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In the past four decades, reports of an unusual vascular disease affecting young and otherwise healthy endurance athletes have begun to emerge. This rare entity has been coined as external iliac artery endofibrosis (EIAE). It has been primarily described in high-level competitive cyclists, suggesting a biomechanical etiology given the repetitive flexion and extension of the hip joint associated with cycling.1,2 Patients present with symptoms of claudication at peak levels of exertion, levels not usually achievable by the untrained individual. Lesions are predominantly isolated to the external iliac artery (EIA), and histologic examination reveals endothelial thickening and fibrosis without evidence of atherosclerosis.1–5 Cases of EIAE have been overwhelmingly described in male athletes, with a paucity of reports in females.2,3 We herein describe two cases of elite female athletes afflicted by EIAE and review the current literature pertaining to this entity in females. Both patients consented to publication of their case details and images.

Meaningful progress in improving employment outcomes for people with intellectual and developmental disabilities continues to be elusive, despite 40 years of investment in research, policy, and supports. This article reviews the current state of employment for individuals with intellectual and developmental disabilities (IDD) and describes policy, practice, and individual factors that influence employment outcomes. Research suggests the need for a holistic approach to change that addresses systems-level strategy, policy, and fiscal investment while strengthening individual experiences with employment and related day services. Recommendations address strengthening the implementation of employment policy, developing pathways to employment, and engaging individuals with IDD and, in particular, individuals with diverse social characteristics in reflecting on the quality of their experiences and supports.

Future mathematics teachers must integrate their knowledge of mathematics, pedagogy, and learners to effectively teach mathematics. Historically, these different forms of knowledge were taught separately in teacher preparation and left to the preservice teacher to integrate on their own. This raises the question; what resources can be leveraged to promote knowledge integration in mathematics courses for teachers? In this study, we identified six instructional actions that were associated with potential knowledge integration when implemented within the environment of a mathematics course for preservice teachers. We posit these instructional actions can be implemented in concise and minimally invasive ways in a variety of mathematics content courses. Further unpacking of these instructional actions and considerations for implementation are provided.

Multistep synthesis is a key capstone experience in organic laboratory instruction. Here, a four-step synthesis of avobenzone, an active component in sunscreens, has been developed that can be completed in two 4 h laboratory periods. This synthesis incorporates green principles and includes an aldol condensation, electrophilic addition of bromine to an alkene, an E2 dehalogenation of a dibromide, and hydration of an alkyne. Highlights of this synthesis include the use of coupling constants to identify alkene configuration, NMR analysis to determine preferred tautomeric form, the use of microwave irradiation to reduce reaction times, a solvent-free synthesis of a chalcone, and a three-step reaction that can be completed in a single lab period.

The structures of secondary mathematics teacher preparation (SMTP) programs in the United States are not well documented. This study sought to identify baseline data for SMTP programs. Survey data was collected from 86 different institutions regarding their SMTP programs. Results indicated that most SMTP programs are housed in mathematics departments, with programs often producing less than 10 teachers per year. Additionally, four-year SMTP programs were most common, with nearly all requiring a teaching methods course as well as clinical experiences. Tenure or tenure-track faculty did most student teaching supervision. Half of the participating institutions reported having a capstone course.

Given the central role that excellent presentation skills plays in management, methods for better developing these skills represent an important area of focus in business education. Rapidly evolving distributed (distance) technologies have compelled businesses to reimagine practices in most areas, and presentations are no exception. In the present study, we examine the potential advantages of video presentations--not from the perspective of the audience, but rather from the perspective of the student as immersed in the process of developing individual presentation skills. We crafted a course project where students collaborate to create a video presentation, replacing a more traditional in-class presentation. To test the effectiveness of this new approach, we conducted a study in which measures from multiple course sections using either the new video creation approach or the traditional presentation approach were compared. For the former, we found a significant improvement in students' presentation skills on five dimensions (central message, supporting material, language, organization, and delivery) as evaluated with the authoritative Oral Communication VALUE Rubric developed by the Association of American Colleges and Universities. We describe the project and the study, and end the article with lessons learned and recommendations for expanding the project's applications to other courses.

