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Limited research has been conducted on coaching of paraprofessionals who serve students with disruptive behaviors. This study builds upon a randomized controlled trial investigating the intervention effects of the Behavior Support Coaching for Paraprofessionals model by examining the specific behavior concerns, coaching goals, and interventions used during behavior support coaching implementation. This study consists of 83 elementary school paraprofessionals who received behavior support coaching and served 163 elementary school students from 27 schools. Behavior support coaches used observational data to identify student behavior needs, set goals, prioritize intervention supports, and monitor progress toward goals. Results revealed inappropriate physical and verbal behaviors were most often targeted as behavior goals. Coaches and paraprofessionals and classroom teachers utilized a broad range of research-based behavior interventions, with token economy and behavioral contract most often implemented. Results indicated significant change in observed student nonengagement and inappropriate physical behaviors when these are targeted as behavior goals. Implications of these findings for research and school practice are presented.

Abstract The GDS(L)-like lipase from the Basidiomycota Pleurotus sapidus (PSA_Lip) was heterologously expressed using Trichoderma reesei with an activity of 350 U L−1. The isoelectric point of 5.0 was determined by isoelectric focusing. The novel PSA_Lip showed only 23.8–25.1%, 25.5%, 26.6% and 28.4% identity to the previously characterized GDSL-like enzymes phospholipase, plant lipase, acetylcholinesterase and acetylxylan esterase, from the carbohydrate esterase family 16, respectively. Therefore, the enzyme was purified from the culture supernatant and the catalytic properties and the substrate specificity of the enzyme were investigated using different assays to reveal its potential function. While no phospholipase, acetylcholinesterase and acetylxylan esterase activities were detected, studies on the hydrolysis of ferulic acid methyl ester (~ 8.3%) and feruloylated carbohydrate 5-O-transferuloyl-arabino-furanose (~ 0.8%) showed low conversions of these substrates. By investigating the hydrolytic activity towards p-nitrophenyl-(pNP)-esters with various chain-lengths, the highest activity was determined for medium chain-length pNP-octanoate at 65 °C and a pH value of 8, while almost no activity was detected for pNP-hexanoate. The enzyme is highly stable when stored at pH 10 and 4 °C for at least 7 days. Moreover, using consensus sequence analysis and homology modeling, we could demonstrate that the PSA_Lip does not contain the usual SGNH residues in the actives site, which are usually present in GDS(L)-like enzymes.

Limited research has examined the qualities of paraprofessional and teacher relationships in schools. Teachers' and paraprofessionals' ability to communicate and collaborate are important for guiding supports for their students. The present study examined characteristics affecting the professional relationship of paraprofessional and teacher pairs working within the same classroom across 58 elementary schools. A total of 108 pairs of paraprofessionals and teachers were asked to independently complete a multidimensional assessment of relationship quality, as well as a demographic survey. Findings overall indicate that both classroom teachers and their paraprofessionals rate their relationship qualities favorably, with paraprofessionals rating relationships more positively than teachers (ds = 0.28 - 0.34). However, there are differences in relationship ratings by race and ethnicity. Implications are discussed and suggestions are given so that paraprofessionals and teachers can continue to develop positive relationships.

The current study examined teacher competence and contextual factors associated with teacher-reported stress in low-income urban elementary schools. Using a sample of 106K-5th grade teachers from 14 low-income urban elementary schools, associations between observed use of instructional and behavior management practices, teacher-reported stress, perceived instrumental and emotional supports, class-wide student academic performance, and behavioral functioning were examined. Teacher-reported stress was significantly related to perceived emotional support, instrumental support, class-wide student academic performance, and class-wide student behavioral functioning. Instrumental and emotional supports, observed instructional and behavioral management practices, and class-wide student academic and behavioral functioning jointly predicted teacher stress. Results from a dominance analysis identified class-wide behavioral functioning, and emotional and instrumental support as the strongest predictors of teacher stress. Study limitations and implications for research and practice are discussed.

