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Abstract Dental primary afferent (DPA) neurons and proprioceptive mesencephalic trigeminal nucleus (MTN) neurons, located in the trigeminal ganglion and the brainstem, respectively, are essential for controlling masticatory functions. Despite extensive transcriptomic studies on various somatosensory neurons, there is still a lack of knowledge about the molecular identities of these populations due to technical challenges in their circuit-validated isolation. Here, we employed high-depth single-cell RNA sequencing (scRNA-seq) in combination with retrograde tracing in mice to identify intrinsic transcriptional features of DPA and MTN neurons. Our transcriptome analysis revealed five major types of DPA neurons with cell type-specific gene enrichment, some of which exhibit unique mechano-nociceptive properties capable of transmitting nociception in response to innocuous mechanical stimuli in the teeth. Furthermore, we discovered cellular heterogeneity within MTN neurons that potentially contribute to their responsiveness to mechanical stretch in the masseter muscle spindles. Additionally, DPA and MTN neurons represented sensory compartments with distinct molecular profiles characterized by various ion channels, receptors, neuropeptides, and mechanoreceptors. Together, our study provides new biological insights regarding the highly specialized mechanosensory functions of DPA and MTN neurons in pain and proprioception.

Abstract Background There is a need for pragmatic and reliable measures of sound factors that affect evidence-based practice (EBP) adoption and implementation in different languages and cultural environments. The Implementation Leadership Scale (ILS) is a brief and efficient measurement tool of strategic leadership for EBP implementation. The objective of this study was to assess the psychometric properties of the Spanish version of the ILS. Methods The process of translation of the original ILS into Spanish consisted of forward translation, panel meeting, and back-translation. Scale face and content validity compared to that of the original version were assessed and ensured before agreement on the final version. Psychometric properties were examined in 144 healthcare professionals (family physicians, pediatricians, practice and pediatric nurses) involved in implementation or improvement research projects. ILS factor structure was tested by confirmatory factor analysis (CFA). Reliability was assessed by internal consistency analysis. The Pearson correlation between the ILS and the Organizational Support dimension of the Organizational Readiness for Knowledge Translation (OR4KT) questionnaire in the subsample of pediatricians and pediatric nurses (n = 52) was estimated for convergent validity analysis. Results The CFA results indicated that the original four theorized first-order factors with a second-order Implementation Leadership factor fit the data well (χ2 = 107.70; df = 45; p

Objectives: Mothers with substance use disorder (SUD) experience a range of emotions such as feeling ostracized, diminished, and distressed while watching their baby experience withdrawal from substances. Being fully present in the now moment is to trust self to do what is best by moving beyond perceived boundaries to care for self and baby. The process of concept building arose from nursing practice encounters in a special care nursery (SCN) for babies who experienced withdrawal from substances. Method: Liehr and Smith’s 10-phase concept building approach was used to guide the development of this concept. Concept building began with a practice story. The emerging concept was named, core qualities identified, and supported through a literature review. The middle range theory of uncertainty in illness was chosen to serve as theoretical support for the concept. A model was created to provide clarity on the relationships within the concept. Result: A mini-saga was gathered from a mother in the SCN whose newborn had experienced withdrawal from substances. The minisaga follows: Due to the baby’s discomfort and judging eyes of the staff, she was unable to mother her baby. As the baby recovered, she asked for help, comforted her baby, and gained confidence to move beyond perceived boundaries to become the mother she envisioned. Overcoming perceived boundaries to attend to self and baby is trusting oneself to do what is best in spite of feeling ostracized, diminished, and distressed while watching baby withdraw from substances. Conclusion: This concept provides the perspective of mothers with SUD through intermodernism from experiences in nursing practice. The Uncertainty in Illness theory further allows practitioners to gain an understanding of the role uncertainty plays in this unique situation.

