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Youth interpersonal firearm violence disproportionately affects Black youth, with residential racial segregation as a key determinant. Racially segregated neighborhoods, which are economically isolated (e.g., neighborhood disadvantage), are linked to increased exposure to violence. This exposure, in turn, is a determinant of youth firearm aggression (i.e., using a gun on someone else). Mechanisms from residential racial segregation to firearm aggression, however, have not been evaluated. Therefore, we tested neighborhood disadvantage and exposure to violence as mediators in the association between residential racial segregation and youth firearm aggression. Participants were 338 Black youth who had used drugs in the past 6 months and sought care in an urban emergency department. Using serial mediation analysis, residential racial segregation was indirectly associated with youth firearm aggression via neighborhood disadvantage and then exposure to violence. While researchers have documented the association between structural racism and firearm violence injury and incidents, our study assessed multiple socioecological mechanisms simultaneously. Identifying the downstream socioecological consequences of residential segregation can guide the development of firearm aggression prevention programs addressing the consequences of racism.

Objective To quantify the implementation of the third Joint British Societies’ Consensus Recommendations for the Prevention of Cardiovascular Disease (JBS3) after coronary event.Methods Using a cross-sectional survey design, patients were consecutively identified in 36 specialist and district general hospitals between 6 months and 2 years, after acute coronary syndrome or revascularisation procedure and invited to a research interview. Outcomes included JBS3 lifestyle, risk factor and therapeutic management goals. Data were collected using standardised methods and instruments by trained study nurses. Blood was analysed in a central laboratory and a glucose tolerance test was performed.Results 3926 eligible patients were invited to participate and 1177 (23.3% women) were interviewed (30% response). 12.5% were from black and minority ethnic groups. 45% were persistent smokers, 36% obese, 52.9% centrally obese, 52% inactive; 30% had a blood pressure >140/90 mm Hg, 54% non-high-density lipoprotein ≥2.5 mmol/L and 44.3% had new dysglycaemia. Prescribing was highest for antiplatelets (94%) and statins (85%). 81% were advised to attend cardiac rehabilitation (86%

Mixed-reality simulation is a technology-based tool used to augment preservice teacher education in special education; as such, researchers have conducted several studies to assess mixed-reality simulation for its effectiveness and efficacy. Though these researchers have concluded that mixed-reality simulation can be an effective tool, there is limited information regarding a synthesis of the study characteristics (e.g., participants' demographic information, amount of time, skills taught using simulation, and participants' perceptions). Understanding these components is critical to the continued success and growth of using mixed-reality simulation in special education coursework. We identified and synthesized eight mixed-reality simulation studies with a total of 256 participants from 2005 to 2021. Together, the eight studies suggest that mixed-reality simulation is a valuable practice-based experience for preservice special educators. Implications for practice and future research are discussed.

Abstract Background Neoadjuvant therapy is increasingly the standard of care in the management of locally advanced adenocarcinoma of the oesophagus and junction (AEG). In randomised controlled trials (RCTs), the MAGIC regimen of pre- and postoperative chemotherapy, and the CROSS regimen of preoperative chemotherapy combined with radiation, were superior to surgery only in RCTs that included AEG but were not powered on this cohort. No completed RCT has directly compared neoadjuvant or perioperative chemotherapy and neoadjuvant chemoradiation. The Neo-AEGIS trial, uniquely powered on AEG, and including comprehensive modern staging, compares both these regimens. Methods This open label, multicentre, phase III RCT randomises patients (cT2-3, N0-3, M0) in a 1:1 fashion to receive CROSS protocol (Carboplatin and Paclitaxel with concurrent radiotherapy, 41.4Gy/23Fr, over 5 weeks). The power calculation is a 10% difference in favour of CROSS, powered at 80%, two-sided alpha level of 0.05, requiring 540 patients to be evaluable, 594 to be recruited if a 10% dropout is included (297 in each group). The primary endpoint is overall survival, with a minimum 3-year follow up. Secondary endpoints include: disease free survival, recurrence rates, clinical and pathological response rates, toxicities of induction regimens, post-operative pathology and tumour regression grade, operative in-hospital complications, and health-related quality of life. The trial also affords opportunities for establishing a bio-resource of pre-treatment and resected tumour, and translational research. Discussion This RCT directly compares two established treatment regimens, and addresses whether radiation therapy positively impacts on overall survival compared with a standard perioperative chemotherapy regimen Sponsor: Irish Clinical Research Group (ICORG). Trial registration NCT01726452 . Protocol 10-14. Date of registration 06/11/2012.

