Project ACCESS: High School Student Learning of Academic Vocabulary in the Rio Grande Valley

Academic language can be a major obstacle to students’ learning in science and math. For English Language Learners this challenge can be even greater. One reason this challenge prevails is the persistent deficit perspective toward students whose native language is Spanish. One way to address this issue is to leverage students’ knowledge of Spanish and personal culture to develop a deeper understanding of academic vocabulary in high school math and science courses. Project ACCESS (Acquisition of Curricular Content for Exceptional Success in STEM) seeks to challenge the assumptions and biases toward students in the Rio Grande Valley (RGV) who have been marginalized in their STEM classes and are underrepresented in STEM. Specifically, Project ACCESS is (1) creating a consortium to examine P-16 STEM education practices in the RGV and (2) developing, implementing, and testing the use of multiple vocabulary strategies (MVS) in high school math and science classrooms. Results from Phase 1 indicate that MVS are highly effective in high school algebra, anatomy, and biology but have limited effectiveness in chemistry and physics. In addition, efforts to address STEM education issues in the RGV are well underway. Research findings, progress toward STEM education consortium efforts, and next steps are discussed

The Effects of Teaching Undergraduate Freshmen Biology Courses in Spanish and English

This study examines the attitudes and experiences of bilingual learners across two instructional types, identifying how the language of instruction affects the context of learning, and how the experience of the learners differs. Participants included 269 predominantly Hispanic undergraduate students in a general biology course attending a Hispanic Serving Institution in a bilingual community along the US-Mexico border. A bilingual faculty member, who recognizes the sociocultural and contextual factors that affect student learning and adopts a teaching philosophy founded in Culturally Responsive Practices (CRP) and valuing students’ Funds of Knowledge taught the class. This study utilized a mixed method design including analyses of quantitative student learning outcomesa and qualitative data on students’ experiences in educational contexts. While all learners were enrolled in sections of the course in which the instructor used CRP, only half of the learners received instruction bilingually in Spanish and English, allowing a comparison of the effects of bilingual instruction. Analyses of student experiences and knowledge gained revealed significantly greater learning in the bilingual courses, compared to English monolingual sections taught by the same faculty member. Results suggest that the use of bilingual instructional approaches can lead to positive outcomes for bilingual undergraduate students. These findings can be used by educators and policy makers alike, with interest in promoting the academic and sociocultural development of bilingual undergraduate students

The Role of Language in Anatomy and Physiology Instruction

Research indicates that student learning of science, student attitudes toward science, and their motivation to learn science and pursue science-related careers is related to classroom instruction. This study examined anatomy and physiology (A&P) classes in a south Texas high school where 97 percent of students are Hispanic bilingual learners. Classes were assigned to control or treatment groups, with the treatment group receiving instruction designed to help students develop a deeper understanding of anatomy vocabulary related to brain structures by making connections to these words in everyday life as well as to their understanding of Spanish. Main effects between group and test scores were significant, with the control group reporting higher test scores than the treatment group. We attribute this finding to a bleed-over of the treatment group instructional design to the control group. In addition, significant differences in mean and median scores were observed with respect to intrinsic motivation and self-efficacy. The statistically significant increases in learning for both groups suggests the activity-, problem-, and project-based (APB) curriculum has the potential to be an effective type of instruction, especially for bilingual learners

Penn State University NSF GK-12 Project: Using Web-Based Education and Interaction with K-12 and College Freshman to Promote Science and Engineering

Penn State University has hosted an NSF-sponsored GK-12 Outreach project for the past five years, and has just begun the second phase of the project. The Penn State project utilizes the talents of many science and engineering graduate students as teachers, mentors and role models for the K-12 classrooms. The project focuses on developing skills of students in the areas of science, technology, engineering and mathematics through the use of Advanced Transportation Technologies. A new project component was devised and implemented-the interaction of K-12 students with college freshman via a website project. The college freshmen were asked to create a website describing a component of Clean Energy , which was to include an assessment tool to provide feedback on their website. When possible, the college freshmen were encouraged to use active learning and inquiry-based learning concepts. This was encouraged so that the college freshman had an opportunity to practice developing scientific inquiry as a skill through a presentation, and provided the K-12 classroom students a unique opportunity to learn through inquiry. The K-12 students were invited to participate in the research by reviewing and critiquing these websites through feedback via the website to the college freshman. The feedback could take many forms, including specific comments and critique along with a creative assessment tool that the college freshman decided to present with their subject materials. This paper will review the educational outcomes garnered by the students, and provide feedback and analysis from the K-12 and college freshman participants

