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Understanding genetic variation among species is essential for effective selection and breeding enhancements. This study was conducted to assess the genetic diversity among three tilapia species (Oreochromis niloticus, Oreochromis aureus, and Oreochromis mossambicus) from several rivers located in South-South Nigeria. A total of 300 samples representing the three species were used for this research. Blood samples were collected from all individuals for DNA extraction, amplification, and sequencing of the mitochondrial (mt) control region. Analysis of mitochondrial DNA revealed that Oreochromis aureus exhibited the greatest number of polymorphic sites, with a total of 225, compared to Oreochromis niloticus and Oreochromis mossambicus, which had 129 and 84 polymorphic sites, respectively. The number of haplotypes was highest in O. niloticus with five, while O. aureus and O. mossambicus each had three haplotypes. O. niloticus also demonstrated the highest haplotype diversity (0.796), whereas O. aureus showed the highest nucleotide diversity (0.139). The largest genetic distance was found between O. aureus and O. mossambicus (0.388), whereas the smallest genetic distance was noted between O. niloticus and O. mossambicus (0.217). Enhancing tilapia production in Nigeria can be achieved by selectively breeding tilapia from the Itu, Ethiope, and New Calabar Rivers, which exhibited high genetic variation. [ABSTRACT FROM AUTHOR]

The UNSCEAR (2000) observed that there could be some exposure at work which would require regulatory control but is not really considered. This study was, therefore, set up to evaluate the effective dose in timber industries in Calabar, Nigeria to determine if the evaluated dose levels could lead to any radiological health effect in the workers, and also determine if the industries require regulatory control. The gamma ray exposure at four timber industries measured using an exposure meter were converted to effective dose and compared with the public and occupational values. The evaluated effective dose values in the timber industries were below public and occupational exposure limits and may not necessarily result in any radiological health hazard. Therefore, they may not require regulatory control.

Preparation for the bioremediation of petroleum contaminants is explored to provide a low-cost and capable strategy for biodegradation of contaminants and renewal of soil fertility. In this study, fermented chicken droppings were used as novel in-situ bio-stimulants and bio-augmentation materials. The investigation determines the capability of fermented chicken droppings to biodegrade the residual total petroleum hydrocarbon compounds in-used engine oil contaminated soil – in the case of auto mechanic shops. The soil was collected at 10 cm depth from the ground, air-dried and sieved with 2.5mm mesh. A 4 kg of soil was weighed into 13 perforated buckets to allow aeration and prevent waterlogging. The setup consists of three replicates that were spiked with 150 ml of used engine oil. 500 ml of the fermented chicken droppings were used to irrigate the contaminated soil at ratio 1:8 periodically for every 3 days per irrigation for 21 days. The uncontaminated soil used as the control group was irrigated with normal water. The TPH composition of the contaminated and remediated soil samples was screened using gas Chromatography tandem mass spectroscopy. Results show that the uncontaminated soil (A-group) had C10 - 24.058 ± 0.02 ppm, C12 - 37.327 ± 0.01 ppm, C14 - 28.515 ± 0.02 ppm and C16 - 12.097 ± 0.02 ppm, respectively out of about 35 TPH compounds that ought to be detected from C8 to C40. The Concentration of TPH in Contaminated soil before irrigation with Chicken droppings – positive control (ppm) B-group gave a significant qualitative and quantitative presence of TPHs in contaminated soil at varying concentrations. 36 TPHs were detected out of forty, starting from C10 - 1.836 ± 0.01 ppm to C38 - 50.150±0.01 ppm. Whereas, the Concentration of residual TPH in Contaminated soil after irrigation with Chicken droppings gave varying levels of residual TPHs ranging from C8 - 1.519 ± 0.02 ppm to C38 - 41.487 ±0.02 ppm. This also gave a resultant/differences in the degradation level of TPHs. Differences in TPH Concentration between before the irrigation and after irrigation of contaminated soil were calculated, C8 had - 0.317 ppm while another TPHs concentration varies accordingly. From the results, one can be deduced that despite other environmental factors that influence the degradation of TPHs, fermented chicken d [ABSTRACT FROM AUTHOR]

Obesity impairs oocyte quality, fertility, pregnancy maintenance, and is associated with offspring birth defects. The model ovotoxicant, 7,12-dimethylbenz[a]anthracene (DMBA), causes ovarian DNA damage and follicle loss. Both DMBA-induced chemical biotransformation and the DNA damage response are partially attenuated in obese relative to lean female mice but whether weight loss could improve the DNA damage response to DMBA exposure has not been explored. Thus, at six weeks of age, C57BL/6 J female mice were divided in three groups: 1) Lean (L; n = 20) fed a chow diet for 12 weeks, 2) obese (O; n = 20) fed a high fat high sugar (HFHS) diet for 12 weeks and, 3) slim-down (S; n = 20). The S group was fed with HFHS diet for 7 weeks until attaining a higher body relative to L mice on week 7.5 and switched to a chow diet for 5 weeks to achieve weight loss. Mice then received either corn oil (CT) or DMBA (D; 1 mg/kg) for 7 d via intraperitoneal injection (n = 10/treatment). Obesity increased (P < 0.05) kidney and spleen weight, and DMBA decreased uterine weight (P < 0.05). Ovarian weight was reduced (P < 0.05) in S mice, but DMBA exposure increased ovary weight in the S mice. LC-MS/MS identified 18, 64, and 7 ovarian proteins as altered (P < 0.05) by DMBA in the L, S and O groups, respectively. In S and O mice, 24 and 8 proteins differed, respectively, from L mice. These findings support weight loss as a strategy to modulate the ovarian genotoxicant response., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Aileen F. Keating reports financial support was provided by National Institute of Environmental Health Sciences. Aileen Keating reports a relationship with National Institute of Environmental Health Sciences that includes: funding grants. Associate Editor for the journal's Reproduction and Biology of Reproduction If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Fetal hepatic dimethylbenz(a)anthracene (DMBA) biotransformation is not defined, thus, this study investigated whether the fetal liver metabolizes DMBA and differs with biological sex. KK.Cg-a/a (lean; n = 20) or KK.Cg-Ay/J (obese; n = 20) pregnant mice were exposed to corn oil (CT) or DMBA (1 mg/kg bw/day) by intraperitoneal injection (n = 10/treatment) from gestation day 7-14. Postnatal day 2 male or female offspring livers were collected. Total RNA (n = 6) and protein (n = 6) were analyzed via a PCR-based array or LC-MS/MS, respectively. The level of Mgst3 was lower (P < 0.05) in livers of female compared to male offspring. Furthermore, in utero DMBA exposure increased (P < 0.1) Cyp2c29 and Gpx3 levels (P < 0.05) in female offspring. In male offspring, the abundance of Ahr, Comt (P < 0.1), Alox5, and Asna1 (P < 0.05) decreased due to DMBA exposure. Female and male offspring had 34 and 21 hepatic proteins altered (P < 0.05) by in utero DMBA exposure, respectively. Opposing patterns for hepatic CD81 and KRT78 occurred, being decreased in females but increased in males, while YWHAG was decreased by DMBA exposure in both. Functional KEGG pathway analysis identified enrichment of 26 and 13 hepatic metabolic proteins in male and female offspring, respectively, due to in utero DMBA exposure. In silico transcription factor analysis of differentially expressed proteins predicted involvement of female NRF1 but male AHR. Thus, hepatic biological sex differences and capacity to respond to toxicants in utero are supported., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Aileen Keating reports financial support was provided by National Institutes of Health. Aileen Keating is Associate Editor for the journals "Biology of Reproduction" and "Reproduction"., (Copyright © 2024. Published by Elsevier Inc.)