Abstract Aims Understanding of the pathophysiology of progressive heart failure (HF) in patients with heart failure with preserved ejection fraction (HFpEF) is incomplete. We sought to identify factors differentially associated with risk of progressive HF death and hospitalization in patients with HFpEF compared with patients with HF and reduced ejection fraction (HFrEF). Methods and results Prospective cohort study of patients newly referred to secondary care with suspicion of HF, based on symptoms and signs of HF and elevated natriuretic peptides (NP), followed up for a minimum of 6 years. HFpEF and HFrEF were diagnosed according to the 2016 European Society of Cardiology guidelines. Of 960 patients referred, 467 had HFpEF (49%), 311 had HFrEF (32%), and 182 (19%) had neither. Atrial fibrillation (AF) was found in 37% of patients with HFpEF and 34% with HFrEF. During 6 years follow‐up, 19% of HFrEF and 14% of HFpEF patients were hospitalized or died due to progressive HF, hazard ratio (HR) 0.67 (95% CI: 0.47–0.96; P = 0.028). AF was the only marker that was differentially associated with progressive HF death or hospitalization in patients with HFpEF HR 2.58 (95% CI: 1.59–4.21; P

Abstract Background There is no standard assessment tool for pediatric home care recipients in Canada, limiting the availability of comparable, population-based data. The objective of this study was to describe pediatric home care recipients who were part of a pilot implementation of the interRAI Pediatric Home Care Assessment Form (PEDS-HC) among medically complex children referred to home care agencies in three regions in Ontario, Canada. Methods All 14 agencies providing home care to children in Ontario were invited to participate in the pilot project, and 9 participated in an education session. Three of these agencies used the PEDS-HC during the pilot implementation between February 2018 and March 2020. We used de-identified data to describe the demographics, home care needs, and diagnoses of pediatric home care recipients. Results The sample of 474 assessments was predominantly male (60.34%), with an average age at assessment of 12.36 years (SD 4.56). Most (78.48%) reported English as their primary language. Most children assessed had between two and eight medical diagnoses. Diagnoses reported varied: gastrointestinal, musculoskeletal, respiratory and neurological conditions were most common. The prevalence of urinary incontinence (40.1%) and bowel incontinence (70.9%) were high. Over 60% of children were rarely or only sometimes understood. A majority of children had adequate hearing (83.5%) and vision (68.6%). Extensive services were being provided in 10% of children assessed. Most children received care both at school and at home (70.89%), with 20.89% receiving home care only. Conclusions The PEDS-HC provides a detailed, standardised descriptive profile of medically complex children receiving home care. Expanding use of PEDS-HC would promote consistency in care planning and delivery on the patient level, enable cross-jurisdictional comparisons, and inform utilization tracking and health care funding decisions on the organization and provincial levels.

We sequenced the complete mitochondrial genome of the flatworm Australopacifica atrata. The species, originally described from New South Wales, Australia, has been found in various locations in the British Isles, New Zealand and in the United States of America; it is thus potentially invasive. The genome is 16513 bp long, encodes for 12 protein coding genes, two ribosomal RNA genes and 20 tRNA genes, and is completely colinear with the other two available Rhynchodeminae. In addition, it shares with them some unusual characters discriminating them from members of the other subfamilies of Geoplanidae, the most noticeable being the extra length of its cox2 gene. The data allow a reliable multigene phylogeny to be derived, and also provide a means of accurate biomonitoring of possible invasiveness by A. atrata.

Teachers in Catholic schools are not immune from pressures to improve students' scores on high stakes tests, and standards-based education is not new to Catholic schools. Nationally, many public school systems have moved to implement Common Core State Standards (CCSS) or other similar standards. Assessment, in turn, has been tied to these standards. In many states, Catholic schools have the option as to whether to implement accepted state standards or to create standards of their own. The Committee on Catholic Education (CCE) gives each bishop the authority to lead the CCSS discussion at the local level and to eventually make a decision based on what is best for each individual diocese (2014). Regardless of implementation of government mandates, students graduating from Catholic schools will ultimately be held to the same standards and outcome-based measures when it comes to their graduates' ability to compete for post-secondary educational scholarships, national merits, and other accolades based in part on national standardized test scores. The academic achievement data provided by public school systems allow parents and others to see if their students meet grade level standards. Catholic schools then, must provide such data if they wish to measure themselves against those enrolled in the competing public and private schooling options. If Catholic schools are to remain a viable option in this ever-increasing competitive educational environment, teachers must become more comfortable collecting and analyzing data in an effort to help drive instruction and high levels of academic achievement. The collection of data to drive instruction is often referred to as data informed instruction (DII). The premise behind DII is to imbed data collection into daily classroom routines, use the data to make any necessary instructional plans or modifications, and to continuously monitor student performance to predict academic gains. When DII is used properly, it becomes an ongoing formative assessment. These formative assessments allow progress monitoring at the individual, class-wide and building levels, while providing an opportunity for teachers to adjust teaching strategies and make instructional modifications as needed (Sattler, 2001). This article outlines how Catholic schools can set up a professional development program that informs, educates, and gains buy-in from teachers surrounding the use of data-informed instruction in Catholic classrooms and across a diocese. The steps that are addressed include the need to change perceptions, inform teachers on how to collect and examine data (behavioral and educational), and end with ways to help make data collection and analysis an efficient component of daily routines.

