Search Results (1,961)

This study examines how the Science of Reading is represented in Twitter discourse and compares these representations to contemporary models of reading development. Although the Science of Reading is frequently positioned as an equity-oriented reform, little is known about how related ideas circulate in public discourse, particularly across social media platforms that increasingly shape teacher learning, policymaking, and public opinion. This content analysis study analyzed a sample of 14,165 tweets containing the hashtag #scienceofreading from 2020–2021 and 2022–2023. It explores two primary questions investigating (1) the extent to which essential literacy skills (e.g., phonological awareness, phonics, comprehension, vocabulary) are referenced in tweets or linked content and (2) the extent to which specific subgroup classifications identified by the National Assessment of Educational Progress (e.g., Black, Hispanic, students with disabilities, low-income, and other populations) are mentioned in the same sample of discourse on Twitter. Findings demonstrate that online discourse on Twitter (now X) includes more references to decoding-related skills such as phonological awareness and phonics, with far fewer mentions of language-related skills such as comprehension or vocabulary. Mentions of subgroups were minimal, while references to students with disabilities with explicit mention of dyslexia occurred at four times the frequency of race- or income-related subgroups. These distributions contrast with persistent national achievement disparities and suggest that contemporary Science of Reading discourse is more strongly oriented toward decoding-related skills than toward equity-focused concerns. Implications for teacher preparation, policy enactment, and critical media literacy are discussed. Full article

Background: Splenic marginal zone lymphoma (SMZL) is a rare indolent lymphoma with extremely limited population-level evidence on social and treatment correlates of survival. Methods: We conducted a retrospective cohort study using SEER (2000 to 2022) to evaluate OS in primary SMZL (ICD O 3 9689; spleen C42.2). We summarized baseline features and treatments and used Kaplan–Meier and Cox regression. Results: The cohort included 3548 patients (mean age: 68.2 years; 53.6% female). Most were White (89.8%) and non-Hispanic (92.1%). The Ann Arbor stage was missing in 39.4%. Treatment included systemic antineoplastic therapy in 26.4%, beam radiation in 0.7%, and primary site surgery in 21.4%. At last follow-up, 56.8% were alive; non-Hodgkin lymphoma accounted for 15.8% deaths in the cohort, with substantial competing causes including heart disease (6.1%). In multivariable Cox analysis, OS was independently associated with age (HR 1.082 per year, 95% CI 1.072–1.091), male sex (HR 1.34, 95% CI 1.14–1.57), Hispanic ethnicity (HR 1.42, 95% CI 1.08–1.88), systemic antineoplastic therapy (HR 1.42, 95% CI 1.18–1.70), divorced/separated marital status vs. married (HR 1.35, 95% CI 1.03–1.77), and stage IV disease (HR 1.70, 95% CI 1.16–2.50). Race and year of diagnosis were not independently associated with OS in the adjusted model. Conclusions: In our large population-based analysis, OS in SMZL tracks with demographic and social variables and competing risks. Stage missingness and treatment selection limit causal inference for management effects. Full article

Adverse childhood experiences (ACEs) are a public health concern in the United States. Using the 2019 National Survey of Children’s Health, this cross-sectional secondary analysis examined associations between cumulative ACEs (0, 1, 2, and 3 or more) and three health behaviors among children ages 6 to 17, including physical activity, recreational screen time, and sleep. Interaction models were also estimated by child sex and race/ethnicity (White non-Hispanic, Black non-Hispanic, and Hispanic) to assess whether these associations differed across groups. Nearly half of children experienced at least one ACE, and about one in eight experienced three or more. In adjusted models, higher numbers of ACEs were associated with a lower likelihood of meeting recreational screen time guidelines and sleep recommendations, while no statistically significant association was observed for meeting physical activity recommendations. Interaction analyses by child sex and race/ethnicity found no statistically significant differences in these associations across groups. These findings suggest that children with higher numbers of ACEs may be less likely to meet recommended sleep and recreational screen time guidelines, underscoring the potential value of trauma-informed strategies that strengthen sleep routines and healthy media practices. Full article

