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Many peptide hormones form an α-helix on binding their receptors1-4, and sensitive methods for their detection could contribute to better clinical management of disease5. De novo protein design can now generate binders with high affinity and specificity to structured proteins6,7. However, the design of interactions between proteins and short peptides with helical propensity is an unmet challenge. Here we describe parametric generation and deep learning-based methods for designing proteins to address this challenge. We show that by extending RFdiffusion8 to enable binder design to flexible targets, and to refining input structure models by successive noising and denoising (partial diffusion), picomolar-affinity binders can be generated to helical peptide targets by either refining designs generated with other methods, or completely de novo starting from random noise distributions without any subsequent experimental optimization. The RFdiffusion designs enable the enrichment and subsequent detection of parathyroid hormone and glucagon by mass spectrometry, and the construction of bioluminescence-based protein biosensors. The ability to design binders to conformationally variable targets, and to optimize by partial diffusion both natural and designed proteins, should be broadly useful.

Complex II (CII) activity controls phenomena that require crosstalk between metabolism and signaling, including neurodegeneration, cancer metabolism, immune activation, and ischemia-reperfusion injury. CII activity can be regulated at the level of assembly, a process that leverages metastable assembly intermediates. The nature of these intermediates and how CII subunits transfer between metastable complexes remains unclear. In this work, we identify metastable species containing the SDHA subunit and its assembly factors, and we assign a preferred temporal sequence of appearance of these species during CII assembly. Structures of two species show that the assembly factors undergo disordered-to-ordered transitions without the appearance of significant secondary structure. The findings identify that intrinsically disordered regions are critical in regulating CII assembly, an observation that has implications for the control of assembly in other biomolecular complexes.

Syphilis is a sexually transmitted infection with manifestations that can mimic other diseases, leading to misdiagnosis. Annular syphilis is a rare atypical secondary syphilitic lesion that seldomly involves the face. Human immunodeficiency virus (HIV) coinfection can increasingly lead to atypical manifestations of syphilis and complicate the diagnosis. Herein, we describe a 29-year-old man with a diagnosis of annular secondary syphilis and HIV coinfection. He had clinical manifestations of annular erythematous papules and plaques with white scales at the edges, distributed and scattered on the face, neck, and upper back. The skin lesions went undetected on several visits and were misdiagnosed owing to similarities with other dermatoses. Serological examination showed positive Treponema pallidum particle agglutination assay and venereal disease research laboratory test titer 1/512, confirming syphilis infection. Results from the histopathological examination supported the diagnosis of secondary syphilis. Positive anti-HIV rapid test results indicated concurrent HIV infection. He was treated for syphilis and given antiretroviral therapy, and showed a good response as demonstrated by improvement of the lesions and serological titers. This case highlights the importance of recognizing the possibility of annular secondary syphilis and HIV coinfection which can have atypical manifestations.

BackgroundGiven the waning of vaccine effectiveness and the shifting of the most dominant strains in the U.S., it is imperative to understand the association between vaccination coverage and Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) disease and mortality at the community levels and whether that association might vary according to the dominant SARS-CoV-2 strains in the U.S.MethodsGeneralized estimating equations were used to estimate associations between U.S. county-level cumulative vaccination rates and booster distribution and the daily change in county-wide Coronavirus 2019 disease (COVID-19) risks and mortality during Alpha, Delta and Omicron predominance. Models were adjusted for potential confounders at both county and state level. A 2-week lag and a 4-week lag were introduced to assess vaccination rate impact on incidence and mortality, respectively.ResultsAmong 3,073 counties in 48 states, the average county population complete vaccination rate of all age groups was 50.79% as of March 11th, 2022. Each percentage increase in vaccination rates was associated with reduction of 4% (relative risk (RR) 0.9607 (95% confidence interval (CI): 0.9553, 0.9661)) and 3% (RR 0.9694 (95% CI: 0.9653, 0.9736)) in county-wide COVID-19 cases and mortality, respectively, when Alpha was the dominant variant. The associations between county-level vaccine rates and COVID-19 incidence diminished during the Delta and Omicron predominance. However, each percent increase in people receiving a booster shot was associated with reduction of 6% (RR 0.9356 (95% CI: 0.9235, 0.9479)) and 4% (RR 0.9595 (95% CI: 0.9431, 0.9761)) in COVID-19 incidence and mortality in the community, respectively, during the Omicron predominance.ConclusionsAssociations between complete vaccination rates and COVID-19 incidence and mortality appeared to vary with shifts in the dominant variant, perhaps due to variations in vaccine efficacy by variant or to waning vaccine immunity over time. Vaccine boosters were associated with notable protection against Omicron disease and mortality.

The states of Oregon and Connecticut and the District of Columbia in the USA mandate the teaching of menstrual education which means the teachers of students with disabilities are expected to be familiar with the topics of hygiene, self-care, and independent living skills in relation to menstrual health needs. Special education teachers may need to attend to pre-menstrual symptoms, collect data on challenging behaviour, and ensure their students have access to period products. Teachers can consult with parents about teaching these skills at home to ensure generalisation of skills across contexts, and to build strong communication between school and home. Teachers should also familiarise themselves with local resources for menstrual supplies and instructional materials for both students and parents. Teaching skills in relation to menstrual health is critical for increasing independence, maintaining individual dignity, and fostering a menstrual experience free of stigma and shame. [ABSTRACT FROM AUTHOR]

Viewing teacher vulnerability as a pedagogical tool, this comparative case study examined two secondary literacy teachers' use of vulnerability in relation to various instructional goals. Through the analysis of eight video‐recorded lessons, we found that teachers demonstrated vulnerability through multiple ways within their literacy instruction through modeling ways of connecting personal experiences to texts, and establishing classroom norms that welcome difficult emotions and experiences. However, we also found that teacher vulnerability can sometimes lead to uncertainty, and even constrain student participation. We argue that teacher vulnerability helps establish a humanizing pedagogy, and offer possible strategies for teachers who are vulnerable within literacy instruction. We conclude with a discussion of different levels of appropriating vulnerability as a pedagogical tool. [ABSTRACT FROM AUTHOR]

