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Extracellular vesicles (EVs) carry diverse bioactive components including nucleic acids, proteins, lipids and metabolites that play versatile roles in intercellular and interorgan communication. The capability to modulate their stability, tissue-specific targeting and cargo render EVs as promising nanotherapeutics for treating heart, lung, blood and sleep (HLBS) diseases. However, current limitations in large-scale manufacturing of therapeutic-grade EVs, and knowledge gaps in EV biogenesis and heterogeneity pose significant challenges in their clinical application as diagnostics or therapeutics for HLBS diseases. To address these challenges, a strategic workshop with multidisciplinary experts in EV biology and U.S. Food and Drug Administration (USFDA) officials was convened by the National Heart, Lung and Blood Institute. The presentations and discussions were focused on summarizing the current state of science and technology for engineering therapeutic EVs for HLBS diseases, identifying critical knowledge gaps and regulatory challenges and suggesting potential solutions to promulgate translation of therapeutic EVs to the clinic. Benchmarks to meet the critical quality attributes set by the USFDA for other cell-based therapeutics were discussed. Development of novel strategies and approaches for scaling-up EV production and the quality control/quality analysis (QC/QA) of EV-based therapeutics were recognized as the necessary milestones for future investigations.

ABSTRACT Migrant nurses face many challenges as they adapt and assimilate into their new working environments. The aim of this cross‐sectional study was to investigate the perceptions of work‐related strain, sense of coherence and intercultural sensitivity among nurses who were employed at a public mental health facility in Qatar. We used three self‐report questionnaires: the work‐related strain inventory, sense of coherence scale and an intercultural sensitivity scale. A cohort of 136 nurses voluntarily engaged in the study. The majority of participants were male, migrated from South Asia and were in their mid‐30s. The study found that both sense of coherence and intercultural sensitivity were inversely proportional to work‐related strain. Work‐related strain was found to be lower than expected; the factors that appear to protect against work‐related strain include longer clinical experience, a high sense of coherence, and intercultural sensitivity. Additionally, greater age and extended clinical experience, combined with a history of work in three or more countries, associated with higher scores on the sense of coherence scale. Lastly, being female, having a postgraduate degree and holding a senior‐level position were associated with increased intercultural sensitivity. As nurses' migration across national and international borders increases in response to global demand, this study has important implications for nursing administrators, educators and policymakers in relation to the development and implementation of strategies to enhance nurses' sense of coherence and intercultural sensitivity and prevent work‐related strain.Trial Registration number: NCT04196751. [ABSTRACT FROM AUTHOR]

Background: Contraception non-use among sexually active adolescents is a major cause of unintended pregnancy (UP). Methods: In this cross-sectional study we sought to identify overall and sex-specific correlates of contraception non-use using the 2015 Philadelphia Youth Risk Behavior Survey (YRBS) (N = 9540). Multivariate regression models were used to examine mental health, sexual activity, substance use, and violence indicators on reported contraception non-use among sexually active youth. Results: Marijuana use among boys and girls was a statistically significant risk factor for contraception non-use. Availability of illegal drugs on school property in the past year was also significantly related to contraception non-use among boys. Conclusions: These results may inform overall and sex-specific adolescent programs to promote consistent contraception use among urban youth within school-based communities.

In late 2014 and early 2015, highly pathogenic avian influenza (HPAI) A(H5N2), A(H5N1), and A(H5N8) viruses were detected in poultry and wild birds in the United States and Canada. A [...]

Background: Insufficient physical activity among urban youth increases risk of chronic disease.Purpose:This study assessed reported physical activity to determine when disparities in participation emerge and what ecologically guided factors are linked with high activity. Methods:We administered a cross-sectional survey to a diverse sample of 321 fourth-, sixth-, and eighth-graders measuring physical activity and a range of ecologically guided variables via self-report. Students who reported high versus low levels of physical activity were compared in bivariate and stepwise regression models stratified by gender and grade to elucidate factors associated with high physical activity. Results: The proportion of highly active students declined between fourth and sixth/eighth grade, driven largely by a decline in highly active girls. Unique factors were associated with high physical activity by grade or gender including self-efficacy among fourth-graders (adjusted odds ratio [aOR] ¼ 14.51, 95% confidence interval [CI], 1.60-131.84), social support among sixth- and eighth-graders (aOR ¼ 5.93, 95% CI, 2.04-17.29) and girls (aOR ¼ 9.03, 95% CI, 1.95-41.75), and perceived normal weight status among boys (aOR ¼ 6.62, 95% CI, 2.18-20.16). Discussion: Declines in physical activity among girls may initiate earlier than previously reported. Translation to Health Education Practice: School-based efforts to increase physical activity levels should be initiated as soon as fourth grade.

Data regarding intervention utilization among the target population are critical to interpret evidence from efficacy trials for school-based interventions. When use of the intervention is voluntary, intervention diffusion becomes a particularly critical variable. We examined the use of Instructional Consultation Teams (IC Teams), a voluntary teacher support program designed to enhance teacher skills for working with students in the general education classroom. Teachers' use of IC Teams was measured in 17 schools implementing the program over 4 years. The percentage of teachers who used the team increased over time, but utilization rates differed substantially among schools. Further, attrition of teachers in the project schools was high; over 48% of teachers had left the schools at the end of the 4-year study. We examined the roles of the principal and IC Teams facilitator in program utilization. Descriptive data and case illustrations suggested that schools with high utilization among teachers had effective, stable facilitators who worked in collaboration with their principals. Implications for studying utilization of educational innovations by school staff are discussed.

Music teachers are often the Pied Pipers of their schools, attracting the interest of students by the nature of the subject they teach. Their students who excel are often the best and brightest, since music reading and music production demand higher-level thinking skills, motor ability, and in the case of ensemble performance, social skills. As more and more students with severe disabilities are included in general education music classes and become part of school budgets, curricula, and assessments where all student growth is measured, music teachers need to be able to offer meaningful participation for all students in music. Deborah Nelson writes in this article that even with a degree in music, a master's degree in special education, and two endorsements, one for gifted students and one for students with severe disabilities, her teacher preparation classes did not address the needs of students with the most severe disabilities. She says that what she has learned in the area has come through the privilege of working with master teachers, attending in-service classes for teachers, enrolling in college classes, reading, and doing action research. However, even with all that under her belt, it has still been her students who have taught her the most by leading her to what they need. While wrestling with the challenge of writing lesson plans that ask students to sing, perform on instruments, read music, dance, and otherwise use higher level thinking skills, Nelson describes ways in which she has become more and more creative and familiar with technology that provides access to learning through virtual music experiences.

Instructional Consultation Teams (IC Teams) are an early intervention service intended to support teachers in working with struggling students. This is a large-scale experimental trial investigating the effects of IC Teams on teacher efficacy, instructional practices, collaboration, and job satisfaction. Public elementary schools (N = 34) were matched based on their risk composite and then randomly assigned to treatment or control groups. A multilevel model tested the effects of IC Teams on the beliefs and practices of teachers (N = 1,440) across three years of implementation. Results indicated that IC Teams had a significant effect on teacher efficacy and collaboration compared to randomly assigned control schools. The remaining effects were nonsignificant.