Introduction: Two universities run a collaborative Medical Radiation Science program where students undertake study in Tasmania before transferring to a partner university in another state to complete their program. This study assessed rates and predictors of graduate radiographers, radiation therapists and nuclear medicine technologists (collectively classified as medical radiation practitioners according to AHPRA [https://www.medicalradiationpracticeboard.gov.au/About.aspx; ahpra.gov.au/registration/registers] contemporary classification) returning to Tasmania and rural locations to practice., Methods: A cross-sectional 22-item online survey including open-ended questions was administered via Facebook. Rates of graduates working in Tasmania and rural locations, work satisfaction, and program efficacy were assessed. Logistic regression was used to assess predictors of working in Tasmania and rural locations., Results: 58 Facebook members from a total of 87 program graduates were invited to participate. Of these, 21 responded. Thirteen (62.0%) were currently working in Tasmania, of which the majority practised in regional (MMM2) areas. Most (90.5%) reported that they were happy at work, with all participants reporting the course prepared them well or very well for their first professional jobs. 71.4% stated that the provision of the first 2 years of the course in their home state influenced their decision to study medical radiation science. Being born in a rural region (MMM > 2) was a predictor for working in Tasmania (OR = 3.5) and rural locations (OR = 1.77). Males were twice as likely to work in Tasmania (OR = 2.3) and more rural locations (OR = 2.0)., Conclusions: Collaboration is beneficial in producing professionals in regions with smaller enrolments limit the ability to grow their own graduates independently. Interuniversity collaborative models are recommended for other rural regions to meet local health workforce needs., (© 2023 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.)

Aim: To quantify changes on RSV- associated hospitalizations during COVID-19 pandemic, among children four years of age or younger at the state and county levels of Texas using routinely acquired hospital admission records., Methods: We used the Texas Public Use Data Files (PUDF) of the Department of State Human Services (DSHS) to obtain hospital admissions and healthcare outcomes from 2006 to 2021. We used the 2006-2019 period to estimate a long-term temporal trend and predict expected values for 2020-2021. Actual and predicted values were used to quantify changes in seasonal trends of the number of hospital admissions and mean length of hospital stay. Additionally, we calculated hospitalization rates and assessed their similarity to rates reported in the RSV Hospitalization Surveillance Network (RSV-NET)., Results: An unusually low number of hospitalizations in 2020 was followed by an unusual peak in the third quarter of 2021. Hospital admissions in 2021 were approximately twice those in a typical year. The mean length of hospital stay typically followed a seasonal trend before COVID-19, but increased by a factor of ∼6.5 during the pandemic. Spatial distribution of hospitalization rates revealed localized healthcare infrastructure overburdens during COVID-19. RSV associated hospitalization rates were, on average, two times higher than those of RSV-NET., Conclusion: Hospital admission data can be used to estimate long-term temporal and spatial trends and quantify changes during events that exacerbate healthcare systems, such as pandemics. Using the mean difference between hospital rates calculated with hospital admissions and hospital rates obtained from RSV-NET, we speculate that state-level hospitalization rates for 2022 could be at least twice those observed in the two previous years, and the highest in the last 17 years., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Uwak, Johnson, Mustapha, Rahman, Tonpay, Regan and Mendoza-Sanchez.)

Objective: This study describes the distribution of the Australian pharmacists' workforce using a range of indicators and identifies predictors of practising outside of metropolitan and regional areas., Methods: A cross-sectional description of the 2019 pharmacy workforce. Pharmacists who completed the 2019 workforce survey as reported in the Australian National Health Workforce Dataset (NHWDS). The main outcome measures were the number of pharmacists per 100 000, the proportion working less than 35 h a week, the proportion with primary qualification from overseas (outside of Australia and New Zealand) and the proportion aged 65 years or older. Additionally, predictors of practising outside of metropolitan and regional areas were also identified., Key Findings: Nationally, there were 102 pharmacists/100 000 with one-third working less than 35 h a week. About 10% of pharmacists obtained their primary qualification from overseas and 4% were 65 years old or older. Males were more likely to practise outside of metropolitan and regional areas [OR, 1.40 (1.30-1.50); P < 0.001], while younger people were less likely to practise outside of these locations [OR, 0.71 (0.66-0.76); P < 0.001]. Those who had obtained their primary qualification overseas were also more likely to practise outside of metropolitan and regional areas., Conclusions: Analysis of the 2019 NHWDS suggests an uneven distribution of the pharmacist workforce. Also, three predictors of practising outside of major cities and regional centres were identified., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society.)

