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BACKGROUND: Gliosarcoma, an isocitrate dehydrogenase wildtype (IDH-WT) variant of glioblastoma, is defined by clonal biphasic differentiation into gliomatous and sarcomatous components. While the transformation from a glioblastoma to gliosarcoma is uncommon, the subsequent transformation to osteosarcoma is rare but may provide additional insights into the biology of these typically distinct cancers. We observed a patient initially diagnosed with glioblastoma, that differentiated into gliosarcoma at recurrence, and further evolved to osteosarcoma at the second relapse. Our objective was to characterize the molecular mechanisms of tumor progression associated with this phenotypic transformation. METHODS: Tumor samples were collected at all 3 stages of disease and RNA sequencing was performed to capture their transcriptomic profiles. Sequential clonal evolution was confirmed by the maintenance of an identical PTEN mutation throughout the tumor differentiation using the TSO500 gene panel. Publicly available datasets and the Nanostring nCounter technology were used to validate the results. RESULTS: The glioblastoma tumor from this patient possessed mixed features of all 3 TCGA-defined transcriptomic subtypes of an IDH-WT glioblastoma and a proportion of osteosarcoma signatures were upregulated in the original tumor. Analysis showed that enhanced transforming growth factor-β (TGF-β) and bone morphogenic protein signaling was associated with tumor transformation. Regulatory network analysis revealed that TGF-β family signaling committed the lineage tumor to osteogenesis by stimulating the expression of runt-related transcription factor 2 (RUNX2), a master regulator of bone formation. CONCLUSIONS: This unusual clinical case provided an opportunity to explore the modulators of longitudinal sarcomatous transformation, potentially uncovering markers indicating predisposition to this change and identification of novel therapeutic targets.

This multiple-case study probes the social-emotional well-being of elementary and middle-grade students labeled as English learners who were enrolled in different bilingual program models in the midwestern United States. Using ecological systems theory, this qualitative study probes students' social-emotional well-being across schools and within different bilingual program models, seeking to determine the structures and practices that nurture positive facets or perpetuate negative facets of student well-being. Findings indicate that interactions with peers and adults in schools influence students' social-emotional well-being, with program-model variations, community demographics, and societal discourse shaping these in-school experiences, relationships, and sentiments. Implications center on critical consideration of bilingual program-model implementation to prepare teachers, promote schoolwide integration, prioritize home languages, and nurture inclusive communities.

Social emotional learning (SEL) fosters students' emotional intelligence and social skills, and research supports the relationships between SEL and academic outcomes. Despite schools implementing SEL as required by state policies, the manner of presentation is critiqued for its relevance to students' cultural complexities. This qualitative study examined the nuances of SEL implementation and its relevance for minoritized students in a sample of SEL school leaders. Among the themes identified were: challenges related to integrating SEL as Tier 1 interventions; shortcomings in assessing student needs and SEL outcomes; buy-in and capacity challenges with teacher interventionists; and the larger context of implementing SEL amid communities' mixed political views about SEL and equity/inclusion efforts. Implications for using SEL to improve diverse students' academic outcomes and well-being are discussed.

Background: To illustrate challenges of imaging interpretation in patients with oligodendroglioma seen at a referral center and evaluate interrater reliability. Methods: Two neuro-oncologists reviewed diagnostic preradiation MRIs of oligodendroglioma patients; interrater reliability was calculated with the kappa coefficient (k). A neuroradiologist measured presurgical apparent diffusion coefficient (ADC), if available. Results: Extensive enhancement was noted in four of 58 patients, k = 0.7; necrosis in seven of 58, k = 0.61; calcification in seven of 17, k = 1.0; diffusion restriction in two of 39 patients, k = 1.0 (all only in grade 3). ADC values with receiver operator characteristic analysis for area under the curve were 0.473, not significantly different from the null hypothesis (p = 0.14). Conclusions: Extensive enhancement, necrosis and calcification correlated with grade 3 oligodendroglioma in our sample. However, interrater variability is an important limitation when assessing radiographic features, supporting the need for standardization of imaging protocols and their interpretation.