Background/Context: Creating instructional materials that authentically meet the needs of marginalized learner groups such as student veterans, multilingual adult learners, and first-generation doctoral students demands consistent application of Universal Design for Learning (UDL) principles coupled with meaningful content expertise about those learners’ traits, access needs, and lived experiences. Faculty at teaching-intensive institutions face persistent constraints of time, knowledge, and course load that make systematic UDL implementation difficult. Objective: This practitioner-scholar case study examines whether HAIST-structured agentic LLM-assisted instructional design can produce UDL-aligned materials for student veterans and multilingual learners at a quality level and time frame realistic for under-resourced faculty. Methodology: Drawing from the Human-AI Symbiotic Theory (HAIST) and UDL guidelines, we document four AI-assisted cycles of instructional design at a Hispanic-Serving Institution. Outcomes related to UDL alignment were measured using a rubric adapted from CAST Guidelines 2.2. Results: Across four materials, initial AI generation averaged 61.4% UDL alignment (SD = 8.7%); following iterative calibration, this rose to 84.2% (SD = 5.3%). The largest gains occurred in the Engagement category. Conclusions: These descriptive findings, interpreted as exploratory rather than inferential given the single-site case study design and n = 4 materials, suggest that HAIST-structured AI-assisted design has the potential to produce accessible materials for underserved learner populations in time frames feasible for working faculty. Learner outcome data were not collected in this study; future quasi-experimental work is needed to assess the effectiveness of these materials with target learner populations. Full article

Atrial septal defect (ASD) has become increasingly common in the USA and now affects 1 in 11.3 children in some places, but space–time analysis has not been applied to this emerging trend. ASD rate (ASDR) data were obtained from the National Birth Defects Prevention Network 2003–2020. Substance (cigarettes, alcohol, cannabis, analgesics, cocaine) use data were obtained from the National Survey of Drug Use and Health. Income data were obtained from the US Census. Analysis was limited to the Non-Hispanic White population by technical factors. Time-sequential univariate and bivariate maps were prepared for both covariates and outcomes and their combinations. Spatial regression of the ASDR was performed using the R package splm. A total of 7.6% of data was interpolated by linear regression. A total of 110,107 ASD cases were identified amongst 17,751,437 live births in 27 US states across 10 reporting periods. Time series maps showed that ASDR showed concordant patterns with indices of cannabis use rather than other substances. This was confirmed by multivariate spatial regression where cannabis and cannabinoids alone were found to significantly relate to ASDR, with p = 0.00002 for cannabidiol. Cannabis legal status similarly tracked with ASDR. Compared to states where cannabis was not legal, ASDR was more prevalent in cannabis-legal states (OR = 2.73 (2.66, 2.80); E-Value 4.90 (lower C.I. 4.76)). Twenty-seven of 34 (79.4%) E-values were >9 (high range) and 34/34 were > 1.25 (causal threshold). Data show that cannabis, including cannabis legalization, is driving the US ASD epidemic. While most high-ASDR states have high rates of cannabis use, Midwestern states where cannabis is farmed, such as Kentucky, Tennessee and Missouri, do not, suggesting other routes of exposure, potentially implicating environmental contamination. ASD is a bellwether marker for cannabinoid teratogenicity, indicating that communities should carefully control cannabinoid exposure and limit transgenerational cannabinoid genotoxicity more generally. Full article

Background/Objectives: Young women with breast cancer (aged ≤ 40 years) have distinct prognostic characteristics, yet little is known about how modifiable body composition factors influence outcomes in this age group. This study examined whether CT-derived body composition measures could identify thresholds that predict overall survival (OS). Methods: This was a single-center, 10-year, matched case–control study nested within a cohort, utilizing retrospectively collected data. Using an institutional database (2009–2018) and the initial cohort of 112 patients, we performed a subset analysis of patients with stage I–III breast cancer at diagnosis who had available pretreatment CT scans to estimate associations with body composition metrics and OS. The final analytic dataset included 89 individuals (49 survivors and 40 deceased). CT scans at the L3 level were analyzed using Slice-O-Matic software to quantify visceral (VAT), subcutaneous (SAT), intermuscular (IMAT), total adipose tissue (TAT), skeletal muscle density (SMD), skeletal muscle gauge (SMG), and skeletal muscle index (SMI). Cox proportional hazard models determined optimal cutpoints for OS. Multivariable models included adjustments for disease stage and hormone receptor status. Results: The median age was 35 (IQR, 32–38); 47% were White and 37% were Black. The majority (78%) were not Hispanic or Latina. Most (67%) were overweight/obese. Specific thresholds for IMAT index (>2.57), VAT (>31.38), and SMG (<2419.89) were associated with worse survival (all p < 0.05), while no cutpoints were identified for other variables. Conclusions: These findings show that muscle fat infiltration and reduced muscle quality have important prognostic value in young women with breast cancer. Exploratory cutpoints derived from routine staging CT scans may help inform risk stratification and generate hypotheses for targeted nutritional or exercise interventions, but require validation in larger, independent cohorts before clinical application. Full article

