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Many peptide hormones form an α-helix on binding their receptors1-4, and sensitive methods for their detection could contribute to better clinical management of disease5. De novo protein design can now generate binders with high affinity and specificity to structured proteins6,7. However, the design of interactions between proteins and short peptides with helical propensity is an unmet challenge. Here we describe parametric generation and deep learning-based methods for designing proteins to address this challenge. We show that by extending RFdiffusion8 to enable binder design to flexible targets, and to refining input structure models by successive noising and denoising (partial diffusion), picomolar-affinity binders can be generated to helical peptide targets by either refining designs generated with other methods, or completely de novo starting from random noise distributions without any subsequent experimental optimization. The RFdiffusion designs enable the enrichment and subsequent detection of parathyroid hormone and glucagon by mass spectrometry, and the construction of bioluminescence-based protein biosensors. The ability to design binders to conformationally variable targets, and to optimize by partial diffusion both natural and designed proteins, should be broadly useful.

Complex II (CII) activity controls phenomena that require crosstalk between metabolism and signaling, including neurodegeneration, cancer metabolism, immune activation, and ischemia-reperfusion injury. CII activity can be regulated at the level of assembly, a process that leverages metastable assembly intermediates. The nature of these intermediates and how CII subunits transfer between metastable complexes remains unclear. In this work, we identify metastable species containing the SDHA subunit and its assembly factors, and we assign a preferred temporal sequence of appearance of these species during CII assembly. Structures of two species show that the assembly factors undergo disordered-to-ordered transitions without the appearance of significant secondary structure. The findings identify that intrinsically disordered regions are critical in regulating CII assembly, an observation that has implications for the control of assembly in other biomolecular complexes.

Syphilis is a sexually transmitted infection with manifestations that can mimic other diseases, leading to misdiagnosis. Annular syphilis is a rare atypical secondary syphilitic lesion that seldomly involves the face. Human immunodeficiency virus (HIV) coinfection can increasingly lead to atypical manifestations of syphilis and complicate the diagnosis. Herein, we describe a 29-year-old man with a diagnosis of annular secondary syphilis and HIV coinfection. He had clinical manifestations of annular erythematous papules and plaques with white scales at the edges, distributed and scattered on the face, neck, and upper back. The skin lesions went undetected on several visits and were misdiagnosed owing to similarities with other dermatoses. Serological examination showed positive Treponema pallidum particle agglutination assay and venereal disease research laboratory test titer 1/512, confirming syphilis infection. Results from the histopathological examination supported the diagnosis of secondary syphilis. Positive anti-HIV rapid test results indicated concurrent HIV infection. He was treated for syphilis and given antiretroviral therapy, and showed a good response as demonstrated by improvement of the lesions and serological titers. This case highlights the importance of recognizing the possibility of annular secondary syphilis and HIV coinfection which can have atypical manifestations.

BackgroundGiven the waning of vaccine effectiveness and the shifting of the most dominant strains in the U.S., it is imperative to understand the association between vaccination coverage and Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) disease and mortality at the community levels and whether that association might vary according to the dominant SARS-CoV-2 strains in the U.S.MethodsGeneralized estimating equations were used to estimate associations between U.S. county-level cumulative vaccination rates and booster distribution and the daily change in county-wide Coronavirus 2019 disease (COVID-19) risks and mortality during Alpha, Delta and Omicron predominance. Models were adjusted for potential confounders at both county and state level. A 2-week lag and a 4-week lag were introduced to assess vaccination rate impact on incidence and mortality, respectively.ResultsAmong 3,073 counties in 48 states, the average county population complete vaccination rate of all age groups was 50.79% as of March 11th, 2022. Each percentage increase in vaccination rates was associated with reduction of 4% (relative risk (RR) 0.9607 (95% confidence interval (CI): 0.9553, 0.9661)) and 3% (RR 0.9694 (95% CI: 0.9653, 0.9736)) in county-wide COVID-19 cases and mortality, respectively, when Alpha was the dominant variant. The associations between county-level vaccine rates and COVID-19 incidence diminished during the Delta and Omicron predominance. However, each percent increase in people receiving a booster shot was associated with reduction of 6% (RR 0.9356 (95% CI: 0.9235, 0.9479)) and 4% (RR 0.9595 (95% CI: 0.9431, 0.9761)) in COVID-19 incidence and mortality in the community, respectively, during the Omicron predominance.ConclusionsAssociations between complete vaccination rates and COVID-19 incidence and mortality appeared to vary with shifts in the dominant variant, perhaps due to variations in vaccine efficacy by variant or to waning vaccine immunity over time. Vaccine boosters were associated with notable protection against Omicron disease and mortality.

