Publications by authors named "Emily Moore"

100 Publications

Fresh Perspectives on an Old Method: Secondary Analysis in a Big Data Era.

Comput Inform Nurs 2021 Aug;39(8):393-399

Author Affiliations: Seattle Children's Hospital (Drs Moore and Thomas), WA; and The University of Arizona College of Nursing (Drs Moore and Gephart), Tucson.

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http://dx.doi.org/10.1097/CIN.0000000000000796DOI Listing
August 2021

Ethnic and social inequalities in COVID-19 outcomes in Scotland: protocol for early pandemic evaluation and enhanced surveillance of COVID-19 (EAVE II).

BMJ Open 2021 08 10;11(8):e048852. Epub 2021 Aug 10.

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK

Introduction: Evidence from previous pandemics, and the current COVID-19 pandemic, has found that risk of infection/severity of disease is disproportionately higher for ethnic minority groups, and those in lower socioeconomic positions. It is imperative that interventions to prevent the spread of COVID-19 are targeted towards high-risk populations. We will investigate the associations between social characteristics (such as ethnicity, occupation and socioeconomic position) and COVID-19 outcomes and the extent to which characteristics/risk factors might explain observed relationships in Scotland.The primary objective of this study is to describe the epidemiology of COVID-19 by social factors. Secondary objectives are to (1) examine receipt of treatment and prevention of COVID-19 by social factors; (2) quantify ethnic/social differences in adverse COVID-19 outcomes; (3) explore potential mediators of relationships between social factors and SARS-CoV-2 infection/COVID-19 prognosis; (4) examine whether occupational COVID-19 differences differ by other social factors and (5) assess quality of ethnicity coding within National Health Service datasets.

Methods And Analysis: We will use a national cohort comprising the adult population of Scotland who completed the 2011 Census and were living in Scotland on 31 March 2020 (~4.3 million people). Census data will be linked to the Early Assessment of Vaccine and Anti-Viral Effectiveness II cohort consisting of primary/secondary care, laboratory data and death records. Sensitivity/specificity and positive/negative predictive values will be used to assess coding quality of ethnicity. Descriptive statistics will be used to examine differences in treatment and prevention of COVID-19. Poisson/Cox regression analyses and mediation techniques will examine ethnic and social differences, and drivers of inequalities in COVID-19. Effect modification (on additive and multiplicative scales) between key variables (such as ethnicity and occupation) will be assessed.

Ethics And Dissemination: Ethical approval was obtained from the National Research Ethics Committee, South East Scotland 02. We will present findings of this study at international conferences, in peer-reviewed journals and to policy-makers.
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http://dx.doi.org/10.1136/bmjopen-2021-048852DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8359861PMC
August 2021

Same room - different windows? A systematic review and meta-analysis of the relationship between self-report and neuropsychological tests of cognitive flexibility in healthy adults.

Clin Psychol Rev 2021 08 26;88:102061. Epub 2021 Jun 26.

Innovation, Implementation & Clinical Translation (IIMPACT) in Health, University of South Australia, Adelaide, Australia. Electronic address:

Cognitive flexibility can be thought of as the ability to effectively adapt one's cognitive and behavioural strategies in response to changing task or environmental demands. To substantiate the common inference that self-report and neuropsychological tests of cognitive flexibility provide 'different windows into the same room', we undertook a systematic review and meta-analysis to determine whether self-report and neuropsychological tests of cognitive flexibility are related in healthy adults. Ten databases and relevant grey literature were searched from inception. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were adhered to. Twenty-one articles satisfied our inclusion criteria. A multi-level random-effects meta-analysis revealed no relationship (0.05, 95% CI = -0.00 to 0.10). Random-effects meta-analyses raised the possibility that the Cognitive Flexibility Scale and the Trail Making Test - part B (time) may be related (0.19, 95% CI = 0.06 to 0.31). We conclude that the relationship between self-report and neuropsychological tests of cognitive flexibility is not large enough to be considered convincing evidence for the two assessment approaches sharing construct validity. These results have clear implications for assessing and interpreting cognitive flexibility research and clinical practice.
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http://dx.doi.org/10.1016/j.cpr.2021.102061DOI Listing
August 2021

Temporal trends and forecasting of COVID-19 hospitalisations and deaths in Scotland using a national real-time patient-level data platform: a statistical modelling study.

Lancet Digit Health 2021 08 5;3(8):e517-e525. Epub 2021 Jul 5.

Usher Institute, The University of Edinburgh, Edinburgh, UK; HDR UK BREATHE Hub, Edinburgh, UK.

Background: As the COVID-19 pandemic continues, national-level surveillance platforms with real-time individual person-level data are required to monitor and predict the epidemiological and clinical profile of COVID-19 and inform public health policy. We aimed to create a national dataset of patient-level data in Scotland to identify temporal trends and COVID-19 risk factors, and to develop a novel statistical prediction model to forecast COVID-19-related deaths and hospitalisations during the second wave.

Methods: We established a surveillance platform to monitor COVID-19 temporal trends using person-level primary care data (including age, sex, socioeconomic status, urban or rural residence, care home residence, and clinical risk factors) linked to data on SARS-CoV-2 RT-PCR tests, hospitalisations, and deaths for all individuals resident in Scotland who were registered with a general practice on Feb 23, 2020. A Cox proportional hazards model was used to estimate the association between clinical risk groups and time to hospitalisation and death. A survival prediction model derived from data from March 1 to June 23, 2020, was created to forecast hospital admissions and deaths from October to December, 2020. We fitted a generalised additive spline model to daily SARS-CoV-2 cases over the previous 10 weeks and used this to create a 28-day forecast of the number of daily cases. The age and risk group pattern of cases in the previous 3 weeks was then used to select a stratified sample of individuals from our cohort who had not previously tested positive, with future cases in each group sampled from a multinomial distribution. We then used their patient characteristics (including age, sex, comorbidities, and socioeconomic status) to predict their probability of hospitalisation or death.

