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This article focuses on the psychometric properties and characteristics of the Assessing School Settings: Interactions of Students and Teachers (ASSIST), an observational assessment administered by trained external observers of teacher practices, classroom context, and student behaviors at the classroom level. Study 1 examines variability, reliability, and convergence between ASSIST scores with data from 3,298 classrooms nested within 185 elementary, middle, and high schools. We report school-level intraclass correlations (ICCs), standard deviations, means, and reliability estimates of ASSIST scales; investigate the correspondence among ASSIST-measured constructs with multilevel correlations; and explore school-level predictors of ASSIST global scale scores. Study 2 further examines reliability over time and convergent validity using repeated ASSIST and Classroom Assessment Scoring System--Secondary (CLASS-S) observations in classrooms of 335 teachers in 41 middle schools. The ASSIST global measures exhibited moderate to good reliability across three same-teacher observations (ICCs ranged from .69 to .82). Associations between all ASSIST and CLASS-S scales suggested close correspondence of the measures, especially at the teacher level and school level. Together, these findings highlight the utility of the ASSIST observational measure, both as a research and practice tool, across multiple school types and classroom contexts, and with potential to inform coaching to improve teachers' classroom management.

Background: teen Mental Health First Aid (tMHFA) is an Australian school-based universal program for grade 10 to 12 students. tMHFA teaches teens how to recognize and respond to a peer in crisis or experiencing mental health concerns. Methods: Schools implementing tMHFA in 2019 and 2020 were propensity score matched, yielding a sample of instructors (n = 130) and students (n = 1915) in 44 high schools in 24 American states. Effectiveness and acceptability were assessed with student surveys at baseline and after implementation. Results: There were significant findings for primary outcomes, including improved helpful first aid intentions (Cohen ds = 0.57 to 0.58), confidence supporting a peer (ds = 0.19 to 0.31); the number of adults rated as helpful (ds = 0.37 to 0.44); and reductions in stigmatizing beliefs (ds = 0.21 to 0.40) and "harmful first aid intentions" (ds = 0.11 to 0.42). Instructors and students rated the program favorably with students sharing improvements on their recognition and responses to mental health problems and crises. Conclusion: tMHFA is an effective, feasible, and scalable training program for increasing mental health literacy and decreasing mental health stigma in adolescents in the short term, consistent with trials of tMHFA in Australian adolescents.

Abstract Background Sepsis is a life‐threatening condition for which critically important antimicrobials are often indicated. The value of blood culture for sepsis is indisputable, but appropriate guidelines on sampling and interpretation are currently lacking in cattle. Objective Compare the diagnostic accuracy of 2 blood culture media (pediatric plus [PP] and plus aerobic [PA]) and hypoglycemia for bacteremia detection. Estimate the contamination risk of blood cultures in critically ill calves. Animals One hundred twenty‐six critically ill calves, 0 to 114 days. Methods Retrospective cross‐sectional study in which the performance of PP, PA and hypoglycemia to diagnose sepsis was assessed using a Bayesian latent class model. A Cox proportional hazards model was used to compare time to positivity (TTP). Potential contamination was descriptively analyzed. Isolates were considered relevant when they were; member of the Enterobacterales, isolated from both blood cultures vials, or well‐known, significant bovine pathogens. Results The sensitivities for PP, PA, and hypoglycemia were higher when excluding assumed contaminants; 68.7% (95% credibility interval = 30.5%‐93.7%), 87.5% (47.0%‐99.5%), and 61.3% (49.7%‐72.4%), respectively. Specificity was estimated at 95.1% (82.2%‐99.7%), 94.2% (80.7%‐99.7%), and 72.4% (64.6%‐79.6%), respectively. Out of 121 interpretable samples, 14.9% grew a presumed contaminant in PA, PP, or both. There was no significant difference in the TTP between PA and PP. Conclusions and Clinical Importance PA and PP appear to outperform hypoglycemia as diagnostic tests for sepsis. PA seems most sensitive, but a larger sample size is required to verify this. Accuracy increased greatly after excluding assumed contaminants. The type of culture did not influence TTP or the contamination rate.

