bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 vaccination in high-risk communities: Case study of Brampton, Ontario
Authors: Gill Manmohit , Datta Dhruv , Gregory Paul , Austin Zubin
Published: September 2022

Background:

The Peel region in Southern Ontario is among the most ethnoculturally diverse and fastest growing areas in Canada. During the COVID-19 pandemic, the multicultural community of Brampton suffered one of the highest infection rates in Canada, in part because of the demographic and socioeconomic characteristics of the community. The role of pharmacists in supporting vaccine uptake in this linguistically, ethnically and religiously diverse community has not been adequately characterized.

Methods:

A qualitative case study approach was used, focusing on one of the major communities in Peel (Brampton). Interviews with community pharmacists and pharmacy staff directly involved in COVID-19 vaccine administration during the pandemic were undertaken to identify common experiences and trends related to providing care and support to this high-risk community. Constant comparative coding was used to identify common themes that can inform ongoing public health supports in future pandemics.

Results:

A total of 29 interviews were completed. Key themes that emerged included 1) the impact of operational, organizational and logistical issues on vaccine uptake in the community; 2) the negative influence of inconsistent messaging from public health and other experts during the pandemic; and 3) the identification of an emerging typology of “vaccine hesitancies” describing different reasons/motivations for avoiding COVID-19 vaccination and approaches taken by pharmacy staff to address these within a multicultural, multilingual practice context.

Discussion:

The COVID-19 vaccination campaign was unprecedented in its size, scope and speed, and community pharmacists were integral in this effort. The unique needs of ethnoculturally, linguistically and socioeconomically diverse communities like Brampton require further studies to examine ways in which the pharmacy profession can positively influence greater vaccine uptake, by increasing understanding of the diverse proliferation of vaccine hesitancies that emerged.
Are Small Effects the Indispensable Foundation for a Cumulative Psychological Science? A Reply to Götz et al. (2022)
Authors: Primbs Maximilian A. , Pennington Charlotte R. , Lakens Daniël , Silan Miguel Alejandro A. , Lieck Dwayne S. N. , Forscher Patrick S. , Buchanan Erin M. , Westwood Samuel J.
Published: September 2022

In the January 2022 issue of Perspectives, Götz et al. argued that small effects are “the indispensable foundation for a cumulative psychological science.” They supported their argument by claiming that (a) psychology, like genetics, consists of complex phenomena explained by additive small effects; (b) psychological-research culture rewards large effects, which means small effects are being ignored; and (c) small effects become meaningful at scale and over time. We rebut these claims with three objections: First, the analogy between genetics and psychology is misleading; second, p values are the main currency for publication in psychology, meaning that any biases in the literature are (currently) caused by pressure to publish statistically significant results and not large effects; and third, claims regarding small effects as important and consequential must be supported by empirical evidence or, at least, a falsifiable line of reasoning. If accepted uncritically, we believe the arguments of Götz et al. could be used as a blanket justification for the importance of any and all “small” effects, thereby undermining best practices in effect-size interpretation. We end with guidance on evaluating effect sizes in relative, not absolute, terms.
People’s Knowledge and Perceptions Towards Bee–Pollinators in the Southern Highlands, Tanzania: Conservation Implications and Strategies
Authors: Ojija Fredrick , Leweri Cecilia
Published: September 2022

Background and research aims

Bees are important pollinators of flowering wild plants and agricultural crops that contribute significantly towards food security, improving people’s livelihoods, and maintaining genetic diversity in plant communities. However, the decline of the bee population due to anthropogenic changes and limited knowledge of bees is threatening bee diversity, particularly in sub–Saharan Africa. Negative perceptions, that is, fear and disgust, are common emotions that lead to a lack of support for bee conservation. Understanding local people’s perceptions is vital as it can help in bee conservation decision making and proper protection actions.

Methods

We conducted the study in the Mbeya and Songwe regions of Tanzania to assess the knowledge and perception of local people about bee–pollinators and conservation using a structured questionnaire

Results

We found that the majority of respondents (91%) have heard about bees (χ2 = 6275, p < 0.001) and their conservation initiatives (71%), and about 84% of respondents consider bees to be important (χ2 = 168.9, p = 0.001). Moreover, Apis mellifera had the highest identification rate, with 52.7% of respondents. A binary logistic model revealed that respondents' knowledge of bee–pollinators and pollination is not influenced by their age (except for respondents aged 15–18 years, p = 0.012) and education level. While 74% of respondents claimed to be afraid of bees, 79% stated that bees are dangerous to humans. The most common cause is personal experience with bee stings. Poor farm management practices, for example, use of fire and deforestation, were noted by 79% of respondents as the most human activities threatening bee–pollinators.

Conclusion

Overall, the respondents were more familiar with A. mellifera compared to non–Apis bee species.

