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Despite well-established health disparities between transgender and cisgender youth, state bills restricting gender-inclusive school supports and health care have dramatically expanded since 2019. While parental support for transgender youth strengthens healthy development, unsupportive parents contribute to suicidality and homelessness. This study examines (1) whether school climate and health gender inequities hold in Wisconsin, a politically contested state without nondiscrimination or bullying legislative protections for transgender youth, and (2) gender differences among adolescents who sought help when depressed or anxious.

Since 2017, hostile anti-LGBTQ+ educational bills rapidly expanded. Using traditional and critical policy analysis across three Midwestern states, we examine (1) whether state and local policymakers (n = 60) adopted trans-inclusive protections aligned with the 2017 federal "Whitaker" ruling, (2) the spread and scope of state and local educational policies concerning LGBTQ+ people, and (3) relationships between LGBTQ and critical race theory (CRT) curricular bills. We find policy erasure in states without pre-"Whitaker" gender-inclusive nondiscrimination laws and expanded efforts to ban LGBTQ+ students from educational opportunities, spaces, and curriculum. LGBTQ+ and CRT curricular bans overlapped. We discuss the implications of policymakers leaning into exclusion over gender reforms.

Background/Context: While trans adults in the U.S. and Canada report higher levels of discrimination and harassment than cisgender adults, but the existing literature lacks comprehensive descriptions of trans school workers' believes about what would improve working conditions, satisfaction, and safety. Purpose: We interrogate systemic forces shaping PK-12 trans educators' workplace experiences through two research questions: (1) What educational reforms did trans PK-12 workers believe would improve working conditions? (2) Did greater policy, organizational, and leadership support contribute to improved job satisfaction and safety? Research Design: The critical quantitative study employed cross-sectional, online survey data from 341 trans school workers in Canada and the United States. We used frequencies to describe respondents' rankings of reforms and logistic regression analysis to examine whether respondents' reports of greater policy protections, organizational supports, and affirming leadership contributed to greater workplace safety and satisfaction. Conclusions/Recommendations: Trans workers reporting safer, more satisfactory school workplaces also indicate their workplaces have multiple tools across socioecological systems to disrupt cisnormativity. Policy protections topped workers' rankings of beneficial reforms, but logistic regression analysis revealed policies mitigated only the most egregious physical safety concerns. Greater organizational supports and affirming leaders consistently contribute to satisfaction and safety. Policies, organizational practices, and leadership approaches working in tandem contribute to safe, satisfying workplaces for PK-12 trans school employees.

We introduce a new way of defining languages accepted by multicounter machines. Given a multicounter machine $M$ and $m \ge 0$, the $m$-crossing language accepted by $M$ is the set of all words where there is an accepting computation of $M$ on $w$ such that, for each counter $j$, each value $c$ that can appear in the counter is crossed at most $m$ times. We study this concept with multicounter machines and also with the partially-blind restriction where a counter cannot detect whether it contains zero or not. We show that both multicounter and partially-blind multicounter languages with one cross define exactly the reversal-bounded multicounter languages, while two crosses can accept strictly more including non-semilinear languages. We find that surprisingly, the family of $m$-crossing languages accepted by multicounter machines, for some $m$, and the family of $m$-crossing languages accepted by partially-blind multicounter machines, for some $m$, coincide. Decidability properties regarding $m$-crossing languages are also analyzed.

Abstract Background Rock slope instability is a complex geotechnical issue that is affected by site-specific rock properties, geological structures, groundwater, and earthquake load conditions. Numerous studies acknowledge these aleatory uncertainties in slope stability assessment; however, understanding the rock behaviour could still be improved. Therefore, this paper aims to summarise the probability methods applied in rock slope stability analysis in mining and civil engineering and develop new probabilistic design and assessment methodologies for four methods, namely empirical/rock mass classifications techniques, kinematic analysis, limit equilibrium (LE), and numerical methods and introduces how to integrate all methods to determine the total probability of failure. The case studies have been conducted based on slopes from Indonesia, a seismically active country, utilising the proposed design methods. Results Regarding the probabilistic empirical/rock mass classification (RMC) technique, this study has identified that seven of the ten most involved input parameters in RMC naturally exhibit aleatory uncertainty. Thus, the optimal way to present the output probability of RMC is as a confidence interval (CI) or total and conditional probability associated with each rock mass class. In probabilistic kinematic analysis, this study presents a systematic method to compute the probabilities of different types of failure alongside the total probability of occurrence (P tK ). The probability of failure (PoF) for jointed generalized Hoek-Brown (GHB) numerical modelling was lower than that obtained through the probabilistic LE approach for a similar slope. However, the PoF of jointed GHB is higher than the LE approach when loaded with 0.1 and 0.15 earthquake coefficients. Conclusions The variation of PoF across different failure criteria determines how epistemic uncertainty is apparent in the modelling process, while the aleatory uncertainty arises from input parameters. Furthermore, this study introduces the total probability of failure equation as a combination of kinematic and kinetic probabilities (limit equilibrium and numerical modelling).

