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Introduction: While some patients recovered, others died across the world thereby losing their loved ones. The objective of the current study is to determine statistical differences in means of the COVID-19 infected population (laboratory confirmed), discharged cases(recovered) and deaths resulting from the COVID-19 pandemic in Rivers State, Nigeria. Material and Methods: In this study, extraction of the infected population (laboratory confirmed), discharged cases, and deaths from COVID-19 was carried out from data obtained from the Nigeria Centre for Disease Control which covered 572 days (25th March 2020 - 17th October 2021). The test for the significance of means among the variables was done using a one-way Analysis of Variance (ANOVA) followed by the Tukey HSD test. The two variables whose means do not significantly differ were tested for strength of relationship and dependence using correlation analysis and cubic polynomial function respectively. Results: Results showed that there is a statistically significant difference between the infected population, discharged cases, and deaths from COVID-19 as obtained from one-way ANOVA (F(2, 1710) = 121.958, p = 0.000). Use of the Tukey HSD test indicated that the means of infected population and discharged cases do not differ from each other (p>0.01); however, mean deaths from COVID-19 significantly differ from others at 99% confidence intervals (p

Abstract Introduction Ineffective and non-interactive learning among nursing students limits opportunities for students’ classroom presentation skills, creativity, and innovation upon completion of their classroom learning activities. Pecha Kucha presentation is the new promising pedagogy that engages students in learning and improves students’ speaking skills and other survival skills. It involves the use of 20 slides, each covering 20 seconds of its presentation. The current study examined the effect of Pecha Kucha’s presentation pedagogy on presentation skills among nursing students in Tanzania. Objectives The aim of this study was to establish comparative nursing student’s presentation skills between exposure to the traditional PowerPoint presentations and Pecha Kucha presentations. Methods The study employed an uncontrolled quasi-experimental design (pre-post) using a quantitative research approach among 230 randomly selected nursing students at the respective training institution. An interviewer-administered structured questionnaire adopted from previous studies to measure presentation skills between June and July 2023 was used. The study involved the training of research assistants, pre-assessment of presentation skills, training of participants, assigning topics to participants, classroom presentations, and post-intervention assessment. A linear regression analysis model was used to determine the effect of the intervention on nursing students’ presentation skills using Statistical Package for Social Solution (SPSS) version 26, set at a 95% confidence interval and 5% significance level. Results Findings revealed that 63 (70.87%) participants were aged ≤ 23 years, of which 151 (65.65%) and 189 (82.17%) of them were males and undergraduate students, respectively. Post-test findings showed a significant mean score change in participants’ presentation skills between baseline (M = 4.07 ± SD = 0.56) and end-line (M = 4.54 ± SD = 0.59) that accounted for 0.4717 ± 0.7793; p

Abstract Global atmospheric concentrations of nitrous oxide have been increasing over previous decades with emerging research suggesting the Arctic as a notable contributor. Thermokarst processes, increasing temperature, and changes in drainage can cause degradation of polygonal tundra landscape features resulting in elevated, well-drained, unvegetated soil surfaces that exhibit large nitrous oxide emissions. Here, we outline the magnitude and some of the dominant factors controlling variability in emissions for these thermokarst landscape features in the North Slope of Alaska. We measured strong nitrous oxide emissions during the growing season from unvegetated high centered polygons (median (mean) = 104.7 (187.7) µg N2O-N m−2 h−1), substantially higher than mean rates associated with Arctic tundra wetlands and of similar magnitude to unvegetated hotspots in peat plateaus and palsa mires. In the absence of vegetation, isotopic enrichment of 15N in these thermokarst features indicates a greater influence of microbial processes, (denitrification and nitrification) from barren soil. Findings reveal that the thermokarst features discussed here (~1.5% of the study area) are likely a notable source of nitrous oxide emissions, as inferred from chamber-based estimates. Growing season emissions, estimated at 16 (28) mg N2O-N ha−1 h−1, may be large enough to affect landscape-level greenhouse gas budgets.

Abstract Background Herpes zoster (HZ), commonly known as “shingles,” may contribute to cognitive decline through mechanisms such as neuroinflammation or direct neuronal injury. However, evidence on the longitudinal association between HZ and cognitive decline is conflicting and whether the risk differs by APOE ε4-carrier status has not been studied; prospective cohort studies on the association between HZ vaccination and cognitive decline are also lacking. Methods We included 149,327 participants from three large cohorts—the Nurses’ Health Study (NHS), NHSII, and Health Professionals Follow-Up Study (HPFS)—to prospectively examine the association between HZ and subsequent subjective cognitive decline (SCD). Poisson regression was used to estimate the multivariable-adjusted relative risk (MVRR) of a 3-unit increment in SCD score according to years since HZ compared with participants with no history of HZ. Results Compared with individuals with no history of HZ, the MVRR (95% CI) of a 3-unit increment in SCD score was significantly and independently higher among individuals with a history of HZ, but the duration of time since HZ when the elevated risk of SCD was statistically significant differed among the cohorts. In NHS, HZ was associated with higher long-term risk of SCD; compared with individuals with no history of HZ, the MVRR (95% CI) of a 3-unit increment in SCD score was 1.14 (1.01, 1.32) for ≥ 13 years since HZ. In NHS II, HZ was associated with higher risk of SCD in both the short-term [MVRR 1.34 (1.18, 1.53) for 1–4 years] and long-term [MVRR 1.20 (1.08, 1.34) for ≥ 13 years since HZ]. In HPFS, an elevated risk of SCD was suggested across all time points. Among the subset of participants with information on APOE ε4, there was a suggestion that the association differed by APOE ε4 carrier status, but the results were not consistent between women and men. Among the subset of women with information on HZ vaccination, there was a suggestion that the long-term risk of SCD may be greater among women who were not vaccinated against HZ. Conclusions Data from three large independent cohorts of women and men showed that HZ was associated with higher long-term risk of SCD, and the risk may differ by APOE ε4-carrier status.

Abstract Background An adequate magnesium intake might lower the risk of frailty through its role in muscle function. Methods We analysed data from 81 524 women aged ≥60 years participating in the Nurses' Health Study. Total magnesium intake was obtained from repeated food frequency questionnaires administered between 1984 and 2010 and self‐reported information on supplementation. Frailty was defined as having at least three of the following five FRAIL scale criteria: fatigue, low strength, reduced aerobic capacity, having ≥5 chronic illnesses and weight loss ≥ 5%. The occurrence of frailty was assessed every 4 years from 1992 to 2018. Cox proportional hazards models adjusted for lifestyle factors, medication use and dietary factors were used to assess the association between magnesium intake and frailty. Results During a median follow‐up of 16 years, we identified 15 477 incident cases of frailty. Women with a higher intake of total energy‐adjusted magnesium had a decreased risk of frailty after adjustment for lifestyle factors, medication use and dietary factors. The relative risk (95% confidence interval) for Quintile 5 (Q5) versus Quintile 1 (Q1) was 0.88 (0.82, 0.94) (P‐trend

Background: Dietary quality plays an important role in disease development and prognosis, and diet is also a key contributor to disparities in many chronic diseases and health conditions. Objectives: This study aimed to assess racial and ethnic disparities experienced by veterans; we examined food intake and dietary quality across different racial and ethnic groups of United States veterans. Methods: The study included 420,730 males and females aged 19–107 y (91.2% males) enrolled in the Veterans Affairs Million Veteran Program with plausible dietary intake measured by food frequency questionnaire. Dietary quality was evaluated with dietary approaches to stop hypertension (DASH) score. Dietary intakes of various race and ethnicity groups were standardized to the age distribution of non-Hispanic White participants, separately for males and females. Differences across race and ethnicity groups were compared using general linear regression models after adjustment for socioeconomic and lifestyle factors as well as military service. Results: Compared to non-Hispanic White males, non-Hispanic Black males had a relatively lower DASH score, higher red and processed meats, higher sugar-sweetened beverages (SSBs), and lower low-fat dairy intakes. Non-Hispanic Asian males had a relatively higher DASH score as compared to non-Hispanic White males with relatively higher intakes of fruits and vegetables and relatively lower intakes of sodium, red meat and SSBs. Age-standardized DASH scores of Hispanic males and “Other” race/ethnicity groups were not statistically different from non-Hispanic White males. Similar race and ethnicity dietary patterns were found in females, although not all reached a statistically significant level. Conclusions: A modest difference in overall dietary quality (i.e., DASH score) was observed, but unique differences in food preferences across the different racial/ethnic groups were identified. Findings from our study may provide insight for the potential development of specific interventions to help address nutritional disparities experienced among veterans.

