Knier, Kit

HappiGenius is a mindfulness-based social–emotional learning (SEL) program developed and initially deployed in the context of COVID-19. Novel features of the HappiGenius program include the use of behavioral practice and activities to enhance traditional classroom-based learning, the capability to teach in a remote setting, and a focus on internalizing behaviors in addition to traditionally targeted externalizing behaviors. A pilot study of four third-grade classrooms completed in the previous academic year showed promising results for improvements in students’ experience of positive affect, self-compassion, total difficulties, and prosocial behaviors. This quasi-experimental case-control study was conducted in 14 third-grade classrooms across four schools in a midsize Midwestern US city. We hypothesized that HappiGenius would lead to improvements in positive affect, self-compassion, and mindfulness, in addition to other social behaviors measured by quantitative standardized scales. We used qualitative methodology to determine whether HappiGenius was feasible and acceptable to teachers for use in the classroom. While there was no statistically significant change in positive affect, self-compassion, or mindfulness, there was meaningful improvement in student internalizing problems and peer problems. Analysis of qualitative data showed the importance of timing during the year to maximize classroom benefits like establishing behavioral expectations early and reducing problem behaviors. The study represents a step in the direction of evaluating the implementation and outcomes of a new social–emotional learning program developed with deliberate attention to internalizing problems alongside traditionally studied externalizing problems.

Background Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a leading cause of end‐stage renal disease in adults affecting 1 in 800 people in the US. Knocking down bicaudal‐C (BicC) in zebrafish and Xenopus has been reported as a method used to model the cystic changes in ADPKD. Gamberi and colleagues [JASN 25: 538A, 2014] recently presented a similar knockdown in Drosophila melanogaster resulting in cystic Malpighian Tubules (MTs) homologous to the human kidney. Additionally, calcium oxalate (CaOx) kidney stones affect ~1 in 10 people in the US, with the incidence increasing ~2‐fold in PKD patients. Methods Our group has investigated the PKD phenotype in Drosophila using a Gal4/UAS‐RNAi system to knockdown the expression of BicC in MTs. We initiated CaOx crystal formation by feeding Na‐oxalate or adding to tubule bathing solution [Hirata, AJP 2012]. Results Penetrance of Uro, CapaR, and c724 drivers in the MTs were compared using UAS‐YFP, resulting in Uro::BicC expression in ~50% of cells with CapaR::BicC approaching 100% and c724 expression specific to MT stellate cells only. MT morphology was analyzed: controls [WT (0%); parental (18%)] occurrence v BicC knockdowns [Uro::BicC (25%); CapaR::BicC (15%); c724::BicC (6.3%)]. Functional tests using Ramsay secretion assays reveal a slower secretion rate in Uro::BicC, CapaR::BicC, and c724::BicC knockdowns compared to WT MTs. In CapaR::BicC knockdowns, slower secretion rates are observed even after stimulation with Drosophila ‐kinin. Since there is an increased risk for ADPKD‐related kidney stones, MT calcium oxalate (CaOx) crystallization experiments were performed to quantify crystal formation in BicC knockdown vs WT MTs. While crystals are present in all oxalate exposed MTs, BicC knockdowns using Uro::BicC and c724::BicC form more CaOx crystals than CapaR::BicC and WT. However, crystals formed by Uro::BicC and c724::BicC knockdowns have a significantly smaller total crystal area and average area/individual crystal compared to both CapaR::BicC and WT. Conclusions These results suggest that BicC knockdown parallels kidney stone increases associated with human PKD, but does not yet consistently mimic morphologic ADPKD‐induced cystic phenotypes usually observed in PKD models. Support or Funding Information DK90278, DK101405, DK101405

When COVID-19 caused worldwide cancellations of summer research immersion programs in 2020, Mayo Clinic rallied to create an alternate virtual experience called Summer Foundations in Research (SFIR). SFIR was designed not only to ensure the continuance of science pathways training for undergraduate scientists but also to support undergraduate mental wellbeing, given the known pandemic stressors. A total of 170 participants took part in the program and were surveyed pre-post for outcomes in biomedical research career knowledge, biomedical research career interest, research skills confidence, and three dimensions of mental wellbeing. Knowledge of and interest in careers involving biomedical research rose significantly following participation in SFIR. The participants’ mean research skills confidence also rose between 0.08 and 1.32 points on a 7-point scale across 12 items from the Clinical Research Appraisal Inventory. Success in science pathways support was accompanied by positive shifts in participant mental wellbeing. Measurable decreases in stress (Perceived Stress Scale, p < 0.0001) accompanied gains in resilience (Brief Resilience Scale, p < 0.0001) and life satisfaction (Satisfaction with Life Scale, p = 0.0005). Collectively, the data suggest that core objectives of traditional in-person summer research programming can be accomplished virtually and that these programs can simultaneously impact student wellbeing. This theoretical framework is particularly salient during COVID-19, but the increased accessibility of virtual programs such as SFIR can continue to bolster science education pathways long after the pandemic is gone.