Implications for conservation

Thus, we suggest that implementation of pollinator management programs is vital to ensure their survival and reduce the perceived threat by dispelling myths and encouraging interest in bees.
Cone-beam CT-assisted microcatheter tip placement at the shunted pouch entry zone: A technical note for anterior condylar arteriovenous fistula
Authors: Matsukawa So , Ishibashi Ryota , Goto Masanori , Terada Yukinori , Hashikata Hirokuni , Iwasaki Koichi , Toda Hiroki
Published: September 2022

Accurate microcatheter placement for anterior condylar arteriovenous fistula (AVF) enables selective transvenous embolization (TVE) and helps to avoid hypoglossal nerve palsy. Anterior condylar AVF has a shunted pouch within the condylar vascular and osseous structures. Detailed anatomical comprehension of the shunted pouch is essential, in addition, we believe that it is important to have a strategy for where in the shunted pouch to start filling with coils. Specifically, we consider that it is important to structurally understand the more upstream location (arterial side) within the shunted pouch (called “ shunted pouch entry zone”), guide the microcatheter there, and embolize from that site. Although several studies have discussed the usefulness of intraoperative cone-beam computed tomography (CBCT) for treating anterior condylar AVF, there are no studies which have mentioned the importance of microcatheter position before coil embolization in selective TVE as in this study. Intraoperative localization of the shunted pouch entry zone is often difficult. Herein, the authors report that cone-beam computed tomography (CBCT) can assist accurate microcatheter tip placement at the shunted pouch entry zone before staring embolization. This is the novel application of intraoperative CBCT to treat anterior condylar AVF successfully treated with precise and selective TVE.
Movement Leadership and Messaging Platforms in Preemptive Repressive Settings: Telegram and the Navalny Movement in Russia
Authors: Herasimenka Aliaksandr
Published: September 2022

People who lead anti-authoritarian digitally enabled movements face a leadership visibility dilemma—a necessity to balance security with publicity while mobilizing followers. The article asks how the reliance on instant messaging platforms (IMPs) to coordinate protest internally shapes the response to this dilemma revealed through internal movement organizing analysis. Our case study is social media protest mobilization by Alexei Navalny’s movement in Russia in 2017. We rely on semi-structured interviews and thematic analysis of communication on Telegram during this mobilization. We offer a theory of leadership in an IMP-organized anti-authoritarian movement. It suggests that the use of messaging platforms during social media protest mobilization enhances capacities for visibility management and polycentricity in such movements. It also fosters the emergence of a specific type of protest movement leader—or shadow anti-authoritarian leadership—that is collective, polycentric, and concealed.
Teaching Practicum During COVID-19: Pre-Service English Language Teachers’ Professional Identities and Motivation
Authors: Choi Lee Jin , Park Mi Yung
Published: September 2022

As the pandemic has brought in a paradigm shift in the way we educate and interact with our students, it has also had profound impacts on the practicum of pre-service teacher education. Focusing on the case of 14 South Korean student teachers who completed their teaching practicum in Spring 2020, this paper explores how the new form of teaching practicum, triggered by the current outbreak, affected student teachers’ professional development and their views on teaching practice and profession. In particular, it examines the ways by which teaching practicums conducted under unpredictable circumstances negatively or positively affect student teachers’ professional identities as teaching practitioners and their motivation to become a teacher. The findings of this study show that the teaching practicum conducted in times of crisis enabled pre-service English language teachers to develop a positive image toward teachers and teaching profession, and realize their potential as innovative and inspiring teachers in the post COVID-19 era.
Sustainability in Social Enterprise Research: A Systematic Literature Review
Authors: Jayawardhana Kumudu , Fernando Imali , Siyambalapitiya Janaka
Published: September 2022

Given the noteworthy contribution to the global socio-economic development, research on social enterprises (SE) has gained prominence over past two decades. Making a clear departure from for-profit counterparts, the core purpose of SEs is to deliver a social mission while at the same time staying financially viable and as a consequence, “sustainability” is strongly embedded in their core drive of existence. Rapidly sprouting body of literature on SE posits that “sustainability” is intensely coincided with “social enterprises.” Although “sustainability” has been a buzz word in the context of SE, lacking of systematization and categorization of knowledge hinders the advancement of SE specific research. Consequently, the primary objective of this paper is systematization and categorization of the extant knowledge on sustainability in SE research context. The study carried-out a systematic literature survey from reputed databases; Scopus, Social Science Citation Index and Science Direct. Removing the repetitions, 136 papers on sustainability was compiled for analysis. The analytical approach was two-fold: First, a citation analysis was performed in order to evaluate the prominent, emerging and popular sustainability-based research areas in the extant body of knowledge in the field. Second, a thematic analysis was performed to analyze and interpret explicit themes on which sustainability concept has been investigated. Paper discovered six themes that the sustainability concept has been researched through significant research popularity disparities can be witnessed among the discovered themes. Since this paper identifies several research gaps and inconsistencies, it noticeably sets path for future research on the concept of sustainability in SE.
Older Adults’ Experiences Moving Community Online in Independent Living During the Covid-19 Pandemic
Authors: Tandukar Barsa , Martin-Hammond Aqueasha
Published: September 2022

In this paper, we explore older adults’ experiences moving daily social activities online in a senior independent living community during the early stages (March 2020–June 2020) of the Covid-19 pandemic in the United States. We present findings of a semi-structured interview study with eight older adult residents where we discuss their needs and how they used technology to support and adapt during the phase of required physical distancing. Our findings suggest that participants felt well supported by their organization and community, and found information and communication technologies (ICTs) that were useful for supporting the transition. However, some participants felt that they did face challenges and the ability to adapt may have been influenced by technology access and residents’ prior established ties within the community. Based on our findings, we reflect on how we might better support older adults living in community settings in future crisis.
Paramedic attitudes towards prehospital spinal care: a cross-sectional survey
Authors: McDonald Neil , Kriellaars Dean , Pryce Rob T.
Published: September 2022

Background

The optimal application of spinal motion restriction (SMR) in the prehospital setting continues to be debated. Few studies have examined how changing guidelines have been received and interpreted by emergency medical services (EMS) personnel. This study surveys paramedics’ attitudes, observations, and self-reported practices around the treatment of potential spine injuries in the prehospital setting.

