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In the United States, legislation ensures that schools provide accommodations to students with disabilities and conditions that impair their functioning. Students with social anxiety, who face many challenges in the school context, often receive these accommodations. Yet, it is unknown whether school-based accommodations achieve their intended aims of mitigating anxiety-related school impairment. The current study therefore examined whether school-based accommodations, assessed as the presence or absence of an Individualized Education Plan (IEP) or 504 Plan, moderate associations between social anxiety symptoms and anxiety-related school impairment. We also explored grade level (elementary versus secondary) as an additional moderator of these associations and included youth sex and ethnicity as covariates. Participants were 504 youth with anxiety disorders (55% boys; 76% elementary level) and their mothers. Based on mothers’ reports, we found significant associations of youth sex, social anxiety, and the presence of an IEP or 504 Plan with anxiety-related school impairment. There were no significant moderation effects. Findings are discussed with regard to the role of school-based accommodations for mitigating anxiety-related school impairment. Further research is needed to understand how to improve school-based accommodations to ensure they help the youth for whom they are designed, especially youth with social anxiety.

STUDY QUESTION How often do patients undergoing frozen embryo transfer (FET) after preimplantation genetic testing for aneuploidy (PGT-A) choose to select for sex and do sex selection rates differ before and after successful delivery of a first baby? SUMMARY ANSWER When a choice was available between male and female embryos, patients selected the sex more frequently when trying to conceive the second child (62%) as compared to the first child (32.4%) and most commonly selected for the opposite sex of the first child. WHAT IS KNOWN ALREADY Sex selection is widely available in US fertility clinics. However, the rate of sex selection for patients undergoing FET after PGT-A is unknown. STUDY DESIGN, SIZE, DURATION This is a retrospective cohort study of 585 patients that took place between January 2013 and February 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS The study took place at a single, urban academic fertility center in the USA. Patients were included if they had a live birth after single euploid FET and returned for at least one subsequent euploid FET. The primary outcomes were the rates of sex selection for first versus second baby. Secondary outcomes were rate of selection for same versus opposite sex as first live birth and overall rate of selection for males versus females. MAIN RESULTS AND THE ROLE OF CHANCE Five hundred and eighty-five patients underwent a total of 1560 single euploid FETs resulting in either one or two live births. A choice between male and female euploid embryos was available for 919 FETs (first child: 67.5% (519/769) versus second child: 50.6% (400/791), P LIMITATIONS, REASONS FOR CAUTION The study was performed at one urban academic medical center in the Northeastern US, which may limit generalizability to other settings where PGT-A may be performed less frequently, or sex selection may be limited or not permitted. In addition, we could not reliably account for whether patients or their partners had prior children and if so, of what sex. WIDER IMPLICATIONS OF THE FINDINGS Patients undergoing PGT-A with both male and female euploid embryos were more likely to select for sex when attempting a second child and usually selected for the opposite sex of their first child. These findings highlight the potential for family balancing for patients who undergo PGT-A in settings where sex selection is permitted. STUDY FUNDING/COMPETING INTEREST(S) This study received no funding. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.

The James Webb Space Telescope's Near Infrared Imager and Slitless Spectrograph (JWST-NIRISS) flies a 7-hole non-redundant mask (NRM), the first such interferometer in space, operating at 3-5 \micron~wavelengths, and a bright limit of $\simeq 4$ magnitudes in W2. We describe the NIRISS Aperture Masking Interferometry (AMI) mode to help potential observers understand its underlying principles, present some sample science cases, explain its operational observing strategies, indicate how AMI proposals can be developed with data simulations, and how AMI data can be analyzed. We also present key results from commissioning AMI. Since the allied Kernel Phase Imaging (KPI) technique benefits from AMI operational strategies, we also cover NIRISS KPI methods and analysis techniques, including a new user-friendly KPI pipeline. The NIRISS KPI bright limit is $\simeq 8$ W2 magnitudes. AMI (and KPI) achieve an inner working angle of $\sim 70$ mas that is well inside the $\sim 400$ mas NIRCam inner working angle for its circular occulter coronagraphs at comparable wavelengths., 30 pages, 10 figures

This chapter argues that Hobbes’s instructions for how to read a text can be applied to Hobbes’s own writings. When we do this, our reading changes from one in which we must obey the sovereign in all things to one in which individual interpretations are valued over and above one centralizing interpreter’s. Following an analogy that Hobbes himself made between the author and the reader of the text on the one hand and the sovereign and subject of the nation on the other, we see that the way Hobbes subverts his own textual authority has implications for the politics that his books promote as well.

