Evolution of Legislation and Crimes Based on Sexual Identity or Orientation in Spain: A Retrospective Observational Study (2011–2021)

Respect for different sexual options and orientations prevents the occurrence of hate crimes against lesbian, gay, bisexual, trans and intersex (LGTBI) persons for this reason. Our aim was to review the legislation that protects the rights of LGTBI people and to quantify the victimization rates of hate crimes based on sexual identity and orientation. A retrospective observational study was conducted across all regions of Spain from 2011–2021. The laws on LGTBI rights in each region were identified. Hate crime victimization data on sexual identity and orientation were collected in annual rates per 100,000 inhabitants, annual percentage change and average change during the study period to assess the trend. The regulatory development of laws against discrimination against LGTBI individuals is heterogeneous across regