a serious public health issue, with the U.S. rates ranging from 6.4% to 73% for victimization across all types and from 11% to 77% for perpetration. Given the high prevalence of ADV and the fact that it has been frequently linked with ACEs earlier in life, it is crucial to thoroughly understand this relation and apply this information to prevention and intervention efforts. However, to date, there are no known reviews synthesizing the link between ACEs and ADV, nor exploring which ACEs have been included across other studies. Methods: To address these gaps, this study included three comprehensive searches to identify the following: (1) the measurement tools used to measure ACEs; (2) the type of ACEs significantly linked with ADV; and (3) the risk and protective factors considered in this relation. Results: A total of 34 studies were included. There were 24 different assessment tools used to measure the ACEs of adolescents, with the number of ACEs included ranging from 1 to 93. All but one study linked at least one ACE to ADV. The types of ACEs linked with ADV consisted of victimization (e.g., child abuse and bullying), witnessing violence (i.e., home and school), and household dysfunction (e.g., caregiver substance abuse). Several risk and protective factors were considered. Conclusions/Implications: This study found the measurement of ACEs in the literature to be inconsistent, making it difficult to synthesize and compare the findings across studies. Despite the measurement inconsistencies, however, most studies linked ACEs with ADV, emphasizing the importance of considering this relation in prevention/intervention programming.

Specialized research training is a key component of graduate education, yet sexual and gender diverse (SGD) emerging scholars may not receive quality training and networking opportunities at their home institutions. International and interdisciplinary trainings by SGD scholars may develop research competence and academic networks, but few such extracurricular research training programs exist. This article presents the curriculum and mixed-method evaluation of the International Student Training Network (ISTN), a two-year bilingual training program designed to train SGD emerging scholars in Canada, the USA, Mexico, and the UK to conduct research with SGD youth. The racially diverse and interdisciplinary trainees (N = 38) completed a competence self-assessment at pre-test, midpoint, and post-test. Significant improvements in knowledge and skill were found, while importance of the concepts remained consistently high. Twelve trainees participated in interviews to reflect on their experience. Thematic analysis produced three themes, describing benefits of the ISTN: (1) 'You do stick out a lot': Fostering SGD scholarly community in academia; (2) 'We were all working together': Bridging the disciplinary and geographic gaps; and (3) 'A transformative experience': Developing scholarly self-concept and academic self-efficacy. The findings highlight the utility of specialized research training for emerging SGD scholars limited by geographical and disciplinary siloes.

Youth with and at risk for disabilities served in alternative education settings frequently struggle with the writing process, which impedes their ability to communicate ideas and opinions with others. Providing explicit teaching of a writing strategy is necessary for this population of youth. This study examined the effects of self-regulated strategy development (SRSD) with self-determination skills on self-advocacy-focused writing probes (e.g., persuasive) for adolescent female youth in a juvenile justice setting. Emphasis was placed on teaching youth how to use persuasive writing as a tool to self-advocate for things they want or need. The SRSD instructional approach was investigated using a multiple-probe-across-participants design to evaluate the effects. Visual analyses indicated a functional relation between SRSD with self-determination instruction and youth's writing skills. All youth demonstrated an increase in organizational quality and self-advocacy in writing from baseline to independent practice. Limitations to the current study and future directions are discussed.

Youth served within juvenile justice facilities are to be afforded the same educational benefits as their peers in nonsecure educational settings, including transition supports. Transition supports include the purposeful delivery of strategies and interventions to build a wide variety of skills based on youth interests and preferences regarding navigating movement from the juvenile justice environment to their neighborhood school, postsecondary education, workforce, or community at large as well as overall success in the new environment. In the current qualitative study, 11 staff (e.g., teachers, administrators, parole officers) who work with justice-involved youth across five states participated in semistructured, open-ended interviews on the transition programming and needs of youth from their facility back to traditional K--12 schools and the community at large. Using the constant comparative method, the interviews were coded to gain a deeper understanding of the transition programming and practices in juvenile justice facilities along with identifying areas for future youth support and research. Five major themes were identified across interviews related to the barriers and successes in transition programming, establishing collaborative partnerships in the community, and gaining access to additional transition resources. We touch on each theme with direct quotes from the interviews and discuss future directions to best support transitioning youth from juvenile justice settings.

Coronaviruses express their structural and accessory genes via a set of subgenomic RNAs, whose synthesis is directed by transcription regulatory sequences (TRSs) in the 5' genomic leader and upstream of each body open reading frame. In SARS-CoV-2, the TRS has the consensus AAACGAAC; upon searching for emergence of this motif in the global SARS-CoV-2 sequences, we find that it evolves frequently, especially in the 3' end of the genome. We show well-supported examples upstream of the Spike gene-within the nsp16 coding region of ORF1b-which is expressed during human infection, and upstream of the canonical Envelope gene TRS, both of which have evolved convergently in multiple lineages. The most frequent neo-TRS is within the coding region of the Nucleocapsid gene, and is present in virtually all viruses from the B.1.1 lineage, including the variants of concern Alpha, Gamma, Omicron and descendants thereof. Here, we demonstrate that this TRS leads to the expression of a novel subgenomic mRNA encoding a truncated C-terminal portion of Nucleocapsid, which is an antagonist of type I interferon production and contributes to viral fitness during infection. We observe distinct phenotypes when the Nucleocapsid coding sequence is mutated compared to when the TRS alone is ablated. Our findings demonstrate that SARS-CoV-2 is undergoing evolutionary changes at the functional RNA level in addition to the amino acid level.