Objective: To identify the risk factors of postoperative severe hyperkalemia after total parathyroidectomy (TPTX) without auto-transplantation in patients with secondary hyperparathyroidism (SHPT). Methods: Data on 406 consecutive patients who underwent TPTX without auto-transplantation for secondary hyperparathyroidism at the General Hospital of Northern Theater Command between January 2013 and January 2023, were prospectively collected. Then, patients were divided into the training set (n=203) and the validation set (n=203) in a ratio of 1:1 by timeline. The patients were divided into severe hyperkalemia group and non-hyperkalemia group according to the postoperative serum kalium level >6.0 mmol/L with ECG changes or serum kalium level ≥6.5 mmol/L. Univariate and multivariate logistic regression analyses were used to evaluate the possible risk factors associated with postoperative severe hyperkalemia after TPTX. The predictive performance was evaluated with receiver operating characteristic (ROC) curves with the areas under the ROC curve (AUC) and calibration curve. Decision curve and clinical impact curve analyses were used to validate the clinical application of the value. Results: The incidence of postoperative severe hyperkalemia was 15.5% in all patients, 17.2% and 13.8% in the training and validation cohorts, respectively. The risk factors associated with postoperative severe hyperkalemia was higher preoperative kalium level. The optimal cut-off value for preoperative serum kalium level was 5.0mmol/L according to the ROC curve. The area under the curve (AUC) achieved good concordance indexes of 0.845 (95%CI, 0.776-0.914) in the training cohort. The sensitivities were 0.829 (95%CI: 0.663-0.934) and 0.857 (95%CI: 0.673-0.960) in the training and validation cohorts, respectively. The specificities were 0.798 (95%CI: 0.729-0.856) and 0.720 (95%CI:0.647-0.785) in the training and validation cohorts, respectively. Calibration curve exhibited a good consistency between actual observations and predicted severe hyperkalemia in the training and validation cohorts. Conclusions: Our study found that the preoperative kalium levels is only a risk factor for postoperative severe hyperkalemia in patients undergoing TPTX for secondary hyperparathyroidism. The threshold for preoperative serum kalium levels is 5.0mmol/L that can serve as a useful indicator for identifying patients with severe hyperkalemia after surgery. These results provide valuable suggestion for clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare demographics, clinical characteristics, and post-surgical outcomes between idiopathic and secondary full-thickness macular holes (MHs). Methods: A retrospective analysis of 348 eyes from 339 patients treated between June 2017 and December 2023 was conducted. The study included both idiopathic and secondary MHs, excluding cases where surgery was not performed or lacked sufficient follow-up. Demographic data, visual acuity (VA), ocular characteristics, and optical coherence tomography measurements were analyzed. Results: Idiopathic MHs were identified in 308 eyes (89%), and secondary MHs in 40 eyes (11%). Idiopathic MH patients were older (mean age: 68.26 vs. 60.13 years; p = 0.001) and more commonly female (63% vs. 40%; p = 0.005). Post-surgical closure was achieved in 86% of all MHs, with a median VA improvement of 15 ETDRS letters (3 Snellen lines). However, secondary MHs had a lower closure rate (67% vs. 89%, p = 0.001) and less VA improvement (2 lines vs. 3 lines, p = 0.001) compared to idiopathic MHs. Significant differences in maximal basal diameter and diameter hole index were noted between the groups. Conclusions: Secondary MHs, accounting for 11% of surgical cases, show poorer anatomical and visual outcomes than idiopathic MHs. Despite lower success rates, early surgical intervention in secondary MHs is recommended to enhance outcomes. Differentiating between idiopathic and secondary MHs is crucial for optimal management. [ABSTRACT FROM AUTHOR]

Background: Secondary schools are important settings for promoting varied physical activity (PA) opportunities for adolescents to promote PA throughout life. However, research on the effect of secondary school-based interventions on future PA is limited. This study examined the potential impact of secondary school-based interventions on the determinants of future PA participation of Aotearoa New Zealand (NZ) adolescents using simulated modelling. Methods: We used data from a nationally representative sample of secondary school students (n = 5035) aged 12–17 between 2017 and 2020 in NZ. We modelled four secondary school-based interventions and their projected impact on five determinants of future PA. Modelled interventions were the technological augmentation of physical education (TAPE), a peer-led PA mentoring programme (PL), physically active learning (PAL) and the inclusion of a natural environment play area (NE). Results: Total weekly PA increased the most from the NE intervention (+ 0.2 h/week), followed by TAPE (+ 0.08 h/week), PAL (+ 0.05 h/week) and PL (-0.06 h/week). Current number of PA settings increased the most in NE (+ 1.75 settings/week), followed by TAPE (+ 1.29 settings/week), PAL (+ 1.21 settings/week) and PL (+ 0.73 settings/week). Current number of PA types increased the most in NE (+ 1.57 types/week), followed by PL (+ 1.05 types/week), TAPE (+ 0.34 types/week) and PAL (+ 0.15 types/week). Physical literacy scores increased the most from PL (+ 3.6%), followed by PAL (+ 3.3%), TAPE (+ 0.43%) and NE (+ 0.12%). Social support scores increased the most from PAL (+ 5%), followed by PL (+ 1.9%), TAPE (+ 1.46%) and NE (+ 0.57%). Conclusions: On average, all interventions benefitted determinants of future PA participation to a small degree. Results show differing magnitudes of the intervention effect by determinant, indicating the complexities surrounding the promotion of PA adherence. Future interventions could be improved through detailed consultation alongside, and involving, adolescents and stakeholders within schools. Researchers should also prioritise the collection of longitudinal PA data and explore its connection with sociodemographic differences between adolescents. [ABSTRACT FROM AUTHOR]

This study aims to determine the motivation of indigenous students in learning Filipino in public schools. There were 10 participants in this study from Francisco Bangoy High School. After the questionnaire was prepared, interviews were conducted and the responses of the participants were analyzed. The design used in the study was quantitative research. In connection with this, data analysis using the Collaizi method and qualitative phenomenological research were employed by the researcher to describe the lived experiences of a person in an event. The participants in the study were selected indigenous students in public schools. Additionally, the result of the study was to find out the motivation of indigenous students in their studies. Conducting further research about the motivation of indigenous students is recommended to ensure their needs are met. And, to identify the obstacles affecting the learning of Filipino by indigenous students. The study recommended that attention should be given to research concerning the motivation of indigenous students to change the public's perception of indigenous students. [ABSTRACT FROM AUTHOR]

Purpose: Risk factors (RFs), like 'body mass index (BMI),' 'age,' and 'gender' correlate with Diabetic Retinopathy (DR) diagnosis and have been widely studied. This study examines how these three secondary RFs independently affect the predictive capacity of primary RFs. Methods: The dataset consisted of four population-based studies on the prevalence of DR and associated RFs in India between 2001 and 2010. An Autoencoder was employed to categorize RFs as primary or secondary. This study evaluated six primary RFs coupled independently with each secondary RF on five machine-learning models. Results: The secondary RF 'gender' gave a maximum increase in Area under the curve (AUC) score to predict DR when combined separately with 'insulin treatment,' 'fasting plasma glucose,' 'hypertension history,' and 'glycosylated hemoglobin' with a maximum increase in AUC for the Naive Bayes model from 0.573 to 0.646, for the Support Vector Machines (SVM) model from 0.644 to 0.691, for the SVM model from 0.487 to 0.607, and for the Decision Tree model from 0.8 to 0.848, respectively. The secondary RFs 'age' and 'BMI' gave a maximum increase in AUC score to predict DR when combined separately with 'diabetes mellitus duration' and 'systolic blood pressure,' with a maximum increase in AUC for the SVM model from 0.389 to 0.621, and for the Decision Tree model from 0.617 to 0.713, respectively. Conclusion: The risk factor 'gender' was the best secondary RF in predicting DR compared to 'age' and 'BMI,' increasing the predictive power of four primary RFs. [ABSTRACT FROM AUTHOR]

We consider two multiplicative statistics on the set of integer partitions: the norm of a partition, which is the product of its parts, and the supernorm of a partition, which is the product of the prime numbers p i indexed by its parts i. We introduce and study new statistics that are sums of reciprocals of supernorms on three statistical ensembles of partitions, labelled by their size | λ | = n , their perimeter equaling n, and their largest part equaling n. We show that the cumulative statistics of the reciprocal supernorm for each of the three ensembles are asymptotic to e γ log n as n → ∞ . [ABSTRACT FROM AUTHOR]

Focal imaging abnormalities in patients with parkinsonism suggest secondary etiology and require a distinctive clinical approach to diagnosis and treatment. We review different entities presenting as secondary parkinsonism associated with structural brain lesions, with emphasis on the clinical course and neuroimaging findings. Secondary parkinsonism may be due to vascular causes, hydrocephalus, space-occupying lesions, metabolic causes (including acquired hepatocerebral degeneration, diabetic uremic encephalopathy, basal ganglia calcifications, osmotic demyelination syndrome), hypoxic-ischaemic brain injury, intoxications (including methanol, carbon monoxide, cyanide, carbon disulfide, manganese poisoning and illicit drugs), infections and immune causes. The onset can vary from acute to chronic. Both uni-and bilateral presentations are possible. Rigidity, bradykinesia and gait abnormalities are more common than rest tremor. Coexisting other movement disorders and additional associated neurological signs may point to the underlying diagnosis. Neuroimaging studies are an essential part in the diagnostic work-up of secondary parkinsonism and may point directly to the underlying etiology. We focus primarily on magnetic resonance imaging to illustrate how structural imaging combined with neurological assessment can lead to diagnosis. It is crucial that typical imaging abnormalities are recognized within the relevant clinical context. Many forms of secondary parkinsonism are reversible with elimination of the specific cause, while some may benefit from symptomatic treatment. This heterogeneous group of acquired disorders has also helped shape our knowledge of Parkinson's disease and basal ganglia pathophysiology, while more recent findings in the field garner support for the network perspective on brain function and neurological disorders. [ABSTRACT FROM AUTHOR]

Although COVID-19 infection is an immunosuppressant disease, many immunosuppressant agents, such as pulse methylprednisolone (PMP), dexamethasone (DXM), and tocilizumab (TCZ), were used during the pandemic. Secondary infections in patients with COVID-19 have been reported recently. This study investigated these agents' effects on secondary infections and outcomes in patients with COVID-19 in intensive care units (ICUs). This study was designed retrospectively, and all data were collected from the tertiary intensive care units of six hospitals between March 2020 and October 2021. All patients were divided into three groups: Group I [GI, PMP (−), DXM (−) and TCZ (−)], Group II [GII, PMP (+), DXM (+)], and Group III [GIII, PMP (+), DXM (+), TCZ (+)]. Demographic data, PaO/FiO2 ratio, laboratory parameters, culture results, and outcomes were recorded. To compare GI-GII and GI-GIII, propensity score matching (PSM) was used by matching 14 parameters. Four hundred twelve patients with COVID-19 in the ICU were included in the study. The number of patients with microorganisms ≥ 2 was 279 (67.7%). After PSM, in GII and GIII, the number of (+) tracheal cultures and (+) bloodstream cultures detected different microorganisms ≥ 2 during the ICU period, neuropathy, tracheotomized patients, duration of IMV, and length of ICU stay were significantly higher than GI. The mortality rate was similar in GI and GII, whereas it was significantly higher in GIII than in GI. The use of immunosuppressant agents in COVID-19 patients may lead to an increase in secondary infections. In addition, increased secondary infections may lead to prolonged ICU stay, prolonged IMV duration, and increased mortality. [ABSTRACT FROM AUTHOR]

