Encouraging Human Papillomavirus Vaccine Uptake: A Healthcare Improvement Project

Abstract Problem: Human papillomaviruses are the causative agents of \u3e95% of cervical cancers, most oropharyngeal and anogenital cancers, yet the vaccination status of the population remains critically low despite Gardasil9 offering robust protection against HPV-related disease. Methods: This quality improvement project utilized a descriptive, observational design to assess the effect of the HPV Encouragement Bundle, a two-step intervention to improve HPV vaccine uptake. Quantitative data was collected via retrospective chart review to assess the effect of the intervention on first-dose administration of Gardasil9 (series initiation), as well as overall Gardasil9 vaccine uptake. Results: Following implementation, Gardasil9 first dose uptake increased from 0% to 8.45%, and overall Gardasil9 uptake increased from 0.8% to 12.68%, in pre- and post-intervention groups, respectively. A Chi-square test of independence was performed to examine the relationship between intervention groups and Gardasil9 administration. A statistically significant relationship was established between intervention groups and Gardasil9 administration, with alpha value of .05, χ2(1) = 14.19, p \u3c .001. Persons in the post-intervention group were more likely to be administered a dose of Gardasil9. Implications for practice: Widespread use of the HPV Encouragement Bundle is a cost-effective, inclusive intervention that could be used to improve Gardasil9 vaccine uptake

Bombesin and bombesin antagonists: studies in Swiss 3T3 cells and human small cell lung cancer.

Bombesins are potent growth factors for murine Swiss 3T3 cells. Using these cells in chemically defined conditions we have been able to characterise the bombesin receptor and the early signals preceding DNA synthesis. We describe two substance P analogues [DArg1, DPro2, DTrp7,9, Leu11] substance P and [DArg1, DPhe5, DTrp7,9, Leu11] substance P which competitively block the binding of bombesins to their receptor and all the events leading to mitogenesis. Bombesins are secreted by human small cell lung cancers (SCLC) and may act as autocrine growth factors for these tumours, so the development of peptide bombesin antagonists could have therapeutic implications. We demonstrate that the antagonists can reversibly inhibit the growth of SCLC in vitro, with relatively little effect on other lung tumours

Machine Learning for Enhancing Dementia Screening in Ageing Deaf Signers of British Sign Language

Real-time hand movement trajectory tracking based on machine learning approaches may assist the early identification of dementia in ageing deaf individuals who are users of British Sign Language (BSL), since there are few clinicians with appropriate communication skills, and a shortage of sign language interpreters. In this paper, we introduce an automatic dementia screening system for ageing Deaf signers of BSL, using a Convolutional Neural Network (CNN) to analyse the sign space envelope and facial expression of BSL signers recorded in normal 2D videos from the BSL corpus. Our approach involves the introduction of a sub-network (the multi-modal feature extractor) which includes an accurate real-time hand trajectory tracking model and a real-time landmark facial motion analysis model. The experiments show the effectiveness of our deep learning based approach in terms of sign space tracking, facial motion tracking and early stage dementia performance assessment tasks

A Multi-modal Machine Learning Approach and Toolkit to Automate Recognition of Early Stages of Dementia among British Sign Language Users

The ageing population trend is correlated with an increased prevalence of acquired cognitive impairments such as dementia. Although there is no cure for dementia, a timely diagnosis helps in obtaining necessary support and appropriate medication. Researchers are working urgently to develop effective technological tools that can help doctors undertake early identification of cognitive disorder. In particular, screening for dementia in ageing Deaf signers of British Sign Language (BSL) poses additional challenges as the diagnostic process is bound up with conditions such as quality and availability of interpreters, as well as appropriate questionnaires and cognitive tests. On the other hand, deep learning based approaches for image and video analysis and understanding are promising, particularly the adoption of Convolutional Neural Network (CNN), which require large amounts of training data. In this paper, however, we demonstrate novelty in the following way: a) a multi-modal machine learning based automatic recognition toolkit for early stages of dementia among BSL users in that features from several parts of the body contributing to the sign envelope, e.g., hand-arm movements and facial expressions, are combined, b) universality in that it is possible to apply our technique to users of any sign language, since it is language independent, c) given the trade-off between complexity and accuracy of machine learning (ML) prediction models as well as the limited amount of training and testing data being available, we show that our approach is not over-fitted and has the potential to scale up

Associations between physical activity, physical fitness, and body composition in adults living in Germany: A cross-sectional study

Background & aims Body composition (BC) changes with age and is associated with morbidity and mortality. A physically active lifestyle influences BC and represents an important predictor of successful aging. To emphasize this, the World Health Organization established activity recommendations for all age groups. We describe BC during adulthood using a cross-sectional sample from a German community and investigate the associations between physical activity (PA), physical fitness (PF), and BC. Methods Data from 329 men and women aged 35 to 86 years were analyzed. PA was measured by questionnaire and classified into sport activity and habitual activity. PF was measured through physical performance tests and BC by bioelectrical impedance analysis. Fat mass index (FMI) and fat-free mass index (FFMI) were calculated to represent height-adjusted BC. Associations between PA, PF, and BC were analyzed using linear regression models. Results For both sexes, strength was positively associated with FFMI (♂: ß = 0.313; ♀: ß = 0.213) and phase angle (♂: ß = 0.357; ♀: ß = 0.409). For FMI, a significant negative association with strength was found only in women (ß = -0.189). Cardiorespiratory fitness showed a negative association with FMI (ß = -0.312) and FFMI (ß = -0.201) for men, while in women a positive association was found for FFMI (ß = 0.186). For coordination, a significant association with FMI was observed only in women (ß = -0.190). Regarding PA only one significant relationship between sport activity and FMI among women (ß = -0.170) was found