The emergence of liquid biopsy technologies holds great promise in the cancer setting, including in pediatric central nervous system (CNS) tumors. In contrast to broad lower-depth sequencing, commonly referred to as low pass whole genome sequencing (WGS), targeted platforms with a higher depth of coverage have also been established. Here, we review targeted liquid biopsy techniques with applicability to pediatric CNS tumors. These include polymerase chain reaction (PCR), both droplet digital PCR and reverse transcription-based PCR, Sanger sequencing, and next-generation sequencing approaches that incorporate amplicon- and hybrid capture-based methods. The goal of this paper is to facilitate an understanding of these targeted techniques and provide a context for clinical relevance within disease categories, as well as a discussion on optimizing real-world implementation for pediatric CNS tumors.

BackgroundWeb-based information and social support are commonly used in rare disease communities where geographic dispersion and limited provider expertise complicate in-person support. We examined web-based resource use among caregivers of individuals with telomere biology disorders (TBDs), which are rare genetic conditions with long diagnostic odysseys and uncertain prognoses including multiorgan system cancer risk. ObjectiveThis study explored internet-based information-seeking and social support practices and perspectives of patients with TBDs and their caregivers. MethodsOur qualitative descriptive study used semistructured interviews of patients with TBDs and caregivers. Data were transcribed verbatim and thematically analyzed by an interdisciplinary team. ResultsA total of 32 adults completed interviews. Participant ages ranged from 27 to 74 years. The majority (n=28, 88%) were female, occupied multiple TBD roles (eg, patient and parent), and had undergone genetic testing. Most engaged in web-based information-seeking (n=29, 91%) and TBD-specific social media (n=26, 81%). Participants found web-based resources useful for information-seeking but reported privacy concerns and frustration with forming supportive relationships. Most participants described ambivalence toward web-based resource use, citing tensions between hunger for information versus distrust, empowerment versus overwhelm, disclosure versus privacy, and accessibility versus connection. Fluctuations in web-based support use arose from perceived harms, information saturation, or decreased relevance over the course of TBD illness experience. ConclusionsIndividuals with TBDs and their caregivers reported frequent use of web-based informational and emotional support. However, ambivalence about the benefits and liabilities of web-based resources and persistent medical uncertainty may impact the adoption of and adherence to web-based support among patients with TBD and caregivers. Our findings suggest web-based psychosocial support should target long-term and multifaceted informational and emotional needs, be user-initiated, be offered alongside in-person formats, provide expert-informed information, and be attentive to personal privacy and evolving support needs of the TBD community. This study suggests web-based resources will be most effective in the TBD context when they achieve the following features: (1) offer a variety of ways to engage (eg, active and passive), (2) provide privacy protections in moderated “safe spaces” designed for personal disclosure, (3) offer separate venues for informational versus emotional support, (4) combine web-based relationship formation with opportunities for in-person gathering, (5) provide information that is reliable, easy to access, and informed by medical professionals, (6) remain mindful of user distress, and (7) are responsive to variations in levels and types of engagement. Additionally, advocacy organizations may wish to avoid traditional social media platforms when designing safe spaces for web-based emotional support, instead pivoting to internet-based tools that minimize privacy threats and limit the perpetual public availability of shared information.

Background: Medical uncertainty may cause distress and challenge medical decision-making for patients with rare diseases and their caregivers. Few studies have examined the experience and management of medical uncertainty in rare disease and the dynamics of multiple medical uncertainty sources, issues, and management strategies. Objective: We explored the experience and management of uncertainty in individuals with telomere biology disorders (TBDs), a set of rare cancer-prone bone marrow failure syndromes, and their caregivers. Design: Participants (N = 32) in this qualitative-descriptive study were individuals with a TBD (n = 17) and/or their caregivers (n = 15). We thematically analyzed transcripts to describe the presence and dynamics of medical uncertainty in TBDs using categories from a previously published taxonomy. Results: Individuals with TBDs and caregivers described medical uncertainty as a chronic burden embodied amidst a range of interrelated sources and issues. Scientific uncertainty included diagnostic and prognostic ambiguity. Practical uncertainty focused on logistical challenges of building and maintaining medical care teams. Personal uncertainty included difficulty realigning self-identity, goals, and relationship expectations post-diagnosis. Scientific, practical, and personal uncertainty issues were entangled. The rarity of TBDs resulted in limited scientific knowledge, which gave rise to practical and personal uncertainties affecting medical decision-making and relationship formation (e.g., creating trusted care teams where patient knowledge of TBDs may exceed that of clinicians). Participants used multiple strategies for uncertainty management, particularly information-seeking and community-building. However, these management strategies could intensify, rather than resolve, participants’ medical uncertainty. Conclusion: In TBDs, medical uncertainty manifests as a network of multiple, interrelated, sources and issues, which require evolving management strategies. Researchers must be mindful that complex, synergistic uncertainty networks contribute to psychosocial challenges in TBDs. Additional research is warranted to address scientific uncertainty in TBDs, including clinical manifestations and underlying biology, and to develop psychosocial interventions that recognize and anticipate evolving uncertainty.