MMC Fall with Injury Prevention Project

Problem/Impact Statement: Patients falls with injury remains an elusive problem at MMC. Over the past 8 quarter, (2016 and 2017) MMC has outperformed 3 of the last 8 Quarters of data. The average rate for the past 8 quarters is .57/1000 patient days with the mean benchmark of .54/per 1000 patient days. MH has determined a focus goal for all the MH hospitals to be below .70/MH 100 patient days as a goal for falls with injury. MMC having the largest volume must be below NDNQI mean to drive this change as the .70 is the average of all MH hospitals. A fall with injury costs on Average cost of a fall with injury is $14,000., more importantly the cost to the patient may be an increase in hospital stay, and increase in level of care. Injuries range from lacerations to fractures and head trauma and death. Approximately 50% of all falls incur an injury. Putting interventions in place to decrease total falls will decrease injuries at MMC

Sex differences in wild-type transthyretin amyloidosis: An analysis from the Transthyretin Amyloidosis Outcomes Survey (THAOS)

INTRODUCTION: Wild-type transthyretin amyloidosis (ATTRwt amyloidosis) is a progressive disease resulting from the accumulation of wild-type transthyretin (TTR) amyloid fibrils, and is diagnosed primarily in males. This analysis examined sex differences in patients with ATTRwt amyloidosis from the Transthyretin Amyloidosis Outcomes Survey (THAOS). METHODS: THAOS is an ongoing, global, longitudinal, observational survey of patients with transthyretin amyloidosis, including both inherited and wild-type disease, and asymptomatic carriers of TTR mutations. THAOS data were analyzed to identify potential differences in demographic and clinical characteristics between males and females with ATTRwt amyloidosis (data cutoff: August 1, 2021). RESULTS: Of 1386 patients with ATTRwt amyloidosis, 84 (6%) were female and 1302 (94%) were male. Females had a higher median age at enrollment (80 vs. 78 years; p = 0.002) and symptom onset (75 vs. 73 years; p = 0.045) than males. Mean left ventricular (LV) ejection fraction was higher (53% vs. 48%; p = 0.001) and mean LV diastolic diameter lower (42 vs. 46 mm; p \u3c 0.001) in females versus males, but sex was not identified as a predictor of LV mean wall thickness adjusted for height (beta coefficient - 0.22; p = 0.460) or a predominantly cardiac phenotype (odds ratio 1.60; p = 0.191). Modified polyneuropathy disability scores differed between groups (p \u3c 0.001), with a larger proportion of scores ≥ IIIa among females (23% vs. 7%). CONCLUSIONS: Females with ATTRwt amyloidosis in THAOS tended to present at a later age and showed signs of less severe cardiac impairment and more severe walking impairment. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00628745

