Towards a unified generic framework to define and observe contacts between livestock and wildlife: a systematic review

Wild animals are the source of many pathogens of livestock and humans. Concerns about the potential transmission of economically important and zoonotic diseases from wildlife have led to increased surveillance at the livestock-wildlife interface. Knowledge of the types, frequency and duration of contacts between livestock and wildlife is necessary to identify risk factors for disease transmission and to design possible mitigation strategies. Observing the behaviour of many wildlife species is challenging due to their cryptic nature and avoidance of humans, meaning there are relatively few studies in this area. Further, a consensus on the definition of what constitutes a 'contact' between wildlife and livestock is lacking. A systematic review was conducted to investigate which livestock-wildlife contacts have been studied and why, as well as the methods used to observe each species. Over 30,000 publications were screened, of which 122 fulfilled specific criteria for inclusion in the analysis. The majority of studies examined cattle contacts with badgers or with deer; studies involving wild pig contacts with cattle or with domestic pigs were the next most frequent. There was a range of observational methods including motion-activated cameras and global positioning system collars. As a result of the wide variation and lack of consensus in the definitions of direct and indirect contacts, we developed a unified framework to define livestock-wildlife contacts that is sufficiently flexible to be applied to most wildlife and livestock species for non-vector-borne diseases. We hope this framework will help standardise the collection and reporting of contact data; a valuable step towards being able to compare the efficacy of wildlife-livestock observation methods. In doing so, it may aid the development of better disease transmission models and improve the design and effectiveness of interventions to reduce or prevent disease transmission.

Patch Testing During the COVID-19 Pandemic: Recommendations of the AEDV's Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC)

As the COVID-19 pandemic gradually comes under control, the members of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) have drawn up a proposed list of the requirements, limitations, and conditioning factors affecting the resumption of work in contact dermatitis units. The assumption is that the severe acute respiratory syndrome coronavirus2 is still circulating and that occasional or seasonal outbreaks will occur. They recommend that the first step should be to assess how many patch tests each clinic can handle and review the waiting list to prioritize cases according to disease severity and urgency. Digital technologies can, where possible, be used to send and receive the documentation necessary for the patch test (information, instructions, informed consent, etc.). If the necessary infrastructure is available, patients can be offered the option of a remote initial consultation. Likewise, in selected cases, the patch test results can be read in a virtual visit using photographs taken by the patient or a video visit can be scheduled to allow the physician to evaluate the site of application remotely. These measures will reduce the number of face-to-face visits required, but will not affect the time spent on each case, which must be scheduled in the normal manner. All of these recommendations are suggestions and should be adapted to the needs and possibilities of each health centre.

The effect of albumin and γ-globulin on synovial fluid lubrication: Implication for knee joint replacements

Total knee arthroplasty has become a routine procedure for patients suffering from joint diseases. Although the number of operations continuously increases, a limited service-life of implants represents a persisting challenge for scientists. Understanding of lubrication may help to suitably explain tribological processes on the way to replacements that become durable well into the third decade of service. The aim of the present study is to assess the formation of protein lubricating film in the knee implant. A developed knee simulator was used to observe the contact of real femoral and transparent polymer tibial component using fluorescent microscopy. The contact was lubricated by various protein solutions with attention to the behaviour of albumin and γ-globulin. In order to suitably mimic a human synovial fluid, hyaluronic acid and phospholipids were subsequently added to the solutions. Further, the change in shape and the migration of the contact zone were studied. The results showed considerable appearance differences of the contact over the swing phase of the simplified gait cycle. Regarding film formation, a strong interaction of the various molecules of synovial fluid was observed. It was found that the thickness of the lubricating layer stabilizes within around 50 s. Throughout the contact zone, protein agglomerations were present and could be clearly visualised using the applied optical technique.

Patch Testing During the COVID-19 Pandemic: Recommendations of the AEDV's Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC)

As the COVID-19 pandemic gradually comes under control, the members of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) have drawn up a proposed list of the requirements, limitations, and conditioning factors affecting the resumption of work in contact dermatitis units. The assumption is that the severe acute respiratory syndrome coronavirus 2 is still circulating and that occasional or seasonal outbreaks will occur. They recommend that the first step should be to assess how many patch tests each clinic can handle and review the waiting list to prioritize cases according to disease severity and urgency. Digital technologies can, where possible, be used to send and receive the documentation necessary for the patch test (information, instructions, informed consent, etc.). If the necessary infrastructure is available, patients can be offered the option of a remote initial consultation. Likewise, in selected cases, the patch test results can be read in a virtual visit using photographs taken by the patient or a video visit can be scheduled to allow the physician to evaluate the site of application remotely. These measures will reduce the number of face-to-face visits required, but will not affect the time spent on each case, which must be scheduled in the normal manner. All of these recommendations are suggestions and should be adapted to the needs and possibilities of each health centre.

