John Carroll University

Context Physical activity, exercise, or both are a staple of lifestyle management approaches both for type 1 diabetes mellitus (T1DM) and type 2 diabetes (T2DM). While the current literature supports both physical activity and exercise for improving glycemic control, reducing cardiovascular risk, maintaining proper weight, and enhancing overall well-being, the optimal prescription regimen remains debated. Evidence Acquisition We searched PubMed and Google Scholar databases for relevant studies on exercise, insulin sensitivity, and glycemic control in people with T1DM and T2DM. Evidence Synthesis In patients with T1DM, exercise generally improves cardiovascular fitness, muscle strength, and glucose levels. However, limited work has evaluated the effect of aerobic plus resistance exercise compared to either exercise type alone on glycemic outcomes. Moreover, less research has evaluated breaks in sedentary behavior with physical activity. When considering the factors that may cause hypoglycemic effects during exercise in T1DM, we found that insulin therapy, meal timing, and neuroendocrine regulation of glucose homeostasis are all important. In T2DM, physical activity is a recommended therapy independent of weight loss. Contemporary consideration of timing of exercise relative to meals and time of day, potential medication interactions, and breaks in sedentary behavior have gained recognition as potentially novel approaches that enhance glucose management. Conclusion Physical activity or exercise is, overall, an effective treatment for glycemia in people with diabetes independent of weight loss. However, additional research surrounding exercise is needed to maximize the health benefit, particularly in “free-living” settings.

Questions European colonization radically transformed the landscapes of eastern North America. Understanding this legacy is vital to managing current ecological communities. To do so requires spatially explicit information about presettlement vegetation. Here we test the ability of species distribution models, which have rarely been used with historical data like land survey records, to generate useful predictions of presettlement tree distributions. These models also allow us to assess pre‐disturbance vegetation‐environment relationships. Location Cuyahoga County, Ohio, USA. Methods Generalized linear models, generalized boosting models, random forests, and maximum entropy models related the distributions of 17 tree taxa to elevation, slope, aspect, and soil type, based on 4234 tree observations from circa‐1800 surveys. Cluster analysis defined forest types and created a prediction map of forest types using random forests. Results This study generated high‐resolution predictions of presettlement tree distributions. Fagus grandifolia and Carya spp. were predicted to have found suitable habitat in over half the area. Elevation was by far the most important predictor, followed by slope. Many taxa were more likely to occur at higher elevations, corresponding to the Allegheny Plateau, while others followed river valleys. Broadly, 51% of the county was predicted to support forest types with Fagus grandifolia and/or Acer spp., and 48% of the county was predicted to support forest types with Quercus spp., Carya spp., and/or Castanea dentata . Conclusions This study demonstrates that species distribution modeling with historical data provides insights into presettlement vegetation and vegetation‐environment relationships. Our results reveal striking ecological patterns not apparent in today's landscape, such as the sharp difference in vegetation between the Central Lowland and Allegheny Plateau. The maps created here offer a historical perspective that can inform conservation, education, and further research.

Our article on the sinking of the S.S. Edmund Fitzgerald provides the basis of this case study. On November 10, 1975, the Great Lakes bulk cargo freighter S.S. Edmund Fitzgerald suddenly and mysteriously sank during a winter storm on Lake Superior (See Fig. 6.1).

Not all case studies have to involve historical events from the national- or international-level.

Case studies were first used in the 1820s as a way of teaching the social sciences and quickly became associated with teaching anthropology, history, sociology, law, medicine, and psychology. Today however, case studies are used in business, education, and all sub-disciplines of the STEM-fields.

By presenting students with relevant background information, comparative timelines, and leading theories as to why events unfolded as they did, we can bring sometimes forgotten events to new generations of students.

In Chapter 4, we analyzed the flammability of the fabrics used to cover the German zeppelin Hindenburg. The flammability of the outer fabrics plays a pivotal role in the current debate surrounding the ship’s destruction.

Scientists no longer adopt a strictly passive approach to history. Instead, they bring sophisticated analytical tools to scrutinize why certain events happened. Far from being a set of agreed upon immutable facts, the historical record is now open to re-examination and re-interpretation.

Often, groups of scientists and engineers go to extreme lengths to test and re-test various design concepts and construction techniques. Immersed in an isolated and high-stress environment, these groups develop a false sense that their products are “fail-safe,” “full-proof,” and “invincible.” Over time, the group accepts a lower and lower standard of performance until that standard becomes the new “norm.” This phenomenon is known as “Normalization of Deviance,” since the departure from a higher, more robust standard has been normalized.

Teachers are often handcuffed to teach predetermined, district- or department-prescribed curricula. Case studies allow front-line research to be brought into the classroom. Teachers can emphasize to students the importance of staying current with recent developments.

