The District Role in Instructional Improvement

Are changing conditions affecting the capacity of districts to provide focus, to coordinate support, and to scale up successful reforms? From a study of the roles played by central office staff members in shaping and supporting instructional reforms in three large urban districts, the authors derive an answer

Real-World Evaluation of Universal Germline Screening for Cancer Treatment-Relevant Pharmacogenes

The purpose of this study was to determine the frequency of clinically actionable treatment-relevant germline pharmacogenomic variants in patients with cancer and assess the real-world clinical utility of universal screening using whole-exome sequencing in this population. Cancer patients underwent research-grade germline whole-exome sequencing as a component of sequencing for somatic variants. Analysis in a clinical bioinformatics pipeline identified clinically actionable pharmacogenomic variants. Clinical Pharmacogenetics Implementation Consortium guidelines defined clinical actionability. We assessed clinical utility by reviewing electronic health records to determine the frequency of patients receiving pharmacogenomically actionable anti-cancer agents and associated outcomes. This observational study evaluated 291 patients with cancer. More than 90% carried any clinically relevant pharmacogenetic variant. At least one disease-relevant variant impacting anti-cancer agents was identified in 26.5% (77/291). Nine patients with toxicity-associated pharmacogenomic variants were treated with a relevant medication: seven UGT1A1 intermediate metabolizers were treated with irinotecan, one intermediate DPYD metabolizer was treated with 5-fluorouracil, and one TPMT poor metabolizer was treated with mercaptopurine. These individuals were more likely to experience treatment-associated toxicities than their wild-type counterparts (p = 0.0567). One UGT1A1 heterozygote died after a single dose of irinotecan due to irinotecan-related adverse effects. Identifying germline pharmacogenomic variants was feasible using whole-exome sequencing. Actionable pharmacogenetic variants are common and relevant to patients undergoing cancer treatment. Universal pharmacogenomic screening can be performed using whole-exome sequencing data originally obtained for quality control purposes and could be considered for patients who are candidates for irinotecan, 5-fluorouracil, capecitabine, and mercaptopurine

What do you mean, ‘megafire’?

BACKGROUND : ‘Megafire’ is an emerging concept commonly used to describe fires that are extreme in terms of size, behaviour, and/or impacts, but the term’s meaning remains ambiguous. APPROACH : We sought to resolve ambiguity surrounding the meaning of ‘megafire’ by conducting a structured review of the use and definition of the term in several languages in the peer-reviewed scientific literature. We collated definitions and descriptions of megafire and identified criteria frequently invoked to define megafire. We recorded the size and location of megafires and mapped them to reveal global variation in the size of fires described as megafires. RESULTS : We identified 109 studies that define the term ‘megafire’ or identify a megafire, with the term first appearing in the peer-reviewed literature in 2005. Seventy-one (~65%) of these studies attempted to describe or define the term. There was considerable variability in the criteria used to define megafire, although definitions of megafire based on fire size were most common. Megafire size thresholds varied geographically from > 100–100,000 ha, with fires > 10,000 ha the most common size threshold (41%, 18/44 studies). Definitions of megafire were most common from studies led by authors from North America (52%, 37/71). We recorded 137 instances from 84 studies where fires were reported as megafires, the vast majority (94%, 129/137) of which exceed 10,000 ha in size. Megafires occurred in a range of biomes, but were most frequently described in forested biomes (112/137, 82%), and usually described single ignition fires (59% 81/137). CONCLUSION : As Earth’s climate and ecosystems change, it is important that scientists can communicate trends in the occurrence of larger and more extreme fires with clarity. To overcome ambiguity, we suggest a definition of megafire as fires > 10,000 ha arising from single or multiple related ignition events. We introduce two additional terms – gigafire (> 100,000 ha) and terafire (> 1,000,000 ha) – for fires of an even larger scale than megafires.DATA AVAILABILITY STATEMENT: A list of the references from which the data were extracted can be found in the Appendix A: Data sources. The data used in this study are openly available at zenodo.org: https://doi.org/10.5281/zenodo.6252145.Threatened Species Recovery Hub; NSW Bushfire Risk Management Research Hub; Australian Wildlife Society; World Wildlife Fund.http://wileyonlinelibrary.com/journal/gebZoology and Entomolog

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Bordering on success: A portrait of the Calexico Unified School District since bilingual education, 1963–2000

This dissertation examines the history, community and culture of the Calexico Unified School District from the inception of bilingual education (ca. 1963) through the present. This California border town of 27,109 graduates more Mexican American students than any other school district in the state. In light of the high drop out rate for Latino students in U.S. schools as a whole, Calexico\u27s statistics are remarkable. This research project focuses on the question of what makes Calexico successful---in the eyes of the community, students, teachers, administrators, and outsiders who look to it as an example of Latino educational attainment. It considers how the unique aspects of Calexico\u27s educational history and cultural identity have influenced local policy, educational practice, and student performance. As Calexico is a bicultural/binational community, the inception and progress of the bilingual program provides the timeframe of the dissertation. Through interviews, observations and careful examination of historical documents, this ethnohistory also seeks to place Calexico in a larger historical and theoretical context. Why is the graduation rate so high? What theories of success and failure inform the educational process in the town? How does Calexico\u27s educational experience compare to that of other Mexican American communities? The story of the first academic program that directly addressed the biculturalism of Calexico\u27s students provides a telling look into how schools and local communities might work together to create educational environments that support local culture and higher levels of student academic performance

