During the last decades, the use of nanotechnology in medicine has effectively been translated to the design of drug delivery systems, nanostructured tissues, diagnostic platforms, and novel nanomaterials against several human diseases and infectious pathogens. Nanotechnology-enabled vaccines have been positioned as solutions to mitigate the pandemic outbreak caused by the novel pathogen severe acute respiratory syndrome coronavirus 2. To fast-track the development of vaccines, unprecedented industrial and academic collaborations emerged around the world, resulting in the clinical translation of effective vaccines in less than one year. In this article, we provide an overview of the path to translation from the bench to the clinic of nanotechnology-enabled messenger ribonucleic acid vaccines and examine in detail the types of delivery systems used, their mechanisms of action, obtained results during each phase of their clinical development and their regulatory approval process. We also analyze how nanotechnology is impacting global health and economy during the COVID-19 pandemic and beyond.
The present study examined the impact of a leadership development program, Leading for Change (LfC) that focused on building the capacity of early educators to lead change as frontline leaders and change agents. Bringing together a relational-entrepreneurial leadership theory lens, the LfC was designed to foster early educators’ leadership mindset, knowledge, and skills that could potentially bring a long-lasting impact on many aspects of the early care and education (ECE) field. With a sample of 31 racially and linguistically diverse early educators, the present study compared participants’ entrepreneurial mindset, leadership competencies, and capacity to act as change agents and leaders before and after the LfC program. Results showed that participants’ perceptions of themselves as leaders were increased after completing the LfC. They also demonstrated more confidence in their own ability to drive positive change where they work and more broadly in the ECE field. Findings from this study suggest that the relational-entrepreneurial leadership approach taps into early educators’ insights, passions, and knowledge and equips them to participate in leadership for quality improvement and positive change.
In this commentary piece, we argue that we must interrogate the meaning of race and examine why and how race does matter in different societies across contexts before we can even consider moving “beyond race.” We understand race as fundamentally related to power, privilege, and oppression; we discuss how we cannot go “beyond race” in the face of persistent racisms, hierarchies and maintenance of power and privilege. We address that demographic changes in itself does not bring us “beyond race” and the importance of active policies and political mobilization through addressing race as an analytical category is necessary to go “beyond racism.”
Background Mental illness stigma is a barrier to engagement in mental health services. This study assesses our hypothesis that specific ethnic identity dimensions influences mental health behavior including stigma. Methodology We performed an online cross sectional observational study among Black adults (n = 248, ages 18–65). We examined the relationship between an individual's approach to their racial identity in the community and stigma behavior towards mental health; generalized linear models were performed. We assessed demographic characteristics as moderators of the primary association. Results Black adults with higher centrality reported lower past stigma behavior (RR = 1.57, CI: 1.11–2.21, P = 0.01), but higher future intended stigma behavior (RR = 0.93, CI: 0.88–0.99, P = 0.02). Majority of respondents reported high centrality and high assimilation; however, assimilation did not appear to correlate with mental health stigma behavior. Age, education and ethnicity appeared to have a limited moderating effect on the association between centrality and stigma behavior. Conclusions Centrality was associated with mental health stigma behavior. By understanding the intersecting characteristics that may increase the likelihood for mental illness stigma, we will be better able to reduce mental illness stigma and optimize engagement in mental health services.
Introduction Global surgery efforts have significantly expanded in the last decade. While an increasing number of general surgery residents are incorporating global surgery experiences and research into their training, few resources are available for residency applicants to evaluate opportunities at programs to which they are applying. Materials and methods A 17-question survey of all general surgery residency program directors (PDs) was conducted by the Global Surgery Student Alliance through emails to the Association of Program Directors in Surgery listserv. PDs indicated if they wished to remain anonymous or include program information in an upcoming online database. Results Two hundred fifty eight general surgery PDs were emailed the survey and 45 (17%) responses were recorded. Twenty eight (62%) programs offered formal global surgery experiences for residents, including clinical rotations, research, and advocacy opportunities. Thirty one (69%) programs were developing a global health center. Forty two (93%) respondents indicated that global surgery education was an important aspect of surgical training. Barriers to global surgery participation included a lack of funding, time constraints, low faculty participation, and minimal institutional interest. Conclusions While most respondents felt that global surgery was important, less than two-thirds offered formal experiences. Despite the significant increase in public awareness and participation in global surgery, these numbers remain low. While this study is limited by a 17% response rate, it demonstrates that more efforts are needed to bolster training, research, and advocacy opportunities for surgical trainees and promote a global perspective on healthcare.
