University of Massachusetts Boston

Situated in the context of advanced placement (AP) reform in the United States, we investigated profiles of teachers’ motivation for participating in professional development (PD) courses in a two-cohort sample of nt1 = 2,369 and nt2 = 2,170 chemistry teachers via multilevel latent class analysis. In addition, the study investigated to what extent profile membership was related to factors at the teacher, school, and PD levels. Participation in PD courses was associated with one of three profiles, labeled “reform-motivated,” “convenience-motivated,” and “interaction-motivated.” Participation in PD courses was more likely to be reform-motivated if a teacher had a major in chemistry, more experience teaching AP, more positive attitudes toward PD, or higher enactment of AP redesign in the classroom, or if the PD course was formal and face-to-face. The results show that teachers have different motivations for participating in PD courses and provide insight into how to engage teachers in professional learning.

Germline genetic testing has been increasingly conducted for treatment implications in patients with prostate cancer due to the expansion of testing eligibility. Understanding patients' comprehension of genetic results is crucial for establishing effective result disclosure practices. This importance has grown due to the increasing prevalence of negative genetic results being conveyed via electronic communication and by providers without a genetics specialization. This study explores patients with prostate cancer's perceptions of genetic results communication. We analyzed 24 qualitative, semi‐structured interviews with patients with prostate cancer at an urban safety‐net hospital who had genetic results documented in their medical records. Interview questions focused on patient experiences with genetic referrals, genetic counseling, and genetic result disclosure. Audio recordings were professionally transcribed and analyzed by the study team utilizing an inductive thematic approach to generate themes from recurring codes. Of those who participated, 18 were interviewed in English, 5 in Spanish, and 1 in Haitian Creole. No participants reported having a pathogenic variant identified with genetic testing. Study participants identified a number of gaps in results communication which led to misconceptions regarding hereditary cancer risk. Three themes were generated: (1) Patients desired clear communication about the next steps after genetic testing, (2) Patients commonly experienced cognitive dissonance with negative genetic results given personal and family history of cancer, and (3) Patients felt reassurance from negative genetic results. This research suggests that maintaining conversations between patients and healthcare providers alongside the delivery of negative results assists in patient comprehension. Additionally, it is essential to evaluate the accessibility and appropriateness of notes and results sent to patients. Ultimately, understanding communication barriers in genetic results return is imperative in order to provide high‐quality genetic care.

Objective Racial and ethnic disparities in rheumatoid arthritis (RA) outcomes are well recognized. However, whether disparities in RA treatment selection and outcomes differ by urban versus rural residence, independent of race, have not been studied. Our objective was to evaluate whether biologic disease‐modifying antirheumatic drug (bDMARD) initiation after methotrexate administration differs by rural versus urban residence among veterans with RA. Methods In this retrospective cohort study using national US Veterans Affairs (VA) databases, we identified adult patients with RA based on the presence of diagnostic codes and DMARD administration. We included patients receiving an initial prescription of methotrexate (index date) between 2005 and 2014, with data through 2016 used for follow‐up. Urban–rural status was categorized using the Veteran Health Administration's Urban/Rural classification. Our primary outcome of interest was time to biologic initiation within two years of starting methotrexate. Multivariable Cox proportional hazards models were conducted adjusting for demographics, comorbidities, and rheumatoid factor or anti‐cyclic citrullinated peptide positivity. Results Among 17,395 veterans with RA (88% male, 42% with rural residence) fulfilling eligibility criteria, 3,259 (19%) initiated a biologic within the first two years of follow‐up. In multivariable models, residence in an urban area was associated with a statistically significant higher biologic administration compared to rural areas (adjusted hazard ratio 1.10 [95% confidence interval 1.02–1.18]). Conclusion Our study found only modest differences in the initiation of biologic therapies among rural‐ versus urban‐residing veterans with RA in the VA health care system. These findings suggest that disparities are not easily explained by rurality within the VA health care system.

