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Previous research by the authors of this piece hinted at the heavy workload of Special Educational Needs Co-ordinators (SENCos) within settings in England, and their ever-mounting challenges in the context of reduced local government services and cuts in funding to schools for their children with Special Educational Needs. As a result of these findings, the aim of this research was to focus exclusively on the lived professional experience of the SENCo in primary schools in England. Through anonymous survey, we asked SENCos to share with us their perception of their role and the responsibilities that it included. Although our sample of 20 was relatively small, it provided rich data about the preparedness and the perceived competence and confidence of those in this role. Workload, and the erosion that excessive demands caused to the well-being of SENCos dealing with complex systems, was prominent in the data we collected, in line with most recent investigations of the educationalist's experience in England. However, our data also raised questions about the status, or lack of, of the SENCo in settings, the way in which the nationally recognised qualification associated with the role is delivered and sources of support available to those in the role.

The epistemological beliefs of students are an important area for higher education research. This paper firstly reports on a research review concerning the impact of epistemological beliefs on academic outcomes. This review indicates that students' epistemological beliefs are an influence on their engagement with learning and academic success, and that educators should consider them in developing learning experiences. This issue became particularly pertinent in the context of a global pandemic that necessitated an international trend in moving to online distance education, where student disengagement is more likely to occur. However, research into distance education students' epistemological beliefs emerged as an under-researched field. Consequently, an empirical questionnaire study was conducted with data collected from 550 distance education students. A principal component analysis indicated that particular epistemological beliefs were significantly associated with students' enjoyment of studying online. Their beliefs regarding the role of fun in online learning materials and activities are discussed, and the usefulness of considering fun and epistemological beliefs as factors within distance learning in higher education is highlighted. [Note: The page range (213-232) shown on the PDF is incorrect. The correct page range is 213-231.]

Recent studies have reported that strengths-based programs, leveraging autistic adolescents' abilities and interests, could improve their skills and facilitate social engagement. However, little is known about the long-term impact of strengths-based approaches. This study aimed to explore the long-term outcomes of community strengths-based programs designed to support autistic adolescents in developing interests and skills in Science, Technology, Engineering, Arts, and Mathematics (STEAM) and the factors influencing their participation in these programs. A repeated cross-sectional survey study over three years recruited 52 parents in 2018, 52 parents in 2019, and 38 parents in 2020. Results highlighted the positive impact of these programs on autistic adolescents' health and well-being, social relationships and interactions, self-confidence and self-esteem, sense of belonging, and activities and participation. Five key elements influencing participation included the enthusiasm of the participants, their self-perception, the approach of the programs, the learning environment, and the attitudes of the mentors. This study implies that strengths-based approaches to intervention and support for autistic adolescents in a supported environment are a social model solution that could potentially have positive participant outcomes. Findings from this study could provide a framework underpinning future strengths-based interventions.

This paper examines the use of vignettes as a research method in a comparative exploration of the provision for children with special educational needs across eleven countries. The investigation selected in-country researchers, who responded to questions with respect to children described in 14 vignettes. The questions related to school placement options; assessment processes; support arrangements; service provision; curriculum responses and those involved in placement decisions. The vignette findings were able to highlight differences in placement decisions between the countries; the general lack of pupil voice in decision making and the ubiquitous influence of medical categories within educational settings. The utility of using vignettes in this type of research is discussed in relation to reflecting the complex reality of educational practice in different countries.

