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Physical education (PE) has the potential to educate students to spend a lifetime in physical activity. An up-and-coming activity that has this potential of lifetime activity is spike ball. Generally, spike ball is played with four players with teams of two. The ball is put into play and the players can move anywhere they want. The objective is to hit the ball into the net so that the opposing team cannot return it. Spike ball presents itself to be an activity for students in high school and college/university. One aspect of increasing activity during spike ball is music being played. Research dealing with music in physical activity settings has found it to enhance endurance and color how people interpret fatigue. Thus, the purpose of this study was to examine the effects of music on PA rates (measured via pedometer) of college students as they play spike ball. Generally, it was learned that music had a positive effect on increased amounts of steps taken and time in activity during spike ball play., Introduction Physical education (PE) could help prepare students to lifelong participation in a multitude of activities (Pangrazi, 2003). K-12 PE is divided into three categories, elementary (K-5), middle school/ junior [...]

This policy analysis will explore the prevalence and purpose of compulsory practical English courses for students across all faculties in universities in Japan. Special attention will be given to English courses taught in two non-English major colleges within a large private Japanese university in Western Japan, which since their inception have been partially outsourced to external education institutions. The first part of this analysis will explore the broader social, cultural, political, and economic context of compulsory English courses in Japanese universities. The second part of this analysis will critically examine the policy of compulsory English courses regarding the role of teachers at Japanese universities and identify opportunities for positive change. This analysis should be particularly insightful for anyone teaching or designing curriculum for English language courses in a Japanese university, especially those who are less familiar with the policies and broader contextual forces that affect their classrooms.

The provision of academic language and learning (ALL) support to undergraduate and postgraduate students has been a staple across higher education institutions in Australia and New Zealand for some time. However, research has established that there are multiple challenges inherent to working across institutional spaces in the ways that ALL staff do. This has included ambiguity about the parameters of their roles and how they connect with staff and students as support professionals. Furthermore, how advisors respond to student wellbeing as part of the support they offer, and how their own wellbeing is accounted for at work, are not well understood. We draw on data from two recent surveys to explore how ALL advisors in Australia and New Zealand understand and respond to student wellbeing within their practice, how ALL work has been affected by COVID-19, advisors' needs for support, and the views of managers in relation to these matters. The participants highlighted tensions related to student wellbeing, staff wellbeing, and academic support, which have either been brought about or intensified by the pandemic. As we move towards living with the pandemic, these tensions will need to be addressed by higher education institutions.

Hemorrhage remains the leading cause of preventable death on the battlefield and the civilian arena. Many of these deaths occur in the prehospital setting. Traumatic brain injury also represents a major source of early mortality and morbidity in military and civilian settings. The inaugural HERETIC (HEmostatic REsuscitation and Trauma Induced Coagulopathy) Symposium convened a multidisciplinary panel of experts in prehospital trauma care to discuss what education and bioengineering advancements in the prehospital space are necessary to improve outcomes in hemorrhagic shock and traumatic brain injury. The panel identified several promising technological breakthroughs, including field point-of-care diagnostics for hemorrhage and brain injury and unique hemorrhage control options for non-compressible torso hemorrhage. Many of these technologies exist but require further advancement to be feasibly and reliably deployed in a prehospital or combat environment. The panel discussed shifting educational and training paradigms to clinical immersion experiences, particularly for prehospital clinicians. The panel discussed an important balance between pushing traditionally hospital-based interventions into the field and developing novel intervention options specifically for the prehospital environment. Advancing prehospital diagnostics may be important not only to allow more targeted applications of therapeutic options, but also to identify patients with less urgent injuries that may not need more advanced diagnostics, interventions, or transfer to a higher level of care in resource-constrained environments. Academia and industry should partner and prioritize some of the promising advances identified with a goal to prepare them for clinical field deployment to optimize the care of patients near the point of injury.

