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Little research on the experiences of persons with intellectual disabilities (ID) during the COVID‐19 pandemic has been done by persons with ID themselves. Moreover, little research focuses on group home residents with ID, despite the greater risks they faced of COVID‐19 transmission and mortality. To address these gaps, researchers with and without ID organized qualitative interviews and a focus group discussion with six group home residents with ID in Massachusetts. Study participants identified as self‐advocates and reported feelings of frustration and isolation that at times were exacerbated by community access restrictions imposed by their group homes. All participants described group home staff efforts to keep them physically safe, while some reported lapses that contributed to their risk of contracting COVID‐19. None described comparable efforts to address their social and mental health needs. All participants received information about COVID‐19 and related precautions from group home staff, but none reported receiving information about heightened risks of contracting COVID‐19 while living in group settings. Also, notwithstanding pandemic‐related challenges, most participants identified at least one positive change in their lives, either by changing where they lived or worked or by forging new relationships. Participants' perspectives, as presented to researchers with ID, shed unique light on the range of group home residents' pandemic experiences, signal opportunities for interventions addressing social isolation, and underscore the efficacy of inclusive research methods in eliciting information from research participants with ID. [ABSTRACT FROM AUTHOR]

We performed a scoping review of literature on schools' transfer of rights practices under the Individuals with Disabilities Education Act (IDEA) with respect to students with intellectual and developmental disabilities. The review found only limited empirical evidence of how IDEA transfer of rights policies are implemented in schools and affect students and parents. We found a substantial disconnect between this limited empirical evidence and generalizations about school practice made in recent literature that is not empirically based. In addition, we found some misunderstanding of relevant federal policy and little attention to variation in states' policies and schools' practices. Further research is needed to understand the intersection of relevant public policy, school practice, and student postsecondary education, employment, and independent living outcomes. [ABSTRACT FROM AUTHOR]

In a previous study, selenocyanate was tentatively identified as a biotransformation product when green algae were exposed to environmentally relevant concentrations of selenate. In this follow-up study, we confirm conclusively the presence of selenocyanate in Chlorella vulgaris culture medium by electrospray mass spectrometry, based on selenium's known isotopic pattern. We also demonstrate that the observed phenomenon extends to other green algae (Chlorella kesslerii and Scenedesmus obliquus) and at least one species of blue-green algae (Synechococcus leopoliensis). Further laboratory experiments show that selenocyanate production by algae is enhanced by addition of nitrate, which appears to serve as a source of cyanide produced in the algae. Ultimately, this biotransformation process was confirmed in field experiments where trace amounts of selenocyanate (0.215 ± 0.010 ppb) were observed in a eutrophic, selenium-impacted river with massive algal blooms, which consisted of filamentous green algae (Cladophora genus) and blue-green algae (Anabaena genus). Selenocyanate abundance was low despite elevated selenium concentrations, apparently due to suppression of selenate uptake by sulfate, and insufficient nitrogen concentrations. Finally, trace levels of several other unidentified selenium-containing compounds were observed in these river water samples; preliminary suggestions for their identities include thioselenate and small organic Se species. [ABSTRACT FROM AUTHOR]

Geologic sequestration of anthropogenic carbon dioxide (CO2) will be a necessary part of a carbon management strategy for reducing atmospheric CO2 emissions so long as fossil fuels are a significant part of the energy mix. Proposed federal and state regulations for underground injection of CO2 require that underground sources of drinking water be protected. Accordingly, proposed federal regulations require analysis of the suitability of different receiving formations for geologic sequestration. This study compiles all available water quality data for four potential CO2 receiving formations in the Greater Green River Basin of southwestern Wyoming. The Greater Green River Basin encompasses two large geologic structures, the Moxa Arch and Rock Springs Uplift, which potentially are capable of storing commercial quantities of CO2 in a number of formations, including the Nugget Sandstone, Tensleep/Weber Sandstone, Madison limestone, and Bighorn Dolomite. The data suggest that except along the basin margins, the Tensleep/Weber, Madison, and Bighorn Formations are suitable targets under proposed federal and state geologic sequestration regulations. However, low total dissolved solids in Nugget Sandstone groundwater in parts of the Rock Springs Uplift suggest the potential for local, fracture-assisted recharge in this area. For this reason the Nugget Sandstone is less suitable than the deeper formations for CO2 storage in the Rock Springs Uplift. [ABSTRACT FROM AUTHOR]