Although COVID-19 infection is an immunosuppressant disease, many immunosuppressant agents, such as pulse methylprednisolone (PMP), dexamethasone (DXM), and tocilizumab (TCZ), were used during the pandemic. Secondary infections in patients with COVID-19 have been reported recently. This study investigated these agents' effects on secondary infections and outcomes in patients with COVID-19 in intensive care units (ICUs). This study was designed retrospectively, and all data were collected from the tertiary intensive care units of six hospitals between March 2020 and October 2021. All patients were divided into three groups: Group I [GI, PMP (−), DXM (−) and TCZ (−)], Group II [GII, PMP (+), DXM (+)], and Group III [GIII, PMP (+), DXM (+), TCZ (+)]. Demographic data, PaO/FiO2 ratio, laboratory parameters, culture results, and outcomes were recorded. To compare GI-GII and GI-GIII, propensity score matching (PSM) was used by matching 14 parameters. Four hundred twelve patients with COVID-19 in the ICU were included in the study. The number of patients with microorganisms ≥ 2 was 279 (67.7%). After PSM, in GII and GIII, the number of (+) tracheal cultures and (+) bloodstream cultures detected different microorganisms ≥ 2 during the ICU period, neuropathy, tracheotomized patients, duration of IMV, and length of ICU stay were significantly higher than GI. The mortality rate was similar in GI and GII, whereas it was significantly higher in GIII than in GI. The use of immunosuppressant agents in COVID-19 patients may lead to an increase in secondary infections. In addition, increased secondary infections may lead to prolonged ICU stay, prolonged IMV duration, and increased mortality. [ABSTRACT FROM AUTHOR]

Disability-inclusive laws and policies – while not sufficient on their own to advance substantive equality – are an essential step that all countries can take to advance non-discrimination and equity in education for children and youth with disabilities. This is the first study to comprehensively review national law and policy guarantees in 193 countries to assess the extent to which countries have harmonized national laws and policies with international commitments to inclusive education articulated in the Convention on the Rights of Persons with Disabilities and the Sustainable Development Goals. While strong guarantees exist across diverse countries, we find that notable gaps remain. Forty-six percent of countries do not broadly prohibit disability-based discrimination through the completion of secondary education. Legislation in 35% of countries does not guarantee persons with disabilities access to integrated education in mainstream education environments along with necessary individualized accommodations through the completion of secondary school. Thirty-one percent of countries that make primary education compulsory do not pair compulsory education with guarantees to integration in mainstream education environments and individualized supports for students with disabilities. These findings can inform reforms in countries without national guarantees and bolster support for implementation in countries where strong legal guarantees to inclusive education already exist. [ABSTRACT FROM AUTHOR]

This analysis explores a literacy teacher's changing perspective about teaching in a prestigious high school after learning about ahimsa, or holistic nonviolence. Drawing from theories of transformational learning and critical pedagogy in addition to understandings of ahimsa, this article presents some of the participant's new perceptions about her teaching and about the culture of the elite high school where she worked, including perceptions of structural violence. New understandings suggest that in order for schools to be nonviolent spaces, structural violences need to be considered alongside more overtly visible forms of violence. There are also implications for teacher learning. When professional development supports transformational change, it can be both inspirational and unnerving, and might shift participants' perspectives and unsettle their ways of relating to established practices and familiar contexts. [ABSTRACT FROM AUTHOR]

This study explored and demonstrated the significant association between teachers' creative self-concepts, namely creative role identity and creative self-efficacy, and teaching for creativity. Multigroup structural equation modeling was used with data from 1,043 primary and secondary teachers. The results confirmed that teachers' creative role identity consisted of their self-view of creative behavior and perceived expectations from school, colleagues, and students. Both personal and contextual aspects of creative role identity were significantly related to teaching for creativity, and school expectations were the most closely associated. The findings showed that secondary teachers had a higher level of creative self-efficacy and performed more creativity-fostering behavior than primary teachers. Some of the personal and contextual antecedents were more balanced for secondary teachers than they were for primary teachers, which contributed to their creative self-efficacy. [ABSTRACT FROM AUTHOR]

Under the best circumstances, achieving or sustaining optimum ecological conditions in estuaries is challenging. Persistent information gaps in estuarine data make it difficult to differentiate natural variability from potential regime shifts. Long-term monitoring is critical for tracking ecological change over time. In the United States (US), many resource management programs are working at maximum capacity to address existing state and federal water quality mandates (e.g., pollutant load limits, climate impact mitigation, and fisheries management) and have little room to expand routine sampling efforts to conduct periodic ecological baseline assessments, especially at state and local scales. Alternative design, monitoring, and assessment approaches are needed to help offset the burden of addressing additional data needs to increase understanding about estuarine system resilience when existing monitoring data are sparse or spatially limited. Research presented here offers a pseudo-probabilistic approach that allows for the use of found or secondary data, such as data on hand and other acquired data, to generate statistically robust characterizations of ecological conditions in estuaries. Our approach uses a generalized pseudo-probabilistic framework to synthesize data from different contributors to inform probabilistic-like baseline assessments. The methodology relies on simple geospatial techniques and existing tools (R package functions) developed for the US Environmental Protection Agency to support ecological monitoring and assessment programs like the National Coastal Condition Assessment. Using secondary estuarine water quality data collected in the Northwest Florida (US) estuaries, demonstrations suggest that the pseudo-probabilistic approach produces estuarine condition assessment results with reasonable statistical confidence, improved spatial representativeness, and value-added information. While the pseudo-probabilistic framework is not a substitute for fully evolved monitoring, it offers a scalable alternative to bridge the gap between limitations in resource management capability and optimal monitoring strategies to track ecological baselines in estuaries over time. [ABSTRACT FROM AUTHOR]