Purpose of review This review highlights contributions of the Global Lipids Genetics Consortium (GLGC) in advancing the understanding of the genetic etiology of blood lipid traits, including total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, and non-HDL cholesterol. We emphasize the consortium's collaborative efforts, discoveries related to lipid and lipoprotein biology, methodological advancements, and utilization in areas extending beyond lipid research. Recent findings The GLGC has identified over 923 genomic loci associated with lipid traits through genome-wide association studies (GWASs), involving more than 1.65 million individuals from globally diverse populations. Many loci have been functionally validated by individuals inside and outside the GLGC community. Recent GLGC studies show increased population diversity enhances variant discovery, fine-mapping of causal loci, and polygenic score prediction for blood lipid levels. Moreover, publicly available GWAS summary statistics have facilitated the exploration of lipid-related genetic influences on cardiovascular and noncardiovascular diseases, with implications for therapeutic development and drug repurposing. Summary The GLGC has significantly advanced the understanding of the genetic basis of lipid levels and serves as the leading resource of GWAS summary statistics for these traits. Continued collaboration will be critical to further understand lipid and lipoprotein biology through large-scale genetic assessments in diverse populations.

This article provides a foundational framework for understanding student leadership training. The authors categorize the article into three key areas: the who defines student leadership trainers as educators who intentionally foster leadership development, with a strong focus on identity exploration, leadership knowledge, and experiential learning. The what explores the nature of leadership training, distinguishing it from leadership education, development, and engagement, emphasizing skill cultivation in immersive settings. The why highlights the importance of leadership training, stressing practical skill development, reflection, and real‐world application. The article positions leadership training as essential for empowering students to engage with leadership challenges through hands‐on, reflective experiences that enhance their competencies. Ultimately, this article serves as an introduction to the special issue on leadership development in training contexts.

Quantum sensors based on solid-state defects, in particular nitrogen-vacancy (NV) centers in diamond, enable precise measurement of magnetic fields, temperature, rotation, and electric fields. Cavity quantum electrodynamic (cQED) readout, in which an NV ensemble is hybridized with a microwave mode, can overcome limitations in optical spin detection and has resulted in leading magnetic sensitivities at the pT-level. This approach, however, remains far from the intrinsic spin-projection noise limit due to thermal Johnson-Nyquist noise and spin saturation effects. Here we tackle these challenges by combining recently demonstrated spin refrigeration techniques with comprehensive nonlinear modeling of the cQED sensor operation. We demonstrate that the optically-polarized NV ensemble simultaneously provides magnetic sensitivity and acts as a heat sink for the deleterious thermal microwave noise background, even when actively probed by a microwave field. Optimizing the NV-cQED system, we demonstrate a broadband sensitivity of 576 ± 6 fT/$\sqrt{{{{\rm{Hz}}}}}$ around 15 kHz in ambient conditions. We then discuss the implications of this approach for the design of future magnetometers, including near-projection-limited devices approaching 3 fT/$\sqrt{{{{\rm{Hz}}}}}$ sensitivity enabled by spin refrigeration.

When the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‐5) was published in 2013, there was a firestorm of controversy about the elimination of the bereavement exclusion. Proponents of this change and of the proposed “complicated grief” designation believed that this change would help clinicians recognise major depression in the context of recent bereavement. Other researchers and clinicians have raised concerns about medicalising grief. In 2022 “prolonged grief disorder” (PGD) was officially included in the DSM‐5‐TR in the trauma‐ and stressor‐related disorders section. Not surprisingly, there has been a push to identify biomarkers and to use neuroimaging to identify the neurobiological basis of PGD. Some researchers have even suggested that PGD is a ‘reward circuit disorder’ akin to addiction and that naltrexone, an opioid antagonist, may be a promising treatment. The purpose of this paper is to show how medicalising grief reinforces a research agenda dedicated to the search for pharmaceutical and psychological ‘magic bullets.’ Following George and Whitehouse (2021), we propose that an ecopsychosocial approach—one that incorporates environmental and contextual factors—is needed.