Let Y (+) be a group, D ⊆ ℤ2 where ℤ(+, ⩽) denotes the ordered group of all integers, and ℤ2 := ℤ×ℤ. We shall use the notations Dx := {u ∈ ℤ | ∃v ∈ X : (u, v) ∈ D}, Dy := {v ∈ ℤ | ∃u ∈ ℤ : (u, v) ∈ D}, Dx+y := {z ∈ ℤ | ∃(u, v) ∈ D : z = u + v}. The main purpose of the article is to find sets D ⊆ ℤ2 that the general solution of the functional equation f (x+y) = g(x)+h(y) for all (x, y) ∈ D with unknown functions f : Dx+y → Y, g : Dx → Y, h : Dy → Y is in the form of f (u) = a(u) + C1 + C2 for all u ∈ Dx+y, g(v) = a(v) + C1 for all v ∈ Dx, h(z) = a(z) + C2 for all z ∈ Dy where a : ℤ → Y is an additive function, C1, C2 ∈ Y are constants.

Abstract Purpose This study aimed to compare demographics, clinical characteristics, and post-surgical outcomes between idiopathic and secondary full-thickness macular holes (MHs). Methods A retrospective analysis of 348 eyes from 339 patients treated between June 2017 and December 2023 was conducted. The study included both idiopathic and secondary MHs, excluding cases where surgery was not performed or lacked sufficient follow-up. Demographic data, visual acuity (VA), ocular characteristics, and optical coherence tomography measurements were analyzed. Results Idiopathic MHs were identified in 308 eyes (89%), and secondary MHs in 40 eyes (11%). Idiopathic MH patients were older (mean age: 68.26 vs. 60.13 years; p = 0.001) and more commonly female (63% vs. 40%; p = 0.005). Post-surgical closure was achieved in 86% of all MHs, with a median VA improvement of 15 ETDRS letters (3 Snellen lines). However, secondary MHs had a lower closure rate (67% vs. 89%, p = 0.001) and less VA improvement (2 lines vs. 3 lines, p = 0.001) compared to idiopathic MHs. Significant differences in maximal basal diameter and diameter hole index were noted between the groups. Conclusions Secondary MHs, accounting for 11% of surgical cases, show poorer anatomical and visual outcomes than idiopathic MHs. Despite lower success rates, early surgical intervention in secondary MHs is recommended to enhance outcomes. Differentiating between idiopathic and secondary MHs is crucial for optimal management.

Abstract Background Secondary schools are important settings for promoting varied physical activity (PA) opportunities for adolescents to promote PA throughout life. However, research on the effect of secondary school-based interventions on future PA is limited. This study examined the potential impact of secondary school-based interventions on the determinants of future PA participation of Aotearoa New Zealand (NZ) adolescents using simulated modelling. Methods We used data from a nationally representative sample of secondary school students (n = 5035) aged 12–17 between 2017 and 2020 in NZ. We modelled four secondary school-based interventions and their projected impact on five determinants of future PA. Modelled interventions were the technological augmentation of physical education (TAPE), a peer-led PA mentoring programme (PL), physically active learning (PAL) and the inclusion of a natural environment play area (NE). Results Total weekly PA increased the most from the NE intervention (+ 0.2 h/week), followed by TAPE (+ 0.08 h/week), PAL (+ 0.05 h/week) and PL (-0.06 h/week). Current number of PA settings increased the most in NE (+ 1.75 settings/week), followed by TAPE (+ 1.29 settings/week), PAL (+ 1.21 settings/week) and PL (+ 0.73 settings/week). Current number of PA types increased the most in NE (+ 1.57 types/week), followed by PL (+ 1.05 types/week), TAPE (+ 0.34 types/week) and PAL (+ 0.15 types/week). Physical literacy scores increased the most from PL (+ 3.6%), followed by PAL (+ 3.3%), TAPE (+ 0.43%) and NE (+ 0.12%). Social support scores increased the most from PAL (+ 5%), followed by PL (+ 1.9%), TAPE (+ 1.46%) and NE (+ 0.57%). Conclusions On average, all interventions benefitted determinants of future PA participation to a small degree. Results show differing magnitudes of the intervention effect by determinant, indicating the complexities surrounding the promotion of PA adherence. Future interventions could be improved through detailed consultation alongside, and involving, adolescents and stakeholders within schools. Researchers should also prioritise the collection of longitudinal PA data and explore its connection with sociodemographic differences between adolescents.

Targeted intracellular delivery via receptor-mediated endocytosis requires the delivered cargo to escape the endosome to prevent lysosomal degradation. This can in principle be achieved by membrane lysis tightly restricted to endosomal membranes upon internalization to avoid general membrane insertion and lysis. Here, we describe the design of small monomeric proteins with buried histidine containing pH-responsive hydrogen bond networks and membrane permeating amphipathic helices. Of the 30 designs that were experimentally tested, all expressed in Escherichia coli, 13 were monomeric with the expected secondary structure, and 4 designs disrupted artificial liposomes in a pH-dependent manner. Mutational analysis showed that the buried histidine hydrogen bond networks mediate pH-responsiveness and control lysis of model membranes within a very narrow range of pH (6.0-5.5) with almost no lysis occurring at neutral pH. These tightly controlled lytic monomers could help mediate endosomal escape in designed targeted delivery platforms.

