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Health equity is the state in which everyone has fair and just opportunities to attain their highest level of health. The field of human genomics has fallen short in increasing health equity, largely because the diversity of the human population has been inadequately reflected among participants of genomics research. This lack of diversity leads to disparities that can have scientific and clinical consequences. Achieving health equity related to genomics will require greater effort in addressing inequities within the field. As part of the commitment of the National Human Genome Research Institute (NHGRI) to advancing health equity, it convened experts in genomics and health equity research to make recommendations and performed a review of current literature to identify the landscape of gaps and opportunities at the interface between human genomics and health equity research. This Perspective describes these findings and examines health equity within the context of human genomics and genomic medicine.

Breast cancer (BC) remains among the most commonly diagnosed cancers in women worldwide. Triple-negative BC (TNBC) is a subset of BC characterized by aggressive behavior, a high risk of distant recurrence, and poor overall survival rates. Chemotherapy is the backbone for treatment in patients with TNBC, but outcomes remain poor compared to other BC subtypes, in part due to the lack of recognized functional targets. In this study, the expression of the tetraspan protein epithelial membrane protein 2 (EMP2) was explored as a predictor of TNBC response to standard chemotherapy. We demonstrate that EMP2 functions as a prognostic biomarker for patients treated with taxane-based chemotherapy, with high expression at both transcriptomic and protein levels following treatment correlating with poor overall survival. Moreover, we show that targeting EMP2 in combination with docetaxel reduces tumor load in syngeneic and xenograft models of TNBC. These results provide support for the prognostic and therapeutic potential of this tetraspan protein, suggesting that anti-EMP2 therapy may be beneficial for the treatment of select chemotherapy-resistant TNBC tumors.

Background: In the state of Kentucky, many status asthmaticus (SA) patients require care in the Pediatric Intensive Care Unit (PICU) and a fraction of these patients may receive “rescue therapies” with inhaled volatile anesthetics (IVA) and/or Extracorporeal Membrane Oxygenation (ECMO). We present a series of such patients with the objective of comparing the clinical parameters of individual patients who received inhaled volatile anesthesia and subsequently the need for ECMO. Methods: Children between 2 and 18 years of age admitted to our PICU from January 2014 to July 2020 with SA were reviewed and categorized as 1) patients who received IVA alone, 2) patients who received IVA and then subsequently ECMO, and 3) patients on ECMO alone. Results: A total of 1772 children with SA episodes were identified with a mortality of 13 patients. Seven children with SA were identified who received either IVA, ECMO, or both. One patient received only IVA, 5 received both IVA and ECMO and one received only ECMO. All received standard asthma therapies of steroids, albuterol, magnesium sulphate, and aminophylline prior to escalation. Six out of seven refractory SA received IVA, and five (83%) of those were subsequently escalated to ECMO. There was an improvement in mean pH after cannulation compared to IVA. pCO2 levels had no improvement after IVA administration but decreased by an average of 20 points after ECMO. Patients peak inspiratory pressures decreased within the 1st 24 h of ECMO cannulation from a mean of 30 to 18. There were no other complications related to ECMO placement. Conclusion: While we cannot decisively draw any conclusions from our study due to the small sample, it was noted that there was no clear advantage of using IVA prior to ECMO in our patients. Most patients who received IVA were escalated to ECMO indicating that early ECMO cannulation may be beneficial. Given the high cost and potential complications of both, there is a need for the development of well-defined guidelines for severe SA management in the PICU.