The role of religious beliefs and collective narcissism in interreligious contact on university students

The rise of exclusive puritanism movements challenges several communities to live in peaceful coexistence. This research aimed to observe the level of interreligious contact among university students. This was a threefold study. The first part was an initial inquiry to construct an interreligious contact scale. The second sought to see the inferential association between interreligious contact, belief in religious teachings (i.e. religious fundamentalism, kindly religious belief, and meta-religion endorsement), and collective narcissism. The third part was to investigate differences in those variables between students who joined student political organizations with religion-based ideology and those who did not. There were 381 respondents from various religious backgrounds (e.g. Muslim, Christian, and other) participating in this research. The result of the exploratory factor analysis indicated a unidimensionality of the interreligious contact scale. Regression analysis found that religious fundamentalism and collective narcissism made individuals less likely to exhibit interreligious contact. However, kindly religious belief and meta-religion endorsement encouraged interreligious contact. In addition, an independent sample t-test suggested that there was a difference in the inclusivism level between religion-based student organization members and non-members. Members of such organization tended to exhibit a lower level of interreligious contact, while their level of religious fundamentalism and collective narcissism were higher compared to their non-member counterparts.

Thymol-Induced Chemical Leukoderma Successfully Treated with 308-Nanometer Excimer Laser

Introduction

Chemical leukoderma (CL) is an acquired depigmenting disorder caused by repeated exposure to chemical compounds. Thymol is a phenol derivative used as a preservative or antiseptic in many commercially available products. Here, we present the second reported case of CL caused by a thymol-containing compound.

Case Presentation

A 48-year-old woman presented with a 4-month history of depigmentation of the nail folds of all ten fingers. This occurred after 1 month of twice-daily application of a thymol-containing compound intended for the removal of gel nails. No improvement was noted after the product was discontinued. There was no family history of vitiligo or other autoimmune disorders. On physical exam, depigmentation of all ten proximal and lateral nail folds was seen, with accentuation on Wood's lamp exam. Partial re-pigmentation was achieved after 32 treatments with 308-nm excimer laser.

Discussion

A thorough history and physical exam are instrumental in differentiating CL from other causes of depigmentation. Avoidance of the offending agent is an essential part of management. It is important to note that many cosmetic products are not tightly regulated by the FDA. Excimer laser is an effective treatment for CL with a favorable side-effect profile.

What Can be Done to Reduce the Public Stigma of Gambling Disorder? Lessons from Other Stigmatised Conditions

Gambling is embedded in Australian cultural history, and perceived as a normal, legitimate leisure activity. Despite this normalisation, people who experience gambling problems are heavily stigmatised which can lead to a variety of harms that extend beyond the individual. The stigma from the general public appears to be based on a stereotype of a typical "problem gambler"-selfish, greedy, impulsive and irresponsible. However, research suggests that people experiencing gambling problems have widely varying characteristics and do not conform to this stereotype. Regardless of whether the stigma is justified, it is both present and problematic. Gamblers experiencing problems delay help-seeking due to feelings of shame and, not unwarranted, expectations of negative judgement because of the heavy stigma associated with the stereotype. As stigma is a primary barrier to treatment and a reason why gambling problems can take longer to acknowledge, it is important to understand and address how stigma can be reduced to minimise the negative consequences of gambling on individuals, their families and friends and the wider community. There is little research on reducing gambling-related stigma, so there is a need to examine strategies used in other stigmatised conditions, such as mental health, to understand the general principles of effective stigma reduction measures. Because gambling disorder is unique, well-hidden and consequently not well understood, there is a need to recognise that techniques used in other domains may differ in their effectiveness within the context of gambling stigma.