Objectives: To explore and synthesise the evidence relating to features of quality in rural health student placements., Design: Scoping review., Data Sources: MEDLINE, CINAHL, Embase, ProQuest, Informit, Scopus, ERIC and several grey literature data sources (1 January 2005 to 13 October 2020)., Study Selection: The review included peer-reviewed and grey literature from Organisation for Economic Co-operation and Development listed countries that focused on quality of health student placements in regional, rural and remote areas., Data Extraction: Data were extracted regarding the methodological and design characteristics of each data source, and the features suggested to contribute to student placement quality under five categories based on a work-integrated learning framework., Results: Of 2866 resulting papers, 101 were included for data charting and content analysis. The literature was dominated by medicine and nursing student placement research. No literature explicitly defined quality in rural health student placements, although proxy indicators for quality such as satisfaction, positive experiences, overall effectiveness and perceived value were identified. Content analysis resulted in four overarching domains pertaining to features of rural health student placement quality: (1) learning and teaching in a rural context, (2) rural student placement characteristics, (3) key relationships and (4) required infrastructure., Conclusion: The findings suggest that quality in rural health student placements hinges on contextually specific features. Further research is required to explore these findings and ways in which these features can be measured during rural health student placements., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) is associated with adverse health effects in children. Valid exposure assessment methods with accurate spatial and temporal resolution across pregnancy is a critical need for advancing environmental health studies., Objective: The objective of this study was to quantify maternal PAH exposure in pregnant women residing in McAllen, Texas where the prematurity rate and childhood asthma prevalence rates are high. A secondary objective was to compare PAH levels in silicone wristbands deployed as passive samplers with concentrations measured using standardized active air-sampling techniques., Methods: Participants carried a backpack that contained air-sampling equipment (i.e., filter and XAD sorbent) and a silicone wristband (i.e., passive sampler) for three nonconsecutive 24-h periods. Filters, XAD tubes, and wristbands were analyzed for PAHs., Results: The median level of exposure for the sum of 16 PAHs measured via active sampling over 24 h was 5.54 ng/m 3 (filters) and 43.82 ng/m 3 (XADs). The median level measured in wristbands (WB) was 586.82 ng/band. Concentrations of the PAH compounds varied across sampling matrix type. Phenanthrene and fluorene were consistently measured for all participants and in all matrix types. Eight additional volatile PAHs were measured in XADs and WBs; the median level of exposure for the sum of these eight PAHs was 342.98 ng/m 3 (XADs) and 632.27 ng/band. The silicone wristbands (WB) and XAD sorbents bound 1-methynaphthalyne, 2-methylnaphthalene, biphenyl following similar patterns of detection., Significance: Since prior studies indicate linkages between PAH exposure and adverse health outcomes in children at the PAH levels detected in our study, further investigation on the associated health effects is needed. Data reflect the ability of silicone wristbands to bind smaller molecular weight, semivolatile PAHs similar to XAD resin. Application of wristbands as passive samplers may be useful in studies evaluating semivolatile PAHs., (© 2021. The Author(s).)

Purpose: The COVID-19 pandemic has disrupted health care delivery and services around the world causing rapid changes to maternity care protocols and pregnant women to give birth with tight restrictions and significant uncertainties. There is a gap in evidence about expectant and new mothers' experiences with birthing during the pandemic. We sought to describe and understand pregnant and new mothers' lived experiences during the COVID-19 pandemic using authentic birth stories., Study Design and Methods: Using a narrative analysis framework, we extracted relevant YouTube birth stories using predetermined search terms and inclusion criteria. Mothers' birth stories were narrated in their second or third trimester or those who had recently given birth during the pandemic. Birth stories were analyzed using an inductive and deductive approach to capture different and salient aspects of the birthing experience., Results: N = 83 birth stories were analyzed. Within these birth stories, four broad themes and 13 subthemes were identified. Key themes included a sense of loss, hospital experiences, experiences with health care providers, and unique experiences during birth and postpartum. The birth stories revealed that the COVID-19 pandemic brought unexpected circumstances, both positive and negative, that had an impact on mothers' overall birthing experience., Clinical Implications: Results provided a detailed description of women's lived experience with giving birth during the COVID-19 pandemic. Maternity nurses should try to provide clear communication and compassionate patient-centered care to relieve women's anxieties about uncertain and unpredictable policy changes on COVID-19 as the pandemic continues to evolve., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Low birth weight is an important risk factor for many co-morbidities both in early life as well as in adulthood. Numerous studies report associations between prenatal exposure to particulate matter (PM) air pollution and low birth weight. Previous systematic reviews and meta-analyses report varying effect sizes and significant heterogeneity between studies, but did not systematically evaluate the quality of individual studies or the overall body of evidence. We conducted a new systematic review to determine how prenatal exposure to PM 2.5 , PM 10 , and coarse PM (PM 2.5-10 ) by trimester and across pregnancy affects infant birth weight. Using the Navigation Guide methodology, we developed and applied a systematic review protocol [CRD42017058805] that included a comprehensive search of the epidemiological literature, risk of bias (ROB) determination, meta-analysis, and evidence evaluation, all using pre-established criteria. In total, 53 studies met our inclusion criteria, which included evaluation of birth weight as a continuous variable. For PM 2.5 and PM 10 , we restricted meta-analyses to studies determined overall as "low" or "probably low" ROB; none of the studies evaluating coarse PM were rated as "low" or "probably low" risk of bias, so all studies were used. For PM 2.5 , we observed that for every 10 µg/m 3 increase in exposure to PM 2.5 in the 2nd or 3rd trimester, respectively, there was an associated 5.69 g decrease (I 2 : 68%, 95% CI: -10.58, -0.79) or 10.67 g decrease in birth weight (I 2 : 84%, 95% CI: -20.91, -0.43). Over the entire pregnancy, for every 10 µg/m 3 increase in PM 2.5 exposure, there was an associated 27.55 g decrease in birth weight (I 2 : 94%, 95% CI: -48.45, -6.65). However, the quality of evidence for PM 2.5 was rated as "low" due to imprecision and/or unexplained heterogeneity among different studies. For PM 10 , we observed that for every 10 µg/m 3 increase in exposure in the 3rd trimester or the entire pregnancy, there was a 6.57 g decrease (I 2 : 0%, 95% CI: -10.66, -2.48) or 8.65 g decrease in birth weight (I 2 : 84%, 95% CI: -16.83, -0.48), respectively. The quality of evidence for PM 10 was rated as "moderate," as heterogeneity was either absent or could be explained. The quality of evidence for coarse PM was rated as very low/low (for risk of bias and imprecision). Overall, while evidence for PM 2.5 and course PM was inadequate primarily due to heterogeneity and risk of bias, respectively, our results support the existence of an inverse association between prenatal PM 10 exposure and low birth weight., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: The purpose of this study was to determine whether cervical cancer is a risk factor for early mortality among women with HIV and whether racial/ethnic disparity predicted in-hospital death among women living with HIV and diagnosed with cervical cancer., Methods: We conducted a population-based study using the National Inpatient Sample (NIS) database comprising hospitalized HIV-positive women with or without cervical cancer diagnosis, from 2003 through 2015. We compared trends in the rates of cervical cancer, in-hospital death, and years of potential life lost (YPLL) by race/ethnicity., Results: We identified 2,613,696 women with HIV, and among them, 5398 had cervical cancer. The prevalence of cervical cancer (per 10,000) was 9.3 for NH-Whites, 30.9 among NH-Blacks, and 30.2 for Hispanics. Rates of cervical cancer over time diminished significantly only among NH-Whites (average annual percent change (AAPC), - 5.8 (- 9.7, - 1.8)), and YPLL in women with cervical cancer decreased significantly only in NH-Whites (AAPC, - 6.2 (- 10.1, - 2.0)). Cervical cancer was associated with increased odds of in-hospital death overall (OR 2.24 (1.59-3.15)) and among NH-Blacks (OR 2.03 (1.30-3.18)) only., Conclusions: NH-Blacks and Hispanics with HIV remain at increased risk for concurrent diagnosis of cervical cancer compared with NH-Whites. Moreover, NH-Black women with HIV and cervical cancer are at greatest risk for in-hospital death. The findings emphasize the need for a more robust prevention strategy among minority women to reduce the high burden of HIV/cervical cancer and related mortality.

