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A three-round Delphi method surveyed 17 experts, identifying 108 essential neurofeedback competencies for counselors-in-training. This research addresses concerns about the impact of neuro-informed practices on counselor identity and scope of practice, providing a foundation for incorporating neurofeedback training into counselor education.

This article describes how I, an American music teacher educator, visited the classrooms of eight Musical Futures Champion Teachers in the United Kingdom and observed their teaching with a focus on informal music learning and nonformal teaching. Musical Futures, a professional development organization in the UK, is the original organization that implemented Lucy Green's research on informal music learning and moved it into the music classroom. Through observation of these Musical Futures teachers' classes, I understood what informal learning and nonformal teaching currently look like in practice and how they are implemented. I witnessed how Green's work directly impacts their teaching philosophies, the processes and pedagogies they implement, and the resources they employ in the classroom.

BACKGROUND: Stroke remains a major health concern globally, with oral anticoagulants widely prescribed for stroke prevention. The efficacy and safety of mechanical thrombectomy (MT) in anticoagulated patients with distal medium vessel occlusions (DMVO) are not well understood. METHODS: This retrospective analysis involved 1282 acute ischemic stroke (AIS) patients who underwent MT in 37 centers across North America, Asia, and Europe from September 2017 to July 2023. Data on demographics, clinical presentation, treatment specifics, and outcomes were collected. The primary outcomes were functional outcomes at 90 days post-MT, measured by modified Rankin Scale (mRS) scores. Secondary outcomes included reperfusion rates, mortality, and hemorrhagic complications. RESULTS: Of the patients, 223 (34%) were on anticoagulation therapy. Anticoagulated patients were older (median age 78 vs 74 years; p

Stress in adult learners is a neglected topic, despite practitioners observing that their adult learners often display psychological discomfort. We address the effects psychological stress has on learning, then define the constructs of stress, trauma, resilience, and psychological distress. Twenty-three adult learners reading at elementary levels completed measures of stress, trauma, resilience, and psychological distress. Procedural details for how we administered the measures to promote feasibility and acceptability in this population are provided. Results indicated that the sample's levels of stress, trauma, and psychological distress were disproportionately high, and levels of resilience were relatively low, compared with the general adult population. Limitations, lessons learned, and practical implications for instructors and administrators are provided.

The growing interest in onsite solar photovoltaic and energy storage systems is partially motivated by customer concerns regarding grid reliability. However, accurately assessing the effectiveness of PVESS in mitigating these interruptions requires a comprehensive understanding of location-specific outage patterns and the ability to simulate realistic scenarios. To address the gap, we introduce the Power Reliability Event Simulation TOol (PRESTO), the first publicly available tool that simulates location-specific power interruptions at the county level. PRESTO allows for a more realistic assessment of system reliability by considering the unpredictability and location-specific patterns of power interruptions. We applied PRESTO in a case study of a single-family home across three U.S. counties, examining the performance of a solar photovoltaic system with 10 kWh of battery storage during short-duration power interruptions. Our findings show that this system reliably met 93 % of energy demand for essential non-heating and cooling loads, fully serving these loads in 84 % of events, despite the constraints of daily time-of-use bill management which limits the battery's state-of-charge reserve. However, when heating and cooling loads were included, system performance decreased significantly, with only 70 % of demand met and full service in 43 % of events. These results highlight the challenges of using solar photovoltaic and energy storage systems for short-duration outages, emphasizing the need to consider factors like battery size and grid charging strategies to improve reliability. Our study demonstrates the practical applications of PRESTO, providing valuable insights into potential mitigation strategies including grid charging and optimizing battery size. © 2017 Elsevier Inc. All rights reserved.

In this qualitative study, we share the musical experiences of seven Ghanaian university music students who primarily play a brass instrument in a university band. The purpose of this study is to illuminate these students' musical experiences during their pre-tertiary years to better understand what those experiences were and how they impacted their current musical abilities and understandings. The research questions for this study are: What were the formal musical experiences of Ghanaian university music majors who play Western-style brass instruments before entering university? What music teaching and learning methods did they experience prior to entering university? Who were the people who taught them music prior to entering university? Findings indicate that musical spaces were mostly outside of the regular school curriculum, including extra-curricular school regimental bands, church brigades, and town bands. Music learning was non-sequential throughout students' pre-tertiary experiences. Lack of access to instruments outside of rehearsals was a barrier to individual practice. Participants showed a lack of clarity about their music teachers' credentials, experience, and backgrounds but their answers suggest that professional development and training programs for teachers would be beneficial. It is recommended that Ghanaian brass band music education is restructured in places where it already exists and where pre-tertiary students choose to play, to include more comprehensive and sequential instrumental music education.

