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Autistic youth participate in less mainstream physical activity than their neurotypical peers. A scoping review was conducted to explore motivational factors influencing participation in structured physical activity for autistic youth. Relevant databases were searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses with the inclusion of stakeholder consultation, to synthesise existing literature describing the participation and motivations of autistic youth in structured physical activities. Eighteen publications met the eligibility criteria. Qualitative data were extracted and analysed using directed content analysis and then mapped to the motivational constructs of the self-determination theory. Autism-specific themes falling outside of the self-determination theory were coded inductively. Competence was the most reported psychological need (k = 14), with intrinsic motivation being the most common motivational regulator (k = 12). Inductive analysis revealed one additional theme, which was the impact of the sensory environment on autistic youths' motivation to participate. Findings indicate that meeting the psychological needs of autistic youth support self-determined motivation to participate in structured physical activities, although fulfilling these needs may differ from their neurotypical peers. Additional autism-specific factors may also influence motivation to participate in structured physical activities. Future research should examine motivational factors that support engagement in structured physical activities through the lens of autistic youth and their experiences.

While extensive quantitative research has shed light on the cognitive mechanisms of dyslexia, few mixed-methods studies have been conducted to examine the perceptions of and attitudes towards learning in children with dyslexia, especially in Hong Kong, a bilingual context. In addition, the validity of the metaphor elicitation technique, which was adopted in previous interview studies, has not yet been examined in children. Therefore, 30 children with dyslexia (age range: 8-13; 10 females) in Hong Kong were interviewed for metaphors regarding six domains: Chinese reading, Chinese writing, having Chinese lessons, English reading, solving maths problems, and dyslexia. Word reading fluency and parent-rated learning interest and confidence were measured to validate the use of the metaphor elicitation method in assessing children's reading attitudes in both Chinese and English using correlation analyses. Perceptions were examined by way of qualitative analyses based on the metaphor entailments. Results showed that children who expressed more positive attitudes towards English reading performed better in English reading. Moreover, the attitudes also positively correlated with the corresponding parents' ratings. These findings suggested that the metaphor elicitation technique is a valid method for assessing attitudes towards English reading in children with dyslexia. Furthermore, their perceptions of dyslexia and learning generally corresponded to those from previous interview studies despite differences in languages and contexts. Importantly, descriptions related to multiple themes, including metalinguistic awareness, cognitive skills, coping strategies, and dyslexia, were well-aligned with scientific findings, demonstrating that children already have a good understanding of dyslexia and various learning domains.

Social-emotional deficits in school-aged children diagnosed with autism spectrum disorder (ASD) greatly hinder these children from fully participating in various school activities in the inclusive education setting. Previous studies have demonstrated evidence regarding the effectiveness of using virtual reality (VR) for enhancing the children's affective expression and social reciprocity. However, considering the technical and logistical complexity of the enabling hardware and software systems, how such approaches can be effectively and sustainably delivered in the school setting remains underexplored. This paper presents a study that utilised VR headsets to enhance affective expression and social reciprocity for children with ASD and explored how the approach could be effectively and sustainably delivered at schools. A total of eight VR learning scenarios were designed based on Kolb's experiential learning framework. 176 children aged 6-12 with a clinical diagnosis of ASD participated in the study. The statistical analyses showed that the participants who received the intervention significantly improved in affective expression and social reciprocity, compared to those who were in the control group. Moreover, the approaches to enhance long-term sustainability have also been presented and discussed in this paper.

The application of artificial intelligence (AI) in academic writing has raised concerns regarding accuracy, ethics, and scientific rigour. Some AI content detectors may not accurately identify AI-generated texts, especially those that have undergone paraphrasing. Therefore, there is a pressing need for efficacious approaches or guidelines to govern AI usage in specific disciplines. Our study aims to compare the accuracy of mainstream AI content detectors and human reviewers in detecting AI-generated rehabilitation-related articles with or without paraphrasing. This cross-sectional study purposively chose 50 rehabilitation-related articles from four peer-reviewed journals, and then fabricated another 50 articles using ChatGPT. Specifically, ChatGPT was used to generate the introduction, discussion, and conclusion sections based on the original titles, methods, and results. Wordtune was then used to rephrase the ChatGPT-generated articles. Six common AI content detectors (Originality.ai, Turnitin, ZeroGPT, GPTZero, Content at Scale, and GPT-2 Output Detector) were employed to identify AI content for the original, ChatGPT-generated and AI-rephrased articles. Four human reviewers (two student reviewers and two professorial reviewers) were recruited to differentiate between the original articles and AI-rephrased articles, which were expected to be more difficult to detect. They were instructed to give reasons for their judgements.Originality.ai correctly detected 100% of ChatGPT-generated and AI-rephrased texts. ZeroGPT accurately detected 96% of ChatGPT-generated and 88% of AI-rephrased articles. The areas under the receiver operating characteristic curve (AUROC) of ZeroGPT were 0.98 for identifying human-written and AI articles. Turnitin showed a 0% misclassification rate for human-written articles, although it only identified 30% of AI-rephrased articles. Professorial reviewers accurately discriminated at least 96% of AI-rephrased articles, but they misclassified 12% of human-written articles as AI-generated. On average, students only identified 76% of AI-rephrased articles. Reviewers identified AI-rephrased articles based on 'incoherent content' (34.36%), followed by 'grammatical errors' (20.26%), and 'insufficient evidence' (16.15%).This study directly compared the accuracy of advanced AI detectors and human reviewers in detecting AI-generated medical writing after paraphrasing. Our findings demonstrate that specific detectors and experienced reviewers can accurately identify articles generated by Large Language Models, even after paraphrasing. The rationale employed by our reviewers in their assessments can inform future evaluation strategies for monitoring AI usage in medical education or publications. AI content detectors may be incorporated as an additional screening tool in the peer-review process of academic journals.

