Positive Models in Literature for the At-Risk Student

It has been found that most at-risk students have a very low self-esteem, which contributes to the sense of failure these students feel about their academic life. This study explored the use of bibliotherapy with secondary students in an effort to raise their self-esteem to a level which would counteract the frustration these students feel as they continually find themselves in failing situations in school. Extensive review of available literature on the topics of self-esteem, motivation, at-risk students, and bibliotherapy resulted in the compilation of an annotated bibliography, complete with suggested uses for the works found therein, selected for the secondary student, with the understanding that at-risk students often function academically below grade level

Theta characteristics and the fixed locus of [-1] on some varieties of Kummer type

We study some combinatorial aspects of the fixed loci of symplectic involutions acting on hyperk\"ahler varieties of Kummer type. Given an abelian surface $A$ with a $(1,d)$-polarization $L$, there is an isomorphism $K_{d-1}A\cong K_{\hat{A}}(0,\hat{l},-1)$ between a hyperk\"ahler of Kummer type that parametrizes length $d$ points on $A$ and one that parametrizes degree $d-1$ line bundles supported on curves in $|\hat{L}|$, where $\hat{L}$ is a $(1,d)$-polarization on $\hat{A}$. We examine the bijection this isomorphism gives between isolated points in the fixed loci of $[-1_A]$ when $d$ is odd, which has a combinatorics related to theta characteristics. Along the way, we give numerical values for a formula of \cite{KMO} counting the number of components of a symplectic involution acting on a Kummer-type variety.Comment: 22 pages, 2 figure

A novel 3D human glioblastoma cell culture system for modeling drug and radiation responses

Background. Glioblastoma (GBM) is the most common primary brain tumor, with dismal prognosis. The failure of drug–radiation combinations with promising preclinical data to translate into effective clinical treatments may relate to the use of simplified 2-dimensional in vitro GBM cultures. Methods. We developed a customized 3D GBM culture system based on a polystyrene scaffold (Alvetex) that recapitulates key histological features of GBM and compared it with conventional 2D cultures with respect to their response to radiation and to molecular targeted agents for which clinical data are available. Results. In 3 patient-derived GBM lines, no difference in radiation sensitivity was observed between 2D and 3D cultures, as measured by clonogenic survival. Three different molecular targeted agents, for which robust clinical data are available were evaluated in 2D and 3D conditions: (i) temozolomide, which improves overall survival and is standard of care for GBM, exhibited statistically significant effects on clonogenic survival in both patient-derived cell lines when evaluated in the 3D model compared with only one cell line in 2D cells; (ii) bevacizumab, which has been shown to increase progression-free survival when added to standard chemoradiation in phase III clinical trials, exhibited marked radiosensitizing activity in our 3D model but had no effect on 2D cells; and (iii) erlotinib, which had no efficacy in clinical trials, displayed no activity in our 3D GBM model, but radiosensitized 2D cells. Conclusions. Our 3D model reliably predicted clinical efficacy, strongly supporting its clinical relevance and potential value in preclinical evaluation of drug–radiation combinations for GBM

Improving Our Reference Data, or How We Killed the Hash Mark

All responsible academic libraries record their reference transactions. It is good practice to know how many patrons have been helped at your service points. For years we have participated in this record keeping with hash marks on paper, painstaking tallying, and manual spreadsheet entry for the purpose of saying, “we helped X patrons during Y month”. But, like most things academic, reference runs on its own calendar and requires more sophisticated tools to truly investigate and evaluate. To generate more useful reference statistics, we created a simple, online tool for recording reference interactions. The tool is accessible anywhere reference is taking place, generating normalized data in a centralized, backed up database. This design allows for more nuanced and granular analysis, in addition to streamlining the reporting process at a later date. Development of the tool has been iterative, soliciting feedback from primary users, including graduate students and librarians. A key part of this process was our decision to build a tool as opposed to purchasing a pre-made one. Our need to better understand our reference staffing needs was key, and a variety of commercial tools tout this ability. However, the barriers to developing such a tool in-house have dramatically lowered, making the creation of web-based tools more common. Similarly, the tool itself uses existing library infrastructure, as it is a simple web form and hooks into an existing database, so infrastructure changes were nil. With a custom-built tool, we have total control over its functionality and reporting. This presentation will discuss the full development and implementation of the new reference statistics tool, along with the data we have collected and the trends we have observed from the first six months of its use