Scalable electronic brain implants with long-term stability and low biological perturbation are crucial technologies for high-quality brain–machine interfaces that can seamlessly access delicate and hard-to-reach regions of the brain. Here, we created “NeuroRoots,” a biomimetic multi-channel implant with similar dimensions (7 μm wide and 1.5 μm thick), mechanical compliance, and spatial distribution as axons in the brain. Unlike planar shank implants, these devices consist of a number of individual electrode “roots,” each tendril independent from the other. A simple microscale delivery approach based on commercially available apparatus minimally perturbs existing neural architectures during surgery. NeuroRoots enables high density single unit recording from the cerebellum in vitro and in vivo. NeuroRoots also reliably recorded action potentials in various brain regions for at least 7 weeks during behavioral experiments in freely-moving rats, without adjustment of electrode position. This minimally invasive axon-like implant design is an important step toward improving the integration and stability of brain–machine interfacing.

Summary: Background: Early-onset Group B Streptococcus (EOGBS) infection leads to substantial morbidity and mortality in newborn infants. Intrapartum antibiotic prophylaxis (IAP) prevents EOGBS infection, but IAP strategies vary. The approach to the provision of IAP can be risk-based, universal or a combination of the two strategies. Previous systematic reviews reported that universal strategies might be most optimal in lowering EOGBS infection, but there is no consensus. Therefore, we aimed to provide up-to-date evidence on effectiveness of different strategies by comparing perinatal outcomes. Methods: A systematic search for EOGBS prevention strategies was performed in MEDLINE, Embase and Web of Science on May 2024. Studies were included if they reported on different strategies and outcomes of interest, including EOGBS infection, IAP administration and antimicrobial resistance regardless of publication date. Summary data was extracted from published reports. Study quality was assessed using the ROBINS-I tool. Random-effects meta-analyses were used to determine risk ratios (RR) and 95%-confidence intervals. PROSPERO registration CRD42023411806. Findings: A total of 6293 records were identified, of which 72 observational studies were included for synthesis with more than 10 million live births. Meta-analysis demonstrated that implementation of any strategy (n = 34 studies, RR 0.46 (0.36–0.60)), risk-based strategies (n = 11 studies, RR 0.65 (0.48–0.87)), or universal strategies (n = 16 studies, RR 0.37 (0.25–0.55)) was associated with a reduced risk of EOGBS infection compared to no strategy. In direct comparison, universal strategies were associated with a reduced risk of EOGBS compared to a risk-based strategy (n = 17 studies, RR 0.41 (0.30–0.55)), while the proportion of women receiving IAP did not differ between risk-based (16%) and universal (21%) strategies (n = 9 studies, RR 1.29 (0.95–1.75)). There was no antimicrobial resistance of EOGBS isolates to penicillin or ampicillin (n = 11 studies). Interpretation: Any IAP strategy could reduce the risk of EOGBS infection without evidence of increasing antimicrobial resistance. Universal strategies give the largest reduction in the EOGBS burden, while not exposing a significantly higher proportion of pregnancies to IAP compared to risk-based strategies. Funding: UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction, a cosponsored programme executed by the World Health Organization.

Abstract Introduction It is unclear whether neurotoxicity due to the antiretroviral drug efavirenz (EFV) results in neurocognitive impairment in people living with HIV (PLWH). Previously, we found that discontinuing EFV was associated with improved processing speed and attention on neuropsychological assessment. In this imaging study, we investigate potential neural mechanisms underlying this cognitive improvement using a BOLD fMRI task assessing cortical and subcortical functioning. Methods Asymptomatic adult PLWH stable on emtricitabine/tenofovirdisoproxil/efavirenz were randomly (1:2) assigned to continue their regimen (n = 12) or to switch to emtricitabine/tenofovirdisoproxil/rilpivirine (n = 28). At baseline and after 12 weeks, both groups performed the Stop-Signal Anticipation Task, which tests reactive and proactive inhibition (indicative of subcortical and cortical functioning, respectively), involving executive functioning, working memory, and attention. Behavior and BOLD fMRI activation levels related to processing speed and attention Z-scores were assessed in 17 pre-defined brain regions. Results Both groups had comparable patient and clinical characteristics. Reactive inhibition behavioral responses improved for both groups on week 12, with other responses unchanged. Between-group activation did not differ significantly. For reactive inhibition, positive Pearson coefficients were observed for the change in BOLD fMRI activation levels and change in processing speed and attention Z-scores in all 17 regions in participants switched to emtricitabine/tenofovir disoproxil/rilpivirine, whereas in the control group, negative correlation coefficients were observed in 10/17 and 13/17 regions, respectively. No differential pattern was observed for proactive inhibition. Conclusion Potential neural mechanisms underlying cognitive improvement after discontinuing EFV in PLWH were found in subcortical functioning, with our findings suggesting that EFV’s effect on attention and processing speed is, at least partially, mediated by reactive inhibition. Trial Registration Clinicaltrials.gov identifier [NCT02308332].