Abstract Objectives The medications used for autoimmune diseases have significantly evolved in recent years, but there is limited knowledge about how treatment practices changed during pregnancy. This study aimed to describe the temporal trends of immunosuppressants, immunomodulators and biologics use during pregnancy among women with autoimmune diseases, compare their use before, during, and after pregnancy, and identify factors predicting the discontinuation of these medications during pregnancy. Methods Using data from the Quebec Pregnancy Cohort (1998–2015), which included women under the RAMQ prescription drug plan for at least 12 months before and after pregnancy, the analysis focused on those with at least one International Classification of Diseases Ninth or Tenth Revision code in the year before pregnancy for inflammatory bowel disease, rheumatoid arthritis, spondylarthropathies, connective tissue diseases, systemic lupus erythematosus, or vasculitis. Exposure to immunosuppressants, immunomodulators and biologics were evaluated before and during the pregnancy. Discontinuation during pregnancy was defined as having no prescriptions filled during pregnancy or overlapping with the first day of gestation (1DG), given that at least one prescription was filled in the year prior to pregnancy. Generalized estimating equations were applied to estimate adjusted odds ratios (aOR) for predicting medication discontinuation during pregnancy. Results Among 441,570 pregnant women, 3,285 had autoimmune diseases. From 1998 to 2014, the use of immunomodulators increased from 3.7% to 11.9%, immunosuppressants from 4.1% to 13.7%, and biologics from 0% to 15.6%. During pregnancy, compared to before, there was a significant decrease in exposure to immunomodulators (8.6% to 5.4%), immunosuppressants (14.2% to 8.7%), and biologics (5.1% to 4.7%). Factors influencing discontinuation varied by medication type; for immunosuppressants, prior biologics use (aOR = 2.12, 95%CI 1.16–3.85) and the year of pregnancy (aOR = 0.93, 95%CI 0.89–0.98) were key factors, while for biologics, it was only the year of pregnancy (aOR = 0.68, 95%CI 0.54–0.86). Conclusions The use of immunomodulators, immunosuppressants, and biologics has increased over time. However, exposure during pregnancy decreased, with recent years showing a lower rate of discontinuation. Understanding the factors influencing medication discontinuation during pregnancy can improve management strategies for women with autoimmune diseases.

Abstract Practice questions are highly sought out for use as a study tool among medical students in undergraduate medical education. At the same time, it remains unknown how medical students use and incorporate practice questions and their rationales into their studies. To explore this heavily relied upon study strategy, semi-structured interviews were conducted with second-year medical students to assess how they approach using practice questions. Qualitative thematic analysis revealed several recurrent themes: (1) Medical students use practice questions for primary learning, (2) Medical students place more importance on the rationale of a practice question versus selecting the right answer, and (3) Medical students view practice questions as being designed to be used once or having a single-use. Together, these themes provide insight into how medical students use practice questions to study, which may guide medical educators in their creation of practice questions with appropriate rationales and provide foundational data for future mixed methods analyses seeking to generalize these findings.

Abstract This report describes the characteristics and outcomes of 18 heavily pretreated patients with multiple myeloma (MM) who were subsequently treated with selinexor. This is a case series of 18 patients with MM who were treated with selinexor and dexamethasone (Sd) or selinexor, bortezomib, and dexamethasone (SVd) in 12 hospitals in the UK between 2019 and 2021. Eight patients received Sd and 10 patients received SVd. Patients received a median of five prior treatment lines, including immunomodulatory agents in 94% and proteasome inhibitors in 94%. Ten patients (55%) had triple‐class refractory disease. Six of the 12 evaluable patients achieved ≥partial response. The median progression‐free survival was 5.6 months, which was higher with SVd (5.7 months) than with Sd (2.1 months). The results support a treatment benefit of selinexor in heavily pretreated patients and support the notion that selinexor may overcome resistance to prior therapies, with no new safety concerns arising.

Children with special educational needs and disabilities (SEND) have a profoundly higher risk of death or injury than their peers when natural disasters occur. International policies call for inclusive disaster risk reduction education (DRRE) to help ameliorate this situation. This paper focuses on Indonesia, which has one the highest incidences of these disasters. A three-part structured literature review was undertaken regarding DRRE and children with SEND, followed by a questionnaire to in schools. Firstly, potential papers were screened against explicit criteria, yielding 23 papers for inclusion in the review. Secondly, these 23 papers were screened for identifiable DRR programmes, producing 12 items. Thirdly, evaluations of these 12 programmes were sought. The findings revealed that children with SEND were largely absent within the published research, the DRRE programmes, and all subsequent evaluations of the DRRE programmes. Questionnaire responses from 769 teachers from across Indonesia indicated that DRRE was often lacking, and that no programmes that were being used were accessible for all children. This is the first study to gain this insight and it concludes that there is a need for DRRE across mainstream, inclusive, and special schools, which has an inclusive and enagaing pedagogy that is accessible for all children.