Abstract Subgroup analysis aims to identify subgroups (usually defined by baseline/demographic characteristics), who would (or not) benefit from an intervention under specific conditions. Often performed post hoc (not pre-specified in the protocol), subgroup analyses are prone to elevated type I error due to multiple testing, inadequate power, and inappropriate statistical interpretation. Aside from the well-known Bonferroni correction, subgroup treatment interaction tests can provide useful information to support the hypothesis. Using data from a previously published randomized trial where a p value of 0.015 was found for the comparison between standard and Hemopatch® groups in (the subgroup of) 135 patients who had hand-sewn pancreatic stump closure we first sought to determine whether there was interaction between the number and proportion of the dependent event of interest (POPF) among the subgroup population (patients with hand-sewn stump closure and use of Hemopatch®), Next, we calculated the relative excess risk due to interaction (RERI) and the “attributable proportion” (AP). The p value of the interaction was p = 0.034, the RERI was − 0.77 (p = 0.0204) (the probability of POPF was 0.77 because of the interaction), the RERI was 13% (patients are 13% less likely to sustain POPF because of the interaction), and the AP was − 0.616 (61.6% of patients who did not develop POPF did so because of the interaction). Although no causality can be implied, Hemopatch® may potentially decrease the POPF after distal pancreatectomy when the stump is closed hand-sewn. The hypothesis generated by our subgroup analysis requires confirmation by a specific, randomized trial, including only patients undergoing hand-sewn closure of the pancreatic stump after distal pancreatectomy. Trial registration: INS-621000-0760.

The hydration shells of phosphate ions and phosphate groups of nucleotides and phospholipid membranes display markedly different structures and hydrogen-bond strengths. Understanding phosphate hydration requires insight into the spatial arrangements of water molecules around phosphates and in thermally activated structure fluctuations on ultrafast time scales. Femtosecond two-dimensional infrared spectroscopy of phosphate vibrations, particularly asymmetric stretching vibrations between 1000 and 1200 cm−1, and ab initio molecular dynamics (AIMD) simulations are combined to map and characterize dynamic local hydration structures and phosphate–water interactions. Phosphoric acid H3PO4 and its anions H2PO4−, HPO42−, and PO43− are studied in aqueous environments of different pH value. The hydration shells of phosphates providing OH donor groups in hydrogen bonds with the first water layer undergo ultrafast structural fluctuations, which induce a pronounced spectral diffusion of vibrational excitations on a sub-300 fs time scale. With a decreasing number of phosphate OH groups, the hydration shell becomes more ordered and rigid. The 2D-IR line shapes observed with hydrated PO43− ions display a pronounced inhomogeneous broadening, reflecting a distribution of hydration geometries without fast equilibration. The AIMD simulations allow for an in-depth characterization of the hydration geometries with different numbers of water molecules in the first hydration layer and different correlation functions of the fluctuating electric field that the water environment exerts on the vibrational phosphate oscillators. [ABSTRACT FROM AUTHOR]

Background: Sleep disturbances, such as insomnia, are common among the elderly population and have been associated with negative health outcomes. Japanese calligraphy is a traditional art practice previously associated with various health benefits, such as stress reduction and improved cognitive function; however, its association with sleep quality has not been fully explored. Methods: This cross-sectional study included 21,207 subjects with basic attributes, health status, depressive symptoms, artistic practices, and sleep habits. Individuals who satisfied the chronic insomnia criteria were categorized into the following subtypes: sleep onset latency (SOL) insomnia, early morning awakening (EMA) insomnia, and wake after sleep offset (WASF) insomnia. The t-test, chi-square test, and logistic regression analysis were used to determine the association between Japanese calligraphy practice and sleep quality. Results: In this study, 17,597 elderly Japanese individuals were included, among whom 13.7 % practiced Japanese calligraphy. Regarding sleep characteristics, 32.0 % had chronic insomnia, 13.1 % had SOL insomnia, 9.1 % had EMA insomnia, and 14.2 % had WASF insomnia. Japanese calligraphy practice was associated with lower rates of chronic insomnia (odds ratio [OR] = 0.85, 95 % confidence interval (CI) = 0.76–0.95), including SOL insomnia (OR = 0.84, 95 % CI = 0.71–0.98), and EMA insomnia (OR = 0.80, 95 % CI = 0.66–0.97) but had no significant association with WASF insomnia. Conclusions: This study suggests that Japanese calligraphy practice is associated with lower odds of insomnia, particularly SOL and EMA insomnia. Calligraphy may be an effective nonpharmacological intervention for insomnia and poor sleep quality among elderly Japanese individuals.