El Correo de Ultramar (1842-1886), periódico ilustrado publicado en París y distribuido entre el público hispano de América, tuvo un rol central en el ingreso y la difusión de la literatura por entregas (las afamadas novelas francesas aparecidas en los folletines de los diarios parisinos, como Los misterios de París o El conde de Montecristo) en las principales ciudades de Latinoamérica. En este trabajo se analiza el efecto editorial que produjo El Correo de Xavier de Lasalle en el incipiente mercado del impreso rioplatense.

Abstract Background Infants born with congenital diaphragmatic hernia (CDH) are at high risk of respiratory insufficiency and pulmonary hypertension. Routine practice includes immediate clamping of the umbilical cord and endotracheal intubation. Experimental animal studies suggest that clamping the umbilical cord guided by physiological changes and after the lungs have been aerated, named physiological-based cord clamping (PBCC), could enhance the fetal-to-neonatal transition in CDH. We describe the statistical analysis plan for the clinical trial evaluating the effects of PBCC versus immediate cord clamping on pulmonary hypertension in infants with CDH (PinC trial). Design The PinC trial is a multicentre, randomised controlled trial in infants with isolated left-sided CDH, born ≥ 35.0 weeks of gestation. The primary outcome is the incidence of pulmonary hypertension in the first 24 h after birth. Maternal outcomes include estimated maternal blood loss. Neonatal secondary outcomes include mortality before discharge, extracorporeal membrane oxygenation therapy, and number of days of mechanical ventilation. Infants are 1:1 randomised to either PBCC or immediate cord clamping using variable random permutated block sizes (4–8), stratified by treatment centre and estimated severity of pulmonary hypoplasia (i.e. mild/moderate/severe). At least 140 infants are needed to detect a relative reduction in pulmonary hypertension by one third, with 80% power and 0.05 significance level. A chi-square test will be used to evaluate the hypothesis that PBCC decreases the occurrence of pulmonary hypertension. This plan is written and submitted without knowledge of the collected data. The trial has been ethically approved. Trial registration ClinicalTrials.gov NCT04373902 (registered April 2020).

Abstract Background Mortality, cerebral injury, and necrotizing enterocolitis (NEC) are common complications of very preterm birth. An important risk factor for these complications is hemodynamic instability. Pre-clinical studies suggest that the timing of umbilical cord clamping affects hemodynamic stability during transition. Standard care is time-based cord clamping (TBCC), with clamping irrespective of lung aeration. It is unknown whether delaying cord clamping until lung aeration and ventilation have been established (physiological-based cord clamping, PBCC) is more beneficial. This document describes the statistical analyses for the ABC3 trial, which aims to assess the efficacy and safety of PBCC, compared to TBCC. Methods The ABC3 trial is a multicenter, randomized trial investigating PBCC (intervention) versus TBCC (control) in very preterm infants. The trial is ethically approved. Preterm infants born before 30 weeks of gestation are randomized after parental informed consent. The primary outcome is intact survival, defined as the composite of survival without major cerebral injury and/or NEC. Secondary short-term outcomes are co-morbidities and adverse events assessed during NICU admission, parental reported outcomes, and long-term neurodevelopmental outcomes assessed at a corrected age of 2 years. To test the hypothesis that PBCC increases intact survival, a logistic regression model will be estimated using generalized estimating equations (accounting for correlation between siblings and observations in the same center) with treatment and gestational age as predictors. This plan is written and submitted without knowledge of the data. Discussion The findings of this trial will provide evidence for future clinical guidelines on optimal cord clamping management at birth. Trial registration ClinicalTrials.gov NCT03808051. Registered on 17 January 2019.

Student engagement is a multidimensional construct influenced by complex student, classroom, and school factors. Although prior research has examined various dimensions of student engagement, few studies have adopted a multilevel approach to simultaneously incorporate observational measures of classroom practices with student and school factors. The current study examined the association between student self-reported affective and behavioral engagement (n = 26,849 students) and observed instructional and behavioral classroom management practices within 401 classrooms in 54 high schools. We employed three-level hierarchical linear modeling and included student, classroom, and school variables. Results indicated that observed teacher use of positive behavior supports was positively and significantly associated with student reports of active engagement in the same classroom. Implications for improving teachers' classroom management practices to promote student engagement are considered. [For the Grantee Submission, see ED611739.]