Organocatalysis by N-heterocyclic carbenes is normally initiated by the deprotonation of precursor azolium ions to form active nucleophilic species. Substituent effects on deprotonation have an impact on catalytic efficiency and provide insight into general catalytic mechanisms by commonly used azolium systems. Using an NMR kinetic method for the analysis of C(3)-H/D exchange, we determined log kex–pD profiles for three ortho-substituted N-aryl triazolium salts, which enables a detailed analysis of ortho-substituent effects on deprotonation. This includes N-5-methoxypyrid-2-yl triazolium salt 7 and di-ortho-methoxy and di-ortho-isopropoxyphenyl triazolium salts 8 and 9, and we acquired additional kinetic data to supplement our previously published analysis of N-pyrid-2-yl triazolium salt 6. For 2-pyridyl triazoliums 6 and 7, novel acid catalysis of C(3)-H/D exchange is observed under acidic conditions. These kinetic data were supplemented by DFT analyses of the conformational preferences of 6 upon N-protonation. A C(3) deprotonation mechanism involving intramolecular general base deprotonation by the pyridyl nitrogen of the N(1)-deuterated dicationic triazolium salt is most consistent with the data. We also report kDO values (protofugalities) for deuteroxide-catalyzed exchange for 6–9. The protofugalities for 8 and 9 are the lowest values to date in the N-aryl triazolium series. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic resulted in many school districts in countries around the world transitioning rapidly to partial or complete remote learning. These disruptions affected all children’s education, but students with disabilities (SWDs) were particularly at-risk because of the challenges of providing accessible support and services through remote teaching programmes. We examine the experience of SWDs in 24 United States school districts of instructional and adaptation models between August 2020 and February 2021. Districts varied in their approaches to remote instruction, compensatory services and prioritising SWDs for returning to the classroom before other students. Districts also varied substantially in the information provided regarding Distance Learning Plans, changes to Individualised Education Programmes and related service delivery. This analysis underscores the need for minimal standards for meeting the educational needs of SWDs during school closures as well as for disseminating good practices on minimising the effects of disruptions in future public health crises. These results have implications for existing practices and future research in the U.S. and other countries with widely disseminated decision making surrounding educational delivery during crises. [ABSTRACT FROM AUTHOR]

Background: Abnormal restricted diffusion on magnetic resonance imaging is often associated with ischemic stroke or anoxic injury, but other conditions can present similarly. We present six cases of an unusual but consistent pattern of restricted diffusion in bilateral hippocampi and cerebellar cortices. This pattern of injury is distinct from typical imaging findings in ischemic, anoxic, or toxic injury, suggesting it may represent an under-recognized clinicoradiographic syndrome. Despite initial presentation with stupor or coma in the context of obstructive hydrocephalus, patients may have acceptable outcomes if offered early intervention.Methods: We identified an ad hoc series of patients at our two institutions between years 2014 and 2017 who presented to the neurocritical care unit with severe, otherwise unexplained cerebellar edema and retrospectively identified several commonalities in history, presentation, and imaging.Results: Between two institutions, we identified six patients-ages 33-59 years, four male-with similar presentations of decreased level of consciousness in the context of intoxicant exposure, with acute cytotoxic edema of the cerebellar cortex, hippocampi, and aspects of the basal nuclei. All patients presented with severe cerebellar edema which led to obstructive hydrocephalus requiring aggressive medical and/or surgical management. The five patients who survived to discharge demonstrated variable degrees of physical and memory impairment on discharge and at follow-up.Conclusions: We present findings of a potentially novel syndrome involving a distinct pattern of cerebellar and hippocampal restricted diffusion, with imaging and clinical characteristics distinct from ischemic stroke, hypoxic injury, and known toxidromes and leukoencephalopathies. Given the potential for favorable outcome despite early obstructive hydrocephalus, early identification and treatment of this syndrome are critical. [ABSTRACT FROM AUTHOR]

Aneurysm morphology has been correlated with rupture. Previous reports identified several morphologic indices that predict rupture status, but they measure only specific qualities of the morphology of an aneurysm in a semiquantitative fashion. Fractal analysis is a geometric technique whereby the overall complexity of a shape is quantified through the calculation of a fractal dimension (FD). By progressively altering the scale of measurement of a shape and determining the number of segments required to incorporate the entire shape, a noninteger value for the dimension of the shape is derived. We present a proof-of-concept study to calculate the FD of an aneurysm for a small cohort of patients with aneurysms in 2 specific locations to determine whether FD is associated with aneurysm rupture status. Twenty-nine aneurysms of the posterior communicating and middle cerebral arteries were segmented from computed tomography angiograms in 29 patients. FD was calculated using a standard box-counting algorithm extended for use with three-dimensional shapes. Nonsphericity index and undulation index (UI) were used to validate the data against previously reported parameters associated with rupture status. Nineteen ruptured and 10 unruptured aneurysms were analyzed. Through logistic regression analysis, lower FD was found to be significantly associated with rupture status (P = 0.035; odds ratio, 0.64; 95% confidence interval, 0.42–0.97 per FD increment of 0.05). In this proof-of-concept study, we present a novel approach to quantify the geometric complexity of intracranial aneurysms through FD. These data suggest an association between FD and patient-specific aneurysm rupture status. [ABSTRACT FROM AUTHOR]

