Lawyers for Jamaal Howard, a Texas inmate scheduled for execution on Wednesday, are seeking to halt his lethal injection by highlighting concerns about the potential degradation of execution drugs, drawing parallels to the botched execution of Christa Pike in Tennessee last week. Howard, convicted of capital murder in the 2000 killing of Vickie Swartout, is set to become the first person executed in the US since Pike's failed injection. His attorneys argue that the pentobarbital to be used in his execution is past its beyond-use date, posing a similar risk to Pike's case where two doses failed to induce unconsciousness. Pike, who survived the attempt, is now conscious and speaking after receiving critical medical care, with her recovery described as 'medically unprecedented.' Howard's legal team has also raised claims of intellectual disability, though the state disputes this, stating he has not provided sufficient evidence. The case has prompted a pending appeal to the US Supreme Court, which in 2002 banned the execution of intellectually disabled individuals but allowed states discretion in determining such cases. Howard's execution would mark the 30th in the US this year and the seventh in Texas, with two more executions scheduled after him. The news follows a detailed account of the 2000 robbery and murder at a Silsbee store, where surveillance footage showed Howard shooting Swartout during a robbery. The case has drawn significant attention to the reliability of lethal injection protocols and the ethical implications of executing inmates with potentially compromised drugs. Howard's lawyers are requesting further information about the Tennessee execution failure to support their argument that Texas's drug supply may be similarly compromised. The state has not yet responded to these requests, and the execution remains scheduled for Wednesday.

Background: A sedentary lifestyle is a global health crisis that contributes to chronic disease and premature mortality. Adolescents with mild intellectual disability attending Dutch practical education (PrO) schools face elevated health risks due to low levels of physical activity (PA) and limited conceptual, social, and practical skills. Digital health interventions offer scalable solutions, but require contextual adaptation informed by formative research. However, understanding of PA behavior in this population and context remains limited because existing research relies on partial lenses and lacks integration of theory, participatory methods, and multistakeholder insights. Objective: We aimed to identify and prioritize PA determinants among adolescents with mild intellectual disability in Dutch PrO schools, using a theory-driven, participatory, and multistakeholder approach to inform the contextual adaptation of digital health interventions. Methods: We used an exploratory sequential mixed methods study design integrating context mapping and concept mapping. Inclusive participatory methods were co-designed with PrO schools for adolescents. In the first qualitative phase, PA determinants were identified through data collected from experts (n=13), teachers (n=8), and adolescents (n=83‐90). Qualitative data from all stakeholder groups were integrated and analyzed using a framework approach grounded in the Theoretical Domains Framework and the Capability, Opportunity, Motivation-Behavior model. In the subsequent quantitative phase, the PA determinants identified across all data sources were translated into inclusive pictorial rating instruments and prioritized from the adolescents’ perspectives using a 7-point Likert scale ranging from barriers to facilitators. Quantitative analyses included descriptive statistics and hierarchical clustering to examine perceived importance and consensus across determinants. Results: Qualitatively, 29 PA determinants were identified and mapped to Capability, Opportunity, Motivation-Behavior components: opportunity (n=15), motivation (n=8), and capability (n=6). Experts and teachers focused on capability and opportunity barriers (eg, impaired skills and cognitive fatigue), while adolescents emphasized motivation and social opportunity facilitators (eg, fun activities, enjoyment, and peer or family support). Quantitatively, adolescents’ ratings showed a positive bias toward facilitators (mean 5.09/7, SD 1.72), and facilitators showed greater consensus than barriers (=0.74). Adolescents rated several determinants as facilitators that experts and teachers emphasized as barriers (eg, those related to impaired skills and self-efficacy). Conclusions: Three meta-inferences informing future intervention adaptation were derived: (1) substantial individual variation exists in adolescents’ perceptions of PA determinants, (2) school-related barriers are highly individualized, and (3) social and emotional facilitators tend to be relatively more shared across adolescents. Integrating findings suggests a dual approach to promoting PA in this population and context: personalized strategies for individual barriers and group-level strategies for shared facilitators. Digital health interventions seem promising to provide accessible and inclusive means of delivering this dual approach at scale.

Kids born with certain congenital infections are approximately three times more likely to be diagnosed as having autism, according to a study out of the Karolinska Institutet in Stockholm, Sweden.

Kids born with certain congenital infections are approximately three times more likely to be diagnosed as having autism, according to a study out of the Karolinska Institutet in Stockholm, Sweden.

CDKL5 deficiency disorder (CDD) is a rare developmental and epileptic encephalopathy resulting from variants in cyclin-dependent kinase-like 5 (CDKL5)…