BackgroundSurvivorship for those living with primary CNS cancers begins at diagnosis, continues throughout a person's life, and includes caregivers. Opportunities and challenges exist to advance survivorship care for those living with primary CNS cancers that necessitate stakeholder involvement.MethodsIn June 2021, NCI-CONNECT convened a two-day virtual workshop about survivorship care in neuro-oncology. Two expert panels provided key recommendations and five working groups considered critical questions to identify strengths, weaknesses, opportunities, and threats to the advancement of survivorship care and developed recommendations and action items.ResultsThe following action items emanated from the workshop: seek endorsement of meeting report from stakeholder organizations; address barriers in access to survivorship care and provider reimbursement; advance survivorship research through NIH and private grant support; develop a survivorship tool kit for providers, people living with primary CNS cancers and their caregivers; provide accessible educational content for neuro-oncology, neurology, and oncology community providers about survivorship care in neuro-oncology; and establish core competencies for survivorship care for neuro-oncology providers to be included in training and standardized exams.ConclusionsAction items aim to address access and reimbursement barriers, expand patient and provider education, develop core competencies, and support survivorship research through funding and other supports.

PurposeTo investigate the toxicity profile and establish an optimal dosing schedule of zotiraciclib with temozolomide in patients with recurrent high-grade astrocytoma.Patients and methodsThis two-stage phase I trial determined the MTD of zotiraciclib combined with either dose-dense (Arm1) or metronomic (Arm2) temozolomide using a Bayesian Optimal Interval design; then a randomized cohort expansion compared the progression-free survival rate at 4 months (PFS4) of the two arms for an efficient determination of a temozolomide schedule to combine with zotiraciclib at MTD. Pharmacokinetic and pharmacogenomic profiling were included. Patient-reported outcome was evaluated by longitudinal symptom burden.ResultsFifty-three patients were enrolled. Dose-limiting toxicities were neutropenia, diarrhea, elevated liver enzymes, and fatigue. MTD of zotiraciclib was 250 mg in both arms and thus selected for the cohort expansion. Dose-dense temozolomide plus zotiraciclib (PSF4 40%) compared favorably with metronomic temozolomide (PFS4 25%). Symptom burden worsened at cycle 2 but stabilized by cycle 4 in both arms. A significant decrease in absolute neutrophil count and neutrophil reactive oxygen species production occurred 12-24 hours after an oral dose of zotiraciclib but both recovered by 72 hours. Pharmacokinetic/pharmacogenomic analyses revealed that the CYP1A2_5347T>C (rs2470890) polymorphism was associated with higher AUCinf value.ConclusionsZotiraciclib combined with temozolomide is safe in patients with recurrent high-grade astrocytomas. Zotiraciclib-induced neutropenia can be profound but mostly transient, warranting close monitoring rather than treatment discontinuation. Once validated, polymorphisms predicting drug metabolism may allow personalized dosing of zotiraciclib.

Across the United States, school stakeholders are grappling with how best to serve the large and often marginalized student subgroup of emergent bilingual learners (EBLs), which includes preparing the wide array of teachers who work with EBLs. This mixed-method study probes one university's efforts to prepare teachers spanning settings from early childhood to high school, considering if and how participation in an EBL-focused graduate program influenced their understandings and practices in schools with large numbers of EBLs. Drawing from pre- and post program surveys and classroom observations, findings indicate that teachers shifted both perceptions and instruction as well as espoused roles as social justice advocates for EBLs and their families. Shifts connected to program curricula and experiences as well as the cohort model involving teachers in neighboring districts. Implications center on utilizing graduate teacher education to promote equity in schools via the preparation of in-service teachers.

Understanding the needs of emergent bilingual learners (EBLs) is important for consultants working to promote inclusive, affirming school environments. Thirty-three school professionals, including teachers, counselors, and social workers (70% female, 20% persons of color, 18% bilingual) shared their perceptions of experiences of EBLs attending high schools in the United States. In this pre-consultation qualitative data collection, themes were identified from six focus groups. Analyses revealed school, family, peer, and individual influences tied to EBLs' well-being. Participants recommended that schools institute culturally-specific structures to support EBLs, but also intervene with non-EBLs, general education teachers, and mainstream curriculum. Findings suggest that schools revise how they support the academic needs of EBLs. While English as a Second Language programs are commonplace in high school EBLs' language development, participants recommended that such programs should not isolate students from their non-EBL counterparts. Participants also recommended increased access to advanced classes. Implications for systems-level consultation are discussed.