Indonesia is committed to creating an inclusive education system. Kindergartens have a key role to play in this endeavour. However, there are specific challenges that need to be addressed if this potential is to be fulfilled. It has been suggested that the use of keyword signs within Sign Supported Big Books (SSBB) as part of everyday story time activities might offer one way to begin to address some of these challenges. This research used a questionnaire method to evaluate the uptake and impact of SSBBs from 214 kindergartens across Indonesia. Analysis of teachers' responses revealed the inclusive affordances of the approach. For the majority of teachers: the books were in regular use in their classrooms, teachers and children enjoyed using them, SSBBs made learning fun, the approach impacted positively on teachers' classroom practice and they reported that it had benefits for children, including those with special educational needs. These results indicate that SSBBs can make a positive contribution towards creating an inclusive kindergarten pedagogy. Suggestions for further developments of the SSBB approach and future research are discussed.

Little is known about the relationship between working memory (WM) abilities and reading in children with cerebral palsy (CP) who have age-appropriate communication and language. The aim of this group case study is to analyze the WM abilities and their relationship to reading in children with CP and age-appropriate communication and language. Fifteen children with CP (6:9 to 11:6 years) and age-appropriate communication and language were identified. They were given tests of communication and language, reading (decoding), and three aspects of WM: phonological short-term memory (PSTM); visuospatial short-term memory (VSTM); and the central executive (CE). The children were divided into two groups; five who had age-appropriate reading (Age-appropriate Readers), and ten with very low reading abilities (Developing Readers). The results showed that PSTM was mostly age appropriate in both reading groups and their scores mostly correlated with their reading abilities. VSTM scores were very poor in both groups and not related to reading group membership or reading. CE abilities were mostly as would be expected for the Age-appropriate Readers, but low for the Developing Readers; CE scores correlated with reading abilities. The findings suggest that there are variations in the working memory abilities in this group of children and that the CE may be an important contributor to their reading development.

Abstract Background Knowledge of the conditions under which abortion is legal is important so that people can advocate for their right to abortion care. Yet minimal research has explored the association between women’s knowledge of abortion legality and the induced abortion care they receive, particularly using population-based survey data. Methods Using national survey data collected by Performance Monitoring for Action (PMA) in Côte d’Ivoire and Ghana, we aimed to compare the prevalence of accurate knowledge of abortion legality, factors associated with knowledge of the law, and the association between knowledge of abortion legality and the source of women’s induced abortion care in these two settings. We ran bivariate and multivariable logistic regressions to assess the relationships of interest. Results We found that awareness and knowledge of the abortion law were low in both Côte d’Ivoire and Ghana. In Cote d’Ivoire, women who were older, more educated, and with past abortion experience were more likely to be aware of the law. In Ghana, knowledge of the law did not vary significantly by demographic characteristics. However, in Ghana, knowledge of the law was correlated with women’s use of the formal healthcare system for abortion care, with greater use of clinical sources in rural areas. Conclusions It is possible that for populations with reduced access to abortion services, such as those in rural areas, knowledge of the law is advantageous for those seeking facility-based abortion care, particularly in settings where abortion is legal for a range of indications. Interventions seeking to improve access to facility-based abortion care in settings where abortion is legal on various grounds should incorporate education on the legal grounds for abortion.