Purpose: This study aims to compare the outcomes of suture-less and multiple suture closure methods on postoperative pain, swelling, and trismus, and associated complications. Materials and methods: This prospective, randomized clinical trial was conducted at the Department of Oral & Maxillofacial Surgery, Goa Dental College & Hospital. Inclusion criteria encompassed subjects aged between 17 and 55 years, classified as American Society of Anaesthesiologists (ASA) I, with asymptomatic impacted third molars falling within the moderately difficult impaction range (Pederson's difficulty index: 5–7). Study excluded individuals classified as ASA II, III, or IV, those with known or suspected allergies to the anaesthetic solution, immunocompromised patients, and individuals taking medications that could affect healing. Pregnant or lactating females and those with a history of bleeding disorders were also excluded. Wound closure methods were compared: Group A underwent primary closure with silk sutures, while Group B had suture-less closure. Subjects were allocated to the specific groups using a simple randomization method. This involved using a lottery-based random sequence to assign each participant to either Group A or Group B. Pain intensity, facial swelling, and trismus were key outcomes. Secondary outcomes included lingual nerve sensation and postoperative complications. Demographics factors, surgical details, radiographic and perioperative data, and physiological parameters were considered. Non-parametric tests and parametric test (repeated measure ANOVA) were employed. Statistical significance was set at P < 0.05. Results: Among 101 participants, both closure techniques exhibited similar outcomes in pain, swelling, and lingual nerve function. However, suture-less closure resulted in significantly less trismus and fewer cases of delayed wound healing. Conclusions: Suture-less method after surgical removal of third molar may reduce trismus compared to multiple sutures. While pain, swelling, and lingual nerve function management were comparable. [ABSTRACT FROM AUTHOR]

Assistive technology (AT) is a critical in providing students with visual impairments (VI) access to classroom information. However, little is known about how the fluid and diverse experiences across core-content classrooms that impact the nature of AT use among students with VI. We conducted three classroom observations of 10 secondary-age (i.e., 6th through 12th grade) students with VI in core-content classrooms (i.e., math, English, social studies, or science). Wide variations in AT use suggest that AT needs are individualized. Additionally, writing tasks, reading tasks, and independent instructional groupings were associated with the highest rates of AT usage. However, students receive little support for using their AT in classrooms. We offer implications and recommendations for research and practice aimed at increasing AT use in core-content classrooms. [ABSTRACT FROM AUTHOR]

Disability-inclusive laws and policies – while not sufficient on their own to advance substantive equality – are an essential step that all countries can take to advance non-discrimination and equity in education for children and youth with disabilities. This is the first study to comprehensively review national law and policy guarantees in 193 countries to assess the extent to which countries have harmonized national laws and policies with international commitments to inclusive education articulated in the Convention on the Rights of Persons with Disabilities and the Sustainable Development Goals. While strong guarantees exist across diverse countries, we find that notable gaps remain. Forty-six percent of countries do not broadly prohibit disability-based discrimination through the completion of secondary education. Legislation in 35% of countries does not guarantee persons with disabilities access to integrated education in mainstream education environments along with necessary individualized accommodations through the completion of secondary school. Thirty-one percent of countries that make primary education compulsory do not pair compulsory education with guarantees to integration in mainstream education environments and individualized supports for students with disabilities. These findings can inform reforms in countries without national guarantees and bolster support for implementation in countries where strong legal guarantees to inclusive education already exist. [ABSTRACT FROM AUTHOR]

This analysis explores a literacy teacher's changing perspective about teaching in a prestigious high school after learning about ahimsa, or holistic nonviolence. Drawing from theories of transformational learning and critical pedagogy in addition to understandings of ahimsa, this article presents some of the participant's new perceptions about her teaching and about the culture of the elite high school where she worked, including perceptions of structural violence. New understandings suggest that in order for schools to be nonviolent spaces, structural violences need to be considered alongside more overtly visible forms of violence. There are also implications for teacher learning. When professional development supports transformational change, it can be both inspirational and unnerving, and might shift participants' perspectives and unsettle their ways of relating to established practices and familiar contexts. [ABSTRACT FROM AUTHOR]

This study explored and demonstrated the significant association between teachers' creative self-concepts, namely creative role identity and creative self-efficacy, and teaching for creativity. Multigroup structural equation modeling was used with data from 1,043 primary and secondary teachers. The results confirmed that teachers' creative role identity consisted of their self-view of creative behavior and perceived expectations from school, colleagues, and students. Both personal and contextual aspects of creative role identity were significantly related to teaching for creativity, and school expectations were the most closely associated. The findings showed that secondary teachers had a higher level of creative self-efficacy and performed more creativity-fostering behavior than primary teachers. Some of the personal and contextual antecedents were more balanced for secondary teachers than they were for primary teachers, which contributed to their creative self-efficacy. [ABSTRACT FROM AUTHOR]

Under the best circumstances, achieving or sustaining optimum ecological conditions in estuaries is challenging. Persistent information gaps in estuarine data make it difficult to differentiate natural variability from potential regime shifts. Long-term monitoring is critical for tracking ecological change over time. In the United States (US), many resource management programs are working at maximum capacity to address existing state and federal water quality mandates (e.g., pollutant load limits, climate impact mitigation, and fisheries management) and have little room to expand routine sampling efforts to conduct periodic ecological baseline assessments, especially at state and local scales. Alternative design, monitoring, and assessment approaches are needed to help offset the burden of addressing additional data needs to increase understanding about estuarine system resilience when existing monitoring data are sparse or spatially limited. Research presented here offers a pseudo-probabilistic approach that allows for the use of found or secondary data, such as data on hand and other acquired data, to generate statistically robust characterizations of ecological conditions in estuaries. Our approach uses a generalized pseudo-probabilistic framework to synthesize data from different contributors to inform probabilistic-like baseline assessments. The methodology relies on simple geospatial techniques and existing tools (R package functions) developed for the US Environmental Protection Agency to support ecological monitoring and assessment programs like the National Coastal Condition Assessment. Using secondary estuarine water quality data collected in the Northwest Florida (US) estuaries, demonstrations suggest that the pseudo-probabilistic approach produces estuarine condition assessment results with reasonable statistical confidence, improved spatial representativeness, and value-added information. While the pseudo-probabilistic framework is not a substitute for fully evolved monitoring, it offers a scalable alternative to bridge the gap between limitations in resource management capability and optimal monitoring strategies to track ecological baselines in estuaries over time. [ABSTRACT FROM AUTHOR]

