Search

Social media use is associated with poor sleep outcomes. We aimed to extend previous research by examining how measures of social media use would affect two sleep characteristics: sleep quality and insomnia symptoms. In addition, we tested a serial mediation model linking social media use to sleep through increases in negative social comparison and pre-sleep cognitive arousal. Participants were 830 emerging adults (ages 18–30) who were recruited for an online survey study in February 2024. The sample was 63.1% female, with an average age of 24. We examined three measures of social media use: duration (minutes of daily use), frequency (number of weekly visits to social media platforms), and emotional investment (attachment to and integration of social media into daily life). Consistent with our hypothesis, greater emotional investment in social media and more frequent social media use were associated with poorer sleep quality and greater insomnia severity. We also found evidence supporting our hypothesized serial mediation model: emotional investment in social media and more frequent social media use were associated with increased negative social comparison, which subsequently increased pre-sleep cognitive arousal, which then led to poorer sleep outcomes. Our findings suggest that negative social comparison and pre-sleep cognitive arousal are important mechanisms linking social media use to poor sleep outcomes. Future studies should aim to test this serial mediation model using longitudinal data and experimental methods. [ABSTRACT FROM AUTHOR]

This observational study examined the relationships between age, vaccine conspiracy beliefs, and COVID-19 vaccine uptake in emerging adults (ages 20–30) and middle-aged adults (ages 50–60) residing in the United States. It also examined sociodemographic predictors of vaccine conspiracy beliefs and COVID-19 vaccine uptake—political conservativism, household income, and educational attainment. We recruited 198 emerging adults and 198 middle-aged adults to complete an online survey assessing vaccine conspiracy beliefs and COVID-19 vaccination status. First, we found that emerging adults reported stronger vaccine conspiracy beliefs than middle-aged adults (estimated mean difference = 0.43, 95CI = 0.08, 0.79, p = 0.017), but that emerging adults and middle-aged adults did not differ in their likelihood of being vaccinated with estimated rates of COVID-19 vaccination uptake of 63% in emerging adults and 64% in middle-aged adults. Political conservativism was associated with stronger vaccine conspiracy beliefs and lower COVID-19 vaccine uptake. Lower household income and lower educational attainment were associated with lower COVID-19 vaccine uptake but not associated with vaccine conspiracy beliefs. Second, we found that age moderated the relationship between vaccine conspiracy beliefs and COVID-19 vaccine uptake; stronger vaccine conspiracy beliefs predicted lower COVID-19 vaccine uptake among middle-aged adults (B = −0.63, 95CI = −0.90, −0.36, p < 0.001) but were not associated with COVID-19 vaccine uptake among emerging adults (B = −0.21, 95CI = −0.47, 0.05, p = 0.12). These results provide insight into the sociodemographic and psychological factors that influence COVID-19 vaccine uptake. Our findings can help to inform the design of targeted public health interventions to increase vaccine uptake in the ongoing fight against COVID-19. Given the crucial role of vaccination in controlling the spread of COVID-19, it is also imperative for future studies to continue investigating how age and vaccine conspiratorial beliefs intersect to impact vaccine uptake. [ABSTRACT FROM AUTHOR]

Background: There is little information about predictors of physical therapy (PT) use among injured workers with back pain. The primary objective of this study is to investigate the associations between PT use and baseline factors not routinely captured in workers' compensation (WC) data. Methods: We conducted a secondary analysis using the Washington State Workers' Compensation Disability Risk Identification Study Cohort, which combines self‐reported surveys with claims data from the Washington State Department of Labor and Industries State Fund. Workers with an accepted or provisional WC claim for back injury between June 2002 and April 2004 were eligible. Baseline factors for PT use were selected from six domains (socio‐demographic, pain and function, psychosocial, clinical, health behaviors, and employment‐related). The outcome was a binary measure for PT use within 1 year of injury. Bivariate and multivariable logistic regression models were conducted to evaluate the associations between PT use and baseline factors. Results: Among the 1370 eligible study participants, we identified 673 (49%) who received at least one PT service. Baseline factors from five of the six domains (all but health behaviors) were associated with PT use, including gender, income, pain and function measures, injury severity rating, catastrophizing, recovery expectations, fear avoidance, mental health score, body mass index, first provider seen for injury, previous injury, and several work‐related factors. Conclusion: We identify baseline factors that are associated with PT use, which may be useful in addressing disparities in access to care for injured workers with back pain in a WC system. [ABSTRACT FROM AUTHOR]

Background: Predicting hamstring graft size preoperatively for anterior cruciate ligament (ACL) reconstruction is important for preempting an insufficient diameter in graft size intraoperatively, possibly leading to graft failure. While there are multiple published methods using magnetic resonance imaging (MRI) picture archiving and communication systems (PACS), most are not feasible and practical. Our study aims to (1) practically predict the ACL hamstring graft size in a numerically continuous manner using the preoperative MRI from any native MRI PACS system, (2) determine the degree of correlation between the predicted and actual graft size, and (3) determine the performance of our prediction method if we define an adequate actual graft size as ≥ 8 mm. Methods: A retrospective review of 112 patients who underwent primary ACL reconstruction with quadrupled hamstring semitendinosus-gracilis grafts at a tertiary institution was conducted between January 2018 and December 2018. Graft diameter can be predicted in a numerically continuous manner as √[2*(AB + CD)], where A and B are the semitendinosus cross-sectional length and breath, respectively, and C and D are the gracilis cross-sectional length and breath, respectively. Results: A moderately positive correlation exists between the predicted and actual graft diameter (r = 0.661 and p <.001). Our method yields a high specificity of 92.6% and a moderate sensitivity of 67.2% if we define an adequate actual graft size as ≥ 8 mm. An area under receiver-operating characteristic curve shows good discrimination (AUC = 0.856). Conclusions: We present a practical method to predict the ACL hamstring graft size with high specificity using preoperative MRI measurements. [ABSTRACT FROM AUTHOR]