The roughskin dogfish Centroscymnus owstonii, a deep‐sea shark, has a patchy global distribution, with most knowledge stemming from incidentally captured specimens. Using a deep‐sea remote lander video system, we observed multiple C. owstonii individuals alive on the footage at 1054 m off Little Cayman, Cayman Islands, Western Atlantic Ocean, marking, to our knowledge, the first record of the species in the Greater Antilles, central Caribbean Sea, while also adding a new species locality record for the Cayman Islands. This study expands our knowledge of the distribution of the roughskin dogfish in the region, and highlights the utility of video lander systems for enhancing and expanding our understanding of the biology and diversity of deep‐sea sharks.

Introduction Although the popularity of oral nicotine products (ONPs) such as ZYN and On! is growing globally, there is limited research on their marketing and advertising. This report describes recent ONP marketing communication to retailers. Promotion to retailers can provide insight into new product flavours and styles, as well as future marketing strategies targeting consumers. Methods We obtained all unique ONP print and online advertisements (ads) (N=50) targeted towards US businesses between January 2016 and August 2022 from Vivvix (formerly Numerator Ad Intel). Two independent reviewers coded for type of ONP, brand, nicotine strength(s), flavour(s), slogan(s), claim(s) and frequency of each component. Results Most ads featured nicotine pouches alone (52%), while 22% featured a mix of ONPs including pouches, tablets and lozenges. By brand, Rogue constituted 36% of ads, followed by Zyn and On! (16% each). Most (82%) ads featured at least one cooling flavour and 48% displayed at least one fruit flavour. Wintergreen flavour appeared most frequently (48%). Most (72%) ads contained a slogan, which frequently highlighted convenience of use (eg, ‘Chew on this Anywhere… Anytime’), bypassing current restrictions on other tobacco and nicotine products use (eg, ‘Laughs at no smoking signs’) and highlighting big profit margins from sales of ONPs for retailers (eg, ‘small pouches big margins’). Conclusion This analysis provides insight into tobacco companies’ strategies for increasing ONP endorsement among retailers. Strategies include appealing to profitability, emphasising convenience of product use and primarily promoting non-tobacco flavours. These findings highlight new trends in ONP products and marketing tactics and identify important areas to monitor to inform tobacco marketing regulations.

Medicinal plants play a crucial role in healthcare practices and are an integral part of human society. A comprehensive checklist of medicinal plants is the basis for the risk and protection. Tropical East Africa (TEA) has a high diversity of medicinal plants. This study compiled a comprehensive checklist using published books and literature comprising 2855 medicinal plants spanning 180 families and 1034 genera in TEA. The family with the largest number of medicinal plant species is Fabaceae, followed by Asteraceae and Rubiaceae. The root emerges as the most utilized part in woody medicinal plants, contrasting with herbaceous plants where leaves take precedence. The regions with high diversity of medicinal plants are mainly concentrated in northern and southern Rwanda, western Burundi, western Uganda, central and western Kenya, as well as northeastern and southwestern Tanzania. Priority conservation areas for medicinal plants were identified based on specific species and risk of collection, and included regions of west-central Kenya, northeastern Tanzania, and eastern Burundi. Our research emphasizes the significance of protecting these valuable medicinal plants by proposing corresponding conservation measures. The medicinal plant resources of TEA remain an opportunity for exploration, and the diversity of medicinal plants needs to be further improved.

