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Modification of Hydrphilic and Hydrophobic Surfaces Using an Ionic-Complementary Peptide
(Public Library of Science (PLOS), 2007) Yang, Hong; Fung, Shan-Yu; Pritzker, Mark; Chen, P.
Ionic-complementary peptides are novel nano-biomaterials with a variety of biomedical applications including potential biosurface engineering. This study presents evidence that a model ionic-complementary peptide EAK16-II is capable of assembling/coating on hydrophilic mica as well as hydrophobic highly ordered pyrolytic graphite (HOPG) surfaces with different nano-patterns. EAK16-II forms randomly oriented nanofibers or nanofiber networks on mica, while ordered nanofibers parallel or oriented 60° or 120° to each other on HOPG, reflecting the crystallographic symmetry of graphite (0001). The density of coated nanofibers on both surfaces can be controlled by adjusting the peptide concentration and the contact time of the peptide solution with the surface. The coated EAK16-II nanofibers alter the wettability of the two surfaces differently: the water contact angle of bare mica surface is measured to be <10°, while it increases to 20.3±2.9° upon 2 h modification of the surface using a 29 µM EAK16 II solution. In contrast, the water contact angle decreases significantly from 71.2±11.1° to 39.4±4.3° after the HOPG surface is coated with a 29 µM peptide solution for 2 h. The stability of the EAK16-II nanofibers on both surfaces is further evaluated by immersing the surface into acidic and basic solutions and analyzing the changes in the nanofiber surface coverage. The EAK16-II nanofibers on mica remain stable in acidic solution but not in alkaline solution, while they are stable on the HOPG surface regardless of the solution pH. This work demonstrates the possibility of using self-assembling peptides for surface modification applications.
Factors associated with time to first birth interval among ever married Bangladeshi women: A comparative analysis on Cox-PH model and parametric models
(Public Library of Science (PLOS), 2024) Setu, Sarmistha Paul; Kabir, Rasel; Islam, Md. Akhtarul; Alauddin, Sharlene; Nahar, Mst. Tanmin
The fertility rate of a married women can be measured by the length of the first birth interval (FBI). This length is influenced by some significant factors. Better knowledge about the factors affecting the birth interval can help in controlling population growth and fertility progress. The main focus of this study was to compare the performance of Cox-Proportional Hazard (Cox-PH) and the parametric Accelerated Failure Time (AFT) model in assessing the impact of significant factors affecting the time to FBI of ever-married Bangladeshi women. Information of 14941 women having a least one birth was included in this study from the most recent nationally representative data 2017-18 Bangladesh Demographic and Health Survey (BDHS). We used the Cox-PH model and AFT model under various parametric forms of survival time distributions (Weibull, Exponential, and Log-normal distribution) to measure the effect of factors influencing FBI. And then, a respective Akaike information criterion (AIC) was calculated for selecting the best-fitted model. According to the AIC and BIC values, the log-normal model fitted better than other AFT models. Based on the log-normal model, women's age and age at first marriage, maternal and paternal education, contraceptive use status, used anything to avoid pregnancy, sex of household head, and spousal age difference had a significant association with FBI of ever married Bangladeshi women. The parametric AFT model (log-normal distribution) was a better fitted model in evaluating the covariates associated with FBI of ever-married Bangladeshi Women. Higher education, the right age at marriage, and proper knowledge about family planning (i.e., contraception use) should be ensured for every married person to control the gap of the first birth.
The Bullshitting Frequency Scale: Development and psychometric properties
(The British Psychological Society, 2020) Littrell, Shane; Risko, Evan F.; Fugelsang, Jonathan A.