Toxicology, as a profession, lacks diversity. Undergraduate students, and especially underrepresented students, are not commonly introduced to toxicology at US colleges and universities. The Toxicology Mentoring and Skills Development Training Program (ToxMSDT) seeks to acquaint underrepresented undergraduates enrolled in STEM fields with toxicology fundamentals and skills to aid their entry into graduate programs and, ultimately, careers in toxicology. ToxMSDT is a collaboration among three universities. It is a year-long holistic training and mentoring program comprised of web resources accessible 24/7 and extensive one-to-one mentor-mentee interactions throughout the year. Evaluation of the two-year pilot program shows that students expressed a significant increase in knowledge about toxicology careers, networking with people involved in the field of toxicology, feelings of being part of the toxicology community, and seeing themselves as someone who will study toxicology, compared with their feelings prior to their participation in the ToxMSDT program. Thirty students have completed the ToxMSDT program and all 10 (100%) of those who have graduated have joined graduate school in toxicology or toxicology-related STEM fields. Of the 20 (66.6%) program alumni still enrolled as undergraduates, five (25%) are in the process of applying to graduate programs and medical schools as of August 2019.

Epidermal Langerhans cells (LCs) are skin-resident dendritic cells that are essential for the induction of skin immunity and tolerance. Transforming growth factor-β 1 (TGFβ1) is a crucial factor for LC maintenance and function. However, the underlying TGFβ1 signaling pathways remain unclear. Our previous research has shown that the TGFβ1/Smad3 signaling pathway does not impact LC homeostasis and maturation. In this study, we generated mice with conditional deletions of either individual Smad2, Smad4, or both Smad2 and Smad4 in the LC lineage or myeloid lineage, to further explore the impact of TGFβ1/Smad signaling pathways on LCs. We found that interruption of Smad2 or Smad4 individually or simultaneously in the LC lineage did not significantly impact the maintenance, maturation, antigen uptake, and migration of LCs in vivo or in vitro during steady state. However, the interruption of both Smad2 and Smad4 pathways in the myeloid lineage led to a dramatic inhibition of bone marrow-derived LCs in the inflammatory state. Overall, our data suggest that canonical TGFβ1/Smad2/4 signaling pathways are dispensable for epidermal LC homeostasis and maturation at steady state, but are critical for the long-term LC repopulation directly originating from the bone marrow in the inflammatory state., (Copyright © 2020 Huang, Li, Yu, Xu, Cvetkovski, Wang, Parajuli, Udo-Inyang, Kaplan, Zhou, Yao and Mi.)

Context: Access to social network sites (SNS) is commonplace, especially among young people globally. Cumulatively, long duration of daily exposure may be having effects on psychological health outcomes, including increased and in some cases, decreased risk of depression and anxiety. Despite these potential effects, there is a paucity of literature on patterns and effects of exposure to social media, especially in developing countries where regular mental health screening is generally unavailable., Aim: This study aims to assess the psychological effects of Internet/social media usage among undergraduates in Calabar., Settings and Design: A descriptive cross-sectional study conducted in the University of Calabar, Nigeria., Methodology: Multi-staged sampling technique was used to recruit equal proportions of the undergraduate students from five selected Faculties in the University. Internet Addiction Test and General Health Questionnaire-28 were used to measure addiction to Internet and psychological health status of the respondents, respectively. Socio-demographic questionnaire was used to obtain information on demographic and social media characteristics of the respondents., Statistical Analysis: Chi-square and independent t-test were used as inferential statistics, with P value set at 0.05., Results: Four hundred and eighteen (418) respondents completed the questionnaires. The mean age was 21.5 ± 3.6 years. Male:female ratio was 1:0.99. WhatsApp (59.8%) was the most commonly visited social media platform, whereas entertainment (52.2%) was the most common reason for social media use. About one-fifth (20.1%) had moderate-to-severe forms of Internet addiction, whereas one-third (33.1%) were psychologically distressed. Psychological distress was found to be significantly more common among respondents with mild/none, compared with those with moderate-to-severe forms of Internet addiction (P = 0.00). Respondents with moderate-to-severe forms of Internet addiction had significantly lower mean depression and anxiety scores compared with those with mild or no form of addiction (P = 0.00)., Conclusions: There is high degree of psychological distress among students, and this was found to be more common among those that were less/not addicted to SNS. Specifically, high degree of Internet addiction may be protecting against the increased risk of depression and anxiety. The implications of these findings on youth counselling and the prevention of mental illnesses in developing countries are discussed in this article., Competing Interests: None