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant recipients

Background Kidney transplantation is the therapy of choice for many patients with end‐stage kidney disease (ESKD) with an improvement in survival rates and satisfactory short term graft survival. However, there has been little improvement in long‐term survival. The place of target of rapamycin inhibitors (TOR‐I) (sirolimus, everolimus), which have different modes of action from other commonly used immunosuppressive agents, in kidney transplantation remains uncertain. This is an update of a review first published in 2006. Objectives To evaluate the short and long‐term benefits and harms of TOR‐I (sirolimus and everolimus) when used in primary immunosuppressive regimens for kidney transplant recipients. Search methods We searched the Cochrane Kidney and Transplant Register of Studies up to 20 September 2019 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register were identified through searches of CENTRAL, MEDLINE and EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov. Selection criteria All randomised controlled trials (RCTs) and quasi‐RCTs in which drug regimens, containing TOR‐I commenced within seven days of transplant, were compared to alternative drug regimens, were included without age restriction, dosage or language of report. Data collection and analysis Three authors independently assessed study eligibility, risk of bias, and extracted data. Results were reported as risk ratios (RR) with 95% confidence intervals (CI) for dichotomous outcomes and mean difference (MD) with 95% CI for continuous outcomes. Statistical analyses were performed using the random‐effects model. The certainty of the evidence was assessed using GRADE Main results Seventy studies (17,462 randomised participants) were included; eight studies included two comparisons to provide 78 comparisons. Outcomes were reported at six months to three years post transplant. Risk of bias was judged to be low for sequence generation in 25 studies, for allocation concealment in 23 studies, performance bias in four studies, detection bias in 65 studies, attrition bias in 45 studies, selective reporting bias in 48 studies, and for other potential bias in three studies. Risk of bias was judged to be at high risk of bias for sequence generation in two studies, allocation concealment in two studies, performance bias in 61 studies, detection bias in one study, attrition bias in four studies, for selective reporting bias in 11 studies and for other potential risk of bias in 46 studies. Compared with CNI and antimetabolite, TOR‐I with antimetabolite probably makes little or no difference to death (RR 1.31, 95% CI 0.87 to 1.98; 19 studies) or malignancies (RR 0.86, 95% CI 0.50 to 1.48; 10 studies); probably increases graft loss censored for death (RR 1.32, 95% CI 0.96 to 1.81; 15 studies), biopsy‐proven acute rejection (RR 1.60, 95% CI 1.25 to 2.04; 15 studies), need to change treatment (RR 2.42, 95% CI 1.88 to 3.11; 14 studies) and wound complications (RR 2.56, 95% CI 1.94 to 3.36; 12 studies) (moderate certainty evidence); but reduces CMV infection (RR 0.43, 95% CI 0.29 to 0.63; 13 studies) (high certainty evidence). Compared with antimetabolites and CNI, TOR‐I with CNI probably makes little or no difference to death (RR 1.06, 95% CI 0.84 to 1.33; 31 studies), graft loss censored for death (RR 1.09, 95% CI 0.82 to 1.45; 26 studies), biopsy‐proven acute rejection (RR 0.95, 95% CI 0.81 to 1.12; 24 studies); and malignancies (RR 0.83, 95% CI 0.64 to 1.07; 17 studies); probably increases the need to change treatment (RR 1.56, 95% CI 1.28 to 1.90; 25 studies), and wound complications (RR 1.56, 95% CI 1.28 to 1.91; 17 studies); but probably reduces CMV infection (RR 0.44, 95% CI 0.34 to 0.58; 25 studies) (moderate certainty evidence). Lower dose TOR‐I and standard dose CNI compared with higher dose TOR‐I and reduced dose CNI probably makes little or no difference to death (RR 1.07, 95% CI 0.64 to 1.78; 9 studies), graft loss censored for death (RR 1.09, 95% CI 0.54 to 2.20; 8 studies), biopsy‐proven acute rejection (RR 0.87, 95% CI 0.67 to 1.13; 8 studies), and CMV infection (RR 1.42, 95% CI 0.78 to 2.60; 5 studies) (moderate certainty evidence); and may make little or no difference to wound complications (RR 0.95, 95% CI 0.53 to 1.71; 3 studies), malignancies (RR 1.04, 95% CI 0.36 to 3.04; 7 studies), and the need to change treatments (RR 1.18, 95% CI 0.58 to 2.42; 5 studies) (low certainty evidence). Lower dose of TOR‐I compared with higher doses probably makes little or no difference to death (RR 0.84, 95% CI 0.67 to 1.06; 13 studies), graft loss censored for death (RR 0.92, 95% CI 0.71 to 1.19; 12 studies), biopsy‐proven acute rejection (RR 1.26, 95% CI 1.10 to 1.43; 11 studies), CMV infection (RR 0.87, 95% CI 0.63 to 1.21; 9 studies), wound complications (RR 0.92, 95% CI 0.66 to 1.29; 7 studies), and malignancy (RR 0.84, 95% CI 0.54 to 1.32; 10 studies) (moderate certainty evidence); and may make little or no difference to the need to change treatments (RR 0.91, 95% CI 0.78 to 1.05; 10 studies) (low certainty evidence). It is uncertain whether sirolimus and everolimus differ in their effects on kidney function and lipid levels because the certainty of the evidence is very low based on a single small study with only three months of follow‐up. Authors' conclusions In studies with follow‐up to three years, TOR‐I with an antimetabolite increases the risk of graft loss and acute rejection compared with CNI and an antimetabolite. TOR‐I with CNI potentially offers an alternative to an antimetabolite with CNI as rates of graft loss and acute rejection are similar between interventions and TOR‐I regimens are associated with a reduced risk of CMV infections. Wound complications and the need to change immunosuppressive medications are higher with TOR‐I regimens. While further new studies are not required, longer‐term follow‐up data from participants in existing methodologically robust RCTs are needed to determine how useful immunosuppressive regimens, which include TOR‐I, are in maintaining kidney transplant function and survival beyond three years

