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Paraeducators play an important role in assisting teachers and other professionals to support students with autism spectrum disorder (ASD), including delivering positive behavioral supports to those students who engage in persistent challenging behavior. The purpose of this multiple baseline design across participants study was to support paraeducators to implement functional communication training (FCT) to address challenging behavior among three students with ASD who used augmentative and alternative communication (AAC). Paraeducators implemented FCT with high levels of fidelity after participating in an initial training session and follow-up coaching and generally found the initial training and coaching strategies to be effective and feasible. Reductions in challenging behavior were variable across student participants. Implications for practice and future research directions are discussed in relation to FCT for students with ASD who use AAC and paraeducator training.

COURTROOMS remain a center of power for the legal field and the representation of gender in the courtroom is an equally powerful statement on the position of women within the [...]

Music therapy can be an effective treatment that prevents stress from contributing to the etiology of disease. For this study, the participants, college students enrolled in an annual Alternative Nutrition class at California State University, Los Angeles, were instructed to select a song to present during class. After listening to each song selection, participants provided written feedback based on a 9-question survey. Self-perceived stress was measured using a Likert scale from 1 to 10, with 10 being the highest level of stress. Microsoft® Excel 2007 Data Analysis, was used to calculate t-Test: Paired Two Sample for Meansat a 5% significance level (a <0.05), and Descriptive Statistics to determine standard deviation with a confidence level for mean at 95%. Results across all four years were statistically significant, demonstrating overall stress reduction in the study sample. The authors recognize that the study sample was derived from a population known to be particularly vulnerable to stress. However, beyond the college population, listening to music can benefit anyone subject to the effects of stress.

The ACTN2 gene encodes α-actinin 2, located in the Z-disc of the sarcomeres in striated muscle. In this study, we sought to investigate the effects of an ACTN2 missense variant of unknown significance (p.A868T) on cardiac muscle structure and function. Left ventricular free wall samples were obtained at the time of cardiac transplantation from a heart failure patient with the ACTN2 A868T heterozygous variant. This variant is in the EF 3–4 domain known to interact with titin and α-actinin. At the ultrastructural level, ACTN2 A868T cardiac samples presented small structural changes in cardiomyocytes when compared to healthy donor samples. However, contractile mechanics of permeabilized ACTN2 A868T variant cardiac tissue displayed higher myofilament Ca2+ sensitivity of isometric force, reduced sinusoidal stiffness, and faster rates of tension redevelopment at all Ca2+ levels. Small-angle X-ray diffraction indicated increased separation between thick and thin filaments, possibly contributing to changes in muscle kinetics. Molecular dynamics simulations indicated that while the mutation does not significantly impact the structure of α-actinin on its own, it likely alters the conformation associated with titin binding. Our results can be explained by two Z-disc mediated communication pathways: one pathway that involves α-actinin's interaction with actin, affecting thin filament regulation, and the other pathway that involves α-actinin's interaction with titin, affecting thick filament activation. This work establishes the role of α-actinin 2 in modulating cross-bridge kinetics and force development in the human myocardium as well as how it can be involved in the development of cardiac disease. [ABSTRACT FROM AUTHOR]

The objective of this analysis was to describe patterns of prescription medication use during pregnancy, including secular trends, with consideration of indication, and distributions of use within demographic subgroups. We conducted a descriptive secondary analysis using data from 9,755 women whose infants served as controls in two large United States case–control studies from 1997–2011 and 2014–2018. After excluding vitamin, herbal, mineral, vaccine, i.v. fluid, and topical products and over‐the‐counter medications, the proportion of women that reported taking at least one prescription medication in the first trimester increased over the study years, from 37% to 50% of women. The corresponding proportions increased with increasing maternal age and years of education, were highest for non‐Hispanic White women (47%) and lowest for Hispanic women (24%). The most common indication for first trimester use of a medication was infection (12–15%). Increases were observed across the years for medications used for indications related to nausea/vomiting, depression/anxiety, infertility, thyroid disease, diabetes, and epilepsy. The largest relative increase in use among women was observed for medications to treat nausea/vomiting, which increased from 3.8% in the earliest years of the study (1997–2001) to 14.8% in 2014–2018, driven in large part by ondansetron use. Prescription medication use in the first trimester of pregnancy is common and increasing. Many medical conditions require treatments among pregnant women, often involving pharmacotherapy, which necessitates consideration of the risk and safety profiles for both mother and fetus. [ABSTRACT FROM AUTHOR]

