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Item Biomarkers of environmental enteric dysfunction and adverse birth outcomes: an observational study among pregnant women living with HIV in Tanzania(Elsevier, 2022-09-17) Miles, Kirby; Lauer, Jacqueline; Muhihi, Alfa; Ulenga, Nzovu; Aboud, Said; Liu, Enju; Choy, Robert K.M.; Arndt, Michael; Kou, Jianqun; Gewirtz, Andrew; Fawzi, Wafaie; Duggan, Christopher; Manji, Karim; Sudfeld, ChristopherBACKGROUND: Environmental enteric dysfunction (EED) may contribute to adverse birth outcomes in low-resource settings. We examined the associations of EED biomarkers with birth outcomes in pregnant women living with human immunodeficiency virus in Dar es Salaam, Tanzania. METHODS: We performed a cohort study of 706 HIV-infected pregnant women. Maternal serum samples collected at 32 weeks gestation were analyzed for markers of EED (anti-flagellin and anti-LPS immunoglobulins, intestinal fatty acid-binding protein [I-FABP] and soluble CD14), systemic inflammation (C-reactive protein and α1-acid glycoprotein [AGP]), and growth hormone resistance (insulin-like growth factor 1 [IGF-1] and fibroblast growth factor 21 [FGF21]. Associations of biomarkers categorized into quartiles with birth outcomes (birthweight, gestational duration, birthweight-for-gestational age, and stillbirth) were assessed using linear and log-binomial regression models adjusted for multiple sociodemographic and clinical variables. FINDINGS: Maternal EED biomarkers were not significantly associated with birthweight, gestation duration, or birthweight-for-gestational age. However, higher quintiles of I-FABP concentrations were associated with greater risk of stillbirth (ptrend=0·02). Higher AGP was associated with lower birthweight and was associated with increased risk of small-for-gestational age births. Higher IGF-1 was associated with higher birthweight and birthweight-for-gestational age while higher FGF21 was associated with shorter gestation and higher risk of preterm birth. INTERPRETATION: Maternal biomarkers of EED, systemic inflammation, and growth hormones were differentially associated with birth outcomes. Biomarkers of EED may be useful to identify pregnant women at risk of adverse birth outcomes, but further research is needed to confirm these findings and elucidate biological mechanisms.Item Vascular aging, the vascular cytoskeleton and aortic stiffness(Open Exploration Publishing, 2021) Kajuluri, Lova Prasadareddy; Singh, Kuldeep; Morgan, Kathleen G.Vascular aging, aortic stiffness and hypertension are mechanistically interrelated. The perspective presented here will focus mainly on the molecular mechanisms of age-associated increases in the stiffness of the vascular smooth muscle cell (VSMC). This review will highlight the mechanisms by which the VSMC contributes to disorders of vascular aging. Distinct functional sub-components of the vascular cell and the molecular mechanisms of the protein-protein interactions, signaling mechanisms and intracellular trafficking processes in the setting of the aging aorta will be detailed.Item Non-muscle myosin II regulates aortic stiffness through effects on specific focal adhesion proteins and the non-muscle cortical cytoskeleton(Journal of Cellular and Molecular Medicine, 2020) Morgan, Kathleen; Singh, KuldeepNon-muscle myosin II (NMII) plays a role in many fundamental cellular processes including cell adhesion, migration, and cytokinesis. However, its role in mammalian vascular function is not well understood. Here, we investigated the function of NMII in the biomechanical and signalling properties of mouse aorta. We found that blebbistatin, an inhibitor of NMII, decreases agonist-induced aortic stress and stiffness in a dose-dependent manner. We also specifically demonstrate that in freshly isolated, contractile, aortic smooth muscle cells, the non-muscle myosin IIA (NMIIA) isoform is associated with contractile filaments in the core of the cell as well as those in the non-muscle cell cortex. However, the non-muscle myosin IIB (NMIIB) isoform is excluded from the cell cortex and colocalizes only with contractile filaments. Furthermore, both siRNA knockdown of NMIIA and NMIIB isoforms in the differentiated A7r5 smooth muscle cell line and blebbistatin-mediated inhibition of NM myosin II suppress agonist-activated increases in phosphorylation of the focal adhesion proteins FAK Y925 and paxillin Y118. Thus, we show in the present study, for the first time that NMII regulates aortic stiffness and stress and that this regulation is mediated through