Glucagon-like peptide 1 (GLP-1) mimetics are effective drugs for treatment of type 2 diabetes, and there is consequently extensive interest in increasing endogenous GLP-1 secretion and L-cell abundance. Here we identify G-protein–coupled bile acid receptor 1 (GPBAR1) as a selective regulator of intestinal L-cell differentiation. Lithocholic acid and the synthetic GPBAR1 agonist, L3740, selectively increased L-cell density in mouse and human intestinal organoids and elevated GLP-1 secretory capacity. L3740 induced expression of Gcg and transcription factors Ngn3 and NeuroD1. L3740 also increased the L-cell number and GLP-1 levels and improved glucose tolerance in vivo. Further mechanistic examination revealed that the effect of L3740 on L cells required intact GLP-1 receptor and serotonin 5-hydroxytryptamine receptor 4 (5-HT4) signaling. Importantly, serotonin signaling through 5-HT4 mimicked the effects of L3740, acting downstream of GLP-1. Thus, GPBAR1 agonists and other powerful GLP-1 secretagogues facilitate L-cell differentiation through a paracrine GLP-1–dependent and serotonin-mediated mechanism.

Though some Reds fans were disappointed that Billy Hamilton wasn't brought back this season, it didn't take long for Cincinnati to find another dynamic player who also brings flash and unpredictability. That would be outfielder Yasiel Puig.

It wasn't just that there were new faces when Reds camp opened Tuesday with the reporting of pitchers and catchers for physicals, there was a different vibe that could be felt in the hallways and clubhouse.

We are looking at the players on each active roster who are making history for their franchises every time they step on the field. We're looking at the player who has compiled the highest WAR (per Baseball Reference) for his current team so far in his career.

¹⁸F-DCFPyL (2-(3-{1-carboxy-5-[(6-¹⁸F-fluoropyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid) is a promising PET radiopharmaceutical targeting prostate-specific membrane antigen (PSMA). We present our experience with this single-academic-center prospective study evaluating the positivity rate of ¹⁸F-DCFPyL PET/CT in patients with biochemical recurrence (BCR) of prostate cancer (PC). Methods: We prospectively enrolled 72 men (52–91 y old; mean ± SD, 71.5 ± 7.2) with BCR after primary definitive treatment with prostatectomy (n = 42) or radiotherapy (n = 30). The presence of lesions compatible with PC was evaluated by 2 independent readers. Fifty-nine patients had scans concurrent with at least one other conventional scan: bone scanning (24), CT (21), MR (20), ¹⁸F-fluciclovine PET/CT (18), or ¹⁸F-NaF PET (14). Findings from ¹⁸F-DCFPyL PET/CT were compared with those from other modalities. Impact on patient management based on ¹⁸F-DCFPyL PET/CT was recorded from clinical chart review. Results: ¹⁸F-DCFPyL PET/CT had an overall positivity rate of 85%, which increased with higher prostate-specific antigen (PSA) levels (ng/mL): 50% (PSA < 0.5), 69% (0.5 ≤ PSA < 1), 100% (1 ≤ PSA < 2), 91% (2 ≤ PSA < 5), and 96% (PSA ≥ 5). ¹⁸F-DCFPyL PET detected more lesions than conventional imaging. For anatomic imaging, 20 of 41 (49%) CT or MRI scans had findings congruent with ¹⁸F-DCFPyL, whereas ¹⁸F-DCFPyL PET was positive in 17 of 41 (41%) cases with negative CT or MRI findings. For bone imaging, 26 of 38 (68%) bone or ¹⁸F-NaF PET scans were congruent with ¹⁸F-DCFPyL PET, whereas ¹⁸F-DCFPyL PET localized bone lesions in 8 of 38 (21%) patients with negative results on bone or ¹⁸F-NaF PET scans. In 8 of 18 (44%) patients, ¹⁸F-fluciclovine PET had located the same lesions as did ¹⁸F-DCFPyL PET, whereas 5 of 18 (28%) patients with negative ¹⁸F-fluciclovine findings had positive ¹⁸F-DCFPyL PET findings and 1 of 18 (6%) patients with negative ¹⁸F-DCFPyL findings had uptake in the prostate bed on ¹⁸F-fluciclovine PET. In the remaining 4 of 18 (22%) patients, ¹⁸F-DCFPyL and ¹⁸F-fluciclovine scans showed different lesions. Lastly, 43 of 72 (60%) patients had treatment changes after ¹⁸F-DCFPyL PET and, most noticeably, 17 of these patients (24% total) had lesion localization only on ¹⁸F-DCFPyL PET, despite negative results on conventional imaging. Conclusion: ¹⁸F-DCFPyL PET/CT is a promising diagnostic tool in the work-up of biochemically recurrent PC, given the high positivity rate as compared with Food and Drug Administration–approved currently available imaging modalities and its impact on clinical management in 60% of patients.