The impact of obesity upon bone metabolism is controversial since both beneficial or harmful effects have been reported. Bone remodeling is modulated by the central nervous system through cytokines, hormones and neuromodulators. The present study aimed to evaluate the effects evoked by bilateral retroperitoneal white adipose tissue (rWAT) denervation (Dnx) upon bone mineral metabolism and remodeling in an experimental model of obesity in rats. Male Wistar rats were fed during 18 weeks with high-fat diet (HFD) or standard diet (SD) as controls, and rWAT Dnx or Sham surgery was performed at the 14th week. Biochemical and hormonal parameters, bone histomorphometry, rWAT and hypothalamus protein and gene expression were analyzed. The HFD group presented decreased bone formation parameters, increased serum and bone leptin and FGF23, increased serum and hypothalamic neuropeptide Y (NPY) and decreased serum 1,25-dihydroxyvitamin D3 and PTH. After rWAT Dnx, bone markers and histomorphometry showed restoration of bone formation, and serum and hypothalamic NPY decreased, without alteration in leptin levels. The present study shows that the denervation of rWAT improved bone formation in obese rats mediated by a preferential reduction in neurohormonal actions of NPY, emphasizing the relevance of the adipose tissue–brain–bone axis in the control of bone metabolism in obesity. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease (COVID-19) survivors exhibit multisystemic alterations after hospitalization. Little is known about long-term imaging and pulmonary function of hospitalized patients intensive care unit (ICU) who survive COVID-19. We aimed to investigate long-term consequences of COVID-19 on the respiratory system of patients discharged from hospital ICU and identify risk factors associated with chest computed tomography (CT) lesion severity. Methods: A prospective cohort study of COVID-19 patients admitted to a tertiary hospital ICU in Brazil (March-August/2020), and followed-up six-twelve months after hospital admission. Initial assessment included: modified Medical Research Council dyspnea scale, SpO2 evaluation, forced vital capacity, and chest X-Ray. Patients with alterations in at least one of these examinations were eligible for CT and pulmonary function tests (PFTs) approximately 16 months after hospital admission. Primary outcome: CT lesion severity (fibrotic-like or non-fibrotic-like). Baseline clinical variables were used to build a machine learning model (ML) to predict the severity of CT lesion. Results: In total, 326 patients (72%) were eligible for CT and PFTs. COVID-19 CT lesions were identified in 81.8% of patients, and half of them showed mild restrictive lung impairment and impaired lung diffusion capacity. Patients with COVID-19 CT findings were stratified into two categories of lesion severity: non-fibrotic-like (50.8%-ground-glass opacities/reticulations) and fibrotic-like (49.2%-traction bronchiectasis/architectural distortion). No association between CT feature severity and altered lung diffusion or functional restrictive/obstructive patterns was found. The ML detected that male sex, ICU and invasive mechanic ventilation (IMV) period, tracheostomy and vasoactive drug need during hospitalization were predictors of CT lesion severity(sensitivity,0.78±0.02;specificity,0.79±0.01;F1-score,0.78±0.02;positive predictive rate,0.78±0.02; accuracy,0.78±0.02; and area under the curve,0.83±0.01). Conclusion: ICU hospitalization due to COVID-19 led to respiratory system alterations six-twelve months after hospital admission. Male sex and critical disease acute phase, characterized by a longer ICU and IMV period, and need for tracheostomy and vasoactive drugs, were risk factors for severe CT lesions six-twelve months after hospital admission. [ABSTRACT FROM AUTHOR]