Recent psychological research has identified important individual differences associated with receptivity to bullshit, which has greatly enhanced our understanding of the processes behind susceptibility to pseudo-profound or otherwise misleading information. However, the bulk of this research attention has focused on cognitive and dispositional factors related to bullshit (the product), while largely overlooking the influences behind bullshitting (the act). Here, we present results from four studies (focusing on the construction and validation of a new, reliable scale measuring the frequency with which individuals engage in two types of bullshitting (persuasive and evasive) in everyday situations. Overall, bullshitting frequency was negatively associated with sincerity, honesty, cognitive ability, open-minded cognition, and self-regard. Additionally, the Bullshitting Frequency Scale was found to reliably measure constructs that are: 1) distinct from lying, and; 2) significantly related to performance on overclaiming and social decision tasks. These results represent an important step forward by demonstrating the utility of the Bullshitting Frequency Scale as well as highlighting certain individual differences that may play important roles in the extent to which individuals engage in everyday bullshitting.
The role of cognitive load in modulating social looking: A mobile eye tracking study.
(Springer, 2020) Bianchi, L. J.; Kingstone, A.; Risko, E. F.
The effect of cognitive load on social attention was examined across three experiments in a live pedestrian passing scenario (Experiments 1 and 2) and with the same scenario presented as a video (Experiment 3). In all three experiments, the load was manipulated using an auditory 2-back task. While the participant was wearing a mobile eye-tracker, the participant’s fixation behavior toward a confederate was recorded and analyzed based on temporal proximity from the confederate (near or far) and the specific regions of the confederate being observed (i.e., head or body). In Experiment 1 we demonstrated an effect of cognitive load such that there was a lower proportion of fixations and time spent fixating toward the confederate in the load condition. A similar pattern of results was found in Experiment 2 when a within-subject design was used. In Experiment 3, which employed a less authentic social situation (i.e., video), a similar effect of cognitive load was observed. Collectively, these results suggest attentional resources play a central role in social attentional behaviors in both authentic (real-world) and less authentic (video recorded) situations.
Not so fast: Individual differences in impulsiveness are only a modest predictor of cognitive reflection.
(Elsevier, 2020) Littrell, Shane; Fugelsang, Jonathan; Risko, Evan F.
The extent to which a person engages in reflective thinking while problem-solving is often measured using the Cognitive Reflection Test (CRT; Frederick, 2005). Some past research has attributed poorer performance on the CRT to impulsiveness, which is consistent with the close conceptual relation between Type I processing and dispositional impulsiveness (and the putative relation between a tendency to engage in Type I processing and poor performance on the CRT). However, existing research has been mixed on whether such a relation exists. To address this ambiguity, we report two large sample size studies examining the relation between impulsiveness and CRT performance. Unlike previous studies, we use a number of different measures of impulsiveness, as well as measures of cognitive ability and analytic thinking style. Overall, impulsiveness is clearly related to CRT performance at the bivariate level. However, once cognitive ability and analytic thinking style are controlled, these relations become small and, in some cases, non- significant. Thus, dispositional impulsiveness, in and of itself, is not a strong predictor of CRT performance.
Offloading information to an external store increases false recall.
(Elsevier, 2020) Lu, Xinyi; Kelly, Megan O.; Risko, Evan F.
Offloading to-be-remembered information is a ubiquitous memory strategy, yet in relying on external memory stores, our ability to recall from internal memory is often diminished. In the present investigation, we examine how offloading impacts true and false recall. Across three experiments, participants studied and wrote down word lists that were each strongly associated with an unstudied critical word. Recall in the Offloading condition (i.e., when they were told that they would have access to their written lists during recall) was contrasted with a No-Offloading condition (i.e., when they were told that they would not have access to their written lists during recall). We found that offloading decreased true recall of presented words while increasing false recall for unpresented critical words. Results are discussed in terms of offloading’s differential effects on the formation of gist and verbatim traces during encoding.
Overconfidently Underthinking: Narcissism negatively predicts Cognitive Reflection
(Taylor & Francis, 2020) Littrell, Shane; Fugelsang, Jonathan; Risko, Evan F.