Abstract Background Little is known about the natural history of hearing loss in adults, despite it being an important public health problem. The purpose of this study is to describe the rate of hearing change per year over the adult lifespan. Methods The 1436 participants are from the MUSC Longitudinal Cohort Study of Age-related Hearing Loss (1988-present). Outcomes are audiometric thresholds at 250, 500, 1000, 2000, 3000, 4000, 6000, and 8000 Hz, averaged across right and left ears, and pure-tone average (PTA). Demographic factors are sex (female/male), race, which is categorized as white or racial Minority, and baseline age group (18-39, 40–59, 60–69, 70+ years). Linear mixed regression models are used to estimate the effect of age (per year) on the rate of threshold and PTA change. Results Participants’ mean age is 63.1 (SD 14.9) years, 57.7% are female, and 17.8% are racial Minority (17.1% were Black or African American). In sex-race-adjusted models, rates of threshold change are 0.42 to 1.44 dB across thresholds. Rates of change differ by sex at most individual thresholds, but not PTA. Females (versus males) showed higher rates of threshold change in higher frequencies but less decline per year in lower frequencies. Black/African American (versus white) participants have lower rates of threshold and PTA change per year. Hearing thresholds decline across the adult lifespan, with older (versus younger) baseline age groups showing higher rates of decline per year. Conclusions Declines to hearing occur across the adult lifespan, and the rate of decline varies by sex, race, and baseline age.

Graduate teaching assistants (GTAs) play a significant role in higher education and in the education of undergraduate students. Previous research suggests that undergraduate students perceive GTAs differently than faculty instructors, but little has been done to explore the nature of those perceptions. This exploratory study uses self-determination theory to investigate how university students describe the effective teaching practices of GTAs and how those descriptions vary depending on GTA gender, GTA international status, and course domain. Findings suggest that the majority of undergraduates described GTAs' competence-supporting practices and that descriptions varied based on GTAs' international status and on course domain. Implications for GTA training are discussed.

Abstract Men tend to eat more meat than women, but it is not clear why. We tested three hypotheses in a cross-cultural design (20,802 individuals in 23 countries across four continents): that gender differences are (a) universal, (b) related to gender roles and thus weaker in countries with higher gender equality and human development, or (c) related to opportunities to express gender roles and thus stronger in countries with higher gender equality and human development. Across all countries, men tended to consume more meat than women. However, this difference increased significantly in countries with greater human development and gender equality. The paradoxical gender gap in meat consumption aligns with previous research that suggests greater differences in behavior across genders in contexts that are more developed and gender equal. We discuss implications for theories of culture and gender as well as practical implications for global meat reduction.

Abstract Background Hearing loss is common in aging adults and is an important public health concern. Self-reported measures of hearing difficulty are often used in research and clinical practice, as they capture the functional impacts of hearing loss on individuals. However, little research has evaluated the prevalence or factors associated with self-reported hearing difficulty. Therefore, the purpose of this study was to determine the prevalence of self-reported hearing difficulty, measured by the Revised Hearing Handicap Inventory (RHHI), and associated factors. Methods This study was conducted in a community-based cohort study based in Charleston, SC. We determined the prevalence of RHHI self-reported hearing difficulty (score ≥ 6 points) and evaluated associated factors with logistic regression models. Results are presented as odds ratios (OR) with corresponding 95% confidence intervals (95% CI). Results There were 1558 participants included in this study (mean age 63.7 [SD 14.4], 56.9% female, 20.0% Minority race). The prevalence of RHHI self-reported hearing difficulty was 48.8%. In a multivariable model, older age (per + 1 year; OR 0.97 [95% CI 0.96, 0.98]), Minority (vs. White) race (OR 0.68 [95% CI 0.49, 0.94]), and speech-in-noise scores that are better than predicted (OR 0.99 [95% CI 0.98, 1.00]) were associated with lower odds of RHHI self-reported hearing difficulty. Furthermore, female (vs. male) sex (OR 1.39 [95% CI 1.03, 1.86]), higher PTA in the worse ear (per + 1 dB; OR 1.10 [95% CI 1.09, 1.12]), more comorbid conditions (vs. 0; 1 condition: OR 1.50 [95% CI 1.07, 2.11]; 2 conditions: OR 1.96 [95% CI 1.32, 2.93]; 3 + conditions: OR 3.00 [95% CI 1.60, 5.62]), noise exposure (OR 1.54 [95% CI 1.16, 2.03]), bothersome tinnitus (OR 2.16 [95% CI 1.59, 2.93]), and more depressive symptoms (OR 1.04 [95% CI 1.01, 1.07]) were associated with higher odds of RHHI self-reported hearing difficulty. Conclusions The prevalence of RHHI self-reported hearing difficulty is high, and associated factors included demographics, audiometric hearing and other hearing-related factors, and physical and mental health. The RHHI likely captures functional impacts of hearing loss that are not captured by audiometry alone. Study findings can support the correct interpretation of the RHHI in research and clinical settings.