There's a lot wrong with the diversity training that goes on in the nation's schools. There are programs that offer shortcuts for communication across racial and ethnic lines, too often drawing on stereotypes rather than challenging them. There are dialogue programs that usher in difficult conversations about racism, prejudice and bias, sometimes opening wounds and creating tensions that leave participants asking, "How did "that" help?" And then there are "feel-good-about-diversity" programs that seem wholly disconnected from the practice and realities of teaching. Lackluster diversity programs aren't limited to in-services, either. A May 2007 survey by Public Agenda found that most new teachers (76 percent) said teaching an ethnically diverse student body was covered in their pre-service training, but less than half said this training helped them "a lot" when they got into actual classrooms. But "something" has to be done, right? The nation's education system has an undeniable problem with race. For decades, white students have enjoyed better academic outcomes than most students of color. A similar gap exists between middle-class students and students who live in poverty. These gaps are measured in test scores and dropout rates, but their impact goes far beyond education statistics, affecting who goes to college and who doesn't, who makes a living wage, who becomes the line worker and who becomes the manager. The "achievement gap," as it's known, is arguably the greatest barrier to true equality in America. This article describes the Teaching Diverse Students Initiative (TDSi) which seeks to empower educators to improve the school experience for children of color. Undertaken by Teaching Tolerance, in partnership with the National Education Association, the American Association of Colleges of Teacher Education, prominent scholars and excellent teachers, TDSi offers a suite of free online professional development tools designed to help educators improve their skills in working across lines of race and ethnicity. TDSi is embedded within a larger framework of best practices for teachers. Through the TDSi tools, educators can learn about concepts such as flexible heterogeneous grouping, culturally responsive pedagogy and collaborative problem solving between teachers and administrators. Ideas such as these are central to effective teaching, and they can improve instruction at any school, regardless of its demographic makeup.

HE'S DEAD AND SHE'S HALF NAKED. TWO IMAGES I encounter at every newspaper stand in Mexico City--machos y putas. A marijuana leaf and stiletto heel in the shape of a [...]

Background: Despite the multitude of clinical manifestations of post-acute sequelae of SARS-CoV-2 infection (PASC), studies applying statistical methods to directly investigate patterns of symptom co-occurrence and their biological correlates are scarce. Methods: We assessed 30 symptoms pertaining to different organ systems in 749 adults (age = 55 ± 14 years; 47% female) during in-person visits conducted at 6–11 months after hospitalization due to coronavirus disease 2019 (COVID-19), including six psychiatric and cognitive manifestations. Symptom co-occurrence was initially investigated using exploratory factor analysis (EFA), and latent variable modeling was then conducted using Item Response Theory (IRT). We investigated associations of latent variable severity with objective indices of persistent physical disability, pulmonary and kidney dysfunction, and C-reactive protein and D-dimer blood levels, measured at the same follow-up assessment. Results: The EFA extracted one factor, explaining 64.8% of variance; loadings were positive for all symptoms, and above 0.35 for 16 of them. The latent trait generated using IRT placed fatigue, psychiatric, and cognitive manifestations as the most discriminative symptoms (coefficients > 1.5, p < 0.001). Latent trait severity was associated with decreased body weight and poorer physical performance (coefficients > 0.240; p ⩽ 0.003), and elevated blood levels of C-reactive protein (coefficient = 0.378; 95% CI 0.215–0.541; p < 0.001) and D-dimer (coefficient = 0.412; 95% CI 0.123–0.702; p = 0.005). Results were similar after excluding subjects with pro-inflammatory comorbidities. Conclusions: Different symptoms that persist for several months after moderate or severe COVID-19 may unite within one latent trait of PASC. This trait is dominated by fatigue and psychiatric symptoms, and is associated with objective signs of physical disability and persistent systemic inflammation. [ABSTRACT FROM AUTHOR]