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Meeting the needs of students in schools has been challenging for many years. Consequently, some schools have responded with comprehensive, multi-tiered intervention systems (e.g., MTSS) aimed at addressing students' academic, behavioral, and social-emotional needs. However, most educators have a rudimentary understanding of these systems and the impact of trauma and traumatic experiences on students' response to interventions. Currently, there is limited research on how building level-administrators integrate trauma-informedness into these tiered systems. This conceptual article outlines the importance of administrators' perception, understanding, and implementation of using a trauma-informed lens in educational decision making, specifically regarding MTSS implementation. This article presents an overview of the literature and an approach to trauma-informed approach that administrators can utilize when making educational decisions, specifically within multi-tiered systems of intervention and student supports.

Limited research examines the process of leading innovative school change from the perspective of principals. In this case study, three school principals implement a novel school model, franchise model schools. Using interviews, the researchers examined the successes and challenges principals experienced while implementing and leading this change. Data analysis revealed three significant challenges leading franchise model schools: (1) low teacher morale at the inception of the model; (2) time management; and (3) alignment among franchise campuses. However, three significant successes surfaced. Franchise principals were able to increase (1) community engagement, (2) autonomy and creativity, and (3) the sharing of best practices. Authors recommend more research context-specific to the school's culture and a principal's level of experience in leading change. Researchers should identify successful innovative schools and examine what change models were used by those principals.

A major barrier to the impact of genomic diagnosis in patients with congenital malformations is the lack of understanding regarding how sequence variants contribute to disease pathogenesis and whether this information could be used to generate patient-specific therapies. Congenital diaphragmatic hernia (CDH) is among the most common and severe of all structural malformations; however, its underlying mechanisms are unclear. We identified loss-of-function sequence variants in the epigenomic regulator gene SIN3A in two patients with complex CDH. Tissue-specific deletion of Sin3a in mice resulted in defects in diaphragm development, lung hypoplasia, and pulmonary hypertension, the cardinal features of CDH and major causes of CDH-associated mortality. Loss of SIN3A in the lung mesenchyme resulted in reduced cellular differentiation, impaired cell proliferation, and increased DNA damage. Treatment of embryonic Sin3a mutant mice with anacardic acid, an inhibitor of histone acetyltransferase, reduced DNA damage, increased cell proliferation and differentiation, improved lung and pulmonary vascular development, and reduced pulmonary hypertension. These findings demonstrate that restoring the balance of histone acetylation can improve lung development in the Sin3a mouse model of CDH.

The article is dedicated to the analysis of the manga by the classic of Japanese anime Osamu Tezuka, Crime and Punishment, based on the eponymous novel by Fyodor Dostoevsky. It is no coincidence that Dostoevsky’s novel served as the “material” for the creation of manga, since the problems considered in it, primarily moral, are of a universal nature and remain relevant today. The period of the late 20th and early 21st centuries is marked by tremendous changes in nearly all spheres of human existence and this fact has inevitably influenced human consciousness and its attitude toward the ways of cognition. The tendency to “consume” that emerged at the end of the 20th century gave rise to a special type of information acquisition, known as “infotainment” (from the English “information” and “entertainment”), which has become one of the characteristics of modern mass culture. This technique, being hybrid in nature, uses stylistic resources of various discourses. The article shows that, having gone beyond the national framework, manga ceases to be confined to the exclusively Japanese book publishing industry. The analyzed manga was published in Japanese in 1953, becoming a clear example of a “secondary text” (according to A.I. Novikov’s terminology), the purpose of which is to popularize Dostoevsky’s work among Japanese youth. Tezuka, demonstrating a deep knowledge of Russian culture, Fyodor Dostoevsky’s and Lev Tolstoy’s works, uses Disney animation techniques when creating manga, as becomes evident when analyzing the actual visual techniques of creating the image of Raskolnikov. Osamu Tezuka’s Crime and Punishment was translated into Russian in 2012 and has not yet been the subject of special research as an example of intersemiotic translation.