Findings: Our cohort included 5 384 819 people, representing 98·6% of the entire estimated population residing in Scotland during 2020. Hospitalisation and death among those testing positive for SARS-CoV-2 between March 1 and June 23, 2020, were associated with several patient characteristics, including male sex (hospitalisation hazard ratio [HR] 1·47, 95% CI 1·38-1·57; death HR 1·62, 1·49-1·76) and various comorbidities, with the highest hospitalisation HR found for transplantation (4·53, 1·87-10·98) and the highest death HR for myoneural disease (2·33, 1·46-3·71). For those testing positive, there were decreasing temporal trends in hospitalisation and death rates. The proportion of positive tests among older age groups (>40 years) and those with at-risk comorbidities increased during October, 2020. On Nov 10, 2020, the projected number of hospitalisations for Dec 8, 2020 (28 days later) was 90 per day (95% prediction interval 55-125) and the projected number of deaths was 21 per day (12-29).

Interpretation: The estimated incidence of SARS-CoV-2 infection based on positive tests recorded in this unique data resource has provided forecasts of hospitalisation and death rates for the whole of Scotland. These findings were used by the Scottish Government to inform their response to reduce COVID-19-related morbidity and mortality.

Funding: Medical Research Council, National Institute for Health Research Health Technology Assessment Programme, UK Research and Innovation Industrial Strategy Challenge Fund, Health Data Research UK, Scottish Government Director General Health and Social Care.
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http://dx.doi.org/10.1016/S2589-7500(21)00105-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8257056PMC
August 2021

Evaluation of Pharmacologic Interventions for Weight Management in a Veteran Population.

Fed Pract 2021 May;38(5):220-226

was a PGY-1 Pharmacy Practice Resident at the time of the study; and are Clinical Pharmacy Specialists, all at Veteran Health Indiana in Indianapolis.

Background: Veterans are disproportionately impacted by weight-related morbidity: 40% of veterans are categorized as obese and an additional 38.5% are overweight. Medications are recommended as an adjunct to lifestyle and dietary changes. Guidelines recommend 7 weight management medications, including orlistat, liraglutide, phentermine, phentermine/topiramate, lorcaserin, and naltrexone/bupropion.

Methods: A single-center, retrospective chart review was conducted for patients who started weight management medications at Veteran Health Indiana in Indianapolis. The primary outcomes included total weight loss and weight loss as a percentage of baseline weight at 3, 6, 12, and > 12 months of therapy. Secondary outcomes included weight loss of 5% from baseline, rate of successful weight maintenance after initial weight loss of 5% from baseline, adverse drug reaction monitoring, and use of weight management medications across clinics at this site.

Results: The absolute weight difference over 12 months of weight management medication therapy was 15.8 kg. At each time point, weight loss was found to be statistically significant when compared with baseline ( < .001). Average weight change was greatest with orlistat (-25.9 kg) and naltrexone/bupropion was associated with a gain of 2.1 kg over the duration of the study. A majority of the patients analyzed lost the guideline-recommended 5 to 10% from baseline while taking weight management medication.

Conclusions: Weight management medications in a veteran population produced initial weight loss consistent with previous studies. However, there is room for improvement in follow-up strategies to promote greater weight maintenance after initial weight loss. Considering the high health care costs, personal burden, and potential long-term complications associated with obesity, efforts to promote continued development of programs that support weight management and maintenance are imperative.
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http://dx.doi.org/10.12788/fp.0117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8221828PMC
May 2021

Laboratory-Based Comparison for the Effects of Environmental Stressors Supports Field Evidence for the Relative Importance of Pollution on Life History and Behavior of the Pond Snail, .

Environ Sci Technol 2021 07 24;55(13):8806-8816. Epub 2021 Jun 24.

School of Health and Life Sciences, University of the West of Scotland, Paisley, PA1 2BE Scotland.

Biodiversity is declining at an alarming rate globally, with freshwater ecosystems particularly threatened. Field-based correlational studies have "ranked" stressors according to their relative effects on freshwater biota, however, supporting cause-effect data from laboratory exposures are lacking. Here, we designed exposures to elicit chronic effects over equivalent exposure ranges for three ubiquitous stressors (temperature: 22-28 °C; pollution [14 component mixture]: 0.05-50 μg/L; invasive predator cue [signal crayfish, ]: 25-100% cue) and investigated effects on physiological end points in the pond snail ( ). All stressors reduced posthatch survival at their highest exposure levels, however, highly divergent effects were observed at lower test levels. Temperature stimulated hatching, growth, and reproduction, whereas pollution delayed hatching, decreased growth, reduced egg number/embryo viability, and induced avoidance behavior. The invasive predator cue stimulated growth and reduced embryo viability. In agreement with field-based ranking of stressors, pollution was identified as having the most severe effects in our test system. We demonstrate here the utility of laboratory studies to effectively determine hierarchy of stressors according to their likelihood of causing harm in the field, which has importance for conservation. Finally, we report negative impacts on life-history traits central to population stability (survival/reproduction) at the lowest pollution level tested (0.05 μg/L).
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http://dx.doi.org/10.1021/acs.est.1c01640DOI Listing
July 2021

State of the science of care coordination, rurality, and well-being for infants with single ventricle heart disease in the Interstage period, an integrative review.

Heart Lung 2021 Sep-Oct;50(5):720-729. Epub 2021 Jun 7.

The University of Arizona College of Nursing PO Box 210203 Tucson, AZ 85721.