the tension-dependent phosphorylation of the focal adhesion proteins FAK and paxillin.Item Ageing causes an aortic contractile dysfunction phenotype by targeting the expression of members of the extracellular signal-regulated kinase pathway(Wiley, 2022-03) Nicholson, Christopher J.; Xing, Yi; Lee, Sophie; Liang, Stephanie; Mohan, Shivani; O'Rourke, Caitlin; Kang, Joshua; Morgan, Kathleen G.The extracellular signal-regulated kinase (ERK) pathway is a well-known regulator of vascular smooth muscle cell proliferation, but it also serves as a regulator of caldesmon, which negatively regulates vascular contractility. This study examined whether aortic contractile function requires ERK activation and if this activation is regulated by ageing. Biomechanical experiments revealed that contractile responses to the alpha1-adrenergic agonist phenylephrine are attenuated specifically in aged mice, which is associated with downregulation of ERK phosphorylation. ERK inhibition attenuates phenylephrine-induced contractility, indicating that the contractile tone is at least partially ERK-dependent. To explore the mechanisms of this age-related downregulation of ERK phosphorylation, we transfected microRNAs, miR-34a and miR-137 we have previously shown to increase with ageing and demonstrated that in A7r5 cells, both miRs downregulate the expression of Src and paxillin, known regulators of ERK signalling, as well as ERK phosphorylation. Further studies in aortic tissues transfected with miRs show that miR-34a but not miR-137 has a negative effect on mRNA levels of Src and paxillin. Furthermore, ERK phosphorylation is decreased in aortic tissue treated with the Src inhibitor PP2. Increases in miR-34a and miR-137 with ageing downregulate the expression of Src and paxillin, leading to impaired ERK signalling and aortic contractile dysfunction.Item Experiences of LGBTQ-identifying students, interns, and practitioners of dietetics(2021) DeBiasse, Michele A.Individuals who identify as lesbian, gay, bisexual, transgender and/or queer (LGBTQ) currently comprise over five percent of the population in America. It is unknown how many dietetics students, interns, or practitioners identify as LGBTQ as these data are not collected by the Academy of Nutrition and Dietetics nor its “sister” organizations. Research suggests that LGBTQ-identifying folx, experience higher rates of anxiety, depression, stigmatization, discrimination and isolation and many have unmet healthcare needs. This holds for LGBTQ-identified individuals studying and practicing in healthcare professions but to date there have been no studies of the dietetics profession. To explore the experiences of LGBTQ-identifying dietetics students, interns and practitioners we conducted a mixed-methods study grounded in Feminist Standpoint theory. National convenience and snowball sampling strategies generated n=131 students, interns and professionals of ACEND-accredited programs for our survey and n=10 for our semi-structured interviews. Qualitative analyses identified themes of overt and covert “underminers” of success including heteronormative assumptions/talk, misgendering, microaggressions, self-editing and closeting, and identified a lack of adequate LGBTQ-related healthcare content in academics/training. Supporters of success included people/groups with supportive characteristics, therapists/mental health professionals, and passion for the field. Survey data indicated significant differences between heterosexual and non-heterosexual respondents to a number of questions including homosexuality in society, awareness of LGBTQ community experiences, importance of academic content/training on nutrition assessment/care of LGBTQ-identified folx and responsibility for advocacy for LGBTQ-identifying patients/clients. Our results indicate need for better data collection, improved coursework/training on inclusion and greater content on nutrition/healthcare needs for LGBTQ-identifying patients and clients.Item Improving iron folic acid consumption through interpersonal communication: findings from the reduction in anemia through normative innovations (RANI) project(Elsevier BV, 2022-01) Ganjoo, Rohini; Rimal, Rajiv N.; Talegawkar, Sameera A.; Sedlander, Erica; Pant, Ichhya; Bingenheimer, Jeffrey; Chandarana, Shikha; Aluc, Aika; Jin, Yichen; Yilma, Hagere; Panda, BikashOBJECTIVE: More than half of Indian women of reproductive age are anemic. Regular iron folic acid uptake can prevent and treat anemia. This study investigated the effect of interpersonal communication on improving IFA use