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BackgroundOlder adults are frequently hospitalized. Family involvement during these hospitalizations is incompletely characterized in the literature. ObjectiveThis study aimed to better understand how families are involved in the care of hospitalized older adults and develop a conceptual model describing the phenomenon of family involvement in the care of hospitalized older adults. MethodsWe describe the protocol of a qualitative evidence synthesis (QES), a systematic review of qualitative studies. We chose to focus on qualitative studies given the complexity and multifaceted nature of family involvement in care, a type of topic best understood through qualitative inquiry. The protocol describes our process of developing a research question and eligibility criteria for inclusion in our QES based on the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, and Research type) tool. It describes the development of our search strategy, which was used to search MEDLINE (via Ovid), Embase (via Elsevier), PsycINFO (via Ovid), and CINAHL Complete (via EBSCO). Title and abstract screening and full-text screening will occur sequentially. Purposive sampling may be used depending on the volume of studies identified as eligible for inclusion during our screening process. Descriptive data regarding included individual studies will be extracted and summarized in tables. The results from included studies will be synthesized using qualitative methods and used to develop a conceptual model. The conceptual model will be presented to community members via engagement panels for further refinement. ResultsAs of September 2023, we have assembled a multidisciplinary team including physicians, nurses, health services researchers, a librarian, a social worker, and a health economist. We have finalized our search strategy and executed the search, yielding 8862 total citations. We are currently screening titles and abstracts and anticipate that full-text screening, data extraction, quality appraisal, and synthesis will be completed by summer of 2024. Conceptual model development will then take place with community engagement panels. We anticipate submitting our manuscript for publication in the fall of 2024. ConclusionsThis paper describes the protocol for a QES of family involvement in the care of hospitalized older adults. We will use identified themes to create a conceptual model to inform further intervention development and policy change. Trial RegistrationPROSPERO 465617; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023465617 International Registered Report Identifier (IRRID)PRR1-10.2196/53255

The complexity of modern biology poses challenges in fostering interdisciplinary understanding, particularly between practicing scientists and the public. Furthermore, scientists often lack formal training in science communication, despite various motivations to engage the public. The science literacy of the public in the biological sciences can also vary across socio-economic and cultural backgrounds. Leveraging popular culture and informal learning practices to promote active learning offers promising avenues to enhance public understanding of biological systems. Organized sports hold collective recognition across various communities and cultures, serving as a means to bring people together. Notably, the NCAA March Madness event holds widespread national and international popularity, presenting an opportunity to laterally apply this concept to promote science communication within STEM and biology education. An educational social media and web-based contest tool was developed integrating NCAA-inspired brackets with animal biological systems concepts. The tool featured tournament-style matchups based on animal biological systems, interesting animal facts, and a voting system, all housed within a user-friendly interface. To encourage regular user access to the tool, graphic designs were developed for all social media posts to aid in visual recruitment to the voting website. Based on online metrics, the use of social media garnered repeat users across both the public and educators. The latter noted the tool's simplicity and informative content. Application of this social media and web-based bracket contest tool, which leverages informal settings for active learning for use in biology education, can foster science communication to engage audiences, improve comprehension, and promote interdisciplinary biology education.

This article provides a comprehensive review and best practices for numerically simulating hydraulic flushing for reservoir sediment management. Three sediment flushing types are discussed: drawdown flushing, pressure flushing, and turbidity current venting. The need for reservoir sediment management and the current practices are reviewed. Different hydraulic drawdown types are described in terms of the basic physical processes involved as well as the empirical/analytical assessment tools that may be used. The primary focus has been on the numerical modeling of various hydraulic flushing options. Three model categories are reviewed: one-dimensional (1D), two-dimensional (2D) depth-averaged or layer-averaged, and three-dimensional (3D) computational fluid dynamics (CFD) models. General guidelines are provided on how to select a proper model given the characteristics of the reservoir and the flushing method, as well as specific guidelines for modeling. Case studies are also presented to illustrate the guidelines.