Abstract Aim The aim of this study was to investigate the psychosocial impact of malocclusion and the motivation for seeking orthodontic treatment among adolescents. Methods A cross-sectional study included 102 adolescents (ages 11–18) whose malocclusion was rated using 3 occlusal indices: IOTN, DAI, and PAR. The participants answered three structured questionnaires selected to measure Oral Health Related Quality of Life (OHRQoL) through the short form of the Child Oral Health Impact Profile (COHIP), the patient's perceived impact related to orthodontics through the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), and self-esteem through the Rosenberg Self-Esteem Scale (RSES). Independent two-tailed t-tests, one-way mixed analysis of variance (ANOVA), and Spearman's correlations were used to test various associations. Results Patients with higher malocclusion scores displayed increased psychosocial impact with weak to moderate correlations (0.2

Cancer of unknown primary (CUP) tumors are biologically very heterogeneous, which complicates stratification of patients for treatment. Consequently, these patients face limited treatment options and a poor prognosis. With this study, we aim to expand on the current knowledge of CUP biology by analyzing two cohorts: a well‐characterized cohort of 44 CUP patients, and 213 metastatic patients with known primary. These cohorts were treated at the same institution and characterized by identical molecular assessments. Through comparative analysis of genomic and transcriptomic data, we found that CUP tumors were characterized by high expression of immune‐related genes and pathways compared to other metastatic tumors. Moreover, CUP tumors uniformly demonstrated high levels of tumor‐infiltrating leukocytes and circulating T cells, indicating a strong immune response. Finally, the genetic landscape of CUP tumors resembled that of other metastatic cancers and demonstrated mutations in established cancer genes. In conclusion, CUP tumors possess a distinct immunophenotype that distinguishes them from other metastatic cancers. These results may suggest an immune response in CUP that facilitates metastatic tumor growth while limiting growth of the primary tumor.

Abstract Chemotherapy induced ovarian failure and infertility is an important concern in female cancer patients of reproductive age or younger, and non-invasive, pharmacological approaches to maintain ovarian function are urgently needed. Given the role of reduced nicotinamide adenine dinucleotide phosphate (NADPH) as an essential cofactor for drug detoxification, we sought to test whether boosting the NAD(P)+ metabolome could protect ovarian function. We show that pharmacological or transgenic strategies to replenish the NAD+ metabolome ameliorates chemotherapy induced female infertility in mice, as measured by oocyte yield, follicle health, and functional breeding trials. Importantly, treatment of a triple-negative breast cancer mouse model with the NAD+ precursor nicotinamide mononucleotide (NMN) reduced tumour growth and did not impair the efficacy of chemotherapy drugs in vivo or in diverse cancer cell lines. Overall, these findings raise the possibility that NAD+ precursors could be a non-invasive strategy for maintaining ovarian function in cancer patients, with potential benefits in cancer therapy.