Objective: Carotenoids are lipophilic plant molecules with antioxidant properties. Some carotenoids such as β-carotene also serve as vitamin A precursors, playing a key role in human health. Carotenoids are transported in lipoproteins with other lipids such as cholesterol, however, the mechanisms responsible for carotenoid storage in tissues and their non-enzymatic elimination remain relatively unexplored. The goal of this study was to examine the contribution of the low-density lipoprotein receptor (LDLR) in the bodily distribution and disposal of carotenoids. Methods: We employed mice lacking one or both carotenoid-cleaving enzymes as suitable models for carotenoid accumulation. We examined the contribution of LDLR in carotenoid distribution by crossbreeding these mice with Ldlr-/- mice or overexpressing LDLR in the liver. Results: Our results show that LDLR plays a dual role in carotenoid homeostasis by simultaneously favoring carotenoid storage in the liver and adipose tissue while facilitating their fecal elimination. Conclusions: Our results highlight a novel role of the LDLR in carotenoid homeostasis, and unveil a previously unrecognized disposal pathway for these important bioactive molecules.

Summary: Background: Prospective associations between total and groups of ultra-processed foods (UPF) and cardiovascular disease (CVD) remained to be characterised. Our aim was to assess the association of total and group-specific UPF intakes with CVD, coronary heart disease (CHD), and stroke in three large prospective cohorts of US adults. Additionally, we conducted a systematic review and meta-analyses on the existing evidence on the associations of total UPF intake with these outcomes. Methods: UPF intake was assessed through food frequency questionnaires in the Nurses’ Health Study (NHS; n = 75,735), Nurses’ Health Study II (NHSII; n = 90,813), and Health Professionals Follow-Up Study (HPFS; n = 40,409). Cox regression estimated cohort-specific associations of total and group-specific UPF intake with risk of CVD (cases = 16,800), CHD (cases = 10,401), and stroke (cases = 6758), subsequently pooled through fixed-effect models. Random-effects meta-analyses pooled existing prospective findings on the UPF-CVD association identified on Medline and Embase up to April 5, 2024, without language restrictions. Risk of bias was assessed with the Newcastle–Ottawa Scale, funnel plots, and Egger’s tests, and meta-evidence was evaluated using NutriGrade. Findings: The baseline mean (SD) age was 50.8 years (7.2) for the NHS, 36.7 years (4.6) for the NHSII, and 53.4 years (9.6) for the HPFS. The proportion of participants of White race was 97.7% in the NHS, 96.4% in the NHSII, and 94.9% in the HPFS. Among the three cohorts, multivariable-adjusted hazard ratios [HRs (95% CIs)] for CVD, CHD, and stroke for the highest (vs. lowest) total UPF intake quintile were 1.11 (1.06–1.16), 1.16 (1.09–1.24), and 1.04 (0.96–1.12), respectively. UPF groups demonstrated divergent associations. Sugar-/artificially-sweetened drinks and processed meats were associated with higher CVD risk, whereas inverse associations were observed for bread/cold cereals, yoghurt/dairy desserts, and savoury snacks. Meta-analysing 22 prospective studies showed that total UPF intake at the highest category (vs. lowest) was associated with 17% (11%–24%), 23% (12%–34%), and 9% (3%–15%) higher CVD, CHD, and stroke risk. Meta-evidence quality was high for CHD, moderate for CVD, and low for stroke. Interpretation: Total UPF intake was adversely associated with CVD and CHD risk in US adults, corroborated by prospective studies from multiple countries, also suggesting a small excess stroke risk. Nutritional advice for cardiovascular health should consider differential consequences of group-specific UPF. Replication is needed in racially/ethnically-diverse populations. Funding: National Institutes of Health (NIH) grants supported the NHS, NHSII, and HPFS.

Abstract Background Nurses around the world are expected to demonstrate competence in performing mental status evaluation. However, there is a gap between what is taught in class and what is practiced for patients with mental illness among nursing students during MSE performance. It is believed that proper pedagogics may enhance this competence. A longitudinal controlled quasi-experimental study design was used to evaluate the effect of using standardized patient simulation-based pedagogics embedded with a lecture in enhancing mental status evaluation cognition among nursing students in Tanzania. Methods A longitudinal controlled quasi-experimental study design with pre-and post-test design studied 311 nursing students in the Tanga and Dodoma regions. The Standardized Patient Simulation-Based Pedagogy (SPSP) package was administered to the intervention group. Both groups underwent baseline and post-test assessments using a Interviewer-adminstered structured questionnaire as the primary data collection tool, which was benchmarked from previous studies. The effectiveness of the intervention was assessed using both descriptive and inferential statistics, specifically the Difference in Difference linear mixed model, and the t-test was carried out using IBM Statistical Package for Social Science (SPSS) software, version 25. Results The participant’s mean age was 21 years ± 2.69 with 68.81% of the students being female. Following the training Students in the intervention group demonstrated a significant increase in MSE cognition post-test, with an overall mean score of (M ± SD = 22.15 ± 4.42;p =

Abstract Background Dietary patterns, encompassing an overall view of individuals’ dietary intake, are suggested as a suitable means of assessing nutrition’s role in chronic disease development. The aim of this study was to evaluate the validity and reproducibility of a food frequency questionnaire (FFQ) designed for use in the Prospective Epidemiological Research Studies in IrAN (PERSIAN), by comparing major dietary patterns assessed by the FFQ with a reference method. Methods Study participants included men and women who enrolled in the PERSIAN Cohort Study at seven of the eighteen centers. These centers were chosen to include dietary variations observed among the different Iranian ethnic populations. Two FFQ were completed for each participant over a one-year study period (FFQ1 upon enrollment and FFQ2 at the end of the study), with 24 interviewer-administered 24-hour dietary recalls (24 h) being completed monthly in between. Spearman correlation coefficients (SCC) were used comparing FFQs 1 and 2 to the 24 h to assess validity, while FFQ1 was compared to FFQ2 to assess reproducibility of the questionnaire. Results Three major dietary patterns—Healthy, Low Protein/High Carb and Unhealthy—were identified, accounting for 70% of variance in the study population. Corrected SCC ranged from 0.31 to 0.61 in the validity and from 0.34 to 0.57 in reproducibility analyses, with the first two patterns, which accounted for over 50% of population variance, correlated at above 0.5 in both parameters, showing acceptable findings. Conclusions The PERSIAN Cohort FFQ is suitable for identification of major dietary patterns in the populations it is used for, in order to assess diet-disease relationships.

Background: The increase in doctoral programs and certifications in the area of engineering education has led to an increase in Engineering Education Scholars (EES) on the job market. As EES seek to find the position that is the correct fit for them, it is important that they have an understanding of the variety of roles that exist, and the flexibility within these roles, to be able to attain their desired career goals. Purpose/Hypothesis: Through our work, we leveraged the model of job crafting to address the following research questions: (1) How do early-career EES craft their roles and responsibilities to achieve their personal and professional goals? and (2) What job crafting practices do early-career EES use as part of their position enactment to make meaning of their positions? Design/Method: Semi-structured interviews were conducted with early-career EES to determine the responsibilities of their roles, the ways in which they are evaluated, and the participants’ own belief and goals for the role, as well as the challenges they encountered and the advice they would provide to others. The job crafting model was used to draft a provisional coding framework that was then applied across each of the transcribed interviews. Finally, memos were reviewed for synergies to develop the personas presented in the results. Results: We identified three personas that characterize the diverse approaches EES take within their positions. Each of these personas employed different job crafting strategies in their position to achieve their goals. While each persona relied heavily on relational crafting, not all personas used all job crafting strategies. Conclusions: This work identified research-based representations of engineering education faculty roles and how job crafting strategies are useful for allowing EES to align their professional and personal goals with their desired role.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the etiological agent of COVID-19, is known to infect people of all ages and both sexes. Senior populations have the greatest risk of severe COVID-19, and sexual dimorphism in clinical outcomes has been reported. Neurological symptoms are widely observed in COVID-19 patients, with many survivors exhibiting persistent neurological and cognitive impairment. The present study aims to investigate the impact of age and sex on the neuroinflammatory response to SARS-CoV-2 infection using a mouse model. Wild-type C57BL/6J mice were intranasally inoculated with SARS-CoV-2 lineage B.1.351, a variant known to infect mice. Older male mice exhibited a significantly greater weight loss and higher viral loads in the lung at 3 days post infection. Notably, no viral RNA was detected in the brains of infected mice. Nevertheless, expression of IL-6, TNF-α, and CCL-2 in the lung and brain increased with viral infection. RNA-seq transcriptomic analysis of brains showed that SARS-CoV-2 infection caused significant changes in gene expression profiles, implicating innate immunity, defense response to virus, and cerebrovascular and neuronal functions. These findings demonstrate that SARS-CoV-2 infection triggers a neuroinflammatory response, despite the lack of detectable virus in the brain. Aberrant activation of innate immune response, disruption of blood-brain barrier and endothelial cell integrity, and suppression of neuronal activity and axonogenesis underlie the impact of SARS-CoV-2 infection on the brain. Understanding the role of these affected pathways in SARS-CoV-2 pathogenesis helps identify appropriate points of therapeutic interventions to alleviate neurological dysfunction observed during COVID-19.