There exists a large body of work examining individual differences in the propensity to engage in reflective thinking processes. However, there is a distinct lack of empirical research examining the role of dispositional factors in these differences and understanding these associations could provide valuable insight into decision-making. Here we examine whether individual differences in cognitive reflection are related to narcissism (excessive self-focused attention) and impulsiveness (trait-based lack of inhibitory control). Participants across three studies completed measures of narcissism, impulsiveness and cognitive reflection. Results indicate that grandiose and vulnerable narcissists differ in their performance on problem-solving tasks (i.e., CRT) and preferences for intuitive thinking, as well as the degree to which they reflect on and understand their own thoughts and enjoy cognitively effortful activities. Additionally, though impulsiveness was significantly related to self-report measures of cognitive reflection (i.e., metacognitive reflection, metacognitive insight, and Need for Cognition), it showed no association with a behavioural measure of cognitive reflection (i.e., CRT scores). Our results suggest that certain individual differences in dispositional and personality characteristics may play important roles in the extent to which individuals engage in certain forms of reflective thinking.
Sequence Effect of Self-Assembling Peptides on the Complexation and In Vitro Delivery of the Hydrophobic Anticancer Drug Ellipticine
(Public Library of Science (PLOS), 2008) Fong, Shan Yu; Yang, Hong; Chen, P.
A special class of self-assembling peptides has been found to be capable of stabilizing the hydrophobic anticancer agent ellipticine in aqueous solution. Here we study the effect of peptide sequence on the complex formation and its anticancer activity in vitro. Three peptides, EAK16-II, EAK16-IV and EFK16-II, were selected to have either a different charge distribution (EAK16-II vs. EAK16-IV) or a varying hydrophobicity (EAK16-II vs. EFK16-II). Results on their complexation with ellipticine revealed that EAK16-II and EAK16-IV were able to stabilize protonated ellipticine or ellipticine microcrystals depending on the peptide concentration; EFK16-II could stabilize neutral ellipticine molecules and ellipticine microcrystals. These different molecular states of ellipticine were expected to affect ellipticine delivery. The anticancer activity of these complexes was tested against two cancer cell lines: A549 and MCF-7, and related to the cell viability. The viability results showed that the complexes with protonated ellipticine were effective in eradicating both cancer cells (viability <0.05), but their dilutions in water were not stable, leading to a fast decrease in their toxicity. In contrast, the complexes formulated with EFK16-II were relatively stable upon dilution, but their original toxicity was relatively low compared to that with protonated ellipticine. Overall, the charge distribution of the peptides seemed not to affect the complex formation and its therapeutic efficacy in vitro; however, the increase in hydrophobicity of the peptides significantly altered the state of stabilized ellipticine and increased the stability of the complexes. This work provides essential information for peptide sequence design in the development of self-assembling peptide-based delivery of hydrophobic anticancer drugs.
Dual harm among patients in the Ontario forensic mental health system
(Public Library of Science (PLOS), 2024) Kaggwa, Mark Mohan; Erb, Bailea; Prat, Sebastien; Davids, Arianna; Bradford, John; Chaimowitz, Gary Andrew; Olagunju, Andrew Toyin
Background Dual harm involves the unfortunate experience of harm to self and others/objects. Safeguarding individuals in forensic psychiatric settings against all forms of harm to self and others is sacrosanct. While understanding dual harm is crucial in the care and rehabilitation of patients in forensic psychiatric settings, only a few studies have explored this phenomenon. This study examined dual harm and its associated clinical and sociodemographic factors among forensic patients in Ontario, Canada. Methods In this retrospective study, we used data from the Ontario Review Board (ORB) (n=1240; mean age 42.54+3.32 years, and 85.73% male). We defined dual harm as the co-occurrence of self-harming behaviour in the last 12 months and violent behaviour towards others or objects (such as verbal, physical, or sexual aggression). We analysed the data in relation to clinical and sociodemographic factors. Results Of 1240 patients, 43 (3.55%) had engaged in dual harm. Most of them had engaged in dual harm related to verbal aggression (3.15%), followed by dual harm related to aggression towards objects (2.97%), dual harm related to aggression towards others (2.73%), and dual harm related to sexual aggression was the rarest (1.32%). Only 12 patients had engaged in all types of dual harm. Having a previous history of dual harm and a diagnosis of a neurodevelopmental disorder increased the chance of perpetrating/engaging in dual harm. However, increasing age and a higher education decreased the chance of dual harm. These factors were similar for different types of dual harm, except for dual harm related to sexual aggression, which was the only subtype associated with having a personality disorder diagnosis. Again, the experience of violence increased the chance of self-harm. Conclusion Dual harm is present among forensic patients in Ontario, and self-harm is prevalent among individuals with various forms of aggression, especially when the violence was perpetrated towards objects. Strategies to manage the risk of self-harm among aggressive patients should be put in place to mitigate dual harm and the associated complications, especially among individuals with neurodevelopmental disorders.
