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We investigated changes in students' reported sense of community in the context of a one-semester first-year seminar course using the Community and School Community Inventory (CSCI) research instrument across two years with differing instructional formats. We report a statistically significant increase in students' sense of perceived classroom community, but not school community, from pre- to post-course assessment in both years. Additionally, students' sense of social community is most significantly increased for women, students of color, and first-generation college students, but only when the instruction is face to face. Conversely, no student groups reported an increased sense of social community during online instruction. A significant increase in students' sense of learning community from pre- to post-course assessment was only reported by students who identified as male in 2020, and by no groups in 2019.

Inequities in birth outcomes are linked to experiential and environmental exposures. There have been expanding and intersecting wicked problems of inequity, racism, and quality gaps in childbearing care during the pandemic. We describe how an intentional transdisciplinary process led to development of a novel knowledge exchange vehicle that can improve health equity in perinatal services. We introduce the Quality Perinatal Services Hub, an open access digital platform to disseminate evidence based guidance, enhance health systems accountability, and provide a two-way flow of information between communities and health systems on rights-based perinatal services. The QPS-Hub responds to both community and decision-makers' needs for information on respectful maternity care. The QPS-Hub is well poised to facilitate collaboration between policy makers, healthcare providers and patients, with particular focus on the needs of childbearing families in underserved and historically excluded communities., Author(s): Saraswathi Vedam [sup.1] , Laurie Zephyrin [sup.2] , Pandora Hardtman [sup.3] , Indra Lusero [sup.4] , Rachel Olson [sup.5] , Sonia S. Hassan [sup.6] , Nynke van den Broek [...]

Children's spontaneous focus on numerosity (SFON) is described as an unprompted tendency that is stable across contexts. The attention to number task (AtN), an experimental forced-choice picture-matching task designed to evaluate select aspects of children's focus on numerosity, may reveal whether task materials can implicitly prompt children to focus on numerosity. In two studies, we replicate earlier findings showing an effect of task context on children's performance on the AtN: When asked to identify one or more matches to a target picture from an array of four options, the frequency with which preschoolers and adults identify a numerosity-based match varies as a function of the features on which the remaining match options are based. We addressed a limitation of the original AtN study by including novel combinations of features as additional trials, with which we continued to demonstrate contextual effects. We also showed that adults seemed more susceptible than children to be primed to attend to numerosity on subsequent trials. Children's focus on numerosity under these experimental conditions was remarkably low. We discuss the implications of these findings for better understanding the SFON construct.

SARS-CoV-2 has been shown to cause wide-ranging ocular abnormalities and vision impairment in COVID-19 patients. However, there is limited understanding of SARS-CoV-2 in ocular transmission, tropism, and associated pathologies. The presence of viral RNA in corneal/conjunctival tissue and tears, along with the evidence of viral entry receptors on the ocular surface, has led to speculation that the eye may serve as a potential route of SARS-CoV-2 transmission. Here, we investigated the interaction of SARS-CoV-2 with cells lining the blood-retinal barrier (BRB) and the role of the eye in its transmission and tropism. The results from our study suggest that SARS-CoV-2 ocular exposure does not cause lung infection and moribund illness in K18-hACE2 mice despite the extended presence of viral remnants in various ocular tissues. In contrast, intranasal exposure not only resulted in SARS-CoV-2 spike (S) protein in different ocular tissues but also induces a hyperinflammatory immune response in the retina. Additionally, the long-term exposure to viral S-protein caused microaneurysm, retinal pigmented epithelium (RPE) mottling, retinal atrophy, and vein occlusion in mouse eyes. Notably, cells lining the BRB, the outer barrier, RPE, and the inner barrier, retinal vascular endothelium, were highly permissive to SARS-CoV-2 replication. Unexpectedly, primary human corneal epithelial cells were comparatively resistant to SARS-CoV-2 infection. The cells lining the BRB showed induced expression of viral entry receptors and increased susceptibility towards SARS-CoV-2-induced cell death. Furthermore, hyperglycemic conditions enhanced the viral entry receptor expression, infectivity, and susceptibility of SARS-CoV-2-induced cell death in the BRB cells, confirming the reported heightened pathological manifestations in comorbid populations. Collectively, our study provides the first evidence of SARS-CoV-2 ocular tropism via cells lining the BRB and that the virus can infect the retina via systemic permeation and induce retinal inflammation. Author summary: SARS-CoV-2 is known to cause several ocular manifestations in COVID-19 patients; however, the role of eyes in viral transmission and ocular tissue tropism remains elusive. The presence of viral remnants in various ocular tissues and fluids from COVID-19 patients has led to an assumption that SARS-CoV-2 may be transmitted through the eyes. Here, we show that SARS-CoV-2 ocular tropism is through cells lining the BRB. SARS-CoV-2 not only infects the various parts of the eye via systemic exposure but also induces a hyperinflammatory immune and antiviral response in the retina. Unexpectedly, the corneal epithelium was found to be resistant to SARS-CoV-2 infection, and ocular exposure of SARS-CoV-2 failed to cause lung pathology and moribund illness. Cells lining the BRB showed induced expression of viral entry receptors and enhanced susceptibility towards SARS-CoV-2-induced cell death, which is further potentiated with comorbidities such as hyperglycemia. Our findings from this study shed light on the role of BRB in SARS-CoV-2 ocular tropism and the role of eyes in viral transmission. [ABSTRACT FROM AUTHOR]