With the rapid advancements of technology, online communication in both K-12 and post-secondary instruction has been widely implemented. Instructors as well as researchers have used various frameworks to evaluate different aspects of online discussions' quality. The online discussions take place synchronously or asynchronously in chat rooms, boards, and blogs, often using mobile applications and usually aimed at understanding course content and concepts. The current review follows up on Spatariu, Hartley, and Bendixen's (2004) classification that placed these frameworks in four categories based on what they were aimed at measuring (disagreement, argumentation, interaction, and content). The current review serves two main purposes. First, newer frameworks are categorized and described while addressing methodological considerations. Second, conclusions and recommendations for future research and instructional applications of online discussion evaluation are made.

Growing up gifted often means growing up "different." As schools struggle to provide appropriately designed interventions for student mental health issues, the role of the school psychologist is becoming increasingly important. In the present article, the role of the school psychologist is discussed, particularly as related to helping gifted students who may be manifesting symptoms of depression, suicidal ideation, and potentially suicidal behavior. Further, a holistic intervention approach is advocated and that accounts for four growth factors--intrapersonal, interpersonal, environmental/contextual, and developmental. Importantly, the specific strategies discussed are designed to help the school psychologist in their many capacities of helping gifted students thrive. Increasingly, however, it must also be recognized that the role of the school psychologist has expanded in recent years, and thus many of the intervention strategies offered may require a team of professionals to effectively implement. Regardless, the strategies discussed are designed to help gifted students thrive in the school setting.

In the United States, employment experiences of people with intellectual and developmental disabilities (IDD) have been dominated by discrepancies between recent policy shifts promoting integrated employment for people with IDD and the stagnation of the employment rate in integrated settings for this population. Although there is no direct source for labor force participation for individuals with IDD in the general population, data from the National Core Indicators Project suggest that, in 2015-2016, only 19% of working-age adults supported by state IDD agencies worked in one of the three forms of integrated employment--group-supported, individual-supported, or competitive (individualized and without supports). Twelve percent (12%) worked in competitive or individual-supported employment, and 7% worked in group-supported employment (Hiersteiner, Bershadsky, Bonardi, & Butterworth, 2016). In addition, individual employment supports have not been implemented with fidelity to a consistent model or set of expectations, and participation in nonwork services has grown rapidly (Domin & Butterworth, 2013; Migliore et al., 2012; Winsor et al., 2017).

Abstract Background Drug-free tracheal intubation has been a common intervention in the context of out-of-hospital cardiac arrest for many years, however its use by paramedics has recently been the subject of much debate. Recent international guidance has recommended that only those achieving high tracheal intubation success should continue to use it. Methods We conducted a retrospective service evaluation of all drug-free tracheal intubation attempts by specialist paramedics (critical care) from South East Coast Ambulance Service NHS Foundation Trust between 1st January and 31st December 2019. Our primary outcome was first-pass success rate, and secondary outcomes were success within two attempts, overall success, Cormack-Lehane grade of view, and use of bougie. Results There were 663 drug-free tracheal intubations and following screening, 605 were reviewed. There was a first-pass success rate of 81.5%, success within two attempts of 96.7%, and an overall success rate of 98.35%. There were ten unsuccessful attempts (1.65%). Bougie use was documented in 83.4% on the first attempt, 93.5% on the second attempt and 100% on the third attempt, Conclusion Specialist paramedics (critical care) are able to deliver drug-free tracheal intubation with good first-pass success and high overall success and are therefore both safe and competent at this intervention.

The sea slug Melibe leonina is an excellent model system for the study of the neural basis of satiation, and previous studies have demonstrated that stomach distention attenuates feeding. Here we expanded on this work by examining the pathway communicating stomach distention to the central nervous system and the effects of distention on motor output. We found that the posterior nerves (PN), which extend posteriorly from the buccal ganglia and innervate the stomach, communicate stomach distention in Melibe. PN lesions led to increased feeding duration and food consumption, and PN activity increased in response to stomach distention. Additionally, the percentage of incomplete feeding movements increased with satiation, and PN stimulation had a similar impact in the nerves that innervate the oral hood. These incomplete movements may be functionally similar to the egestive, food rejecting motions seen in other gastropods and enable Melibe to remain responsive to food, yet adjust their behavior as they become satiated. Such flexibility would not be possible if the entire feeding network were inhibited.

