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Background Deep inferior epigastric perforator (DIEP) flap reconstruction is the gold standard reconstructive technique for women undergoing breast cancer surgery. A preoperative computed tomography angiography (CTA)-dedicated protocol and 3D reconstructions are mandatory for correct surgical planning. Purpose To evaluate the diagnostic performance of a new preoperative CTA protocol and a new reconstruction method in the assessment of DIEP technique. Material and Methods A total of 263 women (median age 49 years, age range 26–73 years) underwent preoperative CTA examination before DIEP flap breast reconstruction. A CTA-dedicated protocol followed by 3D-reconstructions were performed. Identification, branching pattern, and caliber at origin were assessed for each perforator. Intraoperative findings were the standard of reference. The sensitivity, positive predictive value, and diagnostic accuracy of the preoperative CTA protocol were calculated. Results In 255/263 (97%) patients, the dominant perforators assessed by CTA resulted adequate for surgical reconstruction. In 260/263 (99%) cases, the imaging localization of the dominant perforators corresponded with those seen intraoperatively (mean errors ≤1 cm). The preoperative CTA imaging sensitivity, positive predictive value, and diagnostic accuracy in determining the localization of perforators were 99% (95% CI 98–100), 100% and 99% (95% CI 98–100), respectively. No statistically significant differences were found between the CTA findings and the surgical findings for the assessment of branching pattern and caliber of the dominant perforators ( P Conclusion The present protocol has demonstrated high accuracy in the CTA imaging assessment of the perforators before DIEP flap reconstruction with high reproducibility between CT and surgical findings.

A major controversy facing the field of gifted education is the underrepresentation of low income, minority, and dual language students. Strategies for addressing this challenge have been to use universal screening and local norms; however, these useful recommendations continue to focus on traditional testing procedures that measure what students already know and overlook other important traits that contribute to high levels of creative productivity. Assessment for learning examines traits such as interests, instructional preference styles, preferred modes of expression, and executive function skills. Although sometimes referred as the “soft skills,” they have gained much more attention on the parts of college admission officers and employers, especially for higher level leadership positions. Instruments that assess these traits are often completed by the students themselves; and technology and artificial intelligence now allow us to administer and analyze them with the same ease used for traditional standardized tests.

Purpose: This study examines differences in the mechanisms that charter schools and traditional public schools use to facilitate parental school involvement and the degree to which these differences account for the high levels of involvement among charter school parents. Data and Research Methods: We merge data from principals and teachers from the nationally representative Schools and Staffing Survey and National Teacher and Principal Survey with nonprofit tax data from the National Center for Charitable Statistics. We use ordinary least squares regression to explain how charter and traditional public schools involve parents in communal, public-good activities, and individualistic, private-good activities within schools. Findings: Charters are less likely than traditional public schools to use bureaucratic structures, like parent–teacher organizations, and more likely to use nontraditional and less bureaucratic structures, like parent workshops and compacts. The use of such structures mediates a portion of the charter advantage; however, they only partially explain the association between being a charter and parent involvement. Additionally, we find some of the outreach structures that are most common in charter schools, including compacts, are also more strongly associated with parent involvement in charter schools than in traditional public schools. Implications: While charters have more public-good and private-good parent involvement than traditional public schools, our results suggest that the uncritical adoption of outreach strategies from one sector to another is unlikely to result in equal gains in parental involvement.

Parents of academically talented students with various types of learning differences, often called 2E, need to understand how support their children’s unique needs. In this article, we discuss current research about 2E students and focus on how parents can both nurture and find educational opportunities that encourage their children’s strengths and simultaneously address their deficits. Talent development strategies are discussed for parenting for strengths with this population. Too often, 2E students, have conflicting needs that can complicate the identification and development of their talents and so this article concludes with specific recommendations for parents of these students.