Background: Primary care (PC) training programs must incorporate oral health (OH) into their curricula to reduce health disparities. The purpose of this study was to evaluate and compare OH education integration across multiple PC disciplines., Methods: In 2017, the authors surveyed deans and program directors (PDs) across 13 disciplines (2,245 PC programs) and used the Input Process Output framework to evaluate training factors across these disciplines., Results: Nine disciplines represented by 767 respondents were chosen for analysis (disciplines with ³40% response rate were included). Most of the physician assistant (PA) and pediatric nurse practitioner (PNP) programs reported departmental support for OH and covered curriculum content topics on oral health risk assessment and evaluation. Similarly, over-half (>60%) PA and PNP PDs agreed that learners could answer OH-related questions on their board exams., Conclusion: Best practices learned from PNP and PA programs can be shared across disciplines to help bolster OH integration.

Background: Vascular injuries associated with total knee arthroplasty can have limb and life-threatening consequences. The aims of this study were to conduct a meta-analysis of the overall rate of vascular injuries after total knee arthroplasty and to conduct a systematic review of specific major and minor vessel injuries., Methods: All English-language literature published from January 1, 1998, to November 30, 2018, was queried in 4 unique databases using a common search term. This yielded 404 results, of which 270 were unique. Two reviewers then assessed studies for eligibility. All non-human studies, cadaver studies, studies describing only human images, and human studies with non-acute pathology were excluded. The final study included 10 large epidemiological studies and 68 case series or studies. Data from the literature were abstracted into a comma-separated database spreadsheet using Microsoft Excel. A meta-analysis was then performed. Pooled statistics were calculated with weighting by inverse variance assuming a random effect model. I was calculated as a quantifier of heterogeneity and interpreted according to the Cochrane manual. All data analysis was performed using R software., Results: Among the 1,419,557 total knee arthroplasties reported in 10 studies, there were 767 major vascular injuries (0.05% [54 per 100,000 total knee arthroplasties]). Amputation or long-term neurological complications occurred in approximately 21% of patients after major vascular injury. Presentation after 24 hours occurred in 36% of cases. The most frequently injured vessels were the geniculate arteries, popliteal artery, superficial femoral artery, and anterior tibial artery. The injuries that were most likely to result in amputation were femoral artery occlusion, popliteal artery transection, and popliteal artery arteriovenous fistula., Conclusions: Amputation and long-term neurological complications are common complications after a vascular injury associated with a total knee arthroplasty. Preoperative consultation with vascular surgery physicians may be a prudent approach before a surgical procedure for patients with known peripheral vascular disease, diabetes, hypertension, or smoking; however, more data on risk factors are needed. Awareness by the surgical team and implementation of specific strategies during a surgical procedure such as gentle manipulation of the knee and careful retraction may further reduce the rate of injuries., Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Objective: There are limited data on spine stereotactic radiosurgery (SRS) in treating adolescent and young adult (AYA) patients. SRS has the advantages of highly conformal radiation dose delivery in the upfront and retreatment settings, means for dose intensification, and administration over a limited number of sessions leading to a decreased treatment burden. In this study, the authors report the oncological and toxicity outcomes for AYA patients with metastatic sarcoma treated with spine radiosurgery and provide clinicians a guide for considerations in dose, volume, and fractionation., Methods: An institutional review board-approved database of patients treated with SRS in the period from October 2014 through December 2018 was queried. AYA patients, defined by ages 15-29 years, who had been treated with SRS for spine metastases from Ewing sarcoma or osteosarcoma were included in this analysis. Patients with follow-ups shorter than 6 months after SRS were excluded. Local control, overall survival, and toxicity were reported., Results: Seven patients with a total of 11 treated lesions were included in this study. Median patient age was 20.3 years (range 15.1-26.1 years). Three patients had Ewing sarcoma (6 lesions) and 4 patients had osteosarcoma (5 lesions). The median dose delivered was 35 Gy in 5 fractions (range 16-40 Gy, 1-5 fractions). The median follow-up was 11.1 months (range 6.8-26.0 months). Three local failures were observed within the follow-up period. No acute grade 3 or greater toxicity was observed. One patient developed late grade 3 toxicity consisting of radiation enteritis. This patient had previously received radiation to an overlapping volume with conventional fractionation. SRS re-irradiation for this patient was also performed concurrently with chemotherapy administration. No late grade 4 or higher toxicities were observed. No pain flare or vertebral compression fracture was observed. Three patients died within the follow-up period., Conclusions: SRS for spine metastases from Ewing sarcoma and osteosarcoma can be considered as a treatment option in AYA patients and is associated with acceptable toxicity rates. Further studies must be conducted to determine long-term local control and toxicity for this treatment modality.

Objective: This study was conducted to determine and recommend the most up-to-date information on the indications, complications, and outcomes of posterior surgical treatments for cervical spondylotic myelopathy (CSM) on the basis of a literature review., Methods: A comprehensive literature search was performed, using the MEDLINE (PubMed), the Cochrane Register of Controlled Trials, and Web of Science databases, for peer-reviewed articles published in English during the last 10 years., Results: Posterior techniques, which include laminectomy alone, laminectomy with fusion, and laminoplasty, are often used in patients with involvement of 3 or more levels. Posterior decompression for CSM is effective for improving patients' neurological function. Complications resulting from posterior cervical spine surgery include injury to the spinal cord and nerve roots, complications related to posterior screw fixation or instrumentation, C5 palsy, spring-back closure of lamina, and postlaminectomy kyphosis., Conclusion: It is necessary to consider multiple factors when deciding on the appropriate operation for a particular patient. Surgeons need to tailor preoperative discussions to ensure that patients are aware of these facts. Further research is needed on the cost-to-benefit analysis of various surgical approaches, the comparative efficacy of surgical approaches using various techniques, and long-term outcomes, as current knowledge is deficient in this regard.