This cross-sectional study tested the direct and stress-buffering effects of co-sleeping with pets on human sleep characteristics in a nationally-representative sample of United States adults. Participants completed questionnaires assessing their sleep characteristics, including perceived sleep quality, perceived sleep efficiency, insomnia severity, and multidimensional sleep health. We evaluated whether co-sleeping with pets was associated with sleep characteristics and whether co-sleeping with pets moderated the association of stress and sleep characteristics. Exploratory analyses examined whether sleep characteristics were impacted by number of pets, pet type, and bondedness to pets. Our final sample of 1591 participants (Mage = 46.4 years, SD = 17.5; 56% female; 76% White) included 758 participants who reported co-sleeping with pets (47.6%). Co-sleeping with pets was associated with poorer sleep characteristics—specifically, poorer perceived sleep quality and greater insomnia severity. Although higher levels of stress were associated with poorer sleep, we did not observe evidence for a stress-buffering effect of co-sleeping with pets. Exploratory analyses indicated that the negative impact of co-sleeping with pets on human sleep was associated with dog ownership but not cat ownership, more pronounced when individuals own a greater number of pets, and not impacted by bondedness to pets. Our findings contribute to emerging evidence for the impact of co-sleeping with pets on human sleep. Study was pre-registered at: https://aspredicted.org/3VN_WF6. [ABSTRACT FROM AUTHOR]

There is emerging evidence for links between relationship factors and sleep quality. Existing research linking attachment orientation to sleep quality has yielded inconsistent effects, has focused on younger samples, and has not considered underlying mechanisms of action. This research addressed these gaps in two studies that investigated the links between attachment orientation and sleep quality in both younger/middle-aged (Study 1) and older (Study 2) adult couples using Actor–Partner Interdependence Models. We also tested mediating effects of relationship-specific security and negative affect. In both studies, participants completed surveys assessing their attachment orientation, sleep quality, and the proposed mediators. Both studies revealed that relationship-specific security and negative affect mediated the negative association between insecure attachment and one's own sleep quality. This research enhances our understanding of how attachment orientation affects sleep quality, provides a foundation for future research on relationship influences on sleep, and suggests avenues for improving sleep quality. [ABSTRACT FROM AUTHOR]

Attachment theory proposes that close relationships help us to regulate our emotions in stressful and positive situations. However, no previous studies have examined preferences for a partner's emotional response to one's own stressful and positive situations or tested whether these preferences differ based on attachment orientation. This study examines the association of attachment orientation and preferences for partners' emotional responses relative to one's own emotional responses in stressful and positive contexts among 425 United States adults who were currently in a committed relationship of ≥6 months. Data were collected in 2020. Overall, participants preferred their partners to feel and express less distress, less worry, more calm, and more hope than themselves during stressful situations and for their partners to feel and express more excitement, pride, and hope than themselves during positive situations. Higher attachment anxiety predicted preferences for partners to feel and express more distress/worry in stressful situations, whereas higher attachment avoidance predicted preferences for partners to feel and express less hope in stressful situations. Statistical interactions of attachment anxiety × attachment avoidance indicated that the combination of low attachment anxiety and high attachment avoidance (dismissing avoidance) was associated with preferences for partners to feel and express less positive emotions in positive situations, whereas the combination of high attachment anxiety and high attachment avoidance (fearful avoidance) was associated with preferences for partners to feel and express more negative emotions in stressful situations and less positive emotions in positive situations. This investigation provides novel evidence for links between attachment orientation and preferences for partners' emotional responses in two theoretically important contexts, which has implications for the nature and function of emotion regulation in close relationships. Future research is needed to determine the generalizability of these findings to more collectivist cultural contexts. [ABSTRACT FROM AUTHOR]

