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The purpose of this study was to examine 3rd through 5th grade mathematics teachers' demographic information and investigate their perceptions regarding effective instructional practices and their abilities to use technology as an instructional tool in the mathematics classroom in a southern state in the United States. The study revealed that, overall, teachers had positive perceptions about effective instructional practices and their abilities to use technology as an instructional tool in the mathematics classroom. Additionally, there were statistically significant differences found among demographic variables based on the teachers' responses to certain statements from the online survey. The findings in this study provided information for administrators in one Central Mississippi school district to increase student engagement and improve statewide test scores in mathematics.

This study evaluated the Tuning in to Kids (TIK) parenting program delivered in a clinical setting with 77 parents and caregivers (hereafter referred to as “parents”) of children who had experienced complex trauma. The TIK program targets parent emotion socialization to improve children’s emotional and behavioral functioning. The study utilized a single-group design with pre- and post-intervention measures. Seventy-seven parents of children (aged 3–15 years) who had experienced complex trauma completed a ten-week version of the Trauma-Focused Tuning in to Kids program (TF-TIK). Measures examined parent reports of: emotion socialization; parent-child relationship; parent mental health; children’s emotional and behavioral functioning. Parents reported significantly improved emotion socialization, parent-child relationship, parent mental health, as well as child emotion regulation and behavior. This study provides initial support for the use of the TF-TIK parenting program in a clinical setting with parents of children who have experienced complex trauma in order to prevent or reduce problems.

Background Early identification of patients at risk of developing diabetic kidney disease or rapid renal decline is imperative for appropriate patient management, but traditional methods of predicting renal decline are limited. Objective This study evaluated the impact of PromarkerD, a biomarker-based blood test predicting the risk of diabetic kidney disease (DKD) and rapid renal decline. Methods Conjoint analysis clarified the importance of PromarkerD and other patient attributes to physician decisions for type 2 diabetes patients. Forty-two patient profiles were generated, with varying levels of albuminuria, estimated glomerular filtration rate (eGFR), blood pressure, hemoglobin A1c (HbA1c), age, and PromarkerD result. A web-based survey asked each physician to make monitoring/treatment decisions about eight randomly selected profiles. Data were analyzed using multivariable logit models. Results Two hundred three primary care physicians and 197 endocrinologists completed the survey. PromarkerD result was most important for increasing the frequency of risk factor monitoring. PromarkerD was second to HbA1c in importance for deciding to prescribe sodium/glucose cotransporter-2 inhibitors (SGLT2s) with a DKD indication, second to blood pressure for increasing the dose of lisinopril, and second to eGFR for replacing ibuprofen with a non-nephrotoxic medication. Compared with no PromarkerD results, a high-risk PromarkerD result was associated with significantly higher odds of increasing monitoring frequency (odds ratio [OR]: 2.56, 95% confidence interval: 1.90–3.45), prescribing SGLT2s (OR: 1.98 [1.56–2.52]), increasing lisinopril dose (OR: 1.48 [1.17–1.87]), and replacing ibuprofen (OR: 1.78 [1.32–2.40]). A low-risk PromarkerD result was associated with significantly lower odds of increasing monitoring frequency (OR: 0.48 [0.37–0.64]), prescribing SGLT2s (OR: 0.70 [0.56–0.88]), and replacing ibuprofen (OR: 0.75 [0.57–0.99]). Conclusion PromarkerD could increase adoption of renoprotective interventions in patients at high risk for renal decline and lower the likelihood of aggressive treatment in those at low risk. Further studies are needed to assess patient outcomes with PromarkerD in real-world practice.

Oysters and seagrasses provide structurally complex estuarine habitat for fish and invertebrate species. On the U.S. West Coast, complex oyster habitat was historically provided by the native Olympia oyster Ostrea lurida but is now provided by the commercially cultured oyster Crassostrea gigas. Ostrea lurida is found in subtidal and low intertidal areas, whereas C. gigas is predominantly cultured at higher intertidal elevations, resulting in a potential shift in available habitat for other fish and invertebrates that use this intertidal habitat. This change in the available habitat and its use was examined for the juvenile Dungeness crab Metacarcinus magister, and results showed the following: (1) comparable crab densities in remnant and restored populations of O. lurida and cultured C. gigas in two estuaries, (2) generally higher crab densities in both of these shell habitats than those observed in eelgrass Zostera marina or open mud habitat, (3) contemporary juvenile crab density in intertidal areas of Willapa Bay was most influenced by distance from the estuary mouth (declining with increasing distance) but also declined with increasing tidal elevation, and (4) when extrapolated to the estuarine ecosystem scale using areal estimates of habitat coverage, historical habitat provided by O. lurida potentially produced three times more juvenile crabs than those currently produced in cultured C. gigas. Nonetheless, both intertidal oyster habitats contribute more to juvenile crab production than eelgrass or open unstructured mud, and the ecosystem services associated with the placement of native and commercial oyster beds should be considered when defining goals for and permitting both aquaculture and native oyster restoration in Willapa Bay and other U.S. West Coast estuaries. Managers should consider this shifting temporal baseline in intertidal habitat provision, but also conducting similar evaluations at this broader estuary scale when evaluating habitat value for other resources that use these habitats differently.