BackgroundResearch and policy demonstrate the value of and need for systematically identifying and preparing care partners for their caregiving responsibilities while their family member or friend living with dementia is hospitalized. The Care Partner Hospital Assessment Tool (CHAT) has undergone content and face validation and has been endorsed as appropriate by clinicians to facilitate the timely identification and preparation of care partners of older adult patients during their hospitalization. However, the CHAT has not yet been adapted or prospectively evaluated for use with care partners of hospitalized people living with dementia. Adapting and testing the CHAT via a pilot study will provide the necessary evidence to optimize feasibility and enable future efficacy trials. ObjectiveThe purpose of this paper is to describe the study protocol for the adaptation and testing of the CHAT for use among care partners of hospitalized people living with dementia to better prepare them for their caregiving responsibilities after hospital discharge. MethodsOur protocol is based on the National Institutes of Health Stage Model and consists of 2 sequential phases, including formative research and the main trial. In phase 1, we will use a participatory human-centered design process that incorporates people living with dementia and their care partners, health care administrators, and clinicians to adapt the CHAT for dementia care (ie, the Dementia CHAT [D-CHAT]; stage IA). In phase 2, we will partner with a large academic medical system to complete a pilot randomized controlled trial to examine the feasibility and estimate the size of the effect of the D-CHAT on care partners’ preparedness for caregiving (stage IB). We anticipate this study to take approximately 60 months to complete, from study start-up procedures to dissemination. The 2 phases will take place between December 1, 2022, and November 30, 2027. ResultsThe study protocol will yield (1) a converged-upon, ready-for-feasibility testing D-CHAT; (2) descriptive and feasibility characteristics of delivering the D-CHAT; and (3) effect size estimates of the D-CHAT on care partner preparedness. We anticipate that the resultant D-CHAT will provide clinicians with guidance on how to identify and better prepare care partners for hospitalized people living with dementia. In turn, care partners will feel equipped to fulfill caregiving roles for their family members or friends living with dementia. ConclusionsThe expected results of this study are to favorably impact hospital-based care processes and outcomes for people living with dementia and their care partners and to elucidate the essential caregiving role that so many care partners of people living with dementia assume. Trial RegistrationClinicalTrials.gov NCT05592366; https://clinicaltrials.gov/ct2/show/NCT05592366 International Registered Report Identifier (IRRID)PRR1-10.2196/46808

Inappropriate sinus tachycardia (IST) has been defined as a resting heart rate of >100 beats per minute and an average 24-hour heart rate >90 bpm with distressing symptoms resulting from the persistent tachycardia. IST is prevalent in 1% of the middle-aged population, mostly females. Rarely can elderly patients also present with IST. Possible mechanisms of IST include intrinsic sinus node abnormality, beta-adrenergic receptor stimulating autoantibody, beta-adrenergic receptor supersensitivity, muscarinic receptor autoantibody, or hyposensitivity, impaired baroreflex control, depressed efferent parasympathetic/vagal function, nociceptive stimulation, central autonomic overactivity, aberrant neurohumoral modulation, etc. Symptoms associated with IST are palpitations, chest pain, fatigue, shortness of breath, presyncope, and syncope. Despite these distressing symptoms, IST has not been associated with tachycardia-associated cardiomyopathy or increased major cardiovascular events. Various treatment options for patients with IST are ivabradine, beta-adrenergic blockers, calcium channel blockers, psychiatric evaluation, and exercise training. Although, endocardial radiofrequency ablation targeting the sinus node has been used as a treatment modality for otherwise treatment-refractory IST, the results have been dismal. The other modalities used for refractory IST treatment are endocardial modification of the sinus node using radiofrequency energy, combined endo and epicardial ablation of the sinus node, thoracoscopic epicardial ablation of the sinus node, sinus node sparing thoracoscopic and endocardial hybrid ablation. The goal of this review is to provide the readership with the pathophysiological basis of IST and its management options.

