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While active learning strategies have been promoted by researchers as practices to increase performance and retention, some practices have been shown to have unintended negative effects on students such as increasing anxiety. Students often report the debilitating effect of test-taking anxiety on their performance. This study investigated the use of an exam preparation process utilizing clicker questions to help human anatomy students at a community college cope with test-taking anxiety by practicing answering timed questions and regularly confronting the specific impact of anxiety on their performance. Students completed early and late semester surveys which measured self-reported test-taking anxiety levels and social anxiety in response to various teaching practices. There was no difference in test-taking anxiety between students who received clicker questions and students who did not. However, when comparing test taking anxiety across a subset of students who took both the early and late surveys, independent of treatment, a significant decrease in test taking anxiety was observed from the start to the end of the semester. Students also reported a change in effectiveness of teaching practices, rating lectures as effective early in the semester, while emphasizing active learning more at the end of the semester.

Given the high prevalence of psychological distress among vocational training (VT) students, this study aimed to assess the role of interpersonal emotional competence as a resilience factor promoting the educational success of this population. We postulated that emotional competence would promote educational success, both directly and indirectly by fostering students' help-seeking intentions when facing a personal or school-related problem. To test these hypotheses, we used a sample of 219 VT students from the Canadian province of Quebec (68% women, M[subscript age] = 24.58; SD[subscript age] = 7.95) enrolled in various programs (e.g. institutional and home care assistance, welding and fitting, secretarial studies, and professional cooking). These students were assessed two times, during the first half of their training and again after their training. Results from structural equation modelling revealed that emotional competence was a positive predictor of help-seeking intentions and educational success. However, having the intention to seek help did not translate into higher levels of educational success. Overall, these results highlight the importance of supporting VT students in the development and strengthening of their emotional competence to promote their educational success. Future research is needed to further understand the help-seeking process among VT students and its implications for their academic outcomes.

The purpose of this study was to examine the skills and types of instruction present within four commonly used writing textbooks at grades four and five via content and quantitative analyses. Determining the presence of standards-based skills and evidence-based practices may help shed light on the effectiveness and quality of these curricula. The textbooks under investigation included HMH Into Reading Texas for grades 4 and 5 (HMH; Houghton Mifflin Harcourt, 2020), and Texas myView Literacy for grades 4 and 5 (Pearson; Pearson Education, 2020). Findings indicated a lack of focus on composing for a variety of purposes, and a lack of explicit modeling instruction across all textbooks. The majority of activities appeared to be independent student work. Conclusions and recommendations for future research are provided with an emphasis on what is known about evidence-based instruction, and what needs to be included in writing textbooks for student achievement to improve.

Reading comprehension is the ultimate goal of learning to read, as the understanding of text is at the root of the purpose for reading, whether reading for pleasure or reading to learn. At-home reading practices can vary widely family to family -- some families have the knowledge and resources to read effectively with their children, while others have not been afforded the opportunity or knowledge to read with their children. The Advancing Comprehension and Engagement (ACE) Literacy Project is a free reading comprehension resource bringing the evidence-based Knowledge Acquisition & Transformation (KAT) Framework to families via podcast and video episodes in English and Spanish. The aim of the ACE Project is to help ameliorate access barriers to high-quality literacy resources for families by providing engaging, interactive episodes available on major platforms and accessible via cell phones, tablets, or computers. The present article describes the theoretical foundations underlying the ACE Project, details the methods used to develop ACE, describes the format followed in each episode, and discusses the pilot year of the project. Usage statistics are presented. Implications for the future of the ACE Project are discussed in light of initial data collection.

Making inferences is essential to comprehending text. Teachers can ask inferential questions, model their thinking, and teach specific strategies to support upper elementary students in making inferences while reading.

While there has been a recent focus on developing programs to support educational research by community college anatomy and physiology instructors, there is not yet an established long-term community of practice (CoPs) in this particular area. Studies of long-term CoPs, particularly in STEM education, are few and far between. This study examines College in the Schools (CIS), a long-term community of practice for high school anatomy and physiology (A&P) educators in Minnesota and Wisconsin. In addition, this study highlights the factors that attract high school A&P teachers to CIS and the possibility of creating a similar CoP for community college (CC) A&P instructors focused on educational research. It was discovered that despite their varying reasons for joining, members of CIS and CC instructors tend to participate in CoPs similarly. As a result, A&P instructors from CC who are interested in educational research could benefit from a CoP structure similar to CIS over a longer period of time.