In Anarchist Prophets James R. Martel juxtaposes anarchism with what he calls archism in order to theorize the potential for a radical democratic politics. He shows how archism—a centralized and hierarchical political form that is a secularization of ancient Greek and Hebrew prophetic traditions—dominates contemporary politics through a prophet’s promises of peace and prosperity or the threat of violence. Archism is met by anarchism, in which a community shares a collective form of judgment and vision. Martel focuses on the figure of the anarchist prophet, who leads efforts to regain the authority for the community that archism has stolen. The goal of anarchist prophets is to render themselves obsolete and to cede power back to the collective so as to not become archist themselves. Martel locates anarchist prophets in a range of philosophical, literary, and historical examples, from Hobbes and Nietzsche to Mary Shelley and Octavia Butler to Kurdish resistance in Syria and the Spanish Revolution. In so doing, Martel highlights how anarchist forms of collective vision and action can provide the means to overthrow archist authority.

Behavior rating scales represent one of the most commonly used types of assessments in school psychology. Yet, they suffer from a fundamental limitation: They are an indirect methodology influenced...

This study evaluated early and frequent seated breaks from standing work to reduce low back pain (LBP) in known pain developers (PD). Twenty-four participants, classified as either PD or non-PD during a separate 2-hour standing session, performed 124 minutes of standing work with seated breaks at a 3:1 stand-sit ratio with increasing durations from 3:1 minute to 48:16 minutes. Back pain and spine posture measures showed no differences between PD and non-PD. Females had greater left glutaeus medius activation (8.4%MVC) than males (4.5%MVC) and greater glutaeus medius co-contraction. This protocol was successful at reducing LBP in PD to the level of non-PD, with mean pain scores (13 mm) only slightly exceeding the clinical LBP threshold of 10 mm. Early and frequent breaks within the first hour of standing work appear to be an effective solution to reduce the LBP that often occurs at the beginning of standing work.

The quest for better predictive tools as well as new preventative and therapeutic measures for bone fragility and fracture has highlighted the need for greater mechanistic understanding of the bone fracture process. Cortical bone, the major load bearing part of the bone, employs different toughening mechanisms to either inhibit or slow down crack growth which leads to fracture. Among these toughening mechanisms, is the formation of a micro-damage process zone (MDPZ) around the region of the propagating crack. Investigations into the MDPZ to date have primarily been based on quasi-static or cyclic loading rate experiments which do not necessarily replicate physiological fracture rates. Consequently, the impact of fall-related loading rates on the formation of the micro-damage process zone was investigated comparing these to quasi-static loading rate equivalents. The size of MDPZ was found to be 42% smaller in the high-rate group compared to the quasi-static rate group. The smaller MDPZ size was associated with a brittle, unstable fracture behaviour and an overall smaller fracture resistance measure (J

Fall-related hip fractures are a major public health issue. While individual-level risk assessment tools exist, population-level predictive models could catalyze innovation in large-scale interventions. This study presents a hierarchical probabilistic model that predicts population-level hip fracture risk based on Factor of Risk (FOR) principles. Model validation demonstrated that FOR output aligned with a published dataset categorized by sex and hip fracture status. The model predicted normalized FOR for 100000 individuals simulating the Canadian older-adult population. Predicted hip fracture risk was higher for females (by an average of 38%), and increased with age (by15% per decade). Potential applications are discussed.

