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The goal of this study is to verify a grounded theory model of tutoring developed by Babcock, Manning and Rogers (2012) using qualitative research literature as data. The four participants in the current study (three females) were recruited using a convenience sample as they were current or former tutees of the authors. One participant was a middle-school student while the others were college students. To obtain data, participants were tutored by the researchers either online (asynchronously) or face-to-face. Researchers coded the data based on audio recordings of face-to-face sessions and written artefacts of online tutoring sessions. The results support the model developed by Babcock et al. (2012). It is important to verify the grounded theory model since it will close the circle with grounded theory research to apply it to authentic tutoring data. Researchers have proposed grounded theory in tutoring but no one has yet attempted to verify a model. While the original model covered extensive topics such as communication, personal characteristics, outside influences, emotions, temperament, and outcomes, in this brief report we focus mainly on personal characteristics and outside influences. The model fits the data except in the case of asynchronous online tutoring, likely because the original data was from 1983 to 2006 and did not cover much online tutoring.

Members of the mammalian gut microbiota metabolize diverse complex carbohydrates that are not digested by the host, which are collectively labeled "dietary fiber." While the enzymes and transporters that each strain uses to establish a nutrient niche in the gut are often exquisitely specific, the relationship between carbohydrate structure and microbial ecology is imperfectly understood. The present study takes advantage of recent advances in complex carbohydrate structure determination to test the effects of fiber monosaccharide composition on microbial fermentation. Fifty-five fibers with varied monosaccharide composition were fermented by a pooled feline fecal inoculum in a modified MiniBioReactor array system over a period of 72 hours. The content of the monosaccharides glucose and xylose was significantly associated with the reduction of pH during fermentation, which was also predictable from the concentrations of the short-chain fatty acids lactic acid, propionic acid, and the signaling molecule indole-3-acetic acid. Microbiome diversity and composition were also predictable from monosaccharide content and SCFA concentration. In particular, the concentrations of lactic acid and propionic acid correlated with final alpha diversity and were significantly associated with the relative abundance of several of the genera, including Lactobacillus and Dubosiella. Our results suggest that monosaccharide composition offers a generalizable method to compare any dietary fiber of interest and uncover links between diet, gut microbiota, and metabolite production.ImportanceThe survival of a microbial species in the gut depends on the availability of the nutrients necessary for that species to survive. Carbohydrates in the form of non-host digestible fiber are of particular importance, and the set of genes possessed by each species for carbohydrate consumption can vary considerably. Here, differences in the monosaccharides that are the building blocks of fiber are considered for their impact on both the survival of different species of microbes and on the levels of microbial fermentation products produced. This work demonstrates that foods with similar monosaccharide content will have consistent effects on the survival of microbial species and on the production of microbial fermentation products.

TABLE OF CONTENTS I. BACKGROUND 837 II. THE SIGNIFICANCE OF TSA'S FACIAL RECOGNITION 841 PROGRAM III. HISTORICAL DEFERENCE TO AGENCY INTERPRETATIONS 845 IV. HOW THE COURT MIGHT REVIEW THE TSA'S [...], The Transportation Security Administration (TSA) has begun using facial recognition technology (FRT) to screen passengers at airports. Although travelers can currently opt out, it is not clear that this will continue to be an option as the program expands. This raises significant concerns about the amount of personally identifiable information being collected by the agency, as well as the level of discretion the agency has to implement this increasingly invasive technology without input from Congress. This Note proposes that, in light of the United States Supreme Court's shift away from its deferential Chevron standard for reviewing agency action, litigators can and should argue that the TSA's program ought to be struck down. Furthermore, it concludes that, regardless of whether the TSA's program would be invalidated in court, Congress should step in and pass legislation guiding the agency's adoption of FRT. Although much has been written about the Court's evolving Chevron-deference jurisprudence, this Note contributes to the discussion by applying this analysis to the TSA's potentially problematic new FRT program.

The infant gut microbiome is increasingly recognized as a reservoir of antibiotic resistance genes, yet the assembly of gut resistome in infants and its influencing factors remain largely unknown. We characterized resistome in 4132 metagenomes from 963 infants in six countries and 4285 resistance genes were observed. The inherent resistome pattern of healthy infants (N = 272) could be distinguished by two stages: a multicompound resistance phase (Months 0-7) and a tetracycline-mupirocin-β-lactam-dominant phase (Months 8-14). Microbial taxonomy explained 40.7% of the gut resistome of healthy infants, with Escherichia (25.5%) harboring the most resistance genes. In a further analysis with all available infants (N = 963), we found age was the strongest influencer on the resistome and was negatively correlated with the overall resistance during the first 3 years (p