Most eukaryotic genes have been vertically transmitted to the present from distant ancestors. However, variable gene number across species indicates that gene gain and loss also occurs. While new genes typically originate as products of duplications and rearrangements of preexisting genes, putative de novo genes-genes born out of ancestrally nongenic sequence-have been identified. Previous studies of de novo genes in Drosophila have provided evidence that expression in male reproductive tissues is common. However, no studies have focused on female reproductive tissues. Here we begin addressing this gap in the literature by analyzing the transcriptomes of 3 female reproductive tract organs (spermatheca, seminal receptacle, and parovaria) in 3 species-our focal species, Drosophila melanogaster-and 2 closely related species, Drosophila simulans and Drosophila yakuba, with the goal of identifying putative D. melanogaster-specific de novo genes expressed in these tissues. We discovered several candidate genes, located in sequence annotated as intergenic. Consistent with the literature, these genes tend to be short, single exon, and lowly expressed. We also find evidence that some of these genes are expressed in other D. melanogaster tissues and both sexes. The relatively small number of intergenic candidate genes discovered here is similar to that observed in the accessory gland, but substantially fewer than that observed in the testis.

BackgroundEpilepsy management during pregnancy is crucial for both the mother and fetus. The use of antiseizure medications (ASMs) during pregnancy requires careful consideration due to their potential effects on maternal and fetal health.MethodsThis study analyzed trends in ASMs use among pregnant people in four Canadian provinces over 20 years (Manitoba, Saskatchewan, Alberta, and Quebec). Descriptive statistics were utilized to examine the characteristics of the population, with the frequency and patterns of ASM use estimated throughout each trimester. Linear regression models were developed to analyze yearly patterns of ASM utilization for the overall study population, as well as for people with and without epilepsy.ResultsAmong 1,317,141 pregnant individuals across four provinces, 0.7% had epilepsy. Of the total pregnancies, 1.7% (n = 22,783) were exposed to ASMs, comprising 4,392 from pregnant people with epilepsy (PPWE) and 18,391 from those without epilepsy (PPWOE). Results demonstrated varying trends in ASM usage between provinces, with an overall increase in usage among people without epilepsy in Manitoba, Saskatchewan, and Alberta. ASM use among PPWOE surged significantly in Manitoba (24.2–149.1 per 10,000 pregnant people), Saskatchewan (29.4–107.0 per 10,000), and Alberta (65.7–241.7 per 10,000) (p < 0.05). In Alberta, PPWE’s ASM exposure also rose, from 23.6 in 2008 to 43.0 per 10,000 pregnant people in 2021, while Quebec witnessed a decrease from 59.2 in 1998 to 45.5 per 10,000 pregnancies in 2015. Analysis of ASM use by trimester illustrated a substantial decline among PPWOE from 365 days pre-pregnancy to the third trimester in all provinces. ASM utilization by drug class showcased significant shifts, with second-generation ASMs experiencing a notable rise. Carbamazepine, once prominent, declined, making way for lamotrigine. Regional variations underscore diverse preferences, such as clonazepam’s sustained popularity in Manitoba and Quebec.ConclusionThe study identified increasing trends in ASM use, particularly the increased use of second-generation ASMs, and differences in prescription patterns for pregnant individuals with and without epilepsy. These findings reveal changing ASM use patterns, including increased second-generation ASM use and regional disparities, providing valuable insights into real-world prescription practices.

Integrated phenotypes, that is, correlated suites of traits, can impact both evolutionary and ecological processes. Similarly, phenotypic plasticity, or the ability of one genotype to generate multiple phenotypes, can act as both a facilitator and constraint on evolutionary processes. While there has been an increasing focus on correlated behavioural means (i.e. behavioural syndromes), less attention has been paid to how plasticity in different behavioural traits may be correlated. Such correlated behavioural plasticities are likely to affect evolution and ecology, although possibly in different ways. Here, we review key insights from three research fields, behavioural syndromes, phenotypic plasticity and integrated phenotypes to provide a conceptual framework to understand why, how and when plasticities of different behavioural traits may become correlated. In particular, the conditions under which plasticity and behavioural syndromes are predicted to be important are also where correlated behavioural plasticities are likely to have the strongest impacts. In this review, we define correlated behavioural plasticities, summarize the conditions that are likely to give rise to them and highlight testable predictions in an effort to spark targeted research into this important phenomenon. We also provide a worked example to highlight how studying correlated plasticity can yield important new insights.