Shift workers experience poor sleep and dysregulated cardiac autonomic function during sleep. However, it is unknown if this dysregulation persists into retirement, potentially accelerating the age‐associated risk for adverse cardiovascular outcomes. Using sleep deprivation as a physiological challenge to cardiovascular autonomic function, we compared heart rate (HR) and high‐frequency heart rate variability (HF‐HRV) during baseline and recovery sleep following sleep deprivation between retired night shift and day workers. Participants were retired night shift (N = 33) and day workers (N = 37) equated on age (mean [standard deviation] = 68.0 [5.6] years), sex (47% female), race/ethnicity (86% White), and body mass index. Participants completed a 60‐h lab protocol including one night of baseline polysomnography‐monitored sleep, followed by 36 h of sleep deprivation and one night of recovery sleep. Continuously recorded HR was used to calculate HF‐HRV. Linear mixed models compared HR and HF‐HRV during non‐rapid eye movement (NREM) and REM sleep between groups during baseline and recovery nights. Groups did not differ on HR or HF‐HRV during NREM or REM sleep (ps >.05) and did not show differential responses to sleep deprivation. In the full sample, HR increased and HF‐HRV decreased from baseline to recovery during NREM (ps <.05) and REM (ps <.01). Both groups exhibited cardiovascular autonomic changes during recovery sleep following 36 h of sleep deprivation. Sleep deprivation appears to induce cardiovascular autonomic changes that persist into recovery sleep in older adults, regardless of shift work history. This study aimed to determine whether night shift work exerts a long‐term effect on cardiovascular autonomic function. In older adults, regardless of shift work status, autonomic activity shifted during the first night of recovery sleep despite increased sleep depth. Therefore, the first night of recovery sleep may not be as restorative for cardiovascular autonomic function as initially believed. Instead, older adults may require additional nights of sleep to return to their baseline cardiac autonomic function. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic was associated with declines in mental health and increased interest in pet ownership. We aimed to extend past theories and research linking pet ownership and mental health by investigating whether pet ownership was associated with mental health during the initial phases of the COVID-19 pandemic in a sample of American adults. We also tested whether the association of pet ownership and mental health was moderated by relationship status. Participants were 2,906 American adults who were recruited for an online survey study between May 2020 and May 2021. Pet ownership was assessed via dichotomous self-report (yes/no) and mental health was assessed using a 13-item questionnaire. The sample was 69.2% female with an average age of 46.0 years. 36.1% of the sample owned a pet and 68.5% of the sample was currently partnered. There was no overall association of pet ownership and mental health during the COVID-19 pandemic (estimated mean difference (EMD) = 0.35, 95CI = -0.10, 0.80, p = 0.12). However, we found evidence for an association that was moderated by relationship status. Pet ownership was associated with better mental health among partnered individuals (EMD = 0.76, 95CI = 0.21, 1.30, p = 0.006). There was no association of pet ownership and mental health among unpartnered individuals (EMD = -0.41, 95CI = -1.20, 0.37, p = 0.30). Our findings suggest that relationship status may represent a critical moderator of the link between pet ownership and mental health. Future studies are needed to identify specific mechanisms of pet ownership that could explain its varied impact on the mental health of partnered and unpartnered individuals. [ABSTRACT FROM AUTHOR]

Key Features The Urban Health and Demographic Surveillance System (urban HDSS) in selected slums of Dhaka (North and South) and Gazipur City Corporations is a population-based cohort that initially aimed to monitor the primary health care services provided by non-government organizations and urban local bodies of the Local Government Division of Bangladesh. Urban HDSS data can also be used in response to the global call for policy-relevant data on health outcomes, health systems and other dimensions in urban areas relevant to the United Nations' Sustainable Development Goals. [Extracted from the article]

Background: Endoscopic spine surgery has been established as a practical, minimally invasive technique for decompression in patients with lumbar spinal stenosis. However, there remains a paucity of studies prospective cohort study comparing uniportal lumbar endoscopic unilateral laminotomy with bilateral decompression and unilateral biportal endoscopic unilateral laminotomy with bilateral decompression with open spinal decompression—both viable techniques with satisfactory clinical outcomes in the treatment of lumbar spinal stenosis. Objective/aim: To compare the efficacy of UPE and BPE lumbar decompression surgery for patients with lumbar spinal stenosis. Methods: A prospective registry of patients who had undergone spinal decompression for lumbar stenosis via UPE or BPE under a single fellowship trained spine surgeon was studied. Baseline characteristics, initial clinical presentation, and operative details including complications were recorded for all included patients. Clinical outcomes, such as visual analogue scale and Oswestry Disability Index, were recorded at preoperative, immediate postoperative, 2-week, 3-, 6-, and 12-month follow-up periods. Results: A total of 62 patients underwent endoscopic decompression surgery for lumbar spinal stenosis (29 UPE, 33 BPE). No significant baseline differences were found between uniportal and biportal decompression, when comparing operative duration (130 vs. 140 min; p = 0.30), intraoperative blood loss (5.4 vs. 6mLs; p = 0.05), and length of hospital stay (23.6 vs. 20.3 h; p = 0.35). Two patients (7%) who underwent uniportal endoscopic decompression required conversion to open surgery due to inadequate decompression. Intraoperative complication rates were significantly higher in the UPE group (13.4% vs. 0%, p < 0.05). VAS score (leg & back) and ODI improved significantly (p < 0.001) in both endoscopic decompression groups across all follow-up time points, with no appreciable statistical differences between both groups. Conclusion: UPE has the same efficacy as BPE in the treatment of lumbar spinal stenosis. While UPE surgery enjoys added aesthetic benefits of only one wound, BPE had potentially lower risks of intraoperative complication, inadequate decompression, and conversion to open surgery during early period of learning curve. [ABSTRACT FROM AUTHOR]

Background and Objectives: The purpose was to compaSre medium-term clinical and radiological outcomes of Partial Pediculotomy, Partial Vertebrotomy (PPPV) Posterior Endoscopic Cervical Decompression (PECD) surgery versus Anterior Cervical Discectomy and Fusion (ACDF) for patients with cervical disc herniations and foraminal pathologies. Materials and Methods: A prospective registry of patients who had undergone either PPPV PECD surgery or ACDF surgery for cervical disc herniation or foraminal pathologies under a single fellowship-trained spine surgeon was performed. The baseline characteristics and operative details including complications were recorded for all included patients. The clinical outcomes evaluated include VAS, MJOA, motor score, and NDI and MacNab's score. The radiological parameters in neutral-measured facet length, facet area, disc height, C2–C7 angle, neck tilt angle, T1 slope and thoracic inlet angle were also evaluated. Results: A total of 55 patients (29 PPPV PECD, 26 ACDF) were included, with mean follow-up periods of 21.9 and 32.3 months, respectively. Each cohort was noted to have a single case of surgical complication. Statistically significant changes of facet area (49.05 ± 14.50%) and facet length (52.71 ± 15.11%) were noted in the PPPV PECD group. At neutral alignment of the neck on a lateral X-ray, compared to ACDF, PPPV PECD had a statistically significant change in neck tilt angle (−11.68 ± 17.35°) and T1 slope angle (−11.69 ± 19.58°). Whilst both PPPV PECD and ACDF had significant improvements in VAS, MJOA and NDI postoperatively, PPPV PECD was found to be superior across all above scores at various follow-up timepoints compared to its ACDF counterparts. Conclusions: PPPV PECD surgery achieved a satisfactory radiological correction of neck alignment and significantly improved clinical outcomes at medium-term follow-up for our cohort of patients, highlighting its feasibility in treating patients with cervical disc herniations and foraminal pathologies. [ABSTRACT FROM AUTHOR]