Abstract IDH1 and IDH2 mutational status is a critical biomarker with diagnostic, prognostic, and treatment implications in glioma. Although IDH1 p.R132H-specific immunohistochemistry is available, it is unable to identify other mutations in IDH1/2. Next-generation sequencing can accurately determine IDH1/2 mutational status but suffers from long turnaround time when urgent treatment planning and initiation is medically necessary. The Idylla assay can detect IDH1/2 mutational status from unstained formalin-fixed paraffin-embedded (FFPE) slides in as little as a few hours. In a clinical validation, we demonstrate clinical accuracy of 97% compared to next-generation sequencing. Sensitivity studies demonstrated a limit of detection of 2.5-5% variant allele frequency, even at DNA inputs below the manufacturer’s recommended threshold. Overall, the assay is an effective and accurate method for rapid determination of IDH1/2 mutational status.

Abstract The human pathogen Neisseria gonorrhoeae ascends into the upper female reproductive tract to cause damaging inflammation within the Fallopian tubes and pelvic inflammatory disease (PID), increasing the risk of infertility and ectopic pregnancy. The loss of ciliated cells from the epithelium is thought to be both a consequence of inflammation and a cause of adverse sequelae. However, the links between infection, inflammation, and ciliated cell extrusion remain unresolved. With the use of ex vivo cultures of human Fallopian tube paired with RNA sequencing we defined the tissue response to gonococcal challenge, identifying cytokine, chemokine, cell adhesion, and apoptosis related transcripts not previously recognized as potentiators of gonococcal PID. Unexpectedly, IL-17C was one of the most highly induced genes. Yet, this cytokine has no previous association with gonococcal infection nor pelvic inflammatory disease and thus it was selected for further characterization. We show that human Fallopian tubes express the IL-17C receptor on the epithelial surface and that treatment with purified IL-17C induces pro-inflammatory cytokine secretion in addition to sloughing of the epithelium and generalized tissue damage. These results demonstrate a previously unrecognized but critical role of IL-17C in the damaging inflammation induced by gonococci in a human explant model of PID.

Abstract Whole virus-based inactivated SARS-CoV-2 vaccines adjuvanted with aluminum hydroxide have been critical to the COVID-19 pandemic response. Although these vaccines are protective against homologous coronavirus infection, the emergence of novel variants and the presence of large zoonotic reservoirs harboring novel heterologous coronaviruses provide significant opportunities for vaccine breakthrough, which raises the risk of adverse outcomes like vaccine-associated enhanced respiratory disease. Here, we use a female mouse model of coronavirus disease to evaluate inactivated vaccine performance against either homologous challenge with SARS-CoV-2 or heterologous challenge with a bat-derived coronavirus that represents a potential emerging disease threat. We show that inactivated SARS-CoV-2 vaccines adjuvanted with aluminum hydroxide can cause enhanced respiratory disease during heterologous infection, while use of an alternative adjuvant does not drive disease and promotes heterologous viral clearance. In this work, we highlight the impact of adjuvant selection on inactivated vaccine safety and efficacy against heterologous coronavirus infection.