Abstract In this study, we evaluated and forecasted the cumulative opportunities for residents to access radiotherapy services in Cali, Colombia, while accounting for traffic congestion, using a new people-centred methodology with an equity focus. Furthermore, we identified 1–2 optimal locations where new services would maximise accessibility. We utilised open data and publicly available big data. Cali is one of South America's cities most impacted by traffic congestion. Methodology: Using a people-centred approach, we tested a web-based digital platform developed through an iterative participatory design. The platform integrates open data, including the location of radiotherapy services, the disaggregated sociodemographic microdata for the population and places of residence, and big data for travel times from Google Distance Matrix API. We used genetic algorithms to identify optimal locations for new services. We predicted accessibility cumulative opportunities (ACO) for traffic ranging from peak congestion to free-flow conditions with hourly assessments for 6–12 July 2020 and 23–29 November 2020. The interactive digital platform is openly available. Primary and secondary outcomes: We present descriptive statistics and population distribution heatmaps based on 20-min accessibility cumulative opportunities (ACO) isochrones for car journeys. There is no set national or international standard for these travel time thresholds. Most key informants found the 20-min threshold reasonable. These isochrones connect the population-weighted centroid of the traffic analysis zone at the place of residence to the corresponding zone of the radiotherapy service with the shortest travel time under varying traffic conditions ranging from free-flow to peak-traffic congestion levels. Additionally, we conducted a time-series bivariate analysis to assess geographical accessibility based on economic stratum. We identify 1–2 optimal locations where new services would maximize the 20-min ACO during peak-traffic congestion. Results: Traffic congestion significantly diminished accessibility to radiotherapy services, particularly affecting vulnerable populations. For instance, urban 20-min ACO by car dropped from 91% of Cali’s urban population within a 20-min journey to the service during free-flow traffic to 31% during peak traffic for the week of 6–12 July 2020. Percentages represent the population within a 20-min journey by car from their residence to a radiotherapy service. Specific ethnic groups, individuals with lower educational attainment, and residents on the outskirts of Cali experienced disproportionate effects, with accessibility decreasing to 11% during peak traffic compared to 81% during free-flow traffic for low-income households. We predict that strategically adding sufficient services in 1–2 locations in eastern Cali would notably enhance accessibility and reduce inequities. The recommended locations for new services remained consistent in both of our measurements. These findings underscore the significance of prioritising equity and comprehensive care in healthcare accessibility. They also offer a practical approach to optimising service locations to mitigate disparities. Expanding this approach to encompass other transportation modes, services, and cities, or updating measurements, is feasible and affordable. The new approach and data are particularly relevant for planning authorities and urban development actors. Video Abstract

Aim. To evaluate the prognostic value of GDF-15 in relation the development of bleeding and events in stable CAD patients, receiving combined antithrombotic therapy. Materials and methods. The data was obtained from the prospective registry REGATA, 343 CAD patients (249 males), median age 68 [IQR 62; 75] years) were enrolled. Patients with sinus rhythm and concomitant PAD received acetylsalicylic acid in combination with rivaroxaban 2.5 mg bid (31.8%) or clopidogrel (24.8%). Other 43.4% with concomitant atrial fibrillation (AF) received direct oral anticoagulants in combination with antiplatelet therapy after elective percutaneous coronary interventions. Median follow-up was 12 months [IQR 9.0; 18.0]. The safety end point was major and clinically relevant bleedings (type 2–5) according to the BARC classification. Plasma samples for GDF-15 identification were taken at the inclusion and analyzed using ELISA assay. Results. Frequency of BARC 2–5 bleedings was 16% (BARC 2 – 46; BARC 3 – 9; BARC 4–5 – 0), median GDF-15 level was 1185.0 pg/ml [850.0; 1680.0]. In patients with AF and concomitant MFA, the level of GDF-15 was significantly higher than in the subgroups of patients with only AF or MFA (p=0.0022). According to the quintile analysis, GDF-15 values in the top three quintiles of distribution (cut-off value 943 pg/ml) were associated with higher frequency of bleeding events: 23.2% versus 5.1%; p=0.0001. The multivariable logistic regression model demonstrated that bleeding events were independently associated with GDF-15 level943 pg/ml (OR 2.65, 95% CI 1.11–6.30; p=0.0275), AF (OR 2.61, 95% CI 1.41–4.83; p=0.0023) and chronic kidney disease (OR 1.92, 95% CI 1.03–3.60; p=0.0401). Clinical factors determining the risk of bleeding events also determined a GDF-15 elevation. Conclusion. Assessment of GDF-15 level may improve bleeding risk stratification in CAD patients with concomitant AF and/or PAD receiving combined antithrombotic therapy.

Abstract Tritrichomonas foetus is a flagellated and anaerobic parasite able to infect cattle and felines. Despite its prevalence, there is no effective standardized or legal treatment for T. foetus-infected cattle; the vaccination still has limited success in mitigating infections and reducing abortion risk; and nowadays, the diagnosis of T. foetus presents important limitations in terms of sensitivity and specificity in bovines. Here, we characterize the plasma membrane proteome of T. foetus and identify proteins that are represented in different isolates of this protozoan. Additionally, we performed a bioinformatic analysis that revealed the antigenicity potential of some of those proteins. This analysis is the first study to identify common proteins at the plasma membrane of different T. foetus isolates that could be targets for alternative diagnostic or vaccine techniques in the future.