Understanding of tongue deformations during mammalian mastication is limited, but has benefited from recent developments in multiplanar imaging technology. Here, we demonstrate how a standardized radiopaque marker implant configuration and biplanar fluoroscopy can quantify three-dimensional shape changes during chewing in pigs. Transverse and sagittal components of the three-dimensional angle between markers enable characterizing deformations in anatomically relevant directions. The transverse component illustrates bending to the left or to the right, which can occur symmetrically or asymmetrically, the latter sometimes indicating regional widening. The sagittal component reflects 'arching' or convex deformations in the dorsoventral dimension symmetrically or asymmetrically, the latter characteristic of twisting. Trends are detected in both the transverse and sagittal planes, and combinations thereof, to modify tongue shape in complex deformations. Both the transverse and sagittal components were also measured at key jaw and tongue positions, demonstrating variability particularly with respect to maximum and minimum gape. This highlights the fact that unlike tongue position, tongue deformations are more independent of jaw position, likely in response to the ever-changing bolus shape and position. From a methodological perspective, our study showcases advantages of a repeatable three-marker implant configuration suitable for animals of different sizes and highlights considerations for different implant patterns. This article is part of the theme issue 'Food processing and nutritional assimilation in animals'. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is a common complication of pregnancy that carries lasting risks. For women who have a history of GDM, the risk of developing type 2 diabetes mellitus (T2DM) increases by 50 to 60%. To monitor and prevent the development of T2DM, guidelines suggest screening those with a history of GDM at 6-weeks and 3-years post-delivery. For patients with abnormal lab results at the 6-week mark, it is advised to complete lab work sooner, at the 1-year mark. Data suggests that these guidelines are not being followed globally, and most do not receive adequate screening for T2DM. Methods: A retroactive chart review of 203 women between 18 and 55 years old with a past medical history significant for GDM was conducted to determine if patients with GDM completed screening for T2DM at 6-week, 1-year, and 3-year timestamps post-delivery. Patient demographics (age, race, ethnicity, language), clinical characteristics (body mass index), provider gender, and whether prediabetes or T2DM developed were recorded. Patients who did not complete the required follow-up received educational materials via the online portal system, and hemoglobin A1c (HbA1c) screening tests were ordered. Results: Ninety days post-intervention, 38 patients (50%) completed the HbA1c screening test, which exceeded our goal of a 5% improvement. Age and BMI 1-year postpartum were found to be significant factors in whether a patient completed HbA1c screening, with 16/18 (89%) completing screening with a healthy BMI 1-year postpartum (18.5 ≤ BMI < 25.0) but only 11/41 (27%) completing screening for patients under 40 years with an unhealthy BMI 1-year postpartum. Of the 38 patients who completed HbA1c screening, 9 (23.7%) had abnormal screening results. Conclusion: Follow-up surveillance for T2DM among women with a history of GDM is poor. Electronic health records can be used to identify and rectify gaps in care. Dissemination of standardized educational materials and electronic order entry for patients improved screening between the handoff from obstetrics to primary care. [ABSTRACT FROM AUTHOR]