Hepatic Transcriptome Analysis of Hepatitis C Virus Infection in Champanzees Defines Unique Gene Expression Patterns Associated with Viral Clearance
(Public Library of Science (PLOS), 2008) Nanda, Santosh; Havert, Michael B.; Calderon, Gloria M.; Thomson, Michael; Jacobson, Christian; Kastner, Daniel; Liang, T. Jake
Hepatitis C virus infection leads to a high rate of chronicity. Mechanisms of viral clearance and persistence are still poorly understood. In this study, hepatic gene expression analysis was performed to identify any molecular signature associated with the outcome of hepatitis C virus (HCV) infection in chimpanzees. Acutely HCV-infected chimpanzees with self-limited infection or progression to chronicity were studied. Interferon stimulated genes were induced irrespective of the outcome of infection. Early induction of a set of genes associated with cell proliferation and immune activation was associated with subsequent viral clearance. Specifically, two of the genes: interleukin binding factor 3 (ILF3) and cytotoxic granule-associated RNA binding protein (TIA1), associated with robust T-cell response, were highly induced early in chimpanzees with self-limited infection. Up-regulation of genes associated with CD8+ T cell response was evident only during the clearance phase of the acute self-limited infection. The induction of these genes may represent an initial response of cellular injury and proliferation that successfully translates to a "danger signal" leading to induction of adaptive immunity to control viral infection. This primary difference in hepatic gene expression between self-limited and chronic infections supports the concept that successful activation of HCV-specific T-cell response is critical in clearance of acute HCV infection.
smyRNA: A Novel Ab Initio ncRNA Gene Finder
(Public Library of Science (PLOS), 2009) Salari, Raheleh; Aksay, Cagri; Karakoc, Emre; Unrau, Peter J.; Hajirasouliha, Iman; Sahinalp, S. Cenk
Background Non-coding RNAs (ncRNAs) have important functional roles in the cell: for example, they regulate gene expression by means of establishing stable joint structures with target mRNAs via complementary sequence motifs. Sequence motifs are also important determinants of the structure of ncRNAs. Although ncRNAs are abundant, discovering novel ncRNAs on genome sequences has proven to be a hard task; in particular past attempts for ab initio ncRNA search mostly failed with the exception of tools that can identify micro RNAs. Methodology/Principal Findings We present a very general ab initio ncRNA gene finder that exploits differential distributions of sequence motifs between ncRNAs and background genome sequences. Conclusions/Significance Our method, once trained on a set of ncRNAs from a given species, can be applied to a genome sequences of other organisms to find not only ncRNAs homologous to those in the training set but also others that potentially belong to novel (and perhaps unknown) ncRNA families. Availability: http://compbio.cs.sfu.ca/taverna/smyrna
Usability of an automated medication dispension device and adherence dashboard: A study protocol
(Public Library of Science (PLOS), 2024) Patel, Tejal; Laeer, Christoph; Darabi, Hamed; Lachance, Maxime; Anawati, Michelle; Chomienne, Marie-Helene
Non-adherence to prescribed medication regimens can lead to suboptimal control of chronic health conditions and increased hospitalizations. Older adults may find it particularly challenging to self-manage medications due to physical and cognitive limitations, resulting in medication non-adherence. While automated medication dispensing technologies may offer a solution for medication self-management among older adults, these technologies must demonstrate usability before effectiveness can be investigated and products made available for widespread use. This study will aim to measure usability, workload, and unassisted task completion rates of an automated medication dispenser and medication adherence dashboard on the Medipense portal with older adults and their clinicians, respectively. This study is designed as a convergent parallel mixed-methods observational study with older adults and their clinicians. Usability will be examined with the use of the System Usability Scale (SUS) while NASA Load Index (NASA-TLX) will be utilized to assess the workload of both the device and the adherence monitoring platform. Cognitive walkthrough will be utilized prior to usability testing to identify series of steps required to use the automated dispenser and adherence dashboard. This study will assess the unassisted task completion rates to successfully operate the device. Semi-structured interviews with both types of participants will provide qualitative data with which to comprehensively gauge the automated dispenser user experience. The results of this study will allow us to examine usability of both the automated medication dispenser and the adherence dashboard. In clinical practice, usability of technology is important to establish prior to full-scale implementation. Products that are not user friendly, add to workload, impact workflow, or are difficult to navigate by both clinicians and population in general may not be adopted. Usability permits an evaluation of the products, to identify problems that must be addressed prior to implementation and to ensure products are useful in clinical practice,