Purpose: Basilar artery stenosis (BAS) carries high morbidity and mortality, with variable outcomes after endovascular treatments. We systematically reviewed the literature on percutaneous transluminal angioplasty and/or stenting (PTAS) for BAS. Methods: PubMed, EMBASE, Web-of-Science, Scopus, and Cochrane were searched upon the PRISMA guidelines to include prospective/retrospective cohort studies describing PTAS for BAS. Pooled rates of intervention-related complications and outcomes were analyzed with random-effect model meta-analyses. Results: We included 25 retrospective cohort studies comprising 1016 patients. All patients were symptomatic, presenting with transient ischemic attack or ischemic stroke. BAS frequently involved the middle basilar artery (51.4%), mostly classified as Mori-B (57.4%). PTAS for BAS was indicated in severe (≥ 50–70%), symptomatic BAS refractory to dual antiplatelet therapy. Patients underwent angioplasty (95.5%) and/or stenting (92.2%), preferably using Wingspan or Apollo stents. Median baseline BAS was 81% (range, 53–99%), while median post-intervention BAS was 13% (0–75%). Actuarial rates of successful intervention and "good" final outcome were 100% (95% CI: 100–100%) and 89% (95% CI: 85–93%). Intervention-related recurrent ischemic stroke occurred in 85 patients (8.3%) with actuarial rates of 5% (95% CI: 4–7%), differentiated into perforator (5.4%), in-stent (2.6%), and embolic (0.4%). Actuarial rates of intervention-related dissection, restenosis, and death were 0% (95% CI: 0–0%), 1% (95% CI: 0–1%), and 0% (95% CI: 0–2%). Conclusion: Elective PTAS appears to be safe and effective in selected patients with medically refractory, severe, symptomatic, and non-acute BAS. Different stent types and angioplasty-assisted procedures should be considered based on specific clinico-radiological characteristics of the lesions. Future randomized controlled trials are required to corroborate these findings. [ABSTRACT FROM AUTHOR]

Various forms of assistance are offered to help US Veterans achieve success in their post-military lives in recognition of their service. Despite the many successes, a significant number of Veterans continue to remain at risk for negative mental health outcomes, including suicidality and low levels of life satisfaction. These findings may be due to challenges arising from cultural identity dissonance. Problematic strategies used by Veterans to reduce this dissonance can result in a lack of belongingness, a key component in Joiner's Interpersonal Theory of Suicide. The authors suggest that research on the immigrant experience of acculturation may provide a new perspective to better understand issues of identity and sense of belonging in Veterans. Given that most Veterans return to the culture in which they grew up, the authors offer the term "reculturation." The authors propose clinical psychology focus on exploring the reculturation process of Veterans to support program engagement and suicide prevention. [ABSTRACT FROM AUTHOR]

Large navigation and atmospheric uncertainties have historically driven the need for a mid-lift-to-drag-ratio (mid-L/D) vehicle with (L/D)max of 0.6-0.8 for aerocapture at Neptune. Most planetary entry vehicles flown to date are low-L/D blunt-body aeroshells with L/D less than 0.4. The lack of a heritage mid-L/D aeroshell presents a major hurdle for Neptune aerocapture, as the development of a new entry vehicle incurs significant time and investment. Techniques that may allow Neptune aerocapture to be feasible using heritage low-L/D blunt-body aeroshells are investigated that obviate the need for mid-L/D aeroshells. A navigation study is performed to quantify the delivery errors, and a new guidance algorithm with onboard density estimation is developed to accommodate large atmospheric uncertainties. Monte Carlo simulation results indicate that the reduced navigation uncertainty and improved guidance scheme enable a blunt-body aeroshell with L/D=0.3-0.4 to perform aerocapture at Neptune. The expected heat rate is within the capabilities of existing thermal protection system materials. [ABSTRACT FROM AUTHOR]

Posterior reversible encephalopathy syndrome (PRES) is an uncommon but potentially devastating syndrome if not recognized and treated appropriately. As the name implies, recognition of the condition and proper management may reverse the clinical and radiological findings. However, diagnosis is not always straightforward. We present the case of a 24-year-old female who was 4 days post-partum and presented with headache, neck pain, and new-onset seizures. She had undergone epidural anesthesia during labor, and initial imaging was suggestive of intracranial hypotension versus pachymeningitis. Despite initial conservative therapy including anti-epileptic drugs, magnesium therapy, empiric antibiotics, and Trendelenburg positioning, the patient continued to deteriorate. Follow-up imaging was suggestive of PRES with signs of intracranial hypertension. The patient underwent a decompressive suboccipital craniectomy for refractory and severe PRES and later fully recovered. This case highlights the sometimes difficult diagnosis of PRES, possible association with pregnancy, eclampsia/preeclampsia and/or cerebrospinal fluid drainage, and the rare but life-saving need for decompression in severe cases. [ABSTRACT FROM AUTHOR]