among women of reproductive age. METHODS: The Reduction in Anemia through Normative Innovations (RANI) Project is a cluster randomized trial that collected longitudinal data from control (n = 1896) and intervention (n = 1898) communities in Odisha, India at Time 1 and six months later at Time 2. Structural equation models assessed the effect of the intervention on iron folic acid use via multiple interpersonal communication pathways. RESULTS: Compared to the control arm, iron folic acid use significantly increased in the intervention arm. Both, general health interpersonal communication and anemia-specific interpersonal communication were augmented in the intervention communities. The impact of the intervention on iron folic acid use was mediated through anemia-specific interpersonal communication. CONCLUSION: The RANI Project increased interpersonal communication among participants, resulting in increased iron folic acid use for anemia reduction. PRACTICE IMPLICATIONS: Strategic use of targeted interpersonal communication to promote behavior change appears to be a viable strategy to increase iron folic acid use to reduce anemia.Item Determinants of work capacity (predicted VO2max) in non-pregnant women of reproductive age living in rural India(Springer Science and Business Media LLC, 2021-12) DiPietro, Loretta; Bingenheimer, Jeffrey; Talegawkar, Sameera A.; Sedlander, Erica; Yilma, Hagere; Pradhan, Pratima; Rimal, RajivBACKGROUND: The negative impact of anemia on work capacity has been studied extensively in male and female workers; however, the simultaneous contributions of confounding variables such as physical activity, as well as other behavioral and sociodemographic characteristics have not been considered. The purpose of this study was to examine cross-sectionally the multivariable correlates of work capacity in non-pregnant women (n = 330) living in rural India. METHODS: The Reduction in Anemia through Normative Innovations (RANI) Project is a norms-based, clustered randomized controlled trial to reduce anemia among women (15–49 years) living in Odisha, India between 2018 and 2021. For the larger trial, 89 clusters of villages were randomized into treatment and control groups on a 1:1 basis. Women (2055/group) living in 15 selected clusters (40–41 villages) were then randomly selected for data collection. The sampling design also randomly-generated a subset (n = 375) of non-pregnant participants who performed a modified Queen’s College Step Test (QCST) and who wore an activity monitor for 3 days. Predicted work capacity (VO_2max) was determined using the QCST. Levels (h/day) of daily reclining, sitting, standing, walking (steps/day), and energy expenditure (MET∙h/day) were determined using an ActivPAL accelerometer. Hemoglobin concentrations (g/dL) were determined using a HemoCue photometer. Predetermined hierarchical (non-multilevel) regression models tested the independent associations between the primary study variables of interest (physical activity, hemoglobin concentrations) and predicted VO_2max, while adjusting for age, body mass index (BMI: kg/m^2), education, parity, and dietary diversity score. RESULTS: Approximately 61% of the participants had anemia (Hb < 12 g/dL). Age^2 (β = − 0.01; 95% CI: − 0.01, 0.00), BMI (β = − 0.19; 95% CI:-0.28, − 0.09), educational attainment (β = − 1.35; 95% CI: − 2.34, − 0.36), and MET∙h/day (β = 0.19; 95% CI: 0.00, 0.38) were significant and independent determinants of work capacity. Hemoglobin concentration was marginally associated with work capacity in the presence of the other covariables (β = 0.22; 95% CI:-0.02, 0.47). CONCLUSIONS: Our data indicate that factors other than anemia are important correlates of work capacity and should be considered when promoting the health and economic capacity of rural Indian women.Item If fear of infertility restricts contraception use, what do we know about this fear? An examination in rural Ethiopia(BioMed Central, 2022-06-13) Sedlander, Erica; Yilma, Hagere; Emaway, Dessalew; Rimal, Rajiv N.BACKGROUND: Ethiopia has made great progress toward reducing unmet need for family planning and increasing contraception use over the last decade. However, almost one-quarter of women still have an unmet need. The primary reason for non-use is “method-related health concerns” and, within this broad category, the belief that using contraception will cause infertility is common. This belief extends beyond Ethiopia to low-, middle-, and high-income countries across the world. The objective of this paper is to examine associations with