The effect of the COVID-19 pandemic on delirium incidence in Ontario long-term care homes: A retrospective cohort study
(Public Library of Science (PLOS), 2024) Kennedy, Lydia; Hirdes, John P.; Heckman, George; Searle, Samuel D.; McArthur, Caitlin
Objectives To describe delirium incidence before and during the COVID-19 pandemic and examine factors associated with delirium incidence in the long-term care setting. Methods We conducted a retrospective cohort study of Ontario long-term care residents without severe cognitive impairment or baseline delirium with an assessment between February 1, 2029, and March 31, 2021. Data were collected from the interRAI Minimum Data Set (MDS) 2.0. The outcome of interest was delirium development. Selected independent variables were entered into univariate longitudinal generalized estimating equations, followed by multivariate analysis. Odd ratios (ORs) and 95% confidence intervals (CIs) are reported. Results A total of 63,913 residents were included within the comparison sample from February 2019 to February 2020. The pandemic sample consisted of 54,867 residents from March 2020 to March 2021. Incidents of delirium in the comparison sample was 3.4% (2158 residents) compared to 3.2% (1746 residents) in the pandemic sample (P=0.06). Residents who were older, cognitively impaired, and increasingly frail had greater odds of developing delirium. Increased odds were associated with a diagnosis of bipolar disorder (OR 1.27, 95% Cl 1.07-1.51) and anxiolytic use (OR 1.12, 95% Cl 1.01-1.25). Residents who were newly admitted (OR 0.65, 95% Cl 0.60-0.71) and those dependent for activities of daily living (OR 046, 95% Cl 0.33-0.64) had lower odds of delirium development. Conclusions and implications The incidence of delirium did not differ between the year prior to and the first year of the COVID-19 pandemic, indicating that preventative interventions employed by long-term care homes may have been effective. Long-term care residents who are older, frail, cognitively impaired, or had unstable health would benefit from targeted interventions to prevent delirium. Newly admitted residents or those dependent in activities of daily living had lower odds of developing delirium, which could indicate under detection in these groups.
"...but I know something's not right here": Exploring the diagnosis and disclosure experiences of persons living with ALS
(Public Library of Science (PLOS), 2024) Foldvari, Kathleen M.; Stolee, Paul; Neiterman, Elena; Boscart, Veronique; Tong, Catherine
Background Amyotrophic Laterla Sclerosis (ALS), an incurable motor neuron disease, primarily affects those between the ages of 60-79, and has an approximate post-diagnosis life-expectancy of only two to five years. The condition has an unpredictable but ultimately terminal trajectory that poses challenges for patients, caregivers and healthcare providers. While the diagnosis and disclosure are critical periods for intervention and support, knowledge regarding the relational, communicational and psychodynamic forces that occur within the process of diagnostic disclosure is relatively limited. Objectives The purpose of this study was to explore the experiences of persons living with ALS in the diagnosis and disclosure of that condition, with the support of their caregivers. Methods We conducted a focus group and in-depth individual interviews with people living with ALS (n=9), and caregivers (n=9). The interviews were transcribed, cleaned, and anonymized, and then entered into NVivo 11 for thematic analysis. Results Participants discussed the diagnostic process, including inklings and subtle changes prior to diagnosis, attempts at self-diagnosis, and the lengthy assessment process. Time was also a consideration in the diagnostic disclosure process, in which participants shared how the disclosure was the product of longstanding conversations with their care providers. It was described as rarely a shock to finally have confirmation. Participants shared their information seeking strategies and needs for a diagnosis that, for them, typically came with insufficient information on the disease, prognosis, and next steps. Significance This project serves as a step in bridging the relevant gaps in our knowledge and understanding towards improved person-centered care practices in the diagnosis and disclosure of ALS.