Physiologic monitoring systems such as Masimo provide a noninvasive conventional means of capturing critical vital signs data during inpatient hospitalization. This system generates alarms when the patient's vital signs deviate from the set parameters. These devices emit alarms; many of which are nonurgent and potentially false alarms or benign. Alarm fatigue, a coined term in hospitals, describes clinician desensitization to alarms, which is a patient safety issue. Additionally, excess noise hinders a therapeutic environment and can contribute to patient agitation and hospital-acquired delirium. In 2021, The Joint Commission announced a goal to reduce alarm fatigue-related deaths through proper management of alarms. No guidelines exist for reducing benign alarms that contribute to alarm fatigue and staff burnout. Addressing alarm fatigue can improve patient safety, reduce staff burnout, and improve the sensitivity of SpO2 monitoring to detect emergencies. METHODS A quality improvement project was conducted to reduce the false-positive alarm burden by 10 to 20 percentage points within 2 months, from a range of 55% to 85% to a range of 35% to 75%. This would be achieved using key quality improvement methodologies such as Suppliers, Inputs, Process, Outputs, Customers and Requirement (SIPOC+R); Ishikawa Cause-and-Effect diagram; and Define, Measure, Analyze, Improve, and Control (DMAIC). The project consisted of two interventions from February 2021 to April 2021. Data were collected for 1 month for each step of the project: baseline, intervention 1, and intervention 2 data collection. The first intervention designed a messaging system via the electronic medical record (Epic) to assess patient monitoring needs and contact clinicians if discontinuing monitoring was deemed appropriate. The goal of this intervention was to reduce the number of patients on continuous monitoring at any given time. The second intervention educated patients and staff via printed signs pasted to monitors that demonstrated proper device use and placement, instructions for device removal, contact information for managing alarm issues, and how to resolve false-positive alarms. A staff survey was used at the beginning and end of the project to assess for changes in satisfaction with the process. RESULTS Baseline averages were obtained for red alarms (critical alerts for low oxygen saturation and low heart rate), manual snoozes (technicians silencing false-positive alarms), and self-resolves (critical alarms triggered and then resolved for unknown reasons, for example, a patient has tachycardia for 10 seconds, then the heart rate drops below 100 beats/minute, or a patient unplugs a device and then plugs it back in). The first intervention phase demonstrated reductions in all three types. The second intervention phase exhibited an overall decrease in red alarms and manual snoozes from baseline. Selfresolved alarms increased to 125, demonstrating that the educational signs were effective in the hospital rooms. Evaluating the project's overall effectiveness, an average alarm reduction of 25% was noted across all alarm types. CONCLUSIONS Interventions such as sign placement and communication protocols are simple but effective ways to reduce alarm burden for both patients and staff. The clinical significance of this project demonstrates that these methods could be used practically and effectively in any healthcare setting. [ABSTRACT FROM AUTHOR]