Background: Ensuring the quality of interstage management of infants with single ventricle heart disease (SVHD) residing in rural communities is difficult. Tailored care coordination through parental discharge education, formal and informal care team and family communication, adequate access to healthcare, and informed provider handoffs are crucial to the infant's well-being and survival.

Objective: To discuss the state of the science related to care coordination factors and infant wellbeing during the interstage period.

Methods: An integrative review approach to synthesize findings across studies was used. Through constant comparative analysis, all articles were read and coded, broken down into "data bits" or key phrases.

Results: Four major themes were inductively derived: 1) education and confidence-building, 2) communication for building relationships, 3) social work and related mental health support, and 4) availability of resources.

Conclusions: Despite advances in cardiac surgery and related interventions, a clear gap exists regarding care coordination factors and infant well-being, especially in rural communities.
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http://dx.doi.org/10.1016/j.hrtlng.2021.04.014DOI Listing
June 2021

Interim findings from first-dose mass COVID-19 vaccination roll-out and COVID-19 hospital admissions in Scotland: a national prospective cohort study.

Lancet 2021 05 23;397(10285):1646-1657. Epub 2021 Apr 23.

Usher Institute, The University of Edinburgh, Edinburgh, UK.

Background: The BNT162b2 mRNA (Pfizer-BioNTech) and ChAdOx1 nCoV-19 (Oxford-AstraZeneca) COVID-19 vaccines have shown high efficacy against disease in phase 3 clinical trials and are now being used in national vaccination programmes in the UK and several other countries. Studying the real-world effects of these vaccines is an urgent requirement. The aim of our study was to investigate the association between the mass roll-out of the first doses of these COVID-19 vaccines and hospital admissions for COVID-19.

Methods: We did a prospective cohort study using the Early Pandemic Evaluation and Enhanced Surveillance of COVID-19-EAVE II-database comprising linked vaccination, primary care, real-time reverse transcription-PCR testing, and hospital admission patient records for 5·4 million people in Scotland (about 99% of the population) registered at 940 general practices. Individuals who had previously tested positive were excluded from the analysis. A time-dependent Cox model and Poisson regression models with inverse propensity weights were fitted to estimate effectiveness against COVID-19 hospital admission (defined as 1-adjusted rate ratio) following the first dose of vaccine.

Findings: Between Dec 8, 2020, and Feb 22, 2021, a total of 1 331 993 people were vaccinated over the study period. The mean age of those vaccinated was 65·0 years (SD 16·2). The first dose of the BNT162b2 mRNA vaccine was associated with a vaccine effect of 91% (95% CI 85-94) for reduced COVID-19 hospital admission at 28-34 days post-vaccination. Vaccine effect at the same time interval for the ChAdOx1 vaccine was 88% (95% CI 75-94). Results of combined vaccine effects against hospital admission due to COVID-19 were similar when restricting the analysis to those aged 80 years and older (83%, 95% CI 72-89 at 28-34 days post-vaccination).

Interpretation: Mass roll-out of the first doses of the BNT162b2 mRNA and ChAdOx1 vaccines was associated with substantial reductions in the risk of hospital admission due to COVID-19 in Scotland. There remains the possibility that some of the observed effects might have been due to residual confounding.

Funding: UK Research and Innovation (Medical Research Council), Research and Innovation Industrial Strategy Challenge Fund, Health Data Research UK.
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http://dx.doi.org/10.1016/S0140-6736(21)00677-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8064669PMC
May 2021

Outcomes for Implemented Macroeconomic Policy Responses and Multilateral Collaboration Strategies for Economic Recovery After a Crisis: A Rapid Scoping Review.

Int J Health Serv 2021 07 5;51(3):337-349. Epub 2021 Apr 5.

Michael G DeGroote School of Medicine, 3710McMaster University, Hamilton, ON, Canada.

To promote postpandemic recovery, many countries have adopted economic packages that include fiscal, monetary, and financial policy measures; however, the effects of these policies may not be known for several years or more. There is an opportunity for decision makers to learn from past policies that facilitated recovery from other disease outbreaks, crises, and natural disasters that have had a devastating effect on economies around the world. To support the development of the United Nations Research Roadmap for COVID-19 Recovery, this review examined and synthesized peer-reviewed studies and gray literature that focused on macroeconomic policy responses and multilateral coalition strategies from past pandemics and crises to provide a map of the existing evidence. We conducted a systematic search of academic and gray literature databases. After screening, we found 22 records that were eligible for this review. The evidence found demonstrates that macroeconomic and multilateral coalition strategies have various impacts on a diverse set of countries and populations. Although the studies were heterogeneous in nature, most did find positive results for macroeconomic intervention policies that addressed investments to strengthen health and social protection systems, specifically cash and unconventional/nonstandard monetary measures, in-kind transfers, social security financing, and measures geared toward certain population groups.
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http://dx.doi.org/10.1177/00207314211007100DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8193076PMC
July 2021

X chromosome-dependent disruption of placental regulatory networks in hybrid dwarf hamsters.

Genetics 2021 May;218(1)

Division of Biological Sciences, The University of Montana, Missoula, MT 59812, USA.

