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Objective: To investigate the operational outcomes and implementation effects of tiered cardiac telemetry monitoring in a hospital environment using an innovative technology. Patients and Methods: The research focuses on assessing the precision, speed, and reliability of alerts generated by a wireless device in adult patients aged 18 and above, concurrently monitored by a hardwired, continuous cardiac monitor. Using an agile methodology, we tested and validated a nonhardwired, cellular-connected continuous cardiac monitor (InfoBionic MoMe) in 162 patients. A comparison was made between the wireless device and the standard hardwired system, conducted at Mayo Clinic Hospital with Institutional Review Board approval from June 6, 2022, to December 15, 2022. Results: The study revealed a high correlation of events captured compared with the standard care model. Differences in algorithms, alarm parameters, and operational considerations impacting clinical implementation were observed. Connectivity improvements during the study reduced latency from 3-5 minutes to 30 seconds. Delayed alarms were attributed to device damage (4.5% of cases) and poor cellular connections (29% within 31-60 seconds). Conclusion: The implementation of tiered cardiac telemetry in hospital environments, coupled with advancements in remote cardiac monitoring, supports expanded bedside telemetry capabilities and near real-time remote monitoring postdischarge. Although the study successfully validated the wireless device concept, improvements are needed before implementation for inpatient cardiac monitoring. Further research and technological enhancements can build on these findings to enhance health care practices in this domain.

Academic labor has expanded beyond the walls of academic institutions. Academics are expected to communicate with students online, use digital tools to complete their work, and share their research with broad audiences--often through online spaces like social media. Academics also face technology-facilitated violence and abuse (TFVA) in these same spaces. When this happens, employers have a responsibility to protect and support workers. However, recent events have shown that universities are not always prepared to do so. We use data from a discourse analysis of harassment and discrimination policies and interviews with university managers (including Vice President Academics/Provost, Faculty Deans, and directors of human rights offices) to examine how prepared Canadian universities and colleges are to support academics targeted by TFVA. We found that institutions are unprepared in three ways: first, they focus on physical safety over non-contact harms; second, they envision perpetrators to be named, local, and part of the campus community; and third, the reporting process is cumbersome and outpaced by the speed and frequency with which TFVA occurs. We consider these findings in the context of work-overflow and context collapse to demonstrate how the institutional apparatus for maintaining a safe and respectful working environment has not expanded in kind with the extensification of contemporary academic labor.

Given the increase in students with learning disabilities entering university, we investigated a broader group--students with a history of reading difficulties (HRD)--who are known to be at risk of academic struggles. We identified the self-reported reading challenges and strategies of university students with HRD (n = 49) and those with no history of reading difficulties (NRD; n = 88) and examined group differences and relations with first-year grade point average (GPA). Students with HRD reported more difficulties with perceived reading comprehension, concentration, and reading speed than students with NRD. Groups differed in use of reading strategies: Students with HRD were descriptively more likely to reduce reading volume by using alternative materials and chose to read based on text length and availability of alternative materials. For both groups, reading completion and concentration strategies were positively related to GPA, while perceived difficulty with reading comprehension and choosing to read based on interest were negatively related to GPA. Some strategies were negatively associated with GPA for students with NRD, but not for students with HRD. Findings revealed the challenges that students with HRD experience with reading in university and identified strategies, potentially adaptive or maladaptive, that they used to manage their academic reading load.

Objective: Immune checkpoint inhibition (ICI) has significantly advanced the field of immuno-oncology, yet not all patients benefit from this therapy. Combining ICI with other therapeutic modalities, including tumor ablation, is currently being explored as a method to enhance ICI efficacy. Mechanical High-Intensity Focused Ultrasound (M-HIFU) represents a promising tumor ablative therapy, inducing cavitation within the tumor, resulting in tumor cell destruction and the release of danger signals and tumor antigens, two key factors contributing to anti-tumor immune responses.Methods/Results: Preclinical studies on the impact of M-HIFU on the anti-tumor immune response are guiding the translational application of this technique in the clinical setting. This review provides a comprehensive overview of the current understanding of the effects of M-HIFU on the immune system. We report on the effect of M-HIFU on soluble immune modulators and immune cells in different preclinical models, and potential contributions to the anti-tumor immune response. We discuss clinical studies applying M-HIFU and studies that have combined ICI with other ablative therapies to draw parallels to clinical implementation of M-HIFU. Further, we will highlight essential questions that should be addressed in future clinical trials exploring the combination of M-HIFU and ICI in the clinical setting.Conclusion: Overall, this review offers guidance for the clinical implementation of combining M-HIFU with ICI and highlights key questions that remain to be addressed in first clinical studies.