Background: BACE-1 is an aspartate protease that is responsible for the proteolysis of amyloid precursor proteins (APP) into beta-amyloid (Aβ), a neurotoxic peptide in patients with Alzheimer's disease (AD). As such, BACE-1 is a prime pharmacological target in the control of Aβ in the brain and its inhibition will be a sound approach in AD therapy., Methods: The computational pipeline which comprised molecular docking (MD), Quantitative Structure Activity Relationship (QSAR) modelling and Absorption, Distribution, Metabolism, Excretion and Toxicity (ADMET) studies enabled the prediction of molecular interaction and relative inhibitory potentials of the hit compound., Results and Discussion: The current study reports a naturally sourced small molecule inhibitor of BACE1 (C000000956) which was obtained through a computational pipeline. Also, pharmacological constraints such as pH dependent activity of the enzyme and blood brain barrier permeation which have been associated with the efficacy of previous BACE-1 inhibitors were well catered for. Our results suggest that orally delivered C000000956 is a potential small molecule inhibitor of BACE-1 which may find usefulness in AD-therapy., Competing Interests: None declared, (© Georg Thieme Verlag KG Stuttgart · New York.)

The Spine Patient-Reported Outcomes Related Trial (SPORT) is arguably one of the most impactful and insightful studies conducted in spine surgery. Designed as a prospective, multicenter study with randomized and observational cohorts, SPORT has provided vast data on the pathogenesis, treatment effects, clinical outcomes, cost effectiveness of disk herniation, lumbar spinal stenosis, and degenerative spondylolisthesis. With regards to spinal stenosis and degenerative spondylolisthesis, SPORT has demonstrated a sustained benefit from surgical intervention at 2, 4, and 8 years postoperatively. Myriad subgroup analyses have subsequently been performed that have also resulted in clinically relevant findings. These analyses have assessed incidence and risk factors for reoperations and intraoperative complications, impact of patient comorbidities and host factors, influence of epidural injections, patient decision-making, and role of nonoperative therapy. This has resulted in significant findings that may allow spine surgeons to optimize patient outcomes while managing expectations appropriately.

A 2011 study evaluating oral health training in pediatric medical residency programs highlighted opportunities to improve residents' oral health competence. The aim of this 2017 follow-up study was to assess progress since 2011 in promoting development of pediatric residents' oral health competence. A survey was sent to all 281 pediatric and med-peds medical residency program directors to assess the structure and determinants of oral health training in their programs. A total of 110 program directors responded to the 2017 survey (response rate 40%). Just over half (54%) of the respondents reported that their residents received one to two hours of oral health education during residency, while 38% received ≥3 hours (compared to 47% and 48%, respectively, in 2011). There was improvement in the proportion of respondents reporting that their residents integrated fluoride varnish application training in 2017 vs. 2011 (83% vs. 43%; p<0.001). Departmental support for integrating oral health and having an oral health elective were significantly associated with satisfaction with residents' oral health competence. These findings suggest that pediatric and med-peds medical residency programs have improved their residents' oral health awareness and training through integration of at least one hour of oral health education and fluoride varnish training. However, given deficiencies in program structure and uneven perceptions of residents' oral health competence found in this study, opportunities remain to improve pediatric residency programs' oral health curricula.

Background: Carotid artery injury and stroke secondary to prolonged retraction remains an extremely rare complication in anterior cervical discectomy and fusion (ACDF). However, multiple studies have demonstrated that carotid artery retraction during the surgical approach may alter the normal blood flow, leading to a significant reduction in the cross-sectional area of the vessel. Others have suggested that dislodgment of atherosclerotic plaques following manipulation of the carotid artery can be a potential risk for intracranial embolus and stroke., Purpose: We aimed to evaluate: (1) the incidence of postoperative stroke following ACDF and (2) incidence of other postoperative complications in a cohort of patients who had a diagnosis of carotid artery stenosis (CAS) versus those who did not., Patient Sample: This study utilized the Statewide Planning and Research Cooperative System database from January 1, 2009 to December 31, 2013. All patients who underwent (ACDF) and had a preoperative diagnosis of CAS were identified using the International Classification of Disease, ninth revision codes. Those who had a previous history of stroke were excluded. Patients who had CAS were propensity score matched to patients without history of CAS for demographics and Charlson/Deyo comorbidity scores., Outcome Measures: Incidence of postoperative stroke and other complications were compared between the cohorts. The threshold for statistical significance was set at a p<.05. This study received no funding. The authors report no conflict of interests relevant to this study., Results: There were 34,975 patients who underwent an ACDF in the study time period. After excluding those under the age of 18 and with history of previous stroke, there were 61 patients who had CAS that were compared with a propensity-matched cohort. The CAS cohort had a significantly higher incidence of postoperative stroke during their hospitalization (6.6% vs 0%, p<.042). The CAS cohort also had higher rates of acute renal failure (27.9% vs 4.9%, p = .01) and sepsis (18% vs 4.9%, p = .023). There were no stroke related deaths., Conclusions: Patients with CAS who underwent ACDF had a statistically significant greater incidence of developing a postoperative stroke. To the best of our knowledge, no previous study has evaluated the development of postoperative stroke in patients with CAS undergoing ACDF. Larger, multicenter studies are needed to estimate the true incidence of stroke in this specific patient population. However, our results may illustrate the importance of preoperative optimization, approach-selection, and postoperative stroke surveillance in patients with a history of CAS who undergoes ACDF., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Given the potential negative effects that early childhood behavioral problems have on later development, it is important to elucidate risk and protective factors. This study examined household chaos as a predictor of externalizing and internalizing problems among young children from low-income families. Additionally, self-regulation was examined as a moderator of the association between chaos and behavior problems. One hundred young adult mother-toddler dyads participated. Moderation analyses indicated that self-regulation buffered the association between household chaos and child behavior problems. Specifically, greater household chaos was associated with more behavior problems, but only among children with poorer self-regulation. Notably, this pattern was observed for both externalizing and internalizing problems. These findings suggest that early interventions targeting young children's self-regulation skills could help prevent behavior problems among children living in chaotic home environments.