In glioma patients, differentiation between tumor progression (TP) and treatment-related changes (TRCs) remains challenging. Difficulties in classifying imaging alterations may result in a delay or an unnecessary discontinuation of treatment. PET using O-(2-¹⁸F-fluoroethyl)-l-tyrosine (¹⁸F-FET) has been shown to be a useful tool for detecting TP and TRCs. Methods: We retrospectively evaluated 127 consecutive patients with World Health Organization grade II–IV glioma who underwent ¹⁸F-FET PET imaging to distinguish between TP and TRCs. ¹⁸F-FET PET findings were verified by neuropathology (40 patients) or clinicoradiologic follow-up (87 patients). Maximum tumor-to-brain ratios (TBR_max) of ¹⁸F-FET uptake and the slope of the time–activity curves (20–50 min after injection) were determined. The diagnostic accuracy of ¹⁸F-FET PET parameters was evaluated by receiver-operating-characteristic analysis and ² testing. The prognostic value of ¹⁸F-FET PET was estimated using the Kaplan–Meier method. Results: TP was diagnosed in 94 patients (74%) and TRCs in 33 (26%). For differentiating TP from TRCs, receiver-operating-characteristic analysis yielded an optimal ¹⁸F-FET TBR_max cutoff of 1.95 (sensitivity, 70%; specificity, 71%; accuracy, 70%; area under the curve, 0.75 ± 0.05). The highest accuracy was achieved by a combination of TBR_max and slope (sensitivity, 86%; specificity, 67%; accuracy, 81%). However, accuracy was poorer when tumors harbored isocitrate dehydrogenase (IDH) mutations (91% in IDH-wild-type tumors, 67% in IDH-mutant tumors, P < 0.001). ¹⁸F-FET PET results correlated with overall survival (P < 0.001). Conclusion: In our neurooncology department, the diagnostic performance of ¹⁸F-FET PET was convincing but slightly inferior to that of previous reports.

Posttreatment high-grade gliomas are usually monitored with contrast-enhanced MRI, but its diagnostic accuracy is limited as it cannot adequately distinguish between true tumor progression and treatment-related changes. According to recent Response Assessment in Neuro-Oncology recommendations, PET overcomes this limitation. However, it is currently unknown which tracer yields the best results. Therefore, a systematic review and metaanalysis were performed to compare the diagnostic accuracy of the different PET tracers in differentiating tumor progression from treatment-related changes in high-grade glioma patients. Methods: PubMed, Web of Science, and Embase were searched systematically. Study selection, data extraction, and quality assessment were performed independently by 2 authors. Metaanalysis was performed using a bivariate random-effects model when at least 5 studies were included. Results: The systematic review included 39 studies (11 tracers). ¹⁸F-FDG (12 studies, 171 lesions) showed a pooled sensitivity and specificity of 84% (95% confidence interval, 72%–92%) and 84% (95% confidence interval, 69%–93%), respectively. O-(2-¹⁸F-fluoroethyl)-l-tyrosine (¹⁸F-FET) (7 studies, 172 lesions) demonstrated a sensitivity of 90% (95% confidence interval, 81%–95%) and specificity of 85% (95% confidence interval, 71%–93%). For S-¹¹C-methyl)-l-methionine (¹¹C-MET) (8 studies, 151 lesions), sensitivity was 93% (95% confidence interval, 80%–98%) and specificity was 82% (95% confidence interval, 68%–91%). The numbers of included studies for the other tracers were too low to combine, but sensitivity and specificity ranged between 93%–100% and 0%–100%, respectively, for ¹⁸F-FLT; 85%–100% and 72%–100%, respectively, for 3,4-dihydroxy-6-¹⁸F-fluoro-l-phenylalanine (¹⁸F-FDOPA); and 100% and 70%–88%, respectively, for ¹¹C-choline. Conclusion: ¹⁸F-FET and ¹¹C-MET, both amino-acid tracers, showed a comparably higher sensitivity than ¹⁸F-FDG in the differentiation between tumor progression and treatment-related changes in high-grade glioma patients. The evidence for other tracers is limited; thus, ¹⁸F-FET and ¹¹C-MET are preferred when available. Our results support the incorporation of amino-acid PET tracers for the treatment evaluation of high-grade gliomas.