Use of medical face masks versus particulate respirators as a component of personal protective equipment for health care workers in the context of the COVID-19 pandemic

Currently available evidence supports that the predominant route of human-to-human transmission of the SARS-CoV-2 is through respiratory droplets and/or contact routes. The report by the World Health Organization (WHO) Joint Mission on Coronavirus Disease 2019 (COVID-19) in China supports person-to-person droplet and fomite transmission during close unprotected contact with the vast majority of the investigated infection clusters occurring within families, with a household secondary attack rate varying between 3 and 10%, a finding that is not consistent with airborne transmission. The reproduction number (R0) for the SARS-CoV-2 is estimated to be between 2.2-2.7, compatible with other respiratory viruses associated with a droplet/contact mode of transmission and very different than an airborne virus like measles with a R0 widely cited to be between 12 and 18. Based on the scientific evidence accumulated to date, our view is that SARS-CoV-2 is not spread by the airborne route  to  any significant extent and the use of particulate respirators offers no advantage over medical masks as a component of personal protective equipment for the routine care of patients with COVID-19 in the health care setting. Moreover, prolonged use of particulate respirators may result in unintended harms. In conjunction with appropriate hand hygiene, personal protective equipment (PPE) used by health care workers caring for patients with COVID-19 must be used with attention to detail and precision of execution to prevent lapses in adherence and active failures in the donning and doffing of the PPE.

Influence of physical variables on the transfer of Salmonella Typhimurium LT2 between potato (Solanum tuberosum) and stainless steel via static and dynamic contact

Bacterial cross-contamination between foods and contact surfaces can increase food safety risk; however, these processes are not well described in terms of fundamental variables. The objective was to determine the effect of sliding speed (3.75, 5.00, or 7.75 mm/s), contact time (5 or 40 s), normal pressure (~1217 to 8869 Pa), and number of sequential contacts on bacterial transfer to/from potato samples and stainless steel surfaces. Potato samples (~11 g, 3 × 3 × 1 cm) were either pulled across a stainless steel plate inoculated with Salmonella Typhimurium LT2 (~6.23 Log CFU/cm²) (dynamic contact) or placed on the inoculated plate for multiple sequential contacts on uninoculated squares (static contact). Salmonella on the potato and steel plate then were quantified by plating on modified trypticase soy agar. Bacterial transfer increased with increasing sliding speed (P = 0.0098) in dynamic tests and with contact time (P < 0.0001) in static tests. Salmonella on the inoculated potatoes decreased (P < 0.0001) from ~6.5 to ~5.5 Log CFU after 18 sequential static contacts with stainless steel. Reporting transfer results based on fundamental variables will improve the overall impact of bacterial transfer research on equipment design, cleaning/sanitation strategies, and overall food safety.

Root causes of extended length of stay and unplanned readmissions after orthopedic surgery and hand surgery: a retrospective observational cohort study

Background

While previous studies have evaluated the effect of some patient characteristics (e.g. gender, American Society of Anesthesiologists (ASA) class and comorbidity) on outcome in orthopedic and hand day surgery, more detailed information on anesthesia related factors has previously been lacking. Our goal was to investigate the perioperative factors that affect overstay, readmission and contact after day surgery in order to find certain patient profiles more prone to problemed outcomes after day surgery.

Methods

We examined orthopedic and hand day surgery at an orthopedic day surgery unit of Helsinki University Hospital. Patient data of all adult orthopedic and hand day surgery patients (n = 542) over a 3-month period (January 1 – March 31, 2015) operated on at the unit were collected retrospectively using the hospital’s surgery database. These data comprised anesthesia and patient records with a follow-up period of 30 days post-operation. Patients under the age of 16 and patients not eligible for day surgery were excluded. Patient records were searched for an outcome of overstay, readmission or contact with the emergency room or policlinic. Pearson chi-square test, Fischer’s exact test and multivariable logistic regression were used to analyze the effect of various perioperative factors on postoperative outcome.

Results

Various patient and anesthesia related factors were examined for their significance in the outcomes of overstay, readmission or contact. Female gender (p = 0.043), total amount of fentanyl (p = 0.00), use of remifentanil (p = 0.036), other pain medication during procedure (p = 0.005) and administration of antiemetic medication (p = 0.048) emerged as statistically significant on outcome after day surgery.

Conclusions

Overstay and readmission in orthopedic and hand day surgery were clearly connected with female patients undergoing general anesthesia and needing larger amounts of intraoperative opioids. By favoring local and regional anesthesia, side effects of general anesthesia, as well as recovery time, will decrease.

