Effects of State-Level Funding Systems on Identification Rates of Students with Autism Spectrum Disorders

Identification rates of children with autism spectrum disorders (ASD) have been increasing since the year 2000, while federal special education funding has remained stagnant. Researchers gathered data from states related to individual state funding systems, per pupil spending and identification rates of students with ASD to determine if state spending or special education funding methods affected identification rates of students with ASD. While specific funding methodology did not predict rates of identification or PPS, a correlational analysis of individual state PPS and ASD identification rates did have significant results. Spending amounts per pupil corresponded to rates of identification for ASD

Case Study: Unilateral Vocal Cord Paralysis

Patient is an 89-year-old female with a PMH of lung cancer, COPD, AAA, thyroid nodule, bladder cancer, HTN, hypothyroidism presenting to the Emergency Department with a complaint of hoarse voice. Her symptoms started five days prior. She was seen at an urgent care and diagnosed with laryngitis. The shortness of breath is worse when speaking. She denies fever, chills, chest pain, cough, recent URI symptoms, nausea, or vomiting.Vital signs upon arrival were stable. On physical exam the patient was resting comfortably in bed in no distress. Her physical exam was unremarkable with the exception of an airy, hoarse voice.CBC, BMP were unremarkable. Chest x-ray: no areas of acute disease. There was high suspicion for vocal cord paralysis, therefore, bedside laryngoscopy was performed showing left unilateral vocal cord paralysis. CT soft tissue neck and CT chest were then obtained with evidence of a soft tissue focal mass involving the left middle upper lobe/superior left mediastinum.She was diagnosed with unilateral vocal cord paralysis likely related to her mediastinal mass. She was provided with ENT follow-up for further management. She was also instructed to follow-up with her primary care for further management of the mediastinal mass. Discussion: Vocal cords are innervated by the recurrent laryngeal nerve. When this nerve becomes damaged or has mechanical fixation, it causes paralysis of the vocal cords. Symptoms of this include hoarseness, dysphonia, dyspnea, and aspiration. This can be related to malignancy related to the thyroid, lung, esophagus, and/or mediastinum invading the Vagus nerve or recurrent laryngeal nerve. Involvement of the left side is more common than the right because it travels a longer distance in the thoracic cavity through the mediastinal lymph nodes, and around the aortic arch. The most common cause for vocal cord paralysis in females is surgery; malignancy is the most common cause in male. Other factors may also cause vocal cord paralysis, including chronic exposure to heavy metals (arsenic, lead, and mercury), use of the drugs phenytoin and vincristine, history of a connective tissue disorder (such as Marfan syndrome), Lyme disease, sarcoidosis, diabetes, and alcoholism. One study by Toutounchi et al. evaluated the vocal cords with laryngoscopy with a 90-degree telescope as well as full endoscopic examination, CT scan, MRI, barium swallow and thyroid scan. Multiple studies showed greater left side involvement. The most common tumor sites were thyroid and lung tumors. Thyroidectomy and cardiac surgery were the most common surgical reason for vocal cord paralysis. Conclusion: When evaluating a patient with dysphonia, include in the differential diagnosis vocal cord paralysis. Take thorough history and physical exam. Consider the causes of vocal cord paralysis when completing your workup. Remember to ask about personal history of cancer or recent surgery when evaluating patient with dysphonia. Conduct a bedside laryngoscopy. The potential causes of and complications of vocal cord paralysis can life threatening. Provide these patients with Otolaryngology follow up.https://scholarlycommons.henryford.com/merf2019caserpt/1093/thumbnail.jp

Effects of State-Level Funding Systems on Rates of Students Identified as Other Health Impaired

Since 1978, the Education for All Handicapped Children’s Act (now IDEA) committed Congress to provide 40 percent of the average per pupil spending to educate children with disabilities. While states have used a variety of special education funding formulas to attempt to meet the needs of children with disabilities, the funding has never approached the 40 percent benchmark, forcing states to creatively supplement federal dollars. The purpose of this study was to examine the relationship between school funding formulas and identification of students with other health impairment (OHI). The relationship between special education funding formulas and per pupil spending (PPS) was also examined. Results indicated no formula was predictive for identification; however, PPS highly correlated to OHI identification rates. Better understanding of special education funding formulas and how they impact OHI diagnosis frequency and per pupil spending (PPS) is important for special education policymakers at the state and federal levels