Growing up with unauthorized immigrant parents puts children—nearly 80 percent of whom were born in the United States—at a disadvantage, with lower preschool enrollment, reduced socioeconomic progress, and higher rates of linguistic isolation and poverty. This fact sheet examines the number, characteristics, and socioeconomic status of children, both U.S.-citizen and noncitizen, who have unauthorized immigrant parents.

Kellee M. Miller
Jun 1, 2015; 38:971-978
Type 1 Diabetes at a Crossroads

U.S. Navy ships on Monday entered the Barents Sea between Norway and Russia, for the first time since the 1980s, "to assert freedom of navigation and demonstrate seamless integration among allies," the U.S. Navy said.

William J. Jeffcoate
Apr 1, 2018; 41:645-652
Perspectives in Care

The ADA announced May 1 the creation and launch of the PracticeUpdate Clinical Dentistry Channel, which delivers free evidence-based clinical content in general dentistry and specialty topics curated by a world-renowned editorial and advisory board.

Check this page daily for the latest COVID-19 data available from the CDC, WHO and Johns Hopkins University.

BP on Friday announced plans to increase disclosure on its efforts to fight climate change after requests from two groups of investors.

OBJECTIVE

To study whether the effects of intensive glycemic control on major vascular outcomes (a composite of major macrovascular and major microvascular events), all-cause mortality, and severe hypoglycemia events differ among participants with different levels of 10-year risk of atherosclerotic cardiovascular disease (ASCVD) and hemoglobin A_1c (HbA_1c) at baseline.

Confession time. I tend to write this blog with my professional hat on, keeping my personal life, personal. Today, I am writing as a mother of two very dear, but very spirited children. People tend to think since I am a School Psychologist, that I know exactly what to do in my own family, and that I should have it all together. The reality is that I have struggles just like everyone else. Sometimes, my kids just don't listen. Sometimes, I feel overwhelmed too. Sometimes, I don't respond in the most positive manner.

Sometimes it can be very difficult to be positive. I know this from experience. While I'm usually an optimistic person, who tends to find good in situations (at least eventually), I sometimes struggle in the heat of the moment. Especially, when I am running late or stressed about something, I have much less tolerance for resistance and disobedience from my children.

In the last few weeks I've really been having a difficult time with the morning routine. There are a lot of procedures that need to occur efficiently in order for everyone to get to work and school on time. I do not like that I have turned into a Drill Sargent with very little patience for any deviation from the schedule. There are mornings that I tell my children to get dressed multiple times and am ignored multiple times. As the clock ticks and it's time to rush out the door with two children (age 5 and 3) who haven't gotten dressed yet, I become more and more negative. By the time we get to the daily "Yes you are wearing a coat- it's 25 degrees outside!" argument with the second child, I have lost all patience. When they walk to the car, I'm behind carrying everything and making sure the door shuts, and have been known to yell "RUN!, RUN TO THE CAR, RUN!" and eventually pick up the meandering child and put her in the car at my own pace. How's that for a start to one's day? I don't feel very good about those days.

Thankfully, not every morning is like that. There are also days that everyone is calm and everyone got ready (although hurriedly), but we got to school/work on time and in good spirits. Specifically I think of a day earlier this week that I handed all the clothes to my five year old and asked him to get himself dressed and see if he could help his little sister a little bit. He helped her step by step, and was extremely proud of himself. I enthusiastically praised him for his help and everyone went to school and work happy that day.

So what is the difference between the crazy mornings and the relatively calm mornings? I want to say- "my kids." I want to say "some mornings they choose to focus on getting dressed and I don't have to argue with them, so we are happy." And while they do play a small part, the biggest factor is ME. I'm the difference. When I am more calm, I have the mindset to be more positive and encouraging, which the children actually respond to. When I am frantic, I think they retreat and are much more prone to act out or start throwing their own fits (about coats or shoes). Yes, there are days that my kids don't listen the first time. However, they are 3 and 5 years old. Also, they don't care if I am late, it means nothing to them. So, what is the main thing I can do to change our crazy mornings. It's not a magic cure to make my kids get ready in a hurried and frantic manner that will get everyone out the door on time. The answer is getting myself up earlier, so I am not stressing about my tardiness and I can focus on helping everyone else get ready.

