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Career development promotes the development of key life skills, allows students to discover opportunities, connects school to work, encourages collaboration, and is instrumental in preparing students for postsecondary success. Despite this, many elementary educators struggle to seamlessly integrate career development activities into curricula. This paper will explore how to strengthen students' foundational career skills, offer suggestions and resources on how to seamlessly integrate career development into elementary curricula, and how to celebrate and share student learning as elementary students discover their personal, career, and/or educational aspirations.

Abstract It has become increasingly apparent that conducting rigorous, relevant and accepted research requires including Researchers with Lived Expertise/Experience (RWLE) in the research process. Including RWLE can create new knowledge rooted in new perspectives, and support research that is more relevant to affected populations. However, the conversation has primarily focused on how involving RWLE can improve research outcomes, so that inequities are being better addressed; there is very little focus on how involvement in research can and should benefit RWLE themselves, nor of how the research process itself can demonstrate a commitment to addressing inequities. In this commentary, we reflect on the experiences of two RWLE of Homelessness, and a Senior Research Associate who all worked together on a recent study. Informed by the challenges we faced and ways we navigated these, here we discuss key issues that must be given more consideration as involving RWLE becomes a necessary part of conducting research. Research teams must consider the issues of pay equity and job security for RLWE who often work on short-term contracts; supporting the professional development of RWLE for their own career advancement; and paying attention to the language we use and how we communicate research findings so they are accessible. There is a unique opportunity for research teams to incorporate a philosophical and practical orientation towards equity during the research process. While research seeks to understand and explain a phenomenon, it must simultaneously seek to address this very phenomenon through how the research is conducted. Our aim is to further the discussion around including RWLE, and to provide tangible suggestions for research organizations and teams.

BACKGROUND: Diagnostic codes can be instrumental for case identification in Alzheimers disease (AD) research; however, this method has known limitations and cannot distinguish between disease stages. Clinical notes may offer more detailed information including AD severity and can complement diagnostic codes for case identification. OBJECTIVE: To estimate prevalence of mild cognitive impairment (MCI) and AD using diagnostics codes and clinical notes available in the electronic healthcare record (EHR). METHODS: This was a retrospective study in the Veterans Affairs Healthcare System (VAHS). Health records from Veterans aged 65 years or older were reviewed during Fiscal Years (FY) 2010-2019. Overall, 274,736 and 469,569 Veterans were identified based on a rule-based algorithm as having at least one clinical note for MCI and AD, respectively; 201,211 and 149,779 Veterans had a diagnostic code for MCI and AD, respectively. During FY 2011-2018, likely MCI or AD diagnosis was defined by≥2 qualifiers (i.e., notes and/or codes)≥30 days apart. Veterans with only 1 qualifier were considered as suspected MCI/AD. RESULTS: Over the 8-year study, 147,106 and 207,225 Veterans had likely MCI and AD, respectively. From 2011 to 2018, yearly MCI prevalence increased from 0.9% to 2.2%; yearly AD prevalence slightly decreased from 2.4% to 2.1%; mild AD changed from 22.9% to 26.8%, moderate AD changed from 26.5% to 29.1%, and severe AD changed from 24.6% to 30.7. CONCLUSIONS: The relative distribution of AD severities was stable over time. Accurate prevalence estimation is critical for healthcare resource allocation and facilitating patients receiving innovative medicines.

Instructional coaching is increasingly regarded as an essential feature of professional development, but no research exists on content-specific instructional coaching for history teachers. The study examines data from a coaching program in which history teacher leaders served as novice coaches for their colleagues. We found that coached teachers, as a whole, improved in discussion facilitation. Case analysis of two successful and two less successful coach-teacher pairings revealed that successful coaches were more likely to focus on eliciting students' argumentative discourse whereas less successful coach planning sessions focused on discrete historical content knowledge and the disciplinary heuristics of historical thinking. It appears that coaching that emphasized a conceptual redirection toward inquiry and a pedagogical toolkit for fostering student discourse was more closely tied to growth in discussion facilitation and opportunities for student historical reasoning than a coaching approach more narrowly focused on historical concepts.