Main effect models contend that perceived social support benefits mental health in the presence and the absence of stressful events, whereas stress-buffering models contend that perceived social support benefits mental health especially when individuals are facing stressful events. We tested these models of how perceived social support impacts mental health during the COVID-19 pandemic and evaluated whether characteristics of everyday social interactions statistically mediated this association – namely, (a) received support, the visible and deliberate assistance provided by others, and (b) pleasantness, the extent to which an interaction is positive, flows easily, and leads individuals to feel understood and validated. 591 United States adults completed a 3-week ecological momentary assessment protocol sampling characteristics of their everyday social interactions that was used to evaluate between-person average values and within-person daily fluctuations in everyday social interaction characteristics. Global measures of perceived social support and pandemic-related stressors were assessed at baseline. Psychiatric symptoms of depression and anxiety were assessed at baseline, at the end of each day of ecological momentary assessment, and at 3-week follow-up. Consistent with a main effect model, higher baseline perceived social support predicted decreases in psychiatric symptoms at 3-week follow-up (β = −.09, p =.001). Contrary to a stress-buffering model, we did not find an interaction of pandemic-stressors × perceived social support. The main effect of perceived social support on mental health was mediated by the pleasantness of everyday social interactions, but not by received support in everyday social interactions. We found evidence for both main effects and stress-buffering effects of within-person fluctuations in interaction pleasantness on daily changes in mental health. Results suggest the importance of everyday social interaction characteristics, especially their pleasantness, in linking perceived social support and mental health. [ABSTRACT FROM AUTHOR]

Night shift work is associated with poor cardiometabolic outcomes, even post-retirement. However, the characteristics of cardiometabolic function in retired night shift workers (RNSW) compared to retired day workers (RDW) are not well-understood. Rigorous characterization of cardiometabolic dysfunction in RNSW and RDW will inform targeted risk stratification for RNSW. This observational study evaluated whether RNSW (n = 71) had poorer cardiometabolic function than RDW (n = 83). We conducted a multimodal assessment of cardiometabolic function including metabolic syndrome prevalence, brachial artery flow-mediated dilation, and carotid intima-media thickness. Main analyses tested overall group differences. Sex-stratified follow-up analyses tested group differences separately in men and women. RNSW had 2.6-times higher odds of metabolic syndrome prevalence than RDW in unadjusted analyses (95% CI [1.1,6.3]); this association was not significant when adjusting for age, race and education. RNSW and RDW (Mage = 68.4; 55% female) did not differ in percent flow-mediated dilation or carotid intima-media thickness. In sex-stratified analyses, women RNSW had 3.3-times higher odds of having high body mass index than women RDW (95% CI [1.2,10.4]). Men RNSW had 3.9-times higher odds of having high triglycerides than men RDW (95% CI [1.1,14.2]). No other group differences were observed. We found mixed evidence that night shift work exposure was associated with cardiometabolic dysfunction in retirement, possibly in a sex-specific manner. [ABSTRACT FROM AUTHOR]

Joint denervation has been proposed as a less invasive option for surgical management of hand arthritis that preserves joint anatomy while treating pain and decreasing postoperative recovery times. The purpose of this systematic review was to investigate the efficacy and safety of surgical joint denervation for osteoarthritis in the joints of the hand. EMBASE, MEDLINE, and PubMed databases were searched from January 2000 to March 2019. Studies of adult patients with rheumatoid arthritis or osteoarthritis of the hand who underwent joint denervation surgery were included. Two reviewers performed the screening process, data abstraction, and risk of bias assessment (Methodological Index for Non-Randomized Studies). This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with PROSPERO (#125811). Ten studies were included, 9 case series and 1 cohort study, with a total of 192 patients. In all studies, joint denervation improved pain and hand function at follow-up (M = 36.8 months, range = 3-90 months). Pooled analysis of 3 studies on the first carpometacarpal joint showed a statistically significant (P <.001) reduction in pain scores from baseline (M = 6.61 ± 2.03) to postoperatively (M = 1.69 ± 1.27). The combined complication rate was 18.8% (n = 36 of 192), with neuropathic pain or unintended sensory loss (8.8%, n = 17 of 192) being the most common. This review suggests that denervation may be an effective and low-morbidity procedure for treating arthritis of the hand. Prospective, comparative studies are required to further understand the outcomes of denervation compared with traditional surgical interventions. [ABSTRACT FROM AUTHOR]

