Improving Learning for All Students through Equity-Based Inclusive Reform Practices: Effectiveness of a Fully Integrated Schoolwide Model on Student Reading and Math Achievement

The present investigation examines the Schoolwide Applications Model (SAM) as a potentially effective school reform model for increasing equity-based inclusive education practices while at the same time enhancing student reading and math achievement for all students. A three year quasi-experimental comparison group analysis using Latent Growth Modeling (LGM) was employed with seven urban elementary or elementary/middle schools and seven matched comparison schools in the same district. Results suggest significantly larger growth for experimental school students in math and no statistically significant difference in reading score growth between experimental and comparison schools. However, reading score growth for experimental schools was statistically significant in a post hoc analysis of selected schools. Additional descriptive analysis is presented for three schools that implemented the model with the highest measured fidelity; these schools made improvements on both reading and math scores while those of matching comparison schools decreased

Association of Sperm-Associated Antigen 5 and Treatment Response in Patients With Estrogen Receptor-Positive Breast Cancer

There is no proven test that can guide the optimal treatment, either endocrine therapy or chemotherapy, for estrogen receptor-positive breast cancer. Objective: To investigate the associations of sperm-associated antigen 5 (SPAG5) transcript and SPAG5 protein expressions with treatment response in systemic therapy for estrogen receptor-positive breast cancer. Design, Settings, and Participants: This retrospective cohort study included patients with estrogen receptor-positive breast cancer who received 5 years of adjuvant endocrine therapy with or without neoadjuvant anthracycline-based combination chemotherapy (NACT) derived from 11 cohorts from December 1, 1986, to November 28, 2019. The associations of SPAG5 transcript and SPAG5 protein expression with pathological complete response to NACT were evaluated, as was the association of SPAG5 mRNA expression with response to neoadjuvant endocrine therapy. The associations of distal relapse-free survival with SPAG5 transcript or SPAG5 protein expressions were analyzed. Data were analyzed from September 9, 2015, to November 28, 2019. Main Outcomes and Measures: The primary outcomes were breast cancer-specific survival, distal relapse-free survival, pathological complete response, and clinical response. Outcomes were examined using Kaplan-Meier, multivariable logistic, and Cox regression models. Results: This study included 12 720 women aged 24 to 78 years (mean [SD] age, 58.46 [12.45] years) with estrogen receptor-positive breast cancer, including 1073 women with SPAG5 transcript expression and 361 women with SPAG5 protein expression of locally advanced disease stage IIA through IIIC. Women with SPAG5 transcript and SPAG5 protein expressions achieved higher pathological complete response compared with those without SPAG5 transcript or SPAG5 protein expressions (transcript: odds ratio, 2.45 [95% CI, 1.71-3.51]; P < .001; protein: odds ratio, 7.32 [95% CI, 3.33-16.22]; P < .001). Adding adjuvant anthracycline chemotherapy to adjuvant endocrine therapy for SPAG5 mRNA expression in estrogen receptor-positive breast cancer was associated with prolonged 5-year distal relapse-free survival in patients without lymph node involvement (hazard ratio, 0.34 [95% CI, 0.14-0.87]; P = .03) and patients with lymph node involvement (hazard ratio, 0.35 [95% CI, 0.18-0.68]; P = .002) compared with receiving 5-year endocrine therapy alone. Mean (SD) SPAG5 transcript was found to be downregulated after 2 weeks of neoadjuvant endocrine therapy compared with pretreatment levels in 68 of 92 patients (74%) (0.23 [0.18] vs 0.34 [0.24]; P < .001). Conclusions and Relevance: These findings suggest that SPAG5 transcript and SPAG5 protein expressions could be used to guide the optimal therapies for estrogen receptor-positive breast cancer. Retrospective and prospective clinical trials are warranted

Development and Preliminary Technical Adequacy of Schoolwide Integrated Framework for Transformation Fidelity of Implementation Tool