Methods

This was a cross-sectional survey of a North American EMS agency. After development and piloting, the final version of the survey contained four sections covering attitudes towards 1) general practice, 2) specific techniques, 3) assessment protocols, and 4) mechanisms of injury (MOI). Questions used Likert-scale, multiple-choice, yes/no, and free-text responses. Exploratory factor analysis (EFA) was used to identify latent constructs within responses, and factor scores were analyzed by ordinal logistic regression for associations with demographic characteristics (including qualification level, gender, and years of experience). MOI evaluations were assessed for inter-rater reliability (Fleiss’ kappa). Inductive qualitative content analysis, following Elo & Kyngäs (2008), was used to examine free-text responses.

Results

Two hundred twenty responses were received (36% of staff). Raw results indicated that respondents felt that SMR was seen as less important than in the past, that they were treating fewer patients than previously, and that they follow protocol in most situations. The EFA identified two factors: one (Judging MOIs) captured paramedics’ estimation that the presented MOI could potentially cause a spine injury, and another (Treatment Value) reflected respondents’ composite view of the effectiveness, importance, and applicability of SMR. Respondents with advanced life support (ALS) qualification were more likely to be skeptical of the value of SMR compared to those at the basic life support (BLS) level (OR: 2.40, 95%CI: 1.21–4.76,p = 0.01). Overall, respondents showed fair agreement in the evaluation of MOIs (k = 0.31, 95%CI: 0.09–0.49). Content analysis identified tension expressed by respondents between SMR-as-directed and SMR-as-applied.

Conclusion

Results of this survey show that EMS personnel are skeptical of many elements of SMR but use various strategies to balance protocol adherence with optimizing patient care. While identifying several areas for future research, these findings argue for incorporating provider feedback and judgement into future guideline revision.
Immune checkpoint inhibitors and their impact on liver enzymes and attenuation
Authors: Park Benjamin C. , Lee Aaron X. T. , Ye Fei , Turker Isik , Johnson Douglas B.
Published: September 2022

Background

Immune related adverse events impacting the liver are common from immune checkpoint inhibitor (ICI) therapy; however, there is little data regarding the subclinical impact of ICIs on liver inflammation. The study aims to determine whether ICI therapy affects liver attenuation and liver enzymes in melanoma patients with and without hepatic steatosis.

Methods

A retrospective, cohort study was conducted of patients with advanced melanoma treated with ICI therapy who received serial PET-CT scans at the Vanderbilt University Medical Center (VUMC). Primary outcomes included: liver attenuation measured by PET-CT/non-contrast CT and liver enzymes. Hepatic steatosis was diagnosed by radiologists on clinical imaging.

Results

Among 839 patients with advanced melanoma treated with ICIs, 81 had serial PET-CT scans approximately 12 months apart and long-term survival; of these 11 patients had pre-existing steatosis/steatohepatitis. Overall, ICI was not associated with significant increases in liver enzymes in all patients; modest decreases in liver enzymes were observed in patients with pre-existing steatosis/steatohepatitis. Similarly, liver attenuation did not change from baseline to post-treatment (58.44 vs 60.60 HU, + 2.17, p = 0.055).

Conclusions

ICIs may not chronically affect liver enzymes or liver attenuation, a non-invasive measure of liver fat content and inflammation, in the general population or in those with pre-existing steatosis/steatohepatitis.
The soluble VCAM-1 level is a potential biomarker predicting severe acute graft versus host disease after allogeneic hematopoietic cell transplantation
Authors: Heo Sook-Kyoung , Noh Eui-Kyu , Lee Yoo Jin , Shin Yerang , Kim Youjin , Im Hyeon-Su , Kim Hyeyeong , Koh Su Jin , Min Young Joo , Jo Jae-Cheol , Choi Yunsuk
Published: September 2022

Background

Severe graft versus host disease (GVHD) is the main reason for non-relapse mortality following allogeneic hematopoietic cell transplantation (HCT). We investigated the serum protein profiles of patients who had undergone HCT to identify predictive biomarkers of severe acute GVHD (aGVHD).

Methods

Serum samples were collected for 30 patients from day − 7 to day + 14 of HCT. The serum levels of plasma beta2-microglobulin (β2-MG), soluble vascular cell adhesion molecule-1 (sVCAM-1), platelet factor 4, and TNFSF-14 were measured by ELISA as potential biomarkers following 310 cytokine profiling array.

Results

The median age of the study patients was 53.5 years (range, 19–69). All grade and grade 2–4 aGVHD developed in 21 (70.0%) and 17 (56.7%) patients, respectively. Compared with their baseline levels on day − 7, β2-MG and sVCAM-1 were significantly increased on day + 14 of the HCT procedure (P = 0.028 andP < 0.001, respectively). Patients with a grade 2–4 severe aGVHD showed a significantly higher sVCAM-1 level at baseline (day-7) and at day + 14, compared with the other group with a grade 1 aGVHD or no aGVHD (P = 0.028 andP = 0.035, respectively).