Abstract NLRP3 inflammasome has been implicated in neutrophil polarization and extrusion of neutrophil extracellular traps (NETs) in vitro and facilitates secretion of Il1-beta (IL-1β). Permanent ligation of the left anterior descending artery was used to induce MI in WT and NLRP3−/− mice as well as in NLRP3−/− recipient mice transfused with either WT or NLRP3−/− neutrophils. NLRP3 deficiency reduced infarct size to roughly a third of WT heart injury and preserved left ventricular (LV) function at 12 h after MI as assessed by echocardiography and triphenyltetrazolium chloride staining of live tissue. Transfusion of WT but not NLRP3−/− neutrophils after MI increased infarct size in NLRP3−/− mice and significantly reduced LV function. The key features of myocardial tissue in WT neutrophil transfused recipients were increased H3Cit-positive deposits with NET-like morphology and increased tissue levels of IL-1β and plasma levels of von Willebrand Factor (VWF). Flow cytometry analysis also revealed that neutrophil NLRP3 increased the number of labeled and transfused neutrophils in the bone marrow of recipient mice following MI. Our data suggest a key role for neutrophil NLRP3 in the production of IL-1β and deposition of NETs in cardiac tissue exacerbating injury following MI. We provide evidence for a link between neutrophil NLRP3 and VWF release likely enhancing thromboinflammation in the heart. Neutrophil NLRP3 deficiency conferred similar cardioprotective effects to general NLRP3 deletion in MI rendering anti-neutrophil NLRP3 therapy a promising target for early cardioprotective treatment.

Abstract Safe and effective brain tumor surgery aims to remove tumor tissue, not non-tumoral brain. This is a challenge since tumor cells are often not visually distinguishable from peritumoral brain during surgery. To address this, we conducted a multicenter study testing whether the Sentry System could distinguish the three most common types of brain tumors from brain tissue in a label-free manner. The Sentry System is a new real time, in situ brain tumor detection device that merges Raman spectroscopy with machine learning tissue classifiers. Nine hundred and seventy-six in situ spectroscopy measurements and colocalized tissue specimens were acquired from 67 patients undergoing surgery for glioblastoma, brain metastases, or meningioma to assess tumor classification. The device achieved diagnostic accuracies of 91% for glioblastoma, 97% for brain metastases, and 96% for meningiomas. These data show that the Sentry System discriminated tumor containing tissue from non-tumoral brain in real time and prior to resection.

We often remember past experiences in the form of a story. We can even form narratives from events which occur at disparate times. Yet, the neuroscience of memory has historically tried to understand how we remember specific periods of time, or “events.”The hippocampus is necessary for remembering specific events. One possibility is that the hippocampus organizes our memories in time.However, we previously found that narratives can bridge the gap between events in our memory, making events easier to remember.Hypothesis: the hippocampus might link two events together in memory when they can form a single, coherent narrative.

Abstract In this global phase 2 study in patients with relapsed/refractory follicular lymphoma (FL), zandelisib was administered on intermittent dosing to mitigate immune‐related adverse events and infections that have been reported with oral PI3Kδ inhibitors administered daily continuously. Eligible patients with measurable disease and progression after at least two prior therapies were administered zandelisib until disease progression or intolerability. The primary efficacy endpoint was objective response rate (ORR) and the key secondary efficacy endpoint was duration of response (DOR). We report on 121 patients with FL administered zandelisib on intermittent dosing after 8 weeks of daily dosing for tumor debulking. The median number of prior therapies was 3 (range, 2–8) and 45% of patients had refractory disease. The ORR was 73% (95% confidence interval [CI], 63.9–80.4), the complete response (CR) rate was 38% (95% CI, 29.3–47.3), and the median DOR was 16.4 months (95% CI, 9.5–not reached). With a median follow‐up of 14.3 months (range, 1–30.5), the median progression‐free survival was 11.6 months (95% CI, 8.3–not reached). Twenty‐one patients (17%) discontinued therapy due to an adverse event. Grade 3–4 class‐related toxicities included 6% diarrhea, 5% lung infections, 3% colitis (confirmed by biopsy or imaging), 3% rash, 2% AST elevation, and 1% non‐infectious pneumonitis. Zandelisib achieved a high rate of durable responses in heavily pretreated patients with relapsed/refractory FL. The intermittent dosing resulted in a relatively low incidence of severe class‐related toxicities, which supports the evaluation of zandelisib as a single agent and in combination with indolent B‐cell malignancies.