This SoTL study aimed to determine thirty-eight teacher candidates' self-efficacy after experiencing semester one of a yearlong residency. Researchers used a pre/post survey, the Teachers' Sense of Efficacy Scale (TSES), and a retrospective pre TSES to determine perceived levels of self-efficacy in three areas: classroom management, instructional strategies, and student engagement. Findings revealed that pre TSES (candidates scored themselves at the beginning of the semester) and retrospective pre TSES scores (candidates scored themselves at the end of the semester reflecting on where they were at the beginning of the semester) were significantly different, with the retrospective pre TSES showing lower self-efficacy than the pre TSES. Post TSES comparisons to the retrospective pre TSES showed a significant increase, whereas, the comparison of the traditional pre/post TSES showed no significant changes.This suggests teacher candidates had an overinflated sense of self-efficacy and that teacher educators should look beyond the preTSES to provide transformational experiences for teacher candidates.The retro-pre TSES helps teacher educators monitor teacher candidates' change in self-efficacy and gauge program impact.

Objectives Synthesise literature related to perceptions of hearing loss and hearing technology (hearing aids, cochlear implants) among the general public and healthcare providers who do not specialise in ear and hearing care.Design Scoping review.Data sources We searched three databases (PubMed, Scopus, Ovid Medline) in August 2023 for peer-reviewed articles from inception to 2023.Eligibility criteria Peer-reviewed articles or grey literature published in English or Spanish and that were observational or mixed methods were eligible for inclusion. Studies were included if they presented results from original research focused on perceptions of hearing loss and/or hearing technology among the general public and/or healthcare providers who do not specialise in ear and hearing care.Data extraction and synthesis Two reviewers extracted and verified study data, which are synthesised in tables and in the text.Results Twenty-nine peer-reviewed articles were included, 21 of which focused on samples of the general public and 8 on samples of healthcare providers. Perceptions about persons with hearing loss and the use of hearing technology are varied but often negative. The general public and healthcare providers often perceive hearing loss as less serious than other health conditions, including other sensory impairments. In many settings worldwide, the perception that non-biomedical factors, such as curses or evil spirits, can cause hearing loss is common. Importantly, studies showed training that aimed to raise awareness about hearing loss might improve negative or inaccurate perceptions of hearing loss and hearing technology.Conclusions Perceptions of hearing loss and hearing technology are varied but often misinformed and negative. Such information could inform initiatives to raise awareness and change behaviours guided by those perceptions. Ultimately, changing the public’s and healthcare providers’ perceptions of hearing loss could encourage individuals with hearing loss to seek hearing care in a timely and appropriate manner.

Using national data from the National Center for Education Statistics 2011-2012 Schools and Staffing Survey and Common Core of Data, we examined the relationship between K-12 practitioners' risk for stress and the teacher-to-student racial/ethnic congruence. Analyses indicated significant variation in risk for stress by school racial composition and suggested that the likelihood of being categorized as most at-risk for stress is associated with the teacher-to-student racial/ethnic congruence. Findings point to substantial differences in how teachers appraise their environments depending on school context, which has implications for how education stakeholders recruit and prepare classroom practitioners.

Abstract Background Food insecurity is an important social determinant of health that was exacerbated by the COVID-19 pandemic. Both food insecurity and COVID-19 infection disproportionately affect racial and ethnic minority groups, particularly American Indian and Alaska Native communities; however, there is little evidence as to whether food insecurity is associated with COVID-19 infection or COVID-19 preventive behaviors such as vaccination uptake. The purpose of this study was to evaluate associations between food insecurity, COVID-19 infection, and vaccination status among urban American Indian and Alaska Native adults seen at 5 clinics serving urban Native people. Methods In partnership with health organizations in Alaska, Colorado, Kansas, Minnesota, and New Mexico, the study team conducted a cross-sectional survey in 2021 to assess food security status and attitudes, barriers, and facilitators for COVID-19 testing and vaccination. Logistic regression was used to examine the association of food security status with sociodemographic factors and COVID-19 infection and vaccination status. Marginal standardization was applied to present results as prevalence differences. Results Among 730 American Indian and Alaska Native adults, the prevalence of food insecurity measured during the pandemic was 38%. For participants who reported persistent food security status before and during the pandemic (n = 588), the prevalence of food insecurity was 25%. Prevalence of COVID-19 infection and vaccination did not vary by food security status after adjustment for confounders. Conclusions High rates of food insecurity among American Indian and Alaska Native communities likely increased during the COVID-19 pandemic. However, despite the high prevalence of food insecurity, community-led efforts to reduce COVID-19 infection and increase vaccination uptake across Indian Health Service and Tribal healthcare facilities may have mitigated the negative impacts of the pandemic for families experiencing food insecurity. These successful approaches serve as an important reference for future public health efforts that require innovative strategies to improve overall health in American Indian and Alaska Native communities.