Physical therapy education has significantly evolved over the past few decades. While gross anatomy is integral to physical therapy education curricula, the current state of anatomy education within these programs is not well understood. The primary purpose of this report was to provide an update on the current state of anatomy education across United States (US) Doctor of Physical Therapy (DPT) programs. A survey was disseminated to all 261 accredited US physical therapy programs. The survey was deployed in November 2020 with a deadline to respond by January 15, 2021. The response rate was 32.6% (85/261). When teaching anatomy, 90.5% of the responding programs used dissection, 71.4% used didactic lectures, 60.7% used computer-assisted technology, 58% used prosections, 23.8% used plastinated models, and 31% reported using other methods. DPT programs have experienced declines in PhD faculty (15.7%) and Master of Physical Therapy faculty (15.3%) and notable increases in DPT (16.5%) and physician faculty (8.2%) teaching anatomy within DPT programs. Despite greater use of computer-assisted technologies, these technologies have not replaced donor-based dissection in DPT programs.

Purpose: We examined the effect of character complexity on early Chinese literacy (word reading and writing). We also investigated whether cognitive skills (phonological awareness, morphological awareness, and rapid automatized naming [RAN]) could moderate the influence of character complexity on literacy outcomes. Method: Our pre-registered study included a sample of 342 Cantonese - speaking Hong Kong Chinese children (162 males, 180 females, mean age = 7.32, SD = 0.87) from Grade 1 to Grade 3. We used a generalized additive mixed model (GAMM) to estimate the main effect of complexity on word recognition and dictation as well as interaction effects with each of the three cognitive skills. Age and nonverbal IQ were also included as controls. Results: Character complexity had a slightly curvilinear but consistently negative association with word reading, with odds ratios ranging from 0.62 to 0.71 per 10% increase in complexity. RAN and morphological awareness buffered the negative influence of character complexity. For writing to dictation, character complexity was more curvilinear, but character complexity and the interactions between cognitive skills and character complexity were not significant. Conclusion: Complex visual input can be a barrier to early reading development in Chinese, and fostering morphological awareness may help mitigate this effect.

BackgroundChildren with autism spectrum disorder (ASD) are known to experience difficulties in coordinating fine- and gross-motor movement. Previous interventional studies have reported significant effect of exercise-based intervention programs on improving motor skills and alleviating symptoms in ASD; however, researchers are yet to know why some participants experienced less improvement than others. One plausible explanation for suboptimal treatment outcomes is insufficient engagement in the exercise programs due to the children's difficulties in following instructions and performing the correct movements. In the proposed research, we will test the above speculation by manipulating the amount of music-therapy elements into a 10-week Taekwondo training program designed specifically for children with autism.MethodsThis is a randomized controlled trial. Seventy-two children aged 7 to 9 years who meet the diagnostic criteria of ASD will be recruited and randomized into either the "Taekwondo training with elements of music therapy" group or the "Taekwondo training alone" group. In both groups, the participating children will attend Taekwondo training sessions twice a week over 10 consecutive weeks. In the "Taekwondo training with elements of music therapy" group, elements of music therapy will be incorporated into the Taekwondo training. Assessment will be conducted before the program commences, immediately after the completion of the 10-week program, and 2 months after the post-test. The outcome domains to be evaluated include the immediate effects during the exercise sessions. These effects include the level of engagement in the exercise sessions (primary outcome), enjoyment, physical activity level, and rate of perceived exertion. Furthermore, the evaluation will also cover the overall effects of the training program on gross motor skills, Taekwondo skills performance, executive function, psychosocial functioning, and behavioral problems.Discussion/findingsThe findings of this study will inform strategies for the promotion of physical activity and engagement among children with ASD when participating in exercise training classes. The study will also suggest the importance of regular physical activity for the physical and mental well-being of children with ASD.Trial registrationClinical trial registration: URL: http://www.clinicaltrials.gov. ClinicalTrials.gov Identifier: NCT06277778. Registered on 15 February 2024.

The world population is aging. Comprehensive Geriatric assessment (CGA) has been proven to improve the well-being of older adults. However, evidence suggests not all clinicians implement these recommendations in their practice; nor do all patients adhere to them. Currently, there is no up-to-date review of interventions that can improve older adults' adherence to CGA recommendations and health care provider/clinician implementation of those recommendations. The objective of this scoping review protocol is to describe the methodology of the scoping review with the aim to identify interventions that have been tested to improve adherence to CGA recommendations. We will use the Arksey and O'Malley framework and subsequent extension by Levac and colleagues to complete the scoping review. We searched OVID MEDLINE, OVID Embase, EBSCO CINAHL, APA PsychInfo, and Cochrane CENTRAL databases from inception to November 14, 2024, and will include a review of reference lists of included studies. Studies eligible for inclusion are studies of any design that examined one or more interventions aiming to improve clinician implementation of and patient adherence to CGA in any clinical setting. We will use standard methods for study selection, data abstraction, assessment of methodological quality of individual studies, and data synthesis. Results will be analyzed and reported using descriptive numerical summaries and narrative analysis. Findings from the scoping review will be published in a manuscript and presented at scientific conferences.