the belief that contraception use causes infertility and to subsequently suggest potential strategies to address this misperception. METHODS: We collected data from women of reproductive age (between 15 and 49 years old) in 115 rural districts of Ethiopia (n = 706). Our main outcome variable was the belief that contraception causes infertility. We analyzed data, both individual-level factors and interpersonal factors, using nested logistic regression models. RESULTS: Almost half of women in our sample (48.2%) believed that contraceptive use causes infertility. In the final model that included factors from both levels, self-efficacy to use contraception (AOR = 0.81, p < 0.05), visiting a health center and speaking to a provider about family planning in the last 12 months (AOR = 0.78, p < 0.05), and husband support of contraception (AOR = 0.77, p < 0.01) were associated with a reduction in the odds of believing that contraception causes infertility. The belief that infertility will result in abandonment from one’s husband (AOR = 3.06, p < 0.001) was associated with an increase in the odds of holding the belief that contraception causes infertility. A home visit in the last 12 months from a health worker who discussed family planning was not associated with the belief that contraceptive use causes infertility. CONCLUSIONS: Given that this belief is both salient and positively associated with other fears such as abandonment from one’s husband, it is critical for family planning programs to address it. Communication campaigns or interventions that address this misperception among couples may diminish this belief, thereby increasing contraception use and reducing unmet need in rural Ethiopia.Item How does a social norms-based intervention affect behaviour change? Interim findings from a cluster randomised controlled trial in Odisha, India(BMJ Journals, 2022-07-08) Sedlander, Erica; Pant, Ichhya; Bingenheimer, Jeffrey; Yilma, Hagere; Patro, Lipika; Ganjoo, Rohini; Mohanty, Satyanarayan; Rimal, RajivBackground Behaviour change interventions targeting social norms are burgeoning, but researchers have little guidance on what they look like, and which components affect behaviour change. The Reduction in Anaemia through Normative Innovations (RANI) project designed an intervention to increase iron folic acid (IFA) consumption in Odisha, India. Objective This paper examines the effect of the intervention at midline to understand which components of the RANI intervention affect uptake. Methods Using a cluster randomised controlled design, we collected baseline data and midline data 6 months later from women of reproductive age in the control and treatment arms (n=3800) in Angul, Odisha, India. Using nested models, we analysed data from three different intervention components, monthly community-based testing for anaemia, participatory group education sessions, and videos, to determine the extent to which exposure to each of these components accounted for the overall intervention effect on haemoglobin and self-reported IFA use. Results Overall, residing in a treatment as opposed to control village had little effect on midline haemoglobin, but increased the odds of taking supplements by 17 times. Exposure to each of the intervention components had a dose–response relationship with self-reported IFA use. These components, separately and together, accounted for most of the overall effect of treatment assignment on IFA use. Conclusions All intervention components increased iron supplement use to differing degrees of magnitude. It appears that a social norms-based approach can result in improving IFA uptake, though improvements in haemoglobin counts were not yet discernible.Item Multilevel theorizing in health communication: integrating the Risk Perception Attitude (RPA) framework and the Theory of Normative Social Behavior (TNSB)(Public Library of Science (PLoS), 2022-07-22) Yilma, Hagere; Rimal, Rajiv N.; Parida, ManojResearch testing the risk perception attitudes (RPA) framework has demonstrated that efficacy can moderate the effect of risk perceptions on behavior. This effect of efficacy has also been seen at the social-level through tests of the theory of normative social behavior (TNSB). We tested if efficacy could bridge normative factors at a social-level and risk perception at an individual-level. Data for this study come from the Reduction in Anemia through Normative Innovations (RANI) project’s baseline survey in Odisha, India. We used hierarchical regressions to analyze interactions between predictors at various levels