Background and objectives: eNAMPT (extracellular nicotinamide phosphoribosyltransferase), a novel DAMP and TLR4 ligand, is a druggable ARDS therapeutic target with NAMPT promoter SNPs associated with ARDS severity. This study assesses the previously unknown influence of NAMPT promoter SNPs on NAMPT transcription, eNAMPT secretion, and ARDS severity. Methods and design: Human lung endothelial cells (ECs) transfected with NAMPT promoter luciferase reporters harboring SNPs G-1535A, A-1001 C, and C-948A, were exposed to LPS or LPS/18% cyclic stretch (CS) and NAMPT promoter activity, NAMPT protein expression, and secretion assessed. NAMPT genotypes and eNAMPT plasma measurements (Days 0/7) were assessed in two ARDS cohorts (DISCOVERY n = 428; ALVEOLI n = 103). Results: Comparisons of minor allelic frequency (MAF) in both ARDS cohorts with the 1000 Human Genome Project revealed the G-1535A and C-948A SNPs to be significantly associated with ARDS in Blacks compared with controls and trended toward significance in non-Hispanic Whites. LPS-challenged and LPS/18% CS–challenged EC harboring the -1535G wild-type allele exhibited significantly increased NAMPT promoter activity (compared with -1535A) with the -1535G/-948A diplotype exhibiting significantly increased NAMPT promoter activity, NAMPT protein expression, and eNAMPT secretion compared with the -1535A/-948 C diplotype. Highly significant increases in Day 0 eNAMPT plasma values were observed in both DISCOVERY and ALVEOLI ARDS cohorts (compared with healthy controls). Among subjects surviving to Day 7, Day 7 eNAMPT values were significantly increased in Day 28 non-survivors versus survivors. The protective -1535A SNP allele drove -1535A/-1001A and -1535A/-948 C diplotypes that confer significantly reduced ARDS risk (compared with -1535G, -1535G/-1001 C, -1535G/-948A), particularly in Black ARDS subjects. NAMPT SNP comparisons within the two ARDS cohorts did not identify significant association with either APACHE III scores or plasma eNAMPT levels. Conclusion: NAMPT SNPs influence promoter activity, eNAMPT protein expression/secretion, plasma eNAMPT levels, and ARDS severity. NAMPT genotypes are a potential tool for stratification in eNAMPT-focused ARDS clinical trials.

Abstract Recent advances in single-cell RNA sequencing (scRNA-seq) and epithelium lineage labeling have yielded identification of multiple abnormal epithelial progenitor populations during alveolar type 2 (ATII) cell differentiation into alveolar type 1 (ATI) cells during regenerative lung post-fibrotic injury. These abnormal cells include basaloid/basal-like cells, ATII transition cells, and persistent epithelial progenitors (PEPs). These cells occurred and accumulated during the regeneration of distal airway and alveoli in response to both chronic and acute pulmonary injury. Among the alveolar epithelial progenitors, PEPs express a distinct Krt8 + phenotype that is rarely found in intact alveoli. However, post-injury, the Krt8 + phenotype is seen in dysplastic epithelial cells. Fully understanding the characteristics and functions of these newly found, injury-induced abnormal behavioral epithelial progenitors and the signaling pathways regulating their phenotype could potentially point the way to unique therapeutic targets for fibrosing lung diseases. This review summarizes recent advances in understanding these epithelial progenitors as they relate to uncovering regenerative mechanisms.

