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To examine trends and racial and ethnic disparities in early adolescent suicidal thoughts and behaviors in the years immediately prior to the COVID-19 pandemic. This study used pooled data from Centers for Disease Control and Prevention's middle school Youth Risk Behavior Survey (n = 127,912) between 2015 and 2019. Three dichotomized measures of suicide-related behaviors were assessed: suicidal thoughts, planning, and attempts. Weighted prevalence estimates with 95% confidence intervals were calculated for each survey year. Linear trends examined disparities in the prevalence of suicidal thoughts and behaviors, overall and by student demographic characteristics. Main effects odds ratios compared estimates among racial and ethnic minority adolescents with non-Hispanic White students, controlling for sex and grade. Significant linear increases were observed for the percentage of middle school students who reported seriously thinking about suicide (18.2%–22.3%), ever making a suicide plan (11.8%–14.7%), and ever attempting suicide (6.9%–9.3%). Racial and ethnic minority students, other than non-Hispanic Asian, showed higher odds of suicidal thoughts and behaviors compared with non-Hispanic White students. Findings indicate a need for comprehensive suicide prevention to address health equity and disparities in suicide-related behaviors among middle school-aged adolescents. [ABSTRACT FROM AUTHOR]

Fully guided microwave tooth bud ablation has the potential to become a minimally invasive means for managing third molars in adolescent patients. If developed, this new modality could provide improved outcomes and reduced complications compared to traditional third molar management strategies. The purpose of this 28-day longitudinal characterization study was to determine if the healing response following fully guided microwave ablation of second molar tooth buds in juvenile pigs would result in the complete removal of targeted tooth bud tissues, molar agenesis, and no significant collateral tissue damage. Investigators performed fully guided microwave ablation on 24 mandibular second molar tooth buds (#18 and #31) in seven-week-old pigs. Postablation healing assessment consisted of radiographic and histological evaluation of 3 subcohorts (consisting of 4 animals each) at 7-, 14- and 28-days post ablation. Controls were untreated, opposing maxillary second molar tooth buds. Neurological assessment was performed to determine if there was any detectible loss of inferior alveolar nerve function. Healing processes were nearly complete at 28 days post ablation. While one tooth bud was identified as partially ablated at 14 days post treatment, all treated tooth bud tissues were replaced with trabecular new bone formation by the end of this study. There was no detectible loss of inferior alveolar nerve function. The thermal dosing strategy used in this study appears to deliver prescribed ablation volumes and—within the context of this animal model—there was no detected collateral tissue damage. The results of this study confirm the hypothesis that healing processes following fully guided tooth bud ablation resulted in removal of targeted tooth bud tissues, complete molar agenesis, and trabecular new bone growth at 28-days post treatment. [ABSTRACT FROM AUTHOR]

Honors practitioners from fourteen colleges and programs across the country at land-grant, public, and minority-serving institutions partner with agricultural experts to secure a United States Department of Agriculture (USDA) Higher Education Challenge grant focused on the themes of food justice, climate justice, and sustainable agriculture. Authors describe the program's origin, objectives, and curricular outgrowths, highlighting its efficacy for empowering students in areas of systems thinking, career readiness, leadership in the service of addressing social needs, and learning through civic engagement. [ABSTRACT FROM AUTHOR]