Abstract The NASA Perseverance rover discovered light-toned float rocks scattered across the surface of Jezero crater that are particularly rich in alumina ( ~ 35 wt% Al2O3) and depleted in other major elements (except silica). These unique float rocks have heterogeneous mineralogy ranging from kaolinite/halloysite-bearing in hydrated samples, to spinel-bearing in dehydrated samples also containing a dehydrated Al-rich phase. Here we describe SuperCam and Mastcam-Z observations of the float rocks, including the first in situ identification of kaolinite or halloysite on another planet, and dehydrated phases including spinel and apparent partially dehydroxylated kaolinite. The presence of spinel in these samples is likely detrital in origin, surviving kaolinitization, pointing to an ultramafic origin. However, the association of low hydration with increased Al2O3 abundances suggests heating-induced dehydration which could have occurred during the lithification or impact excavation of these rocks. Given the orbital context of kaolinite-bearing megabreccia in the Jezero crater rim, we propose an origin for these rocks involving intense aqueous alteration of the parent material, followed by dehydration/lithification potentially through impact processes, and dispersion into Jezero crater through flood or impact-related processes.

The background and resources presented in this article support teaching about two Tent/Freedom Cities--in Fayette County, Tennessee, and in Lowndes County, Alabama--that were built as a form of civil rights resistance and for housing Black sharecroppers and tenant farmers evicted by oppressive white landlords for marching, attending mass mobilization meetings, and trying to register to vote. The authors conceptualize these Tent/Freedom Cities as forms of Black place-making and anti-racist mobility work and suggest that teaching about these insurgent encampments represents a neglected chapter within the "canon" of what has tended to be commemorated and taught about the Civil Rights Movement. They identify photographs, first-person accounts, and other primary source documentation for exploring and teaching Tent/ Freedom City geographies. In doing so, the authors surmise there is an opportunity to focus on the under-discussed intersection of civil rights struggle and the production of home--complete with moments of lived resistance, resourcefulness, community-building, self-defense, and joy.

The goals of this study were to investigate (a) the dyadic relations of mothers' and children's perceptions of children's anxiety symptoms across development, (b) whether maternal perceptions of children's anxiety serve as a mediator of the association between maternal anxiety and child anxiety, and (c) whether sensitive/structured parenting moderates these processes. Participants were 180 mother-child dyads (96 female) recruited from Quebec, Canada, and assessed in preschool, middle childhood, and early adolescence. Mothers and children completed questionnaires on children's anxiety, and mothers additionally completed a questionnaire on their own anxiety. Maternal sensitivity/structuring was assessed from an observed interaction task. Results from an actor-partner interdependence model suggest (a) maternal perceptions of children's anxiety in middle childhood predict children's self-perceptions in adolescence, but not vice versa; (b) maternal perceptions in middle childhood mediate the link between maternal anxiety in early childhood and child self-perceptions of anxiety in adolescence; and (c) the indirect effect of maternal perceptions is moderated by maternal sensitivity/structuring such that mothers who perceived more anxiety in their children and who were observed to show lower levels of sensitivity/structuring in middle childhood tended to have children who perceived more anxiety in adolescence. Findings suggest that maternal awareness of children's anxiety may be one mechanism, in the presence of relationships characterized by lower levels of sensitivity, through which anxiety risk is transferred from parent to child over time.

In July 2022, the University of Tennessee and the Tennessee Geographic Alliance hosted a three-week summer institute funded by the National Endowment for Humanities (NEH) as part of its "A More Perfect Union" initiative to promote a deeper understanding of United States history and culture. Eighteen K-12 educators from across the country came to Knoxville to explore "The Role of Geographic Mobility in the African American Freedom Struggle." The institute focused on Movement as one of geography's five fundamental themes and highlighted the central role that migration, transportation, and travel and tourism have played in maintaining structural racism and facilitating Black antiracist resistance, self-determination, and world- making across multiple scales and historical periods. This article examines the NEH Institute.