The academic public health and biomedical communities have a long history of researching and documenting the adverse impacts of pollution on human health. However, the healthcare industry itself is a major contributor to pollution as well as the greenhouse gas (GHG) emissions responsible for global warming. For example, the health sectors of the United States, Australia, England, and Canada are estimated to emit a combined 748 million metric tons of carbon dioxide equivalents annually, equivalent to a nation that would rank seventh in the world for GHG emissions. Moreover, the healthcare sector is a major consumer of natural resources, thereby contributing to the imbalances characteristic of what is increasingly being referred to as the Anthropocene and a threat to planetary health. In this article, we summarize current information on the healthcare industry's environmental footprint and the potential for markedly reducing that footprint by applying the principles and tools of sustainability science. We discuss some of the industry's special challenges, including those associated with new construction (which have undergone relatively little examination in relation to sustainability, despite predictions of accelerated growth). We examine current ideas and efforts to advance sustainability solutions in the healthcare industry, in high-, middle-, and low-income countries alike, where the healthcare industry can be expected to grow the fastest. Finally, we review case studies and discuss research needs. Expected final online publication date for the Annual Review of Environment and Resources, Volume 47 is October 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Introduction The incidence of metabolically unhealthy obesity is rising nationally. In this study, we compare wound and overall complications between metabolically unhealthy obese and healthy patients undergoing elective plastic surgery and model how operative time influences a complication risk. Methods Patients undergoing elective breast and body plastic surgery procedures in the 2009-2019 National Surgical Quality Improvement Program (NSQIP) dataset were identified. Complications were compared between metabolically unhealthy obese (body mass index [BMI] > 30 with diabetes and/or hypertension) versus metabolically healthy obese patients (BMI > 30 without diabetes or hypertension). Logistic regression was used to model the probability of wound complications across operative times stratified by metabolic status. Results Of 139,352 patients, 13.4% (n = 18,663) had metabolically unhealthy obesity and 23.8% (n = 33,135) had metabolically healthy obesity. Compared to metabolically healthy patients, metabolically unhealthy patients had higher incidence of wound complications (6.9% versus 5.6%; P < 0.001) and adverse events (12.4% versus 9.6%; P < 0.001), in addition to higher 30-d readmission, returns to the operating room, and length of stay (all P < 0.001). After adjustment, BMI (Odds ratio [OR] 7.86), hypertension (OR 1.15), and diabetes (OR 1.25) were independent risk factors for wound complications (all P < 0.001). Among metabolically unhealthy patients, the operative time was log-linear with a wound complication risk (OR 1.21; P < 0.001). Conclusions Diabetes and hypertension are additive risk factors with obesity for wound complications in elective plastic surgery. Among patients with metabolically unhealthy obesity, a risk of wound complications increases logarithmically with operative time. This distinction with regard to metabolic state might explain the unclear impact of obesity on surgical outcomes within existing surgical literature.
To identify target areas for professional development, this mixed-methods study examined general education teachers’ perceptions of autism and pedagogical practices in early elementary classrooms in the United States. In focus groups, teachers ( N = 18) identified terms they associated with autism and strategies they used for inclusion and relationship building. Participants systematically free-listed and ranked their responses to three prompts. Using ranked responses, saliency scores were calculated to assess the perceived importance and frequency of responses. Teachers’ most salient perceptions of autism (e.g., social difficulties, focused/fixed interests) revealed an awareness of core symptoms. Salient inclusion practices included assigning special classroom responsibilities and showcasing student talents; salient relationship-building strategies included embracing students’ special interests and engaging in one-on-one time. Implications for teacher trainings are discussed.