Abstract Background Dairy contains a complex mixture of lipids, proteins, and micronutrients. Whether habitual dairy consumption is associated with health benefits is not well established. Since dairy is high in nutrients that are potentially protective against frailty, the association between dairy products and the risk of frailty is of interest. Methods We analyzed data from 85,280 women aged ≥ 60 years participating in the Nurses’ Health Study. Consumption of milk, yogurt, and cheese was obtained from repeated food frequency questionnaires administered between 1980 and 2010. Frailty was defined as having at least three of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥ 5 chronic illnesses, and a weight loss of ≥ 5%. The occurrence of frailty was assessed every four years from 1992 to 2018. Cox proportional hazard models were used to examine the association between the intake of dairy foods and frailty. Results During follow-up we identified 15,912 incident cases of frailty. Consumption of milk or yogurt was not associated with the risk of frailty after adjustment for lifestyle factors, medication use, and overall diet quality. Cheese consumption was positively associated with risk of frailty [relative risk (95% confidence interval) for one serving/day increment in consumption: 1.10 (1.05, 1.16)]. Replacing one serving/day of milk, yogurt, or cheese with one serving/day of whole grains, nuts, or legumes was associated with a significant lower risk of frailty, while replacing milk, yogurt, or cheese with red meat or eggs was associated with an increased risk. When milk was replaced with a sugar-sweetened or artificially sweetened beverage, a greater risk of frailty was observed, while replacing milk with orange juice was associated with a lower risk of frailty. Conclusions The results suggest that the association between milk, yogurt, and cheese and frailty partly depends on the replacement product. Habitual consumption of milk or yogurt was not associated with risk of frailty, whereas cheese consumption may be associated with an increased risk.

Background: Overcompression of the distal tibiofibular syndesmosis during open reduction and internal fixation of ankle fracture may affect multidirectional flexibility of the ankle bones. Methods: Ten cadaveric lower limbs (78.3±13.0 years, 4 female, 6 male) underwent biomechanical testing in sagittal, coronal, and axial rotation with degrees of motion quantified. The intact force (100%) was the force needed to compress the syndesmosis just beyond the intact position, and overcompression was defined as 150% of the intact force. After intact testing, the anterior inferior tibiofibular ligament (AITFL), interosseus membrane (IOM), and posterior inferior tibiofibular ligament (PITFL) were sectioned and testing was repeated. The IOM and AITFL were reconstructed in sequence and tested at 100% and 150% compression. Results: Overcompression of the syndesmosis did not significantly reduce ROM of the ankle bones for any loading modality ( P > .05). IOM+AITFL reconstruction restored distal tibiofibular axial rotation to the intact condition. Axial rotation motion was significantly lower with AITFL fixation compared with IOM fixation alone ( P

Abstract Aim The study assessed the knowledge, attitude, intentional practice and individualized factors of COVID‐19 vaccine uptake among adults in Tanzania. Design Hospital‐based analytical cross‐sectional study. Methods Quantitative approaches were adopted to study 312 randomly selected adults using an interviewer‐administered structured questionnaire. Descriptive analysis established frequencies and percentages of variables at a 95% confidence interval and a 5% significance level. Results Mean age was 24.66 ± 6.503 of which 61.5% were males. 86.9% of them were not vaccinated. 57.7% of respondents had inadequate knowledge about the COVID‐19 vaccine, and 61.5% had negative attitudes towards it. 63.8% of adults demonstrated an unwillingness to be vaccinated. Participants' sociodemographic characteristics profiles were significantly associated with COVID‐19 vaccine knowledge, attitude and willingness to uptake it (p

Background Accurate quantification of sodium intake based on self‐reported dietary assessments has been a persistent challenge. We aimed to apply machine‐learning (ML) algorithms to predict 24‐hour urinary sodium excretion from self‐reported questionnaire information. Methods and Results We analyzed 3454 participants from the NHS (Nurses' Health Study), NHS‐II (Nurses' Health Study II), and HPFS (Health Professionals Follow‐Up Study), with repeated measures of 24‐hour urinary sodium excretion over 1 year. We used an ensemble approach to predict averaged 24‐hour urinary sodium excretion using 36 characteristics. The TOHP‐I (Trial of Hypertension Prevention I) was used for the external validation. The final ML algorithms were applied to 167 920 nonhypertensive adults with 30‐year follow‐up to estimate confounder‐adjusted hazard ratio (HR) of incident hypertension for predicted sodium. Averaged 24‐hour urinary sodium excretion was better predicted and calibrated with ML compared with the food frequency questionnaire (Spearman correlation coefficient, 0.51 [95% CI, 0.49–0.54] with ML; 0.19 [95% CI, 0.16–0.23] with the food frequency questionnaire; 0.46 [95% CI, 0.42–0.50] in the TOHP‐I). However, the prediction heavily depended on body size, and the prediction of energy‐adjusted 24‐hour sodium excretion was modestly better using ML. ML‐predicted sodium was modestly more strongly associated than food frequency questionnaire‐based sodium in the NHS‐II (HR comparing Q5 versus Q1, 1.48 [95% CI, 1.40–1.56] with ML; 1.04 [95% CI, 0.99–1.08] with the food frequency questionnaire), but no material differences were observed in the NHS or HPFS. Conclusions The present ML algorithm improved prediction of participants' absolute 24‐hour urinary sodium excretion. The present algorithms may be a generalizable approach for predicting absolute sodium intake but do not substantially reduce the bias stemming from measurement error in disease associations.

Background Food insecurity, a social and economic condition of limited availability of healthy food, is a risk factor for adverse cardiovascular health outcomes among adults; few studies have been conducted in adolescents. This study explores the association between food insecurity and cardiovascular health risk factors among a nationally representative sample of US adolescents, adopting the American Heart Association's Life's Essential 8 metric. Methods and Results We analyzed data from 2534 adolescents aged 12 to 19 years from the 2013 to 2018 National Health and Nutrition Examination Surveys. In the sample, 24.8% of adolescents lived in food‐insecure households. After multivariable adjustment, food insecurity was associated with a 3.23‐unit lower total Life's Essential 8 score (95% CI, −6.32, −0.15) and lower scores on diet quality (β=−5.39 [95% CI, −8.91, −1.87]) and nicotine exposure (β=−4.85 [95% CI, −9.24, −0.45]). Regarding diet, food insecurity was associated with 5% lower Healthy Eating Index‐2015 scores [95% CI, −7%, −2%], particularly lower intakes of whole grains and seafood/plant proteins and marginally higher intake of added sugar. Regarding nicotine exposure, food insecurity was associated with ever use of a tobacco product among m (odds ratio, 1.74 [95% CI, 1.20–2.53]). Compared with their food‐secure counterparts, food‐insecure male (odds ratio, 1.98 [95% CI, 1.07–3.65]) and female (odds ratio, 3.22 [95% CI, 1.60–6.45]) adolescents had higher odds of living with a current indoor smoker. Conclusions In this nationally representative sample of adolescents, food insecurity was associated with multiple indicators of cardiovascular health risk. These findings underscore the need for public health interventions and policies to reduce food insecurity and improve cardioprotective behaviors during adolescence, with particular efforts targeting diet quality and nicotine exposure.

Spinal cord injury (SCI) is associated with currently irreversible consequences in several functional components of the central nervous system. Despite the severity of injury, there remains no approved treatment to restore function. However, with a growing number of preclinical studies and clinical trials, cell transplantation has gained significant potential as a treatment for SCI. Researchers have identified several cell types as potential candidates for transplantation. To optimize successful functional outcomes after transplantation, one key factor concerns generating neuronal cells with regional and subtype specificity, thus calling on the developmental transcriptome patterning of spinal cord cells. A potential source of spinal cord cells for transplantation is the generation of exogenic neuronal progenitor cells via the emerging technologies of gene editing and blastocyst complementation. This review highlights the use of cell transplantation to treat SCI in the context of relevant developmental gene expression patterns useful for producing regionally specific exogenic spinal cells via in vitro differentiation and blastocyst complementation.