With a case study, students see, perhaps for the first time, how operational definitions compare phenomena of interest against known standards or accepted protocols. Our article on the Hindenburg disaster provides an excellent case study to illustrate this point.

The articles and activities from the previous eight chapters, along with background information, additional readings, and classroom presentations, were compiled into a set of classroom modules for pre-service teachers (PSTs).

Over 400 cyanobacterial genera have been described up to the present. Since the Cambridge Rules ( https://www.iapt‐taxon.org/historic/1935.htm : Rendle 1935), a type species (generitype) must be specified at the time of description for a new genus to be validly described. Even though we have entered a time in which sequencing has become practical and widespread, the basic molecular characterization (e.g., 16S rRNA gene sequence) of most cyanobacterial generitypes is still lacking. About 15 cyanobacterial genera were originally described from Scandinavia. Following a field excursion in which the type or syntype localities for the type species of these genera were visited and sampled, we succeeded in finding three type species from their type or syntype localities: Capsosira brebissonii , Stigonema mamillosum , and Paracapsa siderophila . Epitypes for all three generitypes are herein established. Cells or filaments of C. brebissonii and S. mamillosum were isolated and used for single‐cell/filament PCR amplification of the 16S rRNA gene and subsequent cloning and sequencing of the PCR amplicons. This allows a firm establishment of reference sequences of these two genera, to which morphologically similar taxa can now be compared. Stigonema and Capsosira are shown herein to be sister to Aetokthonos hydrillicola , a cyanobacterium known to cause avian vacuolar myelinopathy in birds, including bald eagles.

Aim To replicate and extend previous psychometric findings for the Autism Symptom Dimensions Questionnaire (ASDQ). Method Using a cross‐sectional design in two samples, including a total of 3366 children and adolescents (aged 2–17 years; 1399 with autism spectrum disorder) and a small case series, factor structure, measurement invariance, reliability, construct validity, screening and diagnostic efficiency, and detection of reliable change were examined for the ASDQ. Results Strong psychometric properties were observed, including replicable factor structure, strong measurement invariance, adequate‐to‐excellent scale and conditional reliability, strong convergent and discriminant validity, and good screening efficiency. Importantly, two crucial measurement aspects required for a good treatment outcome measure were found, that is, good test–retest stability and the potential to detect reliable change. As expected for an informant‐reported questionnaire, diagnostic efficiency was weak. Interpretation The ASDQ showed evidence of favorable and well‐replicated psychometric properties in two samples. Good screening but weak diagnostic efficiency, coupled with good test–retest stability, suggest that optimal clinical use is in screening and in detailed clinical characterization beyond what is offered by current informant‐reported measures, with the potential for monitoring response to intervention. Despite relative brevity, the ASDQ provides good coverage of broad and specific aspects of the autism behavioral phenotype, which is consistent with the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

While adolescent foundational skills interventions can be critical levers for reading improvement, district leaders, teachers, and researchers must make complex decisions about how to evaluate their effectiveness in context. In this discussion article, we explore three issues and tensions we experienced during a 2‐year research–practice partnership overhauling Tier II high school reading intervention practices in a district serving largely African American students. First, we discuss assessment and the challenges of using data and reading theory to simultaneously address system‐level and student‐level needs. Second, we share our process for choosing a curriculum and evaluating its effectiveness. Finally, we weigh how students' African American English may have been related to program implementation and foundational skills development. We share our takeaways to help practitioners and researchers seeking systematic foundational skills improvement across a district, especially districts like ours.

Social attention is a key aspect of neurodevelopment and is significantly altered in neurodevelopmental genetic syndromes and many individuals with idiopathic autism spectrum disorder (ASD). The primary aim of the present study was to examine the psychometric properties of webcam‐collected social attention measurements, including four new specific aspects of social attention, in three genetic syndromes (PTEN Hamartoma Tumor Syndrome—PHTS; Malan Syndrome—NFIX; and SYNGAP1‐related disorder—SYNGAP1), a mixed group of other neurodevelopmental genetic syndromes (Other NDGS), and individuals with a range of idiopathic neurodevelopmental disorder (NDD). The secondary aim was to evaluate the construct validity of these social attention measurements, including evaluating known‐groups validity across study groups and concurrent validity for separating ASD and non‐ASD cases. Participants ( N = 467, age 3–45; PHTS n = 102, NFIX n = 23, SYNGAP1 n = 42, other NDGS n = 63, idiopathic NDD n = 53, neurotypical siblings n = 71, and unrelated neurotypical controls n = 113) completed a 4‐min online‐administered social attention paradigm that includes a variety of distinct stimuli at three timepoints (baseline, 1‐month, and 4‐month follow‐up). Social attention measures had good scale and test–retest reliability, with the exception of measures of non‐social preference and face‐specific processing. Unique patterns of social attention emerged across study groups, with near neurotypical levels in PHTS and weaker social attention in NFIX and SYNGAP1 relative to controls. Global social attention had good accuracy in detecting ASD within NDGS participants. Remote monitoring social attention, including distinct aspects of social attention, may be useful for characterizing phenotypic profiles and tracking the natural history of distinct NDGS and idiopathic NDD as well as identifying ASD within NDGS. Given their reproducibility and stability, global social attention and several distinct social attention measures may be useful outcomes for future clinical trials.