Higher rates of food insecurity have been observed among Hispanic immigrants, yet these individuals have traditionally been excluded from food insecurity survey development. The most common Spanish translated food insecurity scale—the Spanish Translation of the U.S. Household Food Security Survey Module (S-FSSM)—may not be capturing how Spanish-speaking immigrant parents conceptualize food insecurity. The purpose of this study was to gain insight into how Spanish-speaking immigrant parents with low English literacy conceptualize household food insecurity within the 18-item S-FSSM and to use this information to revise the S-FSSM instrument. Researchers conducted two rounds of cognitive interviews with Spanish-speaking adults at a community center in Houston, TX, USA (N = 19; Round 1: n = 9, October 2023; Round 2: n = 10, July 2024). Researchers used participants’ feedback to refine the S-FSSM. All participants were female (Rounds 1 and 2 = 100%) and most born in Mexico (Round 1 = 66.7%; Round 2 = 50%). In Round 1, eight items were combined to enhance cultural relevance and to add definitions. Follow-up questions were added to improve clarity. Two items were revised for relevancy, two items had no change, six items were deleted. In Round 2, modifications to wording occurred and one item was added. The revised scale, named Food Access Measure for Immigrant Latinos In America (FAMILIA), resulted in 17 survey items. Study findings suggested that the S-FSSM needed refinement to enhance relevancy for Spanish-speaking immigrant parents with low English literacy. Full article

Background/Objectives: Approximately half of US children who meet traditional cochlear implant (CI) candidacy criteria receive an implant. As candidacy expands to include a broader range of hearing configurations, identifying factors that influence referral completion and CI uptake is increasingly important. This study examined the predictors of CI evaluation completion and surgery among children referred for CI assessment, including both traditional and non-traditional candidates. Methods: The medical records of pediatric patients referred for an initial CI evaluation from 2018 through 2024 were reviewed. Referral outcomes were categorized as evaluation not completed, candidate who declined surgery, or candidate who proceeded with surgery. Two binomial logistic regression models assessed the demographic, audiologic, and contextual predictors of CI evaluation completion and CI uptake, including age at referral, candidate type, insurance, referral year, communication mode, race/ethnicity, unaided thresholds, rurality, and county-level social health determinants. Results: The completion of the CI evaluation was significantly influenced by race/ethnicity, candidate type, referral year, and age. Mixed-race children demonstrated higher completion rates than White children. Completion was lower among children with single-sided deafness (SSD), children referred in 2022, and older children. Among children determined to be candidates, 69% proceeded with surgery. CI uptake showed similar patterns, with lower rates among Hispanic children, children with residual hearing or SSD, children referred in 2022, and older children. Conclusions: CI uptake at this center exceeded national averages but was associated with race/ethnicity, candidate type, age, and year of referral. Targeted counseling and outreach may improve timely referral and informed decision-making. Full article

While the association between food insecurity and adolescent obesity is well-established, the mechanisms through which these co-occurring public health crises are linked remain inadequately understood. Using the Social Ecological Model as a theoretical framework, this study examines how individual (physical activity), interpersonal (household food security), community (poverty level, residence), and societal (race/ethnicity) factors interact to influence adolescent weight outcomes. Cross-sectional data from 37,425 adolescents aged 12–17 years in the 2022–2023 National Survey of Children’s Health using weighted multinomial logistic regression with interaction terms were used. Adolescents experiencing nutrition insecurity (adequate quantity but poor-quality food) had 41% higher odds of obesity (adjusted odds ratio (aOR) = 1.41; 95% CI: 1.20–1.65), while those with food insecurity (insufficient quantity) had 48% higher odds (aOR = 1.48; 95% CI: 1.08–2.02) compared to food-secure peers. Significant effect modification emerged across ecological levels: poverty below the 200% federal poverty level (FPL) significantly amplified the food insecurity–obesity relationship (interaction p < 0.001), Hispanic and Black adolescents demonstrated 49% and 78% higher obesity odds, respectively, independent of household food and nutrition security status, and physical activity showed protective effects that varied by food security context (interaction p = 0.003). These findings underscore the necessity of multi-level interventions addressing structural inequities alongside individual behaviors to combat adolescent obesity in food-insecure populations effectively. Full article