Category: Midfoot/Forefoot; Basic Sciences/Biologics; Other Introduction/Purpose: TMTJ fusion has long been used as a treatment for TMTJ disease. Bone grafting has been shown to potentially improve union rates and often the iliac crest as a donor site has been used to achieve this. Indications for bone grafting include severe disease with greater bone loss and deformity, multiple joints being fused or revision surgery. In our paper we report on our experience of TMTJ fusion using localised bone grafting from either the calcaneum or cuneiform. This incorporates a novel operative technique for graft placement which increases contact area for healing and restores foot biomechanics. This may also therefore reduce non-union rate. Additionally, this localised form of bone grafting avoids the morbidity associated with iliac crest donor sites providing a better tolerated procedure. Methods: Twenty patients were included between 2016 and 2019 who underwent fusion of 39 TMTJs in total. Of these 39 joints 9 were first, 16 were second and 14 were third TMTJ. Two of the first TMTJ Fusions were revisions with double plating and bone grafting for non union. Fourteen patients had standard bone grafting and donor sites were as follows; 7 calcaneal, 1 cuneiform, 6 iliac crest. Seven patients had excision of OA joint and bone graft using precision instruments and surgery using our described technique. Locking plates were used in all twenty patients. Post-operative care included a wound check at two weeks, non-weight- bearing in a cast for 6 weeks and then weight-bearing cast for a further 6 weeks. Patients were followed up in clinic to observe radiological and clinical union. Ct scanning employed when delayed union was suspected. Complications with wound healing and infection were also recorded. Results: 15 of patients were female with a mean age of 59. 38 out of 39 fused joints went on to unite. 10 patients were initially assessed in the Specialist Limb Service (SLS) clinic with gait analysis prior to surgery. One non-union was diagnosed on CT scan in the traditional bone graft technique group. Graft was harvested from iliac crest in this case. All other graft sites resulted in fusion of the joint. All seven patients (100%) who had excision and bone graft using precision bone instruments with the new technique had union without delay. One patient underwent removal of metalware due to prominence. This was a revision double plating case. There were no wound healing problems and no postoperative infections. 80% of patients were satisfied with the results of surgery and reported improvement in quality of life. Conclusion: TMTJ fusion with looking plates remains an appropriate treatment for TMTJ disease providing high rates of successful union. Local donor site for bone grafting does not generate inferior outcomes whilst avoiding the morbidity associated with iliac crest harvesting. Additionally, this work presents a novel technique using precision bone graft instruments and cylindrical bone graft to fuse the TMTJ in the presence of OA. This technique generates increased fusion surface area and may provide better restoration of normal foot biomechanics.

Most assessments adopt a one-size-fits-all approach to provide fair testing opportunities to all learners. However, this rigid approach to assessment may limit the ability for some learners to show what they know and can do. The Caring Assessments framework proposed a guide for the design and development of flexible, personalized, and adaptive assessments to provide each learner with the best opportunity to show what they know and can do. The original framework for caring assessments proposed that caring can be integrated into assessments by leveraging knowledge about learners' characteristics, behaviors, and learning context. Because we also recognize the critical role of acknowledging learners' cultures, identities, and social contexts to provide effective, caring support for all learners, in this paper we expand the framework to the Culturally Enhanced Caring Assessments framework to include personal, social, linguistic, and cultural aspects of learners and the contexts in which they learn. We discuss the culturally enhanced caring assessments framework and the need for further research to address the implementation challenges that can emerge when assessments are flexible, personalized, and adaptive.

There is a strong need to increase the opportunities for and success of the next generation of beef cattle producers. South Dakota State University Extension provides a 2-year educational program called "beefSD;" the purpose is to provide producers with a holistic view of the beef industry, an appreciation for utilizing adaptive management to respond to challenges and opportunities, and skills to assess and manage factors that influence overall operation sustainability. The curriculum has four major components: (1) in person workshops, case studies, interactive webinars, and homework (2) out-of-state learning experiences, (3) ranch to rail program, and (4) networking and mentoring.

Teachers face many challenges, including that of educating English language learner (ELL) students. These students are often placed in regular classrooms and create extra demands on the classroom teacher. Many strategies can be employed with ELLs that relate to best teaching practices. Potential trouble areas are discussed, as are the strategies that classroom teachers may use in educating ELLs. When teachers use these best practices with their students, student achievement is increased and better academic results are obtained. Case study examples garnered from the writer's own teaching experiences serve as illustrations throughout this article.

Summary: The study of biological form is a vital goal of evolutionary biology and functional morphology. We review an emerging set of methods that allow scientists to create and study accurate 3D models of living organisms and animate those models for biomechanical and fluid dynamic analyses. The methods for creating such models include 3D photogrammetry, laser and CT scanning, and 3D software. New multi-camera devices can be used to create accurate 3D models of living animals in the wild and captivity. New websites and virtual reality/augmented reality devices now enable the visualization and sharing of these data. We provide examples of these approaches for animals ranging from large whales to lizards and show applications for several areas: Natural history collections; body condition/scaling, bioinspired robotics, computational fluids dynamics (CFD), machine learning, and education. We provide two datasets to demonstrate the efficacy of CFD and machine learning approaches and conclude with a prospectus.