Abstract Background There is a compelling unmet medical need for biomarker-based models to risk-stratify patients with acute respiratory distress syndrome. Effective stratification would optimize participant selection for clinical trial enrollment by focusing on those most likely to benefit from new interventions. Our objective was to develop a prognostic, biomarker-based model for predicting mortality in adult patients with acute respiratory distress syndrome. Methods This is a secondary analysis using a cohort of 252 mechanically ventilated subjects with the diagnosis of acute respiratory distress syndrome. Survival to day 7 with both day 0 (first day of presentation) and day 7 sample availability was required. Blood was collected for biomarker measurements at first presentation to the intensive care unit and on the seventh day. Biomarkers included cytokine-chemokines, dual-functioning cytozymes, and vascular injury markers. Logistic regression, latent class analysis, and classification and regression tree analysis were used to identify the plasma biomarkers most predictive of 28-day ARDS mortality. Results From eight biologically relevant biomarker candidates, six demonstrated an enhanced capacity to predict mortality at day 0. Latent-class analysis identified two biomarker-based phenotypes. Phenotype A exhibited significantly higher plasma levels of angiopoietin-2, macrophage migration inhibitory factor, interleukin-8, interleukin-1 receptor antagonist, interleukin-6, and extracellular nicotinamide phosphoribosyltransferase (eNAMPT) compared to phenotype B. Mortality at 28 days was significantly higher for phenotype A compared to phenotype B (32% vs 19%, p = 0.04). Conclusions An adult biomarker-based risk model reliably identifies ARDS subjects at risk of death within 28 days of hospitalization.

Resumo Policial masculino de 47 anos foi atendido em consultório com queixa de dispneia aos esforços, edema e dor importantes em braço direito. Relatou ferimento por arma de fogo infraclavicular direito 7 meses antes. Tomografia de tórax mostrou grande dilatação de veia subclávia, veias cervicais e de membro superior direito sem identificação da comunicação arteriovenosa. O paciente foi internado antes da data prevista para tratamento por piora clínica e foi submetido a implante de stent revestido Fluency 8x100 mm em artéria subclávia direita por técnica do varal. Angiografia de controle mostrou artéria subclávia pérvia e fechamento da fístula. Houve melhora dos sintomas em braço direito no primeiro dia após o procedimento. As lesões traumáticas da artéria subclávia são incomuns, porém podem evoluir com alto índice de morbimortalidade O trauma penetrante é o principal agente etiológico, e fístulas arteriovenosas devem ser pesquisadas durante o atendimento do paciente com lesões penetrantes em trajeto vascular.

IntroductionPseudogenes are paralogues of functional genes historically viewed as defunct due to either the lack of regulatory elements or the presence of frameshift mutations. Recent evidence, however, suggests that pseudogenes may regulate gene expression, although the functional role of pseudogenes remains largely unknown. We previously reported that MYLKP1, the pseudogene of MYLK that encodes myosin light chain kinase (MLCK), is highly expressed in lung and colon cancer cell lines and tissues but not in normal lung or colon. The MYLKP1 promoter is minimally active in normal bronchial epithelial cells but highly active in lung adenocarcinoma cells. In this study, we further validate MYLKP1 as an oncogene via elucidation of the functional role of MYLKP1 genetic variants in colon cancer risk.MethodsProliferation and migration assays were performed in MYLKP1-transfected colon and lung cancer cell lines (H441, A549) and commercially-available normal lung and colon cells. Fourteen MYLKP1 SNPs (MAFs >0.01) residing within the 4 kb MYLKP1 promoter region, the core 1.4 kb of MYLKP1 gene, and a 4 kb enhancer region were selected and genotyped in a colorectal cancer cohort. MYLKP1 SNP influences on activity of MYLKP1 promoter (2kb) was assessed by dual luciferase reporter assay.ResultsCancer cell lines, H441 and A549, exhibited increased MYLKP1 expression, increased MYLKP1 luciferase promoter activity, increased proliferation and migration. Genotyping studies identified two MYLKP1 SNPs (rs12490683; rs12497343) that significantly increase risk of colon cancer in African Americans compared to African American controls. Rs12490683 and rs12497343 further increase MYLKP1 promoter activity compared to the wild type MYLKP1 promoter.ConclusionMYLKP1 is a cancer-promoting pseudogene whose genetic variants differentially enhance cancer risk in African American populations.