Abstract Background Firearm injuries are the leading cause of death for U.S. adolescents. Given the prevalence of firearm ownership in the U.S., particularly among parental figures in homes with children and teens, and the relationship between firearm access and injury outcomes, it is vital to shed light on potential parental motivations for keeping firearms in their homes. The purpose of this analysis was to examine whether exposure to community violence is associated with parental firearm ownership. Methods Data from the Firearm Safety Among Children and Teens Consortium’s National Survey (6/24/2020-7/24/2020) was examined. The survey sample comprised parents/caregivers of high-school-age teens (age 14–18). The survey examined various measures, including firearm ownership, storage, community violence exposure, and sociodemographic characteristics. Stepwise logistic regression was used to examine the association between community violence exposure and parental firearm ownership. Results The study included 2,924 participants, with 45.1% identifying as male, 12.9% identifying as Hispanic, and 25.3% identifying as non-White. Among these participants, 43.1% reported firearm ownership, and 49.9% reported exposure to community violence. Regression models demonstrate that community violence exposure is associated with an increased likelihood of firearm ownership among parents/caregivers of high-school age teens (OR = 1.08, p

The complex, trichlorido(1,4,11-triaza-8-azoniatetracyclo[6.6.2.04,16.011,15]hexadecane 1-oxide-κO)zinc(II) monohydrate, [ZnCl3(C12H23N4O)]·H2O, (I), has monoclinic symmetry (space group P21/n) at 120 K. The zinc(II) center adopts a slightly distorted tetrahedral coordination geometry and is coordinated by three chlorine atoms and the oxygen atom of the oxidized tertiary amine of the tetracycle. The amine nitrogen atom, inside the ligand cleft, is protonated and forms a hydrogen bond to the oxygen of the amine oxide. Additional hydrogen-bonding interactions involve the protonated amine, the water solvate oxygen atom, and one of the chloro ligands.

The ability to work with data to extract valuable information is a useful skill set, especially in STEM disciplines that produce large amounts of scientific data. This paper reports on the pedagogy and experience of incorporating fundamental database concepts into a STEM Success course, which included a hands-on project. Students worked in groups to design a database for existing tabular data available on the Web and then derived the data to populate the database using SQL queries. This paper reflects on the experience both from a pedagogical perspective as well as a student perspective, including qualitative code analysis of student feedback and survey results regarding attitudes of confidence using, interest in, and usefulness of databases.

Abstract Survival from ovarian cancer depends on the resection status after primary surgery. We performed genome-wide association analyses for resection status of 7705 ovarian cancer patients, including 4954 with high-grade serous carcinoma (HGSOC), to identify variants associated with residual disease. The most significant association with resection status was observed for rs72845444, upstream of MGMT, in HGSOC (p = 3.9 × 10−8). In gene-based analyses, PPP2R5C was the most strongly associated gene in HGSOC after stage adjustment. In an independent set of 378 ovarian tumours from the AGO-OVAR 11 study, variants near MGMT and PPP2R5C correlated with methylation and transcript levels, and PPP2R5C mRNA levels predicted progression-free survival in patients with residual disease. MGMT encodes a DNA repair enzyme, and PPP2R5C encodes the B56γ subunit of the PP2A tumour suppressor. Our results link heritable variation at these two loci with resection status in HGSOC.

Socially engaged engineering provides for student learning of the design, analysis, and practices of engineering as well as the ways that engineering is situated in sociocultural contexts. This paper provides a conceptual framework regarding socially engaged engineering for K-8 educators, researchers, and curriculum designers. The framework identifies ways to support youth learning of engineering and considerations of technical, social, environmental, and ethical dimensions of engineering. As engineering enters K-8 educational settings, it is important to introduce the discipline in equity-oriented ways. We draw from the field of engineering for social justice to build this framework for examining engineering at the macro-, meso-, and microscales. Situating engineering in sociocultural contexts can be motivating to learners and provide perspectives on the nature of engineering. Our framework was concurrently designed with Youth Engineering Solutions (YES; https://YouthEngineeringSolutions.org) curricular units. To test the applicability of our principles, we applied them to K-8 YES curricula for school and out-of-school environments. Through the coevolution of principles and curricular materials, we developed age-appropriate learning objectives for three levels--lower elementary, upper elementary, and middle school. This paper shares the principles and progression, showing worked examples from curricula to demonstrate how the principles translate into curricular resources. We discuss constraints to the implementation of socially engaged engineering curricula, including those imposed in educational settings and the ideological assumptions about science, engineering, and STEM disciplines. [Paper presented at 2023 American Society for Engineering Education Annual Conference & Exposition, Baltimore, MD.]