Chirostoma humboldtianum is an endemic atherinopsid from Mexico that has been of high socio-cultural and economic importance since pre-Hispanic times. It was the first ictic species from Mexico described for science, and it is considered the basal species that gave rise to a nominal group known as white fish or silversides. The aim of this research was to analyze semen quality in relation to breeding fish size and its effect on sperm cryopreservation during an annual cycle. Sexually mature males were collected from January to December 2023, in San Felix dam, Tiacaque, Mexico State, Mexico. The water temperature was measured, and the photoperiod was obtained from the Instituto Nacional de Geografía y Estadística (INEGI). Males were classified into two groups of total length (TL) after analyzing the variation in TL through a size histogram: (G1) 9–13 cm and (G2) longer than 13 cm. Semen volume (µL), sperm concentration (cells µL⁻¹), and motility percentage (%) were determined in all individuals of each group. Likewise, eight straws were cryopreserved per month per group, each one with 10 µL of semen from a mixture of three randomly selected individuals and cryopreserved at −196 °C for 72 h. The post-thawing motility percentage was subsequently verified. Males produce semen continuously all year round, with two periods of higher volume, March and June–August, defining two reproductive periods. The beginning of the first one coincides with the increase in water temperature, from 13 ± 2 to 18 °C. Males with a length more than 13 cm had a higher semen production compared to smaller males (17.33 ± 7.34 and 12.52 ± 4.41 µL, respectively, p < 0.05). The largest semen volumes were registered in March and from June to August in both groups. However, G2 males presented with a larger semen volume. Both groups had a marked decrease in a similar manner in April–May and September to January (p < 0.05). Sperm concentration was similar throughout the year in both groups (p > 0.05) (G1 = 1.35 ± 0.36 × 10⁶ µL⁻¹) (G2 = 1.31 ± 0.35 × 10⁶ µL⁻¹). In addition, fresh sperm motility was high in both groups (G1 = 96 ± 3%, G2 = 97 ± 4%) (p > 0.05). The highest sperm concentrations were observed in March to July, through to October for both groups (p > 0.05), while post-thaw sperm motility decreased by about 50% (G1 = 45 ± 4%) (G2 = 46 ± 6%) during the annual cycle (p > 0.05). The largest post-thaw motility was observed in March and from July to September in G1 and in March and from June to October in G2. Analysis of semen quality throughout the annual cycle reveals aspects of the reproductive biology of C. humboldtianum, including two reproductive peaks and continuous semen production. Full article

Background/Objectives: Drowning is a leading preventable cause of unintentional injury death, yet U.S. prevention efforts have largely focused on children. Despite international declines in pediatric drowning mortality, adult trends remain poorly characterized. We examined long-term trends and disparities in unintentional drowning mortality among U.S. adults aged ≥25 years from 1999 to 2024. Methods: Using CDC WONDER Multiple Cause of Death data, drowning deaths were identified using ICD-10 codes W65–W74, V90, and V92. Age-adjusted mortality rates (AAMRs) per 100,000 were computed by direct standardization to the 2000 U.S. standard population. Joinpoint regression estimated the annual percent change (APC) and average annual percent change (AAPC). Three sensitivity analyses assessed transport-related code exclusion, pandemic-era restriction, and multiple cause-of-death coding. Results: During 1999–2024, 101,743 unintentional drowning deaths occurred among U.S. adults aged ≥25 years (76,554 males; 25,201 females), with 58.09% in natural water or outdoor settings. The overall AAMR showed a non-significant increase (AAPC: 0.55%, p = 0.054); however, joinpoint analysis identified stable rates through 2013 followed by a significant sustained increase (APC: 1.32%, 95% CI: 0.32–2.32, p = 0.012). The male-to-female rate ratio narrowed significantly from 4.00 (1999) to 3.32 (2024) (ratio of rate ratios: 0.83, p = 0.0006), driven by a sustained female increase (AAPC: 1.27%, p < 0.001). Adults aged 65–85+ showed the steepest rise (AAPC: 1.15%, p < 0.001). Non-Hispanic AI/AN adults had the highest rates (3.47–5.44 per 100,000), and non-metropolitan areas consistently exceeded metropolitan rates. Conclusions: A significant upward trajectory has persisted since 2013, with marked disparities by age, sex, race/ethnicity, and geography. Adult-focused, equity-driven prevention strategies aligned with USNWSAP implementation are needed to address this underrecognized burden. Full article