Embryonic development in mammals is highly sensitive to changes in gene expression within the placenta. The placenta is also highly enriched for genes showing parent-of-origin or imprinted expression, which is predicted to evolve rapidly in response to parental conflict. However, little is known about the evolution of placental gene expression, or if divergence of placental gene expression plays an important role in mammalian speciation. We used crosses between two species of dwarf hamsters (Phodopus sungorus and Phodopus campbelli) to examine the genetic and regulatory underpinnings of severe placental overgrowth in their hybrids. Using quantitative genetic mapping and mitochondrial substitution lines, we show that overgrowth of hybrid placentas was primarily caused by genetic differences on the maternally inherited P. sungorus X chromosome. Mitochondrial interactions did not contribute to abnormal hybrid placental development, and there was only weak correspondence between placental disruption and embryonic growth. Genome-wide analyses of placental transcriptomes from the parental species and first- and second-generation hybrids revealed a central group of co-expressed X-linked and autosomal genes that were highly enriched for maternally biased expression. Expression of this gene network was strongly correlated with placental size and showed widespread misexpression dependent on epistatic interactions with X-linked hybrid incompatibilities. Collectively, our results indicate that the X chromosome is likely to play a prominent role in the evolution of placental gene expression and the accumulation of hybrid developmental barriers between mammalian species.
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http://dx.doi.org/10.1093/genetics/iyab043DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8128391PMC
May 2021

Patient and family perspectives regarding the use of telehealth for cystic fibrosis care.

Pediatr Pulmonol 2021 05 26;56(5):811-813. Epub 2021 Jan 26.

Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia.

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http://dx.doi.org/10.1002/ppul.25262DOI Listing
May 2021

Phytoglycogen Nanoparticle Delivery System for Inorganic Selenium Reduces Cytotoxicity without Impairing Selenium Bioavailability.

Int J Nanomedicine 2020 24;15:10469-10479. Epub 2020 Dec 24.

Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON N2L 3C5, Canada.

Purpose: Selenium is an essential trace element that supports animal health through the antioxidant defense system by protecting cells from oxidative-related damage. Using inorganic selenium species, such as sodium selenite (Na Sel), as a food supplement is cost-effective; however, its limitation as a nutritional supplement is its cytotoxicity. One strategy to mitigate this problem is by delivering inorganic selenium using a nanoparticle delivery system (SeNP).

Methods: Rainbow trout intestinal epithelial cells, bovine turbinate cells and bovine intestinal myofibroblasts were treated with soluble Na Sel or SeNPs. Two SeNP formulations were tested; SeNP-Ionic where inorganic selenium was ionically bound to cationic phytoglycogen (PhG) NPs, and SeNP-Covalent, where inorganic selenium was covalently bound to PhG NPs. Selenium-induced cytotoxicity along with selenium bioavailability were measured.

Results: SeNPs (SeNP-Ionic or SeNP-Covalent) substantially reduced cytotoxicity in all cell types examined compared to similar doses of soluble inorganic selenium. The SeNP formulations did not affect selenium bioavailability, as selenium-induced glutathione peroxidase (GPx) activity and GPx1 transcript levels were similarly elevated whether cells were treated with soluble Na Sel or SeNPs. This was the case for all three cell types tested.

Conclusion: Nanoparticle-assisted inorganic selenium delivery, which demonstrated equal bioavailability without causing deleterious cytotoxic side effects, has potential applications for safely supplementing animal diets with inorganic selenium at what are usually toxic doses.
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http://dx.doi.org/10.2147/IJN.S286948DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769079PMC
February 2021

Tennessee Healthcare Provider Practices, Attitudes, and Knowledge Around HIV Pre-Exposure Prophylaxis.

J Prim Care Community Health 2020 Jan-Dec;11:2150132720984416

Vanderbilt University Medical Center, Nashville, TN, USA.

Introduction/objectives: Pre-exposure prophylaxis (PrEP) use in the southern United States is low despite its effectiveness in preventing HIV acquisition and high regional HIV prevalence. Our objectives were to assess PrEP knowledge, attitudes, and prescribing practices among Tennessee primary care providers.

Methods: We developed an anonymous cross-sectional electronic survey from March to November 2019. Survey development was guided by the Capability, Opportunity, Motivation, and Behavior framework and refined through piloting and interviews. Participants included members of professional society and health center listservs licensed to practice in Tennessee. Respondents were excluded if they did not complete the question regarding PrEP prescription in the previous year or were not in a position to prescribe PrEP (e.g., hospital medicine). Metrics included PrEP prescription in the preceding year, PrEP knowledge scores (range 0-8), provider attitudes about PrEP, and provider and practice characteristics. Knowledge scores and categorical variables were compared across PrEP prescriber status with Wilcoxon rank-sum and Fisher's exact tests, respectively.

Results: Of 147 survey responses, 99 were included and 43 (43%) reported PrEP prescription in the preceding year. Compared with non-prescribers: prescribers had higher median PrEP knowledge scores (7.3 vs 5.6,  < .01), a higher proportion had self-reported patient PrEP inquiries (95% vs 21%,  < .01), and a higher proportion had self-reported good or excellent ability to take a sexual history (83% vs 58%,  = .01) and comfort taking a sexual history (92% vs 63%,  < .01) from men who have sex with men, a subgroup with high HIV risk. Most respondents felt obligated to provide PrEP (65%), and felt all primary care providers should provide PrEP (63%).

Conclusion: PrEP provision is significantly associated with PrEP knowledge, patient PrEP inquiries, and provider sexual history taking ability and comfort. Future research should evaluate temporal relationships between these associations and PrEP prescription as potential routes to increase PrEP provision.
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http://dx.doi.org/10.1177/2150132720984416DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768326PMC
June 2021

Behavior Change, Egg Consumption, and Child Nutrition: A Cluster Randomized Controlled Trial.

Pediatrics 2020 12;146(6)

Institut de l'Environnement et de Recherches Agricoles, Ouagadougou, Burkina Faso.

Background And Objectives: Malnutrition is a significant contributor to child morbidity and mortality globally. Egg consumption has been associated with improved child nutrition yet is rare in rural, resource-poor settings. We test the effects of a culturally tailored behavior change intervention to increase child egg consumption.

Methods: A 3-arm cluster randomized controlled trial was conducted in rural Burkina Faso with 260 mother-child dyads. Children aged 4 to 17 months from 18 villages were included; those with reported history of malnutrition or egg allergy were excluded. Each child in the full intervention arm received 4 chickens, and mothers received the 10-month behavior change package. Participants in the partial intervention arm received only the behavior change package.