We present a synthesis of glacial geomorphology comprising Newfoundland and the surrounding continental shelf. During the last glaciation, this region was encompassed by the Newfoundland Ice Cap that coalesced with the Laurentide Ice Sheet and extended to the continental shelf edge. The subglacial geomorphic signal of terrestrial and marine portions of this ice sheet has been mapped using aerial photography, satellite imagery, SRTM DEMs, multibeam bathymetric data and onshore field mapping over the last 50 years. Here, we build on this, digitizing ∼146,380 features identified in published literature. Using newly available digital elevation data and multibeam bathymetric data, we identify ∼38,550 new features, such as undocumented ice thrust, crevasse and esker ridges and meltwater channels. This updated geomorphological map provides a record of paleo landforms over Newfoundland, enabling future efforts to reconstruct the dynamics, timing and erosion history of ice advance and retreat during the last glacial period..

Introduction: Tumor hypoxia is a feature of many solid malignancies and is known to cause radio resistance. In recent years it has become clear that hypoxic tumor regions also foster an immunosuppressive phenotype and are involved in immunotherapy resistance. It has been proposed that reducing the tumors’ oxygen consumption will result in an increased oxygen concentration in the tissue and improve radio- and immunotherapy efficacy. The aim of this study is to investigate the metabolic rewiring of cancer cells by pharmacological attenuation of oxidative phosphorylation (OXPHOS) and subsequently reduce tumor hypoxia. Material and methods: The metabolic effects of three OXPHOS inhibitors IACS-010759, atovaquone and metformin were explored by measuring oxygen consumption rate, extra cellular acidification rate, and [18F]FDG uptake in 2D and 3D cell culture. Tumor cell growth in 2D cell culture and hypoxia in 3D cell culture were analyzed by live cell imaging. Tumor hypoxia and [18F]FDG uptake in vivo following treatment with IACS-010759 was determined by immunohistochemistry and ex vivo biodistribution respectively. Results: In vitro experiments show that tumor cell metabolism is heterogeneous between different models. Upon OXPHOS inhibition, metabolism shifts from oxygen consumption through OXPHOS towards glycolysis, indicated by increased acidification and glucose uptake. Inhibition of OXPHOS by IACS-010759 treatment reduced diffusion limited tumor hypoxia in both 3D cell culture and in vivo. Although immune cell presence was lower in hypoxic areas compared with normoxic areas, it is not altered following short term OXPHOS inhibition. Discussion: These results show that inhibition of OXPHOS causes a metabolic shift from OXPHOS towards increased glycolysis in 2D and 3D cell culture. Moreover, inhibition of OXPHOS reduces diffusion limited hypoxia in 3D cell culture and murine tumor models. Reduced hypoxia by OXPHOS inhibition might enhance therapy efficacy in future studies. However, caution is warranted as systemic metabolic rewiring can cause adverse effects.

Abstract Background Hypoxia is a common feature of many solid tumors and causes radiotherapy and immunotherapy resistance. Pharmacological inhibition of oxidative phosphorylation (OXPHOS) has emerged as a therapeutic strategy to reduce hypoxia. However, the OXPHOS inhibitors tested in clinical trials caused only moderate responses in hypoxia alleviation or trials were terminated due to dose-limiting toxicities. To improve the therapeutic benefit, FDA approved OXPHOS inhibitors (e.g. atovaquone) were conjugated to triphenylphosphonium (TPP+) to preferentially target cancer cell’s mitochondria. In this study, we evaluated the hypoxia reducing effects of several mitochondria-targeted OXPHOS inhibitors and compared them to non-mitochondria-targeted OXPHOS inhibitors using newly developed spheroid models for diffusion-limited hypoxia. Methods B16OVA murine melanoma cells and MC38 murine colon cancer cells expressing a HIF-Responsive Element (HRE)-induced Green Fluorescent Protein (GFP) with an oxygen-dependent degradation domain (HRE-eGFP-ODD) were generated to assess diffusion-limited hypoxia dynamics in spheroids. Spheroids were treated with IACS-010759, atovaquone, metformin, tamoxifen or with mitochondria-targeted atovaquone (Mito-ATO), PEGylated mitochondria-targeted atovaquone (Mito-PEG-ATO) or mitochondria-targeted tamoxifen (MitoTam). Hypoxia dynamics were followed and quantified over time using the IncuCyte Zoom Live Cell-Imaging system. Results Hypoxic cores developed in B16OVA.HRE and MC38.HRE spheroids within 24 h hours after seeding. Treatment with IACS-010759, metformin, atovaquone, Mito-PEG-ATO and MitoTam showed a dose-dependent reduction of hypoxia in both B16OVA.HRE and MC38.HRE spheroids. Mito-ATO only alleviated hypoxia in MC38.HRE spheroids while tamoxifen was not able to reduce hypoxia in any of the spheroid models. The mitochondria-targeted OXPHOS inhibitors demonstrated stronger anti-hypoxic effects compared to the non-mito-targeted OXPHOS inhibitors. Conclusions We successfully developed a high-throughput spheroid model in which hypoxia dynamics can be quantified over time. Using this model, we showed that the mitochondria-targeted OXPHOS inhibitors Mito-ATO, Mito-PEG-ATO and MitoTam reduce hypoxia in tumor cells in a dose-dependent manner, potentially sensitizing hypoxic tumor cells for radiotherapy.

