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Aquatic invasive species have drastically changed how the San Francisco Estuary functions. During the past 2 decades, the effects of invasive species in the estuary may have increased in response to frequent and severe drought conditions. The invasive overbite clam (Potamocorbula amurensis), and the Asian clam (Corbicula fluminea) have well documented consequences on the estuarine food web, but their responses to drought are not well understood. Another invasive species, the jellyfish Maeotias marginata, can further affect the food web, but these effects have not been studied. We investigated the population responses of these invasive species to dry years and their potential effects on the pelagic food web using data from the Interagency Ecological Program’s monitoring surveys. We found M. marginata rapidly moves upstream with changing salinities during dry years, though it sees its highest abundance during high-outflow years in Suisun Bay and Suisun Marsh. Grazing rates of M. marginata in the estuary have not been quantified but are potentially high during localized blooms. The two invasive clams overlap in distribution, but have opposite population responses to drought conditions, with increases in P. amurensis densities and decreases in C. fluminea densities in dry years. With increasing P. amurensis densities, the clams’ combined annual filtration rates increase during drier years in the confluence and Suisun Marsh. Like M. marginata, P. amurensis also shifts upstream during droughts, but because adults cannot move immediately with a change in salinity, the population center of distribution shifts upstream the year after a dry year as a result of juvenile recruitment. If multiple dry years occur in a row, and both P. amurensis and M. marginata move upstream together, their effects on the food web could be compounded, and phytoplankton and zooplankton biomass could steeply decline in the confluence, affecting higher trophic levels in the estuary.

Acute flaccid myelitis (AFM) is a disabling, polio-like illness mainly affecting children. Outbreaks of AFM have occurred across multiple global regions since 2012, and the disease appears to be caused by non-polio enterovirus infection, posing a major public health challenge. The clinical presentation of flaccid and often profound muscle weakness (which can invoke respiratory failure and other critical complications) can mimic several other acute neurological illnesses. There is no single sensitive and specific test for AFM, and the diagnosis relies on identification of several important clinical, neuroimaging, and cerebrospinal fluid characteristics. Following the acute phase of AFM, patients typically have substantial residual disability and unique long-term rehabilitation needs. In this Review we describe the epidemiology, clinical features, course, and outcomes of AFM to help to guide diagnosis, management, and rehabilitation. Future research directions include further studies evaluating host and pathogen factors, including investigations into genetic, viral, and immunological features of affected patients, host-virus interactions, and investigations of targeted therapeutic approaches to improve the long-term outcomes in this population.

Introduction: Two protocols were developed to guide the use of subdissociative dose ketamine (SDDK) for analgesia and dissociative sedation ketamine for severe agitation/excited delirium in the emergency department (ED). We sought to evaluate the safety of these protocols implemented in 18 EDs within a large health system.Methods: We conducted a retrospective chart review to evaluate all adult patients who received intravenous (IV) SDDK for analgesia and intramuscular (IM) dissociative sedation ketamine for severe agitation/excited delirium in 12 hospital-based and six freestanding EDs over a one-year period from the protocol implementation. We developed a standardized data collection form and used it to record patient information regarding ketamine use, concomitant medication use, and any comorbidities that could have impacted the incidence of adverse events.Results: Approximately 570,000 ED visits occurred during the study period. SDDK was used in 210 ED encounters, while dissociative sedation ketamine for severe agitation/excited delirium was used in 37 ED encounters. SDDK was used in 83% (15/18) of sites while dissociative sedation ketamine was used in 50% (9/18) of sites. Endotracheal intubation, non-rebreather mask, and nasal cannula ≥ four liters per minute were identified in one, five, and three patients, respectively. Neuropsychiatric adverse events were identified in 4% (9/210) of patients who received SDDK.Conclusion: Patients experienced limited neuropsychiatric adverse events from SDDK. Additionally, dissociative sedation ketamine for severe agitation/excited delirium led to less endotracheal intubation than reported in the prehospital literature. The favorable safety profile of ketamine use in the ED may prompt further increases in usage.

Here we describe a pediatric patient with febrile infection–related epilepsy syndrome with a good functional and neurologic outcome after treatment with early and aggressive cytokine-directed immunomodulatory therapy and a seizure management strategy that intentionally avoided a barbiturate coma. A 5-year-old previously healthy male presented with staring, behavioral arrest, and encephalopathy evolving to super-refractory status epilepticus. He had had onset of fever 5 days prior. He was treated with early and aggressive immunomodulatory therapy targeted to his evolving cytokine profile. He was also treated with the ketogenic diet, antiseizure medications, and continuous anesthetic infusions. Pentobarbital was purposely avoided. Now, 2½ years later, he attends mainstream school, has attention-deficit hyperactivity disorder (ADHD), mild neurocognitive impairment, and well-controlled epilepsy. By using cytokine-directed immunotherapy and avoiding a barbiturate coma, we were able to successfully treat a pediatric patient with febrile infection-related epilepsy syndrome and achieve a good outcome. [ABSTRACT FROM AUTHOR]