Objective: This study was performed to determine whether exposure to personal music players (PMPs) in the immediate morning prior to hearing testing confounds the association between mobile phone use and hearing thresholds of adolescents., Design: In this cohort study of cognitive function in year 7 students (median age 13 years, range 11-14), information regarding the weekly use of mobile phones and the use of PMPs was assessed by a questionnaire. Pure-tone audiometry was used to establish hearing thresholds for all participants., Results: Among a cohort of 317 adolescents (60.9% females), 130 were unexposed to PMP use while 33 were exposed to PMP use in the morning prior to hearing testing. No statistically significant difference in hearing threshold shifts was found between adolescents who were and were not exposed to PMP use prior to hearing testing. Likewise, the difference in the use of mobile phones according to the PMP use status was not statistically significant., Conclusion: Exposure to PMPs prior to hearing testing did not introduce confounding in the present study of mobile phone use and hearing loss among adolescents.

Introduction: Changes in pelvic position has been shown to affect acetabular coverage of the femoral head in total hip arthroplasty (THA) and may contribute to complications such as impingement, dislocation, or early wear. Understanding the kinematic changes of these positions during functional activities may help surgeons reach a consensus regarding stable hip mechanics and ideal implant positioning in THA. Therefore, in this study, we aimed to evaluate the following in patients who had unilateral hip OA: 1) dynamic changes; and 2) variability; in the following pelvic position parameters: A) tilt; B) obliquity; and C) rotation standing position to walking. This same data was also collected from a control cohort of normal subjects with non-arthritic hip joints. Data from both cohorts were then compared., Materials and Methods: This study analyzed 50 patients who had unilateral osteoarthritis of the hip. There were 27 men and 23 women who had a mean age of 59 years, a mean height of 173 cm (range, 152 to 200 cm), a mean weight of 84 kg (range, 31.5 to 125 kg), and a mean body mass index (BMI) of 28 kg/m2 [range, 13 to 43 kg/m2). In addition, a cohort of 19 healthy subjects with matching demographics (11 men and 9 women, mean age; 64, mean height; 168 cm, mean weight; 88 kg, mean BMI; 30 kg/m2) served as a control group. Joint marker sets were used for analysis and specific markers were used to assess pelvic position of the participants. In each cohort, mean pelvic tilt, obliquity, and rotation values in standing position, as well as mean minimum and maximum values in walking position were collected and compared. Dynamic change from standing to walking was calculated in both cohorts and then compared. Variability was demonstrated by comparing a graphic representation of individual values from both cohorts., Results: In hip OA patients, wide dynamic changes were demonstrated in pelvic tilt, obliquity, and rotation when going from a standing to a walking position (pelvic tilt; mean standing +8°, [range, -5° to +32°], walking range -13.5° to +33°, obliquity; mean standing +0.4°, [range, -8° to 7°], walking range -14° to +10°, rotation; mean standing -1.5° [range, -16 to +10°], and walking range -28° to +13°). In the non-arthritic cohort, narrower ranges of dynamic changes were recorded (pelvic tilt; mean standing +7°, [range, +4.35° to +9.81°], walking range +4.35° to +9.81°, obliquity; mean standing +0.66° , [range, -0.35° to 1.67°], walking range [-2.8° to 5.1°], rotation; standing mean +0.5° [range, -1.16° to +2.16°], and walking range [-6.8° to +5.1°]). When both cohorts were compared, the hip OA cohort had a three- to four-folds increase in dynamic change relative to the non-arthritic group, and in pelvic tilt, obliquity, and rotation (pelvic tilt; 38.5° vs. 9.3°, obliquity; 23.6° vs. 7.24°, rotation; 39.5° vs. 11.4). In addition, marked variability in pelvic position was also demonstrated when walking ranges of all three parameters for hip OA patients were compared to the non-arthritic subjects., Conclusion: This study utilized a novel and innovative approach to analyze the dynamic changes and variability in pelvic position parameters in patients with hip OA in comparison to non-arthritic matching subjects. Hip OA patients showed marked changes in pelvic tilt, obliquity, and rotation when going from standing to walking. Non-arthritic subjects exhibited much less noticeable changes in all three parameters. When dynamic changes in both cohorts were compared, hip OA patients had a three- to four-folds increase relative to the non-arthritic group with marked variability in walking ranges. These findings may have implications on the acetabular spatial orientation and highlight the need for individual planning when undertaking THA to account for the dynamic changes in pelvic position parameters during functional activities.

RNA sequencing is one of the most highly reliable and reproducible methods of assessing the cell transcriptome. As high-throughput RNA sequencing libraries at the single cell level have recently developed, single cell RNA sequencing has become more feasible and popular in biology research. Single cell RNA sequencing allows investigators to evaluate cell transcriptional profiles at the single cell level. It has become a very useful tool to perform investigations that could not be addressed by other methodologies, such as the assessment of cell-to-cell variation, the identification of rare populations, and the determination of heterogeneity within a cell population. So far, the single cell RNA sequencing technique has been widely applied to embryonic development, immune cell development, and human disease progress and treatment. Here, we describe the history of single cell technology development and its potential application in the field of dermatology., (Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: The association of attention deficit/hyperactivity disorder (ADHD) and fetal alcohol spectrum disorders (FASD) results in a complex constellation of symptoms that complicates the successful diagnosis and treatment of the affected individual. Current literature lacks formal guidelines, randomized control trials, and evidence-based treatment plans for individuals with ADHD and associated FASD. Therefore, a meeting of professional experts was organized with the aim of producing a consensus on identification and treatment guidelines that will aid clinicians in caring for this unique patient population., Methods: Experts from multiple disciplines in the fields of ADHD and FASD convened in London, United Kingdom, for a meeting hosted by the United Kingdom ADHD Partnership (UKAP; www.UKADHD.com ) in June 2015. The meeting provided the opportunity to address the complexities of ADHD and FASD from different perspectives and included presentations, discussions, and group work. The attendees worked towards producing a consensus for a unified approach to ADHD and associated FASD., Results: The authors successfully came to consensus and produced recommended guidelines with specific regards to identification and assessment, interventions and treatments, and multiagency liaisons and care management, highlighting that a lifespan approach to treatment needs to be adopted by all involved. Included in the guidelines are: 1) unique 'red flags', which when identified in the ADHD population can lead to an accurate associated FASD diagnosis, 2) a treatment decision tree, and 3) recommendations for multiagency care management., Conclusions: While clinically useful guidelines were achieved, more research is still needed to contribute to the knowledge base about the diagnosis, treatment, and management of those with ADHD and associated FASD.