Background Surface translations are a method of perturbing an individual’s balance to evoke balance control responses. However, the force plates used to measure kinetic responses often contain artifacts due to inertial properties coupled with the dynamics of surface translation perturbations. Techniques to attenuate these movement artifacts are not well established within the literature. Research question Are amplitude- or frequency-based subtraction processing techniques effective at attenuating inertia-based movement artifacts in kinetic signals during surface translations? Methods One-hundred and two backward surface translations were analyzed from five participants. Perturbation-matched unloaded pre-trials were collected to characterize force plate movement artifacts. For each trial, baseline data was processed to account for inertial artifacts using both amplitude- and frequency-based subtraction methods producing 3 datasets. Root mean square error (RMSE) between the datasets and expected tracings of an unloaded force plate were calculated. The effects of these processes on calculated knee flexion/extension (FE) moment were characterized using an inverse dynamics model which incorporated ground reaction forces and participant kinematics. Results Both amplitude- and frequency-based processing methods resulted in near identical changes and substantially reduced RMSE values compared to original data. An RMSE reduction of 91.4 % was observed for the unloaded force channel which aligned with the direction of translation. Peak stance knee FE moments decreased by an average of 3.7 Nm and the average largest difference between the original data and both processing techniques across all trials was 30.4 Nm. Significance The results provide quantitative evidence that both data processing methods can successfully attenuate the presence of movement artifact found within force plate signals during surface translations. This study provides recommendations to researchers on effective methods for improving data processing techniques to attenuate force plate movement artifacts introduced by surface translations, towards more accurate estimates of joint kinetics during balance reactions.

Muscle activation has been demonstrated to influence impact dynamics during scenarios including running, automotive impacts, and head impacts. This study investigated the effects of targeted muscle activation magnitude on impact dynamics during low energy falls on the hip with human volunteers. Fifteen university-aged participants (eight females, seven males) underwent 12 lateral pelvis release trials. Half of the trials were muscle-'relaxed'; in the remaining 'contracted' trials participants isometrically contracted their gluteus medius to 20-30% of maximal voluntary contraction before the drop was initiated onto a force plate. Peak force applied to the femur-pelvis complex averaged 9.3% higher in contracted compared to relaxed trials (F = 6.798, p = .022). Muscle activation effects were greater for females, resulting in (on average) an 18.5% increase in effective pelvic stiffness (F = 5.838, p = .046) and a 23.4% decrease in time-to-peak-force (F = 5.109, p = .042). In the relaxed trials, muscle activation naturally increased during the impact event, reaching levels of 12.8, 7.5, 11.1, and 19.1% MVC at the time of peak force for the gluteus medias, vastus lateralis, erector spinae, and external oblique, respectively. These findings demonstrated that contraction of trunk and hip musculature increased peak impact force across sexes. In females, increases in the magnitude and rate of loading were accompanied (and likely driven) by increases in system stiffness. Accordingly, incorporating muscle activation contributions into biomechanical models that investigate loading dynamics in the femur and/or pelvis during lateral impacts may improve estimate accuracy.

Hip fracture incidence rates are influenced by body mass index (BMI) and sex, likely through mechanistic pathways that influence dynamics of the pelvis-femur system during fall-related impacts. The goal of this study was to extend our understanding of these impact dynamics by investigating the effects of BMI, sex, and local muscle activation on pressure distribution over the hip region during lateral impacts. Twenty participants underwent "pelvis-release experiments" (which simulate a lateral fall onto the hip), including muscle-'relaxed' and 'contracted' trials. Males and low-BMI individuals exhibited 44 and 55% greater peak pressure, as well as 66 and 56% lower peripheral hip force, compared to females and high-BMI individuals, respectively. Local muscle activation increased peak force by 10%, contact area by 17%, and peripheral hip force by 11% compared to relaxed trials. In summary, males and low-BMI individuals exhibited more concentrated loading over the greater trochanter. Muscle activation increased peak force, but this force was distributed over a larger area, preventing increased localized loading over the greater trochanter. These findings suggest potential value in incorporating sex, gender, and muscle activation-specific force distributions as inputs into computational tissue-level models, and have implications for the design of personalized protective devices including wearable hip protectors.