UN Security Council Resolution 1325 and the successive thematic resolutions together with a variety of reports have shaped the Women, Peace and Security (WPS) agenda. The ensuing policies and institutional responses try to deal with a variety of issues including women’s participation in peace-making initiatives and protection from sexual violence during armed conflict and in its aftermath. As such these responses are underpinned by a reactive approach with a focus on conflict and post-conflict gender-sensitive areas of intervention. While these remain worthwhile interventions, the WPS agenda, in spite of its name, inadequately addresses gender-sensitive areas in peace situations, regardless of the existence of conflicts. Building on feminist critiques of the WPS agenda and the findings and recommendations of the 2015 UN Global study on the implementation of Resolution 1325, the article argues that the WSP agenda and its prevention limb need to elaborate and integrate more explicitly and comprehensively a ...

Background Intrahepatic cholangiocarcinoma (ICC) is the second most common primitive liver cancer and is rising in incidence worldwide. Given its low survival and resectability rates, locoregional therapies such as Yttrium-90 transarterial radioembolization (Y-TARE) are increasingly being employed. This retrospective study aim was to confirm and update our previous results about overall survival (OR), safety, and efficacy of Y-TARE in patients with unresectable/recurrent ICC. Materials and Methods OS was evaluated as primary endpoint while radiological tumor response at 3 months, based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, was considered as secondary endpoint. Results Over a total of 49 patients, the overall median survival was 16 months (27-41 months, 95% confidence interval [CI]) from Y-TARE procedure. A significantly longer survival was recorded in naive patients compared to patients previously submitted to any type of liver-directed treatment and radical surgery (18 vs 14 months, P=.015 and 28 vs 14 months, P=.001, respectively). Target lesion and overall objective response for RECIST 1.1 criteria were 64.6% and 52.1%, respectively. Low rates of postprocedural and late complications were recorded. Conclusions In unresectable and recurrent ICC, Y-TARE confirms its safety and its potential in increasing OS, especially in naive patients.

Regorafenib is a diphenylurea oral multikinase inhibitor, structurally comparable to sorafenib, which targets a variety of kinases implicated in angiogenic and tumor growth-promoting pathways. Regorafenib was the first agent to positively show significant survival advantage as a second-line therapy in patients with unresectable hepatocellular carcinoma (HCC) who had previously failed first-line treatment with sorafenib. Recent evidence has shown that its antitumor efficacy is due to a comprehensive spectrum of tumor neo-angiogenesis and proliferation inhibition and immunomodulatory effects on the tumor microenvironment, which plays a crucial role in tumor development. This review addresses the rationale and supporting evidence for regorafenib’s efficacy in HCC that led to regorafenib’s approval as a second-line therapy. In addition, we review proof from clinical practice studies that validate the RESORCE trial results. We discuss regorafenib’s potential role in the newly emerging therapeutic strategy based on combination with immune checkpoint blockade and its possible extensibility to patient categories not enrolled in the registrative study.

Using data from a spring 2020 survey of nearly 10,000 parents of elementary school parents in one large southeastern public school district, the authors investigate predictors of elementary school student engagement during the initial period of pandemic remote learning. The authors hypothesize that household material and technological resources, school programming and instructional strategies, and family social capital contribute to student engagement in remote learning. The analyses indicate that even after controlling for rich measures of family socioeconomic resources, students with access to high-speed Internet and Internet-enabled devices have higher levels of engagement. Exposure to more diverse socioemotional and academic learning opportunities further predicts higher levels of engagement. In addition, students whose families remained socially connected to other students’ families were more likely to engage online.

Charter schools are promoted by policy makers and advocates as a way to reduce educational inequality. Charter schools tend to enroll higher proportions of black students than do traditional public schools. However, the accountability function of charter schools means that these schools are also more likely to close than traditional public schools. A high incidence of closure can lead to educational instability with students moving in and out of charter schools and traditional schools. We use critical race theory to build on prior work, examining the factors that may promote or constrain charter school closure. Specifically, we ask, how do the racial demographics of a charter school affect its likelihood of closure? Our findings reveal that as the proportion of black students in a charter school increases, so too does its likelihood of closings. Our work suggests that the promotion of charter schools as avenues of racial equity may be misleading.

