Engaging staff to improve COVID-19 vaccination response at long-term care facilities (ENSPIRE): A cluster randomized trial of co-designed, tailored vaccine promotion materials.

BACKGROUND: COVID-19 vaccination rates among long-term care center (LTCC) workers are among the lowest of all frontline health care workers. Current efforts to increase COVID-19 vaccine uptake generally focus on strategies that have proven effective for increasing influenza vaccine uptake among health care workers including educational and communication strategies. Experimental evidence is lacking on the comparative advantage of educational strategies to improve vaccine acceptance and uptake, especially in the context of COVID-19. Despite the lack of evidence, education and communication strategies are recommended to improve COVID-19 vaccination rates and decrease vaccine hesitancy (VH), especially strategies using tailored messaging for disproportionately affected populations. METHODS: We describe a cluster-randomized comparative effectiveness trial with 40 LTCCs and approximately 4000 LTCC workers in 2 geographically, culturally, and ethnically distinct states. We compare the effectiveness of two strategies for increasing COVID-19 booster vaccination rates and willingness to promote COVID-19 booster vaccination: co-design processes for tailoring educational messages vs. an enhanced usual care comparator. Our study focuses on the language and/or cultural groups that are most disproportionately affected by VH and low COVID-19 vaccine uptake in these LTCCs. CONCLUSION: Finding effective methods to increase COVID-19 vaccine uptake and decrease VH among LTCC staff is critical. Beyond COVID-19, better approaches are needed to improve vaccine uptake and decrease VH for a variety of existing vaccines as well as vaccines created to address novel viruses as they emerge.

Freeform geometrical optics II: from parametric representation to CAD/CAM.

Freeform optical surfaces are of great importance because of two main properties. The first is their ability to enhance the image quality of image-forming optical systems; the second is their inherent reduction in the number of surfaces in image and nonimage-forming optical systems. However, the main characteristic of freeform surfaces is that they lack symmetry about any spatial axis. This attribute allows describing freeform surfaces with a mathematical parametric representation. Unfortunately, parametric representation can be extremely extended. On the other hand, when describing freeform surfaces, the explicit representation is commonly preferred because of its compactness and CAD-format exportable easiness. Parametrically represented freeform surfaces can nonetheless be exported to a CAD format, with no significant departure of surface shape, as shown here. The vector method presented here guarantees that the surface's sampling density be proportional to the irradiance on the surface.

Multimodal Characterization of the Late Effects of Traumatic Brain Injury: A Methodological Overview of the Late Effects of Traumatic Brain Injury Project.

Epidemiological studies suggest that a single moderate-to-severe traumatic brain injury (TBI) is associated with an increased risk of neurodegenerative disease, including Alzheimer's disease (AD) and Parkinson's disease (PD). Histopathological studies describe complex neurodegenerative pathologies in individuals exposed to single moderate-to-severe TBI or repetitive mild TBI, including chronic traumatic encephalopathy (CTE). However, the clinicopathological links between TBI and post-traumatic neurodegenerative diseases such as AD, PD, and CTE remain poorly understood. Here, we describe the methodology of the Late Effects of TBI (LETBI) study, whose goals are to characterize chronic post-traumatic neuropathology and to identify in vivo biomarkers of post-traumatic neurodegeneration. LETBI participants undergo extensive clinical evaluation using National Institutes of Health TBI Common Data Elements, proteomic and genomic analysis, structural and functional magnetic resonance imaging (MRI), and prospective consent for brain donation. Selected brain specimens undergo ultra-high resolution ex vivo MRI and histopathological evaluation including whole-mount analysis. Co-registration of ex vivo and in vivo MRI data enables identification of ex vivo lesions that were present during life. In vivo signatures of postmortem pathology are then correlated with cognitive and behavioral data to characterize the clinical phenotype(s) associated with pathological brain lesions. We illustrate the study methods and demonstrate proof of concept for this approach by reporting results from the first LETBI participant, who despite the presence of multiple in vivo and ex vivo pathoanatomic lesions had normal cognition and was functionally independent until her mid-80s. The LETBI project represents a multidisciplinary effort to characterize post-traumatic neuropathology and identify in vivo signatures of postmortem pathology in a prospective study.

Adamantinoma de tibia: manejo quirúrgico con aloinjerto intercalar. A propósito de un caso / Adamantinoma of tibia: Surgical management with intercalary allograft. Report of a case

El adamantinoma es un tumor maligno bifásico que comprende el 0,4% de todos los tumores óseos primarios y el 23% comienza con fracturas patológicas asociadas a traumatismos ocurridos meses o años antes. Presentamos el caso de una paciente de veinte años de edad quien comienza con fractura patológica de la tibia derecha por un trauma de baja energía, con estudios radiológicos e histopatológicos que confirmaron la presencia de un adamantinoma. Fue manejado quirúrgicamente mediante resección amplia del segmento tumoral y reconstrucción con aloinjerto intercalar de tibia fijado con un clavo endomedular de estabilidad multidireccional sustentado con una placa antirrotatoria proximal. Los resultados radiológicos y clínicos fueron satisfactorios.

The adamantinoma is a biphasic malignant tumor comprising 0.4% of all primary bone tumors and 23% debuts with pathological fractures associated with trauma that occurred months or years earlier. We report the case is presented of a twenty-year-old woman that debuted with a pathological fracture of the right tibia with a low-energy trauma. The radiological and histopathological studies confirmed the presence of an adamantinoma. This was treated surgically by wide resection of the tumor and reconstructed with an intercalary allograft bone segment that was fixed with a tibial intramedullary multidirectional antirotatory stability nail sustained further by a proximal plate. The radiological and clinical results were satisfactory.