This design case describes a Welcome Academy for New Faculty in Engineering. To situate the design, this work is motivated by the documented need to make STEM education more inclusive. This need has prompted extensive research on best practices for inclusive teaching, but less is known about how to translate that research into actual teaching practice. This design case addresses that difficulty. Influenced by Thaler and Sunstein's theory of nudging, the Welcome Academy resets the default to expect inclusive teaching. To develop the design, we organized an off-campus summit to solicit input from current engineering faculty on the question, "What do new engineering faculty need to know about diversity, equity, and inclusion (DEI)?" That input guided the creation of a four-hour workshop, delivered the morning after campus-wide new faculty orientation, that included an icebreaker, basic campus demographics, curated DEI-related resources, a campus tour emphasizing historical power dynamics, and presentations by current engineering students. To depict the experience of the design, we describe the final implementation, which varied from the design at points, and the unanimously positive feedback from new faculty. That feedback, however, was not the result of a flawless implementation: We also describe a number of failures that will improve subsequent iterations of the Welcome Academy, emphasizing the importance of communication, respect, and flexibility.

Inverse and injective functions are topics in most college algebra courses. Yet, current materials and course structures may not afford students' conceptual understanding of these important ideas. We describe how students' work with digital activities, "techtivities," linking two different looking graphs that represent relationships between variables in the same dynamic situation, can help to address this problem. To bolster our argument, we provide empirical data from a broader study, drawing on student work and instructor interviews across three institutions. We conclude with illustrations of how techtivities can serve as instructional anchors for injective and inverse functions.

Using a mixed methods approach, we explore a relationship between students' graph reasoning and graph selection via a fully online assessment. Our population includes 673 students enrolled in college algebra, an introductory undergraduate mathematics course, across four U.S. postsecondary institutions. The assessment is accessible on computers, tablets, and mobile phones. There are six items; for each, students are to view a video animation of a dynamic situation (e.g., a toy car moving along a square track), declare their understanding of the situation, select a Cartesian graph to represent a relationship between given attributes in the situation, and enter text to explain their graph choice. To theorize students' graph reasoning, we draw on Thompson's theory of quantitative reasoning, which explains students' conceptions of attributes as being possible to measure. To code students' written responses, we appeal to Johnson and colleagues' graph reasoning framework, which distinguishes students' quantitative reasoning about one or more attributes capable of varying (Covariation, Variation) from students' reasoning about observable elements in a situation (Motion, Iconic). Quantitizing those qualitative codes, we examine connections between the latent variables of students' graph reasoning and graph selection. Using structural equation modeling, we report a significant finding: Students' graph reasoning explains 40% of the variance in their graph selection (standardized regression weight is 0.64, p < 0.001). Furthermore, our results demonstrate that students' quantitative forms of graph reasoning (i.e., variational and covariational reasoning) influence the accuracy of their graph selection.

We present a synthesis of findings from constructivist teaching experiments regarding six schemes children construct for reasoning multiplicatively and tasks to promote them. We provide a task-generating platform game, depictions of each scheme, and supporting tasks. Tasks must be distinguished from children’s thinking, and learning situations must be organized to (a) build on children’s available schemes, (b) promote the next scheme in the sequence, and (c) link to intended mathematical concepts. Presentamos una síntesis de hallazgos de experimentos de enseñanzaconstructivistas en relación con seis esquemas que los niños construyen para razonar multiplicativamente y tareas para promoverlos. Proveemos una plataforma de juego generadora de tareas, descripciones de cada esquema y tareas para apoyarlos. Las tareas deben distinguirse del pensamiento de los niños, y las situaciones de aprendizaje deben organizarse para que (a) se basen en los esquemas que los niños tienen disponibles, (b) promuevan el siguiente esquema en la secuencia y (c) se relacionen con los conceptos matemáticos pretendidos.