Conclusion

Higher sVCAM- levels at baseline and on day + 14 in HCT patients could be a significant predictive biomarker of severe aGVHD.
Autonomy and health-related quality of life in adolescents
Authors: Eriksson Mårten , Boman Eva , Svedberg Pia
Published: September 2022

Background

Autonomy is recognized as important for individual well-being and constitutes one dimension in the KIDSCREEN-instrument measuring health related quality of life (HRQoL) in children and adolescents. However, the autonomy questions in KIDSCREEN are restricted to opportunities to influence leisure time activities, which is a form of autonomy as volition. Yet, there are other aspects of autonomy that might be related to adolescent’s HRQoL. The aims of the present study were first to investigate the psychometric properties of a scale measuring autonomy in adolescence from a control perspective (AAC) including its relation to the autonomy dimension in KIDSCREEN, and second; to investigate AACs ability to predict each of the 10 dimensions constituting KIDSCREEN.

Methods

Students (n = 154) aged 15–16 years who were recruited from schools located in both low (two schools) and high (two schools) socioeconomic status (SES) areas in Sweden participated in a cross-sectional study. The adolescents answered a questionnaire including a new 6-item scale measuring perceived autonomy and HRQoL assessed by the KIDSCREEN-52 instrument. A factor analyses was computed to investigate the relation between the items in the AAC scale and the autonomy items in the KIDSCREEN instrument. Hierarchical regression analyses were computed to investigate if the AAC scale predicted HRQoL in any of the 10 dimensions in KIDSCREEN after controlling for gender, SES and the original autonomy scale included in KIDSCREEN.

Results

The factor analysis showed that all the items from the autonomy scale loaded in one factor and that all the items from the AAC scale loaded in another dimension. The hierarchical regression models showed that the AAC scale uniquely predicted HRQoL in all dimensions of the KIDSCREEN instrument after controlling for gender, SES and the original autonomy scale included in KIDSCREEN-52. A high level of perceived autonomy was associated with a high level of HRQoL for both scales.

Conclusion

A new scale for measuring autonomy from a control perspective has been presented and shown to differ from autonomy as volition. Both forms of autonomy are positively related to HRQoL in adolescence 15–16 years old.
A systematic review of the international evolution of online mental health strategies and recommendations during the COVID-19 pandemic
Authors: Almeda Nerea , Díaz-Milanés Diego , Guiterrez-Colosia Mencia R. , García-Alonso Carlos R.
Published: September 2022

Introduction

The global health crisis caused by the COVID-19 pandemic has had a negative impact on mental health (MH). As a response to the pandemic, international agencies and governmental institutions provided an initial response to the population’s needs. As the pandemic evolved, the population circumstances changed, and some of these international agencies updated their strategies, recommendations, and guidelines for the populations. However, there is currently a lack of information on the attention given to response strategies by the different countries throughout the beginning of the pandemic.

Objectives

1) To evaluate the evolution of online MH strategies and recommendations of selected countries to cope with the MH impact of COVID-19 from the early stages of the pandemic (15 April 2020) to the vaccination period (9 June 2021) and 2) to review and analyse the current structures of these online MH strategies and recommendations.

Methodology

An adaptation of the PRISMA guidelines to review online documents was developed with a questionnaire for MH strategies and recommendations assessment. The search was conducted on Google, including documents from April 2020 to June 2021. Basic statistics and Student’s t test were used to assess the evolution of the documents, while a two-step cluster analysis was performed to assess the organisation and characteristics of the most recent documents.

Results

Statistically significant differences were found both in the number of symptoms and mental disorders and MH strategies and recommendations included in the initial documents and the updated versions generated after vaccines became available. The most recent versions are more complete in all cases. Regarding the forty-six total documents included in the review, the cluster analysis showed a broad distribution from wide-spectrum documents to documents focusing on a specific topic.

Conclusions

Selected governments and related institutions have worked actively on updating their MH online documents, highlighting actions related to bereavement, telehealth and domestic violence. The study supports the use of the adaptation, including the tailor-made questionnaire, of the PRISMA protocol as a potential standard to conduct longitudinal assessments of online documents used to support MH strategies and recommendations.
Life under stay-at-home orders: a panel study of change in social interaction and emotional wellbeing among older Americans during COVID-19 pandemic
Authors: Lin Jielu , Zajdel Melissa , Keller Krystyna R. , Gilpin Macfoy Fiona O. , Shaw Philip , Curtis Brenda , Ungar Lyle , Koehly Laura
Published: September 2022

Background

Recent research has shown the mental health consequence of social distancing during the COVID-19 pandemic, but longitudinal data are relatively scarce. It is unclear whether the pattern of isolation and elevated stress seen at the beginning of the pandemic persists over time. This study evaluates change in social interaction over six months and its impact on emotional wellbeing among older adults.

Methods

We drew data from a panel study with six repeated assessments of social interaction and emotional wellbeing conducted monthly May through October 2020. The sample included a total of 380 White, Black and Hispanic participants aged 50 and over, of whom 33% had low income, who residing in fourteen U.S. states with active stay-at-home orders in May 2020. The analysis examined how change in living arrangement, in-person interaction outside the household, quality of relationship with family and friends, and perceived social support affected trajectories of isolation stress, COVID worry and sadness.