In recent years, institutions have responded to changing school populations by preparing teachers for the growing number of emergent bilingual learners (EBLs). But this preparation largely focuses on supporting students' academic learning and language development, despite enhanced attention to social-emotional well-being in wider educational circles. This comparative case study seeks to understand whether and how teachers are prepared to facilitate this integral component of student learning in five schools with linguistically diverse populations and varied program models to serve EBLs. We first probe how teachers draw from various facets of their preparation to support EBLs' social-emotional well-being, including teacher education, professional development, collaboration with colleagues, and personal experiences. We then consider teachers' and students' perspectives on the requisite expertise to facilitate well-being in classrooms. Findings provide insight for university, district, and school stakeholders seeking to enhance teacher preparation as a means to improve the educational experiences of EBLs.

Shortcomings in schools' efforts to serve English learners (ELs) are often both a function of the continuing scarcity of teacher education and the ability of schools to implement high-quality professional development (PD) to successfully prepare effective teachers for this marginalized student population. Scant literature addresses the processes for initiating EL-focused PD, as well as the effectiveness of PD at the school-wide level. In this study, survey data collected from designing and delivering PD were examined to ascertain what makes for effective PD with respect to teaching ELs. Results of this multi-phase study suggest that educators are looking for not only how they can assess and accommodate the learning needs of ELs but also how to better support the larger contexts in which they learn. Additional findings included the need for learning specific types of strategies, conceptual frameworks, and interventions to help ELs learn both literacy, as well as in specific content areas. Implications for designing and evaluating EL-focused PD are discussed.

PurposeBody image (BI) is an important issue for cancer patients, as patients with BI concerns are susceptible to depression, anxiety, difficulty coping, and poor quality of life (QoL). While this concern has been documented in patients with other malignancies, no data exists of this QoL issue in patients with primary brain tumors (PBT).MethodsA cross-sectional survey of 100 PBT patients was conducted on an IRB approved prospective protocol using structured questionnaires. Participants completed the body image scale (BIS), Appearance Scheme Inventory Revised (ASI-R), MD Anderson Symptom Inventory Brain Tumor (MDASI-BT), and Patient-Reported Outcomes Measurement Information System (PROMIS) Depression, Anxiety, and Psychosocial Impact Positive measures.ResultsThe prevalence of clinically significant body image dissatisfaction (BIS ≥ 10) was 28% (95% CI 19-37%), median BIS score was 5 (range 0-27). The median ASI-R composite score was 2.9 (range 1.5-4.7). BIS was significantly correlated with the ASI-R (r = 0.53, 95% CI 0.37 to 0.65). The mean PROMIS Depression score was 48.4 (SD = 8.9), PROMIS Anxiety score was 49.4 (SD = 9.9), and PROMIS Psychosocial Illness Impact Positive score was 48.9 (SD = 9.7). BIS was significantly correlated with age, and trended with BMI and sex. The PROMIS Psychosocial Illness Impact Positive and PROMIS Anxiety scores were the most strongly related to BIS.ConclusionsThis study, the first to explore altered body image in PBT patients, revealed clinically significant body image dissatisfaction in nearly 1/3 of patients, similar to other malignancies. These findings underscore the potential contribution of disease and treatment-related body image concerns on psychosocial wellbeing in patients with PBT.

High school students labeled as English learners, referred to in this article as emergent bilinguals, participated in a mixed-methods study of their social and emotional well-being. Relationships with school personnel, peer relations, and involvement in support activities were connected to well-being while experiences of microaggressions from teachers and peers, lack of access to advanced curricula, and poor integration with mainstream peers were related to negative well-being. A variety of school, peer, and family themes both promoted and compromised well-being. Students' sense of connection to mainstream students was positively related to school belonging and positive affect. A sense of connection to ethnic peers and a positive ethnic identity were related to positive affect but not school belonging. This pattern of findings suggests that connecting with members of both one's ethnic and the mainstream community may lead to greater well-being but integrating into the mainstream community prompts greater school belonging. Implications for practice and policy are discussed.

