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Smallmouth bass (Micropterus dolomieu) spawn on gravel and cobble in the littoral zone of lakes that may become degraded by the presence of fine sediments and decomposing organic matter. Substrate size and composition have been identified as important variables for nest site selection by male smallmouth bass. We tested whether ‘cleaning’ substrate by removing sediment with a pressure washer would increase the number of bass nests or the average total length (mm) of nesting smallmouth bass in selected areas of Big Rideau Lake, Ontario, Canada the following year using a before-after control-impact design. Treatment was not a significant predictor of nest abundance or average male length. Considering the strength of the experimental design it is reasonable to conclude that this intervention failed to enhance spawning substrate for smallmouth bass. Understanding the factors that maintain productive spawning sites for smallmouth bass is important to restoration effectiveness and determining where habitat enhancement will provide the greatest benefits.

Individuals with disabilities have been less involved in school activities than their peers of the same age and this includes career preparation in science and math (Agran et al., 2019; Eriksson et al., 2007; Jackson et al., 2022). Students with disabilities often lack access to facilities, programs, and equipment, and acceptance by educators, employers, and co-workers (Burgstahler, 1994). The effects of a virtual reality (VR) human anatomy application as the means of teaching science vocabulary definitions and locations acquisition for three different human anatomy systems (digestive, respiratory, and integumentary) to college-age students with intellectual disability (ID) are reviewed. This single subject, multiple baseline study included two transition age youth with ID. The intervention package included both a guided and exploratory portion. Data were collected on the participants' accuracy on the definitions and locations of ten vocabulary words for each of the three body systems on a paper assessment. Findings indicated that a functional relation existed between the implementation of the intervention package and an increase in the accuracy of scores in both definitions and locations for each of the three body systems for each participant.

Background: A growing body of research indicates that music-based interventions show promising results for adults with a wide range of speech, language and communication disorders. Aims: The purpose of this scoping review is to summarize the evidence on how speech-language therapists (SLTs) use music and music-related elements in therapeutic interventions for adults with acquired neurogenic communication impairments. Methods: This scoping review was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. A systematic search of three databases (Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature and OVID Medline) was conducted and articles were included if they (1) incorporated adult human participants; (2) received an assessment or intervention facilitated by an SLT; (3) incorporated techniques and interventions which included music-related elements (e.g., rhythm, melody, harmony and dynamics); (4) were written in the English language; and (5) were peer-reviewed full-text articles. Data were extracted using the Rehabilitation Treatment Specification System framework. Main Contribution: A total of 25 studies met the inclusion criteria. The studies included participants with neurogenic communication impairments secondary to stroke, Parkinson's disease, dementia and traumatic brain injury. Musical interventions identified in the studies were Melodic Intonation Therapy, Modified Melodic Intonation Therapy, choral singing, singing therapy and songwriting. The majority of the studies reported interprofessional collaboration between SLTs and at least one other healthcare clinician and/or musician. Many studies also included music-based interventions lead and facilitated by musically trained SLTs. Conclusion: The results of the studies included in this review indicate that SLTs are using music-based interventions to target therapeutic goals to improve speech, language, voice and quality of life in collaboration with other clinicians and professional musicians.

Interprofessional education (IPE) occurs when students are provided the opportunity to learn with and from others of related professions to improve the potential for future collaboration. The aim of this study was to explore the perceptions of students about working with professionals from different disciplines before and after their engagement in an interprofessional learning activity and determine any changes in their willingness to work in interprofessional teams. Doctor of Pharmacy students from the University of Manitoba and Master's speech-language pathology students from McMaster University participated in an online inter-university and inter-provincial education module. Students were invited to complete the Interprofessional Socialization and Valuing Scale (ISVS-9B) and three open-ended questions to capture attitudes toward interprofessional teams before and after the IPE event. A mixed-method approach was used to assess changes in attitudes, values, and comfort with collaborating. A total of 20 students completed the pre-survey and 19 completed the post-survey; significant changes in total ISVS-9B scores were observed. Four questions of the ISVS-9B also showed significant positive changes after the IPE event. Qualitative themes were identified from responses to the open-ended questions: collaboration optimizes patient care, collaboration is fostered by clear communication, learning from peers increases knowledge and appreciation of professional roles, and IPE fosters the potential for future collaborations. This study suggests that a virtual IPE event tailored to pharmacy and speech-language pathology trainees may be effective in fostering future interdisciplinary collaboration through increasing knowledge and appreciation of other professional roles with a primary goal of optimizing patient care.