Dropout is a major issue facing our country’s schools; however, many students who drop out of school later go on to finish their degree either by returning to high school or by earning a General Education Development (GED) credential. Despite this, there has been relatively little research on these students who “stopout” of high school. Drawing on a sample of high school dropouts, we build on research conceptualizing dropouts as having been “pushed” or “pulled” out of school by examining how routes out of school influence the process of return. Our analysis reveals that being either pushed or pulled has little differential impact on the reengagement process. But, particular reasons within the categories have strong effects on keeping students out of school and on the pathways that they take if they return. Implications are suggested for both school practice and for how researchers should best conceptualize dropouts.

OBJECTIVES: Leukocyte depletion (LD) has been reported to reduce inflammatory damage during cardiopulmonary bypass (CPB). We evaluated the role of LD in pulmonary function and inflammatory response. METHODS: Seventy consecutive CABG patients were randomized (1:1) to receive LD on both arterial and cardioplegia lines (Filters) or standard arterial filters (Controls) during CPB. Estimates of pulmonary function, inflammatory and anti-inflammatory cytokines were collected pre-, intra- and postoperatively. RESULTS: Hospital mortality, intensive care and in-hospital lengths of stay were similar. Although duration of ventilation and incidence of pneumonia were comparable, leukodepleted patients showed higher PaO2/FiO2 (p-between groups = 0.005; ICU arrival p = 0.023; 24 hours p = 0.039; 48 hours p

This article includes an introduction to the Schoolwide Enrichment Model (SEM), with its three components: a total talent portfolio for each child, curriculum differentiation and modification, and enrichment opportunities from the Enrichment Triad Model. Also included is a brief history of the SEM and a summary of 30 years of research underlying this programming model in gifted education and talent development. Exciting new directions in SEM are introduced, including Renzulli Learning, an internet-based tool that identifies students' interests, learning styles, and expression styles that subsequently matches students with thousands of differentiated resources.

UN Security Council Resolution 1325 and the successive thematic resolutions together with a variety of reports have shaped the Women, Peace and Security (WPS) Agenda. The ensuing policies and institutional responses try to deal with a variety of issues including women’s participation in peace making initiatives and protection from sexual violence during armed conflict and in its aftermath. As such these responses are underpinned by a reactive approach with a focus on conflict and post conflict gender–sensitive areas of intervention. While these remain worthwhile interventions, the WPS agenda, in spite of its name, inadequately addresses gender sensitive areas in peace situations, regardless of the existence of conflicts. Building on feminist critiques of the Agenda and the findings and recommendations of the 2015 UN Global study on the implementation of resolution 1325, the article argues that the WSP agenda and its prevention limb need to elaborate and integrate more explicitly and comprehensively a human rights strategy that shifts the focus from a reactive to a proactive model, one which pursues gender equality and women’s human rights in its own right and irrespective of whether conflicts erupt or not. A human rights infused WPS preventive agenda should be premised, on the one hand, on a clear understanding and endorsement of the meaning of gender equality, on the other hand, on the creation of mechanisms and process bolstering the role of international and regional human rights regimes. In particular, robust regional human rights systems have the potential to create fora for the participation of and interaction with domestic constituencies in the region. This in turn could lead to the elaboration of context sensitive, participatory solutions, grounded in international human rights law, to existing forms of discrimination against women, which during conflicts may be exacerbated, for example, in the form of sexual enslavement and abductions as reported in recent and less recent conflicts.

One component of the Javits Gifted and Talented Students Education Act was provision for research on a national scale. In response, The National Research Center on the Gifted and Talented (NRC/GT) was created to design and implement a research portfolio. Based on emphasis in the Javits Act on underrepresented populations, on issues of identification and programming, and on priorities of an initial NRC/GT needs assessment, we elected to concentrate on summarizing the NRC/GT research reflecting identification practices, the status of current curricular and instructional strategies and practices, the development of challenging curricula, and the effectiveness of various professional development strategies as potential catalysts for change. The history underlying the development of the Javits Act and the organization and operation of the NRC/GT are described in the article titled “Laying the Base for the Future: One Cornerstone of the Javits Act” in this special issue of the Journal of Advanced Academics (JOAA).

