The RAG Model: a new paradigm for genetic risk stratification in multiple myeloma

Molecular studies have shown that multiple myeloma is a highly genetically heterogonous disease which may manifest itself as any number of diverse subtypes each with variable clinicopathological features and outcomes. Given this genetic heterogeneity, a universal approach to treatment of myeloma is unlikely to be successful for all patients and instead we should strive for the goal of personalised therapy using rationally informed targeted strategies. Current DNA sequencing technologies allow for whole genome and exome analysis of patient myeloma samples that yield vast amounts of genetic data and provide a mutational overview of the disease. However, the clinical utility of this information currently lags far behind the sequencing technology which is increasingly being incorporated into clinical practice. This paper attempts to address this shortcoming by proposing a novel genetically based “traffic-light” risk stratification system for myeloma, termed the RAG (Red, Amber, Green) model, which represents a simplified concept of how complex genetic data may be compressed into an aggregate risk score. The model aims to incorporate all known clinically important trisomies, translocations, and mutations in myeloma and utilise these to produce a score between 1.0 and 3.0 that can be incorporated into diagnostic, prognostic, and treatment algorithms for the patient

Allied Forces: The Working Alliance for Meaningful ParentEducator Partnerships in Special Education

Strong parent-educator partnerships in special education yield benefits for parents, teachers and students, however there are often obstacles to the development of these partnerships, and teacher preparation programs and professional development are often deficient in preparing special education teachers for the complexities of this relationship building. In the following, the varied interpretations of parental involvement are explored, followed by a discussion of some of the significant obstacles to strong parent-teacher partnerships in special education classrooms. Authors introduce the working alliance as a solution for framing positive parent-educator relationships. Finally, the three elements of a working alliance are described with an emphasis on the element of the shared bond, and five practical applications are discussed

Winter Site Fidelity of Orange-Crowned Warblers (Oreothlypis celata) in the Lower Rio Grande Valley of Texas

Abstract—We documented between-winter site fidelity of orange-crowned warblers (Oreothlypis celata) in the Lower Rio Grande Valley of Texas, between 2004 and 2017. Overall, we recaptured 13.9% of the 201 banded birds in ‡1 subsequent winter season: 20.8% of the 101 birds banded in urban natural areas, and 7.0% of the 100 banded in rural areas. We recaptured 8 birds ‡3 winters after their initial capture, indicating extended winter site fidelity. Resumen—Documentamos la fidelidad al sitio invernal de los chipes olivaceos (Oreothlypis celata) en el Valle del R´ıo Grande Baja de Texas entre 2004 y 2017. En general, se recaptur ´o el 13.9% de los 201 individuos anillados en al menos una temporada invernal posterior: el 20.8% de los 101 individuos anillados en las areas urbanas naturales, y el 7.0% de los 100 anillados en el ´area rural natural. Recapturamos 8 aves tres o m´as inviernos después de su captura inicial, lo que indica la fidelidad prolongada al sitio invernal

Subspecific and breeding status of the Common Yellowthroat (Geothlypis trichas) at Santa Ana National Wildlife Refuge, Hidalgo County, Texas

ABSTRACT—We confirmed the breeding of the Common Yellowthroat (Geothlypis trichas) during 2008–2015 at Santa Ana National Wildlife Refuge and presented measurement evidence that individuals belong to the Brownsville Common Yellowthroat, Geothlypis trichas insperata. This expands the known breeding distribution for this rare and local subspecies. RESUMEN—Se confirm´o la reproducci´on de la mascarita com´un (Geothlypis trichas) durante 2008-2015 en Santa Ana National Wildlife Refuge y se presentaron pruebas de medici ´on que indican que los individuos pertenecen a la subespecie de mascarita com´un, Geothlypis trichas insperata. Esta informaci´on expande la distribuci´on de reproducci´on conocida de esta subespecie rara y local

Examining School Accountability: Discriminating Schools\u27 A-F Report Card Grades

The COVID-19 pandemic disrupted many school accountability systems that rely on student-level achievement data. Many states encountered uncertainty about how to meet federal accountability requirements without typical school data. Prior research provides evidence that student achievement is correlated to students’ social background, which raises concerns about the predictive bias of accountability systems. This mixed-methods study (a) examines the predictive ability of non-achievement-based variables (i.e., students’ social background) on school districts\u27 report card letter grade in Ohio, and (b) explores educators\u27 perceptions of report card grades. Results suggest that social background and community demographic variables have a significant impact on measures of school accountability

Chronic Environmental Stress and the Temporal Course of Depression and Panic Disorder: A Trait-State-Occasion Modeling Approach

Both acute stressful life events and ongoing strains are thought to confer vulnerability to emotional disorders. Unremitting stressful conditions may be particularly pathogenic, but prior research has struggled to delimit chronic versus transient stressful experiences. We aimed to isolate stable stressors-theorized to be indicators of a latent stress proneness trait-and to examine their effects on the temporal course of depression and panic disorder. We recruited 677 patients diagnosed with an emotional disorder and administered interviews for psychopathology and life stress 3 times over 12-month intervals. Trait-state-occasion modeling revealed that 74% of the variance in life stress was stable over the follow-up period. These stable stressors were associated with a more refractory course of depression and, to a smaller degree, panic disorder over time. In addition, neither gender nor participation in cognitive-behavioral therapy affected the persistence of environmental stress over the study time frame. We discuss implications of these findings for explaining depression recurrence, improving psychological interventions for emotional disorders, and the measurement and evaluation of stress proneness

Immunotherapeutic and pharmacological approaches for the treatment of Alzheimer’s disease

The development of efficacious treatments targeting Alzheimer’s disease (AD) aetiology has been proved an extensive, time consuming task. Currently prescribed therapies, primarily acetylcholinesterase inhibitors such as donepezil and the NMDAreceptor antagonist memantine, concentrate on the improvement of symptoms such as cognitive decline and memory loss, however, do not address the underlying pathology of the condition. More recently, efforts have focused on developing drugs that target the hallmarks of AD, amyloid-β (Aβ) plaques and hyperphosphorylated tau tangles. Many clinical trials focusing on the removal of these proteins are presently ongoing, primarily exploring immunotherapeutic avenues such as the antibody aducanumab (targeting Aβ) and the vaccine AADvac-1 (targeting tau). However, the incomplete understanding of AD progression presents a challenge, and further studies focusing on the development of the disease are essential to the expansion of novel, efficient therapeutic routes

Marjolin\u27s Tumor Complicating Chronic Periprosthetic Infection of a Total Knee Arthroplasty

Marjolin\u27s tumor is a term used to describe a malignancy developing in the setting of a chronic wound, infection, or other tissue subject to chronic inflammatory changes. These malignancies usually present after many years of chronicity, and can range from lower grade basal cell carcinomas to high-grade sarcomas. We present the case of a squamous cell carcinoma that developed within a chronic periprosthetic infection of a total knee arthroplasty of 7 years duration. The intra-articular location, association with an orthopaedic implant, and brief latency period are all unique features of this case

Interstitial nitrides revisited - a simple synthesis of MxMo3N (M = Fe, Co, Ni)

The efficient synthesis of polycrystalline filled beta-Mn structured Ni2Mo3N, and the eta-carbides Fe3Mo3N and Co3Mo3N, by a single heating of metal powders at 975 ºC under a hydrogen-nitrogen mixture is reported. Rietveld analysis of high-resolution X-ray powder diffraction data shows that the reduction-nitridation of NiMoO4 produces Ni2Mo3N and nickel; Ni3Mo3N is not obtained in this way and its existence is disproved