This article is dedicated to the late Michael D. Fetters--a giant in the world of mixed methods research, an exceptional researcher and scholar, a professor of family medicine, a caring and beloved family physician, a lifelong learner, a colleague, a mentor, a steadfast advocate, a son, a sibling, a husband, a father, and, above all, a dear friend to everyone who knew him. Inspired by Professor Fetters's innovation, we offer an expanded definition of autoethnography through the formal introduction of the 10 dimensions of autoethnography, as well as the debut of mixed methods autoethnography and of integrated mixed methods autoethnography. An autoethnographic narrative writing style honors both the research genre and the mixed methods researchers' voices.

Emerging research suggests that episodic memory challenges are commonly encountered by autistic individuals; however, the specific nature of these memory challenges remains elusive. Here, we address critical gaps in the literature by examining pattern separation memory, the ability to store distinct memories of similar stimuli, and its links to the core autistic trait of repetitive, restricted interests and behaviors. Utilizing a large sample of over 120 autistic children and well-matched non-autistic peers, we found that autistic children showed significantly reduced performance on pattern separation memory. A clustering analysis identified three distinct pattern separation memory profiles in autism, each characterized by reduced or increased generalization abilities. Importantly, pattern separation memory was negatively correlated with the severity of repetitive, restricted interest and behavior symptoms in autism. These findings offer new evidence for challenges in pattern separation memory in autism and emphasize the need to consider these challenges when assessing and supporting autistic individuals in educational and clinical settings.

The sedimentary sequence in Scladina Cave (Belgium) is well-known for its rich Middle Paleolithic assemblages and its numerous faunal remains. Of particular interest is the presence of a nearly complete mandible of a Neanderthal child. To place all of these finds into the correct chronostratigraphic context, various dating techniques have been applied over the past decades. This resulted in a reasonably well-constrained age model, roughly spanning the last glacial cycle. Age constraints of the lower part of the Scladina sequence as well as from the underlying Sous-Saint-Paul Cave were, however, absent until now. Previous attempts to date several speleothem layers in Scladina Cave using U–Th dating were only partly successful, presumably because diagenetic alteration of speleothem material compromised the ages. In the present study we reassessed U–Th dating of various speleothem levels in Scladina Cave, applying state-of-the-art U–Th dating and carefully selecting material that experienced little to no diagenetic alteration. The new results constitute a robust age framework for the Scladina sequence, which provides precisely dated stratigraphic anchor points that improve the previous age model. Furthermore, new U–Th analyses for speleothems from the lower part of the Scladina sequence and from the Sous-Saint-Paul sequence document Middle Pleistocene ages, making this one of the longer fossil-rich cave sedimentary sequences in NW Europe. The new data confirm that speleothem growth predominantly took place in periods of warmer climate, while siliciclastic sediments characterize the colder intervals. New speleothem ages further suggest that the Neanderthal mandible found in the sequence and previously placed in Marine Isotope Stage 5a or 5b could potentially be as old as Marine Isotope Stage 5d.