Replications provide credibility by demonstrating under what conditions experimental findings can be repeated, the premise behind evidence-based practices. Replications in single-case research also investigate generalization of findings across groups. For groups with high variability, such as individuals with autism, assumptions of generalizability should be based on learners who are similar in critical ways. The purpose of this study was to use Coyne et al.'s framework for replication and the next generation guidelines for single-case research to extend understanding of "for whom" and "under what conditions" modified schema-based instruction (an established evidence-based practice for individuals with autism) is effective. In this distal conceptual replication of Root et al., contextual and instructional variables of theoretical and practical importance were intentionally manipulated or maintained and reported to model transparency and support replicability. Four high school students receiving special education under the Individuals With Disabilities Education Act category of autism were taught mathematical and social problem-solving behaviors within the context of percentage-of-change word problems. Researchers used modified schema-based instruction and augmented reality in a one-on-one setting and assessed generalization to purchasing in the food court of a mall biweekly. We frame our discussion around the recommendations for replication research from Coyne et al. and recommendations for single-case research from Ledford et al., concluding with suggestions for future replications that use single-case research designs. [ABSTRACT FROM AUTHOR]

This STEM research project asks middle school or high school students to work towards creating ecologically friendly packaging. Packaging that can be composted instead of thrown away and collected in landfills and oceans like plastics. This inquiry uses nanocellulose and focuses on water permeability. The fibers of nanocellulose can be dried to make a rather strong and thin film, but due to the spaces between the fibers the film is too water permeable and therefore makes poor packaging materials on its own. Students will create nanocellulose composite films with other biodegradable materials, in an attempt to fill the inter-fiber microscopic spaces and create a new film that can be easily tested for water permeability. Students set up a straightforward science experiment with films, water, and mason jars. They will collect and graph data to determine if their nanocellulose composite films reduce water permeability compared to plain nanocellulose and how close they are to the present standard, plastic. This research is an amalgam of disciplinary core ideas like properties and states of matter, as well as a combination of science and engineering practices. It ignites students' curiosity, provides an organic path to science fair extensions, while also helping to cultivate future scientists, engineers, and environmental activists. [ABSTRACT FROM AUTHOR]

Despite the value of reading, research documents declining reading rates among American adolescents – a decline that exacerbates student dropout rates and academic performance. As a high school English teacher in a public, regional, suburban school, increasing the number of students who deeply read the assigned texts for class has been a career-long focus. Therefore, one of my goals for the 2021–2022 school year was to promote better reading practices among my students using a note-per-pages assignment and to reflect on the results via a teacher research study design. Findings indicate that while certainly not a fail-proof assignment without its flaws, the note-per-pages assignment as the focus of this action research did increase the overall number of students reading the assigned texts and that more students reported feeling the assignment was helpful to their reading practices as the school year progressed. Implications regarding student engagement in and ownership of the reading process, class reading culture, and involving students in the action research process are included. [ABSTRACT FROM AUTHOR]

Background: Little is known about the frequency and impact of the persistent headache and about the incidence of chronic daily headache (CDH) after coronavirus disease 2019 (COVID-19). The aim of this prospective cohort study was to assess the incidence, risk factors, characteristics, and impact of CDH in patients with COVID-19. Methods: In the first stage, 288 patients were interviewed by telephone after the acute phase of COVID-19. Subsequently, 199 patients who presented headache were reinterviewed at least one year after COVID-19. Headaches that persisted beyond the acute phase of COVID-19 for three or more months and presented frequency ≥ 45 days over the first three months were considered to be CDH. Results: One hundred and twenty-three patients were included, 56% were females; median age: 50 years (25th and 75th percentile: 41;58). The headache persisted beyond the acute phase of COVID-19 in 52%, and 20.3% had CDH (95% confidence interval: 13.6--28.2). Individuals who previously had headaches and who had headaches of greater intensity during the acute phase were at higher risk of developing CDH. The group with CDH included more females, greater impact of headache, more persistence of headache beyond the 120th day of COVID-19 and less throbbing headache than did the other individuals whose headache persisted. Conclusions: Patients who had COVID-19 had a high incidence of CDH. Previous headache and greater intensity of headache were associated with higher risk of CDH. [ABSTRACT FROM AUTHOR]

Myeloproliferative neoplasms are clonal hematopoietic stem cell disorders showing proliferation of one or more myeloid lineages. These disorders are characterized by Janus Kinase 2 (JAK2 V617F), Myeloproliferative leukemia (MPL), and Calreticulin (CALR) gene mutations and are seen more commonly in the elderly. These pathognomonic mutations are often absent in children and hence pose a diagnostic challenge. The entire onus of correct diagnosis relies heavily on detailed clinical and laboratory investigations. In the present work, we discuss 4 cases of pediatric myelofibrosis, three of which were secondary to hematolymphoid malignancies, while the remaining one had primary myelofibrosis. Pediatric primary myelofibrosis is a rare entity in children and quite different from adult primary myelofibrosis. The cases in our study show transformation into acute myeloid leukemia, which is associated with an adverse prognosis. Given the rarity of myelofibrosis in children, early and correct diagnosis helps in timely initiation of treatment, which may favorably alter the prognosis. [ABSTRACT FROM AUTHOR]