Background: Associations between the intensity of physical therapy (PT) treatments and health outcomes among individuals with back pain have been examined in the general population; however, few studies have explored these associations in injured workers. Our study objective was to examine whether intensity of PT treatments is positively associated with work and health outcomes in injured workers with back pain. Methods: We conducted a secondary analysis of prospective data collected from the Washington State Workers' Compensation (WC) Disability Risk Identification Study Cohort (D‐RISC). D‐RISC combined survey results with WC data from the Washington State Department of Labor and Industries. Workers with a State Fund WC claim for back injuries between June 2002 and April 2004 and who received PT services within the first year of injury were eligible. Intensity of PT treatment was measured as the type and amount of PT services within 28 days from the first PT visit. Outcome measures included work disability and self‐reported measures for working for pay, pain intensity, and functional status at 1‐year follow‐up. We conducted linear and logistic regression models to test associations. Results: We identified 662 eligible workers. In adjusted models, although the intensity of PT treatment was not significantly associated with work disability at 1‐year follow‐up, it was associated with lower odds of working for pay, decreased pain intensity, and improved functional status. Conclusions: Our findings suggest that there may be small benefits from receiving active PT, manual therapy, and frequent PT treatments within 28 days of initiating PT care. [ABSTRACT FROM AUTHOR]

Background: "Spin" is a form of reporting bias where there is an misappropriated presentation of study results, often overstating efficacy or understating harms. Abstracts of systematic reviews in other clinical domains have been demonstrated to employ spin, which may lead to clinical recommendations that are not justified by the literature.Objectives: The objective of this study was to determine the prevalence of spin strategies in abstracts of plastic surgery systematic reviews.Methods: A literature search was conducted using MEDLINE, Embase, and CENTRAL, to identify all systematic reviews published in the top five plastic surgery journals from 2015-2021. Screening, data extraction, and spin analysis were performed by two independent reviewers. Data checking of the spin analysis was performed by a plastic surgery resident with graduate level training in clinical epidemiology.Results: From an initial search of 826 systematic reviews, 60 systematic reviews and meta-analyses were included in this study. Various types of spin were identified in 73% of systematic review abstracts (n=44). "Conclusion claims the beneficial effect of the experimental treatment despite high risk of bias in primary studies," was the most prevalent type of spin and was identified in 63% of systematic reviews (n=38). There were no significant associations between the presence of spin and study characteristics.Conclusions: The present study found that 73% of abstracts in plastic surgery systematic reviews contain spin. Although systemic reviews represent the highest level of evidence, readers should be aware of types of "spin" when interpreting results and incorporating recommendations into patient care. [ABSTRACT FROM AUTHOR]

Stress in the context of the COVID‐19 pandemic may have a significant impact on health, including sleep health. Older adults may be particularly vulnerable. This study examined associations between perceived stress and sleep health, mental health, physical health, and overall perceived health outcomes among older adults. We also examined whether specific coping strategies moderate these associations. Older adults (n = 115; Mage = 68.62) reported perceived stress, coping strategies, global sleep quality, depressive symptoms, and perceived mental, physical, and overall health before and during the COVID‐19 pandemic. Stress‐health relationships were modelled with hierarchical linear regression. Higher perceived stress was associated with greater depressive symptoms and poorer mental health concurrently and longitudinally. Coping strategies moderated the association of perceived stress with physical health and overall perceived health. For example, higher perceived stress was associated with poorer overall perceived health among those with lower problem‐focussed coping, but not among those with higher problem‐focussed coping. Older adults may benefit from prevention and intervention strategies targeting stress management. Furthermore, identifying people with low problem‐focussed coping might be a useful strategy to prevent worsening health in future public health crises. [ABSTRACT FROM AUTHOR]

Aim: Tau truncation (tr‐tau) by active caspase‐6 (aCasp‐6) generates tau fragments that may be toxic. Yet the relationship between aCasp‐6, different forms of tr‐tau and hyperphosphorylated tau (p‐tau) accumulation in human brains with Alzheimer's disease (AD) and other tauopathies remains unclear. Methods: We generated two neoepitope monoclonal antibodies against tr‐tau sites (D402 and D13) targeted by aCasp‐6. Then, we used five‐plex immunofluorescence to quantify the neuronal and astroglial burden of aCasp‐6, tr‐tau, p‐tau and their co‐occurrence in healthy controls, AD and primary tauopathies. Results: Casp‐6 activation was strongest in AD and Pick's disease (PiD) but almost absent in 4‐repeat (4R) tauopathies. In neurons, the tr‐tau burden was much more abundant in AD and PiD than in 4R tauopathies and disproportionally higher when normalising by p‐tau pathology. Tr‐tau astrogliopathy was detected in low numbers in 4R tauopathies. Unexpectedly, about half of tr‐tau positive neurons in AD and PiD lacked p‐tau aggregates, a finding we confirmed using several p‐tau antibodies. Conclusions: Early modulation of aCasp‐6 to reduce tr‐tau pathology is a promising therapeutic strategy for AD and PiD but is unlikely to benefit 4R tauopathies. The large percentage of tr‐tau‐positive neurons lacking p‐tau suggests that many vulnerable neurons to tau pathology go undetected when using conventional p‐tau antibodies. Therapeutic strategies against tr‐tau pathology could be necessary to modulate the extent of tau abnormalities in AD. The disproportionally higher burden of tr‐tau in AD and PiD supports the development of biofluid biomarkers against tr‐tau to detect AD and PiD and differentiate them from 4R tauopathies at a patient level. [ABSTRACT FROM AUTHOR]