Jacqueline D Cotugno,1 Maree Ferguson,1,2 Hazel Harden,3 Shoni Colquist,3 Annabelle A Stack,1 Jane I Zimmerman,4 Anthony W Russell,4,5 Lauren E Ball,6 Ingrid J Hickman1,71Department of Nutrition and Dietetics, Princess Alexandra Hospital, 2School of Human Movement and Nutrition Sciences, The University of Queensland, 3INNIS Partnership, Brisbane, 4Department of Diabetes & Endocrinology, Princess Alexandra Hospital, 5School of Medicine, University of Queensland, 6Menzies Health Institute Queensland, Griffith University, 7The Mater Research Institute, The University of Queensland, Brisbane, QLD, AustraliaBackground: Insightful accounts of patient experience within a health care system can be valuable for facilitating improvements in service delivery.Objective: The aim of this study was to explore patients’ perceptions and experiences regarding a tertiary hospital Diabetes and Endocrinology outpatient service for the management of type 2 diabetes mellitus (T2DM).Method: Nine patients participated in discovery interviews with an independent trained facilitator. Patients’ stories were synthesized thematically using a constant comparative approach.Results: Three major themes were identified from the patients’ stories: 1) understanding T2DM and diabetes management with subthemes highlighting that specialist care is highly valued by patients who experience a significant burden of diabetes on daily life and who may have low health literacy and low self confidence; 2) relationships with practitioners were viewed critical and perceived lack of empathy impacted the effectiveness of care; and 3) impact of health care systems on service delivery with lack of continuity of care relating to the tertiary hospital model and limitations with appointment bookings negatively impacting on patient experience.Discussion: The patients’ stories suggest that the expectation of establishing a productive, ongoing relationship with practitioners is highly valued. Tertiary clinics for T2DM are well placed to incorporate novel technological approaches for monitoring and follow-up, which may overcome many of the perceived barriers of traditional service delivery.Conclusion: Investing in strategies that promote patient–practitioner relationships may enhance effectiveness of treatment for T2DM by meeting patient expectations of personalized care. Future changes in service delivery would benefit from incorporating patients as key stakeholders in service evaluation.Keywords: diabetes mellitus, discovery interview, health care, personal narratives

OBJECTIVE: Calcium pyrophosphate deposition (CPPD) disease is prevalent and has diverse presentations, but there are no validated classification criteria for this symptomatic arthritis. The American College of Rheumatology (ACR) and EULAR have developed the first-ever validated classification criteria for symptomatic CPPD disease. METHODS: Supported by the ACR and EULAR, a multinational group of investigators followed established methodology to develop these disease classification criteria. The group generated lists of candidate items and refined their definitions, collected de-identified patient profiles, evaluated strengths of associations between candidate items and CPPD disease, developed a classification criteria framework, and used multi-criterion decision analysis to define criteria weights and a classification threshold score. The criteria were validated in an independent cohort. RESULTS: Among patients with joint pain, swelling, or tenderness (entry criterion) whose symptoms are not fully explained by an alternative disease (exclusion criterion), the presence of crowned dens syndrome or calcium pyrophosphate crystals in synovial fluid are sufficient to classify a patient as having CPPD disease. In the absence of these findings, a score>56 points using weighted criteria, comprising clinical features, associated metabolic disorders, and results of laboratory and imaging investigations, can be used to classify as CPPD disease. These criteria had a sensitivity of 92.2% and specificity of 87.9% in the derivation cohort (190 CPPD cases, 148 mimickers), whereas sensitivity was 99.2% and specificity was 92.5% in the validation cohort (251 CPPD cases, 162 mimickers). CONCLUSION: The 2023 ACR/EULAR CPPD disease classification criteria have excellent performance characteristics and will facilitate research in this field.