Background:. Obesity is widely recognized as a significant risk factor for postoperative complications of breast reconstruction. Despite extensive research, there remains a lack of consensus regarding the specific complications and outcomes experienced by patients with obesity who undergo deep inferior epigastric perforator (DIEP) flap reconstruction. To provide a clearer understanding of the challenges faced by patients with obesity, we present a single-center outcome analysis of individuals who underwent DIEP flap reconstruction. Methods:. A cohort of 194 patients who underwent at least 1 DIEP flap was retrospectively analyzed at the University of Nebraska Medical Center utilizing electronic medical records. Patients who underwent DIEP flap breast reconstruction were organized into 5 categories using World Health Organization weight status by body mass index (BMI) obtained from the day of surgery. Surgical complications within 120 days and postsurgical complication-related procedural interventions were also evaluated and compared. Comparisons of variables of interest between weight groups were assessed using Mantel–Haenszel chi-square tests or Spearman correlations. Results:. Increases in patient weight category were associated with increased length of operation (P = 0.003), increased rates of breast fat necrosis (P = 0.04), breast wound dehiscence (P = 0.01), abdominal wound dehiscence (P = 0.02), numbers of abdominal complications (P = 0.001), and rates of requiring an intervention (P = 0.03). Conclusions:. The findings imply that higher BMI values may lead to a higher likelihood of postoperative complications and the need for intervention. It is crucial for patients with obesity to be aware of the elevated risk associated with rising BMI values.

IntroductionPeripheral neuropathy (PN) is the most common neurodegenerative disorder, and the primary causes are chemotherapy-induced peripheral neuropathy (CIPN) and diabetic neuropathy (DN). Transcutaneous auricular vagus nerve stimulation (taVNS) is a promising non-pharmacological and non-invasive intervention that targets key pathways involved with PN. However, research is needed to determine the feasibility, acceptability, and effects of taVNS in people with PN. It is also critical that this research on taVNS include the perspectives of Black and Hispanic/Latino patients, who are often underrepresented in research.MethodsThis research was comprised of two consecutive studies: a survey and a pilot randomized sham-controlled trial (RCT). The survey assessed symptom burden, management strategies, and interest in taVNS among CIPN patients. The pilot RCT evaluated the feasibility, acceptability, and preliminary effects of taVNS in Black and Hispanic/Latino patients with CIPN or diabetic neuropathy. Participants were recruited from the University of Miami medical system, with culturally sensitive approaches to enhance minority participation.ResultsThe survey included 62 respondents, 78% Black or Hispanic/Latino, revealing high symptom burden and significant interest in taVNS (82% expressed moderate to high interest). The pilot RCT enrolled 28 participants, achieving a 42% recruitment rate and 86% retention. taVNS was well tolerated, with no significant adverse effects. Preliminary data indicated a decrease in neuropathic symptoms and an increased heart rate variability (HRV) during active taVNS, suggesting autonomic modulation. Tingling sensation and pain decreased by median values of 2.0 and 1.5, respectively. Additionally, the median values for standard deviation of the RR interval increased from 34.9 (CI = 21.6–44.8) at baseline to 44.8 (CI = 26.5–50.3) during intervention. Exit interviews highlighted positive participant experiences and identified potential barriers, such as protocol length and distrust in medical research.ConclusionThe findings underscore the need for novel CIPN treatments and demonstrate the feasibility of conducting taVNS research in historically underrepresented populations. High interest in taVNS and successful recruitment and retention rates suggest that culturally sensitive approaches can enhance minority participation in clinical trials. These findings will be used to develop a large clinical trial to determine the efficacy of repeated taVNS in a diverse cohort. Clinical Trial Registrationhttps://clinicaltrials.gov, identifier (NCT05896202).

Abstract Background Lumbar degenerative spondylolisthesis (LDS), characterized as degeneration of the intervertebral disc and structural changes of the facet joints, is a condition with varying degrees of instability that may lead to pain, canal stenosis, and subsequent surgical intervention. However, the etiology of LDS remains inconclusive. Gut microbiome dysbiosis may stimulate systemic inflammation in various disorders. However, the role of such dysbiosis upon spine health remains under‐studied. The current study assessed the association of gut microbiome dysbiosis in symptomatic patients with or without LDS. Methods A cross‐sectional analysis within the framework of a prospective study was performed. DNA was extracted from fecal samples collected from adult symptomatic patients with (n = 21) and without LDS (n = 12). Alpha and beta diversity assessed differences in fecal microbial community between groups. Taxon‐by‐taxon analysis identified microbial features with differential relative abundance between groups. Subject demographics and imaging parameters were also assessed. Results There was no significant group differences in age, sex, race, body mass index, smoking/alcohol history, pain profiles, spinopelvic alignment, and Modic changes (p >0.05). LDS subjects had significantly higher disc degeneration severity (p = 0.018) and alpha diversity levels compared to non‐LDS subjects (p = 0.002–0.003). Significant differences in gut microbial community structure were observed between groups (p = 0.046). Subjects with LDS exhibited distinct differences at the phylum level, with a significantly higher Firmicutes to Bacteroidota ratio compared to non‐LDS (p = 0.003). Differential relative abundance analysis identified six taxa with significant differences between the two groups, with LDS demonstrating an increase in putative pro‐inflammatory bacteria (Dialister, CAG‐352) and a decrease in anti‐inflammatory bacteria (Slackia, Escherichia‐Shigella). Conclusion This study is the first to report a significant association of gut microbiome dysbiosis and LDS in symptomatic patients, noting pro‐inflammatory bacterial taxa. This work provides a foundation for future studies addressing the role of the gut microbiome in association with spine health and disease.