The passage of the Jacob K. Javits Gifted and Talented Students Education Act in 1988 was truly a watershed moment in the field of gifted education. The National Research Center on the Gifted and Talented (NRC/GT) represented one part of the overall agenda of research and services supported by the Javits Act. How the Javits Act came to be and the rationale and decisions that formed the underlying framework for Javits are the foci of the first part of this article. The second part of this article provides a brief overview of the NRC/GT organization and mission. Multiple research teams associated with the NRC/GT implemented quantitative and qualitative research studies, invited outstanding scholars in the field to contribute to our research series, and carried out leadership duties assigned to the Center, which have been complementary additions to many contributions made by the other Javits projects over the past several decades.

Contemporary educational institutions are undergoing simultaneous and contradictory transformations in decentralization and standardization. Such change should force us to step back from the schoolhouse doors, examine the institution of education more broadly, and delineate the ways in which it intersects with other institutional domains. Neo-liberal logics are pushing politicians and educators to embrace “local control” of schooling in the form of charter schools and homeschooling. Conversely, standardization in curriculum and teaching to the test are rampant. In this article, I highlight these contradictory educational pulls and call for scholars across specialty areas to collect pertinent data, generate new and synthetic theoretical frameworks, and embed our understanding of education in broader institutional, organizational, and political concerns.

School counselors have a variety of opportunities to serve as advocates and leaders for students identified as twice exceptional (2E). We explore these opportunities and discuss the academic and social/emotional challenges 2E students face and current operational definitions for this population. We also discuss strategies school counselors can use to help students increase their academic and social success. We introduce strengths-based educational approaches as a best practice for working with this unique population, including the use of support strategies, enrichment clusters, and extracurricular activities.

Purpose: Charter schools are unique public schools in part because this type of school can close if it fails to meet objectives set forth by the chartering body that approved it. Thus far, however, little research has been conducted into the causes of charter school closures. In this article, we examine charter school accountability. Research Design: We consider four types of accountability to guide our event history analysis of environmental influences that affect charter school closures in North Carolina. In addition, we present two case studies of schools that closed in North Carolina to better illustrate the differing micro-level processes that can lead to the closure of a school. Findings: We find evidence that market, bureaucratic, and financial accountability processes influence the likelihood that a school will close. The initiation of closure procedures, however, is more complex than our quantitative model alone suggests and our two case studies illustrate the key role that financial accountability plays in charter school closures in North Carolina.

We describe a semester-long active learning project in which students practice the skills of synthesis and analysis by developing portfolios organized around a topic of their own choosing (relevant to their substantive course). We build on prior contributions in four ways. First, we offer a project that is indicative of basic skills in the sociological toolkit and therefore of potential relevance to students’ lives and future careers. Second, we provide the first systematic assessment of the efficacy of course portfolios by using a controlled, pretest-posttest analysis conducted in seven sections of three separate sociology courses. Third, we illustrate the conceptual connections between active learning pedagogy and identity theory and provide evidence that portfolios influence the development of a sociological identity and thought among students. Fourth, we offer instructors an instructional tool that can be employed in any undergraduate sociology course.

Results after isolated aortic valve replacement with bileaflet prostheses in patients over 70 years old were reviewed. One-hundred-twenty-eight elderly patients were operated on between January 1988 and January 2000. Patients with associated heart disease were excluded from the study. Preoperative data, early and late postoperative mortality, all valve related complications and data concerning anticoagulation status were recorded. Hospital mortality was 9.3%. Mean follow-up time was 60.98±2.23 months. Twelve-year actuarial survival was 69.6±0.08%. Valve related and anticoagulation related complication rates (0.8% and 1.6% respectively) and actuarial freedom (99±0.009 both) were low, as well as the mean interval between consecutive INR checks (18.39±1.90 days) and the mean INR value (2.17±0.135). Late echocardiographic results showed low postoperative mean transprosthetic gradients (15.48±0.94). Bileaftlet prostheses in the elderly can achieve excellent results with a low incidence of anticoagulation related complications and low risk of reoperation. Older age can no longer be considered a contraindication to bileaftlet prosthesis implant.