CONTEXTO: O câncer colorretal é causa de morte frequente e sua prevenção deve fazer parte dos programas de rastreamento em indivíduos assintomáticos. OBJETIVO: Avaliar os achados colonoscópicos de pessoas assintomáticas submetidas a colonoscopia. MÉTODO: Foram estudados 153 pessoas assintomáticas submetidas a colonoscopia. Sexo, idade, história pregressa e familiar, tabagismo e etilismo foram avaliados. Indivíduos com hematoquesia macro ou microscópica e os com doença colorretal foram excluídos. Preparo intestinal, presença de pólipos, angioectasias, doença diverticular, processo inflamatório e neoplasia foram investigados. Os pólipos foram classificados de acordo com seu tamanho, número e localização. RESULTADOS: A idade média foi de 52,47 ± 11,64 anos. História familiar de câncer colorretal foi verificada em 20,2% dos indivíduos. Alterações colonoscópicas foram verificadas em 99 indivíduos: pólipos em 64,28%, doença diverticular em 27,92%, alterações inflamatórias em 9,74%, melanose colônica em 2,6% e angioectasias em 7,8%. Houve incidência maior de pólipos em indivíduos acima de 50 anos. A análise de regressão logística mostrou a idade e sexo como fatores preditores para a presença de pólipos (RR = 1,69; 1,23 CONTEXT: Colorectal cancer is the second leading cause of cancer-related death. Prevention of colorectal cancer should be achievable by screening programs in asymptomatic patients. OBJECTIVE: To assess the colonoscopic findings in asymptomatic people submitted to screening. METHODS: A prospective study was undertaken on 153 consecutive asymptomatic people submitted to colonoscopy. Sex, age, previous diseases and familial cases of cancer, as well as tobacco and alcohol ingestion were assessed. Patients with rectal macro- or microscopic bleeding and colorectal diseases were excluded. Bowel preparation, polyps, angioectasias, diverticular disease, inflammation and neoplasm were also verified. Polyps were classified according to their size, number and location. RESULTS: Mean age was 52.5 ± 11.7 years. Family history for colorectal cancer occurred in 79.8% of individuals. Colonoscopic alterations were detected in 99 individuals: polyps in 64.3%, diverticular disease in 27.9%, inflammatory mucosal alterations in 9.7%, melanosi coli in 2.6% and angioectasias in 7.8%. There were an increasing incidence of polyps in patients older than 50 year. Multivariate logistic regression showed age and sex as predictive factors for polyps (OR = 1.43; 1.19

We address a problem of promoting instructional transformation in early undergraduate mathematics courses, via an intervention incorporating novel digital resources ("techtivities"), in conjunction with a faculty learning community (FLC). The techtivities can serve as boundary objects, in order to bridge different communities to which instructors belong. Appealing to Etienne Wenger's Communities of Practice theory, we theorise a role of the instructor as a broker, facilitating "boundary transitions" within, across, and beyond a set of digital resources. By "boundary transition", we mean a transition that is also a brokering move; instructors connect different communities as they draw links between items in their instruction. To ground our argument, we provide empirical evidence from an instructor, Rachel, whose boundary transitions served three functions: (1) to position the techtivities as something that count in the classroom community and connect to topics valued by the broader mathematics community; (2) to communicate to students that their reasoning matters more than whether they provide a correct answer, a practice promoted in the FLC; (3) to connect students' responses to mathematical ideas discussed in the FLC, in which graphs represent a relationship between variables. Instructors' boundary transitions can serve to legitimise novel digital resources within an existing course and thereby challenge the "status quo" in courses where skills and procedures may take precedence over reasoning and sense-making.

We present a case study of an elementary teacher, Jen, who transformed her mathematics teaching practice and deepened her conception of angle measure. Employing Teacher Development Experiment methodology, rooted in a constructivist perspective of learning, we analysed sets of pre/post interviews and classroom observations, for two lessons on angle measure, occurring one year apart. In between, Jen participated in a year-long, school-wide professional development intervention, to support teachers' enactment of conceptual mathematics instruction and foster students' multiplicative and fractional reasoning. Jen transformed her vision and rationale for teaching mathematics, her interpretations of students' mathematical knowing, and her view of what constitutes evidence of mathematical learning. In conjunction, she deepened her knowledge of angle measure, engaging in quantitative reasoning and conceptualising angles as quantities. We discuss implications for supporting teachers to transform their mathematics teaching practice via fostering shifts in their goals for instruction and growth in their mathematical understanding.