BACKGROUND: Despite the proven effectiveness of endovascular therapy (EVT) in acute ischemic strokes (AIS) involving anterior circulation large vessel occlusions, isolated posterior cerebral artery (PCA) occlusions (iPCAo) remain underexplored in clinical trials. This study investigates the comparative effectiveness and safety of EVT against medical management (MM) in patients with iPCAo. METHODS: This multinational, multicenter propensity score-weighted study analyzed data from the Multicenter Analysis of primary Distal medium vessel occlusions: effect of Mechanical Thrombectomy (MAD-MT) registry, involving 37 centers across North America, Asia, and Europe. We included iPCAo patients treated with either EVT or MM. The primary outcome was the modified Rankin Scale (mRS) at 90 days, with secondary outcomes including functional independence, mortality, and safety profiles such as hemorrhagic complications. RESULTS: A total of 177 patients were analyzed (88 MM and 89 EVT). EVT showed a statistically significant improvement in 90-day mRS scores (OR = 0.55, 95% CI = 0.30-1.00, p = 0.048), functional independence (OR = 2.52, 95% CI = 1.02-6.20, p = 0.045), and a reduction in 90-day mortality (OR = 0.12, 95% CI = 0.03-0.54, p = 0.006) compared to MM. Hemorrhagic complications were not significantly different between the groups. CONCLUSION: EVT for iPCAo is associated with better neurological outcomes and lower mortality compared to MM, without an increased risk of hemorrhagic complications. Nevertheless, these results should be interpreted with caution due to the studys observational design. The findings are hypothesis-generating and highlight the need for future randomized controlled trials to confirm these observations and establish definitive treatment guidelines for this patient population.

BACKGROUND: Medium vessel occlusion (MeVO) strokes, particularly affecting the M2 segment of the middle cerebral artery, represent a critical proportion of acute ischemic strokes, posing significant challenges in management and outcome prediction. The efficacy of mechanical thrombectomy (MT) in MeVO stroke may warrant reliable predictors of functional outcomes. This study aimed to investigate the prognostic value of follow-up infarct volume (FIV) for predicting 90-day functional outcomes in MeVO stroke patients undergoing MT. METHODS: This multicenter, retrospective cohort study analyzed data from the Multicenter Analysis of primary Distal medium vessel occlusions: effect of Mechanical Thrombectomy (MAD-MT) registry, covering patients with acute ischemic stroke due to M2 segment occlusion treated with MT. We examined the relationship between 90-day functional outcomes, measured by the modified Rankin Scale (mRS), and follow-up infarct volume (FIV), assessed through CT or MRI within 12-36 h post-MT. RESULTS: Among 130 participants, specific FIV thresholds were identified with high specificity and sensitivity for predicting outcomes. A FIV ⩽5 ml was highly specific for predicting favorable and excellent outcomes. The optimal cut-off for both prognostications was identified at ⩽15 ml by the Youden Index, with significant reductions in the likelihood of favorable outcomes observed above a 40 ml threshold. Receiver Operator Curve (ROC) analyses confirmed FIV as a superior predictor of functional outcomes compared to traditional recanalization scores, such as final modified thrombolysis in cerebral infarction score (mTICI). Multivariable analysis further highlighted the inverse relationship between FIV and positive functional outcomes. CONCLUSIONS: FIV within 36 h post-MT serves as a potent predictor of 90-day functional outcomes in patients with M2 segment MeVO strokes. Establishing FIV thresholds may aid in the prognostication of stroke outcomes, suggesting a role for FIV in guiding post intervention treatment decisions and informing clinical practice. Future research should focus on validating these findings across diverse patient populations and exploring the integration of FIV measurements with other clinical and imaging markers to enhance outcome prediction accuracy.