Although their structures and funding sources differ, Research I institutions and small liberal arts colleges share the same goal of helping students master the knowledge and skills that will enable them to become informed citizens who are able to contribute effectively a democratic society. But how can this transformation be achieved, and what metrics can be used to define success? To answer these questions, institutions must first identify student learning outcomes. According to Keeling and Hersh (2011), the next step is to link those goals to the general education curriculum. One way of evaluating learning outcomes at the institutional level is by applying the backward design method. This involves three steps: (1) identify desired results--in this case, student learning outcomes; (2) determine what constitutes acceptable evidence that the learning outcomes have been achieved by students; and (3) ensure proper alignment between instruction and curricula, a step that should result in improved student performance on the assessments. This should also involve the alignment of course-level goals and the assessment of student learning, both within individual classrooms and across curricula. The gap between student learning goals and curricula can be bridged using the rubrics that the Association of American Colleges and Universities (AAC&U) developed through its Valid Assessment of Learning in Undergraduate Education (VALUE) project (see www.aacu.org/value/rubrics). Over the past two years, the Center for Integrative Studies in General Science at Michigan State University (MSU) has emerged a trailblazer with regard to the large-scale programmatic assessment of the liberal learning goals. In spring of 2012 AAC&U contacted MSU and invited its scientists to help evaluate the rubric for global learning that was then being developed as part of the association's VALUE project. In addition to providing AAC&U with feedback that was used to inform the subsequent revision of the VALUE rubric for global learning, the evaluation process provided an opportunity for the center's faculty to share ideas and resources across their own community of practice--and, therefore, across disciplinary boundaries. By engaging with the VALUE rubric, members of the faculty learning community were able to consider the metacognitive aspects of their own teaching, including consideration of where instruction fits into the broader context of general education science training at MSU. The integration of institution-specific goals for student learning with those specified by the VALUE rubric for global learning won broad support at MSU. The development of MSU's liberal learning goals and global competencies, along with their respective rubrics, and the adaptation of the VALUE rubrics have set the stage for the institution-wide evaluation of curricula and student learning outcomes.

Children's spontaneous focus on numerosity (SFON) is described as an unprompted tendency that is stable across contexts. The attention to number task (AtN), an experimental forced-choice picture-matching task designed to evaluate select aspects of children's focus on numerosity, may reveal whether task materials can implicitly prompt children to focus on numerosity. In two studies, we replicate earlier findings showing an effect of task context on children's performance on the AtN: When asked to identify one or more matches to a target picture from an array of four options, the frequency with which preschoolers and adults identify a numerosity-based match varies as a function of the features on which the remaining match options are based. We addressed a limitation of the original AtN study by including novel combinations of features as additional trials, with which we continued to demonstrate contextual effects. We also showed that adults seemed more susceptible than children to be primed to attend to numerosity on subsequent trials. Children's focus on numerosity under these experimental conditions was remarkably low. We discuss the implications of these findings for better understanding the SFON construct. [ABSTRACT FROM AUTHOR]

Individuals with Mathematics Learning Disabilities have persistent mathematics underperformance but vary with respect to their cognitive profiles. The present study examined mathematics ability and achievement, and associated mathematics-specific numerical skills and domain-general cognitive abilities, in young children with Turner syndrome compared to their matched peers. We utilized two independent peer groups so that group comparisons would account for verbal skills, a hypothesized strength of girls with Turner syndrome, and nonsymbolic magnitude comparison skills, a hypothesized difference of girls with Turner syndrome. This individual matching approach afforded characterization of mathematics profiles of girls with Turner syndrome and girls without Turner syndrome that share potential key features of the Turner syndrome phenotype. Results indicated differences in mathematics ability and nonsymbolic magnitude comparison tasks between girls with Turner syndrome and peers with similar levels of verbal skill. Mathematics ability and mathematics achievement scores of girls with Turner syndrome did not differ significantly from their peers with similar levels of accuracy on a nonsymbolic magnitude comparison task. Cognitive correlates of mathematics outcomes showed disparate patterns across groups. These quantitative and qualitative differences across profiles enhance our understanding of variation in mathematics ability in early childhood and inform how mathematics skills develop in young children with or without Turner syndrome. [ABSTRACT FROM AUTHOR]