Summary: We proposed a personalized intervention that integrates computerized working memory (WM) training with real-time functional neuromonitoring and neurofeedback (NFB) to enhance frontoparietal activity and improve cognitive and clinical outcomes in children with attention-deficit/hyperactivity disorder (ADHD). The study involved 77 children with ADHD aged 7–11 years, who were assigned to either 12 sessions of NFB or treatment-as-usual (i.e., received standard clinical care) groups. Real-time neuromonitoring with functional near-infrared spectroscopy (fNIRS) and fMRI measured frontoparietal activity during n-back task at baseline and post-intervention. Thirty-six participants (21 NFB, 15 treatment-as-usual) completed the study. Significant improvements in NFB group were observed in frontoparietal brain activity and WM performance (primary outcomes). NFB group also showed improvements in Behavior Rating Inventory of Executive Function (BRIEF-2) WM t-scores and Conners 3 ADHD index scores (secondary outcomes) compared to treatment-as-usual group. These findings suggest that neuromonitoring-guided NFB effectively enhances cognitive and clinical outcomes in children with ADHD by targeting brain mechanisms underlying WM deficits.

Background: The perspectives of community partners about their experiences working with medical students and how service-learning experiences affect the communities they serve remains understudied. Objective: This study addressed gaps in the literature by reporting on in-depth interviews conducted with community partners who participated in a well-established medical school service-learning programme. Design: A qualitative study was undertaken using semi-structured interviews and an edited coding strategy. Setting: A convenience sample was recruited from a database of organisations working with the medical school's service-learning organisation. Method: Between 2017 and 2020, the researchers conducted semi-structured interviews with community-based organisation partners who worked with medical students through a service-learning initiative in an urban, underserved area of New Jersey, USA. The authors coded transcripts and identified themes after extensive reading, reflection and team discussion of transcripts and coded text. Authors confirmed thematic saturation after 20 interviews with 21 participants representing 18 different agencies. Results: Three main themes were developed: (1) medical students as role models, (2) community partners' role in shaping medical student education, and (3) reciprocity between community-based organisations and the service-learning programme. Participants found that medical students connected well with young clients and motivated them to pursue higher education or healthcare careers especially when they had a shared ethnic or cultural background. Community partners helped medical students better understand ethnically and socioeconomically diverse communities from a whole-person perspective. Participants described collaborative learning and reciprocity between the service-learning programme and community-based organisations as a 'win-win' situation -- with clients, the organisation and medical students all benefitting. Conclusion: Findings illustrate the importance of reciprocity between medical students and community partners. Incorporating partners in the design and evaluation of service-learning programmes is essential to understanding how community and academic health centres can better collaborate to promote health equity.

Although introns are typically tens to thousands of nucleotides, there are notable exceptions. In flies as well as humans, a small number of genes contain introns that are more than 1000 times larger than typical introns, exceeding hundreds of kilobases (kb) to megabases (Mb). It remains unknown why gigantic introns exist and how cells overcome the challenges associated with their transcription and RNA processing. The Drosophila Y chromosome contains some of the largest genes identified to date: multiple genes exceed 4Mb, with introns accounting for over 99% of the gene span. Here we demonstrate that co-transcriptional splicing of these gigantic Y-linked genes is important to ensure successful transcription: perturbation of splicing led to the attenuation of transcription, leading to a failure to produce mature mRNA. Cytologically, defective splicing of the Y-linked gigantic genes resulted in disorganization of transcripts within the nucleus suggestive of entanglement of transcripts, likely resulting from unspliced long RNAs. We propose that co-transcriptional splicing maintains the length of nascent transcripts of gigantic genes under a critical threshold, preventing their entanglement and ensuring proper gene expression. Our study reveals a novel biological significance of co-transcriptional splicing.