Haitian Creole, or Krey'ol, has a unique history because it is historically an oral language; however, significant efforts have been made to standardize its orthography and to promote its literacy base. It also comes from a diglossic society: Haitian Creole is spoken in familiar settings such as the home, while French is used in formal settings such as government spaces. While Haitian Creole is the source of national pride for many Haitians, it is unfortunately stigmatized by many, and many Haitians do not read or write in Haitian Creole. This brings up new questions regarding parents' needs within a literacy program. For example, it was unknown if Haitian families in Miami-Dade would want books in Haitian Creole for their children. As such, we also sought to examine how the family reading program Baralt et al. 729 could best support Haitian families' needs in addition to other minoritized families. To this end, the overall aims of this study were to: 1. Characterize the literacy environment of families in Miami-Dade County, including (a) books and supporting materials, (b) time spent engaging in shared reading, and (c) facilitators as well as barriers of reading. 2. Learn about Miami-Dade families' hopes and goals for their children's literacy, as well as their concerns and worries. 3. Identify family needs and preferences regarding the design of a family reading program, including (a) books, (b) guides, (c) trusted resources for support, and (d) preferred modes of communication between the program and participants.

Abstract Background Axial spondyloarthritis (axSpA) has strong connections with intestinal inflammation as occurs in Crohn’s disease (CD). However, the immunologic mechanisms that distinguish axSpA, CD, and those with features of both diseases (CD-axSpA) are unknown. This study aimed to address this question by initial unbiased single cell RNA-sequencing (scRNAseq) on a pilot cohort followed by validating findings using flow cytometry and ELISA in a larger cohort. Methods Two individuals each with CD, axSpA, CD-axSpA, and healthy controls (HC) were recruited for a pilot discovery scRNAseq cohort, and the validation cohort consisted of 18 axSpA, 24 CD, 13 CD-axSpA, and 17 HC that was evaluated by flow cytometry on PBMCs and ELISAs for plasma cytokines. Results Uniquely, PBMCs from subjects with CD-axSpA demonstrated a significant increase in granzyme B+ T cells of both CD4+ and CD8+ lineages by both scRNAseq and flow cytometry. T cell maturation was also greater in those with CD-axSpA, particularly the CD4+ granzyme B+ population. Pathway analysis suggested increased interferon response genes in all immune cell populations within CD-axSpA. Although IFN-γ was elevated in the plasma of a subset of subjects with CD-axSpA, IL-6 was also significantly elevated. Conclusions Our findings support the presence of a chronic interferonopathy in subjects with CD-axSpA characterized by interferon signaling by pathway analysis and an expansion of mature, cytotoxic T cells. These data indicate fundamental immunological differences between CD-axSpA and both of the putative “parent” conditions, suggesting that it is a distinct disease with unique natural history and treatment needs.

Summary: We describe the creation of an isogenic cell line panel representing common cancer pathways, with features optimized for high-throughput screening. More than 1,800 cell lines from three normal human cell lines were generated using CRISPR technologies. Surprisingly, most of these lines did not result in complete gene inactivation despite integration of sgRNA at the desired genomic site. A subset of the lines harbored biallelic disruptions of the targeted tumor suppressor gene, yielding a final panel of 100 well-characterized lines covering 19 frequently lost cancer pathways. This panel included genetic markers optimized for sequence-based ratiometric assays for drug-based screening assays. To illustrate the potential utility of this panel, we developed a high-throughput screen that identified Wee1 inhibitor MK-1775 as a selective growth inhibitor of cells with inactivation of TP53. These cell lines and screening approach should prove useful for researchers studying a variety of cellular and biochemical phenomena.