What is the level of uptake of partner notification services in HIV testing in selected health facilities in Gatanga Sub County, Muranga County - Kenya; a retrospective study

BACKGROUND

Identification of people living with HIV is key in HIV prevention and control. Partner Notification service is a World Health Organization backed strategy of reaching out to sexual partners of people diagnosed with HIV for HIV testing. However, its adoption and success rate in Kenya remains unknown.

METHODS

A cross sectional facility based study was undertaken in five purposely selected health facilities in Gatanga Sub county, Muranga County, Kenya. A retrospective review of patient medical records data for HIV positive index clients and their Sexual Partners conducted. Census approach was applied to extract data for study subjects from Partner Notification Services registers for the period covering January 2017 to August 2018. Epi Info software was used for data analysis.

RESULTS

A total of 183 index clients were offered Partner notification services. The mean age of the indexed clients studied was 39(SD ±13.1). Females comprised 64% of clients studied. Of the 183 indexed clients, 89% accepted the services and elicited 216 sexual partners for tracing. The ratio of elicited sexual partners to index client was 1.3:1. Out of the 216 sexual partners, 77% were reached and tested. A total of 46 [32%] of the sexual partners elicited and traced, tested HIV positive. The most preferred approaches were provider referral (51%) and contract referral (45%). Dual referral (4%) was the least preferred approach.

CONCLUSIONS

Assisted Partner notification services is acceptable and an effective strategy of increasing HIV case identification and raising awareness to exposed sexual partners in low resource countries.

Bats and belief: A sequential qualitative study in Thailand

Bats are wildlife and distribute globally. In Thailand, there are hundreds of bat species in different locations within four regions. However, few motivations and influences for having contact with bats have been documented. This sequential qualitative study was conducted in ten provinces representing the four regions of Thailand from September 2016 to June 2017. The study was designed to obtain information on villagers' attitudes, perceptions, beliefs and cultural contexts in relation to bats. Focus group discussions (FGDs) were conducted with 305 respondents. Of these respondents, 142 (46.6%) reported coming into contact with bats through various activities, such as hunting, eating, cooking, collecting bat guano, cleaning bat feces, and finding carcasses in houses and communities. Villagers called bats by different names in different regions. They reported having been in contact with bats in different ways based on occupations, bat species, bat habitats, attitudes, perceptions, beliefs toward bats, and cultural contexts. Villagers in the northern and northeastern regions reported having regularly eaten bats. In contrast, the respondents in the central region did not eat bats due to local norms, religious beliefs, and regulations. By ethnicity, the Blu and Thai Dum groups reported coming into contact with and eating bats more often than the Thais. Our results provide evidence-based information on the human-bat interface in different regions in Thailand. The results of this qualitative study could be useful for strategic planning of proper education and interventions for bat conservation, bat contact behavior, and risk of bat-borne diseases among villagers in the future.

Defining adequate contact for transmission of Mycobacterium tuberculosis in an African urban environment

Background

The risk of infection from respiratory pathogens increases according to the contact rate between the infectious case and susceptible contact, but the definition of adequate contact for transmission is not standard. In this study we aimed to identify factors that can explain the level of contact between tuberculosis cases and their social networks in an African urban environment.

Methods

This was a cross-sectional study conducted in Kampala, Uganda from 2013 to 2017. We carried out an exploratory factor analysis (EFA) in social network data from tuberculosis cases and their contacts. We evaluated the factorability of the data to EFA using the Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO). We used principal axis factoring with oblique rotation to extract and rotate the factors, then we calculated factor scores for each using the weighted sum scores method. We assessed construct validity of the factors by associating the factors with other variables related to social mixing.

Results

Tuberculosis cases (N = 120) listed their encounters with 1154 members of their social networks. Two factors were identified, the first named “Setting” captured 61% of the variance whereas the second, named ‘Relationship’ captured 21%. Median scores for the setting and relationship factors were 10.2 (IQR 7.0, 13.6) and 7.7 (IQR 6.4, 10.1) respectively. Setting and Relationship scores varied according to the age, gender, and nature of the relationship among tuberculosis cases and their contacts. Family members had a higher median setting score (13.8, IQR 11.6, 15.7) than non-family members (7.2, IQR 6.2, 9.4). The median relationship score in family members (9.9, IQR 7.6, 11.5) was also higher than in non-family members (6.9, IQR 5.6, 8.1). For both factors, household contacts had higher scores than extra-household contacts (p < .0001). Contacts of male cases had a lower setting score as opposed to contacts of female cases. In contrast, contacts of male and female cases had similar relationship scores.