Models can codify our understanding of chemical reactivity and serve a useful purpose in the development of new synthetic processes via, for example, evaluating hypothetical reaction conditions or in silico substrate tolerance. Perhaps the most determining factor is the composition of the training data and whether it is sufficient to train a model that can make accurate predictions over the full domain of interest. Here, we discuss the design of reaction datasets in ways that are conducive to data-driven modeling, emphasizing the idea that training set diversity and model generalizability rely on the choice of molecular or reaction representation. We additionally discuss the experimental constraints associated with generating common types of chemistry datasets and how these considerations should influence dataset design and model building.

We often underestimate how much others enjoy initial interactions with us - a phenomenon known as the liking gap. While widely documented, less research has explored how individual differences such as social anxiety and negative social experiences influence the liking gap. To test this, female and non-binary dyads (N = 23) varying in severity of social anxiety and exposure to peer victimization, completed semi-structured dialogues with strangers. Following the interaction, participants rated their own enjoyment and their assumption of their partner’s enjoyment of the interaction. Consistent with past literature, participants underestimated their partner’s enjoyment. The magnitude of the liking gap was greater for participants with more exposure to peer victimization, but not social anxiety. The relationship with peer victimization was specifically linked to incorrect perceptions about their partner’s enjoyment. This suggests that the liking gap may be susceptible to individual differences in peer victimization, rather than a broader phenotype of social anxiety.

Transcatheter aortic valve replacement (TAVR) is a widely accepted treatment strategy for patients with severe aortic stenosis across all risk profiles. Pacing stimulation of the right ventricle (RV) is the conventional method used during TAVR for rapid pacing during balloon dilatation and transcatheter heart valve deployment and for the management of acute bradyarrhythmias. However, RV pacing requires additional venous access and carries a risk of RV perforation and cardiac tamponade. An alternate strategy of utilizing the stiff guidewire in the left ventricle for direct left ventricle pacing during valve deployment is increasingly being adopted, as it may reduce procedure cost, duration, and radiation exposure and potentially mitigate the risks associated with RV pacing. The current review aims to discuss contemporary rapid pacing techniques for TAVR, including their relative safety, efficiency, and outcomes.

The identification and management of patients with aortic stenosis exist along a continuum that includes healthy living, latent progression, diagnosis, treatment, and posttreatment recovery. Barriers to the provision of appropriate care for these patients can occur at any stage along this continuum. Despite the presence of diagnostic echocardiograms, many patients with aortic stenosis are never clinically recognized, and the rate of mismanagement worsens among underrepresented minority groups and women. Regarding the treatment of clinically recognized aortic stenosis, only about half of patients with symptomatic severe aortic stenosis actually undergo aortic valve replacement within 2 ​years of diagnosis. Treatment rates are even lower among patients with symptomatic low-gradient severe aortic stenosis. Although several strategies have been raised by experts within the field to help and improve the diagnosis and treatment of patients with aortic valve disease, timely referral to a heart valve team specialist whenever aortic valve replacement is being considered likely remains the most pertinent intervention. Connecting these patients with fully informed aortic valve disease experts helps facilitate shared decision-making discussions, thus ensuring that patients have the opportunity to learn about and potentially receive the lifesaving interventions available to them.

A national survey of American families was conducted to ascertain the extent of interest in self-directed education (SDE) in the United States. Our research took place in the midst of the COVID-19 pandemic--a moment when we required a much better understanding of what parents need from the US education system. Data were gathered using an online survey aimed at parents or caregivers of young people aged 4-18. A total of 1009 adults completed the caregiver survey. Resulting data were analyzed using SPSS. Results suggest a high degree of openness to SDE. The data also elucidate several questions and concerns that parents and caregivers have about the approach. Data also highlighted differing perceptions of and attitudes towards SDE as a function of race. As the first nationwide survey about SDE, this study has made an important contribution to the existing literature on the subject. Directions for further research are discussed.