Copyright of Agri: Journal of the Turkish Society of Algology / Türk Algoloji (Ağrı) Derneği'nin Yayın Organıdır is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Anxiety in learning foreign languages is a global phenomenon that impacts students' academic performance, with English being a critical language in secondary education. The Foreign Language Classroom Anxiety Scale (FLCAS) has been widely used to assess this anxiety. However, the need to validate and adapt the scale for specific cultural contexts remains a priority in educational research. Objective: To assess the validity and reliability of a Spanish version of the FLCAS among a sample of Peruvian secondary education students, in order to better understand the structure of language learning anxiety in this context. Methods: A total of 818 students from four public educational institutions in southern Peru participated. An instrumental design was used, which included descriptive analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of convergent, divergent validity, and measurement invariance by gender. Results: The EFA recommended a four-factor model that explained 32% of the total variance. Subsequent CFA adjusted this model to 24 items with optimal fit indices (CFI = 0.969; RMSEA = 0.045). The reliability of the factors was acceptable (α > 0.70 for all factors). Convergent and divergent validity was confirmed through significant correlations with related constructs (Fear of Negative Evaluation and Enjoyment of Foreign Language). Gender invariance analysis indicated that the scale is equally applicable to men and women. Conclusion: The Spanish version of the FLCAS is a valid and reliable tool for assessing foreign language classroom anxiety among Peruvian secondary education students. This study contributes to the field of language teaching by providing evidence of the cultural applicability of the FLCAS in the Peruvian context, thus facilitating more effective pedagogical interventions to address language learning anxiety. [ABSTRACT FROM AUTHOR]

Parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23) each play a central role in the pathogenesis of chronic kidney disease (CKD)-mineral and bone disorder. Levels of both hormones increase progressively in advanced CKD and can lead to damage in multiple organs. Secondary hyperparathyroidism (SHPT), characterized by parathyroid hyperplasia with increased PTH secretion, is associated with fractures and mortality. Emerging evidence suggests that these associations may be partially explained by PTH-induced browning of adipose tissue and increased energy expenditure. Observational studies suggest a survival benefit of PTHlowering therapy, and a recent study comparing parathyroidectomy and calcimimetics further suggests the importance of intensive PTH control. The mechanisms underlying the regulation of FGF23 secretion by osteocytes in response to phosphate load have been unclear, but recent experimental studies have identified glycerol-3-phosphate, a byproduct of glycolysis released by the kidney, as a key regulator of FGF23 production. Elevated FGF23 levels have been shown to be associated with mortality, and experimental data suggest off-target adverse effects of FGF23. However, the causal role of FGF23 in adverse outcomes in CKD patients remains to be established. Further studies are needed to determine whether intensive SHPT control improves clinical outcomes and whether treatment targeting FGF23 can improve patient outcomes. [ABSTRACT FROM AUTHOR]

We conducted a systematic review of research involving K-12 students that examined associations among individual differences factors (e.g., working memory) and intertextual integration. We identified 25 studies published in 23 peer-reviewed journal articles and two dissertations/theses. These examined a wide range of individual difference factors, which we organized into four categories: (a) language and literacy, (b) cognition and metacognition, (c) knowledge and beliefs, and (d) motivation, emotion, and personality. We found large variation in the participants, tasks, and document types, and little systematic replication across studies. Nonetheless, results generally showed that variation in literacy, cognition, metacognition, knowledge, beliefs, and motivation are positively and moderately associated with intertextual integration. We discuss the limitations of this work and offer four recommendations for future research. [ABSTRACT FROM AUTHOR]

Mosquitoes transmit numerous infectious diseases to humans, such as dengue, malaria, and yellow fever. The lack of effective medicines and vaccines against these diseases necessitates the development of alternate strategies to impede their transmission. Mosquito control is a crucial approach in this direction. Phenoloxidases (POs), which catalyze sclerotization, melanization, maturation of the exoskeleton, and wound healing, play key roles in physiology, immunity, and mosquito development. POs regulate these processes in multiple steps; therefore, they might be considered potent targets for controlling mosquito populations at different stages. The present review discusses the importance of PO inhibitors, especially the natural metabolites from microbes and plants that invariably control mosquito populations. [ABSTRACT FROM AUTHOR]

Focal imaging abnormalities in patients with parkinsonism suggest secondary etiology and require a distinctive clinical approach to diagnosis and treatment. We review different entities presenting as secondary parkinsonism associated with structural brain lesions, with emphasis on the clinical course and neuroimaging findings. Secondary parkinsonism may be due to vascular causes, hydrocephalus, space-occupying lesions, metabolic causes (including acquired hepatocerebral degeneration, diabetic uremic encephalopathy, basal ganglia calcifications, osmotic demyelination syndrome), hypoxic-ischaemic brain injury, intoxications (including methanol, carbon monoxide, cyanide, carbon disulfide, manganese poisoning and illicit drugs), infections and immune causes. The onset can vary from acute to chronic. Both uni-and bilateral presentations are possible. Rigidity, bradykinesia and gait abnormalities are more common than rest tremor. Coexisting other movement disorders and additional associated neurological signs may point to the underlying diagnosis. Neuroimaging studies are an essential part in the diagnostic work-up of secondary parkinsonism and may point directly to the underlying etiology. We focus primarily on magnetic resonance imaging to illustrate how structural imaging combined with neurological assessment can lead to diagnosis. It is crucial that typical imaging abnormalities are recognized within the relevant clinical context. Many forms of secondary parkinsonism are reversible with elimination of the specific cause, while some may benefit from symptomatic treatment. This heterogeneous group of acquired disorders has also helped shape our knowledge of Parkinson’s disease and basal ganglia pathophysiology, while more recent findings in the field garner support for the network perspective on brain function and neurological disorders.