Purpose: If PK12 administrators aspire to interrupt bias-based bullying, they need to understand their role in perpetuating structural and social inequality. The purpose of this study was to examine administrators': 1) awareness of gender-based bullying, 2) initial intentions to address bullying, and 3) actions that interrupted or perpetuated gender-based bullying. Methods: This qualitative study used a purposeful sample U.S. court cases and 36 interviews with administrators and policy consultants to explore PK12 leaders' understanding of gender-based bullying and actions to disrupt bullying. Findings: Our findings provide a more expansive definition of administrative bullying and brings attention to the personal complicity of educational leaders in perpetuating gender-based bullying. Administrators in this study modeled support for bullying through each of these four types of bullying -- by direct action, facilitated support, accommodating external stakeholders, and resisting efforts to educate themselves or others on issues related to gender-based bullying. All of these approaches allow bias and bullying to continue. The study also reveals how some leaders interrupt bullying by collaborating with students, parents, and community-based organizations. Implications: Policymakers, leadership preparation instructors, and PK12 administrators may be interested in how administrative behaviors perpetuate gender-based bullying. A lack of knowledge about leaders' personal complicity in bullying and about gender-diversity fundamentally interrupts two of the main roles of PK-12 leaders: implementing policies and leading instructional practices. The results of the study suggest the need for additional policies, procedures, and training to support leaders committed to interrupting gender-based bullying.

Peripheral nerve injuries that are not acutely repaired may lead to a nerve gap because of the surrounding zone of injury and elastic recoil of nerve tissue after laceration. This can result in tension across the repair site during primary neurorrhaphy. Decades of basic science literature using in vivo models consistently demonstrate a relationship between increasing strain at a neurorrhaphy site and compromised microvascular blood flow. Clinical and laboratory data suggest tension-free repairs are associated with optimal outcomes; in the setting of a short segmental nerve gap, data suggest primary repair may continue to yield good functional results. In the case of high strain, nerve grafting or other methods should be considered given poor results of primary repairs performed under high tension because of local ischemia and fibrosis on a cellular level.

Abstract Developmental Coordination Disorder (DCD), also known as dyspraxia, affects 5–15% of school-aged children (Hamilton and Sutton, Am Fam Physician 66:1435, 2002) and significantly impacts a child’s ability to learn motor skills and perform everyday activities efficiently and effectively (Zwicker et al., Eur J Paediatr Neurol 16:573–81, 2012). These motor deficits can have a negative impact on academic performance, vocational choices and leisure pursuits (Zwicker et al., Eur J Paediatr Neurol 16:573–81, 2012) and profoundly impact quality of life (Izadi-Najafabadi et al., Res Dev Disabil 84:75–84, 2019). DCD persists into adulthood (Kirby et al., J Adult Dev 18:107–13, 2011), impacting motor as well as emotional and behavioural status (Tal Saban and Kirby, Curr Dev Disord Rep 5:9–17, 2018). Despite the continued increase in research in the field of DCD, awareness of DCD remains poor (O’Kelly NL., From invisibility to invincibility: Guidelines for supporting families through the diagnosis and journey with developmental coordination disorder, 2012) even though it has higher prevalence rates when compared to, for example, autism spectrum disorder (Yan et al., J Autism Dev Disord :1–7, 2024), which in part may be due to a lack of accessible research findings. A fundamental feature of the research process is disseminating research findings. This should involve community members in design and delivery to ensure the accessibility of research findings. In 2022 the DCD-UK committee established a DCD Research Advisory Group (DCD-RAG) which met over the course of 12 months to: (1) identify issues of inaccessible research findings; (2) determine the need for a repository for research summaries; (3) co-create guidelines for authors and (4) agree a process for reviewing research summaries to be housed on the Movement Matters website. The new co-produced research repository, author guidelines and process were launched at the DCD-UK conference in Manchester 2023 and subsequently shared on social media and through the DCD research email list. The creation of the DCD-RAG and the process that we undertook together to create a non-academic repository for DCD research summaries are described. It is hoped that this repository will enable the wider public, community members and professionals to be able to readily benefit from accessible research, increasing a deeper and broader understanding of the evidence in the field.