Results

While their living arrangements (Odds Ratio [OR] = 0.95, 95% Confidence Interval [CI] = 0.87, 1.03) and relationship quality (OR = 0.94, 95% CI = 0.82, 1.01) remained stable, older adults experienced fluctuations in perceived social support (linear Slope b = -1.42, s.e. = 0.16,p < .001, quadratic slope b = 0.50, s.e. = 0.08,p < .001, cubic slope b = -0.04, s.e. = 0.01,p < .001) and increases in in-person conversations outside the household (OR = 1.19, 95% CI = 1.09, 1.29). Living with a spouse/partner stabilized isolation stress (change in linear slope b = 1.16, s.e. = 0.48,p < .05, in quadratic slope b = -0.62, s.e. = 0.26,p < .05, and in cubic slope = 0.09, s.e. = 0.04,p < .05) and COVID worry (change in quadratic slope b = -0.66, s.e. = 0.32,p < .05 and in cubic slope = 0.09, s.e. = 0.04,p < .05) over time. Individuals with better relationship quality with friends had decreased sadness over time (OR = 0.90, 95% CI = 0.82, 0.99). Changes in social support were associated with greater fluctuations in isolation stress and COVID worry.

Conclusions

During the pandemic, social interactions are protective and lack of stability in feeling supported makes older adults vulnerable to stress. Efforts should focus on (re)building and maintaining companionship and support to mitigate the pandemic’s negative impact.
Transportation barriers to care among frequent health care users during the COVID pandemic
Authors: Cochran Abigail L. , McDonald Noreen C. , Prunkl Lauren , Vinella-Brusher Emma , Wang Jueyu , Oluyede Lindsay , Wolfe Mary
Published: September 2022

Background

Transportation problems are known barriers to health care and can result in late arrivals and delayed or missed care. Groups already prone to greater social and economic disadvantage, including low-income individuals and people with chronic conditions, encounter more transportation barriers and experience greater negative health care consequences. Addressing transportation barriers is important not only for mitigating adverse health care outcomes among patients, but also for avoiding additional costs to the health care system. In this study, we investigate transportation barriers to accessing health care services during the COVID-19 pandemic among high-frequency health care users.

Methods

A web-based survey was administered to North Carolina residents aged 18 and older in the UNC Health system who were enrolled in Medicaid or Medicare and had at least six outpatient medical appointments in the past year. 323 complete responses were analyzed to investigate the prevalence of reporting transportation barriers that resulted in having arrived late to, delayed, or missed care, as well as relationships between demographic and other independent variables and transportation barriers. Qualitative analyses were performed on text response data to explain transportation barriers.

Results

Approximately 1 in 3 respondents experienced transportation barriers to health care between June 2020 and June 2021. Multivariate logistic regressions indicate individuals aged 18–64, people with disabilities, and people without a household vehicle were significantly more likely to encounter transportation barriers. Costs of traveling for medical appointments and a lack of driver or car availability emerged as major transportation barriers; however, respondents explained that barriers were often complex, involving circumstantial problems related to one’s ability to access and pay for transportation as well as to personal health.

Conclusions

To address transportation barriers, we recommend more coordination between transportation and health professionals and the implementation of programs that expand access to and improve patient awareness of health care mobility services. We also recommend transportation and health entities direct resources to address transportation barriers equitably, as barriers disproportionately burden younger adults under age 65 enrolled in public insurance programs.
A profile of children’s physical activity data from the 2012 and 2015 health survey for England
Authors: Sims Jamie , Milton Karen , Foster Charlie , Scarborough Peter
Published: September 2022

Background

Low childhood physical activity levels constitute an important modifiable risk for adult non-communicable disease incidence and subsequent socio-economic burden, but few publications have explored age and sex related patterns within the UK population. The aims were to profile child physical activity data from the Health Survey for England from 2012 (1,732 respondents) and 2015 (5,346 respondents).

Methods

Reported physical activity episodes were converted to metabolic equivalents with reference to child-specific compendiums. Physical activity levels were aggregated for each domain, and again to produce total physical activity estimates. Contributions from each domain to total physical activity were explored, stratifying for age, sex, socio-economic deprivation, ethnicity, and weight status. Further analyses were run stratifying for physical activity levels. Few differences were detected between the survey iterations.

Results

Boys reported higher absolute levels of physical activity at all ages and across all domains. For boys and girls, informal activity reduces with age. For boys this reduction is largely mitigated by increased formal sport, but this is not the case for girls. Absolute levels of school activity and active travel remained consistent regardless of total physical activity, thereby comprising an increasingly important proportion of total physical activity for less active children.

Conclusions

We recommend a specific focus on establishing and maintaining girl’s participation in formal sport thorough their teenage years, and a recognition and consolidation of the important role played by active travel and school-based physical activity for the least active children.
A novel bone graft technique combined with plating for aseptic recalcitrant long bone nonunion
Authors: Jiang Yuxuan , Wang Xiaolong , Huang Wei , Zhu Yangjun , Zhang Kun , Feng Dongxu
Published: September 2022

Background

To evaluate the outcomes and efficacy of a new technique of autogenous iliac crest bone grafting combined with locking compression plate (LCP) vertical fixation for aseptic recalcitrant long bone nonunion.