Hydroxyurea reduces sickle cell disease (SCD) complications, but medication adherence is low. We tested 2 mobile health (mHealth) interventions targeting determinants of low adherence among patients (InCharge Health) and low prescribing among providers (HU Toolbox) in a multi-center, non-randomized trial of individuals with SCD ages 15-45. We compared the percentage of days covered (PDC), labs, healthcare utilization, and self-reported pain over 24 weeks of intervention and 12 weeks post-study with a 24-week preintervention interval. We enrolled 293 patients (51% male; median age 27.5 years, 86.8% HbSS/HbSβ0-thalassemia). The mean change in PDC among 235 evaluable subjects increased (39.7% to 56.0%; P < 0.001) and sustained (39.7% to 51.4%, P < 0.001). Mean HbF increased (10.95% to 12.78%; P = 0.03). Self-reported pain frequency reduced (3.54 to 3.35 events/year; P = 0.041). InCharge Health was used ≥1 day by 199 of 235 participants (84.7% implementation; median usage: 17% study days; IQR: 4.8-45.8%). For individuals with ≥1 baseline admission for pain, admissions per 24 weeks declined from baseline through 24 weeks (1.97 to 1.48 events/patient, P = 0.0045) and weeks 25-36 (1.25 events/patient, P = 0.0015). PDC increased with app use (P < 0.001), with the greatest effect in those with private insurance (P = 0.0078), older subjects (P = 0.033), and those with lower pain interference (P = 0.0012). Of the 89 providers (49 hematologists, 36 advanced care providers, 4 unreported), only 11.2% used HU Toolbox ≥1/month on average. This use did not affect change in PDC. Tailoring mHealth solutions to address barriers to hydroxyurea adherence can potentially improve adherence and provide clinical benefits. A definitive randomized study is warranted. This trial was registered at www.clinicaltrials.gov as #NCT04080167.

Abstract Fragile X syndrome (FXS) is a rare neurodevelopmental disorder caused by a CGG repeat expansion ≥ 200 repeats in 5’ untranslated region of the FMR1 gene, leading to intellectual disability and cognitive difficulties, including in the domain of communication. A recent phase 2a clinical trial testing BPN14770, a phosphodiesterase 4D inhibitor, showed improved cognition in 30 adult males with FXS on drug relative to placebo. The initial study found significant improvements in clinical measures assessing cognition, language, and daily functioning in addition to marginal improvements in electroencephalography (EEG) results for the amplitude of the N1 event-related potential (ERP) component. These EEG results suggest BPN14770 improved neural hyperexcitability in FXS. The current study investigated the relationship between BPN14770 pharmacokinetics and the amplitude of the N1 ERP component from the initial data. Consistent with the original group-level finding post-period 1 of the study, participants who received BPN14770 in period 1 showed a significant correlation between N1 amplitude and serum concentration of BPN14770 measured at the end of period 1. These findings strengthen the validity of the original result, indicating that BPN14770 improves cognitive performance by modulating neural hyperexcitability. This study represents the first report of a significant correlation between a reliably abnormal EEG marker and serum concentration of a novel pharmaceutical in FXS.

The authors of this research brief conducted a series of qualitative interviews with people in the Frenchman Bay watershed in Maine concerning a proposal for an aquaculture facility in the bay. Based on the interviews, they identified emergent themes regarding place attachments to Frenchman Bay and sense of place. Scale was identified as an umbrella concept encompassing the other themes, including perceived environmental and community risks and drawbacks; aesthetic, historical, and recreation-based place attachments; and concerns intersecting with adjacent marine tensions such as state licensing processes and the shifting of traditional working waterfronts to tourism-based economies. The study highlights several implications for aquaculture policy in Maine.

Students must be able to produce legible and fluent text when completing classwork and for exam purposes. Some students, however, present with handwriting difficulties in secondary school. When these are significant, intervention may be necessary or alternatives to handwriting may be offered (e.g. use of a word processor). Little is known about current practice of supporting secondary students with handwriting difficulties in England and how recommendations are made to transition to typing. Semi-structured interviews were conducted with 13 practitioners with a responsibility for supporting students with handwriting difficulties. Two themes were identified. The first theme, "doing the right thing," illustrated the tension between practitioners' commitment to supporting students with handwriting difficulties and their uncertainty around what is the "right" approach. The second theme, "influencing practice," described the contextual factors (student and family, school environment and national context) that impact on practitioners' practice and their decision to transition from handwriting to typing. Findings highlight the complexities of supporting this group of students and an urgent need for guidance at a national level to assist best practice. Implications for practice are discussed. Further research examining the effectiveness of handwriting interventions with secondary students and the optimum time to start typing is warranted.