ObjectiveTo examine the social determinants of early childhood caries (ECC), one of the greatest public health risks affecting children, and examine alternative pathways of influence.MethodsA physically healthy, socio-demographically high-risk sample of initially caries-free children, aged 1–4 years, was prospectively studied for 2 years. At 6-month intervals, assessments were made of caries presence from a standard dental exam; oral microbiology was assayed from saliva samples; oral hygiene behaviors and psychological and psychosocial risk exposure were derived from interviews and questionnaires.Results189 children were enrolled; ECC onset occurred in 48 children over the 2-year study period. A composite measure of psychosocial risk was significantly associated with ECC onset over the course of the study (1.57, 95% CI 1.12–2.20, p

IntroductionLes effets de l’utilisation des médias sociaux sur la santé des adolescents soulèvent de plus en plus de préoccupations en matière de santé publique. Nous avons exploré la relation entre cette utilisation et la santé du sommeil chez les adolescents du Canada de 11 à 17 ans. MéthodologieDes données de l’Enquête sur les comportements de santé des jeunes d’âge scolaire de 2017-2018 étaient disponibles pour 12 557 participants (dont 55,2 % de sexe féminin). Des catégories d’utilisation des médias sociaux ont été établies en fonction de la fréquence (utilisation non active, active ou intensive) et de la présence de symptômes évoquant une dépendance (utilisation problématique). Des modèles de régression logistique à effets mixtes ont révélé des associations entre l’utilisation des médias sociaux et sept indicateurs de la santé du sommeil (symptômes d’insomnie, somnolence diurne, utilisation d’un écran avant de se coucher, respect des recommandations sur la durée du sommeil, variabilité du sommeil, heure de coucher tardive les jours d’école et heure de coucher tardive les jours de repos). RésultatsComparativement à une utilisation active des médias sociaux, une utilisation non active a été associée à de meilleurs résultats des indicateurs de la santé du sommeil, sauf en ce qui concerne les symptômes d’insomnie. Une utilisation intensive des médias sociaux a été associée à un risque accru d’indicateurs défavorables de la santé du sommeil (rapport de cotes ajusté [RCa] de 1,09 à 2,24) et une utilisation problématique a été associée au RCa le plus élevé (1,67 à 3,24). Les associations avec une utilisation problématique des médias sociaux étaient plus marquées chez les filles que chez les garçons, en particulier en ce qui concerne l’heure de coucher tardive les jours d’école (RCa = 3,74 vs 1,84) et les jours de repos (RCa = 4,13 vs 2,18). Les associations entre l’utilisation des médias sociaux et les résultats en matière de sommeil ne variaient pas selon la tranche d’âge. ConclusionUne utilisation intensive et une utilisation problématique des médias sociaux ont été associées à un risque accru de troubles du sommeil chez les adolescents du Canada, avec des associations plus marquées chez les filles que chez les garçons. D’autres recherches doivent être menées pour éclaircir les mécanismes à l’origine des associations entre l’utilisation des médias sociaux et le sommeil, de manière à orienter les recommandations en matière de santé publique.

IntroductionPublic health concerns over the impact of social media use (SMU) on adolescent health are growing. We investigated the relationship between SMU and sleep health in adolescents in Canada aged 11 to 17 years. MethodsData from the 2017–2018 Health Behaviour in School-aged Children study were available for 12 557 participants (55.2% female). SMU was categorized by frequency of use (non-active, active and intense) and the presence of addiction-like symptoms (problematic). Mixed effects logistic regression models identified associations between SMU and seven sleep health indicators (insomnia symptoms, daytime wakefulness problems, screen time before bed, meeting sleep duration recommendations, sleep variability and late bedtime on school and non-school days). ResultsCompared to active SMU, non-active SMU was associated with better sleep indicators, except for insomnia symptoms. Intense SMU was associated with greater odds of having poor sleep health indicators (adjusted odds ratio [aORs] from 1.09 to 2.24) and problematic SMU with the highest odds (aORs from 1.67 to 3.24). Associations with problematic SMU were greater among girls than boys, including having a later bedtime on school days (aOR = 3.74 vs. 1.84) and on non-school days (aOR = 4.13 vs. 2.18). Associations between SMU and sleep outcomes did not differ by age group. ConclusionCompared to active SMU, non-active SMU was associated with better sleep indicators, except for insomnia symptoms. Intense SMU was associated with greater odds of having poor sleep health indicators (adjusted odds ratio [aORs] from 1.09 to 2.24) and problematic SMU with the highest odds (aORs from 1.67 to 3.24). Associations with problematic SMU were greater among girls than boys, including having a later bedtime on school days (aOR = 3.74 vs. 1.84) and on non-school days (aOR = 4.13 vs. 2.18). Associations between SMU and sleep outcomes did not differ by age group.