Methods

From July 2010 to September 2020, 36 aseptic recalcitrant long bone nonunions were treated with a bone-forming channel technique and internal LCP fixation. All the patients had received one or more failed treatments. The injury mechanism, nonunion type and duration, and prior treatments were recorded pre-operation. The routine treatment process included nonunion area exposure, previous implant removal, sclerotic bone debridement, LCP fixation, bone-forming channel creation, and iliac bone grafting, and a second LCP fixation when required. At follow-up, X-ray images were obtained to assess bone healing and implant failure. Visual analog scale (VAS), fracture site stability, limb function, activity, muscle strength, limb length, and complications were recorded.

Results

A total of 34 patients (24 males and 10 females) were finally enrolled, with a mean age of 49.8 ± 12.3 years. At a mean follow-up of 35.6 ± 22.0 months, 32 patients displayed bone union, with a healing rate of 94.1% and mean union time of 6.8 ± 2.4 months. The VAS score was 0.7 ± 1 at the final follow-up. The functional results showed that 19 patients were excellent, 11 patients were good, 2 patients were poor, and 2 patients did not heal.

Conclusion

Bone-forming channel technique combined with LCP vertical fixation is an excellent option to treat recalcitrant long bone nonunion.

Level of evidence

Therapeutic Level IV.
Evidence-based selection of orthodontic miniscrews, increasing their success rate in the mandibular buccal shelf. A randomized, prospective clinical trial
Authors: Sarul Michał , Lis Joanna , Park Hyo-Sang , Rumin Kornelia
Published: September 2022

Background

Skeletal anchorage has made it possible to perform complex orthodontic tooth movements that are difficult or even impossible to achieve with conventional orthodontic treatment. Mandibular buccal shelf miniscrews, used for distalization, play a particularly important role in treatment of Class III malocclusion. Unfortunately, stability of the miniscrews placed in the mandible is still considered at higher risk of failure compared to other intraoral locations. The aim of our study was to determine the influence of the miniscrew size on their long-term stability, occurrence of oral mucosa inflammation and pain lasting over 48 h after implantation.

Methods

184 Absoanchor® miniscrews (Dentos, South Korea) in two sizes: SH2018-10 (length 10 mm, ø 1.8–2.0 mm) and SH1514-08 (length 8 mm, ø 1.4–1.5 mm) were inserted in the mandibular buccal shelf in 92 Caucasians aged 20–50 years, diagnosed with Class III malocclusion that required en-masse distalization of the mandibular dentition. Data was statistically analyzed with the level of significance set at p = .05.

Results

91.3% of the SH2018-10 and 75% of the SH1514-08 miniscrews were stable, and this difference was statistically significant (p < .05). Inflammation of the oral mucosa was noticed around both types of miniscrews and affected 50% of the SH2018-10 and 26.09% of the SH1514-08 group (p < .05). Pain lasting longer than 48 h after implantation was related to 60.87% and 20.65% of the SH2018-10 and the SH1514-08 miniscrews (p < .05), respectively. Inflammation associated with larger SH2018-10 miniscrews did not affect their stability (p > .05), contrary to the SH1514-08 ones (p < .05). When inflammation was present, the overall success rate declined to 64.29%, from 94.74% noted for TADs without inflammation. According to the log-rank test, smaller TADs failed significantly sooner than the larger ones (p = .002).

Conclusion

Larger SH2018-10 miniscrews are the anchorage of choice for the mandibular buccal shelf, despite triggering inflammation and long-lasting pain significantly more often than the smaller ones. Therefore, this issue should be discussed with every patient prior to miniscrew use. Trial registration ID: ClinicalTrials.gov Identifier: NCT05280678 Date of Registration: 15/03/2022. Retrospectively registered.
Extraoral low-level laser therapy can decrease pain but not edema and trismus after surgical extraction of impacted mandibular third molars: a randomized, placebo-controlled clinical trial
Authors: Momeni Ehsan , Kazemi Farahnaz , Sanaei-rad Parisa
Published: September 2022

Background

This study aimed to assess the effect of extraoral 940 nm low-level diode laser on pain, edema, and trismus following surgical extraction of impacted mandibular third molars.

Materials and methods

This split-mouth, randomized, placebo-controlled clinical trial evaluated 25 patients with bilaterally impacted mandibular third molars. One side of the jaw was randomly assigned to the laser and the other side to the control group. The laser quadrant received 940 nm diode laser irradiation (0.5 W, 10 J/cm2, continuous-wave mode, 20 s) at three points in the master muscle in contact mode immediately after surgical extraction of third molar. The third molar in the placebo quadrant was extracted after 2 weeks by the same surgeon using the same standard approach. The pain score was measured at 2 and 7 days postoperatively using a visual analog scale (VAS). To assess trismus, the distance between the incisal edges of the upper and lower central incisors was measured in maximum opening. To assess edema, the distance between the tragus and chin point was measured before and immediately after surgery and after 2 and 7 days. Data were analyzed using t-test, ANOVA, and Bonferroni test.