This article investigates how non-native English-speaking teachers' (NNESTs) professional identities can be affected by their employment experiences in Australia. Hermeneutic phenomenological narrative analyses of the written narratives of lived experiences of a group of NNESTs demonstrate how their professional identities were negatively affected by hiring discrimination, which also had psycho-emotional impacts on their professional selves. Socio-cultural representations of race, language, and other cultural attributes convergingly contributed to their unemployment despite meeting country-specific eligibility criteria to be English as a Second Language (ESL) teachers. The interplay between their professional identities and socio-cultural constructs took shape in modes of power relations enmeshed in the historic processes: economic, political, and cultural, which included discourses of native-speakerism, neo-racism, post-colonialism, neoliberalism, and multiculturalism. Despite these modalities, the NNESTs furthered their hybrid professional actions, recognising the value in the global community of multiple and diverse professional experiences.

Abstract Background Indoleamine 2,3-dioxygenase 1 (IDO1) levels correlate with poor outcomes in urothelial carcinoma (UC). IDO1 and programmed death-ligand 1 (PD-L1) are often co-expressed. Epacadostat is a potent and highly selective inhibitor of IDO1. In a subgroup analysis of patients with advanced UC participating in a phase I/II study, epacadostat-pembrolizumab treatment produced an objective response rate (ORR) of 35%. Methods ECHO-303/KEYNOTE-698 was a double-blinded, randomized phase III study of adults with metastatic or unresectable locally advanced UC with recurrence or progression following first-line platinum-based chemotherapy. Participants were randomized to epacadostat 100 mg twice daily (BID) plus pembrolizumab or placebo plus pembrolizumab until completion of 35 pembrolizumab infusions, disease progression, or unacceptable toxicity. The primary endpoint was investigator-assessed ORR per Response Evaluation Criteria in Solid Tumors version 1.1. Results Target enrollment was 648 patients; enrollment was halted early based on efficacy results from the phase III ECHO-301/KEYNOTE-252 study in metastatic melanoma. Forty-two patients were randomized to each treatment arm. Median duration of follow-up was 62 days in each arm. The investigator-assessed ORR (unconfirmed) was 26.2% (95% CI 16.35–48.11) for epacadostat plus pembrolizumab and 11.9% (95% CI 4.67–29.50) for placebo plus pembrolizumab. Two complete responses were reported, both in the placebo-plus-pembrolizumab arm. Circulating kynurenine levels increased from C1D1 to C2D1 in the placebo-plus-pembrolizumab arm and numerically decreased in the epacadostat-plus-pembrolizumab arm. The safety profile of epacadostat plus pembrolizumab was similar to that of pembrolizumab monotherapy, although a numerically greater proportion of patients in the combination vs. control arm experienced treatment-related grade ≥ 3 adverse events (16.7% vs. 7.3%). One patient in each arm died due to cardiovascular events, which were not deemed drug-related. No new safety concerns were identified for either agent. Conclusions Epacadostat plus pembrolizumab demonstrated anti-tumor activity and was generally tolerable as second-line treatment of patients with unresectable locally advanced or recurrent/progressive metastatic UC. Epacadostat 100 mg BID, when administered with pembrolizumab, did not normalize circulating kynurenine in most patients. Further study of combined IDO1/PD-L1 inhibition in this patient population, particularly with epacadostat doses that result in durable normalization of circulating kynurenine, may be warranted. Trial registration ClinicalTrials.gov, NCT03374488. Registered 12/15/2017.