Introduction With increased social isolation due to COVID-19, social media has been increasingly adopted for communication, education, and entertainment. We sought to understand the frequency and characteristics of social media usage among general surgery trainees. Materials and methods General surgery trainees in 15 American training programs were invited to participate in an anonymous electronic survey. The survey included questions about demographics, frequency of social media usage, and perceptions of risks and benefits of social media. Univariate analysis was performed to identify differences between high users of social media (4-7 h per week on at least one platform) and low users (0-3 h or less on all platforms). Results One hundred fifty-seven of 591 (26.6%) trainees completed the survey. Most respondents were PGY3 or lower (75%) and high users of social media (74.5%). Among high users, the most popular platforms were Instagram (85.7%), YouTube (85.1%), and Facebook (83.6%). YouTube and Twitter were popular for surgical education (77.3% and 68.2%, respectively). The most reported benefits of social media were improving patient education and professional networking (85.0%), where high users agreed more strongly about these benefits (P = 0.002). The most reported risks were seeing other residents (42%) or attendings (17%) with unprofessional behavior. High users disagreed more strongly about risks, including observing attendings with unprofessional behavior (P = 0.028). Conclusions Most respondents were high users of social media, particularly Instagram, YouTube, and Facebook. High users incorporated social media into their surgical education while perceiving more benefits and fewer risks of social media.
Background The most widely used copper intrauterine device (IUD) in the world (the TCu380A), and the only product available in many countries, causes side effects and early removals for many users. These problems are exacerbated in nulliparous women, who have smaller uterine cavities compared to parous women. We compared first-year continuation rates and reasons/probabilities for early removal of the TCu380A versus a smaller Belgian copper IUD among nulliparous users. Methods This 12-month interim report is derived from a pre-planned interim analysis of a sub population and focused on key secondary comparative endpoints. In this participant-blinded trial at 16 centres in the USA, we randomised participants aged 17–40 in a 4:1 ratio to the NT380-Mini or the TCu380A. In the first year, participants had follow-up visits at 6-weeks and 3, 6, and 12-months, and a phone contact at 9 months; we documented continued use, expulsions, and reasons for removal. Among participants with successful IUD placement, we compared probabilities of IUD continuation and specific reasons for discontinuation using log-rank tests. This trial is registered with ClinicalTrials.gov number NCT03124160 and is closed to recruitment. Findings Between June 1, 2017, and February 25, 2019, we assigned 927 nulliparous women to either the NT380-Mini (n = 744) or the TCu380A (n = 183); the analysis population was 732 (NT380-Mini) and 176 (TCu380A). Participants using the NT380-Mini, compared to the TCu380A, had higher 12-month continuation rates (78·7% [95% CI: 72·9–84·5%] vs. 70·2% [95% CI: 59·7–80·7], p = 0·014), lower rates of removal for bleeding and/or pain (8·1% vs. 16·2%, p = 0·003) and lower IUD expulsion rates (4·8% vs. 8·9%, p = 0·023), respectively. Interpretation The NT380-Mini offers important benefits for a nulliparous population compared to the TCu380A in the first twelve months, when pivotal experiences typically occur. Higher continuation rates with the NT380-Mini may avert disruptions in contraceptive use and help users avoid unintended pregnancy. Funding Bill & Melinda Gates Foundation, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Mona Lisa, N.V. (Belgium).