Summary: Here, we show that a NOT gated cell therapy (Tmod) can exploit antigens such as epidermal growth factor receptor (EGFR) and human leukocyte antigen-E (HLA-E) which are widely expressed on cancer cells. Noncancerous cells—despite high expression of these antigens—are protected from cytotoxicity by the action of an inhibitory receptor (“blocker”) via a mechanism that involves blocker modulation of CAR surface expression. The blocker is triggered by the product of a polymorphic HLA allele (e.g., HLA-A∗02) deleted in a significant subset of solid tumors via loss of heterozygosity. Moreover, Tmod constructs that target mouse homologs of EGFR or HLA-E for activation, and a mouse-equivalent of HLA-A∗02 for inhibition, protect mice from toxicity caused by the CAR alone. The blocker also controls graft vs. host response in allogeneic T cells in vitro, consistent with the use of Tmod cells for off-the-shelf therapy without additional gene-editing.

Adolescent and young adult (AYA) cancer patients receive palliative medicine consultation at a late stage and face diagnostic delays. Failure to address social determinants of health (SDOH) and AYA-specific needs can adversely impact patient experience. This retrospective observational cohort study used data from chart review to assess the frequency of SDOH impacting AYA patients and setting of initial diagnosis at a US urban safety-net hospital. The association of SDOH variables with delays in treatment, loss of follow-up, and no-shows was tested using Chi-square and t -tests. One hundred seventy five patient charts were reviewed. Sixty-two percent were diagnosed in acute care settings. Substance use disorders, financial, employment, and insurance issues were associated with delayed treatment, with weak to moderate effect sizes. Mental health diagnoses, substance use disorder, homelessness, and financial burdens were associated with patient no-shows, with moderate to large effect sizes. Twenty-five percent of patients received palliative medicine consultation; 70% of these occurred at end of life. This study demonstrates the impact of SDOH on AYA cancer care and the need for policy allowing for intervention on SDOH.

Abstract Brown seaweeds are a rich source of carotenoids, particularly fucoxanthin, which has a wide range of potential health applications. Fucoxanthin fluctuates within and among seaweeds over time, frustrating efforts to utilise this resource. Thus, we require comprehensive analyses of long- and short-term concentrations across species in field conditions. Here, we used High Performance Liquid Chromatography to compare fucoxanthin content in four brown macroalgae, Ascophyllum nodosum, Fucus serratus, Fucus vesiculosus and Saccharina latissima, monthly for 1 year. F. serratus and F. vesiculosus had significantly higher fucoxanthin content (mg/g), which was highest in Spring (0.39 ± 0.04) and Autumn (0.45 ± 0.04) [mean (± SE)]. Two species, A. nodosum and F. serratus, were collected monthly at the same location for a further two non-consecutive years. For both A. nodosum and F. serratus, a significant interaction effect of seasons and years was identified, highlighting that there is variation in fucoxanthin content among and within species over time. We also show that fucoxanthin content differs significantly among months even within seasons. Therefore, it is not sufficient to assess fucoxanthin in single months to represent seasonality. We discuss how weather, nutrients and reproduction may have driven the seasonal variation, and reveal patterns of fucoxanthin concentration that can provide information concerning its availability for many important medical functions.

ABSTRACTSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had an unprecedented impact on human health and highlights the need for genomic epidemiology studies to increase our understanding of virus evolution and spread and to inform policy decisions. We sequenced viral genomes from over 22,000 patient samples tested at Mayo Clinic Laboratories between 2020 and 2022 and used Bayesian phylodynamics to describe county and regional spread in Minnesota. The earliest calculated introduction into Minnesota was to Hennepin County from a domestic source around 22 January 2020; 6 weeks before the first confirmed case in the state. This led to the virus spreading to Northern Minnesota and, eventually, the rest of the state. International introductions were most abundant in Hennepin (home to the Minneapolis/St. Paul International Airport) totaling 45 (out of 107) over the 2-year period. Southern Minnesota counties were most common for domestic introductions, with 19 (out of 64), potentially driven by bordering states such as Iowa and Wisconsin as well as Illinois, which is nearby. Hennepin also was, by far, the most dominant source of in-state transmissions to other Minnesota locations (n = 772) over the 2-year period. We also analyzed the diversity of the location source of SARS-CoV-2 viruses in each county and noted the timing of state-wide policies as well as trends in clinical cases. Neither the number of clinical cases nor the major policy decisions, such as the end of the lockdown period in 2020 or the end of all restrictions in 2021, appeared to have an impact on virus diversity across each individual county.IMPORTANCEWe analyzed over 22,000 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomes of patient samples tested at Mayo Clinic Laboratories during a 2-year period in the COVID-19 pandemic, which included Alpha, Delta, and Omicron variants of concern to examine the roles and relationships of Minnesota virus transmission. We found that Hennepin County, the most populous county, drove the transmission of SARS-CoV-2 viruses in the state after including the formation of earlier clades including 20A, 20C, and 20G, as well as variants of concern Alpha and Delta. We also found that Hennepin County was the source for most of the county-to-county introductions after an initial predicted introduction with the virus in early 2020 from an international source, while other counties acted as transmission “sinks.” In addition, major policies, such as the end of the lockdown period in 2020 or the end of all restrictions in 2021, did not appear to have an impact on virus diversity across individual counties.

PurposeThe total time of radiation treatment delivery for pancreatic cancer patients with daily online adaptive radiation therapy (ART) on an MR-Linac can range from 50 to 90 min. During this period, the target and normal tissues undergo changes due to respiration and physiologic organ motion. We evaluated the dosimetric impact of the intrafraction physiological organ changes.MethodsTen locally advanced pancreatic cancer patients were treated with 50 Gy in five fractions with intensity-modulated respiratory-gated radiation therapy on a 0.35-T MR-Linac. Patients received both pre- and post-treatment volumetric MRIs for each fraction. Gastrointestinal organs at risk (GI-OARs) were delineated on the pre-treatment MRI during the online ART process and retrospectively on the post-treatment MRI. The treated dose distribution for each adaptive plan was assessed on the post-treatment anatomy. Prescribed dose volume histogram metrics for the scheduled plan on the pre-treatment anatomy, the adapted plan on the pre-treatment anatomy, and the adapted plan on post-treatment anatomy were compared to the OAR-defined criteria for adaptation: the volume of the GI-OAR receiving greater than 33 Gy (V33Gy) should be ≤1 cubic centimeter.ResultsAcross the 50 adapted plans for the 10 patients studied, 70% were adapted to meet the duodenum constraint, 74% for the stomach, 12% for the colon, and 48% for the small bowel. Owing to intrafraction organ motion, at the time of post-treatment imaging, the adaptive criteria were exceeded for the duodenum in 62% of fractions, the stomach in 36%, the colon in 10%, and the small bowel in 48%. Compared to the scheduled plan, the post-treatment plans showed a decrease in the V33Gy, demonstrating the benefit of plan adaptation for 66% of the fractions for the duodenum, 95% for the stomach, 100% for the colon, and 79% for the small bowel.ConclusionPost-treatment images demonstrated that over the course of the adaptive plan generation and delivery, the GI-OARs moved from their isotoxic low-dose region and nearer to the dose-escalated high-dose region, exceeding dose-volume constraints. Intrafraction motion can have a significant dosimetric impact; therefore, measures to mitigate this motion are needed. Despite consistent intrafraction motion, plan adaptation still provides a dosimetric benefit.

An offset T-intersection splits a conventional four leg intersection into two three-leg T-intersections to reduce the number of conflicts. While the safety benefits of offset T-intersections have been widely documented, the effects on operations are not well understood. To fix that, this paper employed microsimulation modeling to investigate the differences in operational performance between offset T-intersections and four-leg standard intersections under various traffic demands, intersection spacings, and signal timing schemes for three development types: superstore, hybrid gas station, and residential area. Queue length and delay were employed as measurements of effectiveness. Based on microsimulation modeling, we found that under most of the tested scenarios, offset T-intersections were superior to four-leg intersections in terms of reducing delay for the main street traffic. In addition, we found that the left–right (L-R) offset T-intersection configuration outperformed the right-left (R-L) offset configuration in terms of preventing main-street left turn queue spillback. Based on the simulation results, the paper provided practice-ready guidelines on selecting an optimum intersection configuration for each specific development type given the volume demands and known geometric constraints for a given site.

