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Little is known about uncontrolled vaping, defined as vaping more than the user prefers. We sought to understand e-cigarette users' experiences with uncontrolled vaping and how they restrain their vaping. Participants were 24 US adult e-cigarette users recruited in 2021. We conducted semi-structured qualitative interviews about uncontrolled vaping and restraint strategies and analyzed findings based on behavioral categories described in the Process Model of Self-Control. While most participants (21 of 24) described experiences of uncontrolled vaping, some expressed ambivalence about how much they vaped. To restrain vaping, willpower was rarely used and was not perceived as effective. Distraction , deployment of attention away from the urge to vape, and reappraisal , thinking differently about vaping such as reminding oneself of health consequences, were common and helped some participants limit use in the moment of wanting to vape. Participants described using both s ituation selection , choosing to be in situations where e-cigarette use was less possible, and situation modification , modifying their circumstances to restrict opportunities to vape. Uncontrolled vaping is not yet a well-defined concept for many e-cigarette users. E-cigarette users employed proactive situational strategies that required planning ahead to restrain use and found these strategies more effective compared to reactive strategies. Tobacco control programs and interventions should consider leveraging restraint strategies that people who vape are naturally using and perceive to be effective. • People may experience uncontrolled vaping, or using e-cigarettes more than desired. • Strategies to limit vaping can be mapped onto the Process Model of Self-Control. • Proactive situational strategies are seen as effective in regulating e-cigarette use. [ABSTRACT FROM AUTHOR]

The Amplatzer Vascular Plug Type II™ (AVPII) has been considered and used for the percutaneous closure of certain cases of persistent patent ductus arteriosus. Certain institutions use this device preferentially over the Amplatzer Duct Occluder Type I (ADOI). We present a series of three cases that highlight the versatility and applicability of this device, particularly in cases of adult congenital heart disease. This device is particularly useful when ductal anatomy cannot be precisely elucidated, or in adults with abnormal or difficult to define ductal anatomy. Two of the three cases presented were percutaneous interventions that were performed in Leon, Nicaragua, highlighting the use of the AVPII in resource-limited settings where device adaptability and cost are paramount. • It is often difficult to define the exact shape and conformation of a patent ductus arteriosus. • The Amplatzer Vascular Plug Type II™ (AVPII) can be used as an alternative to other occlusive devices. • In resource-limited settings, an affordable and adaptable device is preferred. [ABSTRACT FROM AUTHOR]

Purpose: Idiopathic scoliosis is generally treated by surgical derotation of the spine. A secondary goal of surgery is minimization of the 'rib hump' deformity. Previous studies have evaluated the effects of surgical releases such as diskectomy, costo-vertebral joint release, facetectomy, and costoplasty on spine mobilization and overall contribution to thoracic stability. The present study was designed to evaluate the biomechanical effects of the rib head joints alone on axial rotation, lateral bending, and segmental rotation, without diskectomy or disruption of anterior or posterior elements. Methods: Four female cadaver thoracic spines with intact sternums and rib cages were mounted in an Instron servo-hydraulic bi-axial MTS. In a 12-step sequence, the costo-vertebral and costo-transverse ligaments were released, first unilaterally from T10-T7, then bilaterally until complete disarticulation between the rib heads and the vertebral bodies. After each release, biomechanical testing, including axial rotation and lateral bending, was performed. Vertebral body displacement was also measured using electromagnetic trackers. Results: We found that rib displacement during axial rotation was significantly increased by unilateral rib head release, and torque was decreased with each successive cut. We also found increased vertebral displacement with sequential rib head release. Conclusions: Our results show that sequential costo-vertebral joint releases result in a decrease in the force required for axial rotation and lateral bending, coupled with an increase in the displacement of vertebral bodies. These findings suggest that surgical release of the costo-transverse and costo-vertebral ligaments can facilitate segmental correction in scoliosis by decreasing the torso's natural biomechanical resistance to this correction. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 3-year-old boy who was presented to the emergency department with a history of intermittent postprandial abdominal pain and vomiting. He had returned from Senegal before presentation and was previously presented with same symptoms that were attributed to viral gastroenteritis. A finding with infection with Ascaris lumbricoides and coinfection with Trichuris trichiura was made, which was treated with albendazole.