Abstract Anaphylaxis is an acute, potentially fatal systemic hypersensitivity reaction with varied mechanisms and clinical presentations. Although prompt recognition and treatment of anaphylaxis are imperative, both patients and healthcare professionals often fail to recognize and diagnose its early signs. Clinical manifestations vary widely, however, the most common signs are cutaneous symptoms, including urticaria and angioedema. Immediate intramuscular administration of epinephrine into the anterolateral thigh is first-line therapy, and is always safe even if the diagnosis is uncertain. The mainstays of long-term management include specialist assessment, allergen avoidance measures, and the provision of an epinephrine auto-injector with an individualized anaphylaxis emergency plan. This article provides an overview of the causes, clinical features, diagnosis, and acute as well as long-term management of anaphylaxis.

Abstract Background Mobile health (mHealth) applications have been utilized in chronic diseases to improve medication adherence, though factors driving engagement remain understudied. We previously demonstrated the benefits of mHealth app utilization in increasing adherence to hydroxyurea. In the “Integration of mHealth into Sickle Cell Disease (SCD) Care to Increase Hydroxyurea Utilization” (meSH) study, greater engagement with the InCharge Health app increased the percentage of days covered (PDC) for hydroxyurea. However, factors influencing app engagement were not investigated. This study aimed to identify patient-level factors associated with mHealth engagement during and post-study among adolescents and adults with SCD. Methods All meSH participants were included. The InCharge Health app use was measured for 24 weeks (study period) and 12 weeks (post-study period). Baseline demographics and validated measures of self-efficacy, financial hardship, and pain severity, impact, and frequency were evaluated as predictors of app engagement during the study period and post-study using linear models. Results Complete app use data were obtained from 284 of 293 participants, including 150 (52.8%) females and 240 (84.8%) who were HbSS/HbSβ0-thalassemia with a median age of 27 years. During the study period, 232 (81.7%) used InCharge Health at least once (median use excluding zeros: 26 days; IQR: 7–72 days). During the post-study period, 132 (46.5%) participants used the app at least once (median use excluding zeros: 16 days; IQR: 3–44 days). During the study period, the HbSS genotype, age > 25 years, higher education, higher self-efficacy score, and lower pain severity were associated with greater app engagement. Only age (p = 0.0032) and financial hardship (p = 0.0125) were significant in a multivariable model after backward elimination. During the post-study period, older age (p = 0.035), lower pain severity (p = 0.021) and lower frequency of pain (p = 0.033) predicted mHealth engagement. All three remained significant in a multivariable model after backward elimination. Conclusions Older age, lower financial hardship, lower pain severity, and greater self-efficacy were associated with increased engagement with a mHealth intervention for improving medication adherence among people living with SCD. This research can shift future app development from focusing on factors that drive patient interaction with mHealth targeting modifiable factors influencing app engagement. Trial registration The trial was registered with ClinicalTrials.gov. Registration Identifier: NCT04080167. Registration date: November 11, 2019.

Abstract This position statement addresses the critical concerns and recommended practices surrounding the use of panel food testing for diagnosing food allergies. Food allergies are a significant public health concern, and the misdiagnosis of food allergies remains a prevalent concern, made worse by the ongoing use of panel food testing. The practice of screening patients for multiple food allergens, regardless of clinical relevance, is commonly referred to as “panel food testing.” Fundamentally, a panel food test is not simply a single test; a panel food test is a series of several distinct tests for multiple foods, each with its own variable predictive value. These tests have not been adequately validated as screening tests and carry a considerable false positive rate. The resulting false diagnoses lead to unnecessary dietary restrictions, increased healthcare costs, and significant psychosocial distress for patients and their families.