Visual perceptual artefacts are distortions or illusions in medical image interpretation arising from the human visual system rather than hardware or imaging acquisition processes. These artefacts, emerging at various visual processing stages, such as the retina, visual pathways, visual cortex, and cognitive interpretation stages, impact the interpretation of cardiothoracic images. This review discusses artefacts including Mach bands, Dark Rim, Background Effects, Ambiguous Figures, Subjective Contours, and the Parallax Effect. A thorough literature search was conducted using PubMed and Google Scholar. Search terms included ‘visual perceptual artifacts’, ‘cardiothoracic imaging’, ‘Mach bands’, ‘dark rim artifact’, ‘stress cardiac MRI’, and ‘radiology visual illusions’. Inclusion criteria encompassed studies focusing on visual perceptual artefacts in cardiothoracic imaging published in peer‐reviewed journals. Studies not addressing visual perceptual artefacts or those focusing on imaging technology, hardware, or software‐related artefacts were excluded. Duplicate studies were removed, and a final selection of 32 studies was analysed. Several key visual perceptual artefacts relevant to cardiothoracic imaging were identified. Mach bands, caused by lateral inhibition in the retina, create false contrasts at object boundaries, potentially mimicking pathologies such as fractures or pneumothoraces. The dark rim artefact observed on stress cardiac MRI, resulting from Gibbs ringing or truncation artefacts, can simulate perfusion defects and complicate diagnosis. Lateral inhibition can possibly accentuate the appearance of the dark rim artefact. Artefacts also fall under illusions of sensation, perception, and image formation. These illusions present both risks and benefits to diagnostic radiology. Recognizing visual perceptual artefacts is crucial for improving diagnostic accuracy and developing strategies to mitigate their impact. A comprehensive understanding and training on these artefacts are essential for radiologists to enhance interpretive skills, reduce diagnostic errors, and ultimately improve patient care in radiology.

Given any toric subvariety Y of a smooth toric variety X of codimension k , we construct a length k resolution of ${\mathcal O}_Y$ by line bundles on X . Furthermore, these line bundles can all be chosen to be direct summands of the pushforward of ${\mathcal O}_X$ under the map of toric Frobenius. The resolutions are built from a stratification of a real torus that was introduced by Bondal and plays a role in homological mirror symmetry. As a corollary, we obtain a virtual analogue of Hilbert’s syzygy theorem for smooth projective toric varieties conjectured by Berkesch, Erman and Smith. Additionally, we prove that the Rouquier dimension of the bounded derived category of coherent sheaves on a toric variety is equal to the dimension of the variety, settling a conjecture of Orlov for these examples. We also prove Bondal’s claim that the pushforward of the structure sheaf under toric Frobenius generates the derived category of a smooth toric variety and formulate a refinement of Uehara’s conjecture that this remains true for arbitrary line bundles.

What if we could save lives just by listening to women? “‘Why Would I go back There?’: Medical Mistrust and the Maternal Mortality Crisis” explores this question through birth narratives from people whose experiences made them hesitant to seek out any medical care. According to the CDC, over half of maternal mortality happens after people leave the hospital, and between 60% and 80% of maternal deaths are preventable. Understanding why these parents are not seeking care is integral to ending preventable maternal deaths. While health policy advocates have developed policies to remove structural and economic barriers to postpartum services, there are still patients who will not return to the hospital, even for lifesaving care. This article explores one possible reason why. Based on interviews with over 100 people who gave birth, this article joins scholars who view medical mistrust as a fundamental barrier to policy compliance. People will only return to the hospital if they think it will be better for them to do so. With an experience‐conscious view in mind, this article ends with relevant policy recommendations gathered from health programs designed to bring trust back into maternal care.