Abstract Background Indoleamine 2,3- dioxygenase 1 (IDO1) is an immunosuppressive enzyme that has been correlated with shorter disease-specific survival in patients with urothelial carcinoma (UC). IDO1 may counteract the antitumor effects of immune checkpoint inhibitors. Epacadostat is a potent and highly selective inhibitor of IDO1. In the phase I/II ECHO-202/KEYNOTE-037 study, epacadostat plus pembrolizumab resulted in a preliminary objective response rate (ORR) of 35% in a cohort of patients with advanced UC. Methods ECHO-307/KEYNOTE-672 was a double-blinded, randomized, phase III study. Eligible adults had confirmed locally advanced/unresectable or metastatic UC of the urinary tract and were ineligible to receive cisplatin-based chemotherapy. Participants were randomly assigned (1:1) to receive epacadostat (100 mg twice daily) plus pembrolizumab (200 mg every 3 weeks) or placebo plus pembrolizumab for up to 35 pembrolizumab infusions. The primary endpoint was investigator-assessed ORR per Response Evaluation Criteria in Solid Tumors (version 1.1). Results A total of 93 patients were randomized (epacadostat plus pembrolizumab, n = 44; placebo plus pembrolizumab, n = 49). Enrollment was stopped early due to emerging data from the phase III ECHO-301/KEYNOTE-252 study. The median duration of follow-up was 64 days in both arms. Based on all available data at cutoff, ORR (unconfirmed) was 31.8% (95% CI, 22.46–55.24%) for epacadostat plus pembrolizumab and 24.5% (95% CI, 15.33–43.67%) for placebo plus pembrolizumab. Circulating kynurenine levels numerically increased from C1D1 to C2D1 in the placebo-plus-pembrolizumab arm and decreased in the epacadostat-plus-pembrolizumab arm. Epacadostat-plus-pembrolizumab combination treatment was well tolerated with a safety profile similar to the placebo arm. Treatment discontinuations due to treatment-related adverse events were more frequent with epacadostat (11.6% vs. 4.1%). Conclusions Treatment with epacadostat plus pembrolizumab resulted in a similar ORR and safety profile as placebo plus pembrolizumab in cisplatin-ineligible patients with previously untreated locally advanced/unresectable or metastatic UC. At a dose of 100 mg twice daily, epacadostat did not appear to completely normalize circulating kynurenine levels when administered with pembrolizumab. Larger studies with longer follow-up and possibly testing higher doses of epacadostat, potentially in different therapy settings, may be warranted. Trial registration ClinicalTrials.gov identifier: NCT03361865, retrospectively registered December 5, 2017.

Introduction: Prostate cancer most commonly metastasizes to the bone and lymph nodes. Gastrointestinal metastasis has been noted in the literature but appears to be an exceedingly uncommon phenomenon. Large intestinal involvement in particular has been reported on only a few occasions, and never concomitantly with small intestinal metastatic involvement. Case Report: We report the case of a 69-year-old gentleman with metastatic castrate-resistant prostate cancer with development of gastrointestinal symptomatology with extensive investigation eventually revealing small and large intestinal polyps subsequently confirmed to be representative of metastatic prostate cancer. Conclusion: This case demonstrates the importance of maintaining a wide differential diagnosis in the context of gastrointestinal symptomatology in malignancy. Thorough endoscopic evaluation may be necessary in such cases in order to identify potential metastatic malignancy in otherwise relatively unremarkable appearing polyps.

Abstract Gender influences the ways that people are involved in and rely on coastal resources and spaces. However, a limited understanding of gender differences in this context hinders the equity and effectiveness of coastal management and conservation. Drawing on data collected through purposive sampling from 3063 people in Fiji, Papua New Guinea, Solomon Islands, Indonesia, Kenya, and Madagascar, we explored how men and women perceived the effects of coastal management and conservation on human well-being. We found significant gender differences in perceptions of the presence of impacts, whereby 37% of women and 46% of men perceived individual-level impacts, while 47% of women and 54% of men perceived community-level impacts. When asked about the degree and direction of impacts, the responses were not significantly different by gender. When describing the types of impacts, women and men articulated these differently, particularly impacts related to economic, governance, and health aspects of well-being. These findings highlight pathways for developing more equitable and gender-responsive coastal management and conservation initiatives aimed at safeguarding biodiversity, sustaining fisheries, and supporting the well-being of all those who depend on the marine environment.