OBJECTIVE: Calcium pyrophosphate deposition (CPPD) disease is prevalent and has diverse presentations, but there are no validated classification criteria for this symptomatic arthritis. The American College of Rheumatology (ACR) and EULAR have developed the first-ever validated classification criteria for symptomatic CPPD disease. METHODS: Supported by the ACR and EULAR, a multinational group of investigators followed established methodology to develop these disease classification criteria. The group generated lists of candidate items and refined their definitions, collected de-identified patient profiles, evaluated strengths of associations between candidate items and CPPD disease, developed a classification criteria framework, and used multi-criterion decision analysis to define criteria weights and a classification threshold score. The criteria were validated in an independent cohort. RESULTS: Among patients with joint pain, swelling, or tenderness (entry criterion) whose symptoms are not fully explained by an alternative disease (exclusion criterion), the presence of crowned dens syndrome or calcium pyrophosphate crystals in synovial fluid are sufficient to classify a patient as having CPPD disease. In the absence of these findings, a score >56 points using weighted criteria, comprising clinical features, associated metabolic disorders, and results of laboratory and imaging investigations, can be used to classify as CPPD disease. These criteria had a sensitivity of 92.2% and specificity of 87.9% in the derivation cohort (190 CPPD cases, 148 mimickers), whereas sensitivity was 99.2% and specificity was 92.5% in the validation cohort (251 CPPD cases, 162 mimickers). CONCLUSION: The 2023 ACR/EULAR CPPD disease classification criteria have excellent performance characteristics and will facilitate research in this field.

ABSTRACT The gut microbiome changes with age and affects regions beyond the gut, including the ovarian cancer tumor microenvironment. In this review summarizing the literature on the gut microbiome in ovarian cancer and in aging, we note trends in the microbiota composition common to both phenomena and trends that are distinctly opposite. Both ovarian cancer and aging are characterized by an increase in proinflammatory bacterial species, particularly those belonging to phylum Proteobacteria and genus Escherichia, and a decrease in short‐chain fatty acid producers, particularly those in Clostridium cluster XIVa (family Lachnospiraceae) and the Actinobacteria genus Bifidobacterium. However, although beneficial bacteria from family Porphyromonadaceae and genus Akkermansia tend to increase with normal, healthy aging, these bacteria tend to decrease in ovarian cancer, similar to what is observed in obesity or unhealthy aging. We also note a lack in the current literature of research demonstrating causal relationships between the gut microbiome and ovarian cancer outcomes and research on the gut microbiome in ovarian cancer in the context of aging, both of which could lead to improvements to ovarian cancer diagnosis and treatment.

The basidiomycete Moniliophthora roreri causes frosty pod rot of cacao (Theobroma cacao) in the western hemisphere. Moniliophthora roreri is considered asexual and haploid throughout its hemibiotrophic life cycle. To understand the processes driving genome modification, using long-read sequencing technology, we sequenced and assembled 5 high-quality M. roreri genomes out of a collection of 99 isolates collected throughout the pathogens range. We obtained chromosome-scale assemblies composed of 11 scaffolds. We used short-read technology to sequence the genomes of 22 similarly chosen isolates. Alignments among the 5 reference assemblies revealed inversions, translocations, and duplications between and within scaffolds. Isolates at the front of the pathogens expanding range tend to share lineage-specific structural variants, as confirmed by short-read sequencing. We identified, for the first time, 3 new mating type A locus alleles (5 in total) and 1 new potential mating type B locus allele (3 in total). Currently, only 2 mating type combinations, A1B1 and A2B2, are known to exist outside of Colombia. A systematic survey of the M. roreri transcriptome across 2 isolates identified an expanded candidate effector pool and provided evidence that effector candidate genes unique to the Moniliophthoras are preferentially expressed during the biotrophic phase of disease. Notably, M. roreri isolates in Costa Rica carry a chromosome segment duplication that has doubled the associated gene complement and includes secreted proteins and candidate effectors. Clonal reproduction of the haploid M. roreri genome has allowed lineages with unique genome structures and compositions to dominate as it expands its range, displaying a significant founder effect.