Tertiary Lymphoid Structures (TLS) are organized aggregates of immune cells such as T cells, B cells, and Dendritic Cells (DCs), as well as fibroblasts, formed postnatally in response to signals from cytokines and chemokines. Central to the function of TLS are DCs, professional antigen-presenting cells (APCs) that coordinate the adaptive immune response, and which can be classified into different subsets, with specific functions, and markers. In this article, we review current data on the contribution of different DC subsets to TLS function in cancer and autoimmunity, two opposite sides of the immune response. Different DC subsets can be found in different tumor types, correlating with cancer prognosis. Moreover, DCs are also present in TLS found in autoimmune and inflammatory conditions, contributing to disease development. Broadly, the presence of DCs in TLS appears to be associated with favorable clinical outcomes in cancer while in autoimmune pathologies these cells are associated with unfavorable prognosis. Therefore, it is important to analyze the complex functions of DCs within TLS in order to enhance our fundamental understanding of immune regulation but also as a possible route to create innovative clinical interventions designed for the specific needs of patients with diverse pathological diseases.

Abstract Objectives PD‐1/PD‐L1 immune checkpoint blockade can be an effective treatment for advanced breast cancer patients. However, patients with oestrogen receptor positive (ER+) tumors often display only low lymphocyte infiltration, while a large part of triple negative (TN) breast tumors does not generate an effective immunotherapy response. Therefore, new treatment strategies have to be developed. Here, we investigate Siglec‐7 and Siglec‐9 as novel ITIM‐bearing inhibitory immune checkpoint receptors similar to PD‐1, but expressed on a broader range of immune cells. Methods We assessed Siglec‐7 and Siglec‐9 (ligand) expression in TN and ER+ breast cancer tumors and their breast cancer cell line‐induced signalling. Results We report that Siglec‐7 and Siglec‐9 are highly expressed in TN tumors, and to a low extent in ER+ tumors. Siglec‐7 was observed on myeloid cells, T cells, and NK cells and Siglec‐9 preferentially on myeloid cells. Expression of sialoglycans, including Siglec‐7 and Siglec‐9 ligands, was observed in both TN and ER+ breast cancer tissue sections. Expression levels of Siglec‐7 and Siglec‐9 ligands were higher on in vitro cultured TN cell lines than ER+ cell lines. Importantly, by applying chimeric Siglec‐7 reporter cells, we showed the induction of Siglec‐7 signalling by multiple TN cell lines, but only by one ER+ cell line. Moreover, Siglec‐7 signalling is directly related to Siglec‐7 ligand expression levels of breast cancer cell lines. Conclusion These data imply that immunotherapy targeting Siglec receptors may be particularly interesting for TN breast cancer patients not responding to current treatment strategies with tumors displaying high immune cell infiltration.