U.S. public education systems are required to provide free appropriate public education to students with disabilities in least restrictive environments that are appropriate to meet their individual needs. The practice of educating students with disabilities in neighborhood schools in age-appropriate general education classrooms and other school settings to meet this requirement has come to be known as “inclusive education.” The longstanding interest in keeping students with disabilities in the same classrooms with their neighbors and peers has created a need for reform to establish equity in America’s schools. Schoolwide Integrated Framework for Transformation (SWIFT) is a whole-system school reform model provided through a national technical assistance center that addresses core features of inclusive education support for elementary and middle schools, particularly those that are chronically low performing and those serving students with the most extensive needs. We describe the development and preliminary technical adequacy of Schoolwide Integrated Framework for Transformation Fidelity of Implementation Tool (SWIFT-FIT) as a means to document the extent to which schools are implementing inclusive education. Findings provide preliminary support for trained assessors using SWIFT-FIT as a valid and reliable instrument to produce evidence that describes the extent to which schools install, implement, and sustain these evidence-based practices. Researchers and other school personnel can use these data to evaluate the impact of implementation on progress as well as important student and other outcomes

Molecular signatures in breast cancer

The use of molecular signatures to add value to standard clinical and pathological parameters has impacted clinical practice in many cancer types, but perhaps most notably in the breast cancer field. This is, in part, due to the considerable complexity of the disease at the clinical, morphological and molecular levels. The adoption of molecular profiling of DNA, RNA and protein continues to reveal important differences in the intrinsic biology between molecular subtypes and has begun to impact the way patients are managed. Several bioinformatic tools have been developed using DNA or RNA-based signatures to stratify the disease into biologically and/or clinically meaningful subgroups. Here, we review the approaches that have been used to develop gene expression signatures into currently available diagnostic assays (e.g., OncotypeDX® and Mammaprint®), plus we describe the latest work on genome sequencing, the methodologies used in the discovery process of mutational signatures, and the potential of these signatures to impact the clinic

A Blueprint for Schoolwide Positive Behavior Support: Implementation of Three Components

This article provides a case study (focus on an eighth-grader with autism) within a case study (focus on an urban middle school) in terms of the implementation of positive behavior support (PBS). Information is provided on the characteristics of three key components of schoolwide PBS-universal support, group support, and individual support. For each component, information is presented on policy, assessment, and intervention in terms of an evolving approach to schoolwide PBS with descriptions of how the components were implemented at the middle school with a particular emphasis on the eighth-grade student. The authors conclude with implications for practice in terms of assessing current resources, providing professional development, and intensifying universal support within urban schools to address some of the complex issues associated with poverty

The Stem Cell Marker CD133 Associates with Enhanced Colony Formation and Cell Motility in Colorectal Cancer

CD133 is a membrane molecule that has been, controversially, reported as a CSC marker in colorectal cancer (CRC). In this study, we sought to clarify the expression and role of CD133 in CRC. Initially the size of the CD133−expressing (CD133+) population in eight well-described CRC cell lines was measured by flow cytometry and was found to range from 0% to >95%. The cell line HT29 has a CD133+ population of >95% and was chosen for functional evaluation of CD133 after gene knockdown by RNA interference. A time course assay showed that CD133 inhibition had no significant effect on cell proliferation or apoptosis. However, CD133 knockdown did result in greater susceptibility to staurosporine-induced apoptosis (p = 0.01) and reduction in cell motility (p<0.04). Since gene knockdown may cause “off-target” effects, the cell line SW480 (which has a CD133+ population of 40%) was sorted into pure CD133+ and CD133− populations to allow functional comparison of isogenic populations separated only by CD133 expression. In concordance with the knockdown experiments, a time course assay showed no significant proliferative differences between the CD133+/CD133− populations. Also greater resistance to staurosporine-induced apoptosis (p = 0.008), greater cell motility (p = 0.03) and greater colony forming efficiency was seen in the CD133+ population than the CD133− population in both 2D and 3D culture (p<0.0001 and p<0.003 respectively). Finally, the plasticity of CD133 expression in tumour cells was tested. Quantitative PCR analysis showed there was transcriptional repression in the CD133− population of SW480. Prolonged culture of a pure CD133− population resulted in re-emergence of CD133+ cells. We conclude that CD133 expression in CRCs is associated with some features attributable to stemness and that there is plasticity of CD133 expression. Further studies are necessary to delineate the mechanistic basis of these features