Results: In this analysis of 250 children, the full (β = 4.3; = 6.6 × 10) and the partial (β = 1.0; = .02) interventions significantly increased egg consumption. The full intervention also significantly increased poultry production (β = 11.6; 95% confidence interval 8.3-15; = 1.1 × 10) and women's decision-making about eggs (β = .66; = .02), and significantly decreased wasting (β = .58; = .03) and underweight (β = .47; = .02).

Conclusions: The culturally tailored behavior change package significantly increased child egg consumption. When coupled with the gift of chickens, the behavior change intervention yielded a greater increase in egg consumption and significantly reduced wasting and underweight. Behavior change strategies to increase egg consumption should be considered among nutrition and health programs in resource-poor settings where poultry is available.
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http://dx.doi.org/10.1542/peds.2020-007930DOI Listing
December 2020

Behavior Change, Egg Consumption, and Child Nutrition: A Cluster Randomized Controlled Trial.

Pediatrics 2020 12;146(6)

Institut de l'Environnement et de Recherches Agricoles, Ouagadougou, Burkina Faso.

Background And Objectives: Malnutrition is a significant contributor to child morbidity and mortality globally. Egg consumption has been associated with improved child nutrition yet is rare in rural, resource-poor settings. We test the effects of a culturally tailored behavior change intervention to increase child egg consumption.

Methods: A 3-arm cluster randomized controlled trial was conducted in rural Burkina Faso with 260 mother-child dyads. Children aged 4 to 17 months from 18 villages were included; those with reported history of malnutrition or egg allergy were excluded. Each child in the full intervention arm received 4 chickens, and mothers received the 10-month behavior change package. Participants in the partial intervention arm received only the behavior change package.

Results: In this analysis of 250 children, the full (β = 4.3; = 6.6 × 10) and the partial (β = 1.0; = .02) interventions significantly increased egg consumption. The full intervention also significantly increased poultry production (β = 11.6; 95% confidence interval 8.3-15; = 1.1 × 10) and women's decision-making about eggs (β = .66; = .02), and significantly decreased wasting (β = .58; = .03) and underweight (β = .47; = .02).

Conclusions: The culturally tailored behavior change package significantly increased child egg consumption. When coupled with the gift of chickens, the behavior change intervention yielded a greater increase in egg consumption and significantly reduced wasting and underweight. Behavior change strategies to increase egg consumption should be considered among nutrition and health programs in resource-poor settings where poultry is available.
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http://dx.doi.org/10.1542/peds.2020-007930DOI Listing
December 2020

Prx1-expressing cells contributing to fracture repair require primary cilia for complete healing in mice.

Bone 2021 02 11;143:115738. Epub 2020 Nov 11.

Harvard School of Dental Medicine, Boston, MA, USA.

Bone is a dynamic organ that is continuously modified during development, load-induced adaptation, and fracture repair. Understanding the cellular and molecular mechanisms for natural fracture healing can lead to therapeutics that enhance the quality of newly formed tissue, advance the rate of healing, or replace the need for invasive surgical procedures. Prx1-expressing cells in the periosteum are thought to supply the majority of osteoblasts and chondrocytes in the fracture callus, but the exact mechanisms for this behavior are unknown. The primary cilium is a sensory organelle that is known to mediate several signaling pathways involved in fracture healing and required for Prx1-expressing cells to contribute to juvenile bone development and adult load-induced bone formation. We therefore investigated the role of Prx1-expressing cell primary cilia in fracture repair by developing a mouse model that enabled us to simultaneously track Prx1 lineage cell fate and disrupt Prx1-expressing cell primary cilia in vivo. The cilium KO mice exhibited abnormally large calluses with significantly decreased bone formation and persistent cartilage nodules. Analysis of mRNA expression in the early soft callus revealed downregulation of osteogenesis, Hh signaling, and Wnt signaling, and upregulation of chondrogenesis and angiogenesis. The mutant mice also exhibited decreased Osx and Periostin but increased αSMA and PECAM-1 protein expression in the hard callus. We further used a Gli1 reporter and found that Hh signaling was significantly upregulated in the mutant callus at later stages of healing. Interestingly, altered protein expression and Hh signaling did not correlate with labeled Prx1-lineage cells, suggesting loss of cilia altered Hh signaling non-autonomously. Overall, cilium KO mice demonstrated severely delayed and incomplete fracture healing, and our findings suggest Prx1-expressing cell primary cilia are necessary to tune Hh signaling for proper fracture repair.
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http://dx.doi.org/10.1016/j.bone.2020.115738DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769995PMC
February 2021

Primary cilia as the nexus of biophysical and hedgehog signaling at the tendon enthesis.

Sci Adv 2020 Oct 30;6(44). Epub 2020 Oct 30.

Department of Orthopedic Surgery, Columbia University, New York, NY, 10032, USA.

The tendon enthesis is a fibrocartilaginous tissue critical for transfer of muscle forces to bone. Enthesis pathologies are common, and surgical repair of tendon to bone is plagued by high failure rates. At the root of these failures is a gap in knowledge of how the tendon enthesis is formed and maintained. We tested the hypothesis that the primary cilium is a hub for transducing biophysical and hedgehog (Hh) signals to regulate tendon enthesis formation and adaptation to loading. Primary cilia were necessary for enthesis development, and cilia assembly was coincident with Hh signaling and enthesis mineralization. Cilia responded inversely to loading; increased loading led to decreased cilia and decreased loading led to increased cilia. Enthesis responses to loading were dependent on Hh signaling through cilia. Results imply a role for tendon enthesis primary cilia as mechanical responders and Hh signal transducers, providing a therapeutic target for tendon enthesis pathologies.
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http://dx.doi.org/10.1126/sciadv.abc1799DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7608799PMC
October 2020

The Un Oeuf study: Design, methods and baseline data from a cluster randomised controlled trial to increase child egg consumption in Burkina Faso.