RATIONALE & OBJECTIVE: Posttransplant hyperparathyroidism is common, and treatment practices are poorly characterized. The goal of this study was to examine the incidence, associations, and outcomes of posttransplant parathyroidectomy and calcimimetic use in a cohort of Medicare-insured US kidney transplant recipients. STUDY DESIGN: Retrospective observational cohort study. SETTING & PARTICIPANTS: We used the US Renal Data System to extract demographic, clinical, and prescription data from Medicare Parts A, B, and D-insured patients who received their first kidney transplant in 2007-2013. We excluded patients with pretransplant parathyroidectomy. PREDICTORS: Calendar year of transplantation and pretransplant patient characteristics. OUTCOME: (1) Incidence of and secular trends in parathyroidectomy and cinacalcet use in the 3 years after transplant; (2) 90-day outcomes after posttransplant parathyroidectomy and cinacalcet initiation. ANALYTICAL APPROACH: Temporal trends and pretransplant correlates of parathyroidectomy and cinacalcet use were assessed using proportional hazards models and multivariable Poisson regression, respectively. RESULTS: The inclusion criteria were met by 30,127 patients, of whom 10,707 used cinacalcet before transplant, 551 underwent posttransplant parathyroidectomy, and 5,413 filled≥1 prescription for cinacalcet. The rate of posttransplant parathyroidectomy was stable over time. By contrast, cinacalcet use increased during the period studied. Long dialysis vintage and pretransplant cinacalcet use were strongly associated with posttransplant parathyroidectomy and cinacalcet use. Roughly 1 in 4 patients were hospitalized within 90 days of posttransplant parathyroidectomy, with hypocalcemia-related diagnoses being the most common complication. Parathyroidectomy (vs cinacalcet initiation) was not associated with an increase in acute kidney injury. LIMITATIONS: We lacked access to laboratory data to help assess the severity of secondary/tertiary hyperparathyroidism. The cohort was limited to Medicare beneficiaries. CONCLUSIONS: Almost one-fifth of our study cohort was treated with parathyroidectomy and/or cinacalcet. Further studies are needed to establish the optimal treatment for posttransplant hyperparathyroidism.

Abstract Background Summarizing the clinical features of children with intussusception secondary to small bowel tumours and enhancing awareness of the disease. Methods Retrospective summary of children with intussusception admitted to our emergency department from January 2016 to January 2022, who underwent surgery and were diagnosed with small bowel tumours. Summarize the types of tumours, clinical presentation, treatment, and prognosis. Results Thirty-one patients were included in our study, 24 males and 7 females, with an age of onset ranging from 1 m to 11y 5 m. Post-operative pathology revealed 4 types of small intestinal tumour, 17 lymphomas, 10 adenomas, 4 inflammatory myofibroblastomas and 1 lipoma. The majority of tumours in the small bowel occur in the ileum (83.9%, 26/31). Abdominal pain, vomiting and bloody stools were the most common clinical signs. Operative findings indicated that the small bowel (54.8%, 17/31) and ileocolic gut were the main sites of intussusception. Two types of procedure were applied: segmental bowel resection (28 cases) and wedge resection of mass in bowel wall (3 cases). All patients recovered well postoperatively, with no surgical complications observed. However, the primary diseases leading to intussusception showed slight differences in long-term prognosis due to variations in tumor types. Conclusions Lymphoma is the most common cause of intussusception in pediatric patients with small bowel tumours, followed by adenoma. Small bowel tumours in children tend to occur in the ileum. Therefore, the treatment of SBT patients not only requires surgeons to address symptoms through surgery and obtain tissue samples but also relies heavily on the expertise of pathologists for accurate diagnosis. This has a significant impact on the overall prognosis of these patients.

AbstractEquitable teaching practices encompass evidence-based strategies utilised by teachers to support the learning of all pupils, while recognising each pupil’s unique background. This study delves into the perspectives of Scottish teachers regarding equity in mathematics, as evidenced by their self-reported practices. By analysing semi-structured interviews with 29 teachers from various school levels (early years, primary, and secondary) through Variation Theory, we were able to uncover common practices, such as ability grouping versus mixed-ability grouping, as well as practices specific to each level. We also identified overlaps between early-years/primary and primary/secondary, highlighting the importance of transitioning from one school level to another. It is imperative for teacher education programmes to address these transitions more explicitly in order to ensure greater continuity and consistency in equitable teaching practices.

Background: Cervical esophageal reconstruction is vital to improve the quality of life in cancer surgery patients. Microsurgery is crucial in providing vascularized tissue for defect repair, particularly in secondary cases with a higher risk of failure due to larger defects and damage from previous surgery and radiotherapy. The purpose of this study was to describe the clinical characteristics of a series of patients who underwent secondary repair of esophageal defects and provide practical information for the management and treatment of such cases based on the authors' experience and the literature review. Methods: We retrospectively reviewed the electronic medical records of the Plastic Surgery Clinic at the University of Trieste to identify cases of patients who underwent secondary esophageal microsurgical reconstructions following oncological surgery. Patient demographics, the etiology of esophageal defects, previous surgical history, and preoperative assessments were collected from medical records. Surgical techniques utilized for reconstruction, such as pedicled flaps or free tissue transfers, were documented along with intraoperative information. Postoperative outcomes, including complications, graft viability, and functional outcomes, were evaluated during follow-up. Results: We treated 13 cases of secondary esophageal reconstructions between 2011 and 2022. Most commonly, Antero-Lateral Thigh (ALT) flaps were used in 10 cases, while 2 cases employed a radial forearm flap (RFF), and 1 case employed a chimeric parascapular flap. No flap failures occurred during a median 50-month follow-up. One ALT flap patient experienced postop stricture but maintained swallowing ability. A single tracheoesophageal fistula occurred in an RFF patient with a history of radiotherapy and complete lymph node dissection. Conclusions: Cervical esophageal reconstruction significantly impacts patients' quality of life by restoring oral feeding and phonation. When local flaps fall short, microsurgical reconstruction with intestinal flaps is valuable but is burdened by limitations. For challenging secondary cases, ALT or RFF flaps emerge as safer options due to their robust pedicles, yielding low complication rates and positive functional outcomes. [ABSTRACT FROM AUTHOR]