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The National Kidney Registry (NKR) Advanced Donation Program enables living donors the opportunity to donate altruistically, or in advance of a potential recipient's transplant, and to receive a voucher that can be redeemed for a future transplant facilitated by the NKR. Family vouchers allow a donor to identify multiple individuals within their immediate family, with the first person in that group in need of a transplant being prioritized to receive a kidney. An increase in vouchers introduces concerns that demand for future voucher redemptions could exceed the supply of available donors and kidneys. A Monte Carlo simulation model was constructed to estimate the annual number of voucher redemptions relative to the number of kidneys available over a 50-year time horizon under several projected scenarios for growth of the program. In all simulated scenarios, the number of available kidneys exceeded voucher redemptions every year. While not able to account for all real-life scenarios, this simulation study found that the NKR should be able to satisfy the likely redemption of increasing numbers of vouchers under a range of possible scenarios over a 50-year time horizon. This modeling exercise suggests that a donor family's future needs can be satisfied through the voucher program.

Despite a century of research searching for what works in teaching and learning, a project that has benefited from political support in the form of the Elementary and Secondary Education Act (ESEA) of 1965, any individual child's experience of learning in school is marked by inequalities based on socioeconomic status, race, immigrant status, and geospatial location (Eppley & Shannon, 2017). The search for what works has remained unchanged in philosophy and design despite long-standing evidence of persistent and growing inequalities among groups (Reardon, 2011). Evidence Based Practice (EBP) has undergirded contemporary education policies and the educational outcomes that have resulted from this research. As such, EBP directs teachers' and students' experiences in school. Education policy in the United States favors a near-exclusive emphasis on evidence-based practice to guide policy and practice about what educational interventions work (Walsh, Reutz, & Williams, 2015). What "works," however, ignores the relevance of context. Context of place, particularly of rural places, is an important consideration for research whose aim is to identify and promote effective and culturally sustaining instruction for students (Gruenewald, 2003; Lester, 2012). This policy column considers the limitations of EBP as the foundational philosophy of contemporary education policy in rural schools and suggests Practice Based Evidence as a socially just alternative.

As organizations continue to expand their implementation of Lean practices, business schools and corporate training organizations have developed numerous games and simulations aimed at teaching Lean concepts in manufacturing settings. However, simulations have lagged behind the most recent adaptations of Lean outside of the factory in services, and more specifically, in office settings. In this article, we present a Lean simulation game, referred to as "Computer Solutions, Inc." that provides participants with hands-on experience in applying Lean principles in a nonmanufacturing setting. The simulation takes place in the order-quote department at "Computer Solutions, Inc.," a company that specializes in designing customized computer solutions for small businesses. The order-quote process is purely office-based and involves such activities as collecting information, processing information, filling out documents, and forwarding those documents to different parts of the organization. This simulation is implemented as a "pencil-and-paper" exercise that can be performed by students in the classroom. Our simulation brings some unique benefits that are often missing from current Lean manufacturing-based simulations. It involves multiple rounds of Lean improvements that can span several weeks, providing students a chance to identify wastes and to make a thoughtful application of Lean tools and techniques. Students also get to experience the challenges of group dynamics that are often present in team-based improvement efforts.

This paper outlines, through a transnational discourse between partners in Egypt and the UK, an overview of the literature on the definition and features of autistic spectrum disorder (ASD) with associated learning needs and health conditions as applied to children and young people in Egypt. As a low- to middle-income country, Egypt has a poor and underdeveloped health, education and social service to support children with ASD and very little research has investigated this phenomenon. This paper adds to the discussion through the shared knowledge and practice in the educational curriculum of children with ASD in Egypt.

Objective: To describe the association between prenatal imaging and neurodevelopmental outcomes of fetuses with rhombencephalosynapsis (RES). Study design: Thirty‐four pregnancies complicated by RES were identified from our institutional databases based on US and/or MRI findings. Genetic testing results were gathered. In cases of termination of pregnancy, we studied the association between prenatal imaging and neuropathologic findings. For those who opted for expectant management, comprehensive developmental assessments and postnatal MRI imaging were evaluated. Results: Over one third of fetuses in our cohort had complete RES. Common intracranial anomalies identified were mesencephalosynapsis, aqueduct stenosis and diencephalosynapsis. The degree of RES was not associated with the frequency of additional central nervous system anomalies. MRI had a good correlation with neuropathologic findings with regard to the degree of RES, aqueduct stenosis and mesencephalosynapsis. Postmortem autopsy showed that one third of our cases had VACTERL‐H and almost all of those had complete RES. All liveborn neonates(n = 6) had aqueduct stenosis requiring ventriculoperitoneal shunting within days of delivery (median 5 days). While a large proportion of prenatally suspected complete RES were found to have partial RES on postnatal imaging, prenatal diagnosis of aqueduct stenosis remained unchanged. All children that were at least 2 years old (n = 3) had global developmental delay. Conclusion: Prenatal assessment of the RES severity is challenging and may be unreliable. Nevertheless, postnatal prognosis is poor for both complete and partial RES. Associated aqueductal stenosis, can be reliably assessed prenatally and this may contribute to worse postnatal prognosis than the degree of RES. Key points: What is already known about this topic?Rhombencephalosynapsis (RES) is a rare cerebellar abnormality which is characterized by midline fusion of the hemispheres with partial or complete loss of the vermis.Assessing the severity of RES postnatally is important as children with complete RES exhibit overall poorer outcomes than those with partial RES. What does this study add?A large proportion of prenatally suspected complete RES were found to have partial RES on postnatal imaging (80%).Precise assessment of the degree of RES prenatally is challenging and may be unreliable. However, associated anomalies, especially aqueduct stenosis, can be reliably assessed prenatally.Regardless of the imaging severity of RES, all neonates with associated aqueductal stenosis required ventriculoperitoneal shunting in the first month of life and exhibited global developmental delay at 2 years of age. [ABSTRACT FROM AUTHOR]