Over 120,000 U.S. children are hospitalized annually for traumatic injury, with approximately 20% developing acute stress disorder (ASD), posttraumatic stress disorder (PTSD), or depression. The ACS COT recommends that trauma centers address emotional recovery after injury; however, few pediatric trauma centers (PTCs) assess behavioral health symptoms. This study describes results from a survey with PTC providers assessing the landscape of behavioral health screening, education, and treatment. Trauma program leaders from 83 US Level I and II trauma centers across 36 states completed a survey assessing center characteristics and decision-making, availability, and perceptions of behavioral health resources. Nearly half (46%) of centers provide behavioral health screens for pediatric patients, and 18% screen family members, with screens mostly conducted by nurses or social workers for ASD or PTSD. Two-thirds provide child behavioral health education and 47% provide education to caregivers/family. Two-thirds provide treatment connections, typically via referrals or outpatient clinics. Behavioral health screening, education, and treatment connections were rated as very important (M > 8.5/10), with higher ratings for the importance of screening children versus caregivers. Child maltreatment (59%), observed patient distress (53%), child substance use (52%), injury mechanism (42%) and severity (42%) were prioritized in screening decision-making. Service provision varies by method, resource, and provider, highlighting the lack of a roadmap for centers to provide behavioral health services. Adoption of universal education and screening procedures in PTCs is crucial to increase access to services for injured children and caregivers. PTCs are well-positioned to offer these services. Level II [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to selectively ablate the entire volume of targeted third molar (3M) tooth buds in a pig model. This study demonstrates the potential for a less-invasive alternative to contemporary surgical techniques for removal of 3Ms.Methods: The investigator developed a mandibular split-mouth animal model study design. The model used pigs because the animals' 3M tooth buds are dimensionally similar to those of humans. The study sample consisted of 5 female Yorkshire-cross pigs at 20 weeks of age. The investigator delivered microwave energy thermal doses to thermocoagulate tooth bud tissues inside the bony crypts of targeted 3M tooth buds. Based on the bony crypt dimensions obtained from computed tomography scans of each subject, the microwave thermal dose was predetermined. The mandibles were dissected to visually compare thermocoagulated right-side 3M tooth bud tissues to left-side untreated controls.Results: All 5 study animals were successfully treated. All 5 fully guided third molar tooth bud ablation (3TBA) procedures resulted in thermocoagulation of the entire volume of targeted 3M tooth bud tissues, with no visual evidence of damage to structures beyond the bony crypt.Conclusions: The animal model developed for this study enabled the demonstration of a fully guided 3TBA protocol. The animal model and 3TBA procedure employed in this study appear to be appropriate for use in future long-term animal studies designed to demonstrate the efficacy of 3TBA for inducing molar agenesis. [ABSTRACT FROM AUTHOR]

Adolescents' health behaviors and experiences contribute to many outcomes, including risks for HIV, other sexually transmitted diseases, and unintended pregnancy. Public health interventions and approaches addressing risk behaviors or experiences in adolescence have the potential for wide-reaching impacts on sexual health and other related outcomes across the lifespan, and schools are a critical venue for such interventions. This paper describes a school-based program model developed by the Centers for Disease Control and Prevention's Division of Adolescent and School Health for preventing HIV/sexually transmitted diseases, unintended pregnancy, and related health risk behaviors and experiences among middle and high school students. This includes a summary of the theoretical and evidence base that inform the model, and a description of the model's activities, organized into three key strategies (sexual health education, sexual health services, and safe and supportive environments) and across three cross-cutting domains (strengthening staff capacity, increasing student access to programs and services, and engaging parent and community partners). The paper also outlines implications for adolescent health professionals and organizations working across schools, clinics, and communities, to address and promote adolescent sexual health and well-being. [ABSTRACT FROM AUTHOR]

Surveys suggest that the general public (i.e., adults or parents) supports sexual health education in schools. However, the number of schools providing sex education continues to decline in the United States. The purpose of this study is to conduct a meta-analysis of U.S.-based representative surveys to provide a pooled estimate of public support for sexual health education delivered in schools. A systematic search of three databases (Medline, PsycInfo, and ERIC) was conducted to identify survey measuring adult and parent attitudes toward sexual health education in school between 2000 and 2016. Meta-analyses were conducted in OpenMetaAnalyst via the metaphor package in R using a DerSimonian-Laird random effect models to account for heterogeneity between surveys. A total of 23 citations met study inclusion and exclusion criteria, representing 15 unique probability surveys conducted with the public. Among the included surveys, 14 were nationwide and 11 included parents or an overrepresentation of parents. Across all survey findings, 88.7% (95% confidence interval = 86.2–91.2) of respondents supported sexual health education. Among surveys that only included parents or oversampled for parents, 90.0% (95% confidence interval = 86.5–93.4) supported sexual health education, and among nationally representative surveys, 87.7% (95% confidence interval = 85.1–90.6) of respondents supported sexual health education. These findings demonstrate overwhelming support for sexual health education delivered in schools. Additional research is needed to determine individual differences in support for specific sexual health education topics and skills delivered through classroom-based instruction. [ABSTRACT FROM AUTHOR]