and efficacy to predict behavioral intention. Efficacy beliefs moderated the effect of injunctive norms (β = 0.07, p < 0.01), collective norms (β = 0.06, p < 0.01), and risk perception (β = 0.04, p < 0.01) on intentions. This study provides preliminary evidence for a multilevel theoretical framework.Item Health care providers' perceptions of barriers to perinatal mental healthcare in South Africa(2021-10-21) Brown, Shelley; Sprague, CourtenayBACKGROUND: Perinatal mental disorders are a leading contributor to morbidity and mortality during pregnancy and postpartum, and are highly treatable when identified early. However, many women, especially in low and middle-income countries, lack access to routine identification and treatment of mental illness in public health settings. The prevalence of perinatal depression and anxiety disorders, common mental disorders, is three times higher for South African women relative to women in high-income countries. The public health system has begun to integrate mental health into maternal care, making South Africa a relevant case study of perinatal mental healthcare. Yet studies are few. We sought to investigate healthcare providers' perceptions of the barriers to early identification and screening of common perinatal mental disorders in public health facilities in South Africa. METHODS: Employing qualitative methods, we used purposive sampling to identify study participants, supplemented by snowball sampling. From September 2019-June 2020, we conducted in-depth interviews with 24 key informants in South Africa. All interviews were recorded and transcribed verbatim. We used a thematic approach to generate initial analytical themes and then conducted iterative coding to refine them. We adapted a delivery systems' framework to organise the findings, depicted in a conceptual map. RESULTS: Reported barriers to early identification and treatment of mental illness in the perinatal period encompassed four levels: (1) structural factors related to policies, systems and resources; (2) socio-cultural factors, including language and cultural barriers; (3) organisational factors, such as lack of provider preparation and training and overburdened clinics; and (4) individual patient and healthcare provider factors. CONCLUSION: Barriers act across multiple levels to reduce quality mental health promotion and care, thereby creating an environment where inequitable access to identification of mental disorders and quality mental health services was embedded into systems and everyday practice. Integrated interventions across multiple levels are essential to improve the early identification and treatment of mental illness in perinatal women in South Africa. We provide recommendations derived from our findings to overcome barriers at each of the four identified levels.Item Draft genome sequences of six strains isolated from the InSight spacecraft and associated surfaces using Oxford Nanopore- and Illumina-based sequencing(2020-05-21) Vera, Daniel L.; Seuylemezian, Arman; Landry, Kyle S.; Hendrickson, RyanWhole-genome sequencing and annotation have allowed planetary protection engineers to assess the functional capabilities of microorganisms isolated from spacecraft hardware and associated surfaces. Here, we report draft genomes of six strains isolated from the InSight mission, determined using Oxford Nanopore- and Illumina-based sequencing.Item Biofilms-impacts on human health and its relevance to space travel(2020-07-03) Landry, Kyle S.; Morey, Jose M.; Bharat, Bharat; Haney, Nora M.; Panesar, Sandip S.As the world looks towards the stars, the impacts of endogenous and exogenous microorganisms on human health during long-duration space flight are subjects of increased interest within the space community. The presence and continued growth of bacterial biofilms about spacecraft has been documented for decades; however, the impact on crew health is in its infancy. The impacts of biofilms are well known in the medical, agricultural, commercial, and industrial spaces. It less known that biofilms are undermining many facets of space travel and that their effects need to be understood and addressed for future space missions. Biofilms can damage space crew health and spoil limited food supply. Yet, at the same time, they can benefit plant systems for food growth, nutrient development, and other biological systems that are being explored for use in space travel. Various biofilm removal techniques have been studied to mitigate the hazards posed by biofilm persistence during space travel. Because the presence of biofilms can advance or hinder humanity's space exploration efforts, an understanding of their impacts over the duration of space flights is of paramount importance.Item Effort-based decision-making and gross motor performance: are they linked?