Background: Neonates with tetralogy of Fallot and symptomatic cyanosis (sTOF) require early intervention, utilizing either a staged repair (SR) or primary repair (PR) approach. They are exposed to several sources of low-dose ionizing radiation, which may contribute to increased cancer risk. Objectives: The purpose of this study was to compare cumulative radiation exposure and associated lifetime attributable risk (LAR) of cancer between treatment strategies in sTOF. Methods: Neonates with sTOF who underwent SR or PR from 2012 to 2017 were retrospectively reviewed from the Congenital Cardiac Research Collaborative. Radiation exposure from all radiologic studies prior to 18 months of age was converted to organ-equivalent doses and projected LAR of cancer incidence using the National Cancer Institute dosimetry tools. Results: There were 242 neonates from 8 centers, including patients with 146 SR and 96 PR. Cumulative total effective dose was significantly higher for SR (median 8.3 mSv, IQR: 3.0-17.4 mSv) than PR (2.1 mSv, IQR: 0.8-8.5 mSv; P 1 mGy in females, the LAR was highest for breast in SR (mean 1.9/1,000 patients). The highest proportion of cancers attributable to radiation exposure was projected for thyroid cancer in females undergoing SR (7.3%). Conclusions: Cumulative radiation exposure and LARs were higher among those undergoing SR compared to PR. This will be an important factor to consider in determining the preferred neonatal treatment strategy and should substantiate efforts to reduce radiation exposure in this vulnerable population.

Adenoviruses (Ads) have demonstrated significant success as replication-deficient (RD) viral vectored vaccines, as well as broad potential across gene therapy and cancer therapy. Ad vectors transduce human cells via direct interactions between the viral fiber knob and cell surface receptors, with secondary cellular integrin interactions. Ad receptor usage is diverse across the extensive phylogeny. Commonly studied human Ad serotype 5 (Ad5), and chimpanzee Ad-derived vector “ChAdOx1” in licensed ChAdOx1 nCoV-19 vaccine, both form primary interactions with the coxsackie and adenovirus receptor (CAR), which is expressed on human epithelial cells and erythrocytes. CAR usage is suboptimal for targeted gene delivery to cells with low/negative CAR expression, including human dendritic cells (DCs) and vascular smooth muscle cells (VSMCs). We evaluated the performance of an RD Ad5 vector pseudotyped with the fiber knob of human Ad serotype 49, termed Ad5/49K vector. Ad5/49K demonstrated superior transduction of murine and human DCs over Ad5, which translated into significantly increased T cell immunogenicity when evaluated in a mouse cancer vaccine model using 5T4 tumor-associated antigen. Additionally, Ad5/49K exhibited enhanced transduction of primary human VSMCs. These data highlight the potential of Ad5/49K vector for both vascular gene therapy applications and as a potent vaccine vector.

Case Presentation: A 22-year-old female presented to the emergency department with a dilated right pupil and mild blurry vision. Physical examination revealed a dilated, sluggishly reactive right pupil, without other ophthalmic or neurologic abnormalities. Neuroimaging was normal. The patient was diagnosed with unilateral benign episodic mydriasis (BEM). Discussion: BEM is a rare cause of acute anisocoria with an underlying pathophysiology that is not well understood. The condition has a female predominance and is associated with a personal or family history of migraine headaches. It is a harmless entity that resolves without intervention and results in no known permanent damage to the eye or visual system. Benign episodic mydriasis is a diagnosis of exclusion that may be considered only after the life- and eyesight-threatening causes of anisocoria.

Abstract Renaming practices are increasingly deployed as a political technology in USA campaigns to do greater justice to the rights, histories, and identities of historically marginalized groups. African American social actors and groups have been especially active in this onomastic or naming activism. To fully make sense of this renaming moment, which is often popularly misrepresented as brand new, we outline an approach that takes a longer view of the history of Black naming by drawing together ideas from the field of Black geographies, specifically Katherine McKittrick’s ideas about Black livingness, and our work in critical place naming studies. As an illustration, we conduct a study of SNCC and the way civil rights workers and mobilized communities valued names and deployed onomastic tactics—the (re)naming of people, places, and institutions as part of their creative and grass-roots activism. These onomastic tactics facilitated and accompanied SNCC’s gathering of antiracist intelligence, constructing a subaltern transportation system, and carrying out a revolutionary remaking of place and affective atmosphere in the face of oppression. We not only seek to add a needed racial genealogy of ongoing naming struggles in America, but also use SNCC’s onomastic tactics to tell a story of the Civil Rights Movement generally not well understood and to expand what counts as activism and who counts as activists beyond canonized celebrations of the Movement in popular media and education. As an important guide to current naming struggles, the SNCC experience is instructive of the fact that renaming alone cannot count as liberation. Rather, the efficacy of naming as a civil rights practice comes from the assembling and mobilizing of names with the broader capacities of people, material places, and political practices and discourses.