School-based sexual health education (SHE) can teach students critical knowledge and skills. For effective SHE, school districts can offer support, including strong curricula and professional development. This study assessed changes in students' sexual health knowledge and sexual behaviors following implementation of enhanced support for SHE delivery in one school district. Sexual health knowledge was assessed at the beginning and end of middle and high school health education classes in a large, urban district (n = 7,555 students). Sexual behaviors were assessed using Youth Risk Behavior Survey data from the district (2015 and 2017) and state (2017). Analyses explored differences in behavior from 2015 (n = 2,596) to 2017 (n = 3,371) among intervention district students and compared intervention district students (n = 3,371) to other students in the same state (n = 1,978). Hierarchical linear model regression analyses revealed significant knowledge gains among students. Logistic regression results revealed that among students in the intervention district, 6 of 16 examined behaviors moved in the intended direction from 2015 to 2017; 1 moved in the unintended direction. Logistic regression results of 2017 data revealed that in comparison of intervention district students to other students in the state, intervention district students had significantly higher odds of reporting condom use at last sex (adjusted odds ratio [AOR] = 1.36, 95% confidence interval [CI] = 1.07–1.72) and significantly lower odds of reporting having had sex with 4+ persons (AOR =.72, 95% CI =.55–.94) or alcohol or drug use before last sex (AOR =.63, 95% CI =.42–.94). Findings suggest potential effects of the district's SHE in increasing knowledge and improving behaviors and experiences among youth. [ABSTRACT FROM AUTHOR]

Pairs of magnets were applied to the loose skin on the backs of mice in order to cause ischemia for periods of 1.5, 2, 2.5 and 3 h followed by reperfusion. We found 1.5 h of ischemia resulted in the most reliable outcome of blanched skin but no redness or skin breakdown. Histological analysis at 4 h of reperfusion showed, in the centre of the insult, condensed nuclei in the epidermis and sebaceous glands with a build up of neutrophils in the blood vessels, and a reduction in the number of fibroblasts. At 24 h, spongiosis was seen in the epidermis and pockets of neutrophils began to accumulate under it, as well as being scatted through the dermis. In the centre of the insult there was a loss of sebaceous gland nuclei and fibroblasts. Four days after the insult, spongiosis was reduced in the epidermis at the edge of the insult but enhanced in the centre and in hair follicles. Leukocytes were seen throughout the central dermis. At 8 days, spongiosis and epidermal thickness had reduced and fibroblasts were reappearing. However, blood vessels still had leukocytes lining the lumen. The gap junction protein connexin 43 was significantly elevated in the epidermis at 4 h and 24 h reperfusion. Ischemia of 1.5 h generates a sterile inflammatory reaction causing the loss of some cell types but leaving the epidermis intact reminiscent of a stage I pressure ulcer. [Display omitted] • Ischemia reperfusion injury in skin leads to sterile inflammation. • Blood vessels become leaky and there is a build up of neutrophils in the dermis. • Spongiosis is seen in the epidermis. • Fibroblasts are lost from the centre of the insult. • Inflammation resolves and fibroblasts return. [ABSTRACT FROM AUTHOR]

To synthesize the diverse body of literature on sexual and gender minority youth (SGMY) and sexual health education. We conducted a systematic search of the literature on SGMY and sexual health education, including SGMY perspectives on sexual health education, the acceptability or effectiveness of programs designed for SGMY, and SGMY-specific results of sexual health education programs delivered to general youth populations. A total of 32 articles were included. Sixteen qualitative studies with SGMY highlight key perspectives underscoring how youth gained inadequate knowledge from sexual health education experiences and received content that excluded their identities and behaviors. Thirteen studies examined the acceptability or effectiveness of sexual health interventions designed for SGMY from which key characteristics of inclusive sexual health education relating to development, content, and delivery emerged. One study found a sexual health education program delivered to a general population of youth was also acceptable for a subsample of sexual minority girls. Future research on SGMY experiences should incorporate populations understudied, including younger adolescents, sexual minority girls, and transgender persons. Further, the effectiveness of inclusive sexual health education in general population settings requires further study. [ABSTRACT FROM AUTHOR]