Conclusions

In this large cross-sectional study from an urban African setting, we identified two factors that can assess adequate contact between tuberculosis cases and their social network members. These findings also confirm the complexity and heterogeneity of social mixing.

Risk factors for bat contact and consumption behaviors in Thailand; a quantitative study

BACKGROUND

Bats serve as an important reservoir for emerging infectious diseases. Bat contact and consumption, which persists in Asia, poses risks for the transmission of bat-borne infections.

METHODS

An analytical cross-sectional survey for risk factors associated with bat contact and consumption behaviors was conducted in ten provinces of Thailand from May 2016 to December 2017. A standardized questionnaire administered through face-to-face interviews was used to collect information from 626 villagers who lived in or nearby areas of high bat density. The questionnaire contained 23 independent variables related to sociodemographic, knowledge, attitudes, practices, and perceptions.

RESULTS

The respondents (n = 626) were 285 females and 341 males, mean age of respondents was 47.58 years-old and lived in rural setting. Our results showed that 36.42% of respondents (n1 = 228) in 10 provinces reported bat contact during the past 6 months. Furthermore, 15.34% of respondents (n2 = 96) in 9 out of 10 provinces reported of having consumed bat meat in the past 6 months. Risk factors for bat contact included sex (male) (OR = 1.56, 95% CI 1.09-2.28), educational attainment (lower than secondary school) (OR = 1.45, 95% CI 1.02-2.18), and the consideration of bats as being economically beneficial to the community (OR = 3.18, 95% CI 2.03-4.97), while agriculture-related occupation (OR = 0.54, 95% CI 0.37-0.79), knowledge that it is safe to eat bats (OR = 0.58, 95% CI 0.37-0.93), practice of allowing children to play with bats (OR = 0.65, 95% CI 0.44-0.96), and attitude of feeling safe in areas where bats live (OR = 0.56, 95% CI 0.38-0.86) were statistically significant protective factors against bat contact. Risk factors for bat consumption included sex (male) (OR = 2.48, 95% CI 1.49-4.11) and educational attainment (lower than secondary school) (OR = 2.21, 95% CI 1.27-3.85), while knowledge of whether bats are safe to eat (OR = 0.04, 95% CI 0.01-0.25), knowledge of whether there are laws pertaining to hunting bats for consumption (OR = 0.35, 95% CI 0.18-0.71), and the practice of allowing children to play with bats (OR = 0.51, 95% CI 0.31-0.81) were statistically significant protective factors against bat consumption.

CONCLUSIONS

This study provides a better understanding of the sociodemographic factors, knowledge, attitudes, perceptions and practices that might influence bat contact and bat consumption behaviors. Information on risk factors can be used for the development of appropriate education and communication interventions to promote proper knowledge, attitudes and practices regarding bats and bat-borne zoonotic diseases in Thailand and other areas in the Southeast Asia region with similar environmental and cultural characteristics.

Social Stigma Towards People with Medically Unexplained Symptoms: the Somatic Symptom Disorder

The majority of previous studies on mental health stigma have focused on medically explained symptoms and the studies on medically unexplained symptoms (MUS) have only assessed the consequences of internalized stigma. A new category in DSM 5, named as somatic symptom disorder (SSD), includes multiple somatic disorders with medically-explained or -unexplained somatic symptoms. This study aimed to test the effects of social stigma on people with SSD with MUS depending on the attribution model. In a class environment, 348 college students from different regions in Turkey were presented with a vignette on a person with SSD with MUS and asked to complete a survey including demographics and attitudes towards that person. Along the same lines with previous findings for other mental disorders, the path analysis using AMOS revealed that stigma-related cognitions (i.e., dependency, dangerousness and responsibility) shaped people's affective (i.e., anger and pity) and behavioral responses (i.e., social distance) to these people. The most important predictor of social distance was pity and the level of contact was not related to social distance. In conclusion, anti-stigma interventions towards SSD with MUS should involve building empathy towards these patients and educating people about this disorder contrary to the recommended interventions for other mental health disorders stressing the importance of contact.