The global pandemic has accelerated the 'move online' of higher education in Indonesia. This study aimed to examine the relationship between Indonesian students' experiences of studying online, their epistemological beliefs and their beliefs about fun in learning. A mixed method approach was used to examine this relationship in a sample of 774 students. A Principal component analysis (PCA) of questionnaire responses identified associations between social constructivist beliefs about learning and the centrality of fun in learning. The PCA was considered together with a thematic analysis of an open question 'Has the COVID-19 situation changed your feelings about online study?' This revealed the significance of the epistemic mismatch between many students' beliefs and the transmissive online pedagogy that they described. This mismatch is implicated as a factor in understanding the students largely negative experiences of online study and the impact on their well-being, albeit within the context of a pandemic. This is the first time that this link has been proposed. The research indicates that examining students' epistemological beliefs can offer insights that are helpful in understanding students' educational engagement and well-being when studying online.

A synergetic partnership of the Maynooth University Department of Adult and Community Education and the Further Education Support Services identified an educational need among Further Education and Training (FET) staff. The outcome was a jointly developed and delivered Level 9 blended learning Postgraduate Certificate in Programme Design and Validation in Further Education and Training (PGPDV). The delivery of the pilot course was significantly challenged by COVID-19's sudden arrival in March 2020, forcing the course fully online. This article gathers feedback on lessons learned and offers practical steps to guide adult educators in pivoting courses for online delivery

The 2010 Gulf of Mexico Deepwater Horizon was the largest oil spill in human history that occurred during a 12-week period in a region less than 100 km from the coast of Louisiana; however, after more than a decade of post-spill research, few definitives can be said to be known about the long-term impacts on the development and distribution of fishes in and around the region of the disaster. Here, we examine endemic Gulf of Mexico fish species that may have been most impacted by noting their past distributions in the region of the spill and examining data of known collecting events and observations over the last twenty years (ten years prior to the spill, ten years post-spill). Five years post-spill, it was reported that 48 of the Gulf’s endemic fish species had not been collected and, with expanded methods, we now report that 29 (of the 78 endemic species) have not been reported in collections since 2010 (five of these are only known from observations post-spill). Although the good news that some previously ‘missing’ species have been found may be cause to celebrate, the lack of information for many species remains a cause for concern given focused sampling efforts post-spill.

Abstract Background Limb-salvage surgery involving the utilization of endoprosthetic replacements is commonly employed following segmental bone resection for primary and secondary bone tumors. This study aimed to evaluate whether a fully porous bridging collar promotes early osseous integration in endoprosthetic replacements. Methods We undertook a retrospective review of all lower-limb endoprostheses utilizing a fully porous endosteal bridging collar design. We matched this cohort with a conventional extra-osteal non-porous fully hydroxyapatite-coated grooved collar cohort according to surgical indication, implant type, resection length, age, and follow-up time. At 6, 12, and 24 months post-implantation, radiographs were assessed for the number of cortices with or without osseointegration on orthogonal radiographs. Each radiograph was scored on a scale of -4 to + 4 for the number of cortices bridging the ongrowth between the bone and the collar of the prosthesis. Implant survival was estimated using the Kaplan–Meier method, and the mean number of osseointegrated cortices at each time point between the collar designs was compared using a paired t-test. Results Ninety patients were retrospectively identified and analyzed. After exclusion, 40 patients with porous bridging collars matched with 40 patients with conventional extra-osteal non-porous collars were included in the study (n = 80). The mean age was 63.4 years (range 16–91 years); there were 37 males and 43 females. The groups showed no difference in implant survival (P = 0.54). The mean number of cortices with radiographic ongrowth for the porous bridging collar and non-porous collar groups was 2.1 and 0.3, respectively, at 6-month (P