Transcranial direct current stimulation (tDCS) is a method of noninvasive neuromodulation and potential therapeutic tool to improve functioning and relieve symptoms across a range of central and peripheral nervous system conditions. Evidence suggests that the effects of tDCS are cumulative with consecutive daily applications needed to achieve clinically meaningful effects. Therefore, there is growing interest in delivering tDCS away from the clinic or research facility, usually at home. To provide a comprehensive guide to operationalize safe and responsible use of tDCS in home settings for both investigative and clinical use. Providing treatment at home can improve access and compliance by decreasing the burden of time and travel for patients and their caregivers, as well as to reach those in remote locations and/or living with more advanced disabilities. To date, methodological approaches for at-home tDCS delivery have varied. After implementing the first basic guidelines for at-home tDCS in clinical trials, this work describes a comprehensive guide for facilitating safe and responsible use of tDCS in home settings enabling access for repeated administration over time. These guidelines provide a reference and standard for practice when employing the use of tDCS outside of the clinic setting. • Guidelines for research and clinical use of tDCS at-home are described by experts. • Minimum device specifications for at-home use are outlined. • Specific considerations for best practices of tDCS are presented in detail. [ABSTRACT FROM AUTHOR]

• Response to restorative cognitive rehabilitation varies in people with MS. • Some patient factors predict increased treatment response. • Predictors of greater treatment response include relapsing-remitting disease course. • They also include higher trait Conscientiousness-Orderliness and gray matter volume. Growing evidence supports the efficacy of restorative cognitive training in people with multiple sclerosis (PwMS), but the effects vary across individuals. Differences in treatment efficacy may be related to baseline individual differences. We investigated clinical characteristics and MRI variables to predict response to a previously validated approach to home-based restorative cognitive training. In a single-arm repeated measures study, 51 PwMS completed a 12-week at-home restorative cognitive training program called BrainHQ, shown to be effective in a placebo-controlled clinical trial. Baseline demographic, clinical, neuropsychological, and brain MRI factors were captured and the effects of treatment were quantified with Symbol Digit Modalities Test (SDMT). Also measured were indices of treatment compliance. Regression modeling was employed to identify the factors associated with greatest SDMT improvement. As a group, patients improved significantly after training: mean SDMT improving from 49.6 ± 14.7 to 52.6 ± 15.6 (t = 3.91, p <0.001). Greater SDMT improvement correlated positively with treatment exposure (r = 0.38, p = 0.007). Increased post-rehabilitation improvement on SDMT was predicted by baseline relapsing-remitting course (β=-0.34, p = 0.017), higher trait Conscientiousness-Orderliness (β=0.29, p = 0.040), and higher baseline gray matter volume (GMV; β=0.31, p = 0.030). The study was designed to explore the variables that predict favorable outcome in a home-based application of a validated restorative cognitive training program. We find good outcomes are most likely in patients with higher trait Conscientiousness-Orderliness, and relapsing-remitting course. The same was found for individuals with higher GMV. Future work in larger cohorts is needed to support these findings and to investigate the unique needs of individuals according to baseline factors. [ABSTRACT FROM AUTHOR]

University students increasingly desire that traditionally taught courses be made available online. While quality standards have been developed for the format and organization of online courses, professors often are left wondering what activities contribute to learning engagement for online students. To investigate this question, an online survey of all students taking an online course during a spring semester was conducted in one state university. A total of 417 students completed the survey, which included three standardized scale variables for learning engagement and two open-ended questions. Course activities that had statistical significance in relationship to students' reported learning engagement include those that changed their understanding of a topic or concept, connected their learning to societal problems, linked their learning to prior experiences and knowledge, and were interpreted as fun. A regression model using these variables, along with control variables of student age, gender, and out-of-school work, resulted in an R2 of 0.484, suggesting that almost half of the variance in learning engagement can be explained via this model. Analysis of responses to the open-ended questions revealed that students found certain aspects of online discussions and interactive assignments engaging, especially those that prompted students with thought-provoking questions that relate to real-world situations and invited students to share diverse opinions and develop personal perspectives. [ABSTRACT FROM AUTHOR]