Background: The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet may slow cognitive decline in older adults. A potential mechanism could be possible anti-inflammatory properties of the MIND-diet. Objective: To examine whether adherence to the MIND diet at baseline is associated with the odds of mild cognitive impairment (MCI) and changes in biomarkers of inflammation (High-sensitivity C-reactive Protein(hsCRP), interleukin-6(IL-6)) over three years in adults ≥70 years. Methods: Adherence to the MIND diet was assessed by food frequency questionnaire (FFQ) at baseline and after three years. Presence of MCI based on the Montreal Cognitive Assessment (MoCA) was defined as

Background: Engineers, educators, and policymakers throughout the United States have been trying to diversify engineering for decades. In response to this shared aspiration, professionals and educators from engineering and other STEM disciplines have constructed Broadening Participation as a phenomenon involving individual and collective efforts in the form of both research and practice. Purpose: The purpose of this paper is to advance the science of Broadening Participation by explaining the relationship between research and practice in this context. Scope: As part of a larger project funded by the National Science Foundation focused on Broadening Participation-efforts aimed at Black Americans, we used Ecological Systems Theory to organize insights from literature, interviews with subject matter experts, and the collective sensemaking of our author team. Discussion/Conclusions: Our insights highlight how Broadening Participation is a sociopolitical phenomenon resulting from social, political, and historical influences related to diversifying engineering. We share these insights in language familiar to engineers (i.e., systems thinking) in hopes to advance stakeholders’ understanding of Broadening Participation. In doing so, our aim is to give the field of engineering an alternative heuristic for conceptualizing, discussing, and approaching Broadening Participation. Though this paper is primarily written from the perspective of Black Americans, it is intended to be useful to the field broadly.

Background Sperm acrosomal SLLP1 binding (SAS1B) protein is found in oocytes, which is necessary for sperm-oocyte interaction, and also in uterine and pancreatic cancers. Anti-SAS1B antibody-drug conjugates (ADCs) arrested growth in these cancers. However, SAS1B expression in cancers and normal tissues has not been characterized. We hypothesized that SAS1B is expressed on the surface of other common solid cancer cells, but not on normal tissue cells, and might be selectively targeted therapeutically.Methods SAS1B expression in human normal and cancer tissues was determined by immunohistochemistry, and complementary DNA (cDNA) libraries were employed to PCR amplify human SAS1B and its transcripts. Monoclonal antibodies (mAbs) to human SAS1B were generated using mouse hybridomas. SAS1B deletion constructs were developed to map SAS1B’s epitope, enabling the creation of a blocking peptide. Indirect immunofluorescence (IIF) of human transfected normal and cancer cells was performed to assess SAS1B expression. SAS1B intracellular versus surface expression in normal and tumor tissues was evaluated by flow cytometry after staining with anti-SAS1B mAb, with specificity confirmed with the blocking peptide. Human cancer lines were treated with increasing mAb and ADC concentrations. ATP was quantitated as a measure of cell viability.Results SAS1B expression was identified in a subset of human cancers and the cytoplasm of pancreatic islet cells. Two new SAS1B splice variants were deduced. Monoclonal antibodies were generated to SAS1B splice variant A. The epitope for mAbs SB2 and SB5 is between SAS1B amino acids 32–39. IIF demonstrated intracellular SAS1B expression in transfected kidney cells and on the cell surface of squamous cell lung carcinoma. Flow cytometry demonstrated intracellular SAS1B expression in all tumors and some normal cells. However, surface expression of SAS1B was identified only on cancer cells. SB2 ADC mediated dose-dependent cytotoxic killing of multiple human cancer lines.Conclusion SAS1B is a novel cancer-oocyte antigen with cell surface expression restricted to cancer cells. In vitro, it is an effective target for antibody-mediated cancer cell lysis. These findings support further exploration of SAS1B as a potential therapeutic cancer target in multiple human cancers, either with ADC or as a chimeric antigen receptor-T (CAR-T) cell target.

Introduction The Department of Veterans Affairs (VA) Million Veteran Program (MVP) nutrition data is derived from dietary food/beverage intake information collected through a semiquantitative food frequency questionnaire (SFFQ). Methods Estimates of dietary energy, nutrient, and non-nutritive food components intakes data were derived from an extensively validated SFFQ, which assessed the habitual frequency of consumption of 61 food items, added sugar, fried food frequency, and 21 nutritional supplements over the 12 months preceding questionnaire administration. Results Complete nutrition data was available for 353,418 MVP participants as of 30th September 2021. Overall, 91.5% of MVP participants with nutrition data were male with an average age of 65.7 years at enrollment. Participants who completed the SFFQ were primarily White (82.5%), and Blacks accounted for 13.2% of the responders. Mean ± SD energy intake for 353, 418 MVP participants was 1428 ±616 kcal/day, which was 1434 ±617 kcal/day for males and 1364 ±601 kcal/day for females. Energy intake and information on 322 nutrients and non-nutritive food components is available through contact with MVP for research collaborations at www.research.va.gov/mvp. Conclusions The energy and nutrient data derived from MVP SFFQ are an invaluable resource for Veteran health and research. In conjunction with the MVP Lifestyle Survey, electronic health records, and genomic data, MVP nutrition data may be used to assess nutritional status and related risk factors, disease prevalence, and determinants of health that can provide scientific support for the development of evidence-based public health policy and health promotion programs and services for Veterans and general population.

Introduction: Excessive consumption of comfort foods, which are mostly high in carbs, and limitations on outdoor and gym-based physical activities, for instance, are associated with foods high in the glycemic index and raise the risk of obesity and type 2 diabetes. In pandemic and or epidemic situations, peoples’ lifestyles may change significantly to lead them to non-communicable diseases. However, lifestyle changes and the occurrence of type 2 diabetes mellitus during the Coronavirus Disease 2019 pandemic among adults have not been well established in Tanzania. This study assessed the prevalence, medication adherence, and determinants of type 2 diabetes mellitus among adults in the country. Methods: A community-based analytical cross-sectional study was conducted in Dodoma region, Tanzania between September and October 2020 of which 107 adults aged above 18 years were studied regardless of whether they were newly diagnosed with type 2 diabetes mellitus or not using a quantitative research approach. Interviewer-administered lifestyle habits and medication adherence structured questionnaires benchmarked from previous studies served as the main tools of data collection. The statistical package for social sciences computer program was used to analyze the data descriptively for frequencies and percentages and by regression analysis model to determine the association between variables with a 95% confidence interval and 5% significance level. Results: With a mean age of 31 ± 2.527 years, 59.8% of the respondents were female. 60.7% and 11.7% of the respondents had unhealthy and moderate lifestyle choices respectively. The prevalence of type 2 diabetes mellitus accounted for 63.9% of the respondents of which 44.6% were diagnostically confirmed during the Coronavirus Disease 2019 pandemic against 19.3% of respondents who were diagnosed before the pandemic. Medication adherence among the type 2 diabetes mellitus respondents accounted for 77.9% of the study respondents. Type 2 diabetes mellitus was significantly associated with being in the 36–55 age group (AOR = 1.054; 95% CI: 0.292, 3.162; p

Abstract Introduction With an increasing number of nursing students in higher education institutions in Tanzania, traditional student presentation pedagogies are insufficient to enhance effective learning. Pecha Kucha presentation is a new promising approach that can improve students’ speaking skills, learning process, creativity, and students’ engagement in learning. It involves the use of 20 slides where each covers 20 s, thus making a total of 6 min and 40 s. The current study will assess the effect of Pecha Kucha’s presentation on presentation knowledge, skills, and learning satisfaction among nursing students in Tanzania. Objectives The objectives of this study aimed to determine the baseline and end-line of Pecha Kucha Presentation knowledge, skills, and learning satisfaction among nursing students. Methods This study protocol proposes to employ an uncontrolled quasi-experimental study design with a quantitative approach among 230 university nursing students in Dodoma Region using simple and stratified sampling techniques. It proposes to employ the researcher-administered questionnaire to assess study variables that arise as students use the Pecha Kucha presentation format to prepare and present their assignments. The study will involve training of research assistants, pre-assessment of study variables, and training, and demonstration of Pecha Kucha presentations format among study participants. It will also involve assigning topics to study participants, submission and evaluation of the prepared assignments, participants’ presentations in the classroom, post-intervention assessment, data analysis, reporting and dissemination of the study findings. Conclusion This study will address and complement the global need to invest in nursing in an attempt to prepare competent nurses who are capable of solving complex health challenges through critical thinking, analysis, collaboration, and effective communication. The study will inform policymakers, health training institutions, and educators about a new engaging, and innovative nursing student presentation approach that enhances students’ creativity, critical thinking skills, and meaningful learning. The referred nursing students’ presentation approach intends to equip the students with survival and life skills in the 21st century in an attempt to meet the global economy and job opportunities. Trial registration It is not applicable as this is not a trial.