This STEM research project asks middle school or high school students to work towards creating ecologically friendly packaging. Packaging that can be composted instead of thrown away and collected in landfills and oceans like plastics. This inquiry uses nanocellulose and focuses on water permeability. The fibers of nanocellulose can be dried to make a rather strong and thin film, but due to the spaces between the fibers the film is too water permeable and therefore makes poor packaging materials on its own. Students will create nanocellulose composite films with other biodegradable materials, in an attempt to fill the inter-fiber microscopic spaces and create a new film that can be easily tested for water permeability. Students set up a straightforward science experiment with films, water, and mason jars. They will collect and graph data to determine if their nanocellulose composite films reduce water permeability compared to plain nanocellulose and how close they are to the present standard, plastic. This research is an amalgam of disciplinary core ideas like properties and states of matter, as well as a combination of science and engineering practices. It ignites students' curiosity, provides an organic path to science fair extensions, while also helping to cultivate future scientists, engineers, and environmental activists. [ABSTRACT FROM AUTHOR]

Despite the value of reading, research documents declining reading rates among American adolescents – a decline that exacerbates student dropout rates and academic performance. As a high school English teacher in a public, regional, suburban school, increasing the number of students who deeply read the assigned texts for class has been a career-long focus. Therefore, one of my goals for the 2021–2022 school year was to promote better reading practices among my students using a note-per-pages assignment and to reflect on the results via a teacher research study design. Findings indicate that while certainly not a fail-proof assignment without its flaws, the note-per-pages assignment as the focus of this action research did increase the overall number of students reading the assigned texts and that more students reported feeling the assignment was helpful to their reading practices as the school year progressed. Implications regarding student engagement in and ownership of the reading process, class reading culture, and involving students in the action research process are included. [ABSTRACT FROM AUTHOR]

Background: Little is known about the frequency and impact of the persistent headache and about the incidence of chronic daily headache (CDH) after coronavirus disease 2019 (COVID-19). The aim of this prospective cohort study was to assess the incidence, risk factors, characteristics, and impact of CDH in patients with COVID-19. Methods: In the first stage, 288 patients were interviewed by telephone after the acute phase of COVID-19. Subsequently, 199 patients who presented headache were reinterviewed at least one year after COVID-19. Headaches that persisted beyond the acute phase of COVID-19 for three or more months and presented frequency ≥ 45 days over the first three months were considered to be CDH. Results: One hundred and twenty-three patients were included, 56% were females; median age: 50 years (25th and 75th percentile: 41;58). The headache persisted beyond the acute phase of COVID-19 in 52%, and 20.3% had CDH (95% confidence interval: 13.6--28.2). Individuals who previously had headaches and who had headaches of greater intensity during the acute phase were at higher risk of developing CDH. The group with CDH included more females, greater impact of headache, more persistence of headache beyond the 120th day of COVID-19 and less throbbing headache than did the other individuals whose headache persisted. Conclusions: Patients who had COVID-19 had a high incidence of CDH. Previous headache and greater intensity of headache were associated with higher risk of CDH. [ABSTRACT FROM AUTHOR]

Myeloproliferative neoplasms are clonal hematopoietic stem cell disorders showing proliferation of one or more myeloid lineages. These disorders are characterized by Janus Kinase 2 (JAK2 V617F), Myeloproliferative leukemia (MPL), and Calreticulin (CALR) gene mutations and are seen more commonly in the elderly. These pathognomonic mutations are often absent in children and hence pose a diagnostic challenge. The entire onus of correct diagnosis relies heavily on detailed clinical and laboratory investigations. In the present work, we discuss 4 cases of pediatric myelofibrosis, three of which were secondary to hematolymphoid malignancies, while the remaining one had primary myelofibrosis. Pediatric primary myelofibrosis is a rare entity in children and quite different from adult primary myelofibrosis. The cases in our study show transformation into acute myeloid leukemia, which is associated with an adverse prognosis. Given the rarity of myelofibrosis in children, early and correct diagnosis helps in timely initiation of treatment, which may favorably alter the prognosis. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Agri: Journal of the Turkish Society of Algology / Türk Algoloji (Ağrı) Derneği'nin Yayın Organıdır is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Targeted intracellular delivery via receptor-mediated endocytosis requires the delivered cargo to escape the endosome to prevent lysosomal degradation. This can in principle be achieved by membrane lysis tightly restricted to endosomal membranes upon internalization to avoid general membrane insertion and lysis. Here, we describe the design of small monomeric proteins with buried histidine containing pH-responsive hydrogen bond networks and membrane permeating amphipathic helices. Of the 30 designs that were experimentally tested, all expressed in Escherichia coli, 13 were monomeric with the expected secondary structure, and 4 designs disrupted artificial liposomes in a pH-dependent manner. Mutational analysis showed that the buried histidine hydrogen bond networks mediate pH-responsiveness and control lysis of model membranes within a very narrow range of pH (6.0-5.5) with almost no lysis occurring at neutral pH. These tightly controlled lytic monomers could help mediate endosomal escape in designed targeted delivery platforms.