So here's the challenge to all parents- Take a look at a part of your day that is prone to go poorly with your kids. Think about what you can do yourself to help change the situation. I don't mean what your children could or should do or what you need to do to change your child. Let's take a hard look at yourself first, and see what you can do to yourself to make a positive change in a situation. For my mornings- it's pretty obvious- like it or not, I need to wake up earlier. I'm always saying I should wake up earlier, but that snooze button is quite tempting every morning. Since I'm blogging about it, I now have many people out there to keep me accountable. I'm thinking that if I were not rushed and frantic, then I would be more patient with my kids and able to start using more positive methods for getting them to get ready. While there is an issue that I'm being ignored sometimes- right now I'm just going to focus on making a change to myself. I'm guessing it will spill into everyone else.

Let's all find one small thing we can do ourselves that will help be a blessing for our entire family.

I spend most days of my life working with various students who are at different parts in the sped referral process. I attend Child Study Meetings where we decide if we are going to evaluate a student. I observe and screen children and talk with parents and teachers to help the committee make a good decision about whether we should do a special education evaluation.   I evaluate those students (this includes Psychological testing, observations, talking with student/teacher/parent, doing rating scales, etc.). I attend eligibility meetings where we determine if the student is eligible for for special education services. All of this is second nature to me and sometimes I need to stop and remember when a parent comes in, that this is NEW.

When I talk to parents, I find that many parents do not fully understand the special education referral process, even when they nod and act like they do. We as school staff need to do a better job of helping the parents understand the process. Parents also need to speak up and ask questions when there is not understanding.

This is a guide for parents to understand the process of special education testing, the testing components, and some of the test data. It is important to note that schools systems and states will vary to some degree. If you have any questions about the process in your school system, ask your school psychologist, teacher, or principal. Parents have every right to ask questions and usually school personnel are happy to help make this process less anxiety-provoking for you. It is important for parents to understand their rights during the special education process.


Special Education Process

After data shows that interventions have been attempted and if a student is suspected of having a disability, a referral is made to evaluate him or her for special education testing. Once the parents sign the Permission for Testing Forms, timelines begin and the schools have 65 business days to complete the assessments and hold the eligibility meeting. Some states may have a different timeline.

During these 65 days, several testing components will be completed with you and your child. The evaluators will write reports and a copy will be given to parents at the eligibility meeting. However, schools are required to have a copy available for parents to pick up two days before the eligibility meeting. It is advised, that parents take advantage of this and read reports before the meeting to help get familiar with the information and to formulate questions. The reports hold a lot of information that can be overwhelming if you are not familiar with this type of testing. Read Understanding Test Scores to understand the types of tests used and what the scores mean.

Additionally, the meeting is likely to bring forth strong emotions as your child’s difficulties are discussed openly. It can be overwhelming for parents, especially when not prepared. When parents do not read the reports prior to the eligibility meeting, they are the only people at the table who come to the meeting not knowing what to expect.


What if My Child is Found ELIGIBLE for Special Education Services?

Once a child is eligible for special education services, the schools have 30 days to develop an Individualized Education Plan (IEP) for the student. This will consist of accommodations, goals, and describe the services offered. Parents are part of a committee to help create this document. Once it is signed, schools are legally required to follow it. It is reviewed once a year, unless parents or teachers feel that changes are necessary. Every three years, the committee will determine if the student should be reevaluated. This is called a triennial evaluation. Sometimes another full evaluation will be conducted, other times a review of records and updated teacher information is used.


What if My Child is Found INELIGIBLE for Special Education Services?

If your child was found ineligible for special education services and you agree with the eligibility findings, then your child will not receive special education. He or she was evaluated because of a problem that still needs to be addressed within regular education. Ask for a separate meeting with your teacher or a team to determine what accommodations or strategies can be used to help.

If you believe that your child requires special education services and has a disability, but was found ineligible for services, make an appointment to meet with the special education director. If an agreement cannot be reached, you may be able to have an Independent Evaluation at the expense of the school. The results of that testing will be brought back to an eligibility meeting. A child MUST have 2 things before they can receive special education services: They must have a disability and there must be a documented educational impact that the student requires special education services to be successful.

With the Trump administration having announced the end of the DACA program, Congress is facing growing calls to protect unauthorized immigrants who came to the U.S. as children. This fact sheet examines DREAM Act bills introduced in Congress as of mid-2017, offering estimates of who might earn conditional legal status—and ultimately legal permanent residence—based on educational, professional, and other requirements in the legislation.

2017 saw the introduction of several bills—two of them by Senate Republicans in the weeks following the Trump administration’s announcement that it would terminate the Deferred Action for Childhood Arrivals (DACA) program—that would provide a pathway to conditional and then legal permanent residence to unauthorized immigrants brought to the United States as children, if they meet a range of educational, professional, and other criteria.