Results

The mean pain score in the first 7 days was significantly lower in the laser group (P < 0.05). Edema and trismus were the same in both groups (P > 0.05). Number of analgesics taken was significantly lower in the laser group (P < 0.05).

Conclusion

Single-session irradiation of 940 nm diode laser can effectively decrease pain following third molar extraction surgery.

Trial registration number: IRCT20141209020258N91 on 29/12/2018.
Associations between HIV testing and multilevel stigmas among gay men and other men who have sex with men in nine urban centers across the United States
Authors: Dibble Kate E. , Murray Sarah M. , Wiginton John Mark , Maksut Jessica L. , Lyons Carrie E. , Aggarwal Rohin , Augustinavicius Jura L. , Al-Tayyib Alia , Sey Ekow Kwa , Ma Yingbo , Flynn Colin , German Danielle , Higgins Emily , Anderson Bridget J. , Menza Timothy W. , Orellana E. Roberto , Flynn Anna B. , Wermuth Paige Padgett , Kienzle Jennifer , Shields Garrett , Baral Stefan D.
Published: September 2022

Background

Complex manifestation of stigma across personal, community, and structural levels and their effect on HIV outcomes are less understood than effects in isolation. Yet, multilevel approaches that jointly assesses HIV criminalization and personal sexual behavior stigma in relation to HIV testing have not been widely employed or have only focused on specific subpopulations. The current study assesses the association of three types of MSM-related sexual behavior-related stigma (family, healthcare, general social stigma) measured at both individual and site levels and the presence/absence of laws criminalizing HIV transmission with HIV testing behaviors to inform HIV surveillance and prevention efforts among HIV-negative MSM in a holistic and integrated way.

Methods

We included nine National HIV Behavioral Surveillance (NHBS) 2017 sites: Baltimore, MD; Denver, CO; Detroit, MI; Houston, TX; Long Island/Nassau-Suffolk, NY; Los Angeles, CA; Portland, OR; San Diego, CA; and Virginia Beach and Norfolk, VA. Multivariable generalized hierarchical linear modeling was used to examine how sexual behavior stigmas (stigma from family, anticipated healthcare stigma, general social stigma) measured at the individual and site levels and state HIV criminalization legislation (no, HIV-specific, or sentence-enhancement laws) were associated with past-year HIV testing behaviors across sites (n = 3,278).

Results

The majority of MSM across sites were tested for HIV in the past two years (n = 2,909, 95.4%) with the average number of times tested ranging from 1.79 (SD = 3.11) in Portland, OR to 4.95 (SD = 4.35) in Los Angeles, CA. In unadjusted models, there was a significant positive relationship between stigma from family and being tested for HIV in the past two years. Site-level HIV-specific criminalization laws were associated with an approximate 5% reduction in the prevalence of receiving any HIV test in the past two years after individual level stigma and sociodemographic covariate adjustments (PR = 0.94, 95% CI, 0.90–0.99).

Conclusions

Structural barriers faced by MSM persist and ending the HIV epidemic in the US requires a supportive legal environment to ensure effective engagement in HIV services among MSM. Home-based solutions, such as self-testing, used to deliver HIV testing may be particularly important in punitive settings while legal change is advocated for on the community and state levels.
Metabolomic changes related to airway inflammation, asthma pathogenesis and systemic activity following inhaled fluticasone furoate/vilanterol: a randomized controlled trial
Authors: Daley-Yates Peter , Keppler Brian , Baines Amanda , Bardsley George , Fingleton James
Published: September 2022

Background

Fluticasone furoate/vilanterol trifenatate (FF/VI) is an inhaled therapy for the treatment of asthma, with a prolonged duration of anti-inflammatory and bronchodilatory action. This study investigated the global metabolomic and lipidomic profile following treatment with FF/VI or placebo and assessed whether changes correlated with exhaled nitric oxide levels as a measure of airway inflammation.

Methods

This was a single-center, randomized, double-blind, placebo-controlled, two-period, crossover, repeat-dose study. Adults with asthma (forced expiratory volume in 1 s ≥ 60% predicted; fraction of exhaled nitric oxide [FeNO] > 40 parts per billion) received once-daily FF/VI 100 µg/25 µg or placebo for 14 days, followed by a 21-day washout period. Serum samples were taken at pre-dose (T1), and 15 and 21 days (T2 and T3, respectively) post dose in each period. The metabolomic and lipidomic profiles were analyzed by liquid chromatography with tandem mass spectrometry and polar liquid chromatography platforms, and ions were matched to a library of standards for metabolite identification and quantification. FeNO values at each timepoint were evaluated for correlations with the biochemical data.

Results

Of 27 randomized participants (mean age 24.5 years, 63% male), 26 provided serum samples for metabolomic analysis. A total of 1969 metabolites were identified, 1634 of which corresponded to a named structure in a reference library. Treatment-related changes in the metabolome were generally subtle, with a modest increase in metabolite perturbations across timepoints. The percentage of metabolites with significant changes (p < 0.05 for all) (increases↑/decreases↓) versus placebo were: 2.1% (1.1%↑/1.0%↓), 6.7% (0.46%↑/6.2%↓) and 11.8% (0.86%↑/10.9%↓) at T1, T2 and T3, respectively. Treatment with FF/VI reduced FeNO levels by 60%, whereas the systemic intermediates involved in NO biosynthesis remained unaffected. Evidence of systemic anti-inflammatory activity was seen in complex lipid pathways, suggesting reduced phospholipase-A2 activity, but without downstream impact on free fatty acids or inflammatory mediators. Consistent with the pathogenesis of asthma, there was evidence of higher fatty acid β-oxidation and lower glycolysis in the placebo arm; this pattern was reversed in the treatment arm.