Given the plentitude of messages in the public arena that promote vaccination against different diseases or raise the possibility of vaccine mandates, we asked whether message effects in one disease domain might spill over into other domains. Our experiment exposed individuals (N = 1755) recruited from an opt-in online panel (Qualtrics) on influenza or COVID-19 pro-vaccination messages then measured intentions to vaccinate for each disease and intentions to support a vaccine mandate for each disease. Messages that targeted flu (vs. COVID-19) exhibited stronger effects on intentions to vaccinate for corresponding (vs. noncorresponding) disease. We observed positive spillover from intention to vaccinate against one disease to intention to vaccinate against the other disease, as well as from vaccination intention type to support for corresponding and noncorresponding vaccine mandates. Although pro-vaccination flu and COVID-19 messages have multiple effects, those effects are congenial. The results adjudicate differences in spillover theory and suggest synergistic effects between pro-vaccination campaigns.

Ingestion of L-theanine and L-tyrosine has been shown to reduce salivary stress biomarkers and improve aspects of cognitive performance in response to stress. However, there have been no studies to concurrently examine the impact of both L-theanine and L-tyrosine ingestion during a mental stress challenge (MSC) involving a brief cognitive challenge and a virtual reality based active shooter training drill. Thus, the purpose of this study was to determine the impact of ingestion of L-theanine and L-tyrosine on markers of stress and cognitive performance in response to a virtual reality active shooter drill and cognitive challenge. The cognitive challenge involved a Stroop challenge and mental arithmetic. Eighty subjects (age = 21 ± 2.6 yrs; male = 46; female = 34) were randomly assigned L-tyrosine (n = 28; 2000 mg), L-theanine (n = 25; 200 mg), or placebo (n = 27) prior to MSC exposure. Saliva samples, state-anxiety inventory (SAI) scales, and heart rate (HR) were collected before and after exposure to the MSC. Saliva was analyzed for stress markers α-amylase (sAA) and secretory immunoglobulin A (SIgA). The MSC resulted in significant increases in sAA, SIgA, HR, and SAI. Ingestion of L-theanine and L-tyrosine did not impact markers of stress. However, the L-tyrosine treatment demonstrated significantly lower missed responses compared to the placebo treatment group during the Stroop challenge. These data demonstrate that ingestion of L-theanine or L-tyrosine does not impact markers of stress in response to a MSC but may impact cognitive performance. This study was pre-registered as a clinical trial ("Impact of supplements on stress markers”: NCT05592561).

ObjectivesTo examine the relationships between pre-pregnancy diabetes mellitus (DM), gestational diabetes mellitus (GDM), pre-pregnancy body mass index (BMI) and county-level social determinants of health, with infant macrosomia within a sample of American Indian/Alaska Native (AI/AN) women receiving Indian Health Service (IHS) care.MethodsThe sample included women-infant dyads representing 1,136 singleton births from fiscal year 2011 (10/1/2019-9/30/2011). Data stemmed from the IHS Improving Health Care Delivery Data Project. Multivariate generalized linear mixed models were fitted to assess the association of macrosomia with pre-pregnancy health status and social determinants of health.ResultsNearly half of the women in the sample were under age 25 years (48.6%), and most had Medicaid health insurance coverage (76.7%). Of those with a pre-pregnancy BMI measure, 66.2% were overweight or obese. Although few women had pre-pregnancy DM (4.0%), GDM was present in 12.8% of women. Most women had a normal term delivery (85.4%). Overweight, obesity, pre-pregnancy DM, and county-level rurality were all significantly associated with higher odds of infant macrosomia.