Longitudinal studies are commonly used to examine possible causal factors associated with human health and disease. However, the statistical models, such as two-way ANOVA, often applied in these studies do not appropriately model the experimental design, resulting in biased and imprecise results. Here, we describe the linear mixed effects (LME) model and how to use it for longitudinal studies. We re-analyze a dataset published by Blanton et al. in 2016 that modeled growth trajectories in mice after microbiome implantation from nourished or malnourished children. We compare the fit and stability of different parameterizations of ANOVA and LME models; most models found that the nourished versus malnourished growth trajectories differed significantly. We show through simulation that the results from the two-way ANOVA and LME models are not always consistent. Incorrectly modeling correlated data can result in increased rates of false positives or false negatives, supporting the need to model correlated data correctly. We provide an interactive Shiny App to enable accessible and appropriate analysis of longitudinal data using LME models.

BACKGROUND: Medical interpreters improve care for patients with Limited English Proficiency but are underused. Protocols to improve interpreter use in primary care are needed. METHODS: Medical Assistants (MAs) screened patients for language needs and arranged for telephone interpreters during rooming in two pilot clinics (PCs). We interviewed MAs and providers and analyzed interviews using modified grounded theory, linking themes to the Promoting Action on Research Implementation in Health Services (PARiHS) framework categories of Context, Evidence, and Facilitation. Providers in PCs and four comparison clinics were surveyed. RESULTS: Context themes included issues with the telephone interpreter vendor; having established teams, roles and workflows; and difficulty incorporating time-sensitive tasks. Evidence themes included engagement in language screening; preferring in-person interpreters; improving the patient experience; and having mixed responses to the protocol. Facilitation themes included MAs needing more support. PC providers were more satisfied with care (OR = 12.7) and communication (OR = 7.6) than comparison clinic providers. CONCLUSIONS: The protocol may improve patient care and communication, but implementation was inconsistent. Language screening is a complex process and further research is needed to improve screening questions and procedures. Future interventions should capitalize on team members’ drives to improve patient care and control costs but also need to consider the impacts of health system changes, and to consider the culture, training needs, roles, and relationships of team members.

Little is known about the impacts of health literacy and English proficiency on the health status of Somali refugees. Data came from interviews in 2009-2011 of 411 adult Somali refugees recently resettled in Massachusetts. English proficiency, health literacy, and physical and mental health were measured using the Basic English Skills Test Plus, the Short Test of Health Literacy in Adults, and the Physical and Mental Component Summaries of the Short Form-12. Associations were analyzed using multiple linear regression. In adjusted analyses, higher English proficiency was associated with worse mental health in males. English proficiency was not associated with physical health. Health literacy was associated with neither physical nor mental health. Language proficiency may adversely affect the mental health of male Somali refugees, contrary to findings in other immigrant groups. Research on underlying mechanisms and opportunities to understand this relationship are needed.

Background: A videotaped declaration by patients of their advance care planning preferences could be an opportunity to supplement advance directive forms and be a source of information for family, caregivers, and clinicians, yet research is needed to examine the content and acceptability of making declarations among patients. Objective: To evaluate the content and acceptability of ‘video declarations’: the process of patients videotaping themselves describing their advance care planning preferences. Design: We showed a brief video describing three approaches to end-of-life care and then invited participants to use an iPad to videotape themselves making a declaration about their wishes. Setting/Subjects: Hospitalized patients from a large urban U.S. safety net hospital. Measurements: We interviewed participants about the acceptability of the declaration process. Declarations were transcribed and coded by a team, with multiple stakeholder input. Results: There were 16 participants; mean age was 60 (SD = 14) years. One participant declined. Out of 15 declarations, most were able to express their wishes for CPR (n = 12) and intubation (n = 13). Participants frequently discussed their family structure (n = 11), religious/spiritual well-being (n = 8), legacy/dignity issues (n = 6), and physical symptoms (n = 6). Nine declarations had directives judged to be unclear. The majority (66%) thought that this process was quite a bit or extremely helpful. Conclusions: Findings show that asking hospitalized patients to make videos describing their advance care planning preferences was feasible and acceptable. While the majority described their wishes around CPR and intubation, a fair amount of uncertainty remained. Further research is needed to support patients in describing their wishes clearly and test the effectiveness of video declarations to promote care concordant with preferences.