Multi-Electron Reduction of Small Molecules by Triiron Reaction Sites

The observation that multi-electron activation of small molecule substrates occurs at polynuclear reaction sites, common to both metalloenzymes and heterogeneous catalysts, has led to the articulation of the polynuclear hypothesis - the idea that the expanded redox reservoir afforded by M-M interactions in polynuclear systems stabilizes multiple oxidation states and facilitates multi-electron transformations. Currently, examples of synthetic clusters that test the viability of polynuclear reaction sites towards effecting multi-electron activation of small molecule substrates are lacking. To test the polynuclear hypothesis, we targeted a system that embodies design elements common to metaloenzyme cofactors: polynuclear reaction sites that feature high-spin, coordinatively unsaturated metal centers. Metallation of tbsLH6 [tbsLH6 = 1,3,5-C6H9(NHC6H4-o-NHSiMe2tBu)3] yields high-spin trinuclear Fe(II) complex (tbsL)Fe3(THF). The filled anti-bonding orbitals in high-spin cluster (tbsL)Fe3(THF) renders ligand reorganization facile, which allows for a range of metal-substrate binding modes. The polynuclear site within the (tbsL)Fe3(THF) cluster cooperatively binds anionic donors and allows 2e- reduction of substrates including inorganic azide and hydrazines, yielding μ3-nitrido and μ3-imido products, respectively. The 4e- reductive N=N bond cleavage of azobenzene is also achieved in the presence of (tbsL)Fe3(THF) to yield Fe3 bis-imido complex ((tbsL)Fe3(μ3-NPh)(μ2-NPh), which has been structurally characterized. Cyclic voltammograms of a series of selected triiron imido and nitrido clusters suggest that oxidation states up to [Fe(IV)][Fe(III)]2 are electrochemically accessible. Addition of neutral pi-acidic molecules including tert-butylisonitrile (tBuNC) and carbon monoxode (CO) to trinuclear cluster (tbsL)Fe3(THF) led to the formation of a new series of coordination compounds, where binding to a single metal center is favored over cooperative substrate binding. Coordinated substrates are activated toward further reactivity, highlighted by the reductive coupling of isonitriles by (tbsL)Fe3(μ1-CNtBu)3 in the presence of phenylsilane. Finally, efforts to synthesize of a family of mixed Fe-Mn clusters that differ by single metal-site substitutions are presented. Substitutionally homogeneous (tbsL)Fe2Mn(THF) cluster is accessed from binuclear complex (tbsLH2 )Fe2. Attempts to synthesize similar Mn2Fe clusters results in isolation of a mixture of heterotrinuclear species. In conjunction with NMR, EPR, Mössbauer, and X-ray fluorescence spectroscopies, anomalous scattering measurements were critical for the unambiguous assignment of the metal substitution products that were synthesized.Chemistry and Chemical Biolog

The role of sand lances (Ammodytes sp.) in the Northwest Atlantic ecosystem: a synthesis of current knowledge with implications for conservation and management

© The Author(s), 2020. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Staudinger, M. D., Goyert, H., Suca, J. J., Coleman, K., Welch, L., Llopiz, J. K., Wiley, D., Altman, I., Applegate, A., Auster, P., Baumann, H., Beaty, J., Boelke, D., Kaufman, L., Loring, P., Moxley, J., Paton, S., Powers, K., Richardson, D., Robbins, J., Runge, J., Smith, B., Spiegel, C., & Steinmetz, H. The role of sand lances (Ammodytes sp.) in the Northwest Atlantic ecosystem: a synthesis of current knowledge with implications for conservation and management. Fish and Fisheries, 00, (2020): 1-34, doi:10.1111/faf.12445.The American sand lance (Ammodytes americanus, Ammodytidae) and the Northern sand lance (A. dubius, Ammodytidae) are small forage fishes that play an important functional role in the Northwest Atlantic Ocean (NWA). The NWA is a highly dynamic ecosystem currently facing increased risks from climate change, fishing and energy development. We need a better understanding of the biology, population dynamics and ecosystem role of Ammodytes to inform relevant management, climate adaptation and conservation efforts. To meet this need, we synthesized available data on the (a) life history, behaviour and distribution; (b) trophic ecology; (c) threats and vulnerabilities; and (d) ecosystem services role of Ammodytes in the NWA. Overall, 72 regional predators including 45 species of fishes, two squids, 16 seabirds and nine marine mammals were found to consume Ammodytes. Priority research needs identified during this effort include basic information on the patterns and drivers in abundance and distribution of Ammodytes, improved assessments of reproductive biology schedules and investigations of regional sensitivity and resilience to climate change, fishing and habitat disturbance. Food web studies are also needed to evaluate trophic linkages and to assess the consequences of inconsistent zooplankton prey and predator fields on energy flow within the NWA ecosystem. Synthesis results represent the first comprehensive assessment of Ammodytes in the NWA and are intended to inform new research and support regional ecosystem‐based management approaches.This manuscript is the result of follow‐up work stemming from a working group formed at a two‐day multidisciplinary and international workshop held at the Parker River National Wildlife Refuge, Massachusetts in May 2017, which convened 55 experts scientists, natural resource managers and conservation practitioners from 15 state, federal, academic and non‐governmental organizations with interest and expertise in Ammodytes ecology. Support for this effort was provided by USFWS, NOAA Stellwagen Bank National Marine Sanctuary, U.S. Department of the Interior, U.S. Geological Survey, Northeast Climate Adaptation Science Center (Award # G16AC00237), an NSF Graduate Research Fellowship to J.J.S., a CINAR Fellow Award to J.K.L. under Cooperative Agreement NA14OAR4320158, NSF award OCE‐1325451 to J.K.L., NSF award OCE‐1459087 to J.A.R, a Regional Sea Grant award to H.B. (RNE16‐CTHCE‐l), a National Marine Sanctuary Foundation award to P.J.A. (18‐08‐B‐196) and grants from the Mudge Foundation. The contents of this paper are the responsibility of the authors and do not necessarily represent the views of the National Oceanographic and Atmospheric Administration, U.S. Fish and Wildlife Service, New England Fishery Management Council and Mid‐Atlantic Fishery Management Council. This manuscript is submitted for publication with the understanding that the United States Government is authorized to reproduce and distribute reprints for Governmental purposes. Any use of trade, firm or product names is for descriptive purposes only and does not imply endorsement by the U.S. Government