The T cell is an immune cell subset highly effective in eliminating cancer cells. Cancer immunotherapy empowers T cells and occupies a solid position in cancer treatment. The response rate, however, remains relatively low (

Introduction: Dapsone is known to cause drug-induced liver injury (DILI) but can rarely induce the formation of hepatic granulomas. We describe a patient with jaundice who demonstrated granulomas on liver biopsy in response to dapsone. Her symptoms were only evident once steroids, used to also treat her pyoderma gangrenosum, had been tapered. Case Presentation: In this case, a 67-year-old female was hospitalized due to 1 day of jaundice. She had started dapsone and prednisone concurrently 7 weeks ago to treat her pyoderma gangrenosum. Steroids were discontinued 4 days prior to symptoms. Her laboratories were notable for newly elevated alkaline phosphatase (756 U/L), aspartate transaminase (199 U/L), alanine transaminase (273 U/L), and total bilirubin (12.6 mg/dL). Dapsone was held due to suspicion for DILI. A liver biopsy was performed and disclosed non-necrotizing hepatic granulomas. After infectious and autoimmune causes were excluded, dapsone was determined to be the cause of her hepatic granulomas. Her bilirubin and liver enzymes steadily normalized over the next 4 weeks following discontinuation of dapsone. Conclusion: Thus, dapsone-related liver injury may present following a steroid taper if dapsone and steroids had been initially started together. Hepatic granulomas, though rare, can be seen when dapsone causes DILI.

Abstract Background More than three‐fourths of cervical cancer cases occur in low‐ and middle‐income countries, with sub‐Saharan Africa (SSA) accounting for approximately 25% of global mortality. The significant rise in the prevalence of cervical cancer in SSA amplifies the burden on caregivers, contributing to elevated rates of mental illness, particularly among spouses who provide care. Men who assume the role of caregivers for their partners with cervical cancer encounter unique challenges and substantial adjustments across multiple facets of life, impacting both their own quality of life and that of their partners. Despite this, there is a notable lack of extensive research on the experiences of male partners in caregiving roles, particularly within SSA countries like Tanzania. Therefore, this study aimed to explore the experiences of male partners providing care for women with cervical cancer in Dar es Salaam, Tanzania. Methods An exploratory qualitative study was undertaken to explore the experiences of 13 male partners, selected purposively and guided by the principle of saturation. Data gathering employed in‐depth interviews utilizing a semistructured interview guide, with subsequent analysis conducted via a thematic analysis approach. Results Five themes and 13 subthemes were generated, encompassing psychosocial distress, attitudes towards cervical cancer, unity in the provision of care, economic burden, and altered sexual relationships. Participants reported experiencing emotional distress, shifts in social responsibilities, financial challenges, and unfulfilled sexual needs. Moreover, they expressed the need for social, psychological, financial, and sexual and reproductive support. Conclusion This study underscores the numerous challenges encountered by male partners caring for women with cervical cancer, encompassing emotional distress, financial strain, and shifts in social and sexual dynamics. The identified themes and subthemes highlight the intricate interplay of these difficulties and stress the necessity for holistic support systems addressing the social, psychological, financial, and sexual aspects of male partners' experiences. The findings emphasize the importance of designing and implementing comprehensive support programmes tailored to the diverse needs of male partners, ultimately enhancing their quality of life and overall well‐being. Patient or Public Contribution Before the study, the nursing manager assisted in selecting three male partners randomly. These partners were involved in the design of the participants' information sheet, the evaluation of the interview schedule and rooms, and the dissemination of information about the study's purpose to the target population. Their valuable input contributed to improving the participant information sheet, refining data collection procedures and addressing ethical considerations. However, these individuals were not considered study participants. Throughout the study, in‐charge nurses in the hospital were informed about the study's goals and helped organize appointments with participants and manage the interview schedule.

Background/Objectives: Physical literacy (PL) is essential to the holistic human experience, emphasizing embodied capability and affording opportunities for inclusive engagement. Despite its recent use as a core programming element, PL from the experiential point of view of individuals experiencing disability has yet to be explored. Excluding these perspectives promotes a culture of ableism, one that devalues the embodied capabilities of those experiencing the world differently. The purpose of this study was to highlight the participant perspective related to PL and explore the value individuals experiencing disability attribute to PL and its development. Methods: Using the communities of practice theoretical model of knowledge as a conceptual framework, 13 participants experiencing disability participated in two focus groups. Participants’ experiences were thematized via the use of thematic analysis, and voices were portrayed through composite narratives, highlighting the shared participant experience and value associated with PL. Results: Three themes emerged: (1) imagine the possibilities, (2) dance like nobody's watching, and (3) no wrong way to move. Composite narratives reflect PL as a valued means of exploration and learning, personal growth, and opportunity related to physical activity and social interaction. Participant value was considered to be enhanced via a learning climate affording opportunities for developing autonomy and a sense of belonging. Conclusion: This research provides an authentic understanding of PL within the context of disability, and what might be used to facilitate its development in such an environment. Individuals experiencing disability contributed to this knowledge and must be continually involved to ensure PL development is inclusive to all.