Challenges in the measurement of racial disparities in school discipline are a significant barrier to identifying policy and programmatic reforms that are effective at closing gaps. This article reviews key measurement issues and presents a set of empirical analyses as an illustrative case study. Specifically, we reframe the interpretation of discipline data in light of initiatives designed to reduce racial discipline disparities. We also characterize common metrics and recognize several additional ones for use in discipline disproportionality outcome evaluations. Leveraging a statewide policy reform as an example, we report findings from a quasi-experimental evaluation, which demonstrated that the various metrics can point to differing conclusions. We conclude with proposed guiding principles for the selection and use of discipline disproportionality metrics in evaluations.

Summary: Background: The outcome of patients with metastatic tumors who discontinued immune checkpoint inhibitors (ICIs) not for progressive disease (PD) has been poorly explored. We performed a meta-analysis of all studies reporting the clinical outcome of patients who discontinued ICIs for reasons other than PD. Methods: We searched PubMed, Embase and Scopus databases, from the inception of each database to December 2023, for clinical trials (randomized or not) and observational studies assessing PD-(L)1 and CTLA-4 inhibitors in patients with metastatic solid tumors who discontinued treatment for reasons other than PD. Each study had to provide swimmer plots or Kaplan–Meier survival curves enabling the reconstruction of individual patient-level data on progression-free survival (PFS) following the discontinuation of immunotherapy. The primary endpoint was PFS from the date of treatment discontinuation overall and according to tumor histotype, type of treatment and reason of discontinuation. The Combersure’s method was used to estimate meta-analytical non-parametric summary survival curves assuming random effects at study level. Findings: Thirty-six studies (2180 patients) were included. The pooled median PFS (mPFS) was 24.7 months (95% CI, 18.8–30.6) and the PFS-rate at 12, 24, and 36 months was respectively 69.8% (95% CI, 63.1–77.3), 51.0% (95% CI, 43.4–59.8) and 34.0% (95% CI, 27.0–42.9). Univariable analysis showed that the mPFS was significantly longer for patients with melanoma (43.0 months), as compared with non-small cell lung cancer (NSCLC, 13.5 months) and renal cell carcinoma (RCC, 10.0 months; between-strata comparison test p-value < 0.001); for patients treated with anti-PD-(L)1 + anti-CTLA-4 as compared with anti-PD-(L)1 monotherapy (44.6 versus 19.9 months; p-value

The type-Silurian Cellon section in the Carnic Alps in Austria underpins much of the current Silurian conodont zonations, forming the basis for the Silurian timescale. However, the Silurian record of the Cellon section lacks radiometric and astrochronological age constraints, making it difficult to gain insights into the processes pacing Silurian (anoxic) events. To attain age constraints and investigate the pacing Silurian (anoxic) events by astronomical cycles, a cyclostratigraphic study was conducted on high-resolution pXRF (CaO, Al2O3, and Fe2O3) and induration records spanning the Ludlow and Pridoli parts of the Cellon section. Astronomical cycles ranging from precession to the 405-kyr eccentricity cycle were first recognised visually in the field and in proxy records. The visual detection of astronomical cycles served as an input for the WaverideR R package, enabling the tracking of the 405-kyr eccentricity period in each proxy’s continous wavelet transform scalograms. These tracked period curves were combined with external age controls through multiple Monte Carlo simulations, generating an (absolute) age model. This age model is used to assign ages and durations and their respective uncertainties to a hiatus in the Ludfordian, conodont zones, lithological units, geochronological units and events, yielding new ages for Silurian stage boundaries (e.g., Gorstian-Ludfordian boundary at 425.92 ± 0.65 Ma, the Ludfordian-Pridoli boundary at 423.03 ± 0.53 Ma, the Silurian-Devonian boundary at 418.86 ± 1.02 Ma), and new durations for the Ludfordian at 2.89 ± 0.35 Myr and Pridoli at 4.24 ± 0.46 Myr. Furthermore, the imprint of astronomical cycles in the Cellon section itself indicates that the Linde, Klev and Silurian-Devonian boundary events all occur after a 2.4-Myr eccentricity node, indicating pacing by astronomical forcing, similar to other Devonian and Cretaceous anoxic events. The Lau event, however, does not appear to coincide with a 2.4-Myr eccentricity node.