Isunakinra, formerly known as EBI-005, is a novel interleukin (IL)-1 receptor inhibitor developed for topical treatment of patients with dry eye disease (DED). This phase 1b/2a multicenter, double-masked, randomized, vehicle controlled environmental trial assessed the safety and biological activity of isunakinra in patients with moderate to severe DED. Subjects (N=74) were randomized to vehicle (placebo) or isunakinra (5 or 20 mg/mL) 3×/daily for 6 weeks. Evaluations included safety, tolerability, biological activity for signs (corneal fluorescein staining [CFS]), symptoms (pain or sore eyes and total Ocular Surface Disease Index [OSDI]), and reduction in rescue artificial tear use. Topical administration of isunakinra (5 and 20 mg/mL) was safe and well tolerated and resulted in clinically relevant improvements in symptoms (OSDI score, painful/sore eye component of OSDI) and signs (total CFS) compared with baseline with no dose response. OSDI scores improved from baseline by 38% (18.9 points) at 6 weeks and CFS scores improved by 33% (3 points) in the isunakinra groups. These changes were not statistically significant compared with the vehicle. Use of artificial rescue tears was significantly reduced in the isunakinra treatment groups (mean=9 vials) compared with vehicle (mean=31 vials). The differences between isunakinra and vehicle treatments were more pronounced in subjects with OSDI scores less than 50 at baseline. Isunakinra was safe, well tolerated and showed clinically meaningful improvements in signs and symptoms of DED. These results encouraged the design of an adequately powered study to characterize the safety and efficacy of isunakinra in ocular surface diseases.

Purpose To evaluate the intraocular pressure (IOP)-lowering efficacy and safety of 10- and 15-μg bimatoprost implant in subjects with open-angle glaucoma (OAG) and ocular hypertension (OHT) after initial and repeated administrations. Design Randomized, 20-month, multicenter, subject- and efficacy evaluator-masked, parallel-group, phase 3 clinical study. Participants Adults with OAG or OHT in each eye, open iridocorneal angle inferiorly in the study eye, and study eye baseline IOP (hour 0; 8 am ) of 22–32 mmHg after washout. Methods Study eyes received bimatoprost implant 10 μg (n = 198) or 15 μg (n = 198) on day 1 with readministration at weeks 16 and 32, or twice-daily topical timolol maleate 0.5% (n = 198). Intraocular pressure was measured at hours 0 and 2 at each visit. Main Outcome Measures Primary end points were IOP and change from baseline IOP through week 12. Safety measures included treatment-emergent adverse events (TEAEs) and corneal endothelial cell density (CECD). Results Both dose strengths of bimatoprost implant were noninferior to timolol in IOP lowering after each administration. Mean diurnal IOP was 24.0, 24.2, and 23.9 mmHg at baseline and from 16.5–17.2, 16.5–17.0, and 17.1–17.5 mmHg through week 12 in the 10-μg implant, 15-μg implant, and timolol groups, respectively. The incidence of corneal and inflammatory TEAEs of interest (e.g., corneal endothelial cell loss, iritis) was higher with bimatoprost implant than timolol and highest with the 15-μg dose strength. Incidence of corneal TEAEs increased after repeated treatment; with 3 administrations at fixed 16-week intervals, incidence of ≥20% CECD loss was 10.2% (10-μg implant) and 21.8% (15-μg implant). Mean best-corrected visual acuity (BCVA) was stable; 3 implant-treated subjects with corneal TEAEs had >2-line BCVA loss at their last visit. Conclusions Both dose strengths of bimatoprost implant met the primary end point of noninferiority to timolol through week 12. One year after 3 administrations, IOP was controlled in most subjects without additional treatment. The risk-benefit assessment favored the 10-μg implant over the 15-μg implant. Ongoing studies are evaluating other administration regimens to reduce the potential for CECD loss. The bimatoprost implant has potential to improve adherence and reduce treatment burden in glaucoma.