BackgroundMaster clinicians are recognized as multidimensional experts in clinical medicine. Studying their formative clinical activities could generate insights to guide medical trainees and early career clinicians.ObjectivesTo investigate which early career activities were adopted more commonly by master clinicians than their matched peers and to characterize master clinicians' early career activities across institutions and specialties.Subjects and methodsWe surveyed master clinicians at seven medical centres about their early career activities. For master clinicians in the Department of Medicine (DOM), we also surveyed matched internist peers.ResultsOf 150 master clinician respondents, 65% were internists (DOM); 35% practiced in other specialties. Compared to their internist peers, there was a trend toward internist master clinicians reading more about their patients' conditions (6.0 vs. 4.8 h per week), reading more case reports (4.0 vs. 2.1 per month), engaging in more frequent teaching duties and devoting less time to research.ConclusionsThe early career activities identified in this study can be adopted by clinicians pursuing clinical excellence and promoted by training programs that seek to foster life-long learning.

In an era of decline and crisis, Catholic school leaders have been encouraged to find innovative ways to enhance a school's operational vitality. Yet to this point, most research on educational change in Catholic schools has focused on the technical tasks school principals can take to "save" individual schools. In this article, we apply a complexity perspective to educational change leadership in Catholic education: leadership for adaptive change. Based on a new empirical analysis of the professional experiences of two Catholic school principals working at four different parish schools, we demonstrate in this article how leadership for adaptive change can operate in Catholic elementary parish schools and assess whether and how the attributes of complex adaptive schools were present in these four elementary schools. We also highlight the organizational and social conditions these two principals confronted that both undermined and promoted their ability to lead for adaptive change at these four schools. Ultimately, we suggest in this article the utility of using a "complex adaptive" approach to understanding change leadership in Catholic elementary schools as opposed to "technically rational" approaches commonly found in contemporary Catholic school leadership research.

PK-12 leaders use gender- and sexuality-inclusivity professional development (IPD) as a tool to improve the school climate for LGBTQ+ students, but IPD programs vary widely in their scope, breadth, duration, instructional approach, and content. In this paper, we present the IPD conceptual framework, which proposes a sustained, intensive, and expansive approach to PD can influence student outcomes through changes in educators' beliefs, attitudes, skills, and knowledge concerning gender and sexuality. Using a large, Midwestern school district as a case study, we examine characteristics of schools participating in an intensive IPD program and whether participation contributed to school disciplinary rates. Using 2018-2019 administrative and program data from the district and state department of instruction, we: (1) describe demographic and program differences between IPD and non-IPD schools, and (2) evaluate the contribution of IPD on disciplinary outcomes using OLS regression analysis controlling for selection characteristics. Our analysis reveals less racial and ethnically-diverse and better financially-resourced schools participate in the IPD program. The regression analysis suggests schools participating in IPD have lower suspension rates, assault rates, and endangering behavior rates compared to non-IPD schools. Several studies indicate supportive leaders and IPD improves school climates for LGBTQ+ students; however, quantitative descriptions of how IPD may influence student behavior remain scarce. Policymakers and educational leaders may be interested in this study's results suggesting a decrease in disciplinary actions among schools committed to IPD with core components of the IPD framework.