In one university-based school leadership preparation program, aspiring school principals were asked to intern virtually with principals during the COVID-19 school closures. During this internship experience, they interviewed principals about leading during a pandemic and wrote reflective responses explaining what they learned about leading during the pandemic. This case study examines the reflections and lessons learned of leading schools during COVID-19 from 27 aspiring principals in two cohorts of a university-based school leadership preparation program. The researchers employed an abductive qualitative analysis for each aspiring principals' reflection using both deductive and inductive coding methods. Findings revealed fourth themes: (1) the need for structure and organization, (2) attending humanistic needs, (3) struggling to respond to policy changes; and (4) finding meaning and uplifting morale. This study can be used to help inform and guide educational leadership preparation and development programs on how to redirect coursework and field-based experiences to better prepare aspiring school principals to lead during school closures.

Abstract The COVID-19 pandemic has been the largest pandemic of the past century, and various genetic factors have played a significant role in this context. This study aimed to analyze the frequency and association between specific SNPs rs3806268 (NLRP3), rs4925543 (NLRP3), rs12150220 (NLRP1), rs455060 (NLRC4), rs699 (AGT), rs1137101 (LEPR), and rs1801133 (MTHFR) and severe/critical outcomes in Brazilian patients with COVID-19. A total of 100 patients were included in the study, comprising 66 cases and 34 controls. DNA was extracted, sequenced, and genotyped via next-generation sequencing (NGS). For non-parametric data, the Mann-Whitney and Kruskal-Wallis tests were used. Fisher’s test and multivariate logistic regression, considering AIC and BIC criteria, were employed for risk analysis. Odds Ratios (OR) were calculated, with significance set at p

Cholesterol crystals (CC) can be responsible for a range of clinical syndromes in the retina from asymptomatic plaques to retinal artery occlusion with clinical trials providing evidence for the efficacy in lipid lowering therapies in preventing ocular pathology. Much of the literature has focused on CC in retinal circulation as a marker of poor systemic health and have attempted to use them to categorize risk of mortality and stroke. More recently cholesterol accumulation and CC formation have been linked to development of diabetic retinopathy with CC formation in the retina due to aberrant retinal cholesterol homeostasis and not simply systemic dyslipidemia.

Abstract Background Breast and cervical cancers pose significant health challenges for women globally, emphasizing the critical importance of effective screening programs for early detection. In Canada, despite the implementation of accessible healthcare systems, ethnic and racialized disparities in cancer screening persist. This study aims to assess ethnic and racialized disparities in breast and cervical cancer screening in Canada. Methods Using 2015–2019 data from the Canadian Community Health Survey, we analyzed women aged 18–70 in distinct ethnic and racial groups. The primary outcome was mammography or Papanicolaou test (pap smear). The secondary outcome was time since the last screening. We used weighted multivariable logistic regression to estimate the odds of having a pap smear or mammography across the ethnic and racialized groups, adjusted for relevant covariates. Results were reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results We included 14,628,067 women of which 72.5% were White, 8.4% Southeast Asian, 4.7% South Asian, 3.4% Indigenous, 2.7% Black, 2.0% West Asian, and 1.6% Latin American. In comparison with the White reference group, a higher odds ratio of not having a pap smear was estimated for the West Asian (5.63; CI 3.85, 8.23), South Asian (5.19; CI 3.79, 7.12), Southeast Asian (4.35; CI 3.46, 5.46), and Black groups (2.62; CI 1.82, 3.78). Disparities in mammography screening were found only for the Southeast Asian group with higher odds of not having screening (1.85; CI 1.15, 2.98) compared to the White reference group. Conclusion This study reveals significant disparities in pap smear and mammography screenings affecting various ethnic groups, particularly in West Asia, South Asian, and Black communities. These findings underscore the urgent need for targeted interventions, policies, and healthcare strategies to address these gaps and ensure equitable access to essential breast and cervical cancer prevention across all ethnicity.