An average of 915 DACA recipients every day will lose their work authorization and protection from deportation once the phaseout of the program moves into full force in spring 2018, MPI estimates. This fact sheet also offers U.S. and state estimates of the school enrollment and educational attainment, workforce participation, and industries and occupations of employment for the nearly 690,000 current DACA holders.

Testimony of Marc Rosenblum before the Senate Committee on Homeland Security and Governmental Affairs for the March 26, 2015 hearing on the characteristics of unauthorized immigrants in the United States and how to address future flows.

The prolonged health and safety stressors of COVID-19 has many parents reaching out to mental health professionals with concern over their teenagers’ increased levels of anxiety. In the United States,...

So, Valentine's Day is two days away, but you know he isn't going to bring you any flowers. And instead of a cuddle and a kiss, you know she is going to dig up that old canard about your mother.

Among psychologists who study sports, there is a code word for parents who lose their temper standing on the sidelines of their children's soccer, baseball and football games: THOSE parents -- Tempestuous, Harried, Overwrought, Self-absorbed and Emotional.

The Center for Responsive Politics recently estimated that it cost $5.8 billion to finance the 2008 general elections. To most people that is a staggeringly large sum and evidence of the profoundly corrupting role that money plays in politics, but to some very smart political watchers, the better...

These fact sheets provide a sociodemographic sketch of parents with children ages 0 to 8 in the 30 states with the largest number of immigrant families, offering data and analysis of some of the key parental characteristics to help stakeholders identify populations that could be targets for early childhood and parent-focused programs working to improve child and parent outcomes.

As states work to build high-quality early childhood systems and implement the federal Workforce Innovation and Opportunity Act (WIOA) and Every Student Succeeds Act (ESSA), having detailed knowledge of the characteristics of immigrant parents can help maximize the effectiveness of programs that seek to improve child and family outcomes, as this commentary explains.

WASHINGTON – While the new Trump administration public charge rule is likely to vastly reshape future legal immigration based on its test to assess if a person might ever use public benefits in the future, the universe of non-citizens who could be denied a green card based on current benefits use is quite small.

Somali and Bhutanese refugees are two of the largest groups recently resettled in the United States and Canada. This report examines factors that might promote or undermine the mental health and overall well-being of children of these refugees, with regard to factors such as past exposure to trauma, parental mental health, educational attainment, social support, and discrimination.

When Shaka Senghor and Ebony Roberts ended their relationship, they made a pact to protect their son from its fallout. What resulted was a poetic meditation on what it means to raise a child together, yet apart. In this moving and deeply personal talk, Senghor and Roberts share their approach to co-parenting -- an equal, active partnership that rolls with the punches and revels in the delights of guiding their child through the world with thought and intention.

STANDARD ERRORS VS STANDARD DEVIATIONS Click to enlarge There’s an ancient haiku that goes: People confuse a well-estimated mean with a certain outcome Ok, that’s not true. But Jake Hofman, Dan Goldstein, and Jessica Hullman have a new paper (recently accepted at CHI 2020) about this. They bet you’ll think the results of their paper […]

The post How visualizing inferential uncertainty can mislead readers about treatment effects in scientific results appeared first on Decision Science News.

In this fifth installment on the growth in dual-language learning, the executive director of the BUENO Center for Multicultural Education at the University of Colorado, Boulder., says districts should focus on the what students and their families need, not what educators want.

Looking for new ways to combat kids who bully, some communities are threatening to fine parents with no evidence that the approach is effective.

Fed up with their district’s unmet pledges to stop steering African American students into low-level classes, parents take action.

The state's highest court allowed some claims brought on behalf of relatives of victims of the 2012 mass shooting at Sandy Hook Elementary School to proceed against the firearms industry.

"The HIV resilience framework will be of relevance to a wide range of people involved at all levels of the HIV response. We hope it provides encouragement for government decision makers and policy developers to pursue consistent and enabling policy and legislative environments and work cooperatively between jurisdictions and across departments to achieve best practice. Our consultation suggests that consistent legislation with the goal of supporting strong health outcomes, making disclosure safe, and eliminating stigmatising laws is crucial to creating environments in which people with HIV feel safe to access testing, treatment, and care. The HIV resilience framework also contains valuable insights for those who have responsibility for HIV health program management and service delivery, providing guidance to help ensure that programs, services, interventions or strategies supporting people living with HIV are developed and delivered in a way that is mindful of the interlinked twin goals of building personal resilience and eliminating stigma and discrimination." --President's message (page 6).

Parent and teenager.