As policy debates concerning LGBTQ+ students and staff continue across the American education system, there is not a clear description of the prevalence of local policy protections, even in states with legislative mandates, nor a strong understanding of how to expand reform initiatives. After conducting a document analysis of policies with a statewide, representative sample of districts, this study uses Illinois as a case study to describe several educational policy levers to scale gender and sexual diversity (GSD) reforms across federal, state, intermediary, and local institutions. The results indicate all districts complied with top-down legislative mandates, but few policies referenced gender or sexual diversity if not state-mandated. A minority of districts enacted policies through administrative guidance (27%), often using language from a state intermediary organization. Results from the regression analysis suggest local factors, such as district size, per pupil spending, and rurality, contribute to adopting guidance, but not policy protections. This study indicates both top-down and bottom-up pathways matter for expanding GSD-related reforms.

Abstract Background Diffuse midline glioma (DMG) is a pediatric tumor with dismal prognosis. Systemic strategies have been unsuccessful and radiotherapy (RT) remains the standard-of-care. A central impediment to treatment is the blood–brain barrier (BBB), which precludes drug delivery to the central nervous system (CNS). Focused ultrasound (FUS) with microbubbles can transiently and non-invasively disrupt the BBB to enhance drug delivery. This study aimed to determine the feasibility of brainstem FUS in combination with clinical doses of RT. We hypothesized that FUS-mediated BBB-opening (BBBO) is safe and feasible with 39 Gy RT. Methods To establish a safety timeline, we administered FUS to the brainstem of non-tumor bearing mice concurrent with or adjuvant to RT; our findings were validated in a syngeneic brainstem murine model of DMG receiving repeated sonication concurrent with RT. The brainstems of male B6 (Cg)-Tyrc-2J/J albino mice were intracranially injected with mouse DMG cells (PDGFB+, H3.3K27M, p53−/−). A clinical RT dose of 39 Gy in 13 fractions (39 Gy/13fx) was delivered using the Small Animal Radiation Research Platform (SARRP) or XRAD-320 irradiator. FUS was administered via a 0.5 MHz transducer, with BBBO and tumor volume monitored by magnetic resonance imaging (MRI). Results FUS-mediated BBBO did not affect cardiorespiratory rate, motor function, or tissue integrity in non-tumor bearing mice receiving RT. Tumor-bearing mice tolerated repeated brainstem BBBO concurrent with RT. 39 Gy/13fx offered local control, though disease progression occurred 3–4 weeks post-RT. Conclusion Repeated FUS-mediated BBBO is safe and feasible concurrent with RT. In our syngeneic DMG murine model, progression occurs, serving as an ideal model for future combination testing with RT and FUS-mediated drug delivery.

Traditional analysis of embedded earth-retaining walls relies on simplistic lateral earth pressure theory methods, which do not allow for direct computation of wall displacements. Contemporary numerical models rely on the Mohr–Coulomb model, which generally falls short of accurate wall displacement prediction. The advanced constitutive small-strain hardening soil model (SS-HSM), effectively captures complex nonlinear soil behavior. However, its application is currently limited, as SS-HSM requires multiple input parameters, rendering numerical modeling a challenging and time-consuming task. This study presents an extensive numerical investigation, where wall displacements from numerical models are compared to empirical findings from a large and reliable database. A novel automated computational scheme is created for model generation and advanced data analysis is undertaken for this objective. The main findings indicate that the SS-HSM can provide realistic predictions of wall displacements. Ultimately, a range of input parameters for the utilization of SS-HSM in earth-retaining wall analysis is established, providing a good starting point for engineers and researchers seeking to model more complex scenarios of embedded walls with the SS-HSM.

In spring 2020 our team received funding from the Rapid Response Research program of the National Science Foundation to develop comics that would help youth understand the COVID-19 pandemic. Our project built on a decade of expertise creating comics about the biology of viruses. In collaboration with virologists and artists, we developed three comic stories about COVID-19 during the pandemic and posted them on-line during the last half of 2020. The fictional narratives address fundamental issues in biology, virology, and network science, in order to help readers understand the complexities of living through a viral pandemic. The stories focus on three themes: the biology and social context of the COVID-19 virus; the relationship of wild animals, particularly bats, to the pandemic; and the impact of the pandemic on Tribal communities. We describe the challenges of comic development during the pandemic and the feedback from youth on whether the comics were appealing, interesting, and understandable. The stories were posted on worldofviruses.unl.edu and are published by the University of Nebraska Press as the book, C'RONA Pandemic Comics, with essays for youth about the virus and the pandemic.