ABSTRACT Newer ‘omics approaches, such as metatranscriptomics and metabolomics, allow functional assessments of the interaction(s) between the gut microbiome and the human host. However, in order to generate meaningful data with these approaches, the method of sample collection is critical. Prior studies have relied on expensive and invasive means toward sample acquisition, such as intestinal biopsy, while other studies have relied on easier methods of collection, such as fecal samples that do not necessarily represent those microbes in contact with the host. In this pilot study, we attempt to characterize a novel, minimally invasive method toward sampling the human microbiome using mucosal cytology brush sampling compared to intestinal gut biopsy samples on 5 healthy participants undergoing routine screening colonoscopy. We compared metatranscriptomic analyses between the two collection methods and identified increased taxonomic evenness and beta diversity in the cytology brush samples and similar community transcriptional profiles between the two methods. Metabolomics assessment demonstrated striking differences between the two methods, implying a difference in bacterial-derived versus human-absorbed metabolites. Put together, this study supports the use of microbiome sampling with cytology brushes, but caution must be exercised when performing metabolomics assessment, as this represents differential metabolite production but not absorption by the host. IMPORTANCE In order to generate meaningful metabolomic and microbiome data, the method of sample collection is critical. This study utilizes and compares two methods for intestinal tissue collection for evaluation of metabolites and microbiomes, finding that using a brush to sample the microbiome provides valuable data. However, for metabolomics assessment, biopsy samples may still be required.

Neurochemical recording techniques have expanded our understanding of the pathophysiology of neurological disorders, as well as the mechanisms of action of treatment modalities like deep brain stimulation (DBS). DBS is used to treat diseases such as Parkinson’s disease, Tourette syndrome, and obsessive-compulsive disorder, among others. Although DBS is effective at alleviating symptoms related to these diseases and improving the quality of life of these patients, the mechanism of action of DBS is currently not fully understood. A leading hypothesis is that DBS modulates the electrical field potential by modifying neuronal firing frequencies to non-pathological rates thus providing therapeutic relief. To address this gap in knowledge, recent advances in electrochemical sensing techniques have given insight into the importance of neurotransmitters, such as dopamine, serotonin, glutamate, and adenosine, in disease pathophysiology. These studies have also highlighted their potential use in tandem with electrophysiology to serve as biomarkers in disease diagnosis and progression monitoring, as well as characterize response to treatment. Here, we provide an overview of disease-relevant neurotransmitters and their roles and implications as biomarkers, as well as innovations to the biosensors used to record these biomarkers. Furthermore, we discuss currently available neurochemical and electrophysiological recording devices, and discuss their viability to be implemented into the development of a closed-loop DBS system.

Summary:. We present our systematic approach to incision planning and skin graft excision for gender-affirming vaginoplasty. This approach is adaptable to patients of different body habitus and genital skin surface area, and it allows for early skin graft harvest with predictable wound tension at closure. We also describe how to adapt in cases of severe genital hypoplasia.

Recent criticisms of large-scale summative assessments have claimed that the assessments are biased against historically excluded groups because of the assessments' lack of cultural representation. Accompanying these criticisms is a call for more culturally responsive assessments--assessments that take into account the background characteristics of the students; their beliefs, values, and ethics; their lived experiences; and everything that affects how they learn and behave and communicate. In this paper, we present provisional principles, based on a review of research, that we deem necessary for fostering cultural responsiveness in assessment. We believe the application of these principles can address the criticisms of current assessments.

Culturally responsive personalized learning (CRPL) emphasizes the importance of aligning personalized learning approaches with previous research on culturally responsive practices to consider social, cultural, and linguistic contexts for learning. In the present discussion, we briefly summarize two bodies of literature considered in defining and developing a framework for CRPL: technology-enabled personalized learning and culturally relevant, responsive, and sustaining pedagogy. We then provide a definition and framework consisting of six key principles of CRPL, along with a brief discussion of theories and empirical evidence to support these principles. These six principles include agency, dynamic adaptation, connection to lived experiences, consideration of social movements, opportunities for collaboration, and shared power. These principles fall into three domains: fostering flexible student-centered learning experiences, leveraging relevant content and practices, and supporting meaningful interactions within a community. Finally, we conclude with some implications of this framework for researchers, policymakers, and practitioners working to ensure that all students receive high-quality learning opportunities that are both personalized and culturally responsive.