Abstract Background Timothy syndrome (OMIM #601005) is a rare disease caused by variants in the gene CACNA1C. Initially, Timothy syndrome was characterized by a cardiac presentation of long QT syndrome and syndactyly of the fingers and/or toes, all associated with the CACNA1C variant, Gly406Arg. However, subsequent identification of diverse variants in CACNA1C has expanded the clinical spectrum, revealing various cardiac and extra-cardiac manifestations. It remains underexplored whether individuals with the canonical Gly406Arg variants in mutually exclusive exon 8A (Timothy syndrome 1) or exon 8 (Timothy syndrome 2) exhibit overlapping symptoms. Moreover, case reports have indicated that some CACNA1C variants may produce a cardiac-selective form of Timothy syndrome often referred to as non-syndromic long QT type 8 or cardiac-only Timothy syndrome, however few reports follow up on these patients to confirm the cardiac selectivity of the phenotype over time. Methods A survey was administered to the parents of patients with Timothy syndrome, querying a broad range of symptoms and clinical features. Study participants were organized into 5 separate categories based on genotype and initial diagnosis, enabling comparison between groups of patients which have been described differentially in the literature. Results Our findings reveal that Timothy syndrome patients commonly exhibit both cardiac and extra-cardiac features, with long QT syndrome, neurodevelopmental impairments, hypoglycemia, and respiratory issues being frequently reported. Notably, the incidence of these features was similar across all patient categories, including those diagnosed with non-syndromic long QT type 8, suggesting that the ‘non-syndromic’ classification may be incomplete. Conclusions This study represents the first Natural History Study of Timothy syndrome, offering a comprehensive overview of the disease’s clinical manifestations. We demonstrate that both cardiac and extra-cardiac features are prevalent across all patient groups, underscoring the syndromic nature of CACNA1C variants. While the critical role of long QT syndrome and cardiac arrhythmias in Timothy syndrome has been well recognized, our findings indicate that hypoglycemia and respiratory dysfunction also pose significant life-threatening risks, emphasizing the need for comprehensive therapeutic management of affected individuals.

Improving the development of the social, emotional, and physical domains during early childhood impacts the overall trajectory of a child's well-being. However, researchers often address these independently, leaving a gap for a more integrated approach to promoting development. This study explores the effects of a dual-component intervention on changes in preschool-aged boys' and girls' gross motor and social-emotional skills. Preschoolers (N = 475; girls = 220 and boys = 255) ages 3-6 years completed the 9-month dual-component intervention and were randomized into control (n = 148) or intervention (n = 327) groups by classroom. Significant improvements were observed in social skills, locomotor, and total Test of Gross Motor Development-3. Additionally, boys and girls improved at the same rate in ball skills, locomotor, and total Test of Gross Motor Development-3. These results suggest that the dual-component intervention can improve preschoolers' social skills and motor skills with no differential effects.

The purpose of this study was to examine the use of virtual reality, an emerging technology, to teach college-age students with intellectual disability and autism to acquire science vocabulary words relating to human anatomy. One student with autism and two students with an intellectual disability participated in a multiple baseline across skills (i.e., acquisition of science vocabulary words) design. Data were collected on the three students' abilities to define and label three sets of human anatomy vocabulary words (i.e., bones, muscles, and organs) while using Organon 3D. Students used this application while using the Oculus Rift S, a virtual reality head-mounted display. Results indicated that all students acquired definitions and labeling knowledge for the new science vocabulary terms in the area of human anatomy.

This study aimed to better understand how autism spectrum disorder (ASD) and developmental coordination disorder (DCD) differ in types of praxis errors made on the Florida Apraxia Battery Modified (FAB-M) and the potential relationships between praxis errors and social deficits in ASD. The ASD group made significantly more timing sequencing errors in imitation of meaningful gestures, as well as more body-part-for-tool errors during gesture-to-command compared to the other two groups. In the ASD group, increased temporal errors in meaningful imitation were significantly correlated with poorer affect recognition and less repetitive behaviors. Thus, in ASD, aspects of imitation ability are related to socioemotional skills and repetitive behaviors.