Extreme weather has a direct and significant impact on buildings and infrastructure, resulting in billions of dollars of damage each year. This problem continues to grow as climate patterns change and buildings are exposed to new and different hazards than what they were designed to withstand. In order to better plan for the long-range sustainment, restoration, modernization, and eventual recapitalization of these buildings, organizations with large building portfolios, such as the U.S. Department of Defense (DoD), must have an awareness of the risks that these extreme weather events present. This research aimed to develop an approach to estimate condition loss and reduction in service life for the components of a building due to extreme weather hazards, to understand the risks that may be present in certain buildings and building systems. To achieve this objective, a damage association matrix was developed that categorizes climate hazards, the damage modes that they produce, and the individual component types impacted. This damage matrix formally links state-of-the-art climate model output, which provides projections of the probability of various climate hazards with a damage effects model that quantifies the consequence on component-level condition and service life. This method is applied to an actual portfolio of buildings in a particular geographic location and with a pre-defined component inventory that comprises the building. This approach can be aggregated to the system-, facility-, and site-level thus helping support billions of dollars in recapitalization decisions related to restoration/modernization of facilities.

IntroductionLimited data exist on factors associated with concurrent use patterns of electronic nicotine delivery systems (ENDS) and cigarettes. We examined longitudinally perceptions and experiences with ENDS in relationship to concurrent use patterns among established, recent smokers who recently initiated ENDS.MethodsParticipant recruitment took place using paid digital advertisements on social media. Between December 2020 and October 2021, 303 adults aged ≥21 years from across the US who currently or recently smoked and had initiated ENDS use within the past 30 days or reinitiated ENDS use after more than one year of non-use were surveyed. Multinomial logistic regressions were conducted to analyze association between the outcome of current use pattern at follow-up at 1 month [rejectors (discontinued ENDS, continued smoking), primary smokers (concurrent users, mostly smoke), dual user (similar smoking and ENDS use), primary vapers (concurrent users, mostly vape), and switchers (discontinued smoking, continued using ENDS) or quitters (discontinued both smoking and ENDS] and perceptions of and experiences with ENDS predictors at baseline.ResultsAt follow-up at 1 to 2 months after initiating ENDS, 20% were rejectors, 31% were primary smokers, 13% were dual users, 19% were primary vapers, and 17% were switchers/quitters. Perceiving ENDS as less harmful than smoking or being uncertain and as equally or more enjoyable smoking, experiencing a lot or complete reduction in cravings to smoking and in irritability with ENDS use, liking the taste of ENDS, and being satisfied with vaping were associated with higher odds of quitting smoking compared to rejecting ENDS or mostly smoking at follow-up at 1 month.ConclusionsFindings highlight the importance of initial ENDS perceptions and experiences when examining tobacco outcomes and potentially for developing policies and interventions targeting smoking cessation. ENDS initiators are differentiating into distinct use patterns based on these factors within a short period of time.

Persistent bullying behavior is that which starts high and remains either moderately high or persistently high, seemingly in spite of intervention/prevention approaches employed: yet little is known about how/why persistent bullying emerges or is sustained. Those who do not respond to interventions and persist with their bullying behavior, require close consideration and more targeted, nuanced approaches. This instrumental case-study uniquely explores a self-identified, high-persistent bully's explanations of how the bullying emerged, and what supported/sustained it to become a persistent behavior. A whole-of-life interview protocol facilitated a reflective exploration of the participant's social and behavioral 'turning points': the influence of transitions and changes in one's life: serving to initially steer him toward bullying others, and eventually sustaining his persistent bullying behavior over time. An interpretative phenomenological analysis (IPA) revealed three 'turning points' which seemingly met his primary personal and social goals/needs of belonging, social positioning and status. This paper adds to the literature by introducing the notion of 'turning points' as a possible mechanism that facilitates the emergence of, and sustains persistent negative/bullying behaviors. Understanding turning points and any chain reactions in the lives of those who engage in higher, persistent levels of bullying can inform the development of future measures, intervention approaches and provide insights into issues of care for individuals engaging in persistent bullying.

This longitudinal study examines (a) whether perceptions of ethnic discrimination during the first weeks of college predicted later school belonging among first-year college students of color (N = 638) attending a predominantly White institution (PWI), (b) whether school belonging, in turn, predicted retention to the second year, and (c) whether ethnic identity centrality buffered the effects of discrimination on school belonging and academic retention. Participants completed measures of ethnic discrimination and identity near the beginning of the first semester and school belonging at the end of the semester. Academic data from the fall of the second year were obtained from school records. Tests of moderated mediation revealed that perceptions of discrimination at the beginning of college had an indirect effect on retention in the second year of college, as mediated by lowered school belonging, but only for students with low and moderate (but not high) ethnic identity centrality.