Abstract Depressive and anxiety symptoms are prevalent among patients with various clinical conditions, resulting in diminished emotional well-being and impaired daily functioning. The neural mechanisms underlying these symptoms, particularly across different disorders, remain unclear, limiting the effectiveness of conventional treatments. Therefore, it is crucial to elucidate the neural underpinnings of depressive and anxiety symptoms and investigate novel, effective treatments across clinical conditions. Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that can help understand the neural underpinnings of symptoms and facilitate the development of interventions, addressing the two research gaps at both neural and clinical levels. Thus, this systematic review and meta-analysis aims to evaluate the existing evidence regarding the therapeutic efficacy of tDCS in reducing depressive and anxiety symptoms among individuals with diverse clinical diagnoses. This review evaluated evidence from fifty-six randomized, sham-controlled trials that administered repeated tDCS sessions with a parallel design, applying a three-level meta-analytic model. tDCS targeting the left dorsolateral prefrontal cortex (DLPFC) at 2-mA intensity demonstrates moderate efficacy in alleviating depressive symptoms, identifying the left DLPFC as a transdiagnostic neural mechanism of depressive symptoms across clinical conditions. In comparison, the findings on anxiety symptoms demonstrate greater heterogeneity. tDCS over the left DLPFC is effective in reducing depressive symptoms and shows promising effects in alleviating anxiety symptoms among individuals with diverse diagnoses. These findings enhance our understanding of the neuropsychological basis of depressive and anxiety symptoms, laying the groundwork for the development of more effective tDCS interventions applicable across clinical conditions.

Abstract Background Juvenile idiopathic arthritis (JIA) comprises a heterogeneous group of conditions that can cause marked disability and diminished quality of life. Data on predictors of clinical response are insufficient to guide selection of the appropriate biologic agent for individual patients. This study aimed to investigate the propensity of S100A8/9 and S100A12 as predictive biomarkers of abatacept response in polyarticular-course juvenile idiopathic arthritis (pJIA). Methods Data from a phase 3 trial (NCT01844518) of subcutaneous abatacept in patients with active pJIA (n = 219) were used in this exploratory analysis. Association between biomarker levels at baseline and improvements in JIA-American College of Rheumatology (ACR) criteria responses or baseline disease activity (measured by Juvenile Arthritis Disease Activity Score in 27 joints using C-reactive protein [JADAS27-CRP]) were assessed. Biomarker level changes from baseline to month 4 were assessed for disease outcome prediction up to 21 months. Results At baseline, 158 patients had available biomarker samples. Lower baseline S100A8/9 levels (≤ 3295 ng/mL) were associated with greater odds of achieving JIA-ACR90 (odds ratio [OR]: 2.54 [95% confidence interval (CI): 1.25–5.18]), JIA-ACR100 (OR: 3.72 [95% CI: 1.48–9.37]), JIA-ACR inactive disease (ID; OR: 4.25 [95% CI: 2.03–8.92]), JADAS27-CRP ID (OR: 2.34 [95% CI: 1.02–5.39]) at month 4, and JIA-ACR ID (OR: 3.01 [95% CI: 1.57–5.78]) at month 16. Lower baseline S100A12 levels (≤ 176 ng/mL) were associated with greater odds of achieving JIA-ACR90 (OR: 2.52 [95% CI: 1.23–5.13]), JIA-ACR100 (OR: 3.68 [95% CI: 1.46–9.28]), JIA-ACR ID (OR: 3.66 [95% CI: 1.76–7.61]), JIA-ACR90 (OR: 2.03 [95% CI: 1.07–3.87]), JIA-ACR100 (OR: 2.14 [95% CI: 1.10–4.17]), and JIA-ACR ID (OR: 4.22 [95% CI: 2.15–8.29]) at month 16. From baseline to month 4, decreases in S100A8/9 and S100A12 generally exceeded 50% among JIA-ACR90/100/ID responders. Conclusion Lower baseline levels of S100A8/9 and S100A12 proteins predicted better response to abatacept treatment than higher levels and may serve as early predictive biomarkers in pJIA. Decreases in these biomarker levels may also predict longer-term response to abatacept in pJIA.

Background The comparison of coronary computed tomography angiography plaques and perivascular adipose tissue (PVAT) between patients with acute myocardial infarction (AMI) posttreatment and patients with stable coronary artery disease is poorly understood. Our objective was to evaluate the differences in coronary computed tomography angiography–quantified plaque and PVAT characteristics in patients post‐AMI and identify signs of residual inflammation. Methods and Results We analyzed 205 patients (age, 59.77±9.24 years; 92.20% men) with AMI ≤1 month and matched them with 205 patients with stable coronary artery disease (age, 60.52±10.04 years; 90.24% men) based on age, sex, and cardiovascular risk factors. Coronary computed tomography angiography scans were assessed for nonculprit plaque and vessel characteristics, plaque volumes by composition, high‐risk plaques, and PVAT mean attenuation. Both patient groups exhibited similar noncalcified plaque volumes (383.35±313.23 versus 378.63±426.25 mm3, P=0.899). However, multivariable analysis revealed that patients post‐AMI had a greater patient‐wise noncalcified plaque volume ratio (estimate, 0.089 [95% CI, 0.053–0.125], P

BackgroundEffective post-stroke mobility, recovery, performance, and participation are key goals for stroke survivors. However, these outcomes may be hindered by post-stroke fatigue (PSF), which can affect numerous aspects of post-stroke mobility, recovery, performance, functioning, community participation, and return to work. This review aimed to assess the scientific evidence on the relationship between PSF and mobility function, functional recovery, functional performance, and participation-related outcomes among stroke survivors.MethodA comprehensive search of Cochrane Central, PubMed, Embase, and Web of Science (WoS) databases was conducted from inception to December 2023. Observational, cross-sectional, and longitudinal studies were included. The methodological quality of the included studies was assessed using the National Institute of Health’s quality assessment tool, while the risk of bias was assessed using the Quality in Prognostic Studies tool. A total of 28 studies (n = 2,495 participants, 1,626 men, mean age ranging from 52.5 ± 9.5 to 71.1 ± 9.9 years) were included. The data analysis was conducted using narrative and quantitative synthesis. Fixed and random effects meta-analyses were conducted to explore the relationships between PSF and relevant outcomes.ResultsChronic PSF was found to have significant negative correlations with mobility (meta r = −0.106, p