Coordinated human-exoskeleton locomotion emerges from regulating virtual energy
(Public Library of Science (PLOS), 2025) Nasiri, Rezvan; Dinovitzer, Hannah; Manohara, Nirosh; Arami, Arash
Lower-limb exoskeletons have demonstrated great potential for gait rehabilitation in individuals with motor impairments; however, maintaining human-exoskeleton coordination remains a challenge. The coordination problem, referred to as any mismatch or asynchrony between the user's intended trajectories and exoskeleton desired trajectories, leads to sub-optimal gait performance, particularly for individuals with residual motor ability. Here, we investigate the virtual energy regulator (VER)'s ability to generate coordinated locomotion in lower limb exoskeleton. Contribution: (1) In this paper, we experimented VER on a group of nine healthy individuals at different speeds (0.6m/s-0.85m/s) to study the resultant gait coordination and naturalness on a large group of users. (2) The resultant assisted gait is compared to the natural and passive (zero-torque exoskeleton) walking conditions in terms of muscle activities, kinematic, spatiotemporal and kinetic measures, and questionnaires. (3) Moreover, we presented the VER's convergence proof considering the user contribution to the gait and introduced a metric to measure the user's contribution to gait. (4) We also compared VER performance with the phase-based path controller in terms of muscle effort reduction and joint kinematics using three able-bodied individuals. Results: (1) The results from the VER demonstrate the emergence of natural, coordinated locomotion, resulting in an average muscle effort reduction ranging from 13.1% to 17.7% at different speeds compared to passive walking. (2) The results from VER revealed improvements in all indicators towards natural gait when compared to walking with a zero-torque exoskeleton, for instance, an enhancement in average knee extension ranging from 3.9 to 4.1 degrees. All indicators suggest that the VER preserves natural gait variability and user engagement in locomotion control. (3) Using VER also yields in 13.9%, 15.1%, and 7.0% average muscle effort reduction when compared to the phase-based path controller. (4) Finally, using our proposed metric, we demonstrated that the resultant locomotion limit cycle is a linear combination of human=intended limit cycle and the VER's limit cycle. These findings may have implications for understanding how the central nervous system controls our locomotion.
Climate-denying rumor propagation in a coupled socio-climate model: Impact on average global temperature
(Public Library of Science (PLOS), 2025) Kumar, Athira Satheesh; Bauch, Chris T.; Anand, Madhur
Individual attitudes vastly affect the transformations we are experiencing and are vital in mitigating or intensifying climate change. A socio-climate model by coupling a model of rumor dynamics in heterogeneous networks to a simple Earth System model is developed, in order to analyze how rumors about climate change impact individuals' opinions when they may choose to either believe or reject the rumors they come across over time. Our model assumes that when individuals experience an increase in the global temperature, they tend to not believe the rumors they come across. The rumor rejectors limit their CO2 emissions to reduce global temperature. Our numerical analysis indicates that, over time, the temperature anomaly becomes less affected by the variations in rumor propagation parameters, and having larger groups (having more members) is more efficient in reducing temperature (by efficiently propagating rumors) than having numerous small groups. It is observed that decreasing the number of individual connections does not reduce the size of the rejector population when there are large numbers of messages sent through groups. Mitigation strategies considered by the rejectors are highly influential. The absence of mitigative behavior in rejectors can cause an increase in the global average temperature by 0.5oC. Our model indicates that rumor propagation in groups has the upper hand in controlling temperature change, compared to individual climate-denying propagation.