This study aims to determine the motivation of indigenous students in learning Filipino in public schools. There were 10 participants in this study from Francisco Bangoy High School. After the questionnaire was prepared, interviews were conducted and the responses of the participants were analyzed. The design used in the study was quantitative research. In connection with this, data analysis using the Collaizi method and qualitative phenomenological research were employed by the researcher to describe the lived experiences of a person in an event. The participants in the study were selected indigenous students in public schools. Additionally, the result of the study was to find out the motivation of indigenous students in their studies. Conducting further research about the motivation of indigenous students is recommended to ensure their needs are met. And, to identify the obstacles affecting the learning of Filipino by indigenous students. The study recommended that attention should be given to research concerning the motivation of indigenous students to change the public's perception of indigenous students. [ABSTRACT FROM AUTHOR]

Purpose: Risk factors (RFs), like 'body mass index (BMI),' 'age,' and 'gender' correlate with Diabetic Retinopathy (DR) diagnosis and have been widely studied. This study examines how these three secondary RFs independently affect the predictive capacity of primary RFs. Methods: The dataset consisted of four population-based studies on the prevalence of DR and associated RFs in India between 2001 and 2010. An Autoencoder was employed to categorize RFs as primary or secondary. This study evaluated six primary RFs coupled independently with each secondary RF on five machine-learning models. Results: The secondary RF 'gender' gave a maximum increase in Area under the curve (AUC) score to predict DR when combined separately with 'insulin treatment,' 'fasting plasma glucose,' 'hypertension history,' and 'glycosylated hemoglobin' with a maximum increase in AUC for the Naive Bayes model from 0.573 to 0.646, for the Support Vector Machines (SVM) model from 0.644 to 0.691, for the SVM model from 0.487 to 0.607, and for the Decision Tree model from 0.8 to 0.848, respectively. The secondary RFs 'age' and 'BMI' gave a maximum increase in AUC score to predict DR when combined separately with 'diabetes mellitus duration' and 'systolic blood pressure,' with a maximum increase in AUC for the SVM model from 0.389 to 0.621, and for the Decision Tree model from 0.617 to 0.713, respectively. Conclusion: The risk factor 'gender' was the best secondary RF in predicting DR compared to 'age' and 'BMI,' increasing the predictive power of four primary RFs. [ABSTRACT FROM AUTHOR]

Abstract Background Summarizing the clinical features of children with intussusception secondary to small bowel tumours and enhancing awareness of the disease. Methods Retrospective summary of children with intussusception admitted to our emergency department from January 2016 to January 2022, who underwent surgery and were diagnosed with small bowel tumours. Summarize the types of tumours, clinical presentation, treatment, and prognosis. Results Thirty-one patients were included in our study, 24 males and 7 females, with an age of onset ranging from 1 m to 11y 5 m. Post-operative pathology revealed 4 types of small intestinal tumour, 17 lymphomas, 10 adenomas, 4 inflammatory myofibroblastomas and 1 lipoma. The majority of tumours in the small bowel occur in the ileum (83.9%, 26/31). Abdominal pain, vomiting and bloody stools were the most common clinical signs. Operative findings indicated that the small bowel (54.8%, 17/31) and ileocolic gut were the main sites of intussusception. Two types of procedure were applied: segmental bowel resection (28 cases) and wedge resection of mass in bowel wall (3 cases). All patients recovered well postoperatively, with no surgical complications observed. However, the primary diseases leading to intussusception showed slight differences in long-term prognosis due to variations in tumor types. Conclusions Lymphoma is the most common cause of intussusception in pediatric patients with small bowel tumours, followed by adenoma. Small bowel tumours in children tend to occur in the ileum. Therefore, the treatment of SBT patients not only requires surgeons to address symptoms through surgery and obtain tissue samples but also relies heavily on the expertise of pathologists for accurate diagnosis. This has a significant impact on the overall prognosis of these patients.

Background: Anxiety in learning foreign languages is a global phenomenon that impacts students' academic performance, with English being a critical language in secondary education. The Foreign Language Classroom Anxiety Scale (FLCAS) has been widely used to assess this anxiety. However, the need to validate and adapt the scale for specific cultural contexts remains a priority in educational research. Objective: To assess the validity and reliability of a Spanish version of the FLCAS among a sample of Peruvian secondary education students, in order to better understand the structure of language learning anxiety in this context. Methods: A total of 818 students from four public educational institutions in southern Peru participated. An instrumental design was used, which included descriptive analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of convergent, divergent validity, and measurement invariance by gender. Results: The EFA recommended a four-factor model that explained 32% of the total variance. Subsequent CFA adjusted this model to 24 items with optimal fit indices (CFI = 0.969; RMSEA = 0.045). The reliability of the factors was acceptable (α > 0.70 for all factors). Convergent and divergent validity was confirmed through significant correlations with related constructs (Fear of Negative Evaluation and Enjoyment of Foreign Language). Gender invariance analysis indicated that the scale is equally applicable to men and women. Conclusion: The Spanish version of the FLCAS is a valid and reliable tool for assessing foreign language classroom anxiety among Peruvian secondary education students. This study contributes to the field of language teaching by providing evidence of the cultural applicability of the FLCAS in the Peruvian context, thus facilitating more effective pedagogical interventions to address language learning anxiety. [ABSTRACT FROM AUTHOR]

Parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23) each play a central role in the pathogenesis of chronic kidney disease (CKD)-mineral and bone disorder. Levels of both hormones increase progressively in advanced CKD and can lead to damage in multiple organs. Secondary hyperparathyroidism (SHPT), characterized by parathyroid hyperplasia with increased PTH secretion, is associated with fractures and mortality. Emerging evidence suggests that these associations may be partially explained by PTH-induced browning of adipose tissue and increased energy expenditure. Observational studies suggest a survival benefit of PTHlowering therapy, and a recent study comparing parathyroidectomy and calcimimetics further suggests the importance of intensive PTH control. The mechanisms underlying the regulation of FGF23 secretion by osteocytes in response to phosphate load have been unclear, but recent experimental studies have identified glycerol-3-phosphate, a byproduct of glycolysis released by the kidney, as a key regulator of FGF23 production. Elevated FGF23 levels have been shown to be associated with mortality, and experimental data suggest off-target adverse effects of FGF23. However, the causal role of FGF23 in adverse outcomes in CKD patients remains to be established. Further studies are needed to determine whether intensive SHPT control improves clinical outcomes and whether treatment targeting FGF23 can improve patient outcomes. [ABSTRACT FROM AUTHOR]

We conducted a systematic review of research involving K-12 students that examined associations among individual differences factors (e.g., working memory) and intertextual integration. We identified 25 studies published in 23 peer-reviewed journal articles and two dissertations/theses. These examined a wide range of individual difference factors, which we organized into four categories: (a) language and literacy, (b) cognition and metacognition, (c) knowledge and beliefs, and (d) motivation, emotion, and personality. We found large variation in the participants, tasks, and document types, and little systematic replication across studies. Nonetheless, results generally showed that variation in literacy, cognition, metacognition, knowledge, beliefs, and motivation are positively and moderately associated with intertextual integration. We discuss the limitations of this work and offer four recommendations for future research. [ABSTRACT FROM AUTHOR]

Mosquitoes transmit numerous infectious diseases to humans, such as dengue, malaria, and yellow fever. The lack of effective medicines and vaccines against these diseases necessitates the development of alternate strategies to impede their transmission. Mosquito control is a crucial approach in this direction. Phenoloxidases (POs), which catalyze sclerotization, melanization, maturation of the exoskeleton, and wound healing, play key roles in physiology, immunity, and mosquito development. POs regulate these processes in multiple steps; therefore, they might be considered potent targets for controlling mosquito populations at different stages. The present review discusses the importance of PO inhibitors, especially the natural metabolites from microbes and plants that invariably control mosquito populations. [ABSTRACT FROM AUTHOR]

Viewing teacher vulnerability as a pedagogical tool, this comparative case study examined two secondary literacy teachers' use of vulnerability in relation to various instructional goals. Through the analysis of eight video‐recorded lessons, we found that teachers demonstrated vulnerability through multiple ways within their literacy instruction through modeling ways of connecting personal experiences to texts, and establishing classroom norms that welcome difficult emotions and experiences. However, we also found that teacher vulnerability can sometimes lead to uncertainty, and even constrain student participation. We argue that teacher vulnerability helps establish a humanizing pedagogy, and offer possible strategies for teachers who are vulnerable within literacy instruction. We conclude with a discussion of different levels of appropriating vulnerability as a pedagogical tool. [ABSTRACT FROM AUTHOR]

Background: Cervical esophageal reconstruction is vital to improve the quality of life in cancer surgery patients. Microsurgery is crucial in providing vascularized tissue for defect repair, particularly in secondary cases with a higher risk of failure due to larger defects and damage from previous surgery and radiotherapy. The purpose of this study was to describe the clinical characteristics of a series of patients who underwent secondary repair of esophageal defects and provide practical information for the management and treatment of such cases based on the authors' experience and the literature review. Methods: We retrospectively reviewed the electronic medical records of the Plastic Surgery Clinic at the University of Trieste to identify cases of patients who underwent secondary esophageal microsurgical reconstructions following oncological surgery. Patient demographics, the etiology of esophageal defects, previous surgical history, and preoperative assessments were collected from medical records. Surgical techniques utilized for reconstruction, such as pedicled flaps or free tissue transfers, were documented along with intraoperative information. Postoperative outcomes, including complications, graft viability, and functional outcomes, were evaluated during follow-up. Results: We treated 13 cases of secondary esophageal reconstructions between 2011 and 2022. Most commonly, Antero-Lateral Thigh (ALT) flaps were used in 10 cases, while 2 cases employed a radial forearm flap (RFF), and 1 case employed a chimeric parascapular flap. No flap failures occurred during a median 50-month follow-up. One ALT flap patient experienced postop stricture but maintained swallowing ability. A single tracheoesophageal fistula occurred in an RFF patient with a history of radiotherapy and complete lymph node dissection. Conclusions: Cervical esophageal reconstruction significantly impacts patients' quality of life by restoring oral feeding and phonation. When local flaps fall short, microsurgical reconstruction with intestinal flaps is valuable but is burdened by limitations. For challenging secondary cases, ALT or RFF flaps emerge as safer options due to their robust pedicles, yielding low complication rates and positive functional outcomes. [ABSTRACT FROM AUTHOR]