Identifying metabolic steps that are specifically required for the survival of cancer cells but are dispensable in normal cells remains a challenge1. Here we report a therapeutic vulnerability in a sugar nucleotide biosynthetic pathway that can be exploited in cancer cells with only a limited impact on normal cells. A systematic examination of conditionally essential metabolic enzymes revealed that UXS1, a Golgi enzyme that converts one sugar nucleotide (UDP-glucuronic acid, UDPGA) to another (UDP-xylose), is essential only in cells that express high levels of the enzyme immediately upstream of it, UGDH. This conditional relationship exists because UXS1 is required to prevent excess accumulation of UDPGA, which is produced by UGDH. UXS1 not only clears away UDPGA but also limits its production through negative feedback on UGDH. Excess UDPGA disrupts Golgi morphology and function, which impedes the trafficking of surface receptors such as EGFR to the plasma membrane and diminishes the signalling capacity of cells. UGDH expression is elevated in several cancers, including lung adenocarcinoma, and is further enhanced during chemoresistant selection. As a result, these cancer cells are selectively dependent on UXS1 for UDPGA detoxification, revealing a potential weakness in tumours with high levels of UGDH.

This technical brief estimates the expected performance of a solar photovoltaic and energy storage system (PVESS) for providing backup power during short-duration power interruption events, accounting for the unpredictable nature of those events. The analysis relies on the Power Reliability Event Simulation TOol (PRESTO), a publicly available model developed by Berkeley Lab to simulate the occurrence of short-duration power interruption events at the county-level. A separate storage dispatch model is then used to simulate PVESS operation and backup performance for each of the large number of interruption events produced by PRESTO. In performing this simulation, the analysis accounts for how the customer operates its battery on a day-to-day basis—in this case, we assume the battery is cycled each day in response to time-of-use rates—and how that, in turn, impacts the battery’s state of charge at the beginning of each interruption event. The analysis presented here is intended to demonstrate an application of the PRESTO model as well as to illustrate some of the key determinants of PVESS backup power performance during short-duration power interruption events. The analysis focuses initially on a typical single-family home in Maricopa County, Arizona, and includes a limited set of scenarios related to system sizing, backup power configuration, and whether the customer charges its battery storage system from the grid during normal operating conditions. The analysis also presents comparative results for two other counties, in Massachusetts (Middlesex) and California (Los Angeles), illustrating how regional differences in climate, interruption patterns, and retail rate structures can affect PVESS performance as a backup power source. In the conclusions, we highlight a number of other important considerations for evaluating PVESS backup power capabilities.

This article focuses on one university literacy camp for kindergarten through sixth grade students that shifted from traditional in-person instruction to a virtual setting during the COVID-19 pandemic. The change from an in-person camp to a virtual camp setting created an opportunity for research in investigating students' attitudes towards literacy, literacy learning, and participation within the newly formatted virtual literacy camp. Twenty-six kindergarten through sixth grade students were interviewed at the beginning and conclusion of a semester-long literacy camp regarding their attitudes toward learning and participation in the literacy camp. Throughout the data, researchers noted the theme of relationships as being prevalent with many participants sharing thoughts specifically in light of the lack of outside interaction during this more isolated era of time. The relationships built between the tutors and the students in this virtual camp were vital to the attitudes and the learning of these study participants. This study provides further direction for supporting students in a virtual literacy clinic setting.

To better understand existing ensemble requirements for music education majors at U.S. institutions, we conducted a content analysis of ensemble requirements for 1,021 degree programs at 465 colleges and universities accredited by the National Association of Schools of Music (NASM). The mean number of ensemble credits required for each degree program was 7.25 (SD = 2.89), and the mean number of semester enrollments required was 7.86 (SD = 1.95). There were significant differences between degree types (e.g., instrumental-focused, choral-focused) in terms of total ensemble credits required and number and kind of subrequirements (e.g., chamber or small ensemble). A majority of programs did not contain specific subrequirements beyond traditional large ensembles, suggesting that many students may not undertake the varied complement of ensemble experiences called for in the NASM standards. By continuing to diversify ensemble offerings and encouraging or requiring students in all degree specializations to develop their musicianship through a variety of ensemble experiences, music programs may be able to make valuable ensemble experiences even more beneficial for undergraduate music education students.