Garden-based learning, a key component of Farm to School (FTS), continues to grow in popularity as a tool for engaging students in hands-on learning. Recent literature calls for professional development to help educators overcome barriers - including a lack of horticulture skills, curricular connections, and time - that often hinder program success and sustainability. This study sought to understand the role of professional development and its ability to support resilient FTS programs in the classroom. Following participation in a multiday FTS professional development program, seven educators participated in an 11-month photo elicitation study to capture their experience implementing FTS in their classrooms. We find that educators drew on FTS professional development to expand their self-efficacy by successfully implementing what they learned, observing effective models, being affirmed by colleagues and others, and growing their overall confidence to engage in the work. Results also identified persistent barriers that professional development alone cannot reduce.

Background: Cyclops lesion after anterior cruciate ligament (ACL) reconstruction can appear on magnetic resonance imaging (MRI) in up to 30% of patients and is symptomatic in up to 9%. Arthroscopic cyclops removal can help restore motion and limit recurrence. Indications: Patient is an 18-year-old male high-level collegiate athlete with a mechanical block to full extension. Patient underwent ACL reconstruction with bone–patellar tendon–bone autograft 15 months prior by an outside physician. The patient had a stable Lachman and pivot-shift examination, but there was a palpable clunk when attempting to extend his knee the final 10°. Patient was unable to perform sport due to symptoms. Postoperative MRI demonstrated a large cyclops lesion. Technique: Bilateral ligamentous examination under anesthesia was performed prior to draping. Standard arthroscopy portals were used. Diagnostic arthroscopy was performed by assessing all critical structures in the knee (ie, meniscus, cartilage, and ligaments). The cyclops lesion was visualized in the intercondylar notch with clear evidence of superior notch impingement with knee extension. Using a standard shaver and radiofrequency ablation, the cyclops lesion was resected with care not to injure the ACL graft or disrupt its integrity. A small superior soft tissue resection was then performed with resection of scar tissue that had formed within the notch. A repeat examination with an arthroscope in the knee revealed no further impingement. Results: Patient was able to return fully to sport at 8 weeks postoperatively with no limitations, with no return of clicking or loss of motion. Discussion/Conclusion: Symptomatic cyclops lesion after ACL reconstruction can be effectively treated with arthroscopic debridement. Postoperatively, patients can return to full sport at 6 to 8 weeks. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Antimuscarinics have long been the cornerstone of treatment for overactive bladder (OAB), with their use spanning decades. This paper reviews the pharmacological properties, historical use, clinical efficacy, and challenges associated with antimuscarinics, revealing that concerns regarding their side effects and lack of bladder selectivity have persisted throughout their history.While long-term efficacy and safety have been established in various populations, adherence remains low due to side effects such as dry mouth, constipation, and cognitive impairment. The risk of cognitive side effects has led to increased scrutiny in older adults, where polypharmacy and anticholinergic burden are significant concerns. Despite advances, including newer formulations like extended-release versions and transdermal applications that improve tolerability, the fundamental issues of adherence and side effects have not been fully resolved.Intravesical administration has been explored to reduce systemic side effects, though its use remains limited to specific patient populations. Future directions in OAB treatment focus on exploring new pharmacological targets, including ion channels, enzymatic pathways, and gene therapy, to develop more selective and effective therapies. Additionally, phenotyping patients with OAB and personalised medicine approaches may enhance treatment outcomes. Despite these persistent challenges, antimuscarinics remain a critical component in the management of OAB.

Purpose: Necrotizing fasciitis, a severe soft tissue bacterial infection, is uncommon in the periocular region due to its rich blood supply. This report highlights a rare case in an immunocompetent infant. Observations: A 10-month-old immunocompetent female exhibited fever, irritability, and right eyelid swelling post-fall. Despite initial treatment with cephalexin for presumed cellulitis, her condition rapidly deteriorated, suggesting necrotizing fasciitis. She stabilized after receiving broad-spectrum intravenous antibiotics and aggressive surgical debridement but later required orbital exenteration due to extensive tissue necrosis. Conclusions and Importance: Periocular necrotizing fasciitis is exceedingly rare, particularly in immunocompetent individuals. Prompt diagnosis and treatment are critical to mitigate morbidity and mortality.