Abstract Background Unsafe sexual behaviours and associated sexual ideas among adolescents may contribute to adverse health consequences for sexual health in adulthood. The patterns of sexual ideology and sociodemographic factors profiles on adolescents' sexual behaviours have not been the subject of a definite consensus in research. The purpose of this study was to investigate the attitude and prevalence of early sexual debut and associated risk sexual behavior among adolescents in Tanzania as the evidence from baseline data in a Randomized Controlled Trial. Methods The study included 647 randomly chosen in-school adolescents from Tanzania and used an analytical cross-section survey in a quantitative research approach. Sexual-risk Behaviour Beliefs and Self-esteem Scale from previous studies were the main data collection tool. According to the Statistical Analysis Software (SAS), computer software version 9.4 descriptive analysis established respondents' socio-demographic profiles, attitudes, prevalence, and determinants linked to teenagers' early sexual debut. The link between the variables was established via multivariate logistic regression at a 5% significance level and a 95% confidence interval. Results The mean age was 15 ± 1.869 years while 57.5% of adolescents were females. 69.7% of adolescents were sexually active whereas 44.8% of them practised sexual behaviours willingly against 24.9% who practised coerced sexual behaviours. The majority (44.4%) and 16.2% of them initiated sexual behaviours during the early and middle adolescence stages respectively. Most adolescents had the ideology that sex was okay to them even before the age of 18 years. Their odds of practicing sexual behaviours were significantly high with the ideology that sex was okay to them even before 18 years of age (AOR = 1.293; p

Stroke is the number one cause of morbidity in the United States and number two cause of death worldwide. There is a critical unmet medical need for more effective treatments of ischemic stroke, and this need is increasing with the shift in demographics to an older population. Recently, several studies have reported the therapeutic potential of stem cell-derived exosomes as new candidates for cell-free treatment in stoke. This review focuses on the use of stem cell-derived exosomes as a potential treatment tool for stroke patients. Therapy using exosomes can have a clear clinical advantage over stem cell transplantation in terms of safety, cost, and convenience, as well as reducing bench-to-bed latency due to fewer regulatory milestones. In this review article, we focus on (1) the therapeutic potential of exosomes in stroke treatment, (2) the optimization process of upstream and downstream production, and (3) preclinical application in a stroke animal model. Finally, we discuss the limitations and challenges faced by exosome therapy in future clinical applications.

Abstract Mucopolysaccharidosis type I (MPS I) is an inherited lysosomal disorder that causes syndromes characterized by physiological dysfunction in many organs and tissues. Despite the recognizable morphological and behavioral deficits associated with MPS I, neither the underlying alterations in functional neural connectivity nor its restoration following gene therapy have been shown. By employing high-resolution resting-state fMRI (rs-fMRI), we found significant reductions in functional neural connectivity in the limbic areas of the brain that play key roles in learning and memory in MPS I mice, and that adeno-associated virus (AAV)-mediated gene therapy can reestablish most brain connectivity. Using logistic regression in MPS I and treated animals, we identified functional networks with the most alterations. The rs-fMRI and statistical methods should be translatable into clinical evaluation of humans with neurological disorders.

Background: The effects of non-pharmaceutical interventions in the prevention of cardiovascular diseases (CVD) in older adults remains unclear. Therefore, the aim was to investigate the effect of 2000 IU/day of vitamin D3, omega-3 fatty acids (1 g/day), and a simple home strength exercise program (SHEP) (3×/week) on lipid and CVD biomarkers plasma changes over 3 years, incident hypertension and major cardiovascular events (MACE). Methods: The risk of MACE (coronary heart event or intervention, heart failure, stroke) was an exploratory endpoint of DO-HEALTH, incident hypertension and change in biomarkers were secondary endpoints. DO-HEALTH is a completed multicentre, randomised, placebo-controlled, 2 × 2 × 2 factorial design trial enrolling 2157 Europeans aged ≥70 years. Results: Participants’ median age was 74 [72, 77] years, 61.7% were women, 82.5% were at least moderately physically active, and 40.7% had 25(OH)D < 20 ng/mL at baseline.Compared to their controls, omega-3 increased HDL-cholesterol (difference in change over 3 years: 0.08 mmol/L, 95% CI 0.05–0.10), decreased triglycerides (−0.08 mmol/L, (95%CI −0.12 to −0.03), but increased total– (0.15 mmol/L, 95%CI 0.09; 0.2), LDL– (0.11 mmol/L, 0.06; 0.16), and non-HDL-cholesterol (0.07 mmol/L, 95%CI 0.02; 0.12). However, neither omega-3 (adjustedHR 1.00, 95%CI 0.64–1.56), nor vitamin D3 (aHR 1.37, 95%CI 0.88–2.14), nor SHEP (aHR 1.18, 95%CI 0.76–1.84) reduced risk of MACE or incident hypertension compared to control. Conclusion: Among generally healthy, active, and largely vitamin D replete, older adults, treatment with omega-3, vitamin D3, and/or SHEP had no benefit on MACE prevention. Only omega-3 supplementation changed lipid biomarkers, but with mixed effects. Trial registration ClinicalTrials.gov identifier: NCT01745263.

The positive Arctic–methane (CH4) feedback forms when more CH4 is released from the Arctic tundra to warm the climate, further stimulating the Arctic to emit CH4. This study utilized the CLM-Microbe model to project CH4 emissions across five distinct Arctic tundra ecosystems on the Alaska North Slope, considering three Shared Socioeconomic Pathway (SSP) scenarios using climate data from three climate models from 2016 to 2100. Employing a hyper-resolution of 5 m × 5 m within 40,000 m2 domains accounted for the Arctic tundra’s high spatial heterogeneity; three sites were near Utqiaġvik (US-Beo, US-Bes, and US-Brw), with one each in Atqasuk (US-Atq) and Ivotuk (US-Ivo). Simulated CH4 emissions substantially increased by a factor of 5.3 to 7.5 under the SSP5–8.5 scenario compared to the SSP1–2.6 and SSP2–4.5 scenarios. The projected CH4 emissions exhibited a stronger response to rising temperature under the SSP5–8.5 scenario than under the SSP1–2.6 and SSP2–4.5 scenarios, primarily due to strong temperature dependence and the enhanced precipitation-induced expansion of anoxic conditions that promoted methanogenesis. The CH4 transport via ebullition and plant-mediated transport is projected to increase under all three SSP scenarios, and ebullition dominated CH4 transport by 2100 across five sites. Projected CH4 emissions varied in temperature sensitivity, with a Q10 range of 2.7 to 60.9 under SSP1–2.6, 3.8 to 17.6 under SSP2–4.5, and 5.7 to 17.2 under SSP5–8.5. Compared with the other three sites, US-Atq and US-Ivo were estimated to have greater increases in CH4 emissions due to warmer temperatures and higher precipitation. The fact that warmer sites and warmer climate scenarios had higher CH4 emissions suggests an intensified positive Arctic–CH4 feedback in the 21st century. Microbial physiology and substrate availability dominated the enhanced CH4 production. The simulated intensified positive feedback underscores the urgent need for a more mechanistic understanding of CH4 dynamics and the development of strategies to mitigate CH4 across the Arctic.

Category: Hindfoot; Basic Sciences/Biologics Introduction/Purpose: Primary repair of mid-substance Achilles tendon rupture may be performed using an open or a percutaneous technique. Previous meta-analyses of clinical data comparing the two techniques have demonstrated mostly equivalent functional outcomes and re-rupture rates. Individual cadaveric studies have also compared the biomechanical properties of the two approaches. However, the results of these studies have been heterogeneous, and there is currently no consensus as to whether one technique may be biomechanically superior. The purpose of this meta-analysis was to evaluate the biomechanical properties of open versus percutaneous Achilles tendon repair. Methods: A systematic review of original research articles was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. To qualify for study inclusion, articles were required to be published in English, utilized a cadaveric laboratory design, and had to directly compare the biomechanical properties of open Achilles repair using a Krackow or Kessler technique versus percutaneous repair using either the PARS (Arthrex) or Achillon (Integra) tendon repair systems. Evaluated outcomes included displacement (mm), load to failure (N), and stiffness (N/m). Results: Nine studies met inclusion criteria, including 190 cadaveric specimens (open: 83, PARS: 56; Achillon: 51) that underwent primary mid-substance Achilles tendon repair. Pooled analysis demonstrated no statistically significant difference in displacement (p = 0.418; Figure 1), load to failure (p = 0.923; Figure 2), or stiffness (p = 0.195; Figure 3) between the open and percutaneous techniques. Among the percutaneous approaches, there was no difference in displacement (p = 0.109; Figure 4) between the PARS and Achillon tendon repair systems. Conclusion: The results of this study suggest that both open and percutaneous techniques are biomechanically viable approaches for primary mid-substance Achilles tendon repair. These biomechanical findings must be interpreted in the context of clinical outcomes data as well as the differing complication profiles of the two techniques to best inform the surgical decision-making process for primary mid-substance Achilles tendon repair.