Despite the benefits of inclusive education, students with emotional disabilities (EDs), who are disproportionately Black, male, and economically marginalized, continue to be placed in segregated education settings more than students with many other classifications (OSEP Fast Facts: Children Identified With Emotional Disturbance, 2020. Retrieved from https://sites.ed.gov/idea/osep-fast-facts-children-IDed-Emotional-Disturbance-20). In this paper, we describe the functioning of a multiyear university-district research-practice partnership (RPP) and the structures that support the partnership's ability to engage in boundary spanning between researchers, practitioners, and district leaders, toward the ultimate goal of implementing a comprehensive inclusive education model for students with or at risk for EDs. First, we examine survey data from partnership members reflecting on elements of the partnership that we hypothesize to be important for supporting strong communication. Next, we present network data from meetings, one of our partnerships' boundary spanning practices, to illustrate the formal connections between RPP members. We found that the partnership had frequent meetings (N = 389), with high levels of co-attendance between university and district members (33%), although there was some variation based on district members' roles. Overall, members were satisfied with the RPP and perceived the partnership positively in terms of its resources, leadership and members, and effectiveness. This paper contributes to an understanding of both boundary spanning practices in RPPs and some of the key partnership conditions and structures that support the implementation and adaptation of a challenging initiative in school-based mental health.

Increasing career demands and expanding role expectations in a hyperconnected world batter higher education professionals, much like a tsunami of crashing waves toss a dingy at sea. To overcome the onslaught, professors are all but mandated to proactively build personal brands that deliver value propositions tightly aligning skills, expertise, and values of respective professionals, sub-units, and the institutions within which they operate, blurring and broadening branding boundaries. Long task lists, scarce time, and frazzled professionals, beckon for mechanisms that scale effort and activity to deliver results and efficiency. This article proposes a framework supporting adoption of transdisciplinary networking as one such effective scaling method. By hosting such events, colleges scaffold a variety of salutary effects that align with faculty development across teaching, research, and service areas.

Institutions of higher education are seeking to support more active learning among faculty, and that support includes the creation of active learning spaces to support more student-centered course activities. However, incremental development of these learning spaces leads to a sorting of students between active and passive learning environments. This study collected repeat-measure data from undergraduate students enrolled in a two-semester course sequence to evaluate factors affecting student enrollment decisions and student attitudes toward learning. We integrated this combination of research tools using a QuantCrit analytic framework, which revealed student attitudes and decision-making processes that were generally stable over the study period for individuals, but very different when examining student enrollment groups over time. Limited access to active learning classrooms forced students to self-sort based on either their social networks or their attitudes toward learning. That, in turn, may create a marginalizing force that pushes out some students--most often women--from undergraduate programs.

Intestinal microbial dysbiosis, intestinal inflammation, and Th17 immunity are all linked to the pathophysiology of spondyloarthritis (SpA); however, the mechanisms linking them remain unknown. One potential hypothesis suggests that the dysbiotic gut microbiome as a whole produces metabolites that influence human immune cells. To identify potential disease-relevant, microbiome-produced metabolites, we performed metabolomics screening and shotgun metagenomics on paired colon biopsies and fecal samples, respectively, from subjects with axial SpA (axSpA, N=21), Crohn’s disease (CD, N=27), and Crohn’s-axSpA overlap (CD-axSpA, N=12), as well as controls (HC, N=24). Using LC-MS based metabolomics of 4 non-inflamed pinch biopsies of the distal colon from subjects, we identified significant alterations in tryptophan pathway metabolites, including an expansion of indole-3-acetate (IAA) in axSpA and CD-axSpA compared to HC and CD and indole-3-acetaldehyde (I3Ald) in axSpA and CD-axSpA but not CD compared to HC, suggesting possible specificity to the development of axSpA. We then performed shotgun metagenomics of fecal samples to characterize gut microbial dysbiosis across these disease states. In spite of no significant differences in alpha-diversity among the 4 groups, our results confirmed differences in gene abundances of numerous enzymes involved in tryptophan metabolism. Specifically, gene abundance of indolepyruvate decarboxylase, which generates IAA and I3Ald, was significantly elevated in individuals with axSpA while gene abundances in HC demonstrated a propensity towards tryptophan synthesis. Such genetic changes were not observed in CD, again suggesting disease specificity for axSpA. Given the emerging role of tryptophan and its metabolites in immune function, altogether these data indicate that tryptophan metabolism into I3Ald and then IAA is one mechanism by which the gut microbiome potentially influences the development of axSpA.