Mitigating Disparities in Community HIV Testing among Youth and Young Adults

Prevention strategies are a key lever for reducing HIV incidence, which differentially affects jurisdictions. HIV incidence coexists with social determinants of health, health-related disparities, poverty, and other risk factors. One zip code in Jacksonville, Florida’s urban core fit the description of a disadvantaged jurisdiction; hence, the local HIV prevention consortia implemented a theory-based, social outreach HIV prevention event, which attracted 189 residents and 64 tested for HIV. Survey data from 120 respondents indicated that event attendees viewed the event’s prevention activities and the supporting entertainment music favorably. Respondents liked the emphases on healthy behaviors, health education, and community capacity to address HIV; but they disliked the outdoor heat and the small turnout; therefore, they recommended hosting future events indoors and doing more advertising. Some respondents even volunteered to assist in planning future events. Logistic regression examined odds ratios for five dichotomous outcome variables cross-tabbed by race, comparing null and saturated models. None of the odds ratios were significant, indicating respondent’s consensus on event feedback. Going forward, event planners aim to implement feedback received from participants; attract a large fan base, and increase the sample size from 120 to 263, so the margin of error is 6.0% rather than 8.92%

Operative vs Nonoperative Management of Unstable Medial Malleolus Fractures:A Randomized Clinical Trial

IMPORTANCE: Unstable ankle fractures are routinely managed operatively. However, because of soft tissue and implant-related complications, recent literature has reported on the nonoperative management of well-reduced medial malleolus fractures after fibular stabilization, but with limited evidence supporting the routine application.OBJECTIVE: To assess the superiority of internal fixation of well-reduced (displacement ≤2 mm) medial malleolus fractures compared with nonfixation after fibular stabilization.DESIGN, SETTING, AND PARTICIPANTS: This superiority, pragmatic, parallel, prospective randomized clinical trial was conducted from October 1, 2017, to August 31, 2021. A total of 154 adult participants (≥16 years) with a closed, unstable bimalleolar or trimalleolar ankle fracture requiring surgery at an academic major trauma center in the UK were assessed. Exclusion criteria included injuries with no medial-sided fracture, open fractures, neurovascular injury, and the inability to comply with follow-up. Data analysis was performed in July 2022 and confirmed in September 2023.INTERVENTIONS: Once the lateral (and where appropriate, posterior) malleolus had been fixed and satisfactory intraoperative reduction of the medial malleolus fracture was confirmed by the operating surgeon, participants were randomly allocated to fixation (n = 78) or nonfixation (n = 76) of the medial malleolus.MAIN OUTCOME AND MEASURE: Olerud-Molander Ankle Score (OMAS) 1 year after randomization (range, 0-100 points, with 0 indicating worst possible outcome and 100 indicating best possible outcome).RESULTS: Among 154 randomized participants (mean [SD] age, 56.5 [16.7] years; 119 [77%] female), 144 (94%) completed the trial. At 1 year, the median OMAS was 80.0 (IQR, 60.0-90.0) in the fixation group compared with 72.5 (IQR, 55.0-90.0) in the nonfixation group (P = .17). Complication rates were comparable. Significantly more patients in the nonfixation group developed a radiographic nonunion (20% vs 0%; P &lt; .001), with 8 of 13 clinically asymptomatic; 1 patient required surgical reintervention for this. Fracture type and reduction quality appeared to influence fracture union and patient outcome.CONCLUSIONS AND RELEVANCE: In this randomized clinical trial comparing internal fixation of well-reduced medial malleolus fractures with nonfixation, after fibular stabilization, fixation was not superior according to the primary outcome. However, 1 in 5 patients developed a radiographic nonunion after nonfixation, and although the reintervention rate to manage this was low, the future implications are unknown. These results support selective nonfixation of anatomically reduced medial malleolar fractures after fibular stabilization.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03362229.</p

Comparison of screening strategies to improve the diagnosis of latent tuberculosis infection in the HIV-positive population: a cohort study

Background HIV is the most important risk factor for progression of latent tuberculosis infection (LTBI) to active tuberculosis (TB). Detection and treatment of LTBI is necessary to reduce the increasing burden of TB in the UK, but a unified LTBI screening approach has not been adopted. Objective To compare the effectiveness of a TB risk-focused approach to LTBI screening in the HIV-positive population against current UK National Institute for Health and Clinical Excellence (NICE) guidance. Design Prospective cohort study. Setting Two urban HIV treatment centres in London, UK. Participants 114 HIV-infected individuals with defined TB risk factors were enrolled prospectively as part of ongoing studies into HIV and TB co-infection. Outcome measures The yield and case detection rate of LTBI cases within the research study were compared with those generated by the NICE criteria. Results 17/114 (14.9%, 95% CI 8.3 to 21.5) had evidence of LTBI. Limiting screening to those meeting NICE criteria for the general population (n=43) would have detected just over half of these, 9/43 (20.9%, 95% CI 8.3 to 33.5) and those meeting criteria for HIV co-infection (n=74) would only have captured 8/74(10.8%, 95% CI 3.6 to 18.1) cases. The case detection rates from the study and NICE approaches were not significantly different. LTBI was associated with the presence of multiple TB risk factors (p=0.002). Conclusion Adoption of a TB risk-focused screening algorithm that does not use CD4 count stratification could prevent more cases of TB reactivation, without changing the case detection rate. These findings should be used to inform a large-scale study to create unified guidelines