Abstract Background Cancer is the fourth leading cause of death in adolescents and young adults (AYA) worldwide. Although successful treatment of cancer in AYA has increased in recent years in most of the world, this is not true for many low‐ and middle‐income countries (LMIC) where over 80% of all AYA live. This study investigated the needs of AYA with cancer in parts of Latin America (LATAM) through the perspectives of non‐physician health care providers and partners. Methods Semi‐structured interviews (in Spanish) were conducted with non‐physician partners from Mexico, Peru, Central America, and the Caribbean over Zoom. Participants were recruited through previously identified local physicians and international non‐physician professionals working in these countries. Transcripts were coded and key themes identified until thematic saturation was reached (Atlas.ti). Findings Thirty participants representing eight countries were interviewed, providing 1202 min of transcript data. Data were organized into barriers, facilitators, and strategies to improve the delivery of health care for AYA with cancer in LATAM at the patient‐ (e.g., financial barriers, continued schooling), parent‐ (e.g., limited medical literacy, advocacy), and hospital‐level (e.g., structural barriers, increasing funding). Interpretation There are many similarities in the barriers and facilitators to AYA care between LATAM and high‐income countries (HIC); however, some characteristics are more unique to LATAM, for example, strict age restrictions for pediatric care and abandonment of therapy. As LATAM countries continue to build cancer control programs, there is an opportunity to consider our identified barriers, facilitators, and strategies to address the unique needs of AYA with cancer.

Abstract Insect activity powers ecosystems and food production globally. Although insect activity is known to vary with the rise and setting of the sun, there is surprisingly limited empirical information on how insect abundance and richness varies across the 24-hour day–night (diel) cycle. Moreover, commonly used methods for sampling insects such as light traps do not provide suitable comparisons of community properties between diel periods. We present a dataset of 1512 observations of abundance and richness during diurnal and nocturnal periods in insect communities worldwide. The data were collected from 99 studies that systematically sampled insect communities during day and night, using sampling methods minimally influenced by diel variation, such as movement-based interception traps. Spanning six continents, 41 countries and 16 insect orders, the data can support investigations into the factors influencing insect diel preferences as well as the causes and consequences of temporal changes in insect biodiversity. The data also provides key baseline information on the diel activity patterns of insect communities for long-term ecological monitoring. These pursuits take on added significance considering contemporary ‘insect declines’ and increasing anthropogenic impacts on diurnal and nocturnal biodiversity.

The genus Leptanilla Emery, 1870 of the family Formicidae, subfamily Leptanillinae, comprises miniscule, pale, blind ants that are rarely collected and poorly understood due to their hypogaeic (i.e. underground) lifestyles. Here we describe a new Leptanilla species from two workers collected via subterranean scraping in the arid Pilbara region of Western Australia. Leptanilla voldemort sp. nov. is the second leptanilline species documented in Australia after the elusive Leptanilla swani Wheeler, 1932. Workers of L. voldemort sp. nov. display a remarkably gracile morphology characterised by elongated legs, antennae, and mandibles, and they are easily differentiated from other Leptanilla species. We also provide new measurements for L. swani from two workers found proximally to the type locality of L. voldemort sp. nov. A key to the worker caste of Leptanilla species of the Australian continent is presented.

Abstract Insects sustain key ecosystem functions, but how their activity varies across the day–night cycle and the underlying drivers are poorly understood. Although entomologists generally expect that more insects are active at night, this notion has not been tested with empirical data at the global scale. Here, we assemble 331 quantitative comparisons of the abundances of insects between day and night periods from 78 studies worldwide and use multi-level meta-analytical models to show that insect activity is on average 31.4% (CI: −6.3%–84.3%) higher at night than in the day. We reveal diel preferences of major insect taxa, and observe higher nocturnal activity in aquatic taxa than in terrestrial ones, as well as in warmer environments. In a separate analysis of the small subset of studies quantifying diel patterns in taxonomic richness (31 comparisons from 13 studies), we detect preliminary evidence of higher nocturnal richness in tropical than temperate communities. The higher overall (but variable) nocturnal activity in insect communities underscores the need to address threats such as light pollution and climate warming that may disproportionately impact nocturnal insects.

Abstract Digital ocular massage has been reported to temporarily lower intraocular pressure (IOP). This could be related to an enhanced aqueous humor outflow; however, the mechanism is not clearly understood. Using anterior segment optical coherence tomography, the Schlemm’s canal (SC) and trabecular meshwork (TM) can be imaged and measured. Here, 66 healthy adults underwent digital ocular massage for 10 min in their right eyes. The IOP and dimensions of the SC and TM were measured before and after ocular massage. All subjects demonstrated IOP reduction from 15.7 ± 2.5 mmHg at baseline to 9.6 ± 2.2 mmHg immediately after, and median of 11.6 mmHg 5-min after ocular massage (Friedman’s test, p