Background/Objective: Assessing Orthostatic Intolerance (OI, symptoms upon standing from supine) is recommended in athletes with sport-related concussions (SRCs), as this is caused by impairments in the cardiovascular autonomic nervous system (cANS). Early Exercise Intolerance (Early EI, symptoms on light physical exertion) is also due to impairments in the cANS but is difficult to incorporate into outpatient clinical practice (cost of personnel, time, equipment). The purpose of this study was to determine if we could use OI to screen for Early EI, as well as understand differences between adolescents who do and do not report OI. Methods: Retrospective chart review. Adolescents with physician-diagnosed SRC performed the 2 min supine to 1 min standing OI test and the Buffalo Concussion Treadmill Test (BCTT) during their first post-SRC visit. Early EI was defined as more-than-mild symptom exacerbation at a heart rate (HR) below 135 bpm on the BCTT; OI was defined as new or increased symptoms of dizziness or lightheadedness on postural change. The sensitivity, specificity and diagnostic accuracy were calculated. Participants with and without OI were compared. Results: In total, 166 adolescents (mean 15.4 years, 58.8% male) were seen a mean of 5.5 days after injury; 48.2% had OI and 52.4% had Early EI, but there was no association between the two measures (Phi = 0.122, p = 0.115). The sensitivity and specificity (with 95% confidence intervals) for OI to screen for Early EI were 54.0% (43.5, 64.3) and 58.2% (47.2, 68.7), respectively. Adolescents with OI had a higher incidence of delayed recovery (24% vs. 9%, p = 0.012). Conclusions: Although both measures seem to be related to impaired autonomic function after SRC, OI has limited accuracy in screening for Early EI, which suggests that their etiologies may be different. Nevertheless, the assessment of OI has clinical utility in the management of SRC.

Aim To examine neurobehavioral findings in three genetic syndromes (PTEN hamartoma tumor syndrome, Malan syndrome [mutations in the NFIX gene], and SYNGAP1‐related disorder), a mixed group of other neurodevelopmental genetic syndromes (NDGS), idiopathic neurodevelopmental disorder, and neurotypical control participants. Method Using a longitudinal case–control design, caregivers reported neurobehavioral information for 498 participants (PTEN hamartoma tumor syndrome n = 112, Malan syndrome n = 24, SYNGAP1‐related disorder n = 47, other NDGS n = 72, idiopathic neurodevelopmental disorder n = 54, neurotypical siblings n = 74, and unrelated neurotypical control participants n = 115) at three timepoints (baseline, and 1‐month and 4‐month follow‐ups) using the online‐administered Neurobehavioral Evaluation Tool (NET). Results NET scales had good scale and test–retest reliability. Unique patterns of neurobehavioral findings emerged, with SYNGAP1‐related disorder and Malan syndrome showing generally more severe symptom and skill patterns than for other groups of patients. Patterns could be partly accounted for by estimated cognitive level, speech level, and the presence of autism spectrum disorder. However, even when accounting for these factors, group differences remained. Reliable change indices are reported. Interpretation Genetic syndromes associated with neurodevelopmental disorders present with unique neurobehavioral profiles that can inform selection of outcome measures in future clinical trials. The NET may be a useful screening and monitoring instrument in clinical practice, where frequent in‐person clinic attendance is difficult for many patients.

Although the production effect is well-established in undergraduates, limited research has examined this effect in children. The primary goal of the current study was to replicate the production effect in preschoolers. In Experiment 1, one group studied all items silently or aloud (pure lists) and another group studied half of the items silently and said half aloud (mixed lists). At recall, the production effect was present in mixed lists but not in pure lists. The results suggest that the effect in mixed lists was due to both a benefit for produced items and a cost to silent items. Experiments 2 and 3 examined whether preschoolers were aware of the benefits of production. The results were mixed and indicate that task difficulty may impact whether production benefits memory. When the metacognitive task was easier (Experiment 3), the production effect replicated. Preschoolers’ judgments indicated they believe that production leads to better memory, but they were overconfident. The current results demonstrate that (1) young children can use production to improve memory when instructed, even before they spontaneously use it, (2) they believe production can benefit memory, and (3) task difficulty may account for discrepancies in prior work examining the production effect in children.