We study the initial-boundary value problem of the stochastic Navier–Stokes equations in half-space. We prove the existence of weak solutions in standard Besov space-valued random processes when the initial data belong to the critical Besov space. [ABSTRACT FROM AUTHOR]

Very little identifiable research explores the factors impacting autistic students' school motivation and how these factors may or may not affect their academic and well-being outcomes in secondary school and beyond, including post-secondary enrollment, employment, and their quality of life. Instead, research on autism and inclusive education mainly focuses on the efficacy of interventions aimed at teaching skills related to sensory, communication, social, and behavior. Methods: A secondary analysis of survey data from an original mixed-method study was conducted to investigate how environmental, teacher, and peer factors are associated with autistic students' school motivation. Eligible participants were between the ages of 15 and 21. In total, 72 participants (n = 72) completed an online survey to share their perspectives on their school experiences. Subsequently, linear regression analysis was conducted to answer the research question. Results: Participants who rated their schools as having pleasant physical spaces and felt that their peers understood them as a person had higher levels of school motivation. Teachers were not found to be significantly related to students' school motivation. Participants who shared that typing was their preferred mode of communication were less motivated to attend school than students who preferred speaking communication. Conclusions: Environmental and peer factors are related to more than the day-to-day school experiences of autistic students; they are also related to their school motivation. These findings add to the existing literature on inclusive education and positive school outcomes for autistic students and offer additional explanations of the barriers that affect autistic students' graduation from secondary school and interest in attending post-secondary education. [ABSTRACT FROM AUTHOR]

With the ongoing amendment of the EU legislation on the treatment of urban wastewater, stricter requirements for the removal of pollutants are expected, which calls for the need for innovative wastewater treatment technologies. Biological systems are still the first choice. A survey of typical bioreactors applied in wastewater treatment is presented. The wastewater treatment objective, biochemical environment, and microbial growth are selected as the main criteria for the classification of these bioreactors. Hydraulic and kinetic aspects are considered, along with the advantages and drawbacks of these bioreactors regarding the selection of the appropriate type of reactor; as well, details regarding the operation of reactors are mentioned. The aim of this paper is to provide operators and designers with a brief overview of the selected traditional and advanced processes, reactors, and technologies for nutrient removal from municipal wastewater. The possibilities and limitations in complying with more strict effluent standards are also discussed. Methods of nutrient recovery are added value. From the evaluation of the published papers, we determine that the currently applied traditional methods for nutrient removal have the potential to also convey the expected stricter limits. [ABSTRACT FROM AUTHOR]

Teachers' assessment practices are invariably related to their knowledge, skills, and beliefs or their assessment literacy. While teachers' assessment literacy continues to gain attention, there is limited empirical research on the relationship between assessment literacy and teachers' practices and beliefs, in particular junior secondary school teachers. Drawing from a larger project, this paper employs a synthesised conceptual framework on assessment literacy to interrogate the assessment practices of eight teachers. The findings reveal that teachers' conceptual knowledge and their conceptions of assessment are influenced by government policies. Teachers acknowledged the importance of effectively interpreting and communicating assessment data in order to support student learning. Finally, the study found that the ways in which teachers meaningfully engaged students in the feedback process created opportunities for building assessment literacy in both teachers and students. This article highlights the gap in how teachers draw upon their conceptual knowledge and how that contextual knowledge allows them to enact assessment within their varied school contexts. [ABSTRACT FROM AUTHOR]

Teachers' actions are grounded on their theoretical and disciplinary knowledge; however, their belief system, and in particular their epistemological beliefs, may be influencing their teaching practices. This study analyzes the scientific production between 2011 and 2021 regarding teachers' epistemological beliefs and their relationship with teaching practice. The methodological design consists of a systematic literature review, following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines in the Web of Science, Scopus, and ERIC databases. The sample considers 18 articles reviewed by thematic content analysis. The results report that this type of belief has a close relationship with teaching approaches, that there are certain inconsistencies with teaching practice, and that links have been established with other areas of study that enrich reflection. It seems prudent and necessary to observe this relationship from a broad, situated, and complex perspective, avoiding generalizing and polarizing the character of these beliefs, by noting that there are various factors involved between what teachers believe about knowledge and what they do in the classroom. [ABSTRACT FROM AUTHOR]

Background: Summarizing the clinical features of children with intussusception secondary to small bowel tumours and enhancing awareness of the disease. Methods: Retrospective summary of children with intussusception admitted to our emergency department from January 2016 to January 2022, who underwent surgery and were diagnosed with small bowel tumours. Summarize the types of tumours, clinical presentation, treatment, and prognosis. Results: Thirty-one patients were included in our study, 24 males and 7 females, with an age of onset ranging from 1 m to 11y 5 m. Post-operative pathology revealed 4 types of small intestinal tumour, 17 lymphomas, 10 adenomas, 4 inflammatory myofibroblastomas and 1 lipoma. The majority of tumours in the small bowel occur in the ileum (83.9%, 26/31). Abdominal pain, vomiting and bloody stools were the most common clinical signs. Operative findings indicated that the small bowel (54.8%, 17/31) and ileocolic gut were the main sites of intussusception. Two types of procedure were applied: segmental bowel resection (28 cases) and wedge resection of mass in bowel wall (3 cases). All patients recovered well postoperatively, with no surgical complications observed. However, the primary diseases leading to intussusception showed slight differences in long-term prognosis due to variations in tumor types. Conclusions: Lymphoma is the most common cause of intussusception in pediatric patients with small bowel tumours, followed by adenoma. Small bowel tumours in children tend to occur in the ileum. Therefore, the treatment of SBT patients not only requires surgeons to address symptoms through surgery and obtain tissue samples but also relies heavily on the expertise of pathologists for accurate diagnosis. This has a significant impact on the overall prognosis of these patients. [ABSTRACT FROM AUTHOR]