The efficacy of vigorous-intensity exercise as an aid to smoking cessation in adults with elevated anxiety sensitivity: study protocol for a randomized controlled trial

Background: Although cigarette smoking is a leading cause of death and disability in the United States (US), over 40 million adults in the US currently smoke. Quitting smoking is particularly difficult for smokers with certain types of psychological vulnerability. Researchers have frequently called attention to the relation between smoking and anxiety-related states and disorders, and evidence suggests that panic and related anxiety vulnerability factors, specifically anxiety sensitivity (AS or fear of somatic arousal), negatively impact cessation. Accordingly, there is merit to targeting AS among smokers to improve cessation outcome. Aerobic exercise has emerged as a promising aid for smoking cessation for this high-risk (for relapse) group because exercise can effectively reduce AS and other factors predicting smoking relapse (for example, withdrawal, depressed mood, anxiety), and it has shown initial efficacy for smoking cessation. The current manuscript presents the rationale, study design and procedures, and design considerations of the Smoking Termination Enhancement Project (STEP). Methods: STEP is a randomized clinical trial that compares a vigorous-intensity exercise intervention to a health and wellness education intervention as an aid for smoking cessation in adults with elevated AS. One hundred and fifty eligible participants will receive standard treatment (ST) for smoking cessation that includes cognitive behavioral therapy (CBT) and nicotine replacement therapy (NRT). In addition, participants will be randomly assigned to either an exercise intervention (ST+EX) or a health and wellness education intervention (ST+CTRL). Participants in both arms will meet 3 times a week for 15 weeks, receiving CBT once a week for the first 7 weeks, and 3 supervised exercise or health and wellness education sessions (depending on randomization) per week for the full 15-week intervention. Participants will be asked to set a quit date for 6 weeks after the baseline visit, and smoking cessation outcomes as well as putative mediator variables will be measured up to 6 months following the quit date. Discussion: The primary objective of STEP is to evaluate whether vigorous-intensity exercise can aid smoking cessation in anxiety vulnerable adults. If effective, the use of vigorous-intensity exercise as a component of smoking cessation interventions would have a significant public health impact. Specifically, in addition to improving smoking cessation treatment outcome, exercise is expected to offer benefits to overall health, which may be particularly important for smokers. The study is also designed to test putative mediators of the intervention effects and therefore has the potential to advance the understanding of exercise-anxiety-smoking relations and guide future research on this topic

Charge-transfer character in a covalent diketopyrrolopyrrole dimer: implications for singlet fission