Aging Parents' and Middle-Aged Children's Evaluations of Parents' Disability and Life Problems

This study examined discrepancies in aging parents' and middle-aged children's evaluations of aging parents' problems and how these discrepancies were associated with relationship characteristics. Using data from the Family Exchanges Study (dyad N = 331 ), discrepancies in the parents' disabilities and life problems reported by parents and their offspring were examined. Children reported a greater number of disabilities and life problems in their parents' lives than parents did. The discrepancy in the number of disabilities was associated with the frequency of phone contact, but not the frequency of in-person contact between generations. Findings confirm the gap in the evaluations of parents' problems between generations, indicating that children may overestimate their parents' problems, whereas parents may underreport their own problems. Frequent phone calls between aging parents and middle-aged children seem to play a positive role in conveying aging parents' problems. The gap in knowledge of parents' problems may lead to unmet needs and/or undesirable support exchanges between parents and offspring. Future research needs to consider both generations' reports and to develop reliable methods to assess parents' problems.

Evaluating health risks associated with exposure to ambient surface waters during recreational activities: A systematic review and meta-analysis

Recreational water quality guidelines protect the public from health risks associated with water recreation by helping to prevent unacceptable concentrations of pathogenic organisms in ambient water. However, illness risk is associated with both the concentration of pathogens in the water and the degree of contact with those pathogens. Different recreational activities can result in different levels of contact with ambient water containing water-borne pathogens. We conducted a systematic literature review and meta-analysis to evaluate risks of illness associated with different recreational activities and different levels of contact to ambient surface waters. We screened 8,618 potentially relevant studies for quantitative measures of risk using inclusion/exclusion criteria established in advance. We categorized recreational activities as swimming, sports-related contact, minimal contact, and sand contact. We combined relative risks using a random effects meta-analysis for adverse health outcome categories representing gastrointestinal illness, respiratory illness, skin, eye, ear, nose, throat, and cold/flu illness. We identified 92 studies meeting our inclusion criteria. Pooled risk estimates indicate significant elevation of gastrointestinal illness with the recreational activity categories swimming (2.19, 95% CI: 1.82, 2.63) and sports-related contact (2.69, 95% CI: 1.04, 6.92), and nonsignificant elevation of gastrointestinal illness with minimal contact (1.27, 95% CI: 0.74, 2.16). We also found a significant elevation of respiratory illness with swimming (1.78, 95% CI: 1.38, 2.29) and sports-related contact (1.49, 95% CI: 1.00, 2.24), and no elevation of respiratory illness with minimal contact (0.90, 95% CI: 0.71, 1.14). This study suggests that exposures associated with different types of recreational activities are important characteristics of the exposure pathway when assessing illness risk associated with recreation in ambient surface waters.

Current Directions in Deep Brain Stimulation for Parkinson's Disease-Directing Current to Maximize Clinical Benefit

Several single-center studies and one large multicenter clinical trial demonstrated that directional deep brain stimulation (DBS) could optimize the volume of tissue activated (VTA) based on the individual placement of the lead in relation to the target. The ability to generate axially asymmetric fields of stimulation translates into a broader therapeutic window (TW) compared to conventional DBS. However, changing the shape and surface of stimulating electrodes (directional segmented vs. conventional ring-shaped) also demands a revision of the programming strategies employed for DBS programming. Model-based approaches have been used to predict the shape of the VTA, which can be visualized on standardized neuroimaging atlases or individual magnetic resonance imaging. While potentially useful for optimizing clinical care, these systems remain limited by factors such as patient-specific anatomical variability, postsurgical lead migrations, and inability to account for individual contact impedances and orientation of the systems of fibers surrounding the electrode. Alternative programming tools based on the functional assessment of stimulation-induced clinical benefits and side effects allow one to collect and analyze data from each electrode of the DBS system and provide an action plan of ranked alternatives for therapeutic settings based on the selection of optimal directional contacts. Overall, an increasing amount of data supports the use of directional DBS. It is conceivable that the use of directionality may reduce the need for complex programming paradigms such as bipolar configurations, frequency or pulse width modulation, or interleaving. At a minimum, stimulation through directional electrodes can be considered as another tool to improve the benefit/side effect ratio. At a maximum, directionality may become the preferred way to program because of its larger TW and lower energy consumption.