Aims: This systematic review aims to identify 3D predictors derived from biplanar reconstruction, and to describe current methods for improving curve prediction in patients with mild adolescent idiopathic scoliosis. Methods: A comprehensive search was conducted by three independent investigators on MEDLINE, PubMed, Web of Science, and Cochrane Library. Search terms included “adolescent idiopathic scoliosis”,“3D”, and “progression”. The inclusion and exclusion criteria were carefully defined to include clinical studies. Risk of bias was assessed with the Quality in Prognostic Studies tool (QUIPS) and Appraisal tool for Cross-Sectional Studies (AXIS), and level of evidence for each predictor was rated with the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. In all, 915 publications were identified, with 377 articles subjected to full-text screening; overall, 31 articles were included. Results: Torsion index (TI) and apical vertebral rotation (AVR) were identified as accurate predictors of curve progression in early visits. Initial TI > 3.7° and AVR > 5.8° were predictive of curve progression. Thoracic hypokyphosis was inconsistently observed in progressive curves with weak evidence. While sagittal wedging was observed in mild curves, there is insufficient evidence for its correlation with curve progression. In curves with initial Cobb angle < 25°, Cobb angle was a poor predictor for future curve progression. Prediction accuracy was improved by incorporating serial reconstructions in stepwise layers. However, a lack of post-hoc analysis was identified in studies involving geometrical models. Conclusion: For patients with mild curves, TI and AVR were identified as predictors of curve progression, with TI > 3.7° and AVR > 5.8° found to be important thresholds. Cobb angle acts as a poor predictor in mild curves, and more investigations are required to assess thoracic kyphosis and wedging as predictors. Cumulative reconstruction of radiographs improves prediction accuracy. Comprehensive analysis between progressive and non-progressive curves is recommended to extract meaningful thresholds for clinical prognostication. Cite this article: Bone Jt Open 2024;5(3):243–251.

The treatment landscape for patients with advanced ALK-positive NSCLC has rapidly evolved following the approval of several ALK TKIs in Canada. However, public funding of ALK TKIs is mostly limited to the first line treatment setting. Using linked provincial health administrative databases, we examined real-world outcomes of patients with advanced ALK-positive NSCLC receiving ALK TKIs in Ontario between 1 January 2012 and 31 December 2021. Demographic, clinical characteristics and treatment patterns were summarized using descriptive statistics. Kaplan–Meier analysis was performed to evaluate progression-free survival (PFS) and overall survival (OS) among the treatment groups. A total of 413 patients were identified. Patients were administered alectinib (n = 154), crizotinib (n = 80), or palliative-intent chemotherapy (n = 55) in the first-line treatment. There was a significant difference in first-line PFS between the treatment groups. The median PFS (mPFS) was not reached for alectinib (95% CI, 568 days—not reached), compared to 8.2 months (95% CI, 171–294 days) for crizotinib (HR = 0.34, p < 0.0001) and 2.4 months (95% CI, 65–100 days) for chemotherapy (HR = 0.14, p < 0.0001). There was no significant difference in first-line OS between the treatment groups. In patients who received more than one line of treatment, there was a significant difference in mOS between patients who received two or more lines of ALK TKIs compared to those who received one line of ALK TKI (mOS = 55 months (95% CI, 400–987 days) and 26 months (95% CI, 1448–2644 days), respectively, HR = 4.64, p < 0.0001). This study confirms the effectiveness of ALK TKIs in real-world practice and supports the potential benefit of multiple lines of ALK TKI on overall survival in patients with ALK-positive NSCLC.

Breast cancer stem cells (CSCs) are resistant to most cancer therapeutics and contribute to tumor recurrence and metastasis. Two breast CSC-promoting transcription factors, truncated glioma-associated oncogene homolog 1 (tGLI1) and signal transducer and activator of transcription 3 (STAT3), have been reported to be frequently co-expressed in HER2-enriched breast cancer and triple-negative breast cancer (TNBC), undergo protein-protein interactions for gene regulation and activation, and functionally cooperate to promote breast CSCs. STAT3 can be activated by activated interleukin-6 receptor/glycoprotein-130 (IL-6R/GP130). Co-targeting of tGLI1 and IL-6R/GP130 has not been investigated in breast cancer or any tumor type. Here, we report that tGLI1 and GP130 are co-overexpressed in the majority of HER2-enriched breast cancers and TNBCs at 53.8% and 44.4%, respectively. tGLI1+IL-6/IL-6R/GP130 signaling is frequently co-enriched and co-activated in HER2-enriched breast cancer and TNBC when compared to luminal subtypes. tGLI1+GP130 co-overexpression strongly promotes CSCs of HER2-enriched breast cancer and TNBC. FDA-approved tGLI1 inhibitor Ketoconazole and GP130 inhibitor Bazedoxifene synergize against breast cancer proliferation and CSC phenotypes in vitro and reduce TNBC tumor growth and metastatic burden in vivo. Our study demonstrates, for the first time, that co-targeting tGLI1 and IL-6R/GP130/STAT3 signaling pathways is synergistic against HER2-enriched breast cancer and TNBC, warranting future clinical investigations.

Breast cancer is the most frequent malignancy in women, constituting 15.2% of all new cancers diagnosed in the United States. Distant breast cancer metastasis accounts for the majority of breast cancer-related deaths; brain metastasis is the third most common site for metastatic breast cancer but is associated with worst prognosis of approximately eight months of survival. Current treatment options for breast cancer brain metastasis (BCBM) are limited and ineffective. To help identify new and effective therapies for BCBM, it is important to investigate the mechanisms by which breast cancer cells metastasize to the brain and thrive in the brain microenvironment. To this end, studies have reported that primary breast tumor cells can prime brain microenvironmental cells, including, astrocytes and microglia, to promote the formation of BCBM through the release of extracellular vesicle-microRNAs (miRNAs). Breast tumor-derived miRNAs can also promote breast cancer cell invasion through the blood-brain barrier by disrupting the integrity of the brain microvascular endothelial cells. In this review, we summarize current literature on breast cancer-derived BCBM-promoting miRNAs, cover their roles in the complex steps of BCBM particularly their interactions with microenvironmental cells within the brain metastatic niche, and finally discuss their therapeutic applications in the management of BCBM.