(2020-06-04) Gill, Simone V.; Abplanalp, Samuel J.; Keegan, Laura; Fulford, DanielThe purpose of this study was to investigate the relationship between effort-based decision making and gross motor performance. Effort-based decision making was measured using a modified version of the Effort Expenditure for Rewards Task (EEfRT), in which participants pressed a button on a keyboard to fill a bar on a screen for monetary reward. Participants received monetary rewards that were commensurate with the level of effort that they were willing to expend. Gross motor performance was measured with a walking task, in which participants matched their steps to the beat of an audio metronome; they walked to metronome beats that were slower and also faster than their normal walking pace. We hypothesized that increased effort during the effort-based decision making task would be paired with an increase in steps taken per minute during the gross motor task. However, the results of this study indicated a lack of a statistically significant relationship between the effort-based decision making task and the gross motor task. Planning rather than decision-making may have been the cognitive construct that governed our gross motor task. These findings can be beneficial when thinking about potential interventions for populations who experience deficits in motor performance and cognition as well as for understanding the relationship between both cognitive and motor performance in healthy adults.Item "Skip the Small Talk" virtual event intended to promote social connection during a global pandemic: online survey study(2021-09-23) Mote, Jasmine; Gill, Kathryn; Fulford, DanielBACKGROUND: Social distancing measures meant to prevent the spread of COVID-19 in the past year have exacerbated loneliness and depression in the United States. While virtual tools exist to improve social connections, there have been limited attempts to assess community-based, virtual methods to promote new social connections. OBJECTIVE: In this proof-of-concept study, we examined the extent to which Skip the Small Talk (STST)-a business dedicated to hosting events to facilitate structured, vulnerable conversations between strangers-helped reduce loneliness in a virtual format in the early months of the 2020 COVID-19 pandemic. We predicted that participants who attended STST virtual events would show a reduction in loneliness, improvement in positive affect, and reduction in negative affect after attending an event. We were also interested in exploring the role of depression symptoms on these results as well as the types of goals participants accomplished by attending STST events. METHODS: Adult participants who registered for an STST virtual event between March 25 and June 30, 2020, completed a survey before attending the event (pre-event survey; N=64) and a separate survey after attending the event (postevent survey; n=25). Participants reported on their depression symptoms, loneliness, and positive and negative affect. Additionally, participants reported the goals they wished to accomplish as well as those they actually accomplished by attending the STST event. RESULTS: The four most cited goals that participants hoped to accomplish before attending the STST event included the following: "to make new friends," "to have deeper/better conversations with other people," "to feel less lonely," and "to practice social skills." A total of 34% (20/58) of participants who completed the pre-event survey reported depression symptoms that indicated a high risk of a major depressive episode in the preceding 2 weeks. Of the 25 participants who completed the pre- and postevent surveys, participants reported a significant reduction in loneliness (P=.03, Cohen d=0.48) and negative affect (P<.001, Cohen d=1.52) after attending the STST event compared to before the event. Additionally, depressive symptoms were significantly positively correlated with change in negative affect (P=.03), suggesting that the higher the depression score was prior to attending the STST event, the higher the reduction in negative affect was following the event. Finally, 100% of the participants who wished to reduce their loneliness (11/11) or feel less socially anxious (5/5) prior to attending the STST event reported that they accomplished those goals after