Background In 2018, the treatment options for unresectable stage III non-small cell lung cancer (NSCLC) changed with durvalumab, an immune checkpoint inhibitor (ICI), which was approved for consolidation therapy following concurrent chemoradiotherapy (cCRT) without disease progression. Despite durvalumab’s clinical benefit, many patients receiving this therapy developed progression. This study evaluated treatment patterns and clinical outcomes in real-world community oncology practices for patients with unresectable stage III NSCLC who received cCRT. Methods This study used The US Oncology Network’s (iKnowMed) electronic health record database supplemented by chart review and included adults diagnosed with unresectable stage III NSCLC initiating cCRT between 11/01/2017 and 10/31/2019, with follow-up through 04/30/2022. cCRT included concurrent treatment with platinum-based chemotherapy and radiation therapy (+/-14 days). Real-world overall survival (rwOS) and real-world progression-free survival (rwPFS) were estimated from cCRT initiation using the Kaplan–Meier method. Results Among 426 patients, 61.5% received durvalumab post-cCRT (cCRT+durvalumab) and 38.5% did not (cCRT alone). Death (28.3%) and disease progression (22.2%) were the most common reasons for not initiating durvalumab. The median age for the cCRT+durvalumab and cCRT alone cohorts were 70 and 71 years, and 71.8% and 61.6% had Eastern Cooperative Oncology Group performance status of 0–1, respectively. 51.5% of cCRT+durvalumab discontinued durvalumab, primarily due to adverse events (35.8%) and disease progression (28.4%). Median rwOS was 50.2 (95% confidence interval [CI]:41.4, not reached) and 11.6 (95% CI:6.5,15.9) months for cCRT+durvalumab and cCRT alone, respectively. Median rwPFS was 28.5 (95% CI:23.3,36.4) months for cCRT+durvalumab and 6.3 (95% CI:4.3,9.3) months for cCRT alone, respectively. 23.7% (cCRT+durvalumab) and 26.2% (cCRT alone) received subsequent treatment, of which, 59.7% (cCRT+durvalumab) and 46.5% (cCRT alone) received ICI. Conclusion Four out of ten patients did not receive consolidation durvalumab mainly due to disease progression. Even among patients who initiated durvalumab, many patients relapsed and were retreated with ICIs. These findings underscore the need to refine treatment strategies for better outcomes in stage III unresectable NSCLC.

The anti-poverty agenda has been at the heart of the World Bank's discourse in recent decades. Social policies started to be identified as strategic for combating poverty and promoting development in poor countries. We analyzed the health policy recommendations made by the World Bank to Brazil in the Lula da Silva and Rousseff administrations from 2003 to 2014. Document analysis was used to explore the partnership contracts between the World Bank and Brazil, projects financed by the World Bank in Brazil, and the document “20 Years of Construction of the Health System in Brazil: An Analysis of the Unified Health System.” Content analysis of documents show that there was a predominance of projects focusing on reducing poverty, while social policies occupied a secondary place in the agenda. The World Bank approached states and municipalities expanding the spread of its state reform agenda, in addition to reinterpreting the structural framework of the Sistema Único de Saúde (SUS). We conclude that the Bank acted to limit the original principles of the SUS in favor of hegemonic interests of the current phase of capitalist accumulation.

Objectives Disorders of the gut–brain interaction (DGBI) arise from a complex interplay of psychosocial factors, altered physiology, and early life factors. In adults, adverse childhood experiences (ACEs) have been associated with DGBI. While both ACEs and DGBI are prevalent among children, the relationship between ACEs and DGBI in childhood is not well understood. Methods Retrospective review of patients aged 3–18 years with ACE scores documented between October 1, 2019 and April 30, 2022 who were divided into three comparison groups: (1) not referred to pediatric gastroenterology (GI); (2) referred to GI and diagnosed with a DGBI; and (3) referred to GI and not diagnosed with a DGBI. Results Of 29,490 patients with ACE scores documented during the study period, 897 completed a GI consultation. Four hundred one (44.7%) were diagnosed with a DGBI. With each additional adverse experience, patients were 1.09 times more likely to have a DGBI diagnosis (95% confidence interval [CI] = 1.056–1.163; p ≤ 0.001). An anxiety diagnosis mediated 73% of this relationship ( p = 0.012). Conclusions Among patients receiving pediatric GI specialty care, higher ACE scores were associated with a higher likelihood of a DGBI diagnosis. Anxiety largely mediates this relationship, suggesting potential avenues for targeted, multidisciplinary interventions in both primary and specialty care settings.