Matern Child Nutr 2021 01 8;17(1):e13069. Epub 2020 Aug 8.

Department of Environment and Global Health, College of Public Health and Health Practices, University of Florida, Gainesville, Florida, USA.

In many low-income countries, such as Burkina Faso, rates of malnutrition are high among children. Research indicates that animal source foods may provide important elements to improve growth and development of young children, especially during periods of rapid development, such as the first 1,000 days of life. The Un Oeuf study is designed to test an innovative behaviour change communication strategy to increase egg consumption in children 6-24 months in Burkina Faso, thereby improving dietary diversity and nutritional outcomes. This 1-year cluster randomised controlled trial tests whether the gifting of chickens by a community champion directly to a child, combined with a behaviour change package of integrated poultry management and human nutrition trainings, can significantly increase egg consumption among children under 2 years in rural communities where egg consumption is very low. The nutrition-sensitive behaviour change package is designed to increase egg consumption through improving livestock production, women's empowerment and food security at the household level. This paper presents a detailed account of the study design and protocol for the Un Oeuf study, alongside a description of the study population. Baseline data show a study population with high rates of malnutrition (stunting 21.6%, wasting 10.8% and underweight 20.4%) and a very low rate of egg consumption-less than 10% among children. Although poultry production is quite common, egg consumption is low reportedly because of cultural norms, including widespread practice of allowing eggs to hatch and a lack of knowledge about the nutritional benefits of egg consumption.
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http://dx.doi.org/10.1111/mcn.13069DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729644PMC
January 2021

Low Levels of Pyrethroid Resistance in Hybrid Offspring of a Highly Resistant and a More Susceptible Mosquito Strain.

J Insect Sci 2020 Jul;20(4)

Department of Biology, New Mexico State University, Las Cruces, NM.

The use of insecticides has been a central approach to control disease-transmitting mosquitoes for the last century. The high prevalence of pyrethroid use as public health insecticides has resulted in the evolution of pyrethroid resistance in many populations of Aedes aegypti (Linnaeus) (Diptera: Culicidae), throughout its global distribution range. Insecticide resistance is often correlated with an associated fitness cost. In this project, we studied the phenotypes of hybrid mosquitoes derived from crossing a pyrethroid-resistant strain of Ae. aegypti (Puerto Rico [PR]) with a more susceptible one (Rockefeller [ROCK]). We first sequenced and compared the para gene of both original strains. We then crossed males from one strain with females of the other, creating two hybrids (Puertofeller, Rockorico). We used a Y-tube choice assay to measure the attraction of these strains towards a human host. We then compared the levels of pyrethroid resistance in the different strains. We found three known resistance mutations in the para gene sequence of the PR strain. In our attraction assays, PR females showed lower attraction to humans, than the ROCK females. Both hybrid strains showed strong attraction to a human host. In the insecticide resistance bottle assays, both hybrid strains showed marginal increases in resistance to permethrin compared to the more susceptible ROCK strain. These results suggest that hybrids of sensitive and permethrin-resistant mosquitoes have an incremental advantage compared to more susceptible mosquitoes when challenged with permethrin. This explains the rapid spread of permethrin resistance that was observed many times in the field.
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http://dx.doi.org/10.1093/jisesa/ieaa060DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7329315PMC
July 2020

The role of goal-related autonomy: A self-determination theory analysis of perfectionism, poor goal progress, and depressive symptoms.

J Couns Psychol 2021 Jan 30;68(1):88-97. Epub 2020 Apr 30.

Department of Psychology, McGill University.

Adopting a self-determination theory perspective, this 3-wave longitudinal study explores the role of perfectionism in goal pursuit and the experience of depressive symptoms. The findings highlight the role of goal-related autonomy in mediating the opposite effects of self-critical and personal standards perfectionism on goal progress and depressive symptoms over the course of an academic year. The results suggest a way of understanding the pathway to depressive symptoms and poor goal progress in perfectionists. They point to a number of implications for clinical practice when working with self-critical perfectionists. Specifically, they indicate that interventions aimed at promoting autonomous motivation, may not only bolster goal progress but also act as a protective factor against depressive symptoms. Together, the results indicate that autonomous motivation is central to goal progress and suggest that low goal-related autonomy can be linked to negative outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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http://dx.doi.org/10.1037/cou0000438DOI Listing
January 2021

Step width variability as a discriminator of age-related gait changes.

J Neuroeng Rehabil 2020 03 5;17(1):41. Epub 2020 Mar 5.

Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Biomechanics Research Building 214, 6160 University Drive South, Omaha, NE, 68182-0860, USA.

Background: There is scientific evidence that older adults aged 65 and over walk with increased step width variability which has been associated with risk of falling. However, there are presently no threshold levels that define the optimal reference range of step width variability. Thus, the purpose of our study was to estimate the optimal reference range for identifying older adults with normative and excessive step width variability.

Methods: We searched systematically the BMC, Cochrane Library, EBSCO, Frontiers, IEEE, PubMed, Scopus, SpringerLink, Web of Science, Wiley, and PROQUEST databases until September 2018, and included the studies that measured step width variability in both younger and older adults during walking at self-selected speed. Data were pooled in meta-analysis, and standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated. A single-decision threshold method based on the Youden index, and a two-decision threshold method based on the uncertain interval method were used to identify the optimal threshold levels (PROSPERO registration: CRD42018107079).