BackgroundVeterinarians hold distinct breed-specific pain sensitivity beliefs that differ from the general public but are highly consistent with one another. This is remarkable as there is no current scientific evidence for biological differences in pain sensitivity across dog breeds. Therefore, the present study evaluated whether pain sensitivity thresholds differ across a set of dog breeds and, if so, whether veterinarians’ pain sensitivity ratings explain these differences or whether these ratings are attributed to behavioral characteristics.MethodsPain sensitivity thresholds [using quantitative sensory testing (QST) methods] and canine behaviors (using owner questionnaires and emotional reactivity tests) were prospectively measured across selected dog breeds. Adult, healthy dogs from 10 dog breeds/breed types were recruited, representing breeds subjectively rated by veterinarians as high (chihuahua, German shepherd, Maltese, Siberian husky), average (border collie, Boston terrier, Jack Russell terrier), or low (golden retriever, pitbull, Labrador retriever) pain sensitivity. A final sample of 149 dogs was included in statistical analyses.ResultsVeterinarians’ pain sensitivity ratings provided a minimal explanation for pain sensitivity thresholds measured using QST in dogs; however, dog breeds did differ in their pain sensitivity thresholds across the QST methods evaluated. Breed differences were observed for some aspects of emotional reactivity tests; however, these behavioral differences did not explain the differences in pain sensitivity thresholds found. Veterinarians’ pain sensitivity ratings were positively associated with dog approach scores for the disgruntled stranger test suggesting that the way dogs greet strangers may be a factor influencing veterinarians’ ratings of pain sensitivity across dog breeds.Conclusions and clinical relevanceOverall, these findings highlight a need to investigate biological mechanisms that may explain breed differences in pain sensitivity because this may inform pain management recommendations. Further, future research should focus on when and how these breed-specific pain sensitivity beliefs developed in veterinarians, as veterinarians’ beliefs could impact the recognition and treatment of pain for canine patients.

Summary: Mechanisms underlying distinct specification, commitment, and differentiation phases of cell fate determination remain undefined due to difficulties capturing these processes. Here, we interrogate the activity of ETV2, a transcription factor necessary and sufficient for hematoendothelial differentiation, within isolated fate intermediates. We observe transcriptional upregulation of Etv2 and opening of ETV2-binding sites, indicating new ETV2 binding, in a common cardiac-hematoendothelial progenitor population. Accessible ETV2-binding sites are active at the Etv2 locus but not at other hematoendothelial regulator genes. Hematoendothelial commitment coincides with the activation of a small repertoire of previously accessible ETV2-binding sites at hematoendothelial regulators. Hematoendothelial differentiation accompanies activation of a large repertoire of new ETV2-binding sites and upregulation of hematopoietic and endothelial gene regulatory networks. This work distinguishes specification, commitment, and sublineage differentiation phases of ETV2-dependent transcription and suggests that the shift from ETV2 binding to ETV2-bound enhancer activation, not ETV2 binding to target enhancers, drives hematoendothelial fate commitment.

Vaccine hesitancy remains a global health threat. Addressing parental vaccine hesitancy is essential to maintaining high vaccine coverage levels and preventing disease outbreaks; however, it is unknown if administering a vaccine hesitancy screening tool negatively impacts parental vaccine beliefs. We conducted a stratified randomized controlled trial in pediatric primary care practices. English-speaking parents ≥18 years of age seeking routine care for infants

