Anti-BCMA/CD19 CAR T Cells with Early Immunomodulatory Maintenance for Multiple Myeloma Responding to Initial or Later-Line Therapy.

We conducted a phase I clinical trial of anti-BCMA chimeric antigen receptor T cells (CART-BCMA) with or without anti-CD19 CAR T cells (huCART19) in multiple myeloma (MM) patients responding to third- or later-line therapy (phase A, N = 10) or high-risk patients responding to first-line therapy (phase B, N = 20), followed by early lenalidomide or pomalidomide maintenance. We observed no high-grade cytokine release syndrome (CRS) and only one instance of low-grade neurologic toxicity. Among 15 subjects with measurable disease, 10 exhibited partial response (PR) or better; among 26 subjects responding to prior therapy, 9 improved their response category and 4 converted to minimal residual disease (MRD)-negative complete response/stringent complete response. Early maintenance therapy was safe, feasible, and coincided in some patients with CAR T-cell reexpansion and late-onset, durable clinical response. Outcomes with CART-BCMA + huCART19 were similar to CART-BCMA alone. Collectively, our results demonstrate favorable safety, pharmacokinetics, and antimyeloma activity of dual-target CAR T-cell therapy in early lines of MM treatment. SIGNIFICANCE: CAR T cells in early lines of MM therapy could be safer and more effective than in the advanced setting, where prior studies have focused. We evaluated the safety, pharmacokinetics, and efficacy of CAR T cells in patients with low disease burden, responding to current therapy, combined with standard maintenance therapy. This article is highlighted in the In This Issue feature, p. 101.

Mindfulness, Contact Anxiety, and Attitudes Toward Students With Visual Impairments Among Certified Adapted Physical Educators.

The purpose of this study was to examine the relationship between interpersonal/intrapersonal mindfulness, contact anxiety, and attitudes toward students with visual impairments among certified adapted physical educators. Participants included 115 certified adapted physical educators who completed a 31-item online survey, composed of a 10-item demographic questionnaire, a 14-item mindfulness in teaching scale, a four-item intergroup anxiety scale, and a three-item attitude scale. Hierarchical multiple regression analyses revealed that intrapersonal mindfulness was a negative predictor of contact anxiety (ß = -0.26, p = .007) and contact anxiety negatively predicted attitudes (ß = -0.22, p = .02). A mediation analysis revealed that intrapersonal mindfulness had an indirect effect on attitudes through contact anxiety, b = 0.09, SE = 0.05, 95% confidence interval [0.006, 0.22]. Collectively, both intrapersonal and interpersonal mindfulness appear to be responsible for the formation of attitudes, but with different underlying processes involved.

Perceived Workplace Experiences of Adapted Physical Educators and Physical Educators.

Purpose: The purpose of this study was to compare the workplace experiences of physical education and adapted physical education teachers while also considering biological sex. Role socialization theory was used as a guiding lens. Method: Participants included 653 teachers (women = 382) who taught physical education (n = 420) or adapted physical education (n = 233). Five instruments were used to examine workplace experiences regarding: (a) marginalization and isolation, (b) two elements of perceived mattering, (c) three role stressors, (d) resilience, and (e) emotional exhaustion. Group comparisons were analyzed using a 2 × 2 (discipline x biological sex) factorial MANCOVA while including years of teaching experience as a covariate. Results: No significant interaction effect between teacher group and biological sex was detected; however, there were significant main effects of teacher group, F(9,640) = 19.49, p < .001; Wilk's Λ = .79, partial-η2 = .22, and of biological sex, F(9,640) = 2.81, p < .01; Wilk's Λ = .96, partial-η2 = .04, on the dependent variables. Significant follow-up univariate tests showed that the adapted physical education teachers perceived less marginalization, less isolation, more perceived mattering, and less emotional exhaustion than the physical education teachers. Women from both groups felt significantly more role overload when compared to the men. Conclusion: Collectively, these findings both relate to and extend role socialization theory in explaining how adapted physical education teachers are socialized through the workplace in comparison to their physical education counterparts. Practical implications for preservice and inservice teacher preparation and future research directions are discussed.

Understanding the Inclusiveness of Integrated Physical Education From the Perspectives of Adults With Visual Impairments.

The purpose of this study was to examine the perspectives of individuals with visual impairment toward inclusion and the inclusiveness of their integrated physical education experiences. A retrospective, qualitative-description research approach was used, and 10 adults (age 20-35 years) with visual impairments acted as the participants. The data sources included one-on-one telephone interviews and reflective interview notes. A theoretical thematic analysis approach was used to analyze the data. Three interrelated themes were identified: "I always felt like a misfit": a missing sense of belonging, acceptance, and value; "I felt very excluded, very pushed to the side": lack of access to activity participation; and "Even though it sucked, I do agree with it": preference for integrated settings. Collectively, the participants recalled that experiencing feelings of inclusion during physical education were rare. Despite this, they expressed a perceived importance of being integrated in contexts with their peers.