A survey of the herpetofauna of Merriwindi State Conservation Area, a small conservation reserve in the western Pilliga forest in northern inland New South Wales, was done over the period 2009 to 2011. In total, 14 frog species (three families) and 25 reptile species (eight families) were recorded by a combination of diurnal active searches, nocturnal road transects and nocturnal searches of water bodies. The herpetofauna community includes a mix of western (Eyrean), northern (Torresian) and eastern (Bassian) species and demonstrates the significant species diversity and conservation value of the Pilliga forest's herpetofauna. Noteworthy findings from this study included the threatened Pale-headed Snake Hoplocephalus bitorquatus, a number of declining woodland reptile species such as the Nobbi Diporiphora nobbi , Brown-blazed Ctenotus Ctenotus allotropis and Australian Coral Snake Brachyurophis australis, and the first documented record of the Striped Burrowing Frog Cyclorana alboguttata from the western ...

In contrast to the paradoxes of chastity that appear to limit women’s options, prescriptive literature often portrays obedience as a virtue that is both performative and reformative. Early modern women were not taught to be unquestioningly obedient but rather that they had a responsibility to be virtuous: to perform submission in order to reform others. This model of performance requires women critically to analyze behavioral prescriptions, because the proper performance necessitates interpretation on their part; this shows that self-reflection is possible and even encouraged. Texts discussed include Robert Snawsel’s A Looking-glasse for Married Folkes and Robert Greene’s Penelope’s Web .

Dynamic regulation of the localization and function of NMDA receptors (NMDARs) is critical for synaptic development and function. The composition and localization of NMDAR subunits at synapses are tightly regulated and can influence the ability of individual synapses to undergo long-lasting changes in response to stimuli. Here, we examine mechanisms by which EphB2, a receptor tyrosine kinase that binds and phosphorylates NMDARs, controls NMDAR subunit localization and function at synapses. We find that, in mature neurons, EphB2 expression levels regulate the amount of NMDARs at synapses, and EphB activation decreases Ca2+-dependent desensitization of NR2B-containing NMDARs. EphBs are required for enhanced localization of NR2B-containing NMDARs at synapses of mature neurons; triple EphB knock-out mice lacking EphB1–3 exhibit homeostatic upregulation of NMDAR surface expression and loss of proper targeting to synaptic sites. These findings demonstrate that, in the mature nervous system, EphBs are key regulators of the synaptic localization of NMDARs.

The second canto of Book III of Edmund Spenser’s The Faerie Queene ends with a peculiar attempt by the nurse Glauce to cure the princess and “sicke virgin” Britomart. Many critics claim that Britom...

NMDARs (N-methyl-D-aspartate receptors) are critical for synaptic function throughout the CNS (central nervous system). NMDAR-mediated Ca2+ influx is implicated in neuronal differentiation, neuronal migration, synaptogenesis, structural remodelling, long-lasting forms of synaptic plasticity and higher cognitive functions. NMDAR-mediated Ca2+ signalling in dendritic spines is not static, but can be remodelled in a cell- and synapse-specific manner by NMDAR subunit composition, protein kinases and neuronal activity during development and in response to sensory experience. Recent evidence indicates that Ca2+ permeability of neuronal NMDARs, NMDAR-mediated Ca2+ signalling in spines and induction of NMDAR-dependent LTP (long-term potentiation) at hippocampal Schaffer collateral–CA1 synapses are under control of the cAMP/PKA (protein kinase A) signalling cascade. Thus, by enhancing Ca2+ influx through NMDARs in spines, PKA can regulate the induction of LTP. An emerging concept is that activity-dependent regulation of NMDAR-mediated Ca2+ signalling by PKA and by extracellular signals that modulate cAMP or protein phosphatases at synaptic sites provides a dynamic and potentially powerful mechanism for bi-directional regulation of synaptic efficacy and remodelling.