Close others often serve as a source of support for our pursuit of personal goals. Although social psychological research indicates that individuals and relationships benefit when couple members provide each other with secure base support for personal goals, few studies have investigated the physiological bases of these types of support interactions. This study of married older adults examined support providers' cardiovascular challenge‐threat responses while they engaged in a laboratory social interaction about the most important goal that their partner (the target) wanted to make progress toward during the next year. Consistent with our hypothesis, support providers' cardiovascular challenge responses were positively associated with targets' ratings of their secure base support provision during the discussion. This study also used structural equation modeling to test a theoretical model of support providers' cardiovascular challenge responses as a physiological basis of secure base support provision that promotes targets' goal progress and thriving over time. Consistent with our theory, support providers' cardiovascular challenge responses were positively associated with targets' goal progress at Year 2 follow‐up. In turn, targets' goal progress at Year 2 predicted increases in targets' overall thriving from Year 1 to Year 3. This investigation provides novel evidence for attachment theory's assertion that biobehavioral caregiving system activation facilitates the provision of secure base support that promotes close others' goal progress and thriving over time. Results of this study also contribute to recent evidence that cardiovascular challenge responses are associated with social behaviors during dyadic interactions. Our investigation implicates cardiovascular challenge‐threat responses as underlying the provision of secure base support. We advance earlier research on attachment theory by providing longitudinal evidence that support providers' cardiovascular challenge responses during a laboratory goal discussion represent activation of the biobehavioral caregiving system, which theoretically facilitates partners' goal progress (exploration) and thriving over time. These findings contribute to scarce research examining cardiovascular challenge‐threat response during social interactions and scarce research on attachment relationships and physiology in older adulthood. [ABSTRACT FROM AUTHOR]

Introduction: With a recent resurgence of the 2019 coronavirus disease (COVID-19) cases globally, an increasing number of healthcare systems are adopting telemedicine as an alternative method of healthcare delivery in a bid to decrease disease transmission. Continued care of orthopaedic patients in the outpatient setting during the coronavirus disease of 2019 era can prove challenging without a systematic workflow, adequate logistics, and careful patient selection for teleconsultation. The aim of this paper is to describe our single-centre experience with the application of telemedicine in our orthopaedic practice, and its effectiveness in maintaining outpatient follow-up of orthopaedic patients. Methodology: We describe our centre's telemedicine model of care for orthopaedic patients on the outpatient follow-up – which includes workforce assembly, population health and target patients, logistics and communications, and overall workflow – with roles and responsibilities of involved people portrayed in detail. Results: Feedback from both patients and orthopaedic surgeons reflected high satisfaction rates with care provided, noting minimal communication and clinical barriers compared to face-to-face consultations. Whilst not without limitations, our protocol allowed for rapid adoption of telemedicine in line with a national-wide initiative to digitize healthcare. Discussion: The implementation of teleconsultation services at our orthopaedic centre has provided an effective method of healthcare delivery while enforcing social distancing measures – which proves vital in combating the spread of COVID-19 and ushering in a new normal. [ABSTRACT FROM AUTHOR]

Growing evidence has documented the adverse impact of the global COVID-19 pandemic on sleep quality among older adults. Given the negative consequences of poor sleep, it is critical to identify factors that provide older adults with resilience against worsening sleep quality. Social integration may represent one such resilience factor. This study evaluated the association of social integration and sleep quality during the COVID-19 pandemic. 113 retired older adults completed assessments of their social integration after the onset of the COVID-19 pandemic, and of their sleep quality before and after the onset of the COVID-19 pandemic. Higher levels of social integration were associated with better sleep quality during the COVID-19 pandemic, even when statistically controlling for pre-pandemic sleep quality. Sex-stratified analyses showed that this association was driven by women in our sample. Social integration may confer resilience against poor sleep quality, especially in older adult women. Additional research is warranted to assess candidate mechanisms and moderators of the link between social integration and sleep quality. [ABSTRACT FROM AUTHOR]

Introduction: Cardiac masses are a rare cause of chest pain. They can often be missed on a chest radiograph performed to evaluate non-specific chest pain and are not readily evaluated with traditional laboratory testing. However, these masses can be visualized with point-of-care ultrasound. Case Report: We present a case of a 19-year-old female presenting with intermittent chest pain, palpitations, and weakness present for two months. The patient had previously been evaluated at our emergency department one week earlier and was diagnosed with anxiety before being discharged. Besides a tachycardic and labile heart rate, physical examination and laboratory testing were unremarkable. Point-of-care cardiac echocardiography subsequently demonstrated findings concerning for a cardiac mass. Conclusion: Cardiac masses are a rare cause of chest pain and palpitations that are easily missed. The advent of point-of-care ultrasonography has afforded us the ability to rapidly assess for structural and functional cardiac abnormalities at bedside, and incorporation of this tool into the evaluation of patients with chest pain offers the ability to detect these rare pathologies. [ABSTRACT FROM AUTHOR]

This article describes the first case of successful nerve grafting for posterior interosseous nerve (PIN) palsy secondary to radiocapitellar joint entrapment 2 years following closed reduction (CR) of a pediatric Monteggia fracture-dislocation (MFD). Patient notes were examined. The literature was reviewed to determine whether similar cases or techniques had been reported. A 5-year-old girl presented with a PIN palsy 2 years following CR of an MFD, demonstrating Medical Research Council (MRC) grade 4 wrist and MRC grade 2 finger and thumb extension. Nerve exploration at 27 months revealed a PIN crushed in the radiocapitellar joint with a proximal neuroma-in-continuity and no response to electrical stimulation. Neurolysis and lateral antebrachial cutaneous nerve cable grafting were performed. The decision to pursue nerve grafting was based on the intraoperative appearance of an atrophic PIN with no response to stimulation, but with minimal muscle atrophy, short distance to target muscles, and pediatric patient with extended reinnervation timeline. Full recovery (MRC grade 5 wrist extension and MRC grade 4+ finger and thumb extension) was achieved at 1-year follow-up. We present the first case of successful nerve grafting for PIN palsy secondary to radiocapitellar joint entrapment 2 years following CR of a type III MFD. Even with significant treatment delay, nerve reconstruction should be considered in the pediatric population. [ABSTRACT FROM AUTHOR]