Focal imaging abnormalities in patients with parkinsonism suggest secondary etiology and require a distinctive clinical approach to diagnosis and treatment. We review different entities presenting as secondary parkinsonism associated with structural brain lesions, with emphasis on the clinical course and neuroimaging findings. Secondary parkinsonism may be due to vascular causes, hydrocephalus, space-occupying lesions, metabolic causes (including acquired hepatocerebral degeneration, diabetic uremic encephalopathy, basal ganglia calcifications, osmotic demyelination syndrome), hypoxic-ischaemic brain injury, intoxications (including methanol, carbon monoxide, cyanide, carbon disulfide, manganese poisoning and illicit drugs), infections and immune causes. The onset can vary from acute to chronic. Both uni-and bilateral presentations are possible. Rigidity, bradykinesia and gait abnormalities are more common than rest tremor. Coexisting other movement disorders and additional associated neurological signs may point to the underlying diagnosis. Neuroimaging studies are an essential part in the diagnostic work-up of secondary parkinsonism and may point directly to the underlying etiology. We focus primarily on magnetic resonance imaging to illustrate how structural imaging combined with neurological assessment can lead to diagnosis. It is crucial that typical imaging abnormalities are recognized within the relevant clinical context. Many forms of secondary parkinsonism are reversible with elimination of the specific cause, while some may benefit from symptomatic treatment. This heterogeneous group of acquired disorders has also helped shape our knowledge of Parkinson’s disease and basal ganglia pathophysiology, while more recent findings in the field garner support for the network perspective on brain function and neurological disorders.

RATIONALE & OBJECTIVE: Posttransplant hyperparathyroidism is common, and treatment practices are poorly characterized. The goal of this study was to examine the incidence, associations, and outcomes of posttransplant parathyroidectomy and calcimimetic use in a cohort of Medicare-insured US kidney transplant recipients. STUDY DESIGN: Retrospective observational cohort study. SETTING & PARTICIPANTS: We used the US Renal Data System to extract demographic, clinical, and prescription data from Medicare Parts A, B, and D-insured patients who received their first kidney transplant in 2007-2013. We excluded patients with pretransplant parathyroidectomy. PREDICTORS: Calendar year of transplantation and pretransplant patient characteristics. OUTCOME: (1) Incidence of and secular trends in parathyroidectomy and cinacalcet use in the 3 years after transplant; (2) 90-day outcomes after posttransplant parathyroidectomy and cinacalcet initiation. ANALYTICAL APPROACH: Temporal trends and pretransplant correlates of parathyroidectomy and cinacalcet use were assessed using proportional hazards models and multivariable Poisson regression, respectively. RESULTS: The inclusion criteria were met by 30,127 patients, of whom 10,707 used cinacalcet before transplant, 551 underwent posttransplant parathyroidectomy, and 5,413 filled≥1 prescription for cinacalcet. The rate of posttransplant parathyroidectomy was stable over time. By contrast, cinacalcet use increased during the period studied. Long dialysis vintage and pretransplant cinacalcet use were strongly associated with posttransplant parathyroidectomy and cinacalcet use. Roughly 1 in 4 patients were hospitalized within 90 days of posttransplant parathyroidectomy, with hypocalcemia-related diagnoses being the most common complication. Parathyroidectomy (vs cinacalcet initiation) was not associated with an increase in acute kidney injury. LIMITATIONS: We lacked access to laboratory data to help assess the severity of secondary/tertiary hyperparathyroidism. The cohort was limited to Medicare beneficiaries. CONCLUSIONS: Almost one-fifth of our study cohort was treated with parathyroidectomy and/or cinacalcet. Further studies are needed to establish the optimal treatment for posttransplant hyperparathyroidism.