the event. CONCLUSIONS: Our preliminary assessment suggests that the virtual format of STST was helpful for reducing loneliness and negative affect for participants, including those experiencing depression symptoms, during the COVID-19 pandemic. While encouraging, additional research is necessary to demonstrate whether STST has benefits when compared to other social events and interventions and whether such benefits persist beyond the events themselves.Item Do cognitive impairments limit treatment gains in a standalone digital intervention for psychosis? A test of the digital divide(2022-06) Fulford, Daniel; Schupbach, Elizabeth; Gard, David E.; Mueser, Kim T.; Mow, Jessica; Leung, LawrenceDigital mental health interventions, such as those provided by smartphone applications (apps), show promise as cost-effective approaches to increasing access to evidence-based psychosocial interventions for psychosis. Although it is well known that limited financial resources can reduce the benefits of digital approaches to mental healthcare, the extent to which cognitive functioning in this population could impact capacity to engage in and benefit from these interventions is less studied. In the current study we examined the extent to which cognitive functioning (premorbid cognitive abilities and social cognition) were related to treatment engagement and outcome in a standalone digital intervention for social functioning. Premorbid cognitive abilities generally showed no association with aggregated treatment engagement markers, including proportion of notifications responded to and degree of interest in working on app content, though there was a small positive association with improvements in social functioning. Social cognition, as measured using facial affect recognition ability, was unrelated to treatment engagement or outcome. These preliminary findings suggest that cognitive functioning is generally not associated with engagement or outcomes in a standalone digital intervention designed for and with people with schizophrenia spectrum disorders.Item From home to hospital: sustainable transfers of care in the United States(Springer, 2021) Dunham, Bria; Hall, Sara; Gutschow, Kim; Davis-Floyd, Robbie; Daviss, B.-A.Due to a range of factors, including but not limited to obstetric complications, a person who had planned to give birth at home may be transferred to a hospital setting. These transfers of care can be facilitated in a sustainable manner by maintaining the pregnant individual’s support personnel, avoiding unnecessary replication of tests and procedures, limiting obstetric interventions to those medically indicated and desired by the pregnant individual, and eliminating the fragmentation of care between sites and providers during the transfer. The Best Practice Guidelines for transfers of planned homebirths to hospital settings, as developed by delegates to the Home Birth Summit, provide a humanized framework for these transfers that may be all the more urgent during disruptive times and for pregnant individuals who face additional vulnerabilities.Item Improvements in upper extremity function following intensive training are independent of corticospinal tract organization in children with unilateral spastic cerebral palsy: a clinical randomized trial(2021) Friel, Kathleen M.; Ferre, Claudio L.; Brandao, Marina; Kuo, Hsing-Ching; Chin, Karen; Hung, Ya-Ching; Robert, Maxime T.; Flamand, Veronique H.; Smorenburg, Ana; Bleyenheuft, Yannick; Carmel, Jason B.; Campos, Talita; Gordon, Andrew M.BACKGROUND/OBJECTIVES: Intensive training of the more affected upper extremity (UE) has been shown to be effective for children with unilateral spastic cerebral palsy (USCP). Two types of UE training have been particularly successful: Constraint-Induced Movement Therapy (CIMT) and Bimanual training. Reorganization of the corticospinal tract (CST) early during development often occurs in USCP. Prior studies have suggested that children with an ipsilateral CST controlling the affected UE may improve less following CIMT than children with a contralateral CST. We tested the hypothesis that improvements in UE function after intensive training depend on CST laterality. Study Participants and Setting: Eighty-two children with USCP, age 5 years 10 months to 17 years, University laboratory setting. MATERIALS/METHODS: Single-pulse transcranial magnetic stimulation (TMS) was used to determine each child's CST connectivity pattern. Children were stratified by age, sex, baseline hand function and CST connectivity pattern, and randomized to