The Relationships Among Perceived Organization Support, Resilience, Perceived Mattering, Emotional Exhaustion, and Job Satisfaction in Adapted Physical Educators.

Although much has been learned about the workplace experiences of physical education teachers, less is known about the unique experiences of adapted physical educators (APEs). Grounded in role socialization theory, the purpose of this study was to understand the relationships among perceived organizational support, resilience, perceived mattering, emotional exhaustion, and job satisfaction in APEs. The participants included 237 APEs from the United States, who completed an online survey. The primary data analyses included confirmatory factor analysis and structural equation modeling. The final structural model was a good fit for the data, χ2(199) = 327.25, p < .001, χ2/df = 1.64; root-mean-square error of approximation = .052 (90% confidence interval [.042, .062], p = .354); standardized root-mean-square residual = .050; nonnormed fit index = .959; comparative-fit index = .964. The results of this study highlight the importance of developing a workplace environment in which APEs feel supported in developing perceptions of matter, reducing emotional exhaustion, and improving job satisfaction.

Socialization of Preservice Adapted Physical Educators: Influence of Teacher Education.

Occupational socialization theory has been used to understand the recruitment, education, and socialization of physical education teachers for nearly 40 yr. It has, however, only recently been applied to the study of adapted physical education teachers. The purpose of this descriptive case study was to understand the socialization of preservice teachers in an adapted physical education teacher education graduate-level program. Participants included 17 purposefully selected preservice teachers (5 male and 12 female) enrolled in a yearlong graduate-level adapted physical education teacher education program. Qualitative data were collected using interviews, reflective journaling, and field notes taken during teaching and coursework observations. Data analysis resulted in the construction of 3 themes: overcoming contextual challenges to meet learners' needs, the importance of field-based teacher education, and coping with the challenges of marginalization. The discussion connects to and advances occupational socialization theory in adapted physical education and suggests that professional socialization may have a more profound influence on preservice adapted physical education teachers than on their physical education counterparts.

The role of radiation treatment in pleural mesothelioma: Highlights of the 14th International Conference of the International mesothelioma interest group.

Radiation remains an important component of mesothelioma treatment in 2018. Its use as a treatment modality continues to evolve as the technology for planning and delivery continues to improve. Use of radiation to improve local control in the involved hemithorax has been a common adjuvant treatment post extrapleural pneumonectomy for many years. Modern treatment options with advanced planning techniques including protons and intensity modulated radiation therapy lead to new potential options for treatment post lung-sparing surgery or in the unresectable setting. Presentations and discussions on the implementation of these strategies for palliation, treatment of oligometastatic recurrence or unresectable disease were the focus of a session dedicated to the role of radiation therapy at the 14th International Conference of the International Mesothelioma Interest Group and are reviewed in this article. Preclinical data to better understand how to integrate radiation and the delivery of novel systemic therapy approached like check point inhibitors are also presented.

Non-coding RNAs in Mammary Gland Development and Disease.

Non-coding RNAs (ncRNAs) are untranslated RNA molecules that function to regulate the expression of numerous genes and associated biochemical pathways and cellular functions. NcRNAs include small interfering RNAs (siRNAs), microRNAs (miRNAs), PIWI-interacting RNAs (piRNAs), small nucleolar RNAs (snoRNAs) and long non-coding RNAs (lncRNAs). They participate in the regulation of all developmental processes and are frequently aberrantly expressed or functionally defective in disease. This Chapter will focus on the role of ncRNAs, in particular miRNAs and lncRNAs, in mammary gland development and disease.

Body mass index and blood pressure screening in a rural public school system: the Healthy Kids Project.

INTRODUCTION: All students (N = 2053) in Anadarko public schools, grades kindergarten through 12, were invited to be screened for height, weight, and blood pressure to assess the health status of this multiracial, multiethnic (American Indian, white, African American, and Hispanic) population in southwestern Oklahoma. METHODS: The Centers for Disease Control and Prevention's 2000 growth charts were used to determine body mass index (BMI) percentiles, and standards from the National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents were used to assess blood pressure. RESULTS: Seven hundred sixty-nine students with active consent participated in the screening. Of these, approximately 28% were overweight. American Indians were at significantly greater risk of being overweight or at risk for overweight than whites (relative risk [RR], 1.4; 95% confidence interval [CI], 1.1-1.7) as were African Americans (RR, 1.5; 95% CI, 1.1-2.0), whereas Hispanics (RR, 1.3; 95% CI, 0.9-2.0) did not have a statistically significant increased risk compared with whites. BMI at or above the 95th percentile was strongly associated with elevated blood pressure (> or =90th percentile) (RR, 3.8; 95% CI, 2.6-5.4). CONCLUSION: Students who participated in this BMI screening in the Anadarko public school system evidenced high rates of excess weight, with American Indians and African Americans at greatest risk. Elevated BMI was strongly associated with elevated blood pressure.