Introduction: Focal Segmental Glomerulosclerosis (FSGS) is a nephrotic syndrome with a variety of clinicopathological presentations and varied responses to treatment. Hence, this study attempts to classify FSGS based on clinical presentation and pathological findings on kidney biopsy, which is essential for appropriate treatment and avoidance of inappropriate use of immunosuppressants. Aim: To analyse clinicopathological findings and responses to immunosuppressants in FSGS. Materials and Methods: A retrospective cohort study was conducted at Department of Nephrology, Vydehi Institute of Medical Sciences and Research Centre Bengaluru, Karnataka, India, to analyse clinicopathological parameters such as urine analysis, 24-hour urine protein, serum creatinine, serum albumin, lipid profile, renal biopsy details, and response to treatment in 97 patients. The study was planned, analysed, and executed between January 2023 and February 2023. All variables were expressed as mean±standard deviation or percentage. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software version 16.0. Results: Among a total of 97 patients, 64% were males. Sudden onset oedema was observed in 90% of the cases, while nephrotic proteinuria was seen in 71%. The Not Otherwise Specified (NOS) variant was noted in 60% of the cases. Complete remission was observed in 61%, suggesting a possible primary FSGS. Persistent nephrotic proteinuria with a poor response to therapy was noted in 32%, indicating a possible secondary/genetic FSGS, despite adequate immunosuppressive therapy. Therefore, differentiating between primary and secondary forms of FSGS has therapeutic and prognostic implications. Accurate diagnosis of each form of FSGS is vital to avoid unnecessary immunosuppressive-based therapy and establish appropriate treatment. Conclusion: Resistance to steroid therapy was observed in one-third of FSGS patients. It is likely that unrecognised genetic FSGS or secondary FSGS were included among the study group of primary FSGS, leading to misinterpretation of treatment responses in primary FSGS. Hence, a clinicopathological approach for correctly differentiating between primary FSGS, secondary (maladaptive, viral, or toxic) FSGS, and genetic FSGS helps in making correct treatment decisions.

AbstractEquitable teaching practices encompass evidence-based strategies utilised by teachers to support the learning of all pupils, while recognising each pupil’s unique background. This study delves into the perspectives of Scottish teachers regarding equity in mathematics, as evidenced by their self-reported practices. By analysing semi-structured interviews with 29 teachers from various school levels (early years, primary, and secondary) through Variation Theory, we were able to uncover common practices, such as ability grouping versus mixed-ability grouping, as well as practices specific to each level. We also identified overlaps between early-years/primary and primary/secondary, highlighting the importance of transitioning from one school level to another. It is imperative for teacher education programmes to address these transitions more explicitly in order to ensure greater continuity and consistency in equitable teaching practices.

The COVID-19 course and immunity differ in children and adults. We analyzed immune response dynamics in 28 families up to 12 months after mild or asymptomatic infection. Unlike adults, the initial response is plasmablast-driven in children. Four months after infection, children show an enhanced specific antibody response and lower but detectable spike 1 protein (S1)-specific B and T cell responses than their parents. While specific antibodies decline, neutralizing antibody activity and breadth increase in both groups. The frequencies of S1-specific B and T cell responses remain stable. However, in children, one year after infection, an increase in the S1-specific IgA class switch and the expression of CD27 on S1-specific B cells and T cell maturation are observed. These results, together with the enhanced neutralizing potential and breadth of the specific antibodies, suggest a progressive maturation of the S1-specific immune response. Hence, the immune response in children persists over 12 months but dynamically changes in quality, with progressive neutralizing, breadth, and memory maturation. This implies a benefit for booster vaccination in children to consolidate memory formation.

Fisher information is a fundamental concept of statistical inference and plays an important role in many areas of statistical analysis. In this paper, we obtain explicit expressions for the Fisher information matrix in ranked set sampling (RSS) from the simple linear regression model with replicated observations. It has been shown to be the sum of two matrices, one of which is the Fisher information matrix based on simple random sampling (SRS). The numerical results show that RSS provides more information than SRS when the same sample size is used. [ABSTRACT FROM AUTHOR]

Behavior-specific praise (BSP) is one of the simplest classroom management strategies to implement and considered an evidence-based practice. Unfortunately, teachers underuse BSP and deliver more reprimands to students in their classrooms. Secondary students receive the highest rates of reprimands and exclusionary discipline (i.e., office discipline referral [ODR], suspension, expulsion) with students of color receiving disproportionate rates compared to their White peers. Performance feedback is a commonly used strategy to change teacher practices however, little is known about the impact of performance feedback on the equitable delivery of BSP and reprimands to students by race and sex. The purpose of this multiple baseline design study was to examine the effects of a visual performance feedback (VPF) intervention with secondary teachers on their equitable delivery of BSP and reprimands and the collateral impacts on student outcomes. In the first phase of intervention, teachers received VPF on their total BSP and reprimands. In the second phase, teachers received disaggregated VPF on their rates of BSP and reprimands delivered to students by race and sex. Results indicate a functional relation between VPF and total BSP and an overall reduction in total reprimands. Mixed results were found between VPF and the equitable delivery of BSP and reprimands rates delivered to students by race and sex. Student outcomes indicated an increase in average class-wide academic engagement and no impact on ODRs as no teacher delivered a single ODR. Key findings, limitations, and future research are discussed. [ABSTRACT FROM AUTHOR]

This article provides an expository review of the relationship between graph C ∗ -algebras and the wavelet theory. This connection was first established by O. Bratteli and P.E.T. Jorgensen in the late 90 ′ s. Various mathematicians paid attention to this connection in the past 25 years, and the area has become active and dynamic now. The major contributors include O. Bratteli, P. E. T. Jorgensen, C. Farsi, E. Gillaspy, S. Kang, J. Packer, M. Marcolli and A. M. Paolucci. Our aim is to provide an expository survey in this direction. [ABSTRACT FROM AUTHOR]