Equity for students includes access to a healthy teacher workforce across all school settings. This study sought to disentangle the role of racial/ethnic (in)congruence in teacher stress from school resources by using propensity score analysis to match Black, Hispanic, and White elementary teachers on individual, classroom, and school characteristics, and examining whether these matched teachers reported differences in stress outcomes when working in schools where the predominant student demography was either congruent or incongruent with their own. Data from the 2015-2016 National Teacher and Principal Survey was used to find propensity score matches among 7540 Black, Hispanic, and White elementary teachers. Black, Hispanic, and White teachers all reported stronger occupational health outcomes in higher-resourced, majority-White schools. Black and Hispanic teachers reported higher levels of occupational health outcomes than White teachers when teaching in under-resourced, majority-minority schools. These findings suggest important implications for teacher training and support, such as considering increased training and reflection opportunities on culturally responsive teaching, broadening policies that homogeneously categorize and aim to uniformly support "teachers of color," and examining the ways in which teacher identity uniquely informs their workplace experiences and may necessitate differentiated resources.

ABSTRACT The Gardnerella genus, comprising at least 13 species, is associated with the polymicrobial disorder bacterial vaginosis (BV). However, the details of BV pathogenesis are poorly defined, and the contributions made by individual species, including Gardnerella spp., are largely unknown. We report here that colony phenotypes characterized by size (large and small) and opacity (opaque and translucent) are phase variable and are conserved among all tested Gardnerella strains, representing at least 10 different species. With the hypothesis that these different variants could be an important missing piece to the enigma of how BV develops in vivo, we characterized their phenotypic, proteomic, and genomic differences. Beyond increased colony size, large colony variants showed reduced vaginolysin secretion and faster growth rate relative to small colony variants. The ability to inhibit the growth of Neisseria gonorrhoeae and commensal Lactobacillus species varied by strain and, in some instances, differed between variants. Proteomics analyses indicated that 127–173 proteins were differentially expressed between variants. Proteins with increased expression in large variants of both strains were associated with amino acid and protein synthesis and protein folding, whereas those increased in small variants were related to nucleotide synthesis, phosphate transport, ABC transport, and glycogen breakdown. Furthermore, whole genome sequencing analyses revealed an abundance of genes associated with variable homopolymer tracts, implicating slipped strand mispairing in Gardnerella phase variation and illuminating the potential for previously unrecognized heterogeneity within clonal populations. Collectively, these results suggest that phase variants may be primed to serve different roles in BV pathogenesis.IMPORTANCEBacterial vaginosis is the most common gynecological disorder in women of childbearing age. Gardnerella species are crucial to the development of this dysbiosis, but the mechanisms involved in the infection are not understood. We discovered that Gardnerella species vary between two different forms, reflected in bacterial colony size. A slow-growing form makes large amounts of the toxin vaginolysin and is better able to survive in human cervix tissue. A fast-growing form is likely the one that proliferates to high numbers just prior to symptom onset and forms the biofilm that serves as a scaffold for multiple BV-associated anaerobic bacteria. Identification of the proteins that vary between different forms of the bacteria as well as those that vary randomly provides insight into the factors important for Gardnerella infection and immune avoidance.