Objective Cognitive impairment is a common symptom of multiple sclerosis (MS) that can lead to declines in daily functioning. Timed instrumental activities of daily living (TIADLs) have been useful to bridge between cognitive testing and real-world functioning in disorders such as Alzheimer's disease and other dementias. However, these have not been standardized for general use, and the tasks that are typically employed have not been sensitive to the detection of milder forms of cognitive deficits. We developed a test of ten TIADLs tasks to measure a broader range of functioning, entitled the “Test of Everyday Cognitive Ability” or TECA, and tested its utility in a diverse sample of participants with MS. Method TECA performance was characterized in n  = 177 participants with MS and compared to healthy controls ( n  = 49). A subset from each group received repeated administration. In addition, all participants completed a standard battery of neuropsychological measures. Results TECA performances were significantly different between MS and control participants. Further, MS participants with cognitive impairment performed significantly slower relative to those MS participants without impairment. Conclusions The TECA is a TIADLs assessment appropriate for use in those with MS as it includes a broad range of task difficulties, requires minimum motor involvement, and is sensitive to MS-related cognitive impairment. The TECA is a brief and repeatable test of TIADLs and its ease of administration makes it suitable for both clinical practice and research settings. [ABSTRACT FROM AUTHOR]

Background Neuropsychiatric disorders are a leading source of disability and require novel treatments that target mechanisms of disease. As such disorders are thought to result from aberrant neuronal circuit activity, neuromodulation approaches are of increasing interest given their potential for manipulating circuits directly. Low intensity transcranial electrical stimulation (tES) with direct currents (transcranial direct current stimulation, tDCS) or alternating currents (transcranial alternating current stimulation, tACS) represent novel, safe, well-tolerated, and relatively inexpensive putative treatment modalities. Objective This report seeks to promote the science, technology and effective clinical applications of these modalities, identify research challenges, and suggest approaches for addressing these needs in order to achieve rigorous, reproducible findings that can advance clinical treatment. Methods The National Institute of Mental Health (NIMH) convened a workshop in September 2016 that brought together experts in basic and human neuroscience, electrical stimulation biophysics and devices, and clinical trial methods to examine the physiological mechanisms underlying tDCS/tACS, technologies and technical strategies for optimizing stimulation protocols, and the state of the science with respect to therapeutic applications and trial designs. Results Advances in understanding mechanisms, methodological and technological improvements (e.g., electronics, computational models to facilitate proper dosing), and improved clinical trial designs are poised to advance rigorous, reproducible therapeutic applications of these techniques. A number of challenges were identified and meeting participants made recommendations made to address them. Conclusions These recommendations align with requirements in NIMH funding opportunity announcements to, among other needs, define dosimetry, demonstrate dose/response relationships, implement rigorous blinded trial designs, employ computational modeling, and demonstrate target engagement when testing stimulation-based interventions for the treatment of mental disorders. [ABSTRACT FROM AUTHOR]

Integrative medicine is a quickly expanding field of health care that emphasizes nutrition as a key component. Dietitians and nutritionists have an opportunity to meet workforce demands by practicing dietetics and integrative medicine (DIM). The purpose of this article is to describe a DIM education program and practicum. We report the results of an interprofessional nutrition education and practicum program between the University of Kansas Medical Center (KUMC) Department of Dietetics and Nutrition and KU Integrative Medicine. This partnered program provides training that builds on the strong foundation of the Nutrition Care Process and adds graduate-level educational and practicum experiences in foundational integrative medicine knowledge, including nutritional approaches from a systems biology perspective, nutrigenomics, and biochemistry as the core knowledge to understand the root cause of a chronic disorder and to choose appropriate nutritional tools for interventions. This interprofessional KUMC program provides a dietetic internship, master's degree, and graduate certificate in DIM and fulfills a need for dietitians and nutritionists who seek careers practicing in an integrative medicine setting. The program fulfills expanding workforce needs to provide quality health care for patients with chronic illnesses. [ABSTRACT FROM AUTHOR]

The article offers information on a study conducted by researchers related to meniscal injury in cats with cranial cruciate ligament (CCL) ruptures. It states that medical records of cats with CCL ruptures which were treated with lateral fabellotibial suture (LFS) technique were studied. It highlights that physical examination showed lameness on the affected limbs and incidence of injuries in them was found to be 67 percent.