Results: Ten studies were retrieved (older adults = 304; younger adults = 219). Step width variability was higher in older than in younger adults (SMD = 1.15, 95% CI = 0.60; 1.70; t = 4.72, p = 0.001). The single-decision method set the threshold level for excessive step width variability at 2.14 cm. For the two-decision method, step width variability values above the upper threshold level of 2.50 cm were considered excessive, while step width variability values below the lower threshold level of 1.97 cm were considered within the optimal reference range.

Conclusion: Step width variability is higher in older adults than in younger adults, with step width variability values above the upper threshold level of 2.50 cm to be considered as excessive. This information could potentially impact rehabilitation technology design for devices targeting lateral stability during walking.
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http://dx.doi.org/10.1186/s12984-020-00671-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059259PMC
March 2020

Prx1-Expressing Progenitor Primary Cilia Mediate Bone Formation in response to Mechanical Loading in Mice.

Stem Cells Int 2019 11;2019:3094154. Epub 2019 Nov 11.

Department of Biomedical Engineering, Columbia University, 500 W 120th Street New York, NY 10027, USA.

Increases in mechanical loading can enhance the addition of new bone, altering geometry and density such that bones better withstand higher forces. Bone-forming osteoblasts have long been thought to originate from progenitors, but the exact source is yet to be identified. Previous studies indicate osteogenic precursors arise from Prx1-expressing progenitors during embryonic development and adult fracture repair. However, it is unknown whether this cell population is also a source for mechanically induced active osteoblasts. We first identified that Prx1 is expressed in skeletally mature mouse periosteum, a thin tissue covering the surface of the bone that is rich in osteoprogenitors. We then traced Prx1 progenitor lineage using a transgenic mouse model carrying both a Prx1-driven tamoxifen-inducible Cre and a ROSA-driven lacZ reporter gene. Cells that expressed Prx1 when compressive axial loading was applied were detected within the cortical bone days after stimulation, indicating osteocytes are of Prx1-expressing cell origin. In addition, we evaluated how these cells sense and respond to physical stimulation by disrupting their primary cilia, which are antenna-like sensory organelles known to enhance mechanical and chemical signaling kinetics. Although Prx1-driven primary cilium disruption did not affect osteoblast recruitment to the bone surface, the relative mineral apposition and bone formation rates were decreased by 53% and 34%, respectively. Thus, this cell population contributes to load-induced bone formation, and primary cilia are needed for a complete response. Interestingly, Prx1-expressing progenitors are easily extracted from periosteum and are perhaps an attractive alternative to marrow stem cells for bone tissue regeneration strategies.
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http://dx.doi.org/10.1155/2019/3094154DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6877967PMC
November 2019

Mania and psychosis associated with right parietal meningioma.

Int J Psychiatry Med 2020 03 7;55(2):74-81. Epub 2019 Nov 7.

Department of Psychiatry, Rutgers New Jersey Medical School, Newark, NJ, USA.

Objective: Meningioma is the most common type of primary central nervous system and intracranial tumor, and psychiatric changes attributed to meningioma include depression, apathy, psychosis, and personality changes. We present a case of a 59-year-old man with right parietal meningioma who developed mania with psychotic features throughout multiple hospitalizations.

Method: Single-case report.

Results: The patient originally presented with headache and bilateral lower extremity weakness. He was found to have a large medial sphenoidal wing meningioma and a small right parietal meningioma. The sphenoidal wing meningioma was removed via craniotomy, but the right parietal meningioma was not resected. In the following years, the patient developed symptoms of mania and psychosis which coincided with an increase in size of the right parietal meningioma.

Conclusions: Previous studies have linked right parietal meningioma to psychosis, but this case is one of the first to suggest that right parietal meningioma may be associated with the development of mania along with psychotic features.
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http://dx.doi.org/10.1177/0091217419885218DOI Listing
March 2020

Efficacy of Active Ingredients From the EPA 25(B) List in Reducing Attraction of Aedes aegypti (Diptera: Culicidae) to Humans.

J Med Entomol 2020 02;57(2):477-484

Department of Biology, New Mexico State University, Las Cruces, NM.

Mosquitoes of the Aedes genus are vectors for dengue, chikungunya, Zika, and yellow fever viruses. Mosquito repellents are an effective way to prevent mosquito bites and reduce the spread of mosquito-borne diseases. In the early 90s, the U.S. Environmental Protection Agency (EPA) published a list of active ingredients that pose minimum risk to human health that can be used as pesticides or repellents without passing the EPA registration process. The present study examined the efficacy of 21 of the active ingredients listed by the EPA 25 (B) exempt list and five commercially available sprays that only contained active ingredients from the EPA 25(B) list in repelling female Aedes aegypti (L.) females. We performed choice bioassays in a controlled laboratory environment, using a Y-tube olfactometer to determine attraction rates of humans to female Ae. aegypti in the presence of one of the 21 active ingredients and five commercially available repellent sprays. We found that cinnamon oil, peppermint oil, spearmint oil, lemongrass oil, and garlic oil reduced mosquito attraction to human odor. Of the five commercial repellent sprays, only one reduced mosquito attraction for up to 30 min in our assay. The EPA 25 (B) list contains active ingredients that under the conditions of our assay repel Ae. aegypti.
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http://dx.doi.org/10.1093/jme/tjz178DOI Listing
February 2020

Effects of decreasing intersession interval duration on graduated exposure treatment during simulated routine dental care.

J Appl Behav Anal 2019 10 29;52(4):944-955. Epub 2019 Sep 29.

The New England Center for Children.