The transcription factor GLI1 (GLI family zinc finger 1) plays a key role in the development and progression of multiple malignancies. To date, regulation of transcriptional activity at target gene promoters is the only molecular event known to underlie the oncogenic function of GLI1. Here, we provide evidence that GLI1 controls chromatin accessibility at distal regulatory regions by modulating the recruitment of SMARCA2 (SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily A, member 2) to these elements. We demonstrate that SMARCA2 endogenously interacts with GLI1 and enhances its transcriptional activity. Mapping experiments indicated that the C-terminal transcriptional activation domain of GLI1 and SMARCA2's central domains, including its ATPase motif, are required for this interaction. Interestingly, similar to SMARCA2, GLI1 overexpression increased chromatin accessibility, as indicated by results of the micrococcal nuclease assay. Further, results of assays for transposase-accessible chromatin with sequencing (ATAC-seq) after GLI1 knockdown supported these findings, revealing that GLI1 regulates chromatin accessibility at several regions distal to gene promoters. Integrated RNA-seq and ATAC-seq data analyses identified a subset of differentially expressed genes located in cis to these regulated chromatin sites. Finally, using the GLI1-regulated gene HHIP (Hedgehog-interacting protein) as a model, we demonstrate that GLI1 and SMARCA2 co-occupy a distal chromatin peak and that SMARCA2 recruitment to this HHIP putative enhancer requires intact GLI1. These findings provide insights into how GLI1 controls gene expression in cancer cells and may inform approaches targeting this oncogenic transcription factor to manage malignancies. [ABSTRACT FROM AUTHOR]

During chewing, movements and deformations of the tongue are coordinated with jaw movements to manage and manipulate the bolus and avoid injury. Individuals with injuries to the lingual nerve report both tongue injuries due to biting and difficulties in chewing, primarily because of impaired bolus management, suggesting that jaw-tongue coordination relies on intact lingual afferents. Here, we investigate how unilateral lingual nerve (LN) transection affects jaw-tongue coordination in an animal model (pig, Sus scrofa). Temporal coordination between jaw pitch (opening-closing) and 1) anteroposterior tongue position (i.e., protraction-retraction), 2) anteroposterior tongue length, and 3) mediolateral tongue width was compared between pre- and post-LN transection using cross-correlation analyses. Overall, following LN transection, the lag between jaw pitch and the majority of tongue kinematics decreased significantly, demonstrating that sensory loss from the tongue alters jaw-tongue coordination. In addition, decrease in jaw-tongue lag suggests that, following LN transection, tongue movements and deformations occur earlier in the gape cycle than when the lingual sensory afferents are intact. If the velocity of tongue movements and deformations remains constant, earlier occurrence can reflect less pronounced movements, possibly to avoid injuries. The results of this study demonstrate that lingual afferents participate in chewing by assisting with coordinating the timing of jaw and tongue movements. The observed changes may affect bolus management performance and/or may represent protective strategies because of altered somatosensory awareness of the tongue. NEW & NOTEWORTHY Chewing requires coordination between tongue and jaw movements. We compared the coordination of tongue movements and deformation relative to jaw opening-closing movements pre- and post-lingual nerve transection during chewing in pigs. These experiments reveal that the timing of jaw-tongue coordination is altered following unilateral disruption of sensory information from the tongue. Therefore, maintenance of jaw-tongue coordination requires bilateral sensory information from the tongue. [ABSTRACT FROM AUTHOR]

Chewing is a rhythmic oral behavior that requires constant modifications of jaw movements in response to changes in food properties. The food-specific kinematic response is dependent on the potential for kinematic flexibility allowed by morphology and modulation of motor control. This study investigates the effects of food toughness and stiffness on the amplitude and variability of jaw movements during chewing in a typical omnivorous mammalian model (pigs). Jaw movements were reconstructed using X-ray Reconstruction Of Moving Morphology (XROMM) and kinematic data associated with the amplitude of jaw pitch (opening-closing) and jaw yaw (mediolateral rotation) were extracted for each cycle. Between-food differences were tested for the amplitude of jaw movements during each phase of the gape cycle, as well as in their respective within-food variability, or stereotypy, as indicated by coefficients of variation. With increasing toughness, jaw pitch amplitude is decreased during fast close, larger and more stereotyped during slow close, smaller but more variable during slow open, and more variable during fast open. In addition, when chewing on tougher foods, the amplitude of jaw yaw during slow close only increases in a subset of individuals, but all become less variable (i.e., more stereotyped). In contrast, increasing food stiffness has no effect on the amplitude or the variability of jaw pitch, whereas jaw yaw increases significantly in the majority of individuals studied. Our data demonstrate that food stiffness and toughness both play a role in modulating gape cycle dynamics by altering the trajectory of jaw movements, especially during the slow-close phase and tooth-food-tooth contact, albeit differently. This highlights how a generalist oral morphology such as that of pigs (e.g., bunodont teeth lacking precise occlusion, permissive temporomandibular joint allowing extensive condylar displacements in 3 dimensions) enables organisms to not only adjust chewing movements in their amplitude, but also in their variability. [ABSTRACT FROM AUTHOR]