Online programs are often viewed as a cost-efficient strategy for increasing revenue for shrinking university budgets but this may not be an accurate assessment. Responsibility Centered Management (RCM) is a budgeting model that is purported to increase efficient delivery of academic programs. As RCM budgeting models have been embraced, many universities have launched online education programs. The Department of Social Work has experienced both successes and challenges with implementing an online MSW program under an RCM model. The Online MSW program has been deemed a success by faculty, students, and the University at large. The purpose of this paper is to share the strategies used in the development, implementation, and management of an online MSW program and provide some general guiding principles for new and existing programs.

Using data from one "successful" school district, I argue that, contrary to its egalitarian rhetoric, No Child Left Behind (NCLB) provides a mechanism for identifying the many whom Hernstein and Murray would exclude from schooling beyond the elementary grades because they cannot learn enough to justify the expense of their teaching. To challenge this conservative agenda in neoliberal clothing, teachers, researchers and the public should contest the political, social, and economic assumptions on which NCLB rests and work to build institutions which revitalize democratic values and support the continuous development of all citizens.

We have two goals for this article: to question the efficacy of evidence-based practice as the foundation of reading education policy and to propose practice-based evidence as a viable, more socially just alternative. In order to reach these goals, we describe the limits of reading policies of the last half century and argue for the possibilities of policies aimed at more equitable distribution of academic literacies among all social groups, recognition of subaltern groups' literacies, and representation of the local in regional and global decision making.

Introduction: Skeletal growth arrest lines (GAL) are transverse lines of metaphyseal radiodensity accompanying episodic severe physiological stress. They are poorly described in fetal remains. Materials and Methods: We searched our autopsy practice for instances of fetal GAL in post mortem radiology, and correlated them with long bone histology and placental pathology. We describe the appearance, distribution, and pathology of GAL in a cohort of fetal autopsies, and compare the placental pathology accompanying GAL to the placental pathology of asymmetrical growth restriction (AGR) in the same time period. Results: In 2108 consecutive fetal post mortems, we found 20 cases with GAL. About 16 were in singletons with AGR. In these 16, the distribution of placental pathologies was similar to a contemporaneous cohort of 113 cases with AGR. Of the remaining 4, two twins out of 9 sets of monochorionic twins with AGR demonstrated GAL. One case of GAL had symmetrical growth restriction with cytomegalovirus infection, and one case had no AGR and an old, unexplained retroplacental hemorrhage. On histology, GAL are characterized by a region of mineralized chondroid, which is variably incorporated into irregular trabecular bone. Discussion: GALs accompany a variety of placental pathologies and twin-twin transfusion, suggesting episodic disease progression. [ABSTRACT FROM AUTHOR]

Introduction: To determine lung hypoplasia in cases with fetal skeletal dysplasia based on the total lung weight at autopsy as the most accountable surrogate marker for pulmonary hypoplasia. Methods: This retrospective cohort study included all pregnancies with antenatal diagnosis of skeletal dysplasia (2012–2018). We included only cases in which information on fetal biometry was available within 2 weeks before delivery and had autopsy and skeletal X-rays + molecular analysis using extracted fetal DNA. We compared the predictive accuracy of fetal sonographic body-proportional ratios (BPRs) including: (1) thoracic circumference-to-abdominal circumference ratio, (2) the femur length-to-abdominal circumference (FL/AC) ratio, (3) head circumference-to-abdominal circumference ratio, and (4) foot length-to-femur length ratio. Lung hypoplasia was defined as total lung weight below −2 SD from the expected mean for gestational age. Results: Fifty three pregnancies with antenatal diagnosis of skeletal dysplasia underwent autopsy included. Lung hypoplasia was determined in 34 (64.1%). Median of gestational age at last sonographic assessment was 21.3 (19.9–24.9) weeks. FL/AC ratio demonstrated the highest area under the curve of 0.817 (95% CI: 0.685–0.949; p < 0.0001). FL/AC ≤0.1550 demonstrated the highest detection rate of 88.2% along with the highest negative predictive value of 75%. Conclusion: Using a novel, more practical approach to predict lung hypoplasia in skeletal dysplasia, fetal sonographic BPRs and, specifically, FL/AC ratio demonstrate a high detection rate of lung hypoplasia. [ABSTRACT FROM AUTHOR]