Association of Triglyceride-Lowering LPL Variants and LDL-C-Lowering LDLR Variants With Risk of Coronary Heart Disease.

IMPORTANCE: Triglycerides and cholesterol are both carried in plasma by apolipoprotein B (ApoB)-containing lipoprotein particles. It is unknown whether lowering plasma triglyceride levels reduces the risk of cardiovascular events to the same extent as lowering low-density lipoprotein cholesterol (LDL-C) levels. OBJECTIVE: To compare the association of triglyceride-lowering variants in the lipoprotein lipase (LPL) gene and LDL-C-lowering variants in the LDL receptor gene (LDLR) with the risk of cardiovascular disease per unit change in ApoB. DESIGN, SETTING, AND PARTICIPANTS: Mendelian randomization analyses evaluating the associations of genetic scores composed of triglyceride-lowering variants in the LPL gene and LDL-C-lowering variants in the LDLR gene, respectively, with the risk of cardiovascular events among participants enrolled in 63 cohort or case-control studies conducted in North America or Europe between 1948 and 2017. EXPOSURES: Differences in plasma triglyceride, LDL-C, and ApoB levels associated with the LPL and LDLR genetic scores. MAIN OUTCOMES AND MEASURES: Odds ratio (OR) for coronary heart disease (CHD)-defined as coronary death, myocardial infarction, or coronary revascularization-per 10-mg/dL lower concentration of ApoB-containing lipoproteins. RESULTS: A total of 654 783 participants, including 91 129 cases of CHD, were included (mean age, 62.7 years; 51.4% women). For each 10-mg/dL lower level of ApoB-containing lipoproteins, the LPL score was associated with 69.9-mg/dL (95% CI, 68.1-71.6; P = 7.1 × 10-1363) lower triglyceride levels and 0.7-mg/dL (95% CI, 0.03-1.4; P = .04) higher LDL-C levels; while the LDLR score was associated with 14.2-mg/dL (95% CI, 13.6-14.8; P = 1.4 × 10-465) lower LDL-C and 1.9-mg/dL (95% CI, 0.1-3.9; P = .04) lower triglyceride levels. Despite these differences in associated lipid levels, the LPL and LDLR scores were associated with similar lower risk of CHD per 10-mg/dL lower level of ApoB-containing lipoproteins (OR, 0.771 [95% CI, 0.741-0.802], P = 3.9 × 10-38 and OR, 0.773 [95% CI, 0.747-0.801], P = 1.1 × 10-46, respectively). In multivariable mendelian randomization analyses, the associations between triglyceride and LDL-C levels with the risk of CHD became null after adjusting for differences in ApoB (triglycerides: OR, 1.014 [95% CI, 0.965-1.065], P = .19; LDL-C: OR, 1.010 [95% CI, 0.967-1.055], P = .19; ApoB: OR, 0.761 [95% CI, 0.723-0.798], P = 7.51 × 10-20). CONCLUSIONS AND RELEVANCE: Triglyceride-lowering LPL variants and LDL-C-lowering LDLR variants were associated with similar lower risk of CHD per unit difference in ApoB. Therefore, the clinical benefit of lowering triglyceride and LDL-C levels may be proportional to the absolute change in ApoB.Dr. Ference is supported by the National Institute for Health Research Cambridge Biomedical Research Centre at the Cambridge University Hospitals NHS Foundation Trust. Dr. Clare Oliver-Williams is supported by Homerton College, University of Cambridge. Dr. Butterworth is supported by the European Research Council. Dr Danesh is supported by the Medical Research Council, British Heart Foundation, and the National Institute for Health Research