Introduction While protective headwear products (PHP) are designed to protect older adults from fall-related head injuries, there are limited data on their protective capacity. This study’s goal was to assess the impact attenuation provided by commercially available PHP during simulated head impacts. Methods A drop tower and Hybrid III headform measured the decrease in peak linear acceleration ( g atten) provided by 12 PHP for front- and back-of-head impacts at low (clinically relevant: 3.5 m/s) and high (5.7 m/s) impact velocities. Results The range of g atten across PHP was larger at the low velocity (56% and 41% for back and frontal impacts, respectively) vs. high velocity condition (27% and 38% for back and frontal impacts, respectively). A significant interaction between impact location and velocity was observed ( p < .05), with significantly greater g atten for back-of-head compared to front-of-head impacts at the low impact velocity (19% mean difference). While not significant, there was a modest positive association between g atten and product padding thickness for back-of-head impacts ( p = .095; r = 0.349). Conclusion This study demonstrates the wide range in impact attenuation across commercially available PHP, and suggests that existing products provide greater impact attenuation during back-of-head impacts. These data may inform evidence-based decisions for clinicians and consumers and help drive industry innovation.

PURPOSE:To demonstrate the successful clinical identification and management of rhino-orbital mucormycosis, a fungal infection with a high mortality rate. PATIENTS AND METHODS:A diabetic male patient with a headache and orbital apex syndrome in the right eye was examined using computed tomography (CT) and magnetic resonance imaging (MRI) for a possible fungal infection. Endoscopic surgical resection was performed and a pathology sample was taken. Specimens were prepared with Gomori methenamine silver and hematoxylin and eosin staining. The patient was treated with liposomal amphotericin B 400 mg daily, followed by posaconazole 400 mg twice daily. RESULTS:CT and MRI revealed a mass of the right sphenoid spreading into the orbit, indicative of a fungal infection. The biopsy confirmed the diagnosis of mucormycosis. Complete recovery of eyelid and oculomotor function was achieved after 10 months of treatment, although the patient continues to suffer from irreversible blindness in the right eye due to optic nerve atrophy. He has been without signs or symptoms of recurrence. CONCLUSION:Patients with rhino-orbito-cerebral mucormycosis need extensive surgical and medical treatment to maximize outcomes. Success requires multidisciplinary management.

In this essay I would like to focus on “The Beast and the Sovereign”—and especially the Second Volume—as being something of an exception to Derrida’s usual hesitations about sovereignty. In other works, such as “Rogues”, Derrida displays a deep ambivalence about sovereignty insofar as for all of his condemnation of sovereign authority, he fears that what might replace it could be even worse (and, to be fair, he also sees positive aspects of sovereignty as well). In “The Beast and the Sovereign,” we find evidence of this ambivalence as well but here, Derrida comes a bit closer to the kind of position advocated by Walter Benjamin wherein sovereignty is an idolatrous practice of politics one which must not be eliminated so much as subverted. In particular, I focus on Derrida’s reading in Volume II of “Robinson Crusoe” as a text that both founds the sovereign subject and subverts it (by revealing its vulnerability, its fictional nature). In looking at how the book disappoints as much as it answers sovereign phantasms of authority and unity, I argue that Derrida transfers his own ambivalence about sovereignty to sovereignty itself, subverting and rupturing its central tenets in the process.

This is a report of the use, efficacy, and theoretic safety of negative-pressure wound therapy over ocular structures as a part of surgical treatment for necrotizing fasciitis. We treated a 65-year-old man with facial necrotizing fasciitis requiring serial debridement and closure of extensive periorbital and nasal wounds with skin grafts. Negative-pressure wound therapy was first used as a bridge to allow temporary closure and to encourage granulation tissue development. It was then used as a bolster dressing to stabilize skin grafts in the complex wound, not amenable to tie-over dressings. Excellent functional and cosmetic reconstruction of the periorbital and nasal regions was achieved. After treatment, the patient's corrected vision was 20/20. To our knowledge, the use of negative-pressure wound therapy directly over ocular structures has not been previously documented. In this case, it was safely used over the eyes with no sequelae to the patient's vision.