Anterior cruciate ligament tear due to non-contact mode of injury associated with higher incidence of meniscal and chondral damage

BACKGROUND

Forces acting on the knee are different in contact and non-contact mode of injuries causing anterior cruciate ligament (ACL) tear. Purpose of this study was to determine the effect of mode of injury on the occurrence of meniscal tear and chondral damage in ACL tear.

METHOD

72 athletes with acute ACL injury (<3 months) were enrolled in the study. Depending on the mode of injury, athletes were divided into two groups - group A (non-contact mode of injury) and group B (contact mode of injury). 49/72 athletes had the non-contact mode of injury (group A), and 23/72 athletes had contact mode of injury (group B). Meniscal tear and chondral damage seen at the time of ACL reconstruction surgery was noted. All athletes were assessed at 12 months follow-up for return to sports, Lysholm score, and WOMAC score.

RESULTS

In group A, 35/49 (71%) athletes and in group B, 9/23(39%) athletes had meniscal tear (p = 0.009). Medial meniscus was more commonly injured in group A [24/49] as compared to group B (5/23; p = 0.03). Chondral damage was also more commonly seen in group A [26/49] as compared to group B (5/23; p = 0.01). At one-year follow-up, 65% of the athletes from group B returned to sports as compared to 57% of the athletes from group A (p-value = 0.6). WOMAC score in group A and B was 95.5 ± 4.88 and 96 ± 4.39 respectively (p = 0.67). Lysholm score in group A and B was 1.02 ± 1.7 and 0.96 ± 1.2 respectively (p = 0.88).

CONCLUSION

Non-contact mode of injury was associated with a higher incidence of meniscal tear and chondral damage. However, the mode of injury does not affect the functional outcome of ACL reconstruction surgery.

Day-to-Day Contact and Help Among Neighbors Measured in the Natural Environment

BACKGROUND AND OBJECTIVES

Empirical evidence suggests that the concept of "neighboring" (i.e., social contact and social support within a neighborhood) is related to between-person differences in well-being among older adults. However, little is known about the within-person differences in older adults' everyday lives, which limits the ecological validity of prior findings. This study examined within-person associations between neighboring and the existence of positive valence, loneliness, and attachment to one's neighborhood.

RESEARCH DESIGN AND METHODS

The sample consisted of 4,620 observations of 20 days, drawn from 77 adults aged between 61 and 90 years. A mobile application on a smartphone was used for data collection.

RESULTS

The results of the multilevel analysis suggest that daily contact with one's neighbors was not significantly associated with daily positive valence, but it was positively related to daily feelings of not being alone and daily attachment to one's neighborhood.

DISCUSSION AND IMPLICATIONS

The study makes noteworthy contributions to the field of gerontology by applying a micro-longitudinal research design to assess real-life within-person information.

The Effectiveness of Two Potential Mass Media Interventions on Stigma: Video-Recorded Social Contact and Audio/Visual Simulations

Two approaches that may be particularly well suited for mass media (large scale) stigma interventions are video-recorded social contact and simulations, but research is rather limited. The purpose of this study was to evaluate two potential mass media interventions on different facets of stigma. Participants (N = 244) completed stigma measures prior to, immediately following, and 1 week following the random assignment of: (1) video-recorded social contact, (2) an audio/visual simulation, or (3) no intervention. The video-recorded social contact led to decreases on preference for social distance and negative emotions across 1 week, but only a temporary decrease on perceptions of dangerousness. In contrast, no significant changes in stigma were noted following the simulation. In sum, video-recorded social contact appears promising and offers many advantages for mass media implementation including low cost, minimal resources, and ease of dissemination. In contrast, further evaluation of audio/visual simulations is warranted before implementation.

Targeting stigma of mental illness among primary care providers: Findings from a pilot feasibility study

Stigmatizing attitudes among primary care (PC) providers potentially contribute to poor health outcomes for individuals with serious mental illness (SMI). In this pilot study, our primary aim is to test the feasibility, and preliminary implementation of two interventions (contact and education) to help change provider attitudes and behavior. Participants were 39 primary care providers from two Veterans Affairs medical centers with 19 randomized to the contact intervention and 20 to the education intervention. Both interventions were delivered in a group setting face-to-face. Stigmatizing attitudes were measured using Opening Minds Scale for Health Care Providers, Attribution Questionnaire and Social Distance Scale at baseline, one month and three months. Data were analyzed using repeated measures analysis of variance (ANOVA). Most providers were white, female, nurses, and older than age 50. For each of the three measures of stigmatizing attitudes there was no statistically significant treatment-by-time interaction rejecting our hypothesis that contact intervention will result in significantly greater reduction in stigmatizing attitudes. Qualitative analysis suggests that the contact intervention was perceived as much needed. This study informs future research to reduce provider stigma. Our intervention was modeled on interventions designed for the general public; different interventions may be needed for providers.