ObjectivesThe Historical Loss Scale (HLS) and Historical Loss Associated Symptoms Scale (HLASS) are standardized measures that have been accepted and previously validated among North American Indigenous communities and allow researchers to measure the impact of Historical Loss. Evidence of the psychometric properties of this instrument have not been assessed for Native Hawaiians, the Indigenous peoples of Hawai‘i. The purpose of this study is to investigate the psychometric properties of the adapted HLS (aHLS) and HLASS for adults from multiple Hawaiian Homestead Communities throughout Hawai‘i.MethodsData are based on cross-sectional surveys administered between 2014 and 2020. The final sample included 491 Native Hawaiian adults who were predominantly female (67.3%) and between the ages of 18–90 years, who were part of the larger study entitled the Hawaiian Homestead Health Survey. Factor analyses were conducted to determine the final model structures of each scale. Reliability and correlation matrices of items are also reported.ResultsThe final factor structure of the aHLS model suggested 3 factors: (1) General loss of culture or cultural loss, (2) Intergenerational loss, and (3) Distrust and destruction of traditional foods. The final HLASS model also suggested 3 factors: (1) Depression and Anger, (2) Shame and Anxiety, and (3) Re-experiencing, fear, and avoidance.ConclusionThese findings have implications for future research, practice, and education that explores the role of Historical Loss and associated symptoms in Native Hawaiians and Indigenous communities at large. In particular, measuring historical loss and associated symptoms in Hawaiian Homestead communities paves the way for quantitative assessments of historical trauma and healing in these communities.

Objectives Home blood pressure monitoring (HBPM) is crucial for managing hypertension, but there is a potential trade-off between measurement accuracy and health/economic outcomes due to asymmetric costs associated with misclassifying an individual as having hypertension or not. We assessed whether adjustments to device readings that increased overall accuracy produced net health and economic benefits. Methods We analyzed data from N = 89 Alaska Native individuals who used 2 HBPM devices and a standard aneroid sphygmomanometer. We modeled changes in expected costs associated with individuals being misclassified as hypertensive or not under 3 different models of adjusting HBPM device readings. Results The gains in accuracy produced by adjusting HBPM readings decreased the overall rate of hypertension misclassification but increased the rate of false-negative readings. Adjusting readings led to a net increase in expected health and economic costs. Discussion Ignoring asymmetric costs of misclassification can escalate overall costs and worsen uncontrolled hypertension. Home blood pressure monitoring algorithms must be cautiously designed, considering both false negatives and positives. Greater transparency in HBPM algorithms is needed for effective coordination among manufacturers, clinicians, and patients.

First-generation college (FGC) students represent 56% of college students in the United States (RTI International, 2019). Studies on the role FGC family in students' campus experiences by Covarrubias et al. (2015) along with Orbe's (2008) work on the role of culture in FGC identity development provide a foundation for understanding FGC experiences. The role of FGC self-authorship (Carpenter & Peña, 2017) on campus also helps support FGC student success. Unexamined are FGC students' homegoing experiences in their communities of origin. This study helps fill a void in the literature about FGC students' experiences in their home communities through the voices of one important student demographic.

Rainfall frequency and intensity are expected to increase in the Arctic, with potential detrimental impacts on permafrost, leading to enhanced thawing and carbon release to the atmosphere. However, there have been very few studies on the effect of discrete rain events on permafrost in the Arctic and sub-Arctic. Conducting controlled rainfall experiments within permafrost landscapes can provide an improved understanding of the effect of changing intensity, duration, and timing of rain events on permafrost tundra ecosystems. Here, we describe the design and implementation of the Next-Generation Ecosystem Experiment Arctic Rainfall Simulator (NARS), a variable intensity (4–82 mm/h) rainfall simulator that can be used to study the effects of rainfall on permafrost stability. The NARS design includes a 3D-printed 4 cm H-flume and uses an eTape resistivity sensor that was calibrated (R2 = 0.9–0.96) to measure discharge from the system. NARS is designed to be lightweight, simple to construct, and can be easily deployed in remote locations. As a field validation of updated rainfall simulator design and modernized controls, NARS was tested on the Seward Peninsula, AK. Because of its portability, versatility in deployment, dimensions, and rainfall intensity, NARS represents a methodological innovation for researching the impacts of rainfall on permafrost environments. HIGHLIGHTS Rainfall is expected to increase in the Arctic over the next century.; The effects of rainfall on permafrost stability are poorly understood.; We developed a variable intensity rainfall simulator for use in remote areas.; The new rainfall simulator is lightweight and modernizes simulator controls.; The simulator can be used to study rain effects on permafrost.;