Bordering on success: A portrait of the Calexico Unified School District since bilingual education, 1963–2000

This dissertation examines the history, community and culture of the Calexico Unified School District from the inception of bilingual education (ca. 1963) through the present. This California border town of 27,109 graduates more Mexican American students than any other school district in the state. In light of the high drop out rate for Latino students in U.S. schools as a whole, Calexico\u27s statistics are remarkable. This research project focuses on the question of what makes Calexico successful---in the eyes of the community, students, teachers, administrators, and outsiders who look to it as an example of Latino educational attainment. It considers how the unique aspects of Calexico\u27s educational history and cultural identity have influenced local policy, educational practice, and student performance. As Calexico is a bicultural/binational community, the inception and progress of the bilingual program provides the timeframe of the dissertation. Through interviews, observations and careful examination of historical documents, this ethnohistory also seeks to place Calexico in a larger historical and theoretical context. Why is the graduation rate so high? What theories of success and failure inform the educational process in the town? How does Calexico\u27s educational experience compare to that of other Mexican American communities? The story of the first academic program that directly addressed the biculturalism of Calexico\u27s students provides a telling look into how schools and local communities might work together to create educational environments that support local culture and higher levels of student academic performance

What do you mean, 'megafire'?

"Megafire" is an emerging concept commonly used to describe fires that are extreme in terms of size, behaviour, and/or impacts, but the term’s meaning remains ambiguous. We sought to resolve ambiguity surrounding the meaning of "megafire’" by conducting a structured review of the use and definition of the term in several languages in the peer-reviewed scientific literature. We collated definitions and descriptions of megafire and identified criteria frequently invoked to define megafire. We recorded the size and location of megafires and mapped them to reveal global variation in the size of fires described as megafires. We identified 109 studies that define the term "megafire" or identify a megafire, with the term first appearing in the peer-reviewed literature in 2005. Seventy-one (~65%) of these studies attempted to describe or define the term. There was considerable variability in the criteria used to define megafire, although definitions of megafire based on fire size were most common. Megafire size thresholds varied geographically from > 100–100,000 ha, with fires > 10,000 ha the most common size threshold (41%, 18/44 studies). Definitions of megafire were most common from studies led by authors from North America (52%, 37/71). We recorded 137 instances from 84 studies where fires were reported as megafires, the vast majority (94%, 129/137) of which exceed 10,000 ha in size. Megafires occurred in a range of biomes, but were most frequently described in forested biomes (112/137, 82%), and usually described single ignition fires (59% 81/137). Conclusion: As Earth’s climate and ecosystems change, it is important that scientists can communicate trends in the occurrence of larger and more extreme fires with clarity. To overcome ambiguity, we suggest a definition of megafire as fires > 10,000 ha arising from single or multiple related ignition events. We introduce two additional terms – gigafire (> 100,000 ha) and terafire (> 1,000,000 ha) – for fires of an even larger scale than megafires.Fil: Linley, Grant D.. Charles Sturt University; AustraliaFil: Jolly, Chris J.. Charles Sturt University; Australia. Macquarie University; AustraliaFil: Doherty, Tim S.. University of Sydney; AustraliaFil: Geary, William L.. Deakin University; AustraliaFil: Armenteras, Dolors. Wildfire Lab; Reino Unido. Universidad Nacional de Colombia; ColombiaFil: Belcher, Claire M.. University of Exeter; Reino UnidoFil: Bliege Bird, Rebecca. State University of Pennsylvania; Estados UnidosFil: Duane, Andrea. University of Melbourne; AustraliaFil: Fletcher, Michael-Shawn. University of Melbourne; AustraliaFil: Giorgis, Melisa Adriana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Haslem, Angie. Rocky Mountain Research Station; Estados Unidos. La Trobe University; AustraliaFil: Jones, Gavin M.. University of New Mexico; Estados UnidosFil: Kelly, Luke T.. School Of Ecosystem And Forest Science; AustraliaFil: Lee, Calvin K. F.. The University Of Hong Kong; Hong KongFil: Nolan, Rachael H.. Hawkesbury Institute For The Environment; AustraliaFil: Parr, Catherine. Centro de Investigaciones Sobre Desertificación (cide-c; España. University of Liverpool; Reino UnidoFil: Pausas Garcia, Juli. Universidad de Valencia; EspañaFil: Price, Jodi N.. Charles Sturt University; AustraliaFil: Regos, Adrián. Universidad de Santiago de Compostela; EspañaFil: Ritchie, Euan G.. Deakin University; AustraliaFil: Ruffault, Julien. Ecologie Des Forêts Méditerranéennes; FranciaFil: Williamson, Grant J.. University of Tasmania; AustraliaFil: Wu, Qianhan. University Of Hong Kong; ChinaFil: Nimmo, Dale G.. Charles Sturt University; Australi

The impact of resolving the Rossby radius at mid-latitudes in the ocean: results from a high-resolution version of the Met Office GC2 coupled model

International audienc