Assessing the feasibility of an integrated collection of education modules for fall and fracture prevention (iCARE) for healthcare providers in long term care: A longitudinal study
(Public Library of Science (PLOS), 2024) Rodrigues, Isabel B.; Ioannidis, George; Kane, Lauren L.; Hillier, Loretta M.; Adachi, Jonathan; Heckman, George; Hirdes, John; Holroyd-Leduc, Jayna; Jaglal, Susan; Kaasalainen, Sharon; Marr, Sharon; McArthur, Caitlin; Straus, Sharon; Tarride, Jean-Eric; Abbas, Momina; Costa, Andrew P.; Lau, Arthur N.; Thabane, Lehana; Papaioannou, Alexandra
Falls and hip fractures are a major health concern among older adults in long term care (LTC) with almost 50% of residents experiencing a fall annually. Hip fractures are one of the most important and frequent fall-related injuries in LTC. There is moderate to strong certainty evidence that multifactorial interventions may reduce the risk of falls and fractures; however, there is little evidence to support its implementation. The purpose of this study was to determine the feasibility (recruitment rate and adaptations) with a subobjective to understand facilitators to and barriers of implementing the PREVENT (Person-centred Routine Fracture PreEVENTion) model in practice. The model includes a multifactorial intervention on diet, exercise, environmental adaptations, hip protectors, medications (including calcium and vitamin D), and medication reviews to treat residents at high risk of fracture. Our secondary outcomes were to determine if there was a change in knowledge uptake of the guidelines among healthcare providers and in the proportion of fracture prevention prescriptions post-intervention. We conducted a mixed-methods longitudinal cohort study in three LTC homes across southern Ontario. A local champion was selected to help guide the implementation of the model and promote best practices. We reported recruitment rates using descriptive statistics and challenges to implementation using content analysis. We reported changes in knowledge uptake and in the proportion of fracture prevention medications using the McNemar's test. We recruited three LTC homes and identified one local champion for each home. We required two months to identify and train the local champion over three, 1.5-hour train-the-trainer sessions, and the local champion required three months to deliver the intervention to a team of healthcare professionals. We identified several facilitators, barriers, and adaptations to PREVENT. Benefits of the model include easy access to the Fracture Risk Scale (FRS), clear and succinct educational material catered to each healthcare professional, and an accredited Continuing Medical Educational module for physicians and nurses. Challenges included misperceptions between the differences in fall and fracture prevention strategies, fear of perceived side effects associated with fracture prevention medications, and time barriers with completing the audit report. Our study found an increase knowledge uptake of the guidelines and an increase in the proportion of fracture prevention prescriptions post-intervention.
Between worlds: Cis-and trans-identifying diaspora Middle Eastern and North African (MENA) women in Ontario, Canada on the intersections of gender, sexuality and sexual health
(Public Library of Science (PLOS), 2024) Kteily-Hawa, Roula; Falenchuk, Olesya; Momani, Bessma; Chikermane, Vijaya; Bartels, Susan; Anand, Praney; Younes, Rania; Abdel-Tawab, Nahla; Abuelezam, Nadia N.; Hammad, Lina; Pahlevan, Tina; Eloulabi, Rama; Ezzeddine, Ahmad; Al-Ezzawi, Anmar; Akel, Mohammed; Loutfy, Mona
Youth Sexual Health and HIV/STI Prevention in Middle Eastern and North African Communities (YSMENA) is the first community-based research study in Canada to explore key determinants of sexual health among diaspora Middle Eastern and North African (MENA) women living in Canada. Our objectives were to identify the factors influencing sexual health for MENA youth and grow an evidence base to strengthen the sexual health response for MENA communities. Using mixed-method design, data were gathered through a quantitative socio-demographic survey and qualitative focus groups with 24 women-identifying MENA youth (16-29 years) living in Ontario, Canada. Six (6) focus groups were held virtually via Zoom, with heterosexual, lesbian, bisexual and queer (LBQ), and trans women. Members of each group participated in two sessions as per the sequential critical dialogical method and transcripts were coded in NVIVO. While participants identified with diverse sexual orientations and across the trans-feminine gender spectrum, key commonalities surfaced, namely the pressures to conform to familial expectations and the barriers faced when accessing healthcare. The trans group experienced compounded levels of exclusion given their unique positioning. Although the challenges faced by the group were deeply entrenched in patriarchy, heteronormativity and internalized shame, many participants demonstrated resilience and self-acceptance that enabled them to forge pathways to health. Findings have important and valuable implications for community-based health programs targeting MENA women as well as healthcare practitioners and service providers.