Cells that have been purified by FACS using intracellular markers are not amenable to gene expression analysis by conventional methods. Pechhold et al. solve this problem with the quantitative nuclease protection assay and apply the approach to study subsets of islet cells. Analyzing specialized cells in heterogeneous tissues is crucial for understanding organ function in health and disease. Thus far, however, there has been no convenient method for studying gene expression in cells purified by fluorescence-activated cell sorting (FACS) using intracellular markers. Here we show that the quantitative nuclease protection assay (qNPA) enables transcriptional analysis of intracytoplasmically stained cells sorted by FACS. Applying the method to mouse pancreatic islet–cell subsets, we detected both expected and unknown lineage-specific gene expression patterns. Some beta cells from pregnant animals were found to express Mafb, previously observed only in immature beta cells during embryonic development. The four 'housekeeping' genes tested were expressed in purified islet-cell subpopulations with a notable variability, dependent on both cell lineage and developmental stage. Application of qNPA to intracellularly stained, FACS-sorted cells should be broadly applicable to the analysis of gene expression in subpopulations of any heterogeneous tissue, including tumors.

Background Glomerular filtration decreases progressively with age in adults. Predictive equation should have proper modelling to adequately account for normal senescence. Methods Corrected 24-h creatinine clearances (CCLs) were measured in a cohort of 773 outpatients from 18 to 90 years old. Multiple linear regression was used to model the effect of age on glomerular filtration. Comparisons were made with the simplified MDRD and the MAYO equations. Impact of the derived equation was tested in a second cohort of 7551 patients with normal serum creatinine. Results While all equations show declining function with age, our results suggest that the GFR reduction is progressive after the age of 30 and continue to decline steadily after the age of 60. This leads to a convex curve in the multiple regression analysis that is best fitted by an equation including the quadratic term (age(2)). In contrast, the MDRD equation produces a faster decrease in early adulthood and a flatter curve after the age of 60 while the MAYO equation produces a more linear effect. MDRD results in the normal range are lower than those estimated by the MAYO equation. These equations, as applied on an independent cohort of 7551 normal outpatients from 18 to 102 years, produce different profile of evolution of GFR with age. Conclusions Inclusion of a quadratic term for age in the formula estimating GFR results in better modelling of the natural decline of renal function associated with ageing. Furthermore, as GFR steadily declines after the age of 30, a single cut-off value of GFR normality for all ages leads to underdiagnosis of young adults and over diagnosis of elderly individuals. Guidelines should take into account the observed reduction of kidney function with age in normal population for optimal evaluation of eGFR.

We describe the time- and position-dependent point spread function (PSF) variation of the Wide Field Channel (WFC) of the Advanced Camera for Surveys (ACS) with the principal component analysis (PCA) technique. The time-dependent change is caused by the temporal variation of the $HST$ focus whereas the position-dependent PSF variation in ACS/WFC at a given focus is mainly the result of changes in aberrations and charge diffusion across the detector, which appear as position-dependent changes in elongation of the astigmatic core and blurring of the PSF, respectively. Using >400 archival images of star cluster fields, we construct a ACS PSF library covering diverse environments of the $HST$ observations (e.g., focus values). We find that interpolation of a small number ($\sim20$) of principal components or ``eigen-PSFs'' per exposure can robustly reproduce the observed variation of the ellipticity and size of the PSF. Our primary interest in this investigation is the application of this PSF library to precision weak-lensing analyses, where accurate knowledge of the instrument's PSF is crucial. However, the high-fidelity of the model judged from the nice agreement with observed PSFs suggests that the model is potentially also useful in other applications such as crowded field stellar photometry, galaxy profile fitting, AGN studies, etc., which similarly demand a fair knowledge of the PSFs at objects' locations. Our PSF models, applicable to any WFC image rectified with the Lanczos3 kernel, are publicly available., Accepted to PASP. To appear in December issue. Figures are degraded to meet the size limit. High-resolution version can be downloaded at http://acs.pha.jhu.edu/~mkjee/acs_psf/acspsf.pdf