Plain Language Summary Whistler‐mode chorus waves play an important role in local heating of electrons in Earth's outer radiation belt. Based on 6‐year measurements from Van Allen Probes, the electron energy spectra of the highest fluxes observed during storm periods demonstrate a similar shape despite of the various levels of storm activity. Using quasi‐linear diffusion simulations, we examine the upper limit of electron acceleration due to chorus waves, and its dependence on the seed electron populations which are accelerated to relativistic energies. The Van Allen Probes observation indicates that the maximum electron fluxes during the storm of 25 October 2016 are close to the highest upper limit of the electron fluxes during the 2013–2018 period. Our simulation reproduces the observed electron acceleration and reveals the natural upper limit of electron acceleration by chorus. The electrons below ∼1 MeV reached the upper limit of acceleration within ∼1 day and then remained at a stable level, while the sharper energy gradient at multi‐MeV indicates ongoing acceleration. This upper limit strongly depends on the lower energy boundary but not on the chorus wave intensity levels. Simulations show that the stable seed population at hundreds of keV is a prerequisite for the continuous relativistic electron acceleration.
The number of families with very old members is growing, and their intergenerational experiences may have significant ramifications for how the family members view their own aging. Using 114 dyads of very old parents (Mage = 93.31) and their “old” children (Mage = 67.78), we investigated whether one’s own (i.e., parents or children) and each other’s (i.e., children or parents) reports of relationship quality, care experiences, and health were associated with selfperceptions of aging. At the bivariate level, parents’ ratings of relationship quality and care experiences were related to some of the children’s health indicators, and vice versa. Very old parents reported less positive self-perceptions of aging than their children, and there was no within-dyad similarity in self-perceptions of aging. Individuals’ own health indicators (i.e., functional limitations, chronic conditions, and depressive symptoms) were associated with their self-perceptions of aging. For parents, their own report of more depressive symptoms was associated with less positive self-perceptions of aging. For children, their own report of more depressive symptoms as well as functional limitations was associated with less positive self-perceptions of aging. Care experiences demonstrated a partner effect for parents, such that children’s report of more caregiving burden was associated with parents’ less positive self-perceptions of aging. The findings provide initial evidence to assess the interdependence of self-perceptions of aging within parent-child ties in very late life. Despite the generational difference in the level of self-perceptions of aging, various facets of the informal care context may contribute to how older individuals view their own aging trajectory.
Political civic participation is an important dimension of engagement in adulthood, but low rates are often reported among middle-aged and older Asian American immigrants. Acculturation to American culture has been associated with more civic participation, yet little is understood about how informal social contexts may play an additional role in these relationships. Using data from the 2015 Asian American Quality of Life survey, this study examined how political civic participation was associated with acculturation and social contexts in a diverse sample of Asian Americans aged 40 and above in Central Texas. Negative binomial regression results indicated that years lived in the U.S., familiarity with American culture, and friend network size were associated with more political participation. Furthermore, social contexts such as larger friend networks exhibited potential to shape how one’s adjustment to life in the U.S. is related to their political participation.
This study explores factors associated with participation in moderate physical activity and muscle strengthening activity in adults with autism receiving state services (age: 18–78 years). Researchers analyzed the National Core Indicators-In Person Survey (2017–2018) data using multilevel mixed effects logistic regression. Older adults on the autism spectrum engaged in both moderate physical activity and muscle strengthening activity less often than younger adults on the autism spectrum (OR 0.99; p < 0.05; OR 0.98; p < 0.001). Individuals reportedly in fair/poor health had 50% lower odds of engaging in moderate physical activity and 30% lower odds of engaging in muscle strengthening compared to those in good/ excellent health (OR 0.50; p < 0.001; OR 0.70; p < 0.001). Moderate physical activity/muscle strengthening initiatives may help foster this group’s healthy aging.