Abstract Background Passive-dynamic ankle–foot orthoses (PD-AFOs) are often prescribed to address plantar flexor weakness during gait, which is commonly observed after stroke. However, limited evidence is available to inform the prescription guidelines of PD-AFO bending stiffness. This study assessed the extent to which PD-AFOs customized to match an individual’s level of plantar flexor weakness influence walking function, as compared to No AFO and their standard of care (SOC) AFO. Methods Mechanical cost-of-transport, self-selected walking speed, and key biomechanical variables were measured while individuals greater than six months post-stroke walked with No AFO, with their SOC AFO, and with a stiffness-customized PD-AFO. Outcomes were compared across these conditions using a repeated measures ANOVA or Friedman test (depending on normality) for group-level analysis and simulation modeling analysis for individual-level analysis. Results Twenty participants completed study activities. Mechanical cost-of-transport and self-selected walking speed improved with the stiffness-customized PD-AFOs compared to No AFO and SOC AFO. However, this did not result in a consistent improvement in other biomechanical variables toward typical values. In line with the heterogeneous nature of the post-stroke population, the response to the PD-AFO was highly variable. Conclusions Stiffness-customized PD-AFOs can improve the mechanical cost-of-transport and self-selected walking speed in many individuals post-stroke, as compared to No AFO and participants’ standard of care AFO. This work provides initial efficacy data for stiffness-customized PD-AFOs in individuals post-stroke and lays the foundation for future studies to enable consistently effective prescription of PD-AFOs for patients post-stroke in clinical practice. Trial Registration: NCT04619043.

Scholarship flourishes in inclusive environments where open deliberations and generative feedback expand both individual and collective thinking. Many researchers, however, have limited access to such settings, and most conventional academic conferences fall short of promises to provide them. We have written this Field Report to share our methods for cultivating a vibrant intellectual community within the Science and Technology Studies Food and Agriculture Network (STSFAN). This is paired with insights from 21 network members on aspects that have allowed STSFAN to thrive, even amid a global pandemic. Our hope is that these insights will encourage others to cultivate their own intellectual communities, where they too can receive the support they need to deepen their scholarship and strengthen their intellectual relationships.

Background/Objective: The frequency of hematospermia in transgender women is unknown. This report aimed to describe the development of hematospermia in a transgender woman. Case Report: A 35-year-old transgender woman treated with estradiol valerate and leuprolide presented with painless rust-tinged ejaculate, urethral bleeding after ejaculation, and intermittent hematuria. Her medical history included gastroesophageal reflux disease, internal hemorrhoids, and attention deficit hyperactivity disorder with negative tobacco smoking and urologic history. Additional medications included emtricitabine-tenofovir disoproxil fumarate and fexofenadine. Physical examination did not reveal constitutional or genitourinary abnormalities. Urinalysis and culture disclosed rare white blood cells with gram-variable bacilli. The chlamydia, gonorrhea, and human immunodeficiency virus test results were negative. Abdominal computed tomography did not reveal bladder or prostate cancer, calcifications, inflammation, or cysts. She continued to have symptoms after this initial workup. One year after the initial symptom onset, transrectal ultrasound disclosed a 1.7-cm midline posterior prostatic cyst with hemorrhagic products, later revealed by magnetic resonance imaging as communicating with the left seminal vesicle. Two ultrasound-guided transperineal biopsy samples revealed benign prostatic tissue with a small focus of Müllerian or endometrial-type tissue, evidenced by immunopositivity for paired-box gene 8 and estrogen receptor in epithelium and cluster of differentiation 10 immunopositivity in stroma. After medical consultation, the patient underwent prostatic cyst aspiration, resection of the transurethral ejaculatory ducts, and orchiectomy. She did not experience any complications after these procedures. Discussion: The etiology of hematospermia may be idiopathic, iatrogenic, anatomic, or pathologic. Conclusion: Occult endometriosis or ectopic Müllerian epithelial tissue growth may occur in transgender women taking feminizing gender-affirming hormone therapy.