Background/Objectives: Diffuse large B-cell lymphoma (DLBCL) and high-grade follicular lymphoma (FL) are aggressive B-cell malignancies predominantly affecting older adults. R-CHOP remains the frontline standard of care, with frail and elderly patients requiring attenuated regimens such as R-mini-CHOP. Real-world comparative data in elderly and Hispanic populations remain limited. We aimed to evaluate outcomes of R-mini-CHOP versus R-CHOP in elderly patients and to explore potential differences by ethnicity. Methods: Single-center retrospective analysis of adult patients older than 70 years with DLBCL and high-grade FL, treated between January 2014 and June 2025. Clinical characteristics, treatment responses, and survival outcomes were analyzed. The overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method. Results: A total of 136 patients were included (72 R-mini-CHOP; 64 R-CHOP). Patients receiving R-mini-CHOP were older (median 82 vs. 74 years) and had higher-risk features. Overall response rates were 88.7% and 92.6% in the R-mini-CHOP and R-CHOP groups, respectively. Two-year OS was 79.3% for R-mini-CHOP and 76.7% for R-CHOP. Median OS and PFS were not reached in either group. Elevated lactate dehydrogenase (LDH) was associated with an inferior response. We identified a trend toward better response with R-CHOP in Hispanic patients, although this was not statistically significant. Conclusions: In this real-world cohort, R-mini-CHOP achieved response and survival outcomes comparable to R-CHOP despite worse baseline characteristics. These findings support the use of dose-attenuated therapy in frail and elderly patients and suggest that equitable access to care may mitigate ethnic disparities in outcomes. Full article

Introduction: Food insecurity (FI) is a social driver that profoundly affects the health of children. Nutritional optimization is essential in patients with congenital heart disease (CHD). Material and Methods: We performed a cross-sectional survey screening for FI among patients aged 0–21 years at an outpatient pediatric cardiology clinic between September 2023 and December 2024. Sociodemographic and clinical data from encounters were collected, and diagnostic codes were used to classify CHD severity. The zip code-level median household income was determined using data from the U.S. Census. The Childhood Opportunity Index categorization was used to determine neighborhood-level resources. Univariate and multivariate logistic regression were used to assess sociodemographic associations with FI. Results: There were 955 encounters with completed FI screening. Positive screens were demonstrated in 200 surveys (20.9%). Compared to English-speaking White families, those with FI were more likely to be of Hispanic ethnicity (66% vs. 45.2%) and primarily speak Spanish (42.5% vs. 15.0%). Families with FI also lived in areas with lower median household income and fewer available resources. In multivariable analysis, after adjusting for ethnicity, income, and neighborhood-level resource availability, Spanish primary language was the only independent risk factor associated with FI (OR 2.7, 95% CI 1.7–4.2, p < 0.0001). There were no differences in FI status by CHD severity. Conclusions: FI was highly prevalent in this cohort and was associated with low-income and low-resource neighborhoods, Hispanic ethnicity, and a Spanish primary language. These results may have implications for targeting future FI interventions. Full article

Background/Objectives: We aimed to identify eating habits associated with hepatic fat fraction (HFF) and assess effect modification by an established genetic variant for fatty liver disease, PNPLA3 rs738409, among 381 general-risk adolescents. Methods: Dietary intake was assessed using the Block Kids Food Frequency Questionnaire and HFF was measured via magnetic resonance imaging (MRI) at age ~16 years. We first characterized naturally occurring dietary patterns using principal component analysis followed by reduced-rank regression with HFF as the response variable to identify a dietary pattern that is both relevant to the population and associated with HFF. Next, we investigated associations of the dietary pattern with HFF using linear regression models that accounted for maternal gestational diabetes, education, and prenatal smoking and child sex, age, Tanner stage, and BMI. Finally, we tested for a dietary pattern and PNPLA3 rs738409 interaction and stratified by genotype if P-interaction < 0.05. Results: The participants were 16.7 ± 1.2 years (range: 12.6–19.6 years). Half were female (50.4%) and 52.0% identified as non-Hispanic White. The dietary pattern of interest was composed of vegetables, fruit, nuts and seeds, oatmeal, sports bars, crackers and sandwiches, and beef, and was inversely associated with HFF (−0.48 [95% CI: −0.81, −0.16]). Stratified analyses revealed the strongest inverse association observed between the diet pattern score and HFF in the high-risk-variant (GG) group (−2.19 [−4.35, −0.03]), followed by the intermediate-risk (CG) group (−0.43 [−0.77, −0.10]), but not the low-risk (CC) group (−0.32 [−0.77, 0.13]). Conclusions: A diet high in vegetables, fruit, nuts and seeds, oatmeal, sports bars, crackers and sandwiches, and beef—potentially capturing an active, on-the-go lifestyle—is associated with lower HFF during adolescence, especially among individuals at genetic risk. Full article