Objective: To help inform decisions regarding the equitable implementation of obesity interventions, we examined whether interventions were equitably reaching the most vulnerable communities, identified communities that received fewer interventions than expected, and estimated the effect of ‘dose’ of interventions on obesity prevalence. Methods: We created a database to identify and characterize obesity-related interventions implemented in Los Angeles County from 2005 to 2015 linked to community-level sociodemographic and obesity prevalence data. We ran generalized linear models with a Gamma distribution and log link to determine if interventions were directed toward vulnerable communities and to identify communities that received fewer interventions than expected. We ran fixed-effects models to estimate the association between obesity prevalence and intervention strategy count among preschool-aged children enrolled in the Special Supplemental Nutrition Assistance Program for Women Infants and Children. Results: We found that interventions targeted vulnerable communities with high poverty rates and percentages of minority residents. The small cluster of communities that received fewer interventions than expected tended to have poor socioeconomic profiles. Communities which received more intervention strategies saw greater declines in obesity prevalence (β = -0.023; 95 % CI: −0.031, −0.016). Conclusions: It is important to determine if interventions are equitably reaching vulnerable populations as resources to tackle childhood obesity become available. Evaluating the population impact of multiple interventions implemented simultaneously presents methodological challenges in measuring intervention dose and identifying cost-effective strategies. Addressing these challenges must be an important research priority as community-wide interventions involve multiple intervention strategies to reduce health disparities.

A variety of measures have been developed to quantify intervention effects for single-case experimental design studies. Within the family of non-overlap indices, the Tau-U measure is one of the most popular indices. There are several Tau-U variants, each one calculated differently. The appropriateness of each Tau-U variant depends upon the data characteristics present within the study (e.g. number of measurement occasions, the within-case variability, and baseline trend). However, inconsistent terminology is used to refer to the Tau-U variants, and researchers can overlook the attributes of the different Tau-U variants. As a result, the Tau-U variants can be applied inappropriately, and this can result in invalid conclusions of intervention effectiveness. This paper proposes a Tau-U flowchart that can assist the decision-making process when using Tau-U with single-case experimental designs that incorporate baseline-intervention (AB) comparisons (e.g. multiple-baseline designs, withdrawal/reversal designs, etc.). The flowchart can help researchers select the appropriate Tau-U variant to use based on their data and research questions. The flowchart is applied to two single-case experimental studies to demonstrate its use.

Discrete trial training is a popular teaching method for individuals with autism, but it is not easily implemented with fidelity due to its complexity. This is the first meta-analysis of single-case experimental design studies to quantify the impact of behavioral skills training on individuals' ability to implement discrete trials with fidelity. Furthermore, this meta-analysis examines the four training methods that make up behavioral skills training--feedback, instruction, modeling, and rehearsal--to determine the "active ingredients" of behavioral skills training. A total of 46 single-case experimental design studies are included in this meta-analysis. Hierarchical linear modeling, which has the ability to analyze clustered data, is the meta-analytic technique used to estimate the effectiveness of behavioral skills training across studies. Results show that behavioral skills training has a statistically significant positive effect on discrete trial training implementation fidelity; therefore, behavior skills training is recommended for discrete trial training implementation instruction.