This study sought to expand the field's understanding of the educational involvement of Latino parents whose children were English Learners and attended Catholic schools. Specifically, we attempted to identify factors that facilitate as well as prohibit involvement in two home-based types of educational involvement and two specific school-based types of educational involvement. In our sample of 329 Latino immigrant parents, their responses yielded a pattern of predictors that appear to be related to both home- and school-based participation. Namely, feeling that teachers are invested in one's child and feeling overwhelmed by other obligations appear as statistically significant predictors of each type of involvement. Perceived language barriers were also significant predictors of parent involvement in two instances. Implications for efforts to support parental educational involvement of Latino immigrant parents are discussed.

Abstract Objective: To analyze the lipid profile and cardiovascular risk of overweight and obese adolescents and correlate the findings with anthropometric measurements. Methods: This is a cross-sectional study on overweight and obese adolescents of both sexes (aged 14 to 18 years old). The collected variables were sex, weight, height, age, total cholesterol, triglycerides, High-density lipoprotein (HDL) and low-density lipoprotein (LDL). The Atherogenic Index of Plasma and Castelli Risk Indices I and II were calculated. These indices were classified into cutoff points to stratify cardiovascular risk. The anthropometric profile was evaluated by Z score according to Body Mass Index for age. Significance level was considered as p≤0.05. Results: A total of 146 adolescents participated in the study; the mean age was 16.4±1.1 years and most of them were girls (74.7%) and obese (52.7%). The prevalent dyslipidemias were high triglycerides (47.9%), LDL (26.7%), total cholesterol (37.7%), and low HDL (46.6%). Most adolescents presented increased atherogenic risk according to the Atherogenic Index of Plasma (55.5%); 15.1% presented high cardiovascular risk according to Castelli Risk Index I; and 13.7%, according to Castelli Risk Index II. Boys presented higher values of anthropometric measurements and Castelli Risk Indices I and II in relation to girls — who, conversely, presented higher values of HDL. There was a positive correlation of the Z score with Atherogenic Index of Plasma and a negative correlation with HDL. Conclusions: The adolescents of the study presented high prevalence of cardiovascular and atherogenic risk according to the evaluated indices. In addition, the increased cardiovascular risk was correlated with higher Body Mass Index.

As a result of the Every Student Succeeds Act (ESSA), schools and districts are encouraged to implement school-wide initiatives to improve outcomes for all students. In accordance with the ESSA, this research study investigated the relationship between school improvement planning and the implementation of school-wide interventions. The study examined survey and extant data from five high schools in a Midwestern state to analyze academic and behavior-related school-wide efforts and their relationship to school improvement. The data showed a statistically significant relationship between school improvement planning and the state's school improvement report card of student performance (Kendall Rank-Order Coefficient, p = 0.025). These findings suggest that schools might consider integrating their school-wide efforts into school improvement planning.

This study investigated the pandemic-era schooling experiences of teachers and families of multilingual learners (MLLs) in the United States, using a strength-based lens to explore innovative, collaborative, and responsive practices. Using a multiple-case study design of three Midwestern districts, we probed how teachers and parents carved out and filled up spaces to facilitate sound practice for MLLs. Findings indicate that stakeholders collaboratively established structures to (a) enhance communication, (b) prioritize holistic well-being, (c) recognize cultural and linguistic strengths, and (d) provide innovative pedagogy. Implications center on building from strengths to transform policy and practice with MLLs in post-pandemic schools. [ABSTRACT FROM AUTHOR]