Conclusions

Despite the prolonged airway anti-inflammatory action of FF/VI, this was accompanied by only subtle systemic metabolomic and lipidomic changes.

Trial registration Prospectively registered on ClinicalTrials.gov registry number NCT02712047
β-Escin overcomes trastuzumab resistance in HER2-positive breast cancer by targeting cancer stem-like features
Authors: Park Soeun , Park Jung Min , Park Minsu , Ko Dongmi , Kim Seongjae , Seo Juyeon , Nam Kee Dal , Jung Eunsun , Farrand Lee , Kim Yoon-Jae , Kim Ji Young , Seo Jae Hong
Published: September 2022

Background

The emergence of de novo or intrinsic trastuzumab resistance is exceedingly high in breast cancer that is HER2 positive and correlates with an abundant cancer stem cell (CSC)-like population. We sought to examine the capacity of β-escin, an anti-inflammatory drug, to address trastuzumab resistance in HER2-positive breast cancer cells.

Methods

The effect of β-escin on trastuzumab-resistant and -sensitive cell lines in vitro was evaluated for apoptosis, expression of HER2 family members, and impact on CSC-like properties. An in vivo model of trastuzumab-resistant JIMT-1 was used to examine the efficacy and toxicity of β-escin.

Results

β-escin induced mitochondrial-mediated apoptosis accompanied by reactive oxygen species (ROS) production and increased active p18Bax fragmentation, leading to caspase-3/-7 activation. Attenuation of CSC-related features by β-escin challenge was accompanied by marked reductions in CD44high/CD24low stem-like cells and aldehyde dehydrogenase 1 (ALDH1) activity as well as hindrance of mammosphere formation. β-escin administration also significantly retarded tumor growth and angiogenesis in a trastuzumab-resistant JIMT-1 xenograft model via downregulation of CSC-associated markers and intracellular domain HER2. Importantly, β-escin selectively inhibited malignant cells and was less toxic to normal mammary cells, and no toxic effects were found in liver and kidney function in animals.

Conclusions

Taken together, our findings highlight β-escin as a promising candidate for the treatment of trastuzumab-resistant HER2-positive breast cancers.
Effects and mechanism of Aβ1−42 on EV-A71 replication
Authors: Zhong Ming , Wang Huiqiang , Yan Haiyan , Wu Shuo , Wang Kun , Yang Lu , Cui Boming , Wu Mengyuan , Li Yuhuan
Published: September 2022

Background

β-Amyloid (Aβ) protein is a pivotal pathogenetic factor in Alzheimer’s disease (AD). However, increasing evidence suggests that the brain has to continuously produce excessive Aβ to efficaciously prevent pathogenic micro-organism infections, which induces and accelerates the disease process of AD. Meanwhile, Aβ exhibits activity against herpes simplex virus type 1 (HSV-1) and influenza A virus (IAV) replication, but not against other neurotropic viruses. Enterovirus A71 (EV-A71) is the most important neurotropic enterovirus in the post-polio era. Given the limitation of existing research on the relationship between Aβ and other virus infections, this study aimed to investigate the potent activity of Aβ on EV-A71 infection and extended the potential function of Aβ in other unenveloped viruses may be linked to Alzheimer's disease or infectious neurological diseases.

Methods

Aβ peptides 1–42 are a major pathological factor of senile plaques in Alzheimer’s disease (AD). Thus, we utilized Aβ1–42 as a test subject to perform our study. The production of monomer Aβ1–42 and their high-molecular oligomer accumulations in neural cells were detected by immunofluorescence assay, ELISA, or Western blot assay. The inhibitory activity of Aβ1–42 peptides against EV-A71 in vitro was detected by Western blot analysis or qRT-PCR. The mechanism of Aβ1–42 against EV-A71 replication was analyzed by time-of-addition assay, attachment inhibition assay, pre-attachment inhibition analysis, viral-penetration inhibition assay, TEM analysis of virus agglutination, and pull-down assay.

Results

We found that EV-A71 infection induced Aβ production and accumulation in SH-SY5Y cells. We also revealed for the first time that Aβ1–42 efficiently inhibited the RNA level of EV-A71 VP1, and the protein levels of VP1, VP2, and nonstructural protein 3AB in SH-SY5Y, Vero, and human rhabdomyosarcoma (RD) cells. Mechanistically, we demonstrated that Aβ1–42 primarily targeted the early stage of EV-A71 entry to inhibit virus replication by binding virus capsid protein VP1 or scavenger receptor class B member 2. Moreover, Aβ1–42 formed non-enveloped EV-A71 particle aggregates within a certain period and bound to the capsid protein VP1, which partially caused Aβ1–42 to prevent viruses from infecting cells.

Conclusions

Our findings unveiled that Aβ1–42 effectively inhibited nonenveloped EV-A71 by targeting the early phase of an EV-A71 life cycle, thereby extending the potential function of Aβ in other non-envelope viruses linked to infectious neurological diseases.