Background: Adequate margins are technically difficult to achieve for malignant tumors involving the sacroiliac joint due to limited accessibility and viewing window. In order to address the technical difficulties faced in iliosacral tumor resection, we proposed a technique for precise osteotomy, which involved the use of canulated screws and Gigli saw (CSGS) that facilitated directional control, anteroposterior linkage of resection points and adequate surgical margins. The purpose of the current study was to evaluate whether CSGS technique facilitated sagittal osteotomy at sacral side, and were adequate surgical margins achieved? Also functional and oncological outcomes was determined along with the noteworthy complications. Methods: From April 2018 to November 2019, we retrospectively reviewed 15 patients who underwent resections for primary tumors of pelvis or sacrum necessitating iliosacral joint removal using the proposed CSGS technique. Chondrosarcoma was the most common diagnosis. The osteotomy site within sacrum was at ipsilateral ventral sacral foramina in 8 cases, midline of sacrum in 5 cases, and contralateral ventral sacral foramina and sacral ala with 1 case each. The average intraoperative blood loss was 3640 mL (range, 1200 and 6000 mL) with a mean operation duration of 7.4 hours (range, 5 to 12 hours). The mean follow-up was 23.0 months (range, 18 and 39 months) for alive patients. Results: Surgical margins were wide in 12 patients (80%), wide-contaminated in 1 patient (6.7%), and marginal in 2 patients (13.3%). R0 resection was achieved in 12 (80%) patients and R1 resection in 3 patients. There were three local recurrences (20%) occurred at a mean time of 11 months postoperatively. No local recurrence was observed at sacral osteotomy. The overall one-year and three-year survival rate was 86.7% and 72.7% respectively.Complications occurred in three patients. Conclusions: The current study demonstrated that CSGS technique for tumor resection within the sacrum and pelvis was feasible and can achieve ideal resection accuracies. The use of CSGS was associated with high likelihood of negative margin resections in the current series. Intraoperative use of CSGS appeared to be technically straightforward and allowed achievement of planned surgical margins. It is worthwhile to consider the use of CSGS technique in resection of pelvic tumors with sacral invasion and iliosacral tumors, however further follow-up at mid to long-term is warranted to observe local recurrence rate. [ABSTRACT FROM AUTHOR]

Previous studies have drawn causal associations between fluoroquinolone use and collagen pathologies including tendon rupture and retinopathy. This meta-analysis attempted to assess the association between fluoroquinolone use and the risk of aortic dissection or aortic aneurysm. A systematic search was performed on Medline, EMBASE, and the Cochrane library. 9 studies were included in final analysis. Primary random-effects meta-analysis of 7 studies, excluding 2 pharmacovigilance studies demonstrated statistically increased odds of aortic dissection (OR, 2.38; 95% CI, 1.71–3.32) aortic aneurysm (OR, 1.98; 95% CI, 1.59–2.48), and aortic aneurysm or dissection (OR, 1.47; 95% CI, 1.13–1.89; I2 = 72%) with current use of fluoroquinolones compared to their nonuser counterparts. Based on the "number needed-to-harm" analysis, 7246 (95% CI: 4329 to 14,085) patients would need to be treated with fluoroquinolones for a duration of at least three days in order for one additional patient to be harmed, assuming a population baseline incidence of aortic dissection and aneurysm rupture to be 10 per 100,000 patient-years. With strong statistical association, these findings suggest a causal relationship, warranting future research to elucidate the pathophysiological and mechanistic plausibility of this association. These findings however, should not cease prescription of fluoroquinolones, especially when clinically indicated. [ABSTRACT FROM AUTHOR]

Background: Workers' compensation claims among Medicare beneficiaries have not been described previously. To examine the healthcare burden of work‐related injury and illness among Medicare beneficiaries, we assessed the characteristics, healthcare utilization, and financial costs among Medicare beneficiaries with claims for which workers' compensation was the primary payer. Methods: We extracted final action fee‐for‐service Medicare claims from 1999 to 2016 where workers' compensation had primary responsibility for claim payment and beneficiary, claim type, diagnoses, and cost information from these claims. Results: During 1999–2016, workers' compensation was the primary payer for 2,010,200 claims among 330,491 Medicare beneficiaries, and 58.7% of these beneficiaries had more than one claim. Carrier claims submitted by noninstitutional providers constituted the majority (94.5%) of claims. Diagnosis codes indicated 19.4% of claims were related to diseases of the musculoskeletal system and connective tissue and 12.9% were related to disease of the circulatory system. Workers' compensation insurance paid $880.4 million for these claims while Medicare paid $269.7 million and beneficiaries paid $37.4 million. Conclusions: Workers' compensation paid 74% of the total amount to providers for these work‐related medical claims among Medicare beneficiaries. Claim diagnoses were similar to those of all workers' compensation claims in the United States. Describing these work‐related claims helps identify the healthcare burden due to occupational injury and illness among Medicare beneficiaries resulting from employment and identifies a need for more comprehensive collection and surveillance of work‐related medical claims. [ABSTRACT FROM AUTHOR]