Objective: High self‐efficacy is associated with improved self‐care and reduced symptoms in cancer patients but has not been fully interrogated in adults with central nervous system (CNS) cancers. We aimed to identify the relationship between self‐efficacy levels in managing emotions (SEMEM) and social interactions (SEMSI) by examining sample characteristics and symptom burden. Methods: Sample characteristics and patient‐reported outcome (PRO) measures addressing self‐efficacy (PROMIS SEMEM & SEMSI) and symptom burden (MDASI BT or SP) were collected in a novel web‐based study of 158 adult patients diagnosed with rare CNS tumors. Results: The sample was predominantly female (73%), diagnosed with an ependymoma (66%), and had a median age of 45 (19–75). Low SEMEM was associated with a longer duration of symptoms before surgery (r = −0.26) and female gender (92%) among brain tumor (BT) participants and in spinal cord tumors (SCT), those with lower education (r = 0.29). Reporting low SEMSI was associated with being married (42%), lower education (r = 0.22), and a prolonged time with symptoms before surgery (r = 0.29) in those with BTs, with no associations identified in SCT. More severe mood‐related interference (including mood, enjoyment of life, and relationship with others) was associated with lower SEMEM among both locations (r = −0.61 brain, r = −0.28 spine) and SEMSI in BT participants (r = −0.54). Conclusions: Low self‐efficacy was linked to a prolonged time between symptom onset and initial surgery, education, gender, and marital status and was associated with higher mood‐related interference. Understanding characteristics associated with low self‐efficacy underscores a need for future studies to tailor interventions that enhance self‐efficacy. [ABSTRACT FROM AUTHOR]

Background Burnout is a syndrome characterized by emotional exhaustion, depersonalization, and a reduced sense of accomplishment, which commonly arises from chronic workplace stress in the medical field. Given the higher risk of burnout in younger age groups reported in some studies, the Society for Neuro-Oncology (SNO) Young Investigator (YI) and Wellness Committees combined efforts to examine burnout in the SNO YI membership to better understand and address their needs. Methods We distributed an anonymous online survey to SNO members in 2019. Only those meeting the definition of a YI were asked to complete the survey. The survey consisted of questions about personal and professional characteristics as well as the validated Maslach Burnout Inventory-Human Services Survey (MBI-HSS) questionnaire. Statistical analyses included descriptive statistics, univariate and multivariate analyses, and incorporation of previously defined burnout profiles. Results Data were analyzed for 173 participants who self-identified as YI. Measures of burnout showed that YI members scored higher on emotional exhaustion and depersonalization compared to normative population but similar to those in a prior SNO general membership survey. With respect to burnout profiles, 30% of YI respondents classified as overextended and 15% as burnout. Organizational challenges were the most common contributors to stress. Conclusions Similar to results from a previous survey completed by general SNO membership, the prevalence of burnout among neuro-oncology clinical and research YI is high, and is mainly characterized by overextension, warranting interventions at institutional and organizational levels. [ABSTRACT FROM AUTHOR]

The client's perception of the therapy relationship is an essential component of modern theoretical orientations. To date, there is a lack of quantitative research examining how the therapeutic bond affects therapy outcomes in college counseling. This study used path analysis to examine longitudinal therapy outcomes with 423 college students. Having a stronger therapeutic bond predicted decreased symptoms of depression, social anxiety, and academic distress. Findings support continued attention to developing a working relationship.

This qualitative study examined 17 school counselors' pandemic‐related experiences to identify demands, resources, and consequences to well‐being. Among the main demands were increases in student social‐emotional impairment, role confusion, and top‐down policy modifications that made it more challenging to do their jobs. The top resources were support from colleagues and individual limit‐setting. Consequences to well‐being were mixed, but exhaustion and recommitments to self‐care were the most frequently reported. Implications for retention of school counselors and training are discussed. Practitioner Points: After the pandemic, school counselors saw a significant change in social‐emotional demands from students.A major consequence of the pandemic for school counselors was personal exhaustion.Support from colleagues and a commitment to self‐care contributed to resilience in school counselors. [ABSTRACT FROM AUTHOR]

Despite what we have learned about the causes and consequences of bullying, efforts to reduce bullying through interventions to date have yielded modest results. Most bullying prevention efforts have targeted perpetrators and victims, ignoring the powerful role that observers play in maintaining cycles of bullying. This article presents literature from the fields of bystander behavior, empathy training, multicultural education, and ally/social justice orientation development; integrates relevant findings; and proposes a comprehensive model of upstanding behavior to inform prevention efforts. Through helping youth understand the value of being upstanders, there is a greater propensity for our schools and communities to become safer, more compassionate places that value the contributions of all members.