Abstract Introduction Laparoscopic colectomy is rarely performed for ischemic colitis. The aim of this propensity score-matched study was to compare preoperative characteristics, intraoperative details and short-term outcomes for emergent laparoscopic colectomy versus the traditional open approach for patients with ischemic colitis. Methods Retrospective review of 96 patients who underwent emergent colectomy for ischemic colitis between January 2011 and December 2020 (39 via laparoscopy, 57 via laparotomy) was performed. We compared short-term outcomes after using a one-to-one ratio and nearest-neighbor propensity score matching to obtain similar preoperative and intraoperative parameters in each group. Results Patients in the open group experienced more surgical site complications (52.6% vs. 23.0%, p = 0.004), more intra-abdominal abscesses (47.3% vs. 17.9%, p = 0.003), longer need for ventilator support (20 days vs. 0 days, p

Abstract Background Adjunct hemostats can be of use in certain surgical settings. We compared the effectiveness of two hemostats, Hemopatch® and Surgicel® Original in controlling bleeding from liver lesions in an experimental model. Methods Control of grades 1 (mild) and 2 (moderate) bleeding (according to the Validated Intraoperative Bleeding [VIBe] SCALE) was assessed for 10 min after Hemopatch® (n = 198) or Surgicel® Original (n = 199) application on 397 liver surface lesions. The primary endpoint was hemostatic success (reaching VIBe SCALE grade 0 at 10 min). The secondary endpoint was time to hemostasis (time to reach and maintain grade 0). A generalized linear mixed model and an accelerated failure time model were used to assess the primary and secondary endpoints, respectively. Results The overall hemostatic success rate of Hemopatch® was statistically significantly superior to that of Surgicel® Original (83.8% versus 73.4%; p = 0.0036; odds ratio [OR] 2.38, 95% confidence interval [CI] 1.33–4.27) and time to hemostasis was reduced by 15.9% (p = 0.0032; 95% CI 0.749–0.944). Grade 2 bleeds treated with Hemopatch® had statistically significantly higher hemostatic success (71.7% versus 48.5%; p = 0.0007; OR 2.97, 95% CI 1.58–5.58) and shorter time to hemostasis (49.6% reduction, p = 3.6 × 10–8); differences for grade 1 bleeds (hemostatic success rate or time to hemostasis) were not statistically significant. Conclusions Hemopatch® provided better control of VIBe SCALE bleeding compared to Surgicel® Original for Grade 2 bleeds in this porcine model, highlighting the importance of choosing a suitable hemostat to optimize control of bleeding during surgery.

Installation art, with its immersive and participatory character, has been argued to require the use and awareness of the body, which potentially constitute key parts of the artwork's experience and appreciation. Heightened body awareness is even argued to be a key to particularly profound emotional or even transformative states, which have been frequently ascribed to this genre. However, the body in the experience of installation art has rarely been empirically considered. To address this gap, we investigated the body's role in the experience of Tomás Saraceno's in orbit installation. Based on a list of self-report items created from a review of the theoretical literature, we—for the first time—captured (quantitatively and qualitatively): what kind of subjective bodily experiences visitors (N = 230) reported, how these items grouped into clusters (using network science), and how these relate to emotion, art appraisal, and transformative outcomes. Network analysis of the items determined four communities related to “interoception,” “presence,” “disturbance,” and “proprioception.” Proprioception (e.g., awareness of balance/movement/weight) turned out to be a significant determinant of art appreciation in our study, and, together with “disturbing” body experiences (feeling awkward/watched/chills), coincided with transformation. We also assessed individual differences in body awareness yet did not find that these moderate those relationships. We suggest future research on installation art based on a more unified assessment of the role of the body in embodied-enactive aesthetics and its relation to the intensity and impact of art experience in general.

Formation of neutrophil extracellular traps was first described in 2004, showing that NETs are composed of decondensed chromatin fibers and nuclear and granule components. Free DNA is often used to quantify NETs, but to differentiate NETosis from necrotic DNA-release, immunofluorescence microscopy with NET-specific markers is required. Although evaluation by hand is time-consuming and difficult to standardize, it is still widespread. Unfortunately, no standardized method and only limited software tools are available for NET evaluation. This study provides an overview of recent techniques in use and aims to compare two published computer-based methods with hand counting. We found that the selected semi-automated quantification method and fully automated quantification via NETQUANT differed significantly from results obtained by hand and exhibited problems in detection of complex NET structures with partially illogical results. In contrast to that, trained persons were able to adapt to varying settings. Future approaches aimed at developing deep-learning algorithms for fast and reproducible quantification of NETs are needed.