Small-Scale and Global Dynamos and the Area and Flux Distributions of Active Regions, Sunspot Groups, and Sunspots: A Multi-Database Study

In this work we take advantage of eleven different sunspot group, sunspot, and active region databases to characterize the area and flux distributions of photospheric magnetic structures. We find that, when taken separately, different databases are better fitted by different distributions (as has been reported previously in the literature). However, we find that all our databases can be reconciled by the simple application of a proportionality constant, and that, in reality, different databases are sampling different parts of a composite distribution. This composite distribution is made up by linear combination of Weibull and log-normal distributions -- where a pure Weibull (log-normal) characterizes the distribution of structures with fluxes below (above) $10^{21}$Mx ($10^{22}$Mx). We propose that this is evidence of two separate mechanisms giving rise to visible structures on the photosphere: one directly connected to the global component of the dynamo (and the generation of bipolar active regions), and the other with the small-scale component of the dynamo (and the fragmentation of magnetic structures due to their interaction with turbulent convection). Additionally, we demonstrate that the Weibull distribution shows the expected linear behavior of a power-law distribution (when extended into smaller fluxes), making our results compatible with the results of Parnell et al. (2009)

Effect of an Injury Awareness Education Program on Risk-Taking Behaviors and Injuries in Juvenile Justice Offenders: A Retrospective Cohort Study

Background Risk-taking behavior is a leading cause of injury and death amongst young people. Methodology and Principal Findings This was a retrospective cohort study on the effectiveness of a 1-day youth injury awareness education program (Prevent Alcohol and Risk-related Trauma in Youth, P.A.R.T.Y.) program in reducing risk taking behaviors and injuries of juvenille justice offenders in Western Australia. Of the 3659 juvenile justice offenders convicted by the court magistrates between 2006 and 2010, 225 were referred to the P.A.R.T.Y. education program. In a before and after survey of these 225 participants, a significant proportion of them stated that they were more receptive to modifying their risk-taking behavior (21% before vs. 57% after). Using data from the Western Australia Police and Department of Health, the incidence of subsequent offences and injuries of all juvenile justice offenders was assessed. The incidence of subsequent traffic or violence-related offences was significantly lower for those who had attended the program compared to those who did not (3.6% vs. 26.8%; absolute risk reduction [ARR] = 23.2%, 95% confidence interval [CI] 19.9%–25.8%; number needed to benefit = 4.3, 95%CI 3.9–5.1; p = 0.001), as were injuries leading to hospitalization (0% vs. 1.6% including 0.2% fatality; ARR = 1.6%, 95%CI 1.2%–2.1%) and alcohol or drug-related offences (0% vs. 2.4%; ARR 2.4%, 95%CI 1.9%–2.9%). In the multivariate analysis, only P.A.R.T.Y. education program attendance (odds ratio [OR] 0.10, 95%CI 0.05–0.21) and a higher socioeconomic background (OR 0.97 per decile increment in Index of Relative Socioeconomic Advantage and Disadvantage, 95%CI 0.93–0.99) were associated with a lower risk of subsequent traffic or violence-related offences. Significance Participation in an injury education program involving real-life trauma scenarios was associated with a reduced subsequent risk of committing violence- or traffic-related offences, injuries, and death for juvenille justice offenders