Aging and scaling laws in β\beta-hydroquinone-clathrate

The dielectric permittivity of the orientational glass methanol(x=0.73)-$\beta$-hydroquinone-clathrate has been studied as function of temperature and waiting time using different temperature-time-protocols. We study aging, rejuvenation and memory effects in the glassy phase and discuss similarities and differences to aging in spin-glasses. We argue that the diluted methanol-clathrate, although conceptually close to its magnetic pendants, takes an intermediate character between a true spin-glass and a pure random field system

Fracture healing following high energy tibial trauma: Ilizarov versus Taylor Spatial Frame

Introduction: The optimal treatment of high energy tibial fractures remains controversial and a challenging orthopaedic problem. The role of external fi xators for all these tibial fractures has been shown to be crucial. Methods: A fi ve-year consecutive series was reviewed retrospectively, identifying two treatment groups: Ilizarov and Taylor Spatial Frame (TSF; Smith & Nephew, Memphis, TN, US). Fracture healing time was the primary outcome measure. Results: A total of 112 patients (85 Ilizarov, 37 TSF) were identifi ed for the review with a mean age of 45 years. This was higher in women (57 years) than in men (41 years). There was no signifi cant difference between frame types (p=0.83). The median healing time was 163 days in both groups. There was no signifi cant difference in healing time between smokers and non-smokers (180 vs 165 days respectively, p=0.07), open or closed fractures (p=0.13) or age and healing time (Spearman's r=0.12, p=0.18). There was no incidence of non-union or re-fracture following frame removal in either group. Conclusions: Despite the assumption of the rigid construct of the TSF, the median time to union was similar to that of the Ilizarov frame and the TSF therefore can play a signifi cant role in complex tibial fractures

Family predictors of physical activity change during the COVID-19 lockdown in preschool children in Germany

The COVID-19 pandemic is associated with crucial changes in children’s daily life including their physical activity (PA) and screen time (ST). Among preschool children, the family represents an important factor for sufficient PA levels by being the gatekeeper for PA. Thus, the aim of this study was to investigate the influence of the family environment, specifically SES, parental support, and having siblings on COVID-19-related changes of PA and ST behavior in 317 (170 boys, 147 girls) German preschool children using longitudinal data. Our results indicate a decline in total amount of sports-related PA, an increase in outdoor play, as well as an increase in leisure ST in preschool children. The changes in total amount of PA differed between children with different levels of parental support as well as in dependence on having siblings. Furthermore, levels of outdoor play and ST in preschool children were influenced by environmental factors like having access to their own garden. We conclude that the family environment (parental support as well as physical environment) is highly relevant for PA and ST levels in preschool children. To provide every child with PA opportunities during potential future lockdowns, restriction policies should be adapted and parents need sophisticated information about the importance of their support and thus the PA levels of their children

Treatment of bone metastases from breast cancer with (3-amino-1-hydroxypropylidene)-1,1-bisphosphonate (APD).

Twenty-eight patients with progressive symptomatic bone metastases from breast cancer received (3-amino-1-hydroxypropylidene)-1,1-bisphosphonate (APD) 30 mg in 500 ml of 0.9% saline infused over 2 h every 14 days. No other systemic therapy for breast cancer was prescribed. All patients had progressed on at least one previous systemic treatment. APD was continued until the disease progressed. Patients were assessed for objective response by the UICC criteria. In addition, subjective response was determined by a pain questionnaire. Radiological evidence of bone healing with sclerosis of lytic disease (UICC partial response) was seen in 4 patients. The median duration of response was 10 months. Eleven patients had stable disease for at least 3 months (median 5 months) and 9 progressed. Symptomatic response occurred in 9 patients and 12 reported an improvement in quality of life. Treatment was tolerated well with no significant toxicity. In conclusion, long-term inhibition of bone destruction is possible with APD therapy alone and both subjective and objective responses are seen

The Influence of Cortisol, Flow, and Anxiety on Performance in E-Sports: A Field Study

Background and Objectives. Most performance theories were tested under controlled laboratory settings and offer therefore only limited transferability to real-life situations. E-sport competitions offer a relatively controllable while at the same time competitive setting, and our aim was to examine different influencing factors on competitive performance. Design and Methods. Salivary cortisol was measured immediately before, after, and 30 minutes after a game of 23 computer players during e-sport tournaments. The players answered the Flow Short Scale, which consists of the two subdimensions “flow experience” and “anxiety” subsequent to their game. The performance was assessed by the result of each player’s game (win or loss). Results. Mean cortisol levels increased significantly during the game but response patterns were inconsistent. Winners and losers differed significantly in anxiety with winners showing higher anxiety levels. After dividing the sample into three groups of different cortisol response patterns, significant differences in performance and anxiety were found, with low to moderate levels of cortisol being associated with the highest performance and anxiety. Conclusions. A low to moderate physiological arousal and a simultaneously high level of anxiety represent a favorable state for achieving optimal performance during e-sports. Anxiety seems to exert a stronger influence on performance than physiological arousal