Diagnostic potential of genomic blood biomarkers of pulmonary fibrosis in a prospective cohort
(Public Library of Science (PLOS), 2024) He, Daniel; Shannon, Casey P.; Hirota, Jeremy A.; Ask, Kjetil; Ryerson, Christopher J.; Tebbutt, Scott J.
Fibrotic interstitial lung diseases (ILDs) result from excessive deposition of extracellular matrix (ECM) proteins in the lung, causing irreversible damage to the lung architecture. Clinical management of ILDs differs depending on the diagnosis, but differentiation between subtypes can be difficult and better clinical biomarkers are needed. In this study, we use a 166-gene NanoString assay to investigate whether there are ILD subtype-specific transcripts in whole blood. We identified one transcript, killer cell lectin like receptor 1 (KLRF1), as differentially expressed between idiopathic pulmonary fibrosis (IPF) and systemic sclerosis-associated ILD (SSc-ILD), and identified two transcripts (VCAN, LTK) associated with IPF expression against other ILD subtypes. These findings were validated by examining their expression in ILD lung, with KLRF1 expression significantly higher in SSc-ILD compared to IPF and hypersensitivity pneumonitis (HP) samples. Taken together, this pilot study provides support for the use of the peripheral transcriptome in identifying diagnostic biomarkers of ILD with biological relevance.
Proposal of the Implementation Theory Selection Model and exemplar application in fall injury prevention
(Public Library of Science (PLOS), 2024) Korall, Alexandra M.B; Chong, Helen; Komisar, Vicki; Mackey, Dawn C.; Khan, Masood; Hoekstra, Femke; Brown, Susan G.; Gardner, Pauli; Hames, Christine; Laing, Andrew C.; Sibley, Kathryn M.
Introduction The use of theories, models and/or frameworks (TMFs) in implementation research and practice is essential for developing useful and testable implementation strategies. Recommendations and tools exist to aid implementation groups in selecting TMFs, but they do not explicitly outline a systematic method for identifying and selecting TMFs. This paper aimed to (1) propose a systematic consensus-based method to select TMFs to support implementation processes, and to (2) demonstrate the use of this novel method in the context of researching the implementation of hip protectors for fracture prevention in long-term care (LTC). Materials & methods We developed a systematic, consensus-based method for selecting TMFs, referred to as the Implementation Theory Selection Model (ITSM). The ITSM comprises five steps: (1) identify potentially relevant TMFs; (2) narrow the pool of TMFs; (3) appraise the relevance of eligible TMFs; (4) prioritize a short-list of TMFs for further, in-depth consideration; and (5) select TMFs through consensus with investigators and research user partners. We operationalized each step of the ITSM through a project investigating determinants of hip protector use and organizational readiness for implementation in a LTC organization in Ontario, Canada. Results Using the ITSM in our case example, we identified 66 TMFs (Step 1). Of these, 23 met our eligibility criteria (Step 2) and were appraised twice, by five appraisers (Step 3). Six TMFs (Step 4) advanced to the consensus meeting, which was attended by nine investigators and three research users, including two organizational partners and one older adult. Three rounds of voting yielded a tie between the TMFs the group felt would be most appropriate. Research users from our partner LTC organization made the final selection preferring the combination of the Practical, Robust Implementation and Sustainability Model and Consolidated Framework for Implementation Research (Step 5). Conclusions The ITSM offers a step-by-step guide for implementation groups to adopt a rigorous, transparent and reproducible method for TMF selection. Although we have demonstrated the feasibility of operationalizing each step of the ITSM in our case example, continued research is needed to evaluate the refine the ITSM to ensure it is appropriate for a wide variety of implementation contexts.

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