Thousands of children are diagnosed with cancer each year and are unable to participate in normative developmental and cultural contexts such as school. Little is known about how children with cancer perceive attending school in alternative settings, such as the home and hospital, while receiving treatment. This study coded the drawings of 10 children with cancer to explore how they perceive these school experiences; adapted from previous developmental and medical literature, drawings were analyzed for expressions across developmental domains and representations of the illness experience. It was found that participants primarily represented social perceptions of their school experiences; physical and illness-related representations were varied and often absent from the drawings. Participants perceived schooling through a social lens, suggesting the need for interventions to maximize social interactions with teachers and peers in this population. Teachers working with children with cancer should maximize socialization opportunities during hospitalization and treatment to promote continued development. In addition, policymakers and health care administrators should fund and implement interactive and educational group programs for children with cancer and apply techniques to help these students remain connected with classmates in the community even during cancer therapy.

• Sleep, epilepsy and outcome measures were highly heterogenous across the literature. • Poor sleep related to reduced life quality in epileptic children and adolescents. • Sleep issues related to poor behaviour/mood in epileptic children and adolescents. • Poor sleep did not consistently relate to cognitive outcomes in paediatric epilepsy. • No study reported relationships with sleep and academics in paediatric epilepsy. In children and adolescents with epilepsy (CAWE), disturbed sleep and functional difficulties are frequently present, but their relationship is unclear. In this scoping review we aimed to explore associations between sleep and functional outcomes in CAWE. We registered the protocol with open science framework and conducted the review according to the PRISMA Extension for Scoping Reviews. We searched Medline, Embase, PsycINFO and PubMed for original studies reporting on relations between sleep and functional outcomes (adaptive/quality of life, behavioural/mood, cognitive & academic) in CAWE. To assess the quality of studies we used an extended version of the checklist employed by Winsor and colleagues [ 1 ]. We identified 14 studies that included 1,785 CAWE and 1,260 control children, with a mean age of 9.94 and 10.13 years, respectively. The studies were highly heterogeneous with respect to samples, epilepsy variables, and methods used to assess sleep and functional outcomes. The quality of studies was medium. Associations between sleep and adaptive/quality of life, behavioural/mood, cognitive and academic outcomes were examined in 2, 10, 6, and 0 studies, respectively. Across studies, in CAWE, greater sleep disturbances were related to worse behavioural/mood outcomes, ranging from depression/anxiety to ADHD symptoms. Sleep disturbances did not consistently relate to cognitive outcomes, but they related to worse adaptive outcomes in both studies that examined their relationship. Our study provides evidence of relationship between disturbed sleep and behavioural/mood difficulties, which alerts to the need for careful evaluation and treatment of sleep disturbances in CAWE. Our study also highlights the need to examine relationships between sleep and other functional outcomes in CAWE, as studies conducted in the general population suggest that sleep disturbances may be modifiable and associated with improved functional outcomes. [ABSTRACT FROM AUTHOR]

Abstract Human‐mediated hybridization threatens many native species, but the effects of introgressive hybridization on life‐history expression are rarely quantified, especially in vertebrates. We quantified the effects of non‐native rainbow trout admixture on important life‐history traits including growth and partial migration behavior in three populations of westslope cutthroat trout over five years. Rainbow trout admixture was associated with increased summer growth rates in all populations and decreased spring growth rates in two populations with cooler spring temperatures. These results indicate that non‐native admixture may increase growth under warmer conditions, but cutthroat trout have higher growth rates during cooler periods. Non‐native admixture consistently increased expression of migratory behavior, suggesting that there is a genomic basis for life‐history differences between these species. Our results show that effects of interspecific hybridization on fitness traits can be the product of genotype‐by‐environment interactions even when there are minor differences in environmental optima between hybridizing species. These results also indicate that while environmentally mediated traits like growth may play a role in population‐level consequences of admixture, strong genetic influences on migratory life‐history differences between these species likely explains the continued spread of non‐native hybridization at the landscape‐level, despite selection against hybrids at the population‐level.

Many bacteria use the second messenger cyclic diguanylate (c-di-GMP) to control motility, biofilm production and virulence. Here, the authors identify a thermosensitive enzyme that synthesizes c-di-GMP and modulates temperature-dependent motility, biofilm development and virulence in the opportunistic pathogen Pseudomonas aeruginosa.