Early use of genome sequencing (GS) in the diagnostic odyssey can reduce suffering and improve care, but questions remain about which patient populations are most amenable to GS as a first-line diagnostic test. To address this, the Medical Genome Initiative conducted a literature review to identify appropriate clinical indications for GS. Studies published from January 2011 to August 2022 that reported on the diagnostic yield (DY) or clinical utility of GS were included. An exploratory meta-analysis using a random effects model evaluated DY based on cohort size and diagnosed cases per cohort. Seventy-one studies met inclusion criteria, comprising over 13,000 patients who received GS in one of the following settings: hospitalized pediatric patients, pediatric outpatients, adult outpatients, or mixed. GS was the first-line test in 38% (27/71). The unweighted mean DY of first-line GS was 45% (12-73%), 33% (6-86%) in cohorts with prior genetic testing, and 33% (9-60%) in exome-negative cohorts. Clinical utility was reported in 81% of first-line GS studies in hospitalized pediatric patients. Changes in management varied by cohort and underlying molecular diagnosis (24-100%). To develop evidence-informed points to consider, the quality of all 71 studies was assessed using modified American College of Radiology (ACR) criteria, with five core points to consider developed, including recommendations for use of GS in the N/PICU, in lieu of sequential testing and when disorders with substantial allelic heterogeneity are suspected. Future large and controlled studies in the pediatric and adult populations may support further refinement of these recommendations.

Background and study aims The Bethesda ERCP Skill Assessment Tool (BESAT) is a video-based assessment tool of technical endoscopic retrograde cholangiopancreatography (ERCP) skill with previously established validity evidence. We aimed to assess the discriminative validity of the BESAT in differentiating ERCP skill levels. Methods Twelve experienced ERCP practitioners from tertiary academic centers were asked to blindly rate 43 ERCP videos using the BESAT. ERCP videos consisted of native biliary cannulation and sphincterotomy and were recorded from 10 unique endoscopists of various ERCP experience (from advanced endoscopy fellow to > 10 years of ERCP experience). Inter-rater reliability, discriminative validity, and internal structure validity were subsequently assessed. Results The BESAT was found to reliably differentiate between endoscopists of varying levels of ERCP experience with experienced ERCPists scoring higher than novice ERCPists in 11 of 13 (85%) instrument items. Inter-rater reliability for BESAT items ranged from good to excellent (intraclass correlation range: 0.86 to 0.93). Internal structure validity was assessed with item-total correlations ranging from 0.53 to 0.83. Conclusions Study findings demonstrate that the BESAT, a video-based ERCP skill assessment tool, has high inter-rater reliability and has discriminative validity in differentiating novice from expert ERCP skill. Further investigations are needed to determine the role of video-based assessment in improving trainee learning curves and patient outcomes.

BACKGROUND: Fecal shedding of SARS-CoV-2 occurs during infection, particularly in pediatric populations. The gut microbiota are associated with resistance to enteric pathogens. COVID-19 is associated with alterations to the gut microbiome. We hypothesized that the gut microbiome of infants born to SARS-CoV-2+ mothers differs between infants with and without fecal shedding of the virus. METHODS: We enrolled 10 infants born to SARS-CoV-2+ mothers. We used qPCR on fecal RNA to test for SARS-CoV-2 and 16S rRNA gene sequencing of the V4 region to assess the gut microbiome. Infant SARS-CoV-2 status from nasal swabs was abstracted from medical records. RESULTS: Of the 10 included infants, nine were tested for SARS-CoV-2 by nasal swab with 1 testing positive. Four infants, including the nasal swab positive infant, had at least one sample with detectable levels of SARS-CoV-2 fecal shedding. Detection of both SARS-CoV-2 genes in feces was associated with increased gut alpha diversity compared to no detection by a linear mixed effects model (p

To address the gap in understanding precipitation changes in Southeast Asia and to enhance the reliability of climate projections for the region through moisture budget analysis, this study examines the differences among six multi-model ensembles of CMIP6 simulated precipitation in term of moisture budget analysis. It investigates the relative contributions of thermodynamic and dynamic components to seasonal precipitation changes over Southeast Asia under the highest emission scenario, SSP5-8.5. The comparison between ensembles indicates that Good performance model ensembles slightly outperform the combination of all resolution and all category ensembles in reducing the biases. There is no strong evidence showing that good category ensembles outperform the combination of all model ensemble groups in simulating the spatial pattern of historical seasonal precipitation. From the perspective of moisture budget, regions receiving seasonal high rainfall intensity are mainly influenced by the moisture convergence during the monsoon seasons: northeast monsoon (December‒January‒February) and southwest monsoon (June–July–August). By the late 21st century (2081–2100), all model ensemble projections show an increase in December‒January‒February precipitation over the northern Southeast Asia and decreased June‒July‒August rainfall in the southern regions. The moisture budget analysis explained that the seasonal mean rainfall change in Southeast Asia is largely influenced by evaporation and followed by moisture flux convergence. The changes in moisture flux convergence are contributed by both the dynamic and thermodynamic components. Greater inter-model uncertainty was found in the precipitation dynamic component compared to the thermodynamic component suggesting the existence of large discrepancy between the various approaches used by GCMs in describing atmospheric dynamics. The study highlights that the Good model ensemble with middle to low resolution is able to narrow the inter-model uncertainties in terms of the moisture budget analysis compared to the combination of all Good model ensembles.