It is well known that students benefit from opportunities to interpret and create different representations (e.g., diagrams, graphs, tables, symbols) of mathematical ideas. Employing Marton's Variation theory as a lens, I argue for an expansion of the use of multiple representations in task design for graphs: Incorporate two different forms of the same type of graph to represent a relationship between variables in a situation. With this approach, designers, teachers, and researchers can engineer opportunities for students to discern, or separate, features of representation systems, such as the Cartesian coordinate system, and in turn, promote students' mathematical reasoning.

Students enrolled in introductory math courses, such as college algebra, deserve to do more than find answers and fix mistakes. We present one interactive digital activity, the Cannon Man "Techtivity," which we developed to provide opportunities for students to develop an understanding of function, beyond just applying a rule, such as the vertical line test. With an accompanying facilitation guide, we describe how we promote instructor moves to privilege student reasoning. We provide student data to support the effectiveness of this approach. We conclude with implications for weaving such opportunities into the fabric of college algebra.

We examine a hypothesis implied by Steffe's constructivist model of children's numerical reasoning: a child's "spontaneous" additive strategy may relate to a foundational form of multiplicative reasoning, termed multiplicative double counting (mDC). To this end, we mix quantitative and qualitative analyses of 31 fourth graders' responses during clinical, task-based interviews. All participants spontaneously used one of three additive strategies--counting-on, doubling, or break-apart-make-ten (BAMT)--to correctly solve an addition word problem (8 + 7). We found between-group differences, with asymmetric association of those ordinal variables. We found counting-on to be mainly related to premultiplicative reasoning and BAMT to mDC reasoning. We discuss the theoretical significance and implications of this corroboration of Steffe's model.

We posit a dual approach to digital task design: to engineer opportunities for students to conceive of graphs as representing relationships between quantities and to foreground students' reasoning and exploration, rather than their answer-finding. Locally integrating Ference Marton's variation theory and Patrick Thompson's theory of quantitative reasoning, we designed digital task sequences, in which students were to create different graphs linked to the same video animations. We report results of a qualitative study of thirteen secondary students (aged 15-17), who participated in digital, task-based, individual interviews. We investigated two questions: (1) How do students conceive of what graphs represent when engaging with digital task sequences? (2) How do student conceptions of graphs shift when working within and across digital task sequences? Two conceptions were particularly stable -- relationships between quantities and literal motion of an object. When students demonstrated conceptions of graphs as representing change in a single quantity, they shifted to conceptions of relationships between quantities. We explain how a critical aspect: What graphs should represent, intertwined with students' graph-sketching. Finally, we discuss implications for digital task design to promote students' conceptions of mathematical representations, such as graphs.

Background: Skin concerns are frequent among urban‐living Aboriginal children, yet specialist dermatology consultations are limited with studies highlighting the need for improved cultural security. Through newly established paediatric dermatology clinics at two urban Aboriginal Community Controlled Health Organisations (ACCHOs), we aimed to describe clinic and patient data, including disease frequencies and associations, to inform dermatology service provision and advocacy. Methods: A prospective cohort study of Aboriginal children and young people (CYP, 0–18 years) attending Aboriginal Health Practitioner (AHP) co‐ordinated paediatric dermatology clinics at two urban ACCHOs. Results: Data were collected from 32 clinics over 19 months, with 335 episodes of care and a mean attendance rate of 74%. From 78 new patients, 72 (92%) were recruited into the study, only one of whom had previously received dermatologist assessment. Eczema, tinea or acne accounted for 47% (34/72) of referrals, and 60% of patients received their first appointment within 4 weeks of referral. In 47/72 (65%) consultations, the GP referral and dermatologist diagnosis concurred. The most frequent diagnoses (primary or secondary) at first consultation were atopic dermatitis (26%, 19/72), dermatophyte infections (25%, 18/72), acne (21%, 15/72), bacterial skin infections (18%, 13/72) and post‐inflammatory dyspigmentation (18%, 13/72). Three categories of the 2022 Australasian College of Dermatologists curriculum (infections, eczema/dermatitis, pigmentary disorders) accounted for 59% of all diagnoses. Conclusions: This study highlights the specialist dermatology needs of urban‐living Aboriginal CYP. ACCHO‐embedded dermatology clinics co‐ordinated by AHPs demonstrated benefits for Aboriginal CYP in accessing care. Opportunities to embed dermatology practice within ACCHOs should be prioritised. [ABSTRACT FROM AUTHOR]

Background and objective Despite increasing urbanisation, little is known about skin health for urban-living Aboriginal children and young people (CYP, aged <18 years). This study aimed to investigate the primary care burden and clinical characteristics of skin conditions in this cohort. Methods A one-year retrospective cohort study of urban-living Aboriginal CYP presenting for general practitioner (GP) consultation at an Aboriginal Community Controlled Health Organisation (ACCHO) was conducted. Results At least one dermatological diagnosis was made in 27% (253/939) of GP face-to-face consultations for the 585 urban-living Aboriginal CYP included. Infections and dermatitis accounted for 54% (152/284) and 18% (50/284) of all dermatological diagnoses, respectively. Bacterial skin infection (BSI) cumulative incidence was 13% (74/585; 95% CI 10--16%), with recurrent BSI affecting <1% (5/585; 95% CI 0.3--2%) and hospitalisation required in 1% (1/82; 95% CI 0.06--7%) of incident BSI cases. Discussion We present a culturally secure, multidisciplinary skin health assessment model within an urban ACCHO, where dermatological conditions account for a significant proportion of GP workload. [ABSTRACT FROM AUTHOR]

In this article, we share design guidelines for the development and use of online, video-based "teaching playgrounds," which provide opportunities for prospective teachers to engage in professional noticing of teaching practices. Through teaching playgrounds, we provide an instantiation of the Presence+Experience framework, which combines the Community of Inquiry model with Kolb's experiential learning cycle. Teaching playgrounds offer a viable mechanism for instructors and designers to incorporate "high touch" learning experiences into "high tech" online teacher preparation courses. Using quantitative methods, we demonstrate the efficacy of online content methods courses incorporating teaching playgrounds. We address implications for the incorporation of online content methods courses in mathematics and science teacher education programs.

The U.S.'s education system has been in a state of crisis for decades. Reform attempts addressed with each administration, such as "A Nation at Risk" during the Reagan campaign, "No Child Left Behind" during the Bush administration, and the most recent, Obama's "Race to the Top" initiative, elucidate America's struggles in academic equity (Martin & Lazaro, 2011). According to the Organization for Economic Co-operation and Development (OECD, 2018), the United States' ranking falls short of international achievement (the highest ranking 17 out of 39 in the area of reading, and the abysmal ranking of 32 out of 39 for math), despite boasting the number one ranking for gross domestic product (GDP; World Bank, 2017). The disparity between finances and achievement contradicts expectations, especially when compared to nations such as Cuba, an economically disadvantaged society that maintains high levels of academic performance. The assumption that a financially stable society should have the funds necessary to use research to promote academic success, in addition to funding the changes necessary to achieve them warrants further investigation into how a nation such as the United States falls short in comparison. Two overarching questions guided the authors of this article: (1) How does Cuba achieve superior performance with limited means while the United States struggles scholastically; and (2) How can the United States implement the Cuban practices to bolster academic achievement?