Teachers in urban schools experience significant stressors that can impact their effectiveness, well-being, retention, and ability to meet the needs of their students. The current mixed methods study explored 160 urban teachers' thoughts and feelings in response to challenging classroom situations, factors that predicted the prevalence of these reactions, and teachers' help-seeking attitudes. Results revealed the most prevalent thoughts that emerged were inability to resolve the situation, problem-solving, factors beyond the classroom, wanting a break, and personal locus of control. The most prevalent feelings that emerged were anger, anxiety, sadness, emotional exhaustion, incompetence, positivity, and confusion. The amount of professional and social--emotional support teachers received predicted a greater prevalence of productive thoughts and fewer negative emotions. Additionally, teachers related a relative openness to pursuing professional psychological services. Taken altogether, the findings suggest that urban teachers can be supported via forms of professional and social--emotional support in managing stressors in their workplace. Implications for professional development and teacher education programs are discussed.

The connections between climate change, the environment, and mental health have been well documented by psychological research. However, the extent to which health service psychologists who work in clinical settings address these issues with clients is not well understood. Health service psychology trainees participated in an exploratory investigation of the predictors of ecotherapeutic intervention use in their clinical work. The significant predictors were trainees' environmental justice beliefs and the degree to which environmentalism issues were discussed in their training programs and supervision. However, social justice attitudes, along with biospheric values and environmental identity, were significant predictors of environmental justice beliefs. Biospheric values and environmental identity were also significant predictors of personal conservation behaviors, but personal behaviors did not predict professional attention to environmental issues. Implications for training are discussed. [ABSTRACT FROM AUTHOR]

The purpose of the current investigation was to examine the relationships among a range of specific barriers and facilitators of parent involvement and a variety of types of school involvement within a diverse group of immigrant parents of English Learners (ELs) in four elementary school districts. In-home types of educational involvement such as monitoring homework and asking children about their school day were the most commonly reported behaviors, and utilizing community resources was found to be the least common type of parental involvement. Involvement type was predicted by parental demographic factors such as comfort with English language, educational background, and ethnicity, as well as perceptions of barriers and overall school climate. The findings of this study have implications for the design and implementation of interventions (e.g., parent programs, school policy changes) aimed at increasing the parental involvement of EL children. (Contains 3 tables.)

This mixed-methods study examined the socioemotional experiences of 57 alumni of language support programs (i.e., English as a second language, bilingual education) to identify effects of being English learners (ELs). Findings revealed the need for multicultural sensitivity to ELs, bullying episodes, social exclusion, and not disclosing negative experiences. Participants valued opportunities to meet diverse peers, appreciated teacher support, and viewed negative experiences as a source of motivation to achieve. Participants with greater numbers of negative experiences were less connected to ethnic communities, were more marginalized by their ethnic peers, and had lower school belonging. School- based support was correlated with school belonging and overall perceptions of support. Years in ESL classrooms was correlated with negative affect. Support from school and family along with ethnic identity and sense of connection to ethnic community were significant predictors of positive affect. Findings have implications for consultation and professional development of personnel working with ELs.

While evidence of the mental health effects of bullying has amassed in recent years, less scholarship explores the dynamics of bullying as it manifests in culturally diverse environments. The purpose of this study was to determine how contextual factors influence participation in bullying behaviors in a sample of urban, low-income, ethnic minority students. Using structural equation modeling, researchers tested whether social competence mediates the relationship between (a) parents' messages about aggression, (b) school belonging, (c) personal control and the outcome of bullying. Results of the study support evidence for a direct relationship between parental messages and bullying, social skills and bullying, parental messages and social skills, and personal control and social skills. Findings also indicate an indirect relationship between personal control and bully perpetration. Implications and directions for future research on contextual factors associated with bullying are discussed.