Abstract Background Efforts to distribute naloxone have equipped more people with the ability to reverse opioid overdoses but people who use drugs are often reluctant to call 911 due to concerns for legal repercussions. Rural communities face unique challenges in reducing overdose deaths compared to urban communities, including limited access to harm reduction services as well as greater concerns about stigma and privacy. Methods The Rural Opioid Initiative was funded in 2017 to better understand the health-related harms associated with the opioid crisis in rural US communities and consists of eight studies spanning ten states and 65 counties. Each study conducted semi-structured qualitative interviews with people who use drugs to understand contextual factors influencing drug use and health behaviors. We analyzed qualitative data from seven studies with data available at the time of analysis to understand peer response to overdose. Results Of the 304 participants interviewed, 55% were men, 70% were white, 80% reported current injection drug use, and 60% reported methamphetamine use. Similar to what has been found in studies focused on urban settings, people who use drugs in rural communities use a range of strategies to reverse overdoses, including non-evidence-based approaches. Several reported that multiple doses of naloxone are needed to reverse overdose. Three themes emerged around the willingness to call 911, including (1) hesitancy to call 911 for fear of legal consequences, (2) negative perceptions or experiences with law enforcement officers, and (3) efforts to obtain medical intervention while avoiding identification/law enforcement involvement. Conclusion People who use drugs employ multiple strategies to attempt overdose reversal, including non-evidence-based approaches. Greater education about the most effective and least harmful strategies is needed. Reluctance to call 911 is rooted in concerns about potential legal consequences as well as perceptions about law enforcement officers, which may be heightened in rural communities where people who use drugs are more easily identified by law enforcement. People who use drugs will go to great strides to connect their peers to needed medical services, suggesting that comprehensive interventions to reduce interactions with law enforcement officers and eliminate legal consequences for reporting overdoses are critical.

HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic, progressive neurological disorder and shares many radiological and clinical features with other more prevalent myelopathies. Here, we quantified spinal cord and brain volumes in adults with HAM/TSP in comparison with healthy volunteers (HVs) and individuals diagnosed with relapsing–remitting or progressive multiple sclerosis (RRMS or P-MS). Clinical disability and MRI were assessed in 24 HVs, 43 HAM/TSP subjects, and 46 MS subjects. Spinal cord cross-sectional area (SCCSA) and brain tissue volumes were measured and compared. HAM/TSP subjects had significantly lower SCCSA corresponding to cervical levels 2 and 3 (C2–3) (54.0 ± 8 mm2), cervical levels 4 and 5 (C4–5) (57.8 ± 8 mm2), and thoracic levels 4 to 9 (T4–9) (22.7 ± 4 mm2) and significantly elevated brain white matter hyperintensity (WMH) fraction (0.004 ± 0.008) compared to the HVs (C2–3: 69.4 ± 8 mm2, C4–5: 75.1 ± 9 mm2, T4–9: 34.1 ± 4 mm2; all p < 0.0001; and WMH: 0.0005 ± 0.0007; p < 0.001). In the HAM/TSP subjects, SCCSA at all levels but not WMH showed a significant correlation with clinical disability scores. WMH in HAM/TSP subjects, therefore, may not be related to clinical disability. SCCSA in our limited RRMS cohort was higher than the HAM/TSP cohort (C2–3: 67.6 ± 8 mm2, C4–5: 72.7 ± 9 mm2, T4–9: 33.4 ± 5 mm2; all p < 0.0001) and WMH was lower than in P-MS subjects (p = 0.0067). Principal component analysis suggested that SCCSA and WMH may be used to differentiate HAM/TSP from MS. Understanding these differences msay help establish early diagnostic criteria for HAM/TSP patients.