Précis: In this longitudinal study of patients with open-angle (OAG), pseudoexfoliative (PXE), or neovascular glaucoma (NVG) receiving glaucoma drainage devices (GDD), posttube cumulative rates of reoperation, corneal graft, and visually threatening complications (VT-complications) increased beyond 5 years and were not significantly affected by glaucoma type. Purpose: To study the need for additional glaucoma surgery and development of complications after first GDD surgery in eyes with primary OAG, PXE, or NVG glaucoma. Patients and Methods: There were 306 eyes with OAG (n=185), PXE (n=60), or NVG (n=61) glaucoma who received a first GDD between 1996 and 2017. Outcomes including glaucoma reoperation, corneal graft procedure, and VT-complications after GDD were measured. Kaplan-Meier analysis was used to compare cumulative rate of reaching outcomes over time after GDD placement among the 3 glaucoma groups. Results: When comparing the OAG, PXE, and NVG groups, there were no significant differences in post-GDD cumulative rates of reoperation (P=0.33), corneal graft (P=0.26), or VT-complications (P=0.65) over time. For all eyes, the overall cumulative rates for each outcome measure increased beyond 5 years, and specific Kaplan-Meier rates (5-y, 10-y) included: reoperation (16%, 25%), corneal graft (6%, 12%), VT-complications (9%, 14%). When comparing specific GDDs, the Ahmed FP7 had a higher cumulative reoperation rate over time compared with the Baerveldt 350 (P=0.019). Conclusion: Glaucoma type did not significantly affect post-GDD cumulative rates of reoperation, corneal graft, and VT-complication among the OAG, PXE, and NVG groups. For all eyes, cumulative rates of reoperation, corneal graft, and VT-complications increased beyond 5 years. The Ahmed FP7 had a significantly higher cumulative reoperation rate compared with the Baerveldt 350 over time.

Précis: Kaplan-Meier analysis was used to compare the rate of corneal grafting after glaucoma drainage device (GDD) placement in pediatric and adult patients. Adults were at an increased risk of receiving a corneal graft after device placement. Purpose: The goal of this study was to compare the rate of corneal graft implantation after GDD placement in pediatric and adult patients. Patients: Patients receiving a GDD between January 1, 1985 and December 31, 2017 were selected from the medical records. Patients receiving their first device while <18 years of age were considered children for the extent of the study. Methods: We compared the rate of receiving a corneal graft after GDD implantation using Kaplan-Meier analysis. Baseline patient characteristics and surgical characteristics were compared using a generalized estimating equation. Results: Corneal grafting occurred in 8.6% of adults and 4.7% of children from the original cohort. The rate of receiving a corneal graft at 5, 10, and 15 years was 9.4%, 16.8%, 39.4% and 1.6%, 1.6%, 12.5% for adults and children, respectively. However, certain characteristics were different between the 2 groups. Conclusion: Adult patients were more likely to receive a corneal graft after GDD placement. However, pediatric and adult patients differed in the prevalence of preexisting corneal disease, glaucoma type, GDD type used, and types of previous surgeries. Elucidation of the impact of these factors on corneal graft rate requires a larger cohort size.

Elevated intraocular pressure (IOP) is the most prevalent risk factor for primary open-angle glaucoma. However, IOP alone does not fully describe a mechanical basis for disease in patients with normal tension glaucoma or primary open-angle glaucoma. The translaminar pressure difference (TLPD) theory proposes that the pressure gradient generated by the difference of IOP and cerebrospinal fluid pressure (CSFp) acting at the level of the optic nerve can lead to cupping and glaucoma when IOP is higher than normal and/or CSFp is lower than normal. The study results to date have generally supported the TLPD theory; however, varying methods, populations, and sample sizes make it difficult to compare results. To further assess whether there is an association between low CSFp and open-angle glaucoma, 30 years of clinical data that assess 96,543 lumbar punctures were analyzed. Patients with open-angle glaucoma showed a significantly lower CSFp than randomly selected normal control patients (9.9 ± 3 mm·Hg (n = 86) versus 12.1 ± 3.6 mm·Hg (n = 114), p < 0.001 ) following adjustment for age and sex. This retrospective study provides strong evidence for an association between open-angle glaucoma and low CSFp.

Précis: Over 10 years in a tertiary care setting, glaucoma drainage devices (GDDs) have not increased as a reason for keratoplasty. Purpose: The purpose of this study was to determine whether the reasons for keratoplasty have changed between 10 years in a tertiary care setting, with special attention to the rate of GDDs as a reason for keratoplasty. Methods: Patients aged 18 years or above who underwent keratoplasty at Mayo Clinic, Rochester, MN from 2005 to 2006 and 2015 to 2016 were studied. All reasons for keratoplasty performed in the study time period are assessed, including patients who previously had a GDD implanted in the same eye. After analyzing the reasons for keratoplasty, we assess whether the reasons for keratoplasty have changed between 2005 to 2006 and 2015 to 2016 in association with the increasing placement of GDDs. Results: The number of keratoplasty procedures performed in the 2 time periods increased by 62% from 163 (2005 to 2006) to 264 (2015 to 2016), whereas GDD placement increased by 164% from 80 GDD (2005 to 2006) to 211 GDD (2015 to 2016). Although the performance of keratoplasty increased between the 2 points in time, the frequency of each cause for keratoplasty did not change significantly. The majority of keratoplasties were performed due to corneal disease, and GDDs made up a small portion of reasons for keratoplasty (2005 to 2006, 4.29%; 2015 to 2016, 5.68%). Conclusions: The frequency of GDDs as a reason for keratoplasty has not changed significantly between 10 years in this tertiary care setting. Patients with GDDs who later required keratoplasty had associated features including multiple surgical procedures and comorbid infection, pseudophakic bullous keratopathy, Fuchs dystrophy, pseudoexfoliation, uveitis, and congenital glaucoma.