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Understanding students' perspectives on inclusive behavior is important for addressing the bullying, victimization, and exclusion that many middle school and high school students, particularly marginalized students, continue to face at school. This study explored how students give meaning to inclusive behavior at school and the conditions that support inclusive behavior. Using data from 30 focus groups conducted with students, the findings expand on three primary themes: students' broad descriptions of inclusive behavior, their understanding of the qualities and characteristics of an inclusive person, and their beliefs about what makes a school inclusive. Findings from this study can inform organizational practices to facilitate inclusive behavior in schools in a manner consistent with how students themselves view inclusivity.

Background: Atypical primary hyperparathyroidism (PHPT), which includes normocalcemic and normohormonal variants, can be a diagnostic challenge. We sought to create a machine learning model to predict the probability of a patient having atypical presentations of PHPT. Methods: A model was constructed using logistic regression of PHPT patients and were compared to controls. Variables included sex, body mass index (BMI), calcium, PTH, 25-hydroxyvitamin D, phosphorus, chloride, sodium, alkaline phosphatase, and creatinine. The performance of the model was evaluated using the area under the curve (AUC). Results: The study included 4987 controls and 433 patients with atypical PHPT. Calcium, PTH, vitamin D, phosphorus, BMI, and sex were found to significantly contribute to the performance of the model, achieving an AUC of 0.999. The sensitivity, specificity, positive and negative predictive values were 92.9 %, 99.7 %, 96.3 % and 99.4 %, respectively. Conclusion: Machine learning can reliably aid in the recognition of PHPT in patients with atypical variants. Clinical relevance: When evaluating patients with atypical variants of primary hyperparathyroidism, the clinician needs to be able to identify subtle relationships in the patient laboratory test to make the diagnosis. These relationships can be found with machine learning and incorporated to predictive models which can ease and improve the diagnosis.

Abstract Background Culex mosquitoes are the primary vectors of West Nile virus (WNV) across the USA. Understanding when these vectors are active indicates times when WNV transmission can occur. This study determined the proportion of female Culex mosquitoes that were in diapause during the fall and winter and when they terminated diapause and began blood feeding in the spring. Methods Mosquitoes were collected from parks using various traps and/or aspirated from culverts in Franklin County, Ohio, from October to mid-May from 2019 to 2022. Culex mosquitoes were morphologically identified to species, and the ovaries of females were dissected to determine their diapause and parity statuses. Results By early October 2021, roughly 95% of Culex pipiens collected in culverts were in diapause and 98% of Cx. erraticus were in diapause. Furthermore, gravid and blood-fed Culex salinarius, Cx. pipiens, and Cx. restuans were collected in late November in 2019 and 2021 in standard mosquito traps. In the winter of 2021, the proportions of non-diapausing Culex decreased within culverts. The last non-diapausing Cx. erraticus was collected in late December 2021 while the final non-diapausing Cx. pipiens was collected in mid-January 2022, both in culverts. Roughly 50% of Cx. pipiens terminated diapause by mid-March 2022, further supported by our collections of gravid females in late March in all 3 years of mosquito collection. In fact, male mosquitoes of Cx. pipiens, Cx. restuans, and Cx. territans were collected by the 1st week of May in 2022, indicating that multiple species of Culex produced a second generation that reached adulthood by this time. Conclusions We collected blood-fed and gravid Culex females into late November in 2 of the 3 years of our collections, indicating that it might be possible for WNV transmission to occur in late fall in temperate climates like Ohio. The persistence of non-diapausing Cx. pipiens and Cx. erraticus throughout December has important implications for the winter survival of WNV vectors and our overall understanding of diapause. Finally, determining when Culex terminate diapause in the spring may allow us to optimize mosquito management programs and reduce the spread of WNV before it is transmitted to humans. Graphical Abstract

Abstract Mosquitoes transmit a wide variety of devastating pathogens when they bite vertebrate hosts and feed on their blood. However, three entire mosquito genera and many individual species in other genera have evolved a nonbiting life history in which blood is not required to produce eggs. Our long‐term goal is to develop novel interventions that reduce or eliminate the biting behavior in vector mosquitoes. A previous study used biting and nonbiting populations of a nonvector mosquito, Wyeomyia smithii, as a model to uncover the transcriptional basis of the evolutionary transition from a biting to a nonbiting life history. Herein, we ask whether the molecular pathways that were differentially expressed due to differences in biting behavior in W. smithii are also differentially expressed between subspecies of Culex pipiens that are obligate biting (Culex pipiens pipiens) and facultatively nonbiting (Culex pipiens molestus). Results from RNAseq of adult heads show dramatic upregulation of transcripts in the ribosomal protein pathway in biting C. pipiens, recapitulating the results in W. smithii, and implicating the ancient and highly conserved ribosome as the intersection to understanding the evolutionary and physiological basis of blood feeding in mosquitoes. Biting Culex also strongly upregulate energy production pathways, including oxidative phosphorylation and the citric acid (TCA) cycle relative to nonbiters, a distinction that was not observed in W. smithii. Amino acid metabolism pathways were enriched for differentially expressed genes in biting versus nonbiting Culex. Relative to biters, nonbiting Culex upregulated sugar metabolism and transcripts contributing to reproductive allocation (vitellogenin and cathepsins). These results provide a foundation for developing strategies to determine the natural evolutionary transition between a biting and nonbiting life history in vector mosquitoes.