Yersinia pestis is the causative agent of pneumonic plague, a disease involving uncontrolled bacterial growth and host immunopathology. Secondary septicemic plague commonly occurs as a consequence of the host inflammatory response that causes vasodilation and vascular leakage, which facilitates systemic spread of the bacteria and the colonization of secondary tissues. The mortality rates of pneumonic and septicemic plague are high even when antibiotics are administered. In this work, we show that primary pneumonic or secondary septicemic plague can be preferentially modeled in mice by varying the volume used for intranasal delivery of Y. pestis. Low volume intranasal challenge (10μL) of wild type Y. pestis resulted in a high frequency of lethal secondary septicemic plague, with a low degree of primary lung infection and rapid development of sepsis. In contrast, high volume intranasal challenge (30μL) yielded uniform early lung infection and primary disease and a significant increase in lethality. In a commonly used BSL2 model, high volume challenge with Y. pestis lacking the pigmentation locus (pgm-) gave 105-fold greater deposition compared to low volume challenge, yet moribund mice did not develop severe lung disease and there was no detectable difference in lethality. These data indicate the primary cause of death of mice in the BSL2 model is sepsis regardless of intranasal dosing method. Overall, these findings allow for the preferential modeling of pneumonic or septicemic plague by intranasal dosing of mice with Y. pestis. [ABSTRACT FROM AUTHOR]

Highlights • Lingual nerve injuries, which occur during routine dental and other oral procedures, affect feeding. • In the pig, unilateral lingual nerve denervation alters the temporal and spatial dynamics of jaw movements during chewing. • The timing of jaw movements show a highly individualized response following the injury as compared to changes in spatial dynamics. • Maintaining tongue-jaw coordination is critical and can come at the expense of bolus handling and masticatory performance. Abstract Objective This study evaluates the effect of unilateral lingual sensory loss on the spatial and temporal dynamics of jaw movements during pig chewing. Design X-ray Reconstruction of Moving Morphology (XROMM) was used to reconstruct the 3-dimensional jaw movements of 6 pigs during chewing before and after complete unilateral lingual nerve transection. The effect of the transection were evaluated at the temporal and spatial level using Multiple Analysis of Variance. Temporal variables include gape cycle and phase durations, and the corresponding relative phase durations. Spatial variables include the amplitude of jaw opening, jaw yaw, and mandibular retraction-protraction. Results The temporal and spatial dynamics of jaw movements did not differ when chewing ipsilateral versus contralateral to the transection. When compared to pre-transection data, 4 of the 6 animals showed significant changes in temporal characteristics of the gape cycle following the transection, irrespective of chewing side, but the specific response to the lesion was highly dependent on the animal. On the other hand, in affected individuals the amplitude of jaw movements was altered similarly in all 3 dimensions: jaw opening and protraction-retraction increased whereas jaw yaw decreased. Conclusion The variable impact of this injury in this animal model suggests that individuals use different compensatory strategies to adjust or maintain the temporal dynamics of the gape cycle. Because the amplitude of jaw movements are more adversely affected than their timing, results suggest that maintaining the tongue-jaw coordination is critical and this can come at the expense of bolus handling and masticatory performance. [ABSTRACT FROM AUTHOR]