Summary: Background & aims: Metabolic effects of dietary fat quality in people with type 2 diabetes are not well-understood. The study objective was to evaluate effects of conjugated linoleic acid (CLA) and safflower (SAF) oils on glycemia, blood lipids, and inflammation. The hypothesis we tested is that dietary oils improve glycemia, lipids, and inflammatory markers in a time-dependent way that follows accumulation of linoleic acid and CLA isomers in serum of subjects supplemented with dietary oils. Methods: Fifty-five post-menopausal, obese women with type 2 diabetes enrolled, and 35 completed this randomized, double-masked crossover study. Treatments were 8 g daily of CLA and SAF for 16 weeks each. We used a multiple testing procedure with pre-determined steps analysis to determine the earliest time that a significant effect was detected. Results: CLA did not alter measured metabolic parameters. SAF decreased HbA1c (−0.64 ± 0.18%, p = 0.0007) and C-reactive protein (−13.6 ± 8.2 mg/L, p = 0.0472), increased QUICKI (0.0077 ± 0.0035, p = 0.0146) with a minimum time to effect observed 16 weeks after treatment. SAF increased HDL cholesterol (0.12 ± 0.05 mmol/L, p = 0.0228) with the minimum time to detect an effect of SAF at 12 weeks. The minimum time to detect an increase of c9t11-CLA, t10c12-CLA, and linoleic acid in serum of women supplemented CLA or SAF, respectively, was four weeks. Conclusions: We conclude that 8 g of SAF daily improved glycemia, inflammation, and blood lipids, indicating that small changes in dietary fat quality may augment diabetes treatments to improve risk factors for diabetes-related complications. [Copyright &y& Elsevier]

• The MS-specific FSIQ-RMS can advance the understanding and management of fatigue. • Fatigue influenced daily functioning for most with relapsing multiple sclerosis. • Fatigue increased with symptom exacerbation, depression, sleep disorders and pain. Fatigue is among the most frequent and disabling symptoms in patients with relapsing multiple sclerosis (RMS). To measure MS fatigue and its impact on daily life in a real-world US population using an MS-specific patient-reported outcome (PRO) instrument, the Fatigue Symptoms and Impacts Questionnaire-RMS (FSIQ-RMS). This ongoing prospective study recruited RMS patients from an online patient community (Carenity) across US. Baseline assessment data are reported. Participants completed questionnaires, including the 20-item FSIQ-RMS questionnaire, with the first seven symptom-related items collected daily for seven days, and the other 13 items on the seventh day assessing impacts of fatigue. The FSIQ-RMS scores range from 0 to 100 (higher score=greater severity). The impact of fatigue on several aspects of patients' lives was rated from 0 (no impact) to 10 (very high impact). Data on disease history, disease status, sleep, social and emotional functioning were also captured. Baseline assessment data of 300 RMS patients are reported while follow-up assessments up to 18 months are planned. 300 RMS participants completed the 7-day assessment (mean age 43.0 years, 88% women). Fatigue was rated as severe, with a mean score of 57.3 for the FSIQ-RMS symptom domain; 3 impact sub-domain scores were 42.3, 43.4 and 50.1 (physical, cognitive/emotional, and coping). Participants who were not in relapse (78%) reported less severe fatigue than those in relapse (22%): mean±SD symptom score of 54.6 ± 17.8 vs. 67.0 ± 19.7, p < 0.001. Fatigue had a higher intensity among those with depression than without (49% vs. 51%, with mean ± SD symptom score of 62.8 ± 16.9 vs. 52.1 ± 19.3, p < 0.001), and among those with sleep disorder than without (27% vs. 73%, 61.2 ± 19.2 vs. 55.9 ± 18.6; p < 0.05). The most common factor associated with increased fatigue was heat exposure (82%). Most participants (52%) reported experiencing fatigue before their MS diagnosis. Fatigue influences daily functioning for most patients with RMS. The FSIQ-RMS is a novel and MS-specific PRO measure that can advance the understanding and management of fatigue. [ABSTRACT FROM AUTHOR]