The US Preventive Services Task Force has recommended offering preexposure prophylaxis (PrEP) to individuals who are at high risk of human immunodeficiency virus acquisition. Because PrEP treatment does not prevent bacterial sexually transmitted infections (STIs), Centers for Disease Control and Prevention treatment guidelines recommend STI screening for individuals taking PrEP every 3 to 6 months. No known studies estimate STI screening among individuals using PrEP in the US South, a geographic region with high rates of human immunodeficiency virus and bacterial STIs. Objectives: The purpose of this study was to measure sexually transmitted infection (STI) testing among Medicaid enrollees initiating preexposure prophylaxis (PrEP) to prevent human immunodeficiency virus. Secondary data are in the form of Medicaid enrollment and claims data in six states in the US South. Methods: Research partnerships in six states in the US South developed a distributed research network to accomplish study aims. Each state identified all first-time PrEP users in fiscal year 2017–2018 (combined N = 990) and measured the presence of STI testing for chlamydia, syphilis, and gonorrhea through 2019. Each state calculated the percentage of individuals with at least one STI test during 3-, 6-, and 12-month follow-up periods. Results: The proportion of first-time PrEP users that received an STI test varied by state: 37% to 67% of all of the individuals in each state who initiated PrEP received a test within the first 6 months of PrEP treatment and 50% to 77% received a test within the first 12 months. Conclusions: Although the Centers for Disease Control and Prevention recommends STI testing at least every 6 months for PrEP users, our analysis of Medicaid data suggests that STI testing occurs less frequently than recommended in populations at elevated risk of syphilis, gonorrhea, and chlamydia. [ABSTRACT FROM AUTHOR]

Purpose: The ovine model is often used to evaluate new spine fusion technologies prior to clinical testing. An important aspect of designing sheep surgery protocols is to select the appropriate postoperative time period for comparing fusion outcomes. Unfortunately, determining the ideal study endpoint is complicated by the fact that prior published studies have not used consistent timeframes. Thus, the primary aim of this study was to provide a reference for investigators as to the expected fusion outcomes of control groups at varying timepoints in sheep spine surgery models.Methods: We identified published sheep fusion studies using autograft, interbody cages, and/or instrumentation. Fusion data were extracted, converted to a common scale, and analyzed across studied timepoints.Results: Overall, 29 studies of 360 fusion levels were identified: 11 ALIF (158 levels), 3 PLIF/TLIF (28 levels), 8 PLF (90 levels), and 7 ACDF (84 levels). Studied timepoints ranged from 4 to 48 weeks postoperative. In general, fusion rates varied across techniques and instrumentation. The time to reach solid fusion differed by as many as 20 weeks between control groups.Conclusions: Recommended timeframes for future studies designed to show either superiority over controls or equivalent outcomes with controls were developed based on aggregate results. Designating ideal study endpoints for sheep fusion models has both ethical implications associated with responsible use of animals in research, and economic implications given the cost of animal research. The current results can guide the development of future research methods and help investigators choose appropriate study timelines for various control groups. [ABSTRACT FROM AUTHOR]

Introduction: The rates of syphilis among pregnant women and infants have increased in recent years, particularly in the U.S. South. Although state policies require prenatal syphilis testing, recent screening rates comparable across Southern states are not known. The purpose of this study is to measure syphilis screening among Medicaid enrollees with delivery in states in the U.S. South.Methods: A total of 6 state-university research partnerships in the U.S. South developed a distributed research network to analyze Medicaid claims data using a common analytic approach for enrollees with delivery in fiscal years 2017-2018 and 2018-2019 (combined N=504,943). In 2020-2021, each state calculated the percentage of enrollees with delivery with a syphilis screen test during the first trimester, third trimester, and at any point during pregnancy. Percentages for those with first-trimester enrollment were compared with the percentages of those who enrolled in Medicaid later in pregnancy.Results: Prenatal syphilis screening during pregnancy ranged from 56% to 91%. Screening was higher among those enrolled in Medicaid during the first trimester than in those enrolled later in pregnancy.Conclusions: Despite state laws requiring syphilis screening during pregnancy, screening was much lower than 100%, and states varied in syphilis screening rates among Medicaid enrollees. Findings indicate that access to Medicaid in the first trimester is associated with higher rates of syphilis screening and that efforts to improve access to screening in practice settings are needed. [ABSTRACT FROM AUTHOR]