receive either CIMT or Bimanual training, each of which were provided in a day-camp setting (90 h). Hand function was tested before, immediately and 6 months after the intervention with the Jebsen-Taylor Test of Hand Function, the Assisting Hand Assessment, the Box and Block Test, and ABILHAND-Kids. The Canadian Occupational Performance Measure was used to track goal achievement and the Pediatric Evaluation of Disability Inventory was used to assess functioning in daily living activities at home. RESULTS: In contrast to our hypothesis, participants had statistically similar improvements for both CIMT and Bimanual training for all measures independent of their CST connectivity pattern (contralateral, ipsilateral, or bilateral) (p < 0.05 in all cases). CONCLUSIONS/SIGNIFICANCE: The efficacy of CIMT and Bimanual training is independent of CST connectivity pattern. Children with an ipsilateral CST, previously thought to be maladaptive, have the capacity to improve as well as children with a contralateral or bilateral CST following intensive CIMT or Bimanual training. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02918890.Item Leveraging genomics to understand threats in a migratory waterbird(Wiley, 2021-03-22) Larison, Brenda; Lindsay, Alec R.; Bossu, Christen; Sorenson, Michael D.; Kaplan, Joseph D.; Evers, David C.; DaCosta, Jeffrey M.; Smith, Thomas B.; Ruegg, KristenUnderstanding how risk factors affect populations across their annual cycle is a major challenge for conserving migratory birds. For example, disease outbreaks may happen on the breeding grounds, the wintering grounds, or during migration and are expected to accelerate under climate change. The ability to identify the geographic origins of impacted individuals, especially outside of breeding areas, might make it possible to predict demographic trends and inform conservation decision-making. However, such an effort is made more challenging by the degraded state of carcasses and resulting low quality of DNA available. Here, we describe a rapid and low-cost approach for identifying the origins of birds sampled across their annual cycle that is robust even when DNA quality is poor. We illustrate the approach in the common loon (Gavia immer), an iconic migratory aquatic bird that is under increasing threat on both its breeding and wintering areas. Using 300 samples collected from across the breeding range, we develop a panel of 158 single-nucleotide polymorphisms (SNP) loci with divergent allele frequencies across six genetic subpopulations. We use this SNP panel to identify the breeding grounds for 142 live nonbreeding individuals and carcasses. For example, genetic assignment of loons sampled during botulism outbreaks in parts of the Great Lakes provides evidence for the significant role the lakes play as migratory stopover areas for loons that breed across wide swaths of Canada, and highlights the vulnerability of a large segment of the breeding population to botulism outbreaks that are occurring in the Great Lakes with increasing frequency. Our results illustrate that the use of SNP panels to identify breeding origins of carcasses collected during the nonbreeding season can improve our understanding of the population-specific impacts of mortality from disease and anthropogenic stressors, ultimately allowing more effective management.Item Eating disorders in male athletes: factors associated with onset and maintenance(Human Kinetics, 2021-09-01) Freedman, Julie; Hage, Sally; Quatromoni, Paula A.Male athletes are underrepresented in eating disorders research. This phenomenological study investigated the experiences of male athletes who self-identified as having an eating disorder, disordered eating, or compulsive exercise behaviors. Eight male collegiate athletes were interviewed, and qualitative analysis identified factors associated with the onset and maintenance of disordered behaviors. Among the novel findings was the salient influence of social media as a driver of body dissatisfaction and disordered behaviors. The participants described a perceived sense of control and feeling of pride associated with the use of behaviors, cultural norms in a male sport environment that sustained these behaviors, and a shared belief that, until they experienced a loss of control over their use of behaviors, they would not likely ask for help or seek treatment. These findings have implications for additional research, as well as individual and systems-level strategies for the prevention, screening, and treatment of eating and exercise disorders in male sport.