Category: Trauma; Ankle Introduction/Purpose: Overtightening of the distal tibiofibular syndesmosis during open reduction and internal fixation (ORIF) of ankle fractures remains a clinical concern, and there are limited data delineating the effect of syndesmosis overcompression on subsequent range of motion of the ankle joint bones. The primary objective of the current study was to determine the effect of syndesmotic overcompression on the relative range of motion (ROM) of the tibia, fibula, and talus, and to determine the syndesmotic fixation construct that most accurately restores native motion. Methods: Ten cadaveric lower limbs were utilized (78.3±13.0 yrs, 4F; 6M). A musculoskeletal simulator at ±7.5 Nm was used to test flexibility in dorsiflexion-plantarflexion, inversion-eversion, and internal-external rotation. After intact testing, syndesmotic probes were used to arthroscopically measure the intact position of the distal tibiofibular syndesmosis. The force needed to compress the syndesmosis just beyond the intact position represented the intact force (100%), and overcompression was defined as 150% of the intact force. The anterior inferior tibiofibular ligament (AITFL), interosseus membrane (IOM), and posterior inferior tibiofibular ligament (PITFL) were then sectioned. Testing was repeated for destabilized, IOM reconstruction at 100% compression and 150% overcompression, IOM reconstruction plus AITFL fixation at 100% compression and 150% overcompression, and AITFL fixation alone. ROM data was reported as a percentage of the intact condition. Repeated measures ANOVA and Bonferroni post hoc test were performed to assess differences between conditions with p< 0.05. Results: Average force needed to compress the syndesmosis was 71.0 ± 22.2 N. There was a significant increase in distal tibiofibular ROM in internal and external rotation for all conditions compared to intact (Figure 1) (p < 0.05). In the axial plane, reconstruction of the IOM membrane did not restore the intact condition and was similar to the destabilized treatment, regardless of compression force. The addition of AITFL fixation significantly reduced distal tibiofibular motion compared to IOM reconstructions alone, but still did not approach the intact condition. Overcompression of the syndesmosis did not significantly affect relative ROM of the ankle bones in any plane (p>0.05). Changes in the proximal tibiofibular ROM were similar in magnitude and direction as the distal tibiofibular ROM for all conditions. Conclusion: In the current study, overcompression of the distal tibiofibular syndesmosis did not restrict relative ROM of the tibia, fibula, or talus. Reconstructing the AITFL in addition to the IOM decreased tibiofibular ROM, particularly in the axial plane. In the clinical setting, surgical reconstruction with dynamic fixation of the distal tibiofibular syndesmosis may result in increased ROM and mechanical stress at the proximal tibiofibular articulation.

Category: Ankle; Other Introduction/Purpose: Peroneus brevis (PB) tendon tears are an important cause of lateral ankle pain. When PB tears are irreparable, allograft reconstruction maintains native anatomy and avoids the morbidity of tenodesis and tendon transfer procedures. Current data on allograft PB reconstruction is limited to small case series. We sought to retrospectively determine the clinical outcomes and complications in a large series of patients who underwent PB tendon reconstruction with semitendinosus allograft. Methods: After institutional review board approval, patients with PB tears who underwent tendon reconstruction with semitendinosus allograft at a single tertiary center between March 2010 and January 2020 were retrospectively reviewed. Hospital records, preoperative and postoperative visual analog pain scale (VAS), and complications were evaluated. A phone survey was conducted to assess postoperative work status, use of assistive devices, satisfaction, and patient-reported outcomes (PROMIS scores). Results: Sixty-eight patients (69 feet) (24 men,44 women) were identified. Mean age at surgery was 51.7 years (range, 23.0-74.0) and mean follow-up was 20.4 months (range, 3.4-71.4). VAS pain scale improved postoperatively (4.0±2.7 vs 2.4±2.8, p=0.0012). Most common complication was sural neuralgia in 18 (26.1%) feet, but only 2 (11%) required surgery. The allograft failed in 7 (10.1%) feet (Table 1).Of 29 (42.6%) patients available for survey, 25 (86.2%) were employed preoperatively, of whom 23 (92.0%) returned to work. Of the 29 survey patients, 25 (86.2%) did not use an assistive device, 20 (69.0%) reported being satisfied, and average T-scores for physical function and pain interference were 49.5±9.7 and 50.8±9.7, respectively. Revision PB surgery (30 [43%] feet) was not associated with sural neuralgia or patient satisfaction. Conclusion: This study demonstrated a relatively high rate of postoperative transient sural neuralgia after PB reconstruction with semitendinosus allograft, but the rate of reoperation for this complication was low. Among the subgroup of patients who completed a phone survey, there was a high rate of return to work, low rate of assistive device use, and good patient satisfaction after the procedure. These findings suggest that allograft reconstruction is a clinically effective treatment for irreparable PB tendon tears when few other options exist.

Regardless of the importance of youth in socio-economic development around the globe, adolescents aged between 10 and 19 years face problems ranging from their basic to Sexual and Reproductive Health economic needs (SRH). This study determined baseline parent-adolescent communication about SRH from a randomized controlled trial of integrated reproductive health materials in a Problem-Based Pedagogy (PBP) for shaping safe sexual behavior among adolescents in Tanzania. The study employed a baseline cross-section survey from a randomized controlled trial of integrated reproductive health materials in a problem-based learning pedagogy for shaping safe sexual behavior among 647 randomly selected adolescents in Tanzanian ordinary-level secondary schools. The response rate of the study was 100% of which 57.5% were females. Totalities of 73.3% of adolescents reported having never communicated with their parents about SRH. Parent-adolescent communication about SRH matters was found to be low and thus, recommends collaborative parent-adolescent interventions to address it accordingly.

Abstract Background Higher baseline intakes of flavonoid-rich foods and beverages are associated with a lower risk of chronic disease and mortality in observational studies. However, associations between changes in intakes and mortality remain unclear. We aimed to evaluate associations between 8-year changes in intakes of (1) individual flavonoid-rich foods and (2) a composite measure (termed the ‘flavodiet’) of foods and beverages that are known to be main contributors to flavonoid intake and subsequent total and cause-specific mortality. Methods We evaluated associations between 8-year changes in intakes of (1) individual flavonoid-rich foods and (2) a novel ‘flavodiet’ score and total and cause-specific mortality. We included 55,786 females from the Nurses’ Health Study (NHS) and 29,800 males from the Health Professionals Follow-up Study (HPFS), without chronic disease at baseline in our analyses. Using multivariable-adjusted Cox proportional hazard models, we examined associations of 8-year changes in intakes of (1) flavonoid-rich foods and (2) the flavodiet score with subsequent 2-year lagged 6-year risk of mortality adjusting for baseline intakes. Data were pooled using fixed-effects meta-analyses. Results We documented 15,293 deaths in the NHS and 8988 deaths in HPFS between 1986 and 2018. For blueberries, red wine and peppers, a 5%, 4% and 9% lower risk of mortality, respectively, was seen for each 3.5 servings/week increase in intakes while for tea, a 3% lower risk was seen for each 7 servings/week increase [Pooled HR (95% CI) for blueberries; 0.95 (0.91, 0.99); red wine: 0.96 (0.93, 0.99); peppers: 0.91 (0.88, 0.95); and tea: 0.97 (0.95, 0.98)]. Conversely, a 3.5 servings/week increase in intakes of onions and grapefruit plus grapefruit juice was associated with a 5% and 6% higher risk of total mortality, respectively. An increase of 3 servings per day in the flavodiet score was associated with an 8% lower risk of total mortality [Pooled HR: 0.92 (0.89, 0.96)], and a 13% lower risk of neurological mortality [Pooled HR: 0.87 (0.79, 0.97)], after multivariable adjustments. Conclusions Encouraging an increased intake of specific flavonoid-rich foods and beverages, namely tea, blueberries, red wine, and peppers, even in middle age, may lower early mortality risk.