IL-15Rα membrane anchorage in either cis or trans is required for stabilization of IL-15 and optimal signaling

Interleukin (IL)-15 plays an important role in the communication between immune cells. It delivers its signal through different modes involving three receptor chains: IL-15Rα, IL-2Rβ and IL-2Rγc. The combination of the different chains result in the formation of IL-15Rα/IL-2Rβ/γc trimeric or IL-2Rβ/γc dimeric receptors. In this study, we have investigated the role of the IL-15Rα chain in stabilizing the cytokine in the IL-2Rβ/γc dimeric receptor. By analyzing the key amino acid residues of IL-15 facing IL-2Rβ, we provide evidence of differential interfaces in the presence or in the absence of membrane-anchored IL-15Rα. Moreover, we found that the anchorage of IL-15Rα to the cell surface regardless its mode of presentation - i.e. cis or trans - is crucial for complete signaling. These observations show how the cells can finely modulate the intensity of cytokine signaling through the quality and the level of expression of the receptor chains.

Support for discriminatory behaviours against immigrants in Italy: Perceived threat and positive beliefs mediate the effect of contact with immigrants

The present study aimed at investigating whether the effects of intergroup contact on support for discriminatory behaviours against immigrants was mediated by perceived threat from immigrants and positive beliefs toward immigrants. Using data from the Italian national survey on "Discrimination by Gender, Sexual Orientation and Ethnic Origin," which followed a multi-stage stratified cluster sampling procedure, a representative sample of 5509 Italian residents (53.4% women), aged 18 to 74 years, participated. Findings showed that contact with immigrants was negatively related to perceived threat, and positively related to positive beliefs toward immigrants. Mediational analysis conducted by structural equation modelling, indicated that support for discriminatory behaviours was positively associated with perceived threat, and negatively associated with positive beliefs toward immigrants. Both variables together mediated the relationship between contact with immigrants and support for discriminatory behaviours against immigrants; individually, indirect relationships were also significant. To promote interaction between natives and immigrants by reducing the perceived threat and strengthening positive beliefs toward immigrants might lessen support for discriminatory behaviours against immigrants.

Micromechanical modeling of the contact stiffness of an osseointegrated bone-implant interface

Background

The surgical success of cementless implants is determined by the evolution of the biomechanical properties of the bone–implant interface (BII). One difficulty to model the biomechanical behavior of the BII comes from the implant surface roughness and from the partial contact between bone tissue and the implant. The determination of the constitutive law of the BII would be of interest in the context of implant finite element (FE) modeling to take into account the imperfect characteristics of the BII. The aim of the present study is to determine an effective contact stiffness \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\left( {K_{c}^{\text{FEM}} } \right)$$\end{document}KcFEM of an osseointegrated BII accounting for its micromechanical features such as surface roughness, bone–implant contact ratio (BIC) and periprosthetic bone properties. To do so, a 2D FE model of the BII under normal contact conditions was developed and was used to determine the behavior of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$K_{c}^{\text{FEM}}$$\end{document}KcFEM.

Results

The model is validated by comparison with three analytical schemes based on micromechanical homogenization including two Lekesiz’s models (considering interacting and non-interacting micro-cracks) and a Kachanov’s model. \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$K_{c}^{\text{FEM}}$$\end{document}KcFEM is found to be comprised between 10¹³ and 10¹⁵ N/m³ according to the properties of the BII. \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$K_{c}^{\text{FEM}}$$\end{document}KcFEM is shown to increase nonlinearly as a function of the BIC and to decrease as a function of the roughness amplitude for high BIC values (above around 20%). Moreover, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$K_{c}^{\text{FEM}}$$\end{document}KcFEM decreases as a function of the roughness wavelength and increases linearly as a function of the Young’s modulus of periprosthetic bone tissue.

Conclusions

These results open new paths in implant biomechanical modeling since this model may be used in future macroscopic finite element models modeling the bone–implant system to replace perfectly rigid BII conditions.