The Impact of Second Step Implementation on Students’ Social-Emotional Skills in an Elementary School Setting

A positive classroom and a positive school environment are needed to best support students, especially those students with major behavioral concerns. The implementation of the Second Step curriculum is one way to support positive student behavior. This study examined the impact of Second Step implementation methods on students’ emotion management skills. Peer-to-peer, small-group teacher intervention, and whole-group implementation groups in kindergarten and fifth-grade classrooms were studied. Data collection methods included observational checklists, a district created formative assessment, and pre- and post-tests created by the Second Step curriculum. The data collected indicated that many students had an accurate understanding of social-emotional learning skills, but they did not implement emotion-management skills consistently. However, students participating in peer-to-peer emotion management teaching were more self-aware and applied emotion management skills more frequently when compared to students receiving small-group and whole-group instruction. Based on these results, peer-to-peer instruction methods are recommended to strengthen Second Step emotion management skill instruction and student self-awareness

A mixed methods study of symptom perception in patients with chronic heart failure

Background,br> Early heart failure (HF) symptoms are frequently unrecognized for reasons that are unclear. We explored symptom perception in patients with chronic HF. Methods We enrolled 36 HF out-patients into a longitudinal sequential explanatory mixed methods study. We used objectively measured thoracic fluid accumulation and daily reports of signs and symptoms to evaluate accuracy of detected changes in fluid retention. Patterns of symptom interpretation and response were explored in telephone interviews conducted every 2 weeks for 3-months. Results In this sample, 44% had a mismatch between objective and subjective fluid retention; younger persons were more likely to have mismatch. In interviews, two patterns were identified: those able to interpret and respond appropriately to symptoms were higher in decision-making skill and the quality of social support received. Conclusion Many HF patients were poor at interpreting and managing their symptoms. These results suggest a subgroup of patients to target for intervention

1327. The Diagnosis of Subarachnoid Neurocysticercosis Is Often Delayed And Other Findings of a Multicenter Retrospective in the USA

Abstract Background Subarachnoid (racemose) neurocysticercosis (SANCC) is an uncommon but severe form of Taenia solium infection. There is limited evidence to guide clinical management of these patients. Methods We performed a multicenter retrospective chart review of 15 U.S. sites. A total of 69 subjects with racemose disease were entered. Results The most common region of exposure was Mexico (67%) followed by Central America (24%). Median age was 43 years (range 15-76) and 71% were male. Common symptoms at the time of index admission were headache (80%), nausea/vomiting (46%), dizziness (44%), and blurry vision (33%). Cysts were intracranial in 64 (93%) subjects and exclusively intraspinal in 4. One patient had meningitis without visible cystic lesions. Incident admission magnetic resonance imaging (MRI) demonstrated ventriculomegaly in 41 (59%) and focal findings in 9 (13%) including ischemic infarct, subarachnoid hemorrhage, and/or arterial aneurysm. For 55 (80%), SANCC was first diagnosed during the index admission. Of these, 23 (42%) had prior medical visits and substantial delay in diagnosis (i.e. previously seen with hydrocephalus [27%], stroke [5.5%], and/or meningitis [11%], missed diagnostic radiologic features [4%], or inadequate imaging [5.5%]). Of the 69 subjects, 54% underwent a neurosurgical procedure during index admission (cyst removal n=16, EVD/shunt/ventriculostomy n=24). At the time of discharge, 6 (8.6%) patients were not given albendazole and/or praziquantel due to cost or availability. Six months following discharge, 4 weeks was associated with increased risk for new cyst development on follow up imaging at a median of 3.8 years following discharge (range 2.6 months-8 years). Those with a delayed diagnosis received a significantly longer duration of corticosteroids (median 8 weeks) than those without a delay (median 5 weeks, p=0.047). Conclusion The diagnosis of SANCC is often missed, and most patients require neurosurgical intervention. Antiparasitic therapy is suboptimal, especially with regimens developed for parenchymal NCC. Disclosures Jeffrey D. Jenks, MD, MPH, Astellas: Grant/Research Support|F2G: Grant/Research Support|Pfizer: Grant/Research Suppor

Comparison of bivalent and monovalent SARS-CoV-2 variant vaccines: the phase 2 randomized open-label COVAIL trial.