Colonic migrating motor complexes (CMMCs) are spontaneous, anally propagating constrictions, repeating every 3–5 min in mouse colon in vitro. They are regulated by the enteric nervous system and may be equivalent to mass movement contractions. We examined postnatal development of CMMCs and circular muscle innervation to gain insight into mechanisms regulating transit in the maturing colon. Video recordings of mouse colon in vitro were used to construct spatiotemporal maps of spontaneous contractile patterns. Development of nitric oxide synthase (NOS) and cholinergic nerve terminals in the circular muscle was examined immunohistochemically. In adults, CMMCs appeared regularly at 4.6 ± 0.9-min intervals ( n = 5). These intervals were reduced by inhibition of NOS (2.7 ± 0.2 min; n = 5; P < 0.05). CMMCs were abolished by tetrodotoxin ( n = 4). CMMCs at postnatal day (P)10 were indistinguishable from adult. At birth and P4, CMMCs were absent. Instead, small constrictions that propagated both orally and anally, “ripples,” were seen. Ripples were unaffected by tetrodotoxin or inhibition of NOS and were present in Ret−/−mice (which lack enteric neurons) at embryonic day 18.5. In P6 mice, only ripples were seen in control, but NOS inhibition induced CMMCs ( n = 8). NOS terminals were abundant in the circular muscle at birth; cholinergic terminals were sparse but were common by P10. In mouse, myogenic ripples are the only mechanism available to produce colonic transit at birth. At P6, neural circuits that generate CMMCs are present but are inhibited by tonic activity of nitric oxide. Adult patterns appear by P10.

The postsynaptic density (PSD) at excitatory synapses is a dynamic complex of glutamatergic receptors and associated proteins that governs synaptic structure and coordinates signal transduction. In this study, we report that BRAG1, a putative guanine nucleotide exchange factor for the Arf family of GTP-binding proteins, is a major component of the PSD. BRAG1 was identified in a 190 kDa band in the PSD fraction with the use of mass spectrometry coupled to searching of a protein sequence database. BRAG1 expression is abundant in the adult rat forebrain, and it is strongly enriched in the PSD fraction compared to forebrain homogenate and synaptosomes. Immunocytochemical localization of BRAG1 in dissociated hippocampal neurons shows that it forms discrete clusters that colocalize with the postsynaptic marker PSD-95 at sites along dendrites. BRAG1 contains a Sec7 domain, a domain that catalyzes exchange of GDP for GTP on the Arf family of small GTP-binding proteins. In their GTP-bound active state, Arfs regulate trafficking of vesicles and cytoskeletal structure. We demonstrate that the Sec7 domain of BRAG1 promotes binding of GTP to Arf in vitro. These data suggest that BRAG1 may modulate the functions of Arfs at synaptic sites.

The marine sedimentary record exhibits evidence for episodes of enhanced organic carbon burial known as 'oceanic anoxic events' (OAEs). They are characterized by carbon-isotope excursions in marine and terrestrial reservoirs and mass extinction of marine faunas. Causal mechanisms for the enhancement of organic carbon burial during OAEs are still debated, but it is thought that such events should draw down significant quantities of atmospheric carbon dioxide. In the case of the Toarcian OAE (approximately 183 million years ago), a short-lived negative carbon-isotope excursion in oceanic and terrestrial reservoirs has been interpreted to indicate raised atmospheric carbon dioxide caused by oxidation of methane catastrophically released from either marine gas hydrates or magma-intruded organic-rich rocks. Here we test these two leading hypotheses for a negative carbon isotopic excursion marking the initiation of the Toarcian OAE using a high-resolution atmospheric carbon dioxide record obtained from fossil leaf stomatal frequency. We find that coincident with the negative carbon-isotope excursion carbon dioxide is first drawn down by 350 +/- 100 p.p.m.v. and then abruptly elevated by 1,200 +/- 400 p.p.m.v, and infer a global cooling and greenhouse warming of 2.5 +/- 0.1 degrees C and 6.5 +/- 1 degrees C, respectively. The pattern and magnitude of carbon dioxide change are difficult to reconcile with catastrophic input of isotopically light methane from hydrates as the cause of the negative isotopic signal. Our carbon dioxide record better supports a magma-intrusion hypothesis, and suggests that injection of isotopically light carbon from the release of thermogenic methane occurred owing to the intrusion of Gondwana coals by Toarcian-aged Karoo-Ferrar dolerites.