Understanding the molecular and physiological processes underlying biting behavior in vector mosquitoes has important implications for developing novel strategies to suppress disease transmission. Here, we conduct small-RNA sequencing and qRT-PCR to identify differentially expressed microRNAs (miRNAs) in the head tissues of two subspecies of Culex pipiens that differ in biting behavior and the ability to produce eggs without blood feeding. We identified eight differentially expressed miRNAs between biting C. pipiens pipiens (Pipiens) and non-biting C. pipiens molestus (Molestus); six of these miRNAs have validated functions or predicted targets related to energy utilization (miR8-5-p, miR-283, miR-2952-3p, miR-1891), reproduction (miR-1891), and immunity (miR-2934-3p, miR-92a, miR8-5-p). Although miRNAs regulating physiological processes associated with blood feeding have previously been shown to be differentially expressed in response to a blood meal, our results are the first to demonstrate differential miRNA expression in anticipation of a blood meal before blood is actually imbibed. We compare our current miRNA results to three previous studies of differential messenger RNA expression in the head tissues of mosquitoes. Taken together, the combined results consistently show that biting mosquitoes commit to specific physiological processes in anticipation of a blood meal, while non-biting mosquitoes mitigate these anticipatory costs.

Abstract BackgroundInfraorbital hollows can give a fatigued or aged appearance, which can be treated by volumizing the segmented transition from the tear trough to the cheek with hyaluronic acid filler. Due to thin skin and the complex anatomy of the infraorbital area, both short- and long-term side effects (SEs) from this treatment are very common. While some patients are clear surgical candidates vs filler candidates, in real-world practice, many, if not most, patients are on a continuum where either procedure is appropriate, and the treatment decision is individualized based on each person’s risk vs benefit profile. ObjectivesCommon aesthetic SEs from hyaluronic acid filler treatment in the infraorbital area will be reviewed, including their etiology, prevention, detection, and treatment. MethodsThe author’s experience from injecting the infraorbital areas of more than 800 patients in private clinical practice and observations from both short- and long-term follow-ups over 8 years is leveraged to provide detailed guidance. ResultsRecommendations on injection techniques, patient selection, and patient education are presented along with algorithms for the prevention and management of bruising, short- and long-term swelling, bumps, and blue discoloration (which is usually secondary to swelling from the filler rather than just the filler alone placed or migrating too superficially). ConclusionsFor nearly all patients, complete dissolution of filler with hyaluronidase is not required to address the issue, and the guidelines provided here will assist clinicians in the management of SEs to increase patient satisfaction with their treatment and aesthetic outcome. Level of Evidence: 5

Students participate in a "social community" of learners. For children with learning problems, mastering the skills needed to actively participate in this community can be a challenge. How can teachers find time to provide social skills instruction, given the pressures to teach academic subjects first and foremost? This article shows school personnel ways to infuse social skills instruction into their existing instructional activities throughout the school day by: (1) Integrating social skills and academic instruction; (2) Amplifying the impact of pre-planned instruction through impromptu responses to naturally occurring social skills problems; and (3) Adding a social skills dimension to the classroom environment and routines. This article introduces and illustrates use of the Social Skills Tools for Teachers, a suite of instructional planning aids available on the web at www.csde.umb.edu/ToolsforTeachers.php. Findings presented show that school personnel have successfully utilized the tools to infuse social skills instruction into daily teaching activities. (Contains 1 figure and 5 tables.)

Although most clinicians agree that diffusion of botulinum neurotoxin (BoNT) occurs, its extent, timeline, and clinical importance have been debated. A literature search on PubMed (National Institutes of Health, Bethesda, MD) was done up to January 15, 2023, which included the following search terms: botulinum toxin A uptake; botulinum toxin A diffusion; and botulinum spread. A total of 421 publication titles were found and analyzed. Based on titles, the author selected 54 publications as potentially applicable and reviewed each 1 in depth, along with its supporting references. There are several publications that support a novel theory that small amounts of BoNT can remain in the area days after injection and spread to adjacent muscles. Although current thinking is that BoNT is completely taken up within hours, making its spread days after injection of BoNT not a plausible theory, the following literature review and case report support a novel theory. Level of Evidence: 5 [ABSTRACT FROM AUTHOR]