Diverse antibody repertoires spanning multiple lymphoid organs (i.e., bone marrow, spleen, lymph nodes) form the foundation of protective humoral immunity. Changes in their composition across lymphoid organs are a consequence of B-cell selection and migration events leading to a highly dynamic and unique physiological landscape of antibody repertoires upon antigenic challenge (e.g., vaccination). However, to what extent B cells encoding identical or similar antibody sequences (clones) are distributed across multiple lymphoid organs and how this is shaped by the strength of a humoral response remains largely unexplored. Here, we performed an in-depth systems analysis of antibody repertoires across multiple distinct lymphoid organs of immunized mice and discovered that organ-specific antibody repertoire features (i.e., germline V-gene usage and clonal expansion profiles) equilibrated upon a strong humoral response (multiple immunizations and high serum titers). This resulted in a surprisingly high degree of repertoire consolidation, characterized by highly connected and overlapping B-cell clones across multiple lymphoid organs. Finally, we revealed distinct physiological axes indicating clonal migrations and showed that antibody repertoire consolidation directly correlated with antigen specificity. Our study uncovered how a strong humoral response resulted in a more uniform but redundant physiological landscape of antibody repertoires, indicating that increases in antibody serum titers were a result of synergistic contributions from antigen-specific B-cell clones distributed across multiple lymphoid organs. Our findings provide valuable insights for the assessment and design of vaccine strategies.

Teaching music can be very stressful. The music education literature includes investigations of sources of stress and suggestions for stress relief, although it lacks a consistent underlying conceptual framework for stress. Role stress--a framework for understanding stress related to workplace dynamics--has the potential to provide structure while accounting for the nuance and complexity of organizations. The purpose of this study was to adapt and develop psychometrically sound questionnaires and then collect data to test a model to determine relationships among role stressors, role stress, and other variables of interest. Participants (N = 1,576) responded to items related to six hypothesized role stressors, specialization and teaching loads, holding multiple jobs, years taught, job satisfaction, organizational commitment, and intent to leave the current job. I analyzed the data using descriptive statistics, factor analysis, and structural equation modeling. Key findings included (a) strong relationships among role stress and negative occupational outcomes, (b) confirmation of four known role stressors but nonseparation of role conflict and role ambiguity in statistical models, and (c) weak relationships between role stress and model covariates (years teaching, within-specialization teaching, and having multiple jobs). These results have implications for current and prospective secondary music teachers, music teacher educators, and school administrators.

BACKGROUND: Meniscal and chondral damage is common in the patient undergoing revision anterior cruciate ligament (ACL) reconstruction. PURPOSE: To determine if meniscal and/or articular cartilage pathology at the time of revision ACL surgery significantly influences a patients outcome at 6-year follow-up. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Patients undergoing revision ACL reconstruction were prospectively enrolled between 2006 and 2011. Data collection included baseline demographics, surgical technique, pathology, treatment, and scores from 4 validated patient-reported outcome instruments: International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Marx Activity Rating Scale. Patients were followed up at 6 years and asked to complete the identical set of outcome instruments. Regression analysis assessed the meniscal and articular cartilage pathology risk factors for clinical outcomes 6 years after revision ACL reconstruction. RESULTS: An overall 1234 patients were enrolled (716 males, 58%; median age, 26 years). Surgeons reported the pathology at the time of revision surgery in the medial meniscus (45%), lateral meniscus (36%), medial femoral condyle (43%), lateral femoral condyle (29%), medial tibial plateau (11%), lateral tibial plateau (17%), patella (30%), and trochlea (21%). Six-year follow-up was obtained on 79% of the sample (980/1234). Meniscal pathology and articular cartilage pathology (medial femoral condyle, lateral femoral condyle, lateral tibial plateau, trochlea, and patella) were significant drivers of poorer patient-reported outcomes at 6 years (IKDC, KOOS, WOMAC, and Marx). The most consistent factors driving outcomes were having a medial meniscal excision (either before or at the time of revision surgery) and patellofemoral articular cartilage pathology. Six-year Marx activity levels were negatively affected by having either a repair/excision of the medial meniscus (odds ratio range, 1.45-1.72; P≤ .04) or grade 3-4 patellar chondrosis (odds ratio, 1.72; P = .04). Meniscal pathology occurring before the index revision surgery negatively affected scores on all KOOS subscales except for sports/recreation (P < .05). Articular cartilage pathology significantly impaired all KOOS subscale scores (P < .05). Lower baseline outcome scores, higher body mass index, being a smoker, and incurring subsequent surgery all significantly increased the odds of reporting poorer clinical outcomes at 6 years. CONCLUSION: Meniscal and chondral pathology at the time of revision ACL reconstruction has continued significant detrimental effects on patient-reported outcomes at 6 years after revision surgery.