Cheryl Shoubridge and Jozef Gecz and colleagues report the identification of mutations in IQSEC2, a guanine nucleotide exchange factor for ARF GTPases, in individuals with non-syndromic intellectual disability. The first family identified as having a nonsyndromic intellectual disability was mapped in 1988. Here we show that a mutation of IQSEC2, encoding a guanine nucleotide exchange factor for the ADP-ribosylation factor family of small GTPases, caused this disorder. In addition to MRX1, IQSEC2 mutations were identified in three other families with X-linked intellectual disability. This discovery was made possible by systematic and unbiased X chromosome exome resequencing.

The NMDA-type glutamate receptor (NMDAR) is essential for synaptogenesis, synaptic plasticity, and higher cognitive function. Emerging evidence indicates that NMDAR Ca2+permeability is under the control of cAMP/protein kinase A (PKA) signaling. Whereas the functional impact of PKA on NMDAR-dependent Ca2+signaling is well established, the molecular target remains unknown. Here we identify serine residue 1166 (Ser1166) in the carboxy-terminal tail of the NMDAR subunit GluN2B to be a direct molecular and functional target of PKA phosphorylation critical to NMDAR-dependent Ca2+permeation and Ca2+signaling in spines. Activation of β-adrenergic and D1/D5-dopamine receptors induces Ser1166 phosphorylation. Loss of this single phosphorylation site abolishes PKA-dependent potentiation of NMDAR Ca2+permeation, synaptic currents, and Ca2+rises in dendritic spines. We further show that adverse experience in the form of forced swim, but not exposure to fox urine, elicits striking phosphorylation of Ser1166in vivo, indicating differential impact of different forms of stress. Our data identify a novel molecular and functional target of PKA essential to NMDAR-mediated Ca2+signaling at synapses and regulated by the emotional response to stress.

This study examined lower extremity power performance, using the Margaria-Kalamen Power Test, after a dynamic warm-up with (resisted) and without (nonresisted) a weighted vest. Sixteen (n = 16) high school male football players, ages 14-18 years, participated in 2 randomly ordered testing sessions. One session involved performing the team's standard dynamic warm-up while wearing a vest weighted at 5% of the individual athlete's body weight before performing 3 trials of the Margaria-Kalamen Power Test. The second session involved performing the same dynamic warm-up without wearing a weighted vest before performing 3 trials of the Margaria-Kalamen Power Test. The warm-up performed by the athletes consisted of various lower extremity dynamic movements over a 5-minute period. No significant difference was found in power performance between the resisted and nonresisted dynamic warm-up protocols (p > 0.05). The use of a dynamic warm-up with a vest weighted at 5% of the athlete's body weight was not advantageous for increasing lower extremity power output in this study. The results of this study suggest that resisted dynamic warm-up protocols may not augment the production of power performance in high school football players.

The purpose of this study was to compare gender, humanistic qualities or technical competence (HQTC), and age when an obstetrician-gynecologist is selected.Participants saw photographs (2 women, 2 men) without descriptors then the same photographs with descriptors. To test whether HQTC were more important than gender, the men in the photographs were given HQTC descriptors. Female patients, visitors, and staff at Hartford Hospital along with community and outpatient sites were recruited. Demographic information was collected.From 901 participants, 83% chose a woman, 59% of whom selected gender or age as the reason. Single and younger patients were more likely to choose female and younger providers, respectively. With descriptors, 62% of the women chose a male provider. A significant number chose a different gender provider (P.001) and made their selection for a different reason (P.001).More women chose a female provider when no additional information is known. A significant number changed their selection when male providers were described with HQTC.

We examine variations in the basic structure of quantum dot molecules (fourfold quantum dot nanostructures forming around a central facetted pit) in the SixGe1−x/Si(100) system. Arrays of quantum dot molecules are seeded by Ga+ focused ion beam (FIB) prepatterning of the Si substrate prior to epitaxial Si buffer layer growth and GexSi1−x film deposition. Five main variants to the regular quantum dot molecule structure are observed. The populations of these variant structures depend on the initial FIB processing conditions; their frequencies generally increase with increasing prepatterned pit depth and with increasing incident ion energy. This work suggests both routes to improving uniformity of regular quantum dot molecule arrays as well as routes to enabling synthesis of a wider range of nanostructure geometries.

A hybrid organosilica monolith was synthesized containing an allyl functionality. This provided a viable platform for producing silica-based, chromatographic, monolithic columns with the stationary phase bonded through a surface silicon-carbon bond rather than a conventional siloxane bond.