Purpose: The superior soft-tissue contrast of MRI-guided radiotherapy offers enhanced localization accuracy of the spinal cord in spine Stereotactic Body Radiotherapy (SBRT). This work includes a planning study for spine-SBRT on an MR-Linac. Additionally, a patient with spine metastasis was treated using an adaptive radiation therapy workflow. We report our initial experience of targeting accuracy, image-guided localization, on-line adaptive planning, and treatment with real-time intrafraction imaging with automatic beam gating.Methods: Six spine-SBRT patients were retrospectively re-planned to 18 Gy in 1-fraction on a commercial, Monte Carlo-based MR-Linac treatment planning system. Plans were generated using 9–13 step-and-shoot intensity-modulated radiation therapy 6 MV-flattening filter free beams and optimized to achieve plan quality criteria recommended by RTOG-0631. One thoracic vertebral body clinical case was treated to 27 Gy in 3-fractions utilizing ART, where daily anatomical changes were accounted for via re-planning and treatment in an on-line manner to account for limited ability to correct rotational setup uncertainties.Results: Plans met all critical-tissue constraints outlined in RTOG-0631 and AAPM Task Group-101, while covering 90% of the target with the prescription dose. Clinically, visibility of the spinal cord allowed for patient setup focusing on spinal cord-alignment. Utilization of the online ART workflow, while re-contouring the target and spinal cord, enabled an increase in prescription dose coverage from 89 to 95% in two of three fractions while maintaining acceptable doses to organs-at-risk. Real-time MR-cine imaging demonstrated sufficient quality for the automatic beam gating algorithm to provide intrafraction motion management of the spinal canal utilizing a 3.0 mm gating boundary and 1–2% region of excursion allowance, in the sagittal plane. A decrease in coverage, below the 95% threshold was noted in post-treatment volumetric imaging due to lateral movement not observed during real-time gating.Conclusion: Achieved plan quality and deliverability was within accepted standards. MR-guidance with an on-line ART workflow offered increased accuracy in the localization of the spinal cord at the time of treatment to enhance both tissue sparing and target volume coverage. Increased spatial resolution of cine-images, and tracking in three-dimensions would be beneficial for future spine-SBRT treatments on the MR-Linac.

Abstract Background Varicella zoster virus central nervous system infections can present as aseptic meningitis, encephalitis, myelitis, and vasculopathy. Diagnosis is based on identification of varicella zoster virus deoxyribonucleic acid (DNA) in the cerebrospinal fluid by polymerase chain reaction. Therapy for these infections is acyclovir or valacyclovir. However, acyclovir can have neurotoxic effects that can mimic the presentation of varicella zoster virus central nervous system disease. We present a rare presentation of a patient who had acyclovir-induced neurotoxicity who also had a false-positive cerebrospinal fluid varicella zoster virus polymerase chain reaction result, creating a management dilemma. We review the clinical characteristics of acyclovir-induced neurotoxicity. In addition, we present the diagnostic characteristics of the cerebrospinal fluid viral polymerase chain reaction and alternative methods to diagnose central nervous system varicella zoster virus disease. Case presentation A 68-year-old Hispanic man with end-stage renal disease was diagnosed with cutaneous zoster at an outside facility and was started on acyclovir 4 days prior to admission. His family noted worsening confusion, agitation, speech difficulty, and hallucinations, leading them to bring him to the emergency department. His cerebrospinal fluid varicella zoster virus polymerase chain reaction result was positive, indicating the presence of varicella zoster virus deoxyribonucleic acid in the cerebrospinal fluid; however, he did not have cerebrospinal fluid pleocytosis typical of varicella zoster virus meningoencephalitis. Pharmacy records from the outside hospital revealed supratherapeutic acyclovir dosing. This led to a diagnostic dilemma over whether this patient had varicella zoster virus encephalitis or acyclovir-induced neurotoxicity. Acyclovir was discontinued, and the patient underwent two sessions of hemodialysis to remove acyclovir, which led to a full neurologic recovery. Conclusions Varicella zoster virus encephalitis and acyclovir-induced neurotoxicity can have similar presentations. Varicella zoster virus deoxyribonucleic acid can be present in the cerebrospinal fluid during active cutaneous zoster in the absence of central nervous system disease. If concern for central nervous system varicella zoster virus disease remains high, additional testing with cerebrospinal fluid serology can be performed. Compared with central nervous system varicella zoster virus disease, acyclovir-induced neurotoxicity has a more predictable clinical resolution once drug therapy is discontinued or the patient undergoes hemodialysis, which can aid in making the diagnosis. Clinicians should be aware of this rare and dangerous complication of acyclovir. In addition, clinicians should have an understanding of the diagnostic limitations of cerebrospinal fluid viral polymerase chain reaction and have alternative approaches available to diagnose central nervous system varicella zoster virus disease when it is suspected.