This study examined associations of therapeutic alliance and treatment delivery fidelity with treatment retention in Stimulant Abusers to Engage in Twelve-Step (STAGE-12), a community-based trial of 12-Step Facilitation (TSF) conducted within the National Drug Abuse Treatment Clinical Trials Network (CTN). The STAGE-12 trial randomized 234 stimulant abusers enrolled in 10 outpatient drug treatment programs to an eight-session, group and individual TSF intervention. During the study, TSF participants rated therapeutic alliance using the Helping Alliance questionnaire-II. After the study, independent raters evaluated treatment delivery fidelity of all TSF sessions on adherence, competence, and therapist empathy. Poisson regression modeling examined relationships of treatment delivery fidelity and therapeutic alliance with treatment retention (measured by number of sessions attended) for 174 participants with complete fidelity and alliance data. Therapeutic alliance (p = .005) and therapist competence (p = .010) were significantly associated with better treatment retention. Therapist adherence was associated with poorer retention in a nonsignificant trend (p = .061). In conclusion, stronger therapeutic alliance and higher therapist competence in the delivery of a TSF intervention were associated with better treatment retention whereas treatment adherence was not. Training and fidelity monitoring of TSF should focus on general therapist skills and therapeutic alliance development to maximize treatment retention. (PsycINFO Database Record

Students come to university with diverse tastes, experiences, and backgrounds, yet we often want them to embrace a body of aesthetics, philosophies, and ideologies that reflect the material we and our established disciplines value as central. However, by using their own backgrounds as a basis for exploration, discovery, and sharing, students can learn a great amount from each other's tastes and experiences. Two assignments designed for a first-year foundation course in music history and literature draw on personal backgrounds. Personal Music History and Music Repertoire Assignment allow students to bring the music they know and love, as well as their life experiences to the study of a new body of musical literature. Although music-specific, these assignments can be tailored to virtually any field of study within a first-year foundation course. Engagement on a personal level with course-related material makes the transition from high school to a university-level course smoother.

As well as content, what are we teaching our students and what opportunities can we take to influence their current and future success as graduate students, professionals, and contributors to a wider society? One thing we can teach them is a sense of professionalism; however, that is defined in different disciplines and varying career paths. By substituting for the often vaguely-defined "participation" component of a grade a "professionalism" mark, a place is created for students to learn and exercise mature approaches to their work and their roles within the university. Presented as a proactive and positive element within the student's control, instead of a punitive grade component, the professionalism mark can result in dramatic changes in class behaviour, participation, attitudes, accountability, and self-motivation. The following scenarios outline different situations, which may ring true to a number of instructors and which professionalism marks might address.

In this explorative and collectively written paper, researchers and archivists from the research project Children's cultural heritage — the visual voices of the archive ponder, wrestle with, confront, and dig deeper into what it means to preserve and include children's own voices in archives. The authors acknowledge that child-produced cultural objects are historical landmarks and significant parts of national heritage. The article raises questions about where and how the 'doing' of what is here called children's cultural heritage takes place, what it means to archive from children's perspectives, and what aspects of children are saved during these preservation and archival management processes. To collect, preserve and provide access to heritage might empower and affirm individuals and subordinated groups of people who have not been seen or heard in the historical past, in the present, or in future pasts. Children, as a category, is one such subordinated group in heritage contexts. Adults therefore have a responsibility to empower children by strengthening their position towards other social groups, towards society and the heritage domain. This article provides insights into the challenges that heritage establishments face in taking children's cultural heritage seriously. [ABSTRACT FROM AUTHOR]

Background and Purpose: Children with developmental disabilities have increased risk of epilepsy and need for overnight video electroencephalographic (EEG) monitoring. However, video EEGs have historically been considered difficult to complete for this population. An autism support service at a pediatric tertiary care hospital implemented a coordinated team approach to help children with developmental disability tolerate overnight video EEGs. The project included completion of a caregiver-report preprocedure questionnaire that then was shared with the multidisciplinary team and used to create individualized care plans. The current study aims to describe rates of video EEG completion and need for lead placement under general anesthesia among children with autism and related disabilities who received these supports. Methods: Rates of video EEG completion and general anesthesia use were analyzed for children referred to the support service between April 2019 and November 2021. Results: A total of 182 children with developmental disability (mean age = 10.3 years, 54.9% diagnosed with autism) met inclusion criteria. 92.9% (n = 169) of children successfully completed EEG (leads on ≥12 hours). Only 19.2% (n = 35) required general anesthesia for video EEG lead placement. The majority (80.2%) of parents (n = 146) completed the preprocedure questionnaire. Video EEG outcomes did not differ based on completion of the questionnaire. Parent-reported challenges with communication and cooperation were associated with shorter video EEG duration and greater use of general anesthesia. Conclusions: These findings suggest that most children with developmental disability can complete video EEG with sufficient support. Preprocedure planning can identify children who would benefit from additional accommodations. Further research is necessary to clarify which supports are most helpful. [ABSTRACT FROM AUTHOR]