Thwaites Glacier represents 15% of the ice discharge from the West Antarctic Ice Sheet and influences a wider catchment1-3. Because it is grounded below sea level4,5, Thwaites Glacier is thought to be susceptible to runaway retreat triggered at the grounding line (GL) at which the glacier reaches the ocean6,7. Recent ice-flow acceleration2,8 and retreat of the ice front8-10 and GL11,12 indicate that ice loss will continue. The relative impacts of mechanisms underlying recent retreat are however uncertain. Here we show sustained GL retreat from at least 2011 to 2020 and resolve mechanisms of ice-shelf melt at the submetre scale. Our conclusions are based on observations of the Thwaites Eastern Ice Shelf (TEIS) from an underwater vehicle, extending from the GL to 3 km oceanward and from the ice-ocean interface to the sea floor. These observations show a rough ice base above a sea floor sloping upward towards the GL and an ocean cavity in which the warmest water exceeds 2 °C above freezing. Data closest to the ice base show that enhanced melting occurs along sloped surfaces that initiate near the GL and evolve into steep-sided terraces. This pronounced melting along steep ice faces, including in crevasses, produces stratification that suppresses melt along flat interfaces. These data imply that slope-dependent melting sculpts the ice base and acts as an important response to ocean warming.

Many academic libraries renovate physical spaces to address the needs of the 21st century learner. This study presents the assessment tools used to evaluate the use of space prior to a branch library renovation as well as results of two post-renovation assessments to examine the success of the project. The pre-renovation survey showed that library users desired extended hours of operation, better furniture, more power outlets, more private and group study spaces, better lighting, and more comfort. Both post-renovation survey results indicated an increase in satisfaction of all areas except access to food options and hours of operation.

BackgroundInvasive species threaten the productivity and stability of natural and managed ecosystems. Predicting the spread of invaders, which can aid in early mitigation efforts, is a major challenge, especially in the face of climate change. While ecological niche models are effective tools to assess habitat suitability for invaders, such models have rarely been created for invasive pest species with rapidly expanding ranges. Here, we leveraged a national monitoring effort from 543 sites over 3 years to assess factors mediating the occurrence and abundance of brown marmorated stink bug (BMSB, Halyomorpha halys), an invasive insect pest that has readily established throughout much of the United States.ResultsWe used maximum entropy models to estimate the suitable habitat of BMSB under several climate scenarios, and generalized boosted models to assess environmental factors that regulated BMSB abundance. Our models captured BMSB distribution and abundance with high accuracy, and predicted a 70% increase in suitable habitat under future climate scenarios. However, environmental factors that mediated the geographical distribution of BMSB were different from those driving abundance. While BMSB occurrence was most affected by winter precipitation and proximity to populated areas, BMSB abundance was influenced most strongly by evapotranspiration and solar photoperiod.ConclusionOur results suggest that linking models of establishment (occurrence) and population dynamics (abundance) offers a more effective way to forecast the spread and impact of BMSB and other invasive species than simply occurrence-based models, allowing for targeted mitigation efforts. Implications of distribution shifts under climate change are discussed. © 2022 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Sphingolipids play important signaling and structural roles in cells. Here, we find that during de novo sphingolipid biosynthesis, a toxic metabolite is formed with critical implications for cancer cell survival. The enzyme catalyzing the first step in this pathway, serine palmitoyltransferase complex (SPT), is upregulated in breast and other cancers. SPT is dispensable for cancer cell proliferation, as sphingolipids can be salvaged from the environment. However, SPT activity introduces a liability as its product, 3-ketodihydrosphingosine (3KDS), is toxic and requires clearance via the downstream enzyme 3-ketodihydrosphingosine reductase (KDSR). In cancer cells, but not normal cells, targeting KDSR induces toxic 3KDS accumulation leading to endoplasmic reticulum (ER) dysfunction and loss of proteostasis. Furthermore, the antitumor effect of KDSR disruption can be enhanced by increasing metabolic input (via high-fat diet) to allow greater 3KDS production. Thus, de novo sphingolipid biosynthesis entails a detoxification requirement in cancer cells that can be therapeutically exploited.