The tumor microenvironment of glioblastoma IDH-wildtype is highly immune suppressive and is characterized by a strong component of myeloid-derived suppressor cells (MDSCs). To interfere with the immune suppressive functions of MDSCs, a comprehensive understanding on how MDSCs acquire their suppressive phenotype is essential. Previously, we and others have shown a distinct Sialic acid-binding immunoglobulin-like lectin (Siglec) receptor expression profile for MDSCs in glioblastoma. Siglec receptors can transmit inhibitory signals comparable to PD-1 and are suggested to act as glyco-immune checkpoints. Here, we investigated how glioma specific Siglec-sialic acid interactions influence myeloid immune suppressive functions. Co-culturing monocytes with glioblastoma cells induced CD163 expression on the monocytes. Upon desialylation of the glioblastoma cells, this induction of CD163 was hampered, and furthermore, the monocytes were now able to secrete higher amounts of IL-6 and TNFα compared to fully sialylated glioblastoma cells. Additionally, Siglec-specific triggering using anti-Siglec-7 or Siglec-9 antibodies displayed a decreased TNFα secretion by the monocytes, validating the role of the Siglec–Sialic axis in the co-culture experiments. Together, our results demonstrate that glioblastoma cells induce a myeloid immune-suppressive phenotype that could be partly rescued by lowering the glioblastoma-associated sialic acid levels. This manuscript supports further research of the Siglec–Sialic acid axis in the context of glioblastoma and its potential to improve clinical outcome.

Background Cognitive deficits are associated with poor quality of life and increased risk of development of dementia in patients with Parkinson’s disease (PD) psychosis. The trajectory of cognitive decline in PD psychosis remains however unclear.Objective We examined this using data from the Parkinson’s Progression Markers Initiative study.Methods We analysed data from patients with drug-naïve PD (n=676) and healthy controls (HC, n=187) over 5 years, and examined all cognitive measures assessed at each time point. We classified patients with PD into those who developed psychosis over the course of the study (PDP) and those without psychosis throughout (PDnP) using the Movement Disorders Society Unified Parkinson’s Disease Rating Scale part I hallucinations/psychosis item. We used linear mixed-effect models with restricted maximum likelihood. Age, sex, ethnicity, education and neuropsychiatric and PD-specific symptoms were entered as covariates of interest.Findings There were no baseline cognitive differences between PD patient groups. There were differences in cognitive performance between PD and HC across the majority of the assessments.Patients with PDP exhibited greater cognitive decline over 5 years compared with PDnP across most domains even after controlling for sociodemographics, depression, sleepiness, rapid eye movement sleep behaviour disorder and motor symptom severity (immediate recall, b=−0.288, p=0.003; delayed recall, b=−0.146, p=0.003; global cognition, Montreal Cognitive Assessment, b=−0.206, p

Proverbs 30:3–5 depends on Job 38–39, hence, the use of the divine name Eloah in Prov 30:5. We note the same in Ps 18:31 but with the substitution of the name of YHWH for Eloah, as part of the messianic Yahwist reaffirmation of the writing of the whole Psalter. In this perspective, Ps 18:32 identifies Eloah with YHWH. In the parallel of 2 Sam 22 to Ps 18, the name Eloah is not repeated, the emphasis being on the relationship between David and the Psalter. Deuteronomy 32 agrees with the overall redaction of the Psalter, which jointly reaffirms the Davidic Messiah and the Torah of Moses, in the general introduction (Ps 1, the Torah and Ps 2, the Messiah), in the first Book, Pss 3––41 (Ps 18, the Messiah and Ps 19, the Torah) and the fifth Book, Pss 107–150 (Ps 119, the Torah and Pss 120–132, the Messiah). Thus as inclusion, Deut 32:2–4 is based on Ps 18:31–32 with the reference to YHWH the ROCK, an allusion to the Temple and its cult, including the performance of the Psalter. The vocabulary of this passage from Ps 18 appears again in the following verses of Deut 32, including the name Eloah in Dt 32:15, 17, its only occurrences in Deuteronomy.