We report a patient with hereditary erythrocytosis who underwent a therapeutic phlebotomy and had a post-phlebotomy hematocrit that was higher than the pre-phlebotomy hematocrit. We could not discern a reason for this hematocrit increase after phlebotomy. Instead of performing another phlebotomy, we performed an automated red cell depletion via an apheresis instrument. This procedure is essentially a red cell exchange, but 5% albumin is used as the replacement fluid instead of red blood cells. The patient’s hematocrit decreased from 80% to 39% after three consecutive daily red cell depletion procedures. We share our experience to report the unusual finding of a patient’s hematocrit that increased with phlebotomy and to raise awareness of the red cell depletion procedure.

Taxane-induced peripheral neuropathy (TIPN) is a devastating survivorship issue for many cancer patients. In addition to its impact on quality of life, this toxicity may lead to dose reductions or treatment discontinuation, adversely impacting survival outcomes and leading to health disparities in African Americans (AA). Our lab has previously identified deleterious mutations in SET-Binding Factor 2 (SBF2) that significantly associated with severe TIPN in AA patients. Here, we demonstrate the impact of SBF2 on taxane-induced neuronal damage using an ex vivo model of SBF2 knockdown of induced pluripotent stem cell-derived sensory neurons. Knockdown of SBF2 exacerbated paclitaxel changes to cell viability and neurite outgrowth while attenuating paclitaxel-induced sodium current inhibition. Our studies identified paclitaxel-induced expression changes specific to mature sensory neurons and revealed candidate genes involved in the exacerbation of paclitaxel-induced phenotypes accompanying SBF2 knockdown. Overall, these findings provide ex vivo support for the impact of SBF2 on the development of TIPN and shed light on the potential pathways involved.

We tested whether acute microplastic exposure impacts information gathering and processing (cognition) in hermit crabs (Pagurus bernhardus). For five days, we kept 51 hermit crabs in tanks containing either polyethylene microspheres (n = 27) or no plastic (n = 24). We then transferred individuals into an intermediate-quality shell and presented them with two vials containing either a better or worse shell. Because touching both shell vials required an equivalent behavioural response, this design controlled for general activity. Plastic-exposed hermit crabs were less likely and slower than controls to touch the better shell vial, instead preferring the worse shell vial. Microplastics, therefore, impaired assessments and decision-making, providing direct evidence of acute microplastic exposure disrupting hermit crab cognition.

The Parent Attitudes about Childhood Vaccines (PACV) survey is a validated instrument for identifying vaccine-hesitant parents; however, a Spanish version is not available. Utilizing the WHO framework for translating survey instruments, we used an iterative process for developing the Spanish PACV that included forward translation, expert panel review, back translation and pre-testing that utilized cognitive interviewing. We made revisions to the Spanish PACV at each step, focusing on addressing inclusivity, readability, clarity and conceptual equivalence. The expert panel was comprised of 6 Spanish-speaking medical and research professionals who worked alongside 3 study team members. Pre-testing was conducted using convenience sampling of Spanish-speaking parents (N = 35) who had a child receiving care at the residents’ continuity clinic at Texas Children’s Hospital. Most pre-testing participants were married (80.6%), mothers (97.1%), ≥30 years of age (88.2%) and had a high school education or less (70.6%). While the majority of participants stated the survey was easy to complete, the translation of 5 PACV items was further revised to improve interpretability. We conclude that the final Spanish PACV is conceptually equivalent and culturally appropriate for most Hispanic populations.

This article applies the Community of Inquiry (CoI) framework to a particular disciplinary context: first-year writing (FYW). Students enrolled in online FYW courses across three institutions (n = 272) completed a version of the CoI survey that was slightly modified to fit the disciplinary context of writing studies. A factor analysis was conducted to determine how well the CoI in Writing Studies data aligned with typical CoI survey research; teaching presence and cognitive presence loaded onto single factors, but the social presence items divided into multiple factors. The authors put their findings in conversation with other scholarship about social presence, especially Carlon et al. (2012) and Kreijns et al. (2014), and advocate for differentiating between survey items that relate to “social presence,” “social comfort,” “attitude,” and “social learning.” They also recommend that future disciplinary uses of the CoI Survey include survey items that ask students to report on the extent to which they engaged in the types of social learning that the discipline values.