Abstract Background To harmonize and enhance economic growth at the individual, family, community, and national levels, healthy women embody the guardian of family health and a healthy world. They are anticipated to have the freedom to choose their identity in opposition to female genital mutilation in a thoughtful, responsible, and informed manner. Despite restrictive traditions and culture, it is unclear from the available information what exactly would be the drivers of FGM practices in Tanzania from an individual or social perspective. The purpose of this study was to evaluate female genital mutilation among women of reproductive age in terms of its frequency, knowledge, attitudes, and purposeful practice. Methods Three hundred twenty-four randomly selected Tanzanian women of reproductive age were studied using a community-based analytical cross-sectional study design quantitatively. Structured questionnaires from earlier studies that were delivered by interviewers were utilized to gather information from the study participants. The statistical software package Statistical Packages for Social Science was used to examine the data. (SPSS v.23). A 5% significance threshold was used with a 95% confidence interval. Result A total of 324 women of reproductive age participated in the study with a 100% response rate with a mean age of 25 ± 7.481 years. Findings revealed that 81.8% (n = 265) of study participants were mutilated. 85.6% (n = 277) of women had inadequate knowledge about FGM, and 75.9% (n = 246) had a negative attitude toward it. However, 68.8% (n = 223) of them were willing to practice FGM. Their age (36–49 years) (AOR = 2.053; p

We aimed to investigate the associations between maternal intake of folate, vitamin B12, B6, B2, methionine, choline, phosphatidylcholine and betaine during the period surrounding pregnancy and offspring weight outcomes from birth to early adulthood. These associations were examined among 2454 mother–child pairs from the Nurses’ Health Study II and Growing Up Today Study. Maternal energy-adjusted nutrient intakes were derived from food frequency questionnaires. Birth weight, body size at age 5 and repeated BMI measurements were considered. Overweight/obesity was defined according to the International Obesity Task Force (p-trend: 0.003). The association was stronger among offspring born to mothers with high red meat intake (high red meat RRQ5vsQ1 = 1.50 [1.14–1.98], p-trend: 0.001; low red meat RRQ5vsQ1 = 1.05 [0.87–1.27], p-trend: 0.46; p-interaction = 0.13). Future studies confirming the association between a higher maternal phosphatidylcholine intake during pregnancy and offspring risk of being overweight or obese are needed.

Graduate education in engineering is an extremely challenging, complex entity that is difficult to change. The purpose of this exploratory research paper was to investigate the applicability of the Collective Impact framework, which has been used within community organizing contexts, to organize the change efforts of a center focused on advancing equitable graduate education within engineering. We sought to understand how the conditions of Collective Impact (i.e., common agenda, backbone organization, mutually reinforcing activities, shared measurement system, and continuous communication) could facilitate the organization of equity-focused change efforts across a college of engineering at a single institution. To achieve this, we took an action research approach. We found the Collective Impact framework to be a useful tool for organizing cross-sectional partnerships to facilitate equity-focused change in graduate education; we also found the five conditions of Collective Impact to be applicable to the higher education context, with some intentional considerations and modifications. Through coordinated efforts, the Collective Impact framework can support the goal of reorienting existing decentralized structures, resource flows, and decision processes to foster bottom-up and top-down change processes to advance equitable support for graduate students.

Four methods of computational quantum chemistry are used in a study of hyperconjugation in protonated aromatic molecules. Benzene, benzenium, toluene, and four isomeric forms of toluenium are examined using the self-consistent field level of theory followed by configuration interaction and coupled cluster calculations, as well as density functional theory. Results for proton affinities, geometric parameters, atomic populations, dipole moments, and polarizabilities are reported. The calculated results are in good agreement with previous computational studies and with experimental data. The presence of hyperconjugation is evident from the shortened carbon–carbon bond lengths in the aromatic ring and concomitant changes in dipole moments and polarizabilities. The proton affinities of benzene and toluene compare well with experimental values. The examination of all of the toluenium isomers reveals that the position of the methyl group has a minor impact on the strength of hyperconjugation, although the most stable isomer is found to be the para form. Mulliken population analyses indicate that the addition of a proton contributes to aromatic hyperconjugation and increases the strength of π-bonds at the expense of σ-bonds.

Abstract Objective: To examine the association between adherence to plant-based diets and mortality. Design: Prospective study. We calculated a plant-based diet index (PDI) by assigning positive scores to plant foods and reverse scores to animal foods. We also created a healthful PDI (hPDI) and an unhealthful PDI (uPDI) by further separating the healthy plant foods from less-healthy plant foods. Setting: The VA Million Veteran Program. Participants: 315 919 men and women aged 19–104 years who completed a FFQ at the baseline. Results: We documented 31 136 deaths during the follow-up. A higher PDI was significantly associated with lower total mortality (hazard ratio (HR) comparing extreme deciles = 0·75, 95 % CI: 0·71, 0·79, P trend < 0·001]. We observed an inverse association between hPDI and total mortality (HR comparing extreme deciles = 0·64, 95 % CI: 0·61, 0·68, P trend < 0·001), whereas uPDI was positively associated with total mortality (HR comparing extreme deciles = 1·41, 95 % CI: 1·33, 1·49, P trend < 0·001). Similar significant associations of PDI, hPDI and uPDI were also observed for CVD and cancer mortality. The associations between the PDI and total mortality were consistent among African and European American participants, and participants free from CVD and cancer and those who were diagnosed with major chronic disease at baseline. Conclusions: A greater adherence to a plant-based diet was associated with substantially lower total mortality in this large population of veterans. These findings support recommending plant-rich dietary patterns for the prevention of major chronic diseases.

Abstract Background Unplanned pregnancies and sexually transmitted infections (STIs) Human Immunodeficiency Virus (HIV) inclusive, have remained to be a significant public health challenges among young people, especially across middle and low-income countries. Self-efficacy on the right ways of using condoms appears to be effective against the aforementioned health-related problems. However, most women of reproductive age tend not to use them when they are using highly effective contraceptives such as implants, and/or injectable hormones. It is unknown whether the uptake of female condoms among young girls is significantly high or not. Examining female students’ perceived motivators, knowledge, attitudes, and self-reported and intentional female condom practice in training institutions seems to be a key precursor in addressing the challenge. Methods The institutional-based analytical cross-sectional survey in a quantitative research approach was adopted to study 384 randomly selected female students from higher training institutions, in Tanzania. Interviewer-administered structured questionnaires from previous studies were the main data collection tools. Data analysis was done using a statistical package for social science (SPSS) with the strength of statistical limits set at a 95% confidence interval and a 5% significance level. Results The response rate of the study was 100% with 24 ± 2.122 years respondents’ mean age while and 32.7% of them were in the third year of their studies. Only 6.2% of the respondents reported having used female condoms while 26.3% of them have not ever seen packages of female condoms. The minority of the respondents (21.7%, 23.3%, and 9.4%) demonstrated good knowledge, positive attitude, and intention to use female condoms respectively. Their age, accommodation, marital status, peer groups, previous training, knowledge, and attitude related significantly to their intentional practices of female condom use (p

Abstract Background The Mediterranean diet and other dietary patterns rich in fruits and vegetables have been linked to lower risk of frailty in older adults. However, not all plant‐based diets are necessarily healthful, and no previous study has evaluated the role of the quality of plant‐based dietary patterns in frailty risk. Our aim was to assess the association between plant‐based diet quality and risk of frailty. Methods Prospective cohort consisted with 82 234 women aged ≥60 years from the Nurses' Health Study, who were followed from 1990 through 2014. The dates of analysis were April 14 to June 23, 2021. Dietary data were collected every 4 years using a validated semi‐quantitative food frequency questionnaire. The plant‐based diet quality was assessed with two indices (range 18–90 points): (a) healthful plant‐based diet index (hPDI), where healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils and tea/coffee) received positive scores, while less healthy plant foods (fruit juices, sweetened beverages, refined grains, potatoes, and sweets/desserts) and animal foods received reverse scores; and (b) unhealthful plant‐based diet index (uPDI) where positive scores were given to less healthy plant foods and reverse scores to healthy plant foods and animal foods. Frailty incidence was assessed every 4 years, being defined as having three or more of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥5 illnesses and weight loss ≥5%. Multivariable‐adjusted Cox proportional‐hazards models were used to estimate hazard ratios (HRs) and their 95% confidence interval (CI). Results We identified 12 910 incident cases of frailty over 1 176 401 person‐year follow‐up. In the multivariable analysis, the hPDI was inversely associated with the risk of frailty (hazard ratio [HR] for the highest vs. lowest quintile: 0.77, 95% confidence interval: 0.72–0.81; P trend

Abstract Background Safe and healthy learning environment in pre-schools has received increased attention in promoting the well-being of pre-school children. However, pediatric injuries have remained one of the leading causes of childhood morbidity and mortality around the globe. Empowering pre-school teachers with first aid competencies have been identified as being of potential strategy against pediatric health burdens of problem. This study tested the effect of established pediatric first aid training on pre-school teachers’ knowledge, attitude, and intention to practice first aid management to pre-school children in Zanzibar. Methods Uncontrolled quasi-experimental design with a quantitative research approach was conducted in Teachers’ Resource Centers among 120 preschool teachers at Pemba Island, Zanzibar. First aid training was facilitated based on the prescribed guidelines and standards of materials adapted from the American Academy of Pediatrics and implemented. The intervention was preceded by a baseline assessment using structured questionnaires adopted from previous studies that served as the main data collection tool. Results Participants’ mean age was 32 years ± 6.2 with 84.2% of the sample being females. Given the training, post-test findings demonstrated a significant increase (p