The weathering alkalinity flux from mid-latitudes to the ocean will be strongly altered by climate warming by 2100. Under different emissions scenarios either a strengthening or a weakening of the flux and thus of the oceanic CO2 buffer is predicted.

Abstract Background Fitspiration is a social media phenomenon purported to inspire viewers to lead healthier lifestyles but can result in negative psychological outcomes such as body dissatisfaction. This study aimed to develop a tool to audit Instagram fitspiration accounts and screen for content that could have potentially negative psychological effects. Methods This study developed and implemented an audit tool to (1) identify credible fitspiration accounts (i.e., accounts that do not portray potentially harmful or unhealthy content) and (2) describe the content of identified accounts. The most recent 15 posts of 100 leading Instagram fitspiration accounts were audited. Accounts were deemed non-credible and were excluded if they contained fewer than four fitness-related posts or portrayed nudity or inappropriate clothing, sexualisation or objectification, extreme body types, “thinspiration”, or negative messages. Results Many accounts contained fewer than four fitness-related posts (n = 41), sexualisation or objectification (n = 26), nudity or inappropriate clothing (n = 22), and/or extreme body types (n = 15). Three accounts failed on all four criteria, while 13, 10 and 33 failed on three, two, or one criterion, respectively. Therefore, only 41% of accounts were considered credible. Inter-rater reliability (percentage agreement and Brennan and Prediger’s coefficient κq) was high (Stage 1: 92% agreement [95% CI 87, 97], κq 0.84 [95% CI 0.73, 0.95]; Stage 2: 93% agreement [95% CI 83, 100], κq 0.85 [95% CI 0.67, 1.00]). Account holders of credible fitspiration accounts were predominantly female (59%), aged 25–34 (54%), Caucasian (62%), and from the United States (79%). Half held a qualification related to physical activity or physical health (e.g., personal trainer, physiotherapy; 54%). Most included accounts included an exercise video (93%) and example workout (76%). Conclusion While many popular Instagram fitspiration accounts offered credible content such as example workouts, many accounts contained sexualisation, objectification or promotion of unhealthy or unrealistic body shapes. The audit tool could be used by Instagram users to ensure the accounts they follow do not portray potentially harmful or unhealthy content. Future research could use the audit tool to identify credible fitspiration accounts and examine whether exposure to these accounts positively influences physical activity.

Deglaciation of the northwestern Laurentide Ice Sheet in the central Mackenzie Valley opened the northern portion of the deglacial Ice-Free Corridor between the Laurentide and Cordilleran ice sheets and a drainage route to the Arctic Ocean. In addition, ice sheet saddle collapse in this section of the Laurentide Ice Sheet has been implicated as a mechanism for delivering substantial freshwater influx into the Arctic Ocean on centennial timescales. However, there is little empirical data to constrain the deglaciation chronology in the central Mackenzie Valley where the northern slopes of the ice saddle were located. Here, we present 30 new 10Be cosmogenic nuclide exposure dates across six sites, including two elevation transects, which constrain the timing and rate of thinning and retreat of the Laurentide Ice Sheet in the area. Our new 10Be dates indicate that the initial deglaciation of the eastern summits of the central Mackenzie Mountains began at ∼15.8 ka (17.1–14.6 ka), ∼1000 years earlier than in previous reconstructions. The main phase of ice saddle collapse occurred between ∼14.9 and 13.6 ka, consistent with numerical modelling simulations, placing this event within the Bølling–Allerød interval (14.6–12.9 ka). Our new dates require a revision of ice margin retreat dynamics, with ice retreating more easterly rather than southward along the Mackenzie Valley. In addition, we quantify a total sea level rise contribution from the Cordilleran–Laurentide ice saddle region of ∼11.2 m between 16 and 13 ka.

Physical literacy (PL) has been readily accepted and integrated globally, including organizations affording services to individuals experiencing disability. Despite its uptake, recent research has illustrated that understandings of PL reflect the normative standards of those who do not experience disability, leading to practices that diminish the unique and embodied capability of others while simultaneously validating ableism. While a shift towards recognizing and valuing the heterogeneity associated with PL has recently occurred, the ableist narrative persists. As a result, the operationalization of PL directly contradicts its conceptualization, fostering a physical activity climate that continues to marginalize individuals experiencing disability. With this in mind, this paper critically unpacks PL, challenging the existing ableist narrative and offering suggestions to heighten the level of inclusivity that underscores PL. Pathways, where physical activity professionals contribute to reproducing ableism, will be discussed.