PURPOSEThis study aimed to identify, evaluate, and rank suitable safety innovations developed during the COVID-19 pandemic in Latin American and Caribbean (LAC) radiation oncology centers.METHODSWe conducted a multimodal participatory engagement collaboration with the Latin-American and Caribbean Society of Medical Oncology. The study consisted of four phases. Innovations were collected from a panel of radiotherapy experts representing a diverse group of 11 countries from LAC (Phase I). Next, a medical scientific team compared the innovations against international standards regarding their potential impact on risk of infection, clinical operation, and continuity of quality cancer care (Phase II). Their findings were supplied to the country representatives who rated the innovations for acceptability in their cancer centers (Phase III), resulting in a final report of the panel's recommendations (Phase IV).RESULTSA total of 81 innovations were reported by the country representatives and merged by the medical scientific team into 24 innovations that combined similar innovations. The 24 innovations were grouped into six categories including practices aimed at (1) reducing clinic crowding (n = 3), (2) increasing screening and vaccinations for COVID-19 disease (n = 5), (3) implementing social distancing (n = 6), (4) strengthening personal infection equipment and disinfection (n = 6), (5) avoiding delaying or shortening treatment protocols (n = 2), and (6) mixed procedures (n = 2). The medical scientific team found nearly all innovations were supported by international recommendations and rated as safe, efficient, and acceptable.CONCLUSIONBy using the lessons learned from the Community-Led Action Research in Oncology: Pandemic-Appropriate Radiotherapy Innovations Evaluated study, a manual of scalable practices in radiation oncology clinics may be developed to guide actions during future large-scale public health crises in low- and middle-income countries of LAC.

ObjectiveTo investigate the psychometric properties of the Lift and Carry Test (LCT) time in people with stroke.DesignCross-sectional design.SettingUniversity based neurorehabilitation laboratory.ParticipantsTwenty-four people with stroke and 24 healthy controls.Outcome measuresLift and Carry Test (LCT), Fugl-Meyer Assessment of upper extremity and lower extremity, ankle dorsiflexor and plantarflexor muscle strength, Berg Balance Scale (BBS), Timed Up and Go (TUG) and Community Integration Measure.ResultsThe mean LCT time (29.70s) in people with stroke was more than double of that in healthy controls (13.70s). The LCT showed excellent intra-rater, inter-rater and test–retest reliability [intraclass correlation coefficient (ICC) = 0.943–1.000]. The LCT times demonstrated a significant negative correlation with the BBS score (rs = −0.771) and significant positive correlations with the TUG times (rs = 0.933). There was no significant correlation between LCT times and FMA score (p > 0.05). An optimal cut-off LCT time of 15.48 s (sensitivity = 95.8%, specificity = 87.5%) was identified to differentiate between people with stroke and healthy controls (area under the curve = 0.957).ConclusionLCT is an excellent clinical test for examining advanced functional ability in people with stroke and distinguishing people with stroke from healthy controls.

AimTo assess the effects of SDF and SDF+KI treatment on enamel and dentin carious lesions in primary teeth using x-ray Microtomography (XMT) and back scattered scanning electron microscopy (BSE-SEM).MethodsArtificial enamel caries of 3 caries free primary teeth were created by immersion of the samples in 50 ml demineralization solution for 72 h. Three other teeth with natural dentin caries were selected. Both groups were divided into 3 subgroups: EC–Enamel Control; ES–Enamel with SDF application; ESK–Enamel with SDF followed by KI application; DC–Dentin Control; DS–Dentin with SDF application; DSK–Dentin with SDF followed by KI application. Each tooth was imaged using XMT at 3 time points: (1) Pretreatment; (2) after immersion in remineralization solution for 120 h, with or without SDF or SDF+KI; (3) after subsequent immersion in demineralization solution for 72 h. The change of radiopacities of the lesions in these time points were assessed from the XMT images. After the XMT scans, all teeth were investigated microscopically using BSE-SEM.ResultsIn EC, no change in linear attenuation coefficient (LAC) was observed after remineralization, but LAC reduction was observed after subsequent demineralization. For ES, thin layer of high LAC material was deposited on the enamel surface after remineralization, and further reduction of LAC was observed after demineralization. In ESK, the surface layer was lost after SDF+KI, and small reduction of LAC was observed after demineralization. In DC, no LAC change was observed after remineralization, but reduction of LAC was detected after demineralization. In DS, high LAC material was formed on the carious dentin surface and randomly inside the lesion. No further LAC change was found after demineralization. In DSK, thick layer of high LAC material was deposited on the carious surface and inside the dentinal tubules. No further LAC reduction was found after subsequent demineralization.ConclusionSDF and SDF+KI did not protect artificial enamel under acid attack even though Ag products were deposited in the porous enamel. However, SDF and SDF+KI shows protective properties against acid challenges and Ag products are deposited in carious dentin lesion without tubular structure randomly; and within dentinal tubules when these structures are retained.