We update theories of teacher expectancy and cultural capital by linking them to discussions of technology. We argue for broadening the span of culturally important forms of capital by including the digital dimension of cultural capital. Based on data from the third-grade and fifth-grade waves of the Early Childhood Longitudinal Survey–Kindergarten cohort (ECLS-K), results suggest a comprehensive model where teachers play a prominent, mediating role in the effects of computer proficiency on academic achievement. These findings have practical applications within classrooms, which can lead to a reduction in stratification. Our findings modernize and renew theoretical tools for understanding teacher and student interactions and the effects on achievement outcomes

Why and how should a society devote special resources to the development of giftedness in young people for the twenty-first century? If we agree that the goals of gifted education and talent development are to maximize young people’s opportunities for self-fulfillment and increase society’s reservoir of creative problem solvers and producers of knowledge, then it would seem wise that programming and services enhance students’ capacity for creative productivity, not just content acquisition. This general theory for the development of human potential is discussed through an exploration of four research-based subtheories: the Three-Ring Conception of Giftedness, the Enrichment Triad Model, Operation Houndstooth, and Executive Functions. In this article, a reexamination of current gifted and talented programming is intended to generate future research, extend dialogue among scholars, and inspire continued support for programming based on theory and related research.

The SEM and related services and programs described in this article focus on the development of both academic and creative talents through enrichment and engaging learning experiences. The research that provides compelling evidence has been summarized in the hope that urban educators will consider implementing this approach. The research supports the use of enrichment and gifted education pedagogy to provide enjoyable learning experiences as well as increased achievement scores for urban students and also presents evidence that this approach may be more effective than the use of other types of programs. Overemphasis on test preparation and mechanistic instruction and the use of remedial materials has made many urban classrooms dreary places to learn. When enrichment pedagogy is extended to urban students, these high-end opportunities can provide more advanced and enriched learning experiences that promote creativity and engagement, as well as enable students to apply thinking skills and use knowledge in an integrated, inductive, and problem-oriented manner. In urban classrooms where students are using Renzulli Learning, both engagement and wonder emerge when they take a virtual field trip to a world-famous museum, research a topic in their area of interest, complete a self-selected independent study, or apply critical and creative thinking skills in areas of choice. The SEM integrates advanced opportunities for talent development in different types and levels of enrichment, and differentiation for students in all learning opportunities, such as enrichment clusters, the SEM-R, Renzulli Learning, and the Enrichment Triad Model. The many changes taking place in urban schools should enable educators to examine a broad range of techniques for providing equitably for all students. The research described in this article and the practical experiences gained through a few decades of field testing and refining the SEM, particularly in urban areas and in schools that serve culturally diverse students, have demonstrated the many positive benefits to students and teachers that result from using an enrichment approach, including higher achievement and lower underachievement (Baum, 1988; Baum et al., 1999; Beecher & Sweeny, 2008; Gavin et al., 2007; Little et al., 2007; Reis et al., 2007; Reis et al., 2008). Academically talented students, who may be placed at risk for underachieving in school, are also the beneficiaries of this type of pedagogy. Like any innovation, implementing programs such as those described in this article requires time, energy, acceptance, and support from teachers. Yet urban educators who have effectively implemented the SEM and its related programs indicate that it takes no longer than normal teaching practices (Reis & Renzulli, 2003). More important, they report that the benefits for all students make their efforts worthwhile, suggesting that engagement and enjoyment should be considered an integral part of urban education. One urban teacher's comment about enrichment clusters reflects the attitude of most teachers who have participated in enrichment pedagogy research, “Suddenly I remembered why I had gone into teaching in the first place. I had forgotten, and I didn't even know I had forgotten. Then I remembered what I had always thought teaching would be all about” (Reis, Gentry, & Park, 1995).