When students require support to improve outcomes in a variety of domains, educators provide youth with school-based intervention. When educators require support to improve their professional practice, school leaders and support personnel (e.g., school psychologists) provide teachers with professional development (PD), consultation, and coaching. This multi-study article describes how the Assessment of Culturally and Contextually Relevant Supports (ACCReS) was developed with the purpose of assessment driving intervention for teachers in need of support to engage in culturally responsive practice. Items for the ACCReS were created via a multi-step process including review by both expert and practitioner panels. Then, results of an exploratory factor analysis with a national sample of teachers ( N = 500) in Study 1 yielded three subscales. A confirmatory factor analysis conducted with a separate sample of teachers ( N = 400) in Study 2 produced adequate model fit. In Study 3, analyses with another final sample of teachers ( N = 99) indicated preliminary evidence of convergent validity between the ACCReS and two measures of teacher self-efficacy of culturally responsive practice. Data from the ACCReS can shape the content of educator intervention (e.g., PD) and promote more equitable student outcomes for youth.
Background and Objectives: Understanding the influence of social resources on health is crucial in gerontological research. However, access to social resources may differ by one’s particular LGBT identity and the intersection of LGBT identity with other sociodemographic characteristics, including age. Research Design and Methods: Using 2010 data from Caring and Aging With Pride (N = 2,536), this study examined how access to social resources varied by LGBT identity and whether the effect of LGBT identity was modified by additional sociodemographic characteristics among LGBT adults aged 50 to 95. Results: Lesbian respondents had larger social networks than gay male respondents, and gay male respondents had smaller networks than transgender respondents. Lesbian respondents reported more social support and community belonging than other identity groups. Bisexual male respondents and transgender respondents had less support than gay male respondents, and bisexual male respondents reported less community belonging than gay male respondents. Age and education moderated the association between LGBT identity and social support. Discussion and Implications: This study demonstrated differences in access to social resources according to environmental circumstances that can intersect and govern access to social resources. Findings highlight the importance of considering social support separately from social network size; thus, large social networks do not necessarily provide ample social support. LGBT older adults had different perceptions of social support than their middle-aged counterparts. Health and human service professionals should not only consider the sexual and gender identity of their LGBT clients, but also education and age when assessing access to social resources.
Biomaterials with the ability to self-heal and recover their structural integrity offer many advantages for applications in biomedicine. The past decade has witnessed the rapid emergence of a new class of self-healing biomaterials commonly termed injectable, or printable in the context of 3D printing. These self-healing injectable biomaterials, mostly hydrogels and other soft condensed matter based on reversible chemistry, are able to temporarily fluidize under shear stress and subsequently recover their original mechanical properties. Self-healing injectable hydrogels offer distinct advantages compared to traditional biomaterials. Most notably, they can be administered in a locally targeted and minimally invasive manner through a narrow syringe without the need for invasive surgery. Their moldability allows for a patient-specific intervention and shows great prospects for personalized medicine. Injected hydrogels can facilitate tissue regeneration in multiple ways owing to their viscoelastic and diffusive nature, ranging from simple mechanical support, spatiotemporally controlled delivery of cells or therapeutics, to local recruitment and modulation of host cells to promote tissue regeneration. Consequently, self-healing injectable hydrogels have been at the forefront of many cutting-edge tissue regeneration strategies. This study provides a critical review of the current state of self-healing injectable hydrogels for tissue regeneration. As key challenges toward further maturation of this exciting research field, we identify (i) the trade-off between the self-healing and injectability of hydrogels vs their physical stability, (ii) the lack of consensus on rheological characterization and quantitative benchmarks for self-healing injectable hydrogels, particularly regarding the capillary flow in syringes, and (iii) practical limitations regarding translation toward therapeutically effective formulations for regeneration of specific tissues. Hence, here we (i) review chemical and physical design strategies for self-healing injectable hydrogels, (ii) provide a practical guide for their rheological analysis, and (iii) showcase their applicability for regeneration of various tissues and 3D printing of complex tissues and organoids.
Institution pages aggregate content on ResearchGate related to an institution. The members listed on this page have self-identified as being affiliated with this institution. Publications listed on this page were identified by our algorithms as relating to this institution. This page was not created or approved by the institution. If you represent an institution and have questions about these pages or wish to report inaccurate content, you can contact us here.