Diketopyrrolopyrrole (DPP) is a strongly absorbing, photostable chromophore that can undergo singlet fission (SF), a photophysical process that promises to significantly enhance solar‐cell performance. In the solid state, DPP packs in a herringbone arrangement that maximizes intermolecular donor–acceptor interactions, suggesting that charge‐transfer (CT) states play a role in DPP SF. In order to characterize intermolecular DPP CT states in molecular assemblies, we have synthesized a covalent DPP dimer bridged by a xanthene linker, which places two thiophene‐substituted DPPs (TDPPs) in a cofacial arrangement that mimics chromophore π–π stacking in the thin film. After photoexcitation in polar solvents, symmetry‐breaking charge separation forms the fully charge separated TDPP+.–TDPP−. ion‐pair state. In nonpolar solvents, charge separation is incomplete leading to the TDPPδ+–TDPPδ− CT state, which is in pseudoequilibrium with the relaxed S1S0 state observed by transient absorption and emission spectroscopy. This study highlights the importance of intramolecular coupling as well as the importance of entropy to promoting SF in chromophore dimers for which SF is endo‐ or isoergic

MUC1 mucin stabilizes and activates hypoxia-inducible factor 1 alpha to regulate metabolism in pancreatic cancer

Aberrant glucose metabolism is one of the hallmarks of cancer that facilitates cancer cell survival and proliferation. Here, we demonstrate that MUC1, a large, type I transmembrane protein that is overexpressed in several carcinomas including pancreatic adenocarcinoma, modulates cancer cell metabolism to facilitate growth properties of cancer cells. MUC1 occupies the promoter elements of multiple genes directly involved in glucose metabolism and regulates their expression. Furthermore, MUC1 expression enhances glycolytic activity in pancreatic cancer cells. We also demonstrate that MUC1 expression enhances in vivo glucose uptake and expression of genes involved in glucose uptake and metabolism in orthotopic implantation models of pancreatic cancer. The MUC1 cytoplasmic tail is known to activate multiple signaling pathways through its interactions with several transcription factors/coregulators at the promoter elements of various genes. Our results indicate that MUC1 acts as a modulator of the hypoxic response in pancreatic cancer cells by regulating the expression/stability and activity of hypoxia-inducible factor-1α (HIF-1α). MUC1 physically interacts with HIF-1α and p300 and stabilizes the former at the protein level. By using a ChIP assay, we demonstrate that MUC1 facilitates recruitment of HIF-1α and p300 on glycolytic gene promoters in a hypoxia-dependent manner. Also, by metabolomic studies, we demonstrate that MUC1 regulates multiple metabolite intermediates in the glucose and amino acid metabolic pathways. Thus, our studies indicate that MUC1 acts as a master regulator of the metabolic program and facilitates metabolic alterations in the hypoxic environments that help tumor cells survive and proliferate under such conditions

Failure of A Novel, Rapid Antigen and Antibody Combination Test to Detect Antigen-Positive HIV Infection in African Adults with Early HIV Infection

BACKGROUND: Acute HIV infection (prior to antibody seroconversion) represents a high-risk window for HIV transmission. Development of a test to detect acute infection at the point-of-care is urgent. METHODS: Volunteers enrolled in a prospective study of HIV incidence in four African cities, Kigali in Rwanda and Ndola, Kitwe and Lusaka in Zambia, were tested regularly for HIV by rapid antibody test and p24 antigen ELISA. Five subgroups of samples were also tested by the Determine Ag/Ab Combo test 1) Antigen positive, antibody negative (acute infection); 2) Antigen positive, antibody positive; 3) Antigen negative, antibody positive; 4) Antigen negative, antibody negative; and 5) Antigen false positive, antibody negative (HIV uninfected). A sixth group included serial dilutions from a p24 antigen-positive control sample. Combo test results were reported as antigen positive, antibody positive, or both. RESULTS: Of 34 group 1 samples with VL between 5x105 and >1.5x107 copies/mL (median 3.5x106), 1 (2.9%) was detected by the Combo antigen component, 7 (20.6%) others were positive by the Combo antibody component. No group 2 samples were antigen positive by the Combo test (0/18). Sensitivity of the Combo antigen test was therefore 1.9% (1/52, 95% CI 0.0, 9.9). One false positive Combo antibody result (1/30, 3.3%) was observed in group 4. No false-positive Combo antigen results were observed. The Combo antigen test was positive in group 6 at concentrations of 80 pg/mL, faintly positive at 40 and 20 pg/mL, and negative thereafter. The p24 ELISA antigen test remained positive at 5 pg/mL. CONCLUSIONS: Although the antibody component of the Combo test detected antibodies to HIV earlier than the comparison antibody tests used, less than 2% of the cases of antigen-positive HIV infection were detected by the Combo antigen component. The development of a rapid point-of-care test to diagnose acute HIV infection remains an urgent goal