Digital technologies have fast become integral within literacy learning and teaching across contexts as students engage with a variety of digital and multimodal texts. While teachers in New Zealand schools have a high degree of autonomy in the design and planning of literacy programs, little is currently known about how they understand and enact multiliteracies pedagogy (MLP). Using data gathered via interviews and classroom observations in an intermediate school in New Zealand, this article adopts a narrative inquiry approach to explore one teacher's approaches to using digital technologies and texts within literacy instruction. We explore in particular the ways in which MLP may be enacted "implicitly" rather than explicitly, within the complex matrix of teachers' personal beliefs and learning experiences, the perceived learning needs of students, and the school curriculum. We conclude with a call for the conscious and purposeful teaching of MLP, focusing on synaesthesia and the semiotic functions of texts.

The final observable product of a successful doctoral programme is typically a thesis that has been critically examined by senior academics and considered to demonstrate a significant contribution to knowledge. However, it is a conviction underpinning this special issue that the doctorate should be acknowledged, explored and understood as a process which is expectedly imbued with unexpected challenges for the doctoral candidate. Negotiating these challenges is a necessary part of the process. The doctoral research process has been metaphorically described as a "journey" (Edwards & Mackay, 2012; McAlpine & Amundsen, 2009; Rath & Mutch, 2014; Skakni, 2018a, 2018b). While the doctoral journey has the potential to present destabilising experiences, discomfort and cognitive dissonance, candidates bring their own reasons and motivations to the process (Skakni, 2018b). According to Skakni (2018b), "the act of engaging in doctoral studies lies on a set of individuals' desires, intentions and aspirations, which serve as a driving force oriented toward the future" (p. 200). As such, the doctoral journey presents both facilitating and constraining opportunities that help nourish the quest for self, intellectual quests and professional quest (Skakni, 2018b).

Other effective area-based conservation measures (OECMs) are sites outside of protected areas that deliver the effective, long-term conservation of biodiversity. Both protected areas and OECMs contribute to the implementation of the Global Biodiversity Framework’s Target 3, which calls for the conservation of 30% of marine, terrestrial and inland water areas by 2030. This paper provides the first global assessment of the contribution of OECMs to GBF Target 3. Between 2019 and 2023, 820 sites in nine countries and territories were reported to the World Database on OECMs, covering 1.9 million km2 of the Earth’s surface and, in the terrestrial realm, contributing over 1% to the 30% coverage target. Notably, over 50% of reported OECMs are under governance by governments and less than 2% are governed by Indigenous peoples and local communities. In countries and territories that have reported OECMs, a far greater proportion of OECMs than protected areas are under shared governance (40.9% compared to 2.5%), and collaborative governance is the most common governance sub-type among reported OECMs. This paper finds that almost 30% of the 820 reported OECMs overlap with identified Key Biodiversity Areas, which are one global classification of areas of particular importance for biodiversity. With Target 3’s pressing deadline of 2030, there is an urgent need to scale up understanding and local to national engagement with the OECM framework, ensuring that it fulfills its potential to recognize diverse forms of equitable governance and effective conservation.

IntroductionBivalve aquaculture has direct and indirect effects on plankton communities, which are highly sensitive to short-term (seasonal, interannual) and long-term climate changes, although how these dynamics alter aquaculture ecosystem interactions is poorly understood. MethodsWe investigate seasonal patterns in plankton abundance and community structure spanning several size fractions from 0.2 µm up to 5 mm, in a deep aquaculture embayment in northeast Newfoundland, Canada.ResultsUsing flow cytometry and FlowCam imaging, we observed a clear seasonal relationship between fraction sizes driven by water column stratification (freshwater input, nutrient availability, light availability, water temperature). Plankton abundance decreased proportionally with increasing size fraction, aligning with size spectra theory. Within the bay, greater mesozooplankton abundance, and a greater relative abundance of copepods, was observed closest to the aquaculture lease. No significant spatial effect was observed for phytoplankton composition. DiscussionWhile the months of August to October showed statistically similar plankton composition and size distribution slopes (i.e., food chain efficiency) and could be used for interannual variability comparisons of plankton composition, sampling for longer periods could capture long-term phenological shifts in plankton abundance and composition. Conclusions provide guidance on optimal sampling to monitor and assess aquaculture pathways of effects.