Based on a case study of Sri Lanka's ICT in education experiences, this paper discusses how countries in the Global South (developing and emerging countries) could take up the opportunities of ICT for access to quality education. Sri Lanka is used as a case study because it is at the emerging state of using ICT in education with a relatively high access to education and ranked high on achievements in education. The paper starts with an overview on the potential and current challenges of harnessing ICT for access to quality education in the Global South. By conducting a case study of Sri Lanka, we identify and analyse the key factors that facilitate or hinder the realisation of the opportunities. With the promising practices and lessons learnt, a total of six strategies that can help policymakers and education leaders of Global South countries are generalised; we believe that when these strategies are considered, ICT for access to quality education will be enhanced. [ABSTRACT FROM AUTHOR]

Information and Communication Technologies (ICT) have had significant impacts on many sectors in today's knowledge economy. In developing and emerging countries, ICT have enhanced equity, quality, and efficiency in the education sector. However, the adoption of ICT in the South Asian countries' education sector has not been at scale and its impacts have been limited. There are several gaps and issues that are hindering the wider adoption of ICT and limiting its impacts in the education sector. Through the case studies of the adoption of ICT for education in Bangladesh and Nepal, this paper examines the gaps and issues to be addressed in order to better leverage ICT to enhance education equity, quality, and efficiency. This discussion is guided by the ICT in the education framework that has been developed by the authors, and could provide insights into the state of ICT in education and offer strategies to better leverage ICT for the education sector of other countries in South Asia and the region. [ABSTRACT FROM AUTHOR]

This study analyzes data from a new Urban Health and Demographic Surveillance (UHDSS) in five slums in Dhaka (North and South) and Gazipur City Corporations to examine the relationship between migration status and maternal and child health service utilization. Migration status was determined by duration in urban slums (<= 9.99 years, 10-19.99 years, 20+ years, and urban-born). Compared to those born in the city, migrants were characterized by significant disadvantages in every maternal, neonatal, and child health (MNCH) indicator under study, including antenatal care, facility-based delivery, doctor-assisted delivery, child immunization, caesarean-section delivery, and use of modern contraceptives. We found that the level of service coverage among migrants gradually converged-but did not fully converge-to that of the urban-born with increasing duration in the city. We observed a strong positive association between wealth and total MNCH coverage, with a more modest association with higher levels of schooling attainment. Women who were engaged in market employment were less likely to receive adequate coverage, suggesting a tradeoff between livelihood attainment and mother-and-child health. After controlling for these socioeconomic and neighborhood variations in coverage, the duration gradient was diminished but still significant. In line with existing studies of healthcare access, this study highlights the persistent and widespread burden of unequal access to maternal and child health care facing migrants to slum areas, even relative to the overall disadvantages experienced in informal settlements. [ABSTRACT FROM AUTHOR]

Mindfulness interventions have garnered significant attention as a complementary health treatment for many physical and psychological conditions. While some research has shown that mindfulness training can decrease psychological and physiological stress responses, it remains unclear whether mindfulness training impacts inflammation—a predictor of poor health outcomes. In addition, little research has examined the active components of mindfulness that may drive health-related improvements. Here, we provide data from two 3-arm randomized controlled trials that examined the effect of mindfulness training on inflammation in stressed community adults. Specifically, we examined whether training individuals to have an accepting attitude towards present moment experiences is a key emotion regulation skill that can lead to decreases in inflammation. Both studies randomly assigned participants to one of three conditions: mindfulness training that taught both attention monitoring and acceptance skills (Monitor+Accept); mindfulness training teaching monitoring without the acceptance component (Monitor Only); or a control condition. Study 1 employed a novel 2-week smartphone-based intervention and Study 2 employed a standard 8-week Mindfulness-Based Stress Reduction (MBSR) intervention. We hypothesized that Monitor+Accept training would lead to reductions in the inflammatory biomarker C-Reactive Protein (CRP) compared to Monitor Only training and control groups. Contrary to this hypothesis, we found that Monitor+Accept mindfulness training did not lead to reductions in CRP. Exploratory analyses combining study subsamples, however, suggest that both mindfulness interventions may reduce CRP in populations at risk for systemic inflammation—midlife-to-older adults and individuals with high BMI. Overall, the present studies contribute significantly to the question of whether mindfulness interventions can reduce systemic markers of low-grade inflammation. [ABSTRACT FROM AUTHOR]

Mindfulness-based interventions have been suggested as one way to improve employee well-being in the workplace. Despite these purported benefits, there have been few well-controlled randomized controlled trials (RCTs) evaluating mindfulness training in the workplace. Here, we conducted a two-arm RCT at work among employees of a digital marketing firm comparing the efficacy of a high-dose 6-week mindfulness training to a low-dose single-day mindfulness training for improving multiple measures of employee well-being assessed using ecological momentary assessment. High-dose mindfulness training reduced both perceived and momentary stress, and buffered employees against worsened affect and decreased coping efficacy compared to low-dose mindfulness training. These results provide well-controlled evidence that mindfulness training programs can reduce momentary stress at work, suggesting that more intensive mindfulness training doses (i.e., 6 weeks) may be necessary for improving workplace well-being outcomes. This RCT utilizes a novel experience sampling approach to measure the effects of a mindfulness intervention on employee well-being and considers potential dose-response effects of mindfulness training at work. [ABSTRACT FROM AUTHOR]