Abstract The donor–acceptor (D–A) dye 4‐(bis‐4‐(5‐(2,2‐dicyano‐vinyl)‐thiophene‐2‐yl)‐phenyl‐amino)‐benzoic acid (P1) has been frequently used to functionalize NiO photocathodes and induce photoelectrochemical reduction of protons when coupled to a suitable catalyst. Photoinduced twisting of the P1 dye is steered on NiO by co‐adsorption of tetradecanoic acid (C14, myristic acid (MA)). Density Functional Theory and time‐resolved photoluminescence studies confirm that twisting lowers the energy levels of the photoexcited D–A dye. The apolar environment provided by the MA suppresses photoinduced D–A twisting, retards charge recombination following photoinduced charge separation between P1 and NiO, and provides a larger electrochemical potential increasing the photocurrent. Very interestingly, co‐adsorption of MA induces H2 evolution upon photoexcitation without the presence of an H2 evolution catalyst. Based on prior art, the formation of H2 is assigned to the dissolution of Ni2+, followed by reduction and re‐deposition of Ni nanoparticles acting as the catalytically active site. It propose that only excited P1 with suppressed twisting provides the sufficient electrochemical potential to induce deposition of Ni nanoparticles. The work illustrates the importance of understanding the effects of photoinduced intramolecular twisting and highlights the promise of designing twisting‐limited D–A dyes to create efficient solar fuel devices.

BACKGROUND: Up to 95% of digital fluoroscopy screening studies are free of pathologic changes. Radiologists typically spend the majority of their time reviewing and describing such studies. In these cases, artificial intelligence systems can be used to automate the description, thereby saving physicians’ time [1–3]. AIM: The aim of this study was to compare the efficacy of various algorithms within an existing artificial intelligence system in an ultra-high sensitivity scenario and to estimate the percentage of X-rays that could be automatically characterized. MATERIALS AND METHODS: The artificial intelligence system “Cels.Fluorography” version 0.15.3 was used for the analysis. A dataset derived from disparate medical organizations, comprising 11,707 studies devoid of pathology and 5,846 studies exhibiting pathology, was selected for comparison. A subsample of 500 studies with pathology and 9,500 studies without pathology (5% to 95% balance) was randomly selected 1,000 times from the dataset to calculate the metrics. The resulting metrics were then averaged. The markup of two physicians was used as the source of the target variable. In the event of a discrepancy in opinion, the study was subjected to an expert physician evaluation. An X-ray was considered pathological if the final markup contained at least one of 12 radiological features [4]. Five methods were used to compare metrics: by maximum (1) and mean (2) probability of radiological features localized by the neural network-detector; by maximum (3) and mean (4) probability of feature presence derived from dedicated “heads” of the neural network trained to determine the presence of each feature on the image (0 for no feature, 1 for presence); by probability (5) derived from a separate “head” of the neural network trained to determine the binary presence of pathology on the study (0 for normal, 1 for pathology). For each method, a response threshold was selected to ensure that no more than one missed pathology was identified per 1,000 examinations in the current subsample. The percentage of X-rays that could be correctly identified as pathology-free by artificial intelligence was calculated as the main quality metric. RESULTS: The methods demonstrated the following average percentages of norm dropout: 66.4%, 72.2%, 69.0%, 74.1%, 68.7%—and the following area under the ROC curve: 0.948, 0.957, 0.964, 0.967, 0.971. The 95% confidence interval for the dropout rate associated with the optimal method was found to be 66.1% to 79.4%. CONCLUSIONS: Modern artificial intelligence systems can be used to automate the description of a significant portion of screenings. The most efficacious method for norm screening (over 74% of the flow) was demonstrated by the averaging of probabilities derived from special “heads” of the neural network trained to identify the presence of pathology.