HARES is a supportive (high G') HA filler with a low degree of water affinity (gel swelling) and modification (<1% BDDE) that has a well-established safety and efficacy profile in the literature, especially for infraorbital hollow (IOH) rejuvenation. To further support the safety of this product, a long-term review of delayed-onset adverse events of interest (DAEIs) related to HARES was conducted using reports from a global post-marketing safety surveillance database over the past 23 years. This review demonstrated low reporting frequencies of delayed-onset nodules and inflammatory events, establishing a long-term safety profile for HARES that supports its continued use in clinical practice, especially for IOH rejuvenation. [ABSTRACT FROM AUTHOR]

Context: The Afirma® GSC aids in risk stratifying indeterminate thyroid nodule cytology (ITN). The 2018 GSC validation study (VS) reported a sensitivity (SN) of 91%, specificity (SP) of 68%, positive predictive value (PPV) of 47%, and negative predictive value (NPV) of 96%. Since then, 13 independent real-world (RW) postvalidation studies have been published. Objective: This study's objective is to compare the RW GSC performance to the VS metrics. Methods: Rules and assumptions applying to this analysis include: (1) At least 1 patient with molecular benign results must have surgery for that study to be included in SN, SP, and NPV analyses. (2) Molecular benign results without surgical histology are considered true negatives (TN) (as are molecular benign results with benign surgical histology). (3) Unoperated patients with suspicious results are either excluded from analysis (observed PPV [oPPV] and observed SP [oSP]) or assumed histology negatives (false positives; conservative PPV [cPPV] and conservative SP [cSP]) 4. Noninvasive follicular thyroid neoplasm with papillary-like nuclear features is considered malignant. Results: In RW studies, the GSC demonstrates a SN, oSP, oPPV, and NPV of 97%, 88%, 65%, 99% respectively, and conservative RW performance showed cSP of 80% and cPPV of 49%, all significantly higher than the VS except for SN and cPPV. There was also a higher benign call rate (BCR) of 67% in RW studies compared to 54% in the VS (P<0.05). Conclusion: RW data for the Afirma GSC demonstrates significantly better oSP and oPPV performance than the VS, indicating an increased yield of cancers for resected GSC suspicious nodules. The higher BCR likely increases the overall rate of clinical observation in lieu of surgery. [ABSTRACT FROM AUTHOR]

Investigations of why students with emotional disturbance (ED) are underidentified in special education have often focused on economic factors and problems with the definition of ED. The present study focuses on variation in underidentification across states and its relationship to political ideology. State-level political, economic, and demographic data were obtained from multiple sources, including the National Election Pool exit polls (2008), the U.S. Census Bureau (2010), the National Center for Educational Statistics (2010), the U.S. Department of Education/Office of Special Education Programs (2009), and the National Center for Children in Poverty (2009). The authors conducted a series of regression analyses in which per pupil expenditure, per capita income, percentage child poverty, ethnicity, and conservatism were used to explain state rates of ED identification and state rates of intellectual disability (ID) identification. The resulting model for the identification of ED explained more than 50% of the variance, with conservatism being the strongest predictor ([beta] = -0.72, p less than 0.001), whereas per pupil expenditure was nonsignificant. States with higher levels of conservatism had distinctly lower ED identification rates. Conservatism was not a significant factor in state identification of ID. The influence of state political leaning on ED identification and special education for children and youth with ED is discussed. (Contains 4 tables.)

Lack of progress of children with emotional disturbance (ED) has begun to be documented in longitudinal school-based studies. Variability in these studies may be due to several factors, including widespread differences in academic, behavioral, and social functioning of these children, their special education status, and school contextual factors. In this study, 86 children were followed over a two-year period: children were drawn from three subgroups--children with ED receiving special education in low-income schools, children with ED receiving special education services in high-income schools, and children not receiving special education services but who were considered high risk for ED. Outcome measures included reading and math achievement along with ratings of behavioral progress. Despite initial differences in overall functioning, there was, almost without exception, no significant progress in any of the three subgroups over the course of a full academic year. This lack of progress was not related to the type of special education and related services that students received in self-contained or full inclusion programs. Results and implications are discussed regarding lack of response of children with or at risk for ED to intervention in both general and special education. (Contains 4 tables.)

The authors examined the academic characteristics of 140 elementary-aged students served under the category of emotional disturbance (ED) from schools that differed in income level, performance on state testing, and suspension rates. School income accounted for a large amount of the variance in the reading and math achievement of students with ED as measured by the Woodcock-Johnson III. However, relative academic performance (as measured by performance on state testing compared with same-school peers and teacher ratings of academic competence) was similar across school income levels. Implications for intervention research and eligibility practices for students with ED are discussed. (Contains 6 tables.)