Myotonic dystrophy (DM) is a multi-system neuromuscular disorder for which there is no treatment. We have developed a medium throughput phenotypic assay, based on the identification of nuclear foci in DM patient cell lines using in situ hybridization and high-content imaging to screen for potentially useful therapeutic compounds. A series of further assays based on molecular features of DM have also been employed. Two compounds that reduce and/or remove nuclear foci have been identified, Ro 31-8220 and chromomycin A3. Ro 31-8220 is a PKC inhibitor, previously shown to affect the hyperphosphorylation of CELF1 and ameliorate the cardiac phenotype in a DM1 mouse model. We show that the same compound eliminates nuclear foci, reduces MBNL1 protein in the nucleus, affects ATP2A1 alternative splicing and reduces steady-state levels of CELF1 protein. We demonstrate that this effect is independent of PKC activity and conclude that this compound may be acting on alternative kinase targets within DM pathophysiology. Understanding the activity profile for this compound is key for the development of targeted therapeutics in the treatment of DM.

Background: Significant disparities exist in children's receipt of preventive dental care (PDC) in the United States. Many of the children at greatest risk of dental disease do not receive timely PDC; when they do receive dental care, it is often more for relief of dental pain. Chelsea is a low-income, diverse Massachusetts community with high rates of untreated childhood caries. There are various dental resources available in Chelsea, yet many children do not access dental care at levels equivalent to their needs., Objective: Using Chelsea as a case-study, to explore factors contributing to forgone PDC (including the age 1 dental visit) in an in-depth way., Methods: We used a qualitative study design that included semi-structured interviews with parents of preschool children residing in Chelsea, and Chelsea-based providers including pediatricians, dentists, a dental hygienist and early childhood care providers. We examined: a) parents' dental attitudes and oral health cultural beliefs; b) parents' and providers' perspectives on facilitators and barriers to PDC, reasons for unmet needs, and proposed solutions to address the problem. We recorded, transcribed and independently coded all interviews. Using rigorous, iterative qualitative data analyses procedures, we identified emergent themes., Results: Factors perceived to facilitate receipt of PDC included Head-Start oral health policies, strong pediatric primary care/dental linkages, community outreach and advertising, and parents' own oral health experiences. Most parents and providers perceived there to be an adequate number of accessible dental services and resources in Chelsea, including for Medicaid enrollees. However, several barriers impeded children from receiving timely PDC, the most frequently cited being insurance related problems for children and adults. Other barriers included limited dental services for children <2 years, perceived poor quality of some dental practices, lack of emphasis on prevention-based dental care, poor care-coordination, and insufficient culturally-appropriate care. Important family-level barriers included parental oral health literacy, cultural factors, limited English proficiency and competing priorities. Several solutions were proposed to address identified barriers., Conclusion: Even in a community with a considerable number of dental resources, various factors may preclude access to these services by preschool-aged children. Opportunities exist to address modifiable factors through strategic oral health policies, community outreach and improved care coordination between physicians, dentists and early childhood care providers.

Improper management of hospital waste has been reported to be responsible for several acute outbreaks like the severe acute respiratory syndrome (SARS). In spite of these challenges, hospital wastes are sometimes not properly handled in Nigeria. To date, there has not been an adequate study on the effect and fate of burnt hospital waste on agricultural soil. The effect of burnt hospital wastes on the agricultural soil was conducted on soils sampled around farm settlement near Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, South West Nigeria. PIXE technique was employed with a 1.7 MV 5SDH Tandem Pelletron accelerator available at Centre for Energy Research and Development O.A.U Ile-Ife, Nigeria. Eleven elements- Si, Cl, K, Ca, Ti, V, Cr, Mn, Fe, Zr and Pb were detected and their concentrations and enrichment factors determined. The presence of Pb and Cl at the elevated concentrations range of (77.8 ± 3.5 - 279.6 ± 97.6 and 102.2 ± 37.4 -167.2±17.43) ppm respectively in this study, is of serious health concern because of the agricultural practices in the neighborhoods of the study sites. There is a need for proper handling of hospital and other related hazardous wastes because of the possibility of such posing serious environmental pollution problems.

Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed neurobehavioural disorder in childhood, affecting over 5% of children worldwide. As well as the core symptoms of inattention, hyperactivity and impulsivity, patients often exhibit learning difficulties and impairment in social functioning. The frequency of referral is higher for boys than for girls (about 2:1), and girls are generally older at the time of referral.Pharmacological therapy is considered the first-line treatment for patients with severe ADHD and severe impairment. Stimulant medications are licensed in the UK for the management of ADHD in school-age children and young people, and are effective in controlling ADHD symptoms.While immediate-release preparations of methylphenidate (MPH) have proven effective in the treatment of ADHD, there are a number of problems associated with their use, most notably compliance, stigma and medication diversion. Modified release preparations are now available that overcome the need for multiple daily dosing, and which offer different MPH release profiles, thereby enabling the physician to match the medication to the patient's particular requirements.This review describes the diagnosis, referral and treatment pathways for patients with ADHD in the UK and the practical considerations when initiating pharmacological treatment. The clinical experience of treating ADHD with a modified-release MPH preparation (Equasym XL®) is illustrated with case studies.