Background The majority of adolescents are currently becoming sexually active before their 18th birthday having to battle with unsafe sexual behaviors, teenage pregnancies, sexually transmitted infections, and school dropouts. The study designed and tested the effect of integrated reproductive health lesson materials in a Problem-Based pedagogy (PBP) to enhance safe sexual behaviors among adolescents in Tanzania.Methods Clustered Randomized Controlled Trial was adopted among 660 adolescents in Tanzania. The study consisted of three research arms including pure PBP, Hybrid PBP, and Lecture-Based Pedagogy (LBP). Sexual-risk Behavior Beliefs and Self-esteem Scale adopted from previous studies measured adolescents' sexual behaviors. A Statistical Analysis Software (SAS) version 9.4 was used to analyze data. Descriptive analysis established adolescents' socio-demographic profiles. Generalized Estimating Equation (GEE) determined the effect of interventions on adolescents' intentions to practice safe sexual behaviors at a 95% confidence interval and a significance level of 5%.Results Adolescents' mean age was 15 ± 1.869 years. Sums of 57.5% (n = 380) were females. 39.5% of adolescents were sexually active whereas 44.8% of them initiated sexual intercourse by the age between 10 and 12 years. The end-line findings showed that 54.9% of adolescents in the LBP group demonstrated a significant intention to unsafe sexual behaviors against 26.3% and 30.9% of adolescents in the pure PBP and Hybrid PBP groups respectively. The Difference-In-Difference odds ratio for unsafe sexual behavior among adolescents in the Hybrid PBP and pure PBP was less (AOR = 0.30; p < 0.0001; 95%CI: 0.1398, 0.5559) and (AOR = 0.30, p < 0.0002; 95%CI: 0.1386, 0.5487) contrary to a control group respectively.Conclusion The integrated RH lesson materials in a PBP can change a spectrum of sexual behavior among adolescents in Tanzania. This study suggests school teachers and health workers work together to facilitate RH lessons using PBP to enhance safe sexual behaviors among adolescents for their healthy adulthood and future investment.Trial registration: Pan African Clinical Trial Registry identifier: PACTR202009656160779..

Background:. The use of multiple cables of sural nerve autograft is common for peripheral nerve reconstruction when injured nerve caliber exceeds the nerve graft caliber. Although the optimal matching of neural to nonneural elements and its association with functional outcomes are unknown, it is reasonable to consider maximizing the neural tissue structure available for nerve regeneration. No prior studies have compared directly the cross-sectional fascicular area between cabled nerve autografts and size-selected nerve allografts. This study evaluated the cross-sectional fascicular area between native nerve stumps and two reconstructive nerve grafting methods: cabled sural nerve autograft (CSNA) and processed nerve allograft (PNA). Methods:. CSNA from matched cadaveric specimens and PNA were used to reconstruct nerve defects in the median and ulnar nerves of six pairs of cadaveric specimens. Nerve reconstructions were done by fellowship-trained hand surgeons. The total nerve area, fascicular area, and nonfascicular area were measured histologically. Results:. The CSNA grafts had significantly less fascicular area than PNA and caliber-matched native nerve. The PNA grafts had a significantly higher percent fascicular area compared with the intercalary CNSA graft. Conclusions:. Fascicular area was significantly greater in PNA versus CSNA. The PNA consistently demonstrated a match in fascicular area closer to the native nerve stumps than CSNA, where CSNA had significantly smaller fascicular area compared with native nerve stumps.

Organ transplantation is a highly utilized treatment for many medical conditions, yet the number of patients waiting for organs far exceeds the number available. The challenges and limitations currently associated with organ transplantation and technological advances in gene editing techniques have led scientists to pursue alternate solutions to the donor organ shortage. Growing human organs in animals and harvesting those organs for transplantation into humans is one such solution. These chimeric animals usually have certain genes necessary for a specific organ’s development inhibited at an early developmental stage, followed by the addition of cultured pluripotent human cells to fill that developmental niche. The result is a chimeric animal that contains human organs which are available for transplant into a patient, circumventing some of the limitations currently involved in donor organ transplantation. In this review, we will discuss both the current scientific and legal landscape of human–animal chimera (HAC) research. We present an overview of the technological advances that allow for the creation of HACs, the patents that currently exist on these methods, as well as current public attitude and understanding that can influence HAC research policy. We complement our scientific and public attitude discussion with a regulatory overview of chimera research at both the national and state level, while also contrasting current U.S. legislation with regulations in other countries. Overall, we provide a comprehensive analysis of the legal and scientific barriers to conducting research on HACs for the generation of transplantable human organs, as well as provide recommendations for the future.

PurposeA semi-quantitative food frequency questionnaire (FFQ) was developed for use in the Prospective Epidemiological Research Studies in IrAN (PERSIAN Cohort), investigating non-communicable disease risk factors. This study aimed to assess the validity and reproducibility of this FFQ, through food group intake.MethodsParticipants, recruited from seven PERSIAN cohort centers, completed the FFQ at the beginning of the study (FFQ1) and at the end (FFQ2), with a 12-month interval in between, during which two 24-h dietary recalls (24 h) were completed each month. Correlation coefficients of the median intake of food groups recorded by the FFQs were compared to those of the 24 h to assess validity, and the two FFQs were compared to assess reproducibility of findings.ResultsOverall, data from 978 participants were included in this validation analysis. Of the 26 food groups assessed, Tea, Sugars, Whole/Refined Grains, and Solid Fats/Oils, had the strongest correlations (0.6–0.79), while Red Meat, Chicken and Eggs showed moderate correlations (0.42–0.59). The weakest correlations observed belonged to Fresh fruit Juice and Other Meats (0.23–0.32). Reproducibility was assessed among those who completed both FFQ1 and FFQ2 (n = 848), revealing moderate to strong correlations in all food groups, ranging from 0.42 in Legumes to 0.72 in both Sugar and Sweetened Drinks.ConclusionThe PERSIAN Cohort FFQ is appropriate to rank individuals based on food group intake.

Periventricular-intraventricular hemorrhage (PIVH) is common in extremely low gestational age neonates (ELGAN) and leads to motor and behavioral impairments. Currently there is no effective treatment for PIVH. Whether human nonhematopoietic umbilical cord blood-derived stem cell (nh-UCBSC) administration reduces the severity of brain injury and improves long-term motor and behavioral function was tested in an ELGAN-equivalent neonatal rat model of PIVH. In a collagenase-induced unilateral PIVH on postnatal day (P) 2 model, rat pups received a single dose of nh-UCBSCs at a dose of 1 × 10 6 cells i.p. on P6 (PIVH + UCBSC group) or were left untreated (Untreated PIVH group). Motor deficit was determined using forelimb placement, edge-push, and elevated body swing tests at 2 months ( N = 5–8). Behavior was evaluated using open field exploration and rearing tests at 4 months ( N =10–12). Cavity volume and hemispheric volume loss on the PIVH side were determined at 7 months ( N = 6–7). Outcomes were compared between the Untreated PIVH and PIVH + UCBSC groups and a Control group. Unilateral motor deficits were present in 60%–100% of rats in the Untreated PIVH group and 12.5% rats in the PIVH + UCBSC group ( P = 0.02). Untreated PIVH group exhibited a higher number of quadrant crossings in open field exploration, indicating low emotionality and poor habituation, and had a cavitary lesion and hemispheric volume loss on the PIVH side. Performance in open field exploration correlated with cavity volume ( r 2 = 0.25; P < 0.05). Compared with the Untreated PIVH group, performance in open field exploration was better ( P = 0.0025) and hemispheric volume loss was lower (19.9 ± 4.4% vs 6.1 ± 2.6%, P = 0.018) in the PIVH + UCBSC group. These results suggest that a single dose of nh-UCBSCs administered in the subacute period after PIVH reduces the severity of injury and improves neurodevelopment in neonatal rats.

Abstract Background There is evidence that an overall healthy diet is associated with lower risk of frailty. However, the effect of diet composition, specifically the role of protein intake on frailty, is mostly unclear. The aim of this study was to evaluate the intake of protein, including total, plant, animal, and dairy protein, in relation to frailty incidence in a large cohort of older women. Methods We analysed data from 85 871 women aged ≥60 participating in the Nurses' Health Study. Intake of protein was measured nine times during follow‐up from 1980 until 2010. Frailty was defined as having at least three of the following five criteria from the Fatigue, Resistance, Ambulation, Illnesses and Loss of Weight (FRAIL) scale: fatigue, low strength, reduced aerobic capacity, having ≥5 illnesses, and weight loss of ≥5%. The occurrence of frailty was assessed every 4 years from 1992 up to 2014. Results During follow‐up, we identified 13 279 incident cases of frailty. Women with a higher intake of plant protein had a lower risk of developing frailty after adjustment for all relevant confounders [relative risks across quintiles of consumption: 1.00, 0.94, 0.89, 0.86, and 0.86; P‐trend