Reports suggest that individuals with developmental disabilities often engage in behavior during dental visits that precludes regular dental care. Graduated exposure therapies are an effective treatment for avoidant behavior in people with developmental delays, and some studies show that the duration of the intersession interval (ISI) can impact the effectiveness of graduated exposure treatments for typically developing individuals. The current study examined the effects of decreasing ISI on outcomes of a graduated exposure treatment during simulated routine dental care for 3 individuals diagnosed with autism. Treatment consisted of graduated exposure and extinction for disruptive behavior. Initially, sessions were conducted once per week. In subsequent conditions, treatment sessions were conducted 3-5 times per week. A nonconcurrent multiple baseline across subjects design was used to demonstrate experimental control. Results suggest that decreasing ISI durations can produce improved treatment outcomes.
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http://dx.doi.org/10.1002/jaba.642DOI Listing
October 2019

Prolonged exposure to simulated microgravity diminishes dendritic cell immunogenicity.

Sci Rep 2019 09 25;9(1):13825. Epub 2019 Sep 25.

Magnolia Research Center, Division of Biomedical Sciences, Department of Microbiology and Immunology, Edward Via College of Osteopathic Medicine Carolinas Campus, Spartanburg, SC, 29303, USA.

Immune dysfunction due to microgravity remains a hurdle in the next step of human space exploration. Dendritic cells (DC) represent a critical component of immunity, given their role in the detection of invaders and the subsequent task of activating T cells to respond and eliminate the threat. Upon encounter with microbes, DC undergo a process of maturation, whereby the cells upregulate the expression of surface proteins and secrete cytokines, both required for the optimal activation of CD4 and CD8 T cells. In this study, DC were cultured from 2-14 days in a rotary cell culture system, which generates a simulated microgravity (SMG) environment, and then the cells were assessed for maturation status and the capacity to activate T cells. Short-term culture (<72 h) of DC in SMG resulted in an increased expression of surface proteins associated with maturation and interleukin-6 production. Subsequently, the SMG exposed DC were superior to Static control DC at activating both CD4 and CD8 T cells as measured by interleukin-2 and interferon-γ production, respectively. However, long-term culture (4-14 d) of DC in SMG reduced the expression of maturation markers and the capacity to activate T cells as compared to Static DC controls.
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http://dx.doi.org/10.1038/s41598-019-50311-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761163PMC
September 2019

Prolonged exposure to simulated microgravity diminishes dendritic cell immunogenicity.

Sci Rep 2019 09 25;9(1):13825. Epub 2019 Sep 25.

Magnolia Research Center, Division of Biomedical Sciences, Department of Microbiology and Immunology, Edward Via College of Osteopathic Medicine Carolinas Campus, Spartanburg, SC, 29303, USA.

Immune dysfunction due to microgravity remains a hurdle in the next step of human space exploration. Dendritic cells (DC) represent a critical component of immunity, given their role in the detection of invaders and the subsequent task of activating T cells to respond and eliminate the threat. Upon encounter with microbes, DC undergo a process of maturation, whereby the cells upregulate the expression of surface proteins and secrete cytokines, both required for the optimal activation of CD4 and CD8 T cells. In this study, DC were cultured from 2-14 days in a rotary cell culture system, which generates a simulated microgravity (SMG) environment, and then the cells were assessed for maturation status and the capacity to activate T cells. Short-term culture (<72 h) of DC in SMG resulted in an increased expression of surface proteins associated with maturation and interleukin-6 production. Subsequently, the SMG exposed DC were superior to Static control DC at activating both CD4 and CD8 T cells as measured by interleukin-2 and interferon-γ production, respectively. However, long-term culture (4-14 d) of DC in SMG reduced the expression of maturation markers and the capacity to activate T cells as compared to Static DC controls.
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http://dx.doi.org/10.1038/s41598-019-50311-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761163PMC
September 2019

Response to: Comparison between modified and conventional one-handed chest compression techniques for child cardiopulmonary resuscitation: A randomised, non-blind, cross-over simulation trial.

J Paediatr Child Health 2019 07;55(7):878

Acute Medicine, Imperial College Healthcare NHS Trust Charing Cross Hospital, London, United Kingdom.

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http://dx.doi.org/10.1111/jpc.14494DOI Listing
July 2019

Zika Testing Behaviors and Risk Perceptions Among Pregnant Women in Miami-Dade County, One Year After Local Transmission.

Matern Child Health J 2019 Aug;23(8):1140-1145

Florida Department of Health in Miami-Dade County, Epidemiology, Disease Control, and Immunization Services, 8600 NW 17th Street, Miami, FL, 33126, USA.

Objectives: This study sought to describe the knowledge and perceptions of pregnant women in Miami-Dade County concerning Zika virus (ZIKV) in their community, to characterize their testing behaviors, and to identify any barriers that would keep them from seeking testing.

Methods: The Florida Department of Health in Miami-Dade County partnered with the Healthy Start Coalition of Miami-Dade to administer an assessment survey in eight OBGYN clinics from June to August 2017. The survey captured past ZIKV testing practices, attitudes towards testing, barriers to testing, risk perception of ZIKV in the participants' community, and ZIKV-related knowledge. Descriptive analyses were performed on variables of interest. Chi squared tests examined associations between categorical variables.

Results: A total of 363 participants were included in the analysis. Of these, 203 (55.9%) thought they should be tested for ZIKV, and less than half of the participants reported having been previously tested (152, 41.9%). Participants with some high school education were significantly more likely than those with higher education levels to see ZIKV as a "big problem" in the community (p = 0.0026). There was a significant association (p ≤ 0.0001) between women who thought that they should be tested, and those who perceived ZIKV to be a medium or big problem in their community.

Conclusions For Practice: Health interventions that focus on increasing ZIKV knowledge should also place greater emphasis on risk communication when targeting the pregnant population. Having a higher risk perception may be more predictive of testing behaviors than having a lack of barriers or a high level of ZIKV-related knowledge.
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http://dx.doi.org/10.1007/s10995-019-02756-xDOI Listing
August 2019
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