The article deals with the linguistic and psychological concepts explaining the perception of multimodal texts that imply information about violence. The importance of the subject is verified by the task of countering the spread of ideologies of violence, extremism, and terrorism in Internet communication. The multimodal text is considered a popular means of propagating radical ideas relating to incitement to social discord. The absence of complex models explaining the transmission of violence through multimodal texts is observed. It is shown that linguistic and psychological concepts can be relevant resources for building such a model. The purpose of the article is to generalize concepts in the form of intra- and extralinguistic factors that determine the perception of information about violence in a multimodal text. The generalization of cognitive linguistic theories into the group of intralinguistic factors is complemented by the conclusion that the semantic structure of a multimodal text is formed by visual, sign, and verbal coding systems; the perception of information about violence is determined by the typicality of linguistic means and the presence of logical and semantic links between the elements of a multimodal text. The conclusion is made about the influence of aggressiveness, personal attitude toward violence, and the experience of using violence on the perception of multimodal information about violence by the reader. The article may be interesting to linguists, psychologists, and a wide range of researchers in the field of humanities and humanities-related social sciences.

Objective: To systematically review studies examining the effects of home-visiting preventive parenting programs (HV-PPs) on improving the quality of mother-child interactions in early childhood. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol, we identified 3,586 studies published between 2018 and 2022 by searching the following databases: PubMed, Web of Science, BVS/LILACS, SciELO, and PsycNET/PsycINFO. After applying the eligibility criteria, 17 articles were selected for review. Results: Most studies were conducted in high-income countries (53%) and the remainder were conducted in upper-middle-income countries, predominantly using a randomized controlled trial design and with strong methodological quality. The 17 studies applied 13 different HV-PPs, predominantly using video feedback, based on various dosages and schedules. Most studies (77%) showed significant positive effects on mother-child interactions by improving mainly positive maternal behaviors (e.g., sensitivity and responsiveness). Positive effects occurred independent of the study design, sample characteristics, measures, and constructs assessed. However, the findings suggest that the combination of fewer than six sessions, durations shorter than three months, and a very early start did not impact mother-child interactions, as expected. Few studies have explored negative maternal behaviors, children’s behaviors, and dyadic interactions such as mutuality and synchrony. Conclusions: HV-PPs positively impacted mother-child interactions in early childhood despite the large heterogeneity across program designs, outcome measures, and overlapping constructs. Based on the results, we discuss the practical and economic implications of using parenting programs as a preventive approach.

Abstract Purpose Immunoglobulin replacement therapy is a standard treatment for patients with antibody production deficiencies, which is of interest in patients with chronic obstructive pulmonary disease (COPD). This systematic review, registered with PROSPERO (CRD42021281118), assessed the current literature regarding immunoglobulin replacement therapy on COPD clinical outcomes in patients with low immunoglobulin G (IgG) serum concentrations. Methods Literature searches conducted from inception to August 23, 2021, in databases including MEDLINE, EMBASE, and CINAHL. Population (sex, age, comorbidities), baseline clinical characteristics (pulmonary function testing results, IgG levels), and outcome (hospitalizations, emergency department visits) were extracted after title/abstract and full text screening. The Cochrane risk of bias assessment form was used for risk of bias assessment of randomized controlled trials and the National Heart, Lung, and Blood Institute (NHLBI) assessment was used for pre and post studies. Results A total of 1381 studies were identified in the preliminary search, and 874 records were screened after duplicates were removed. Screening 77 full texts yielded four studies that were included in the review. Conclusion It is unclear whether immune globulin replacement therapy reduces acute exacerbation frequency and severity in COPD. Current evidence suggests that it is worth considering, but better developed protocols for administration of immune globulin supplementation is required for future randomized controlled trials.

Amateur film discourse is a new special subtype of discourse that has not yet been subjected to scientific research. Its participants have no special cinema education: they discuss the film industry based on their own life experience, ideas, and values. This work was part of the contemporary anthropocentric paradigm, where language comes to the fore as the most important property of human beings. The article identifies the genre of amateur film discourse using online Russian comments to the screen adaptation of Henry James’s What Maisie Knew (1897), directed by S. McGehee and D. Siegel (2012). The methods of comparison and discourse analysis revealed sincerity in the way the commentors evaluated their impressions. The commentors seemed focused on the plot and the action. The discourse was highly emotional and colloquial, filled with aposiopesis and rhetorical questions.