Vaccine protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection wanes over time, requiring updated boosters. In a phase 2, open-label, randomized clinical trial with sequentially enrolled stages at 22 US sites, we assessed safety and immunogenicity of a second boost with monovalent or bivalent variant vaccines from mRNA and protein-based platforms targeting wild-type, Beta, Delta and Omicron BA.1 spike antigens. The primary outcome was pseudovirus neutralization titers at 50% inhibitory dilution (ID50 titers) with 95% confidence intervals against different SARS-CoV-2 strains. The secondary outcome assessed safety by solicited local and systemic adverse events (AEs), unsolicited AEs, serious AEs and AEs of special interest. Boosting with prototype/wild-type vaccines produced numerically lower ID50 titers than any variant-containing vaccine against all variants. Conversely, boosting with a variant vaccine excluding prototype was not associated with decreased neutralization against D614G. Omicron BA.1 or Beta monovalent vaccines were nearly equivalent to Omicron BA.1 + prototype or Beta + prototype bivalent vaccines for neutralization of Beta, Omicron BA.1 and Omicron BA.4/5, although they were lower for contemporaneous Omicron subvariants. Safety was similar across arms and stages and comparable to previous reports. Our study shows that updated vaccines targeting Beta or Omicron BA.1 provide broadly crossprotective neutralizing antibody responses against diverse SARS-CoV-2 variants without sacrificing immunity to the ancestral strain. ClinicalTrials.gov registration: NCT05289037

Comparison of bivalent and monovalent SARS-CoV-2 variant vaccines: the phase 2 randomized open-label COVAIL trial.

Acknowledgements: We thank all the participants in this trial; the members of the safety monitoring committee (K. Talaat, J. Treanor, G. Paulsen and D. Stablein), who provided thoughtful discussions resulting in the early trial design; and staff members at Moderna, Pfizer and Sanofi–GSK for their collaboration, scientific input and sharing of documents needed to implement the trial. The COVAIL trial has been funded in part with federal funds from the NIAID and the National Cancer Institute, NIH, under contract HHSN261200800001E 75N910D00024, task order no. 75N91022F00007, and in part by the Office of the Assistant Secretary for Preparedness and Response, Biomedical Advanced Research and Development Authority, under Government Contract no. 75A50122C00008 with Monogram Biosciences, LabCorp. This work was also supported in part with federal funds from the NIAID, NIH, under contract no. 75N93021C00012, and by the Infectious Diseases Clinical Research Consortium (IDCRC) through the NIAID, under award no. UM1AI148684. D.J.S., A.N., S.H.W. and S.T. were supported by the NIH—NIAID Centers of Excellence for Influenza Research and Response (CEIRR) contract no. 75N93021C00014 as part of the SAVE program. D.C.M. and A.E. were supported by the NIAID Collaborative Influenza Vaccine Innovation Centers (CIVICs) contract no. 75N93019C00050. Testing of neutralizing antibody titers by Monogram Biosciences, LabCorp has been funded in part with federal funds from the Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response, Biomedical Advanced Research and Development Authority, under contract no. 75A50122C00008. Testing for anti-N-specific antibody was conducted by Cerba Research under contract no. 75N93021D00021. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the NIH—NIAID.Vaccine protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection wanes over time, requiring updated boosters. In a phase 2, open-label, randomized clinical trial with sequentially enrolled stages at 22 US sites, we assessed safety and immunogenicity of a second boost with monovalent or bivalent variant vaccines from mRNA and protein-based platforms targeting wild-type, Beta, Delta and Omicron BA.1 spike antigens. The primary outcome was pseudovirus neutralization titers at 50% inhibitory dilution (ID50 titers) with 95% confidence intervals against different SARS-CoV-2 strains. The secondary outcome assessed safety by solicited local and systemic adverse events (AEs), unsolicited AEs, serious AEs and AEs of special interest. Boosting with prototype/wild-type vaccines produced numerically lower ID50 titers than any variant-containing vaccine against all variants. Conversely, boosting with a variant vaccine excluding prototype was not associated with decreased neutralization against D614G. Omicron BA.1 or Beta monovalent vaccines were nearly equivalent to Omicron BA.1 + prototype or Beta + prototype bivalent vaccines for neutralization of Beta, Omicron BA.1 and Omicron BA.4/5, although they were lower for contemporaneous Omicron subvariants. Safety was similar across arms and stages and comparable to previous reports. Our study shows that updated vaccines targeting Beta or Omicron BA.1 provide broadly crossprotective neutralizing antibody responses against diverse SARS-CoV-2 variants without sacrificing immunity to the ancestral strain. ClinicalTrials.gov registration: NCT05289037