In this work, we provide clear evidence of magnetic anisotropy in the local orbital moment of a molecular thin film based on the SCO complex [Fe(H2B(pz)2)2(bipy)] (pz = pyrazol−1−yl, bipy = 2,2′−bipyridine). Field dependent x-ray magnetic circular dichroism measurements indicate that the magnetic easy axis for the orbital moment is along the surface normal direction. Along with the presence of a critical field, our observation points to the existence of an anisotropic energy barrier in the high-spin state. The estimated nonzero coupling constant of ∼2.47 × 10−5 eV molecule−1 indicates that the observed magnetocrystalline anisotropy is mostly due to spin-orbit coupling. The spin- and orbital-component anisotropies are determined to be 30.9 and 5.04 meV molecule−1, respectively. Furthermore, the estimated g factor in the range of 2.2-2.45 is consistent with the expected values. This work has paved the way for an understanding of the spin-state-switching mechanism in the presence of magnetic perturbations.

Getting feedback on assignments is a ubiquitous educational experience. Researchers have typically described the feedback process in one of two ways--feedback as transmission of information from a more knowledgeable other to the learner or feedback as a student-centered dialogue. The present study highlights a gap between theory and practice by comparing undergraduate students' perceptions of the purpose and preferred content of feedback to the views of academics. To measure students' perceptions and preferences about feedback, we administered a survey to 80 undergraduate students from a large research university in the United States. We also analyzed the content of genuine feedback a subset of those students received as part of one of their authentic classroom assignments. Overall, results suggest a shared understanding of the purpose of feedback between students and academics. However, students do not necessarily want to receive feedback that reflects those purposes. Theoretical and practical implications of this misalignment between students' views on the purpose of feedback and their actual experiences with feedback are discussed.

Abstract Background Dogs with lymphoma that fail cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy (CHOP) before completion of their protocol are commonly thought to have poor long‐term outcome, but no previous studies have evaluated the effect of early relapse on progression‐free interval (PFI) or overall survival time (OST) for patients undergoing rescue chemotherapy. Objective Correlate rescue treatment outcomes in dogs with multicentric lymphoma with outcomes after 1st‐line CHOP chemotherapy. Methods Data were collected from 6 previous retrospective or prospective studies in 187 dogs with multicentric lymphoma that received 1st‐line CHOP chemotherapy and then received either lomustine (CCNU), L‐asparaginase and prednisone (LAP), or rabacfosadine (RAB, Tanovea), with or without prednisone or L‐asparaginase. Results The PFI after initiation of CHOP chemotherapy was significantly associated with response rate postprogression, PFI, and postrescue survival time (ST) for both rescue protocols. Immunophenotype (B‐ vs T‐cell) was not significantly associated with response, PFI or OST for LAP but was significantly associated with response and PFI for RAB. Conclusion Dogs that experience short PFI during or after 1st‐line CHOP chemotherapy had lower response rates to rescue treatment, with shorter PFI and ST. Immunophenotype did not significantly affect outcome with LAP but was associated with PFI for RAB.

Abstract Increasing placental perfusion (PP) could improve outcomes of growth‐restricted fetuses. One way of increasing PP may be by using phosphodiesterase (PDE)‐5 inhibitors, which induce vasodilatation of vascular beds. We used a combination of clinically relevant magnetic resonance imaging (MRI) techniques to characterize the impact that tadalafil infusion has on maternal, placental and fetal circulations. At 116–117 days’ gestational age (dGA; term, 150 days), pregnant ewes (n = 6) underwent fetal catheterization surgery. At 120–123 dGA ewes were anaesthetized and MRI scans were performed during three acquisition windows: a basal state and then ∼15–75 min (TAD 1) and ∼75–135 min (TAD 2) post maternal administration (24 mg; intravenous bolus) of tadalafil. Phase contrast MRI and T2 oximetry were used to measure blood flow and oxygen delivery. Placental diffusion and PP were assessed using the Diffusion‐Relaxation Combined Imaging for Detailed Placental Evaluation—‘DECIDE’ technique. Uterine artery (UtA) blood flow when normalized to maternal left ventricular cardiac output (LVCO) was reduced in both TAD periods. DECIDE imaging found no impact of tadalafil on placental diffusivity or fetoplacental blood volume fraction. Maternal‐placental blood volume fraction was increased in the TAD 2 period. Fetal DO2 and V̇O2 were not affected by maternal tadalafil administration. Maternal tadalafil administration did not increase UtA blood flow and thus may not be an effective vasodilator at the level of the UtAs. The increased maternal–placental blood volume fraction may indicate local vasodilatation of the maternal intervillous space, which may have compensated for the reduced proportion of UtA DO2.