Evaluation of a pragmatic trial of a collaborative school-based obesity prevention intervention in a low-income urban district.

Broader adoption of effective school-based obesity prevention interventions is critical to the success of ongoing efforts to address the childhood obesity epidemic. School-level barriers to adopting evidence-based interventions may be overcome by empowering school-level leaders to select appropriate intervention components. We used a quasi-experimental pragmatic trial design to evaluate a tailored obesity prevention intervention in 9 schools in a mid-sized urban school district in upstate New York from fall 2013 to spring 2016. We analyzed repeated height and weight measurements from an existing district screening system on 5882 students from intervention and control schools matched using propensity score methods. We assessed diet and physical activity changes in intervention schools using surveys and direct observation. The intervention led to a change of -0.27 (p = 0.026, 95% Confidence Interval (CI): -0.51, -0.03) and -0.28 (p = 0.031, 95% CI: -0.54, -0.03) BMI units in spring 2014 and fall 2014, respectively. There were no significant differences between intervention and control from spring 2015 to spring 2016. Despite the lack of sustained effects on BMI, we demonstrated the potential of supporting school leaders in a low-income district to implement supportive policy and practice changes and of using an existing BMI screening system to reduce the burden of health promotion evaluation.

Use of acoustic myography to evaluate forelimb muscle function in retriever dogs carrying different mouth weights.

Objectives: To evaluate the effect of mouth weight on gait and relative function of forelimb muscles in retriever hunting dogs as a possible explanation for biceps tendinopathy. Methods: Ten sound retriever dogs underwent acoustic myography, measuring efficiency (E-score), spatial summation (S-score), and temporal summation (T-score) during walk and trot on a pressure-sensitive walkway while carrying a 0 lb (0 kg), 1 lb (0.45 kg), and 3.2 lb (1.45 kg) mouth weight. Gait data included total pressure index (TPI), step length, and stance time. Statistics included a mixed effects model significant at p < 0.05. Results: Forelimb TPI increased with increasing weight. There was no significant change in individual muscle parameters in response to weight. Significance was found in between-muscle comparisons. For walk, T-score was significantly lower in triceps vs. brachiocephalicus with 1 lb, not with 3.2 lb., S-score was significantly lower in the biceps at 0, 1 lb, and triceps at 0 lb. when compared to brachiocephalicus, E-score was significantly lower in deltoideus vs. brachiocephalicus at trot with l and 3.2 lb. There was an overall significant effect of muscle on T-score at trot, but no individual muscle comparison was significant. Conclusion: Forelimb load increases with mouth weight. Deltoideus had a longer contraction time in response to increasing weight at trot when compared to brachiocephalicus. The biceps muscle did not show increased work in response to increasing weight. Clinical relevance: The underlying etiology of biceps tendinopathies in retriever dogs remains uncertain but is not due to increasing weight.

Arctic corridors and northern voices project: Methods for community-based participatory mapping for low impact shipping corridors in Arctic Canada.

Documenting Inuit and local knowledge is critical to its consideration within policy discussions around Arctic shipping; especially considering the rapid increase in ship traffic due to reductions in sea ice and climate change. We present our unique community-based research approach which incorporated youth training, participatory mapping, qualitative focus group discussions, and verification exercises to document Inuit communities' perspectives in Arctic Canada about Low Impact Shipping Corridors. These qualitative activities provided appropriate context and understanding around community-created maps, community-identified opportunities, concerns, and recommendations, and the policy relevance and feasibility of recommendations posed. Three activity phases were employed; 1) before engaging in in-community research, 2) during in-community research, and 3) after completing in-community research. Spatial and non-spatial data were analyzed using ArcGIS® and NVivo software, respectively. These methods and observations can inform future research initiatives, particularly transdisciplinary teams, including those involving southern-based (early career) researchers, working in Inuit Nunangat.•Methods presented here ensured that scientific processes and outputs were robust and rigorous and research was conducted in a respectful, reciprocal manner.•Only through the collaborative efforts of a transdisciplinary team could scientific rigour be attained and respect be afforded.•The approach can be easily applied to document community members' perspectives on local priorities.

The Dorsal 4-finger Technique: A Novel Method to Examine Metacarpophalangeal Joints in Patients with Rheumatoid Arthritis.

OBJECTIVE: To describe the dorsal 4-finger technique (DFFT) in examining metacarpophalangeal (MCP) joints of patients with rheumatoid arthritis (RA) and compare it to the traditional 2-finger technique (TFT) using ultrasound (US) as a gold standard. METHODS: Four rheumatologists evaluated 180 MCP joints of 18 patients with RA. All patients underwent US for greyscale (GSUS) and power Doppler US (PDUS). Agreements between rheumatologists, the 2 techniques, and US were evaluated using Cohen κ and the first-order agreement coefficient (AC1) κ methods. RESULTS: The population comprised 17 females (94.4%) with a mean (SD) age and disease duration of 56.8 (14.4) and 21.8 (12.9) years, respectively. Eight patients (44.4%) were taking methotrexate monotherapy, while 10 patients (55.6%) were receiving biologics. US evaluation revealed 69 (38.3%) and 30 (16.7%) joints exhibited synovitis grade 2-3 by GSUS and PDUS, respectively. Effusion was documented in 30 joints (16.7%). The mean intraobserver agreement using the DFFT and TFT were 80.5% and 86%, respectively. The mean interobserver agreements using the DFFT and TFT were 84% and 74%, respectively. κ agreement with US findings was similar for both techniques in tender joints but was higher for the DFFT in nontender joints (0.33 vs 0.07, p = 0.015 for GSUS) and (0.48 vs 0.11, p = 0.002 for PDUS). The DFFT had a higher sensitivity in detecting ballottement by GSUS (0.47 vs 0.2, p < 0.001) and PDUS (0.60 vs 0.27, p < 0.001). CONCLUSION: The DFFT is a novel, reproducible, and reliable method to examine MCP joints, and it has a better correlation with US than the traditional TFT.

Cancer-killing CAR therapies gain speed.

In recent clinical trials, engineered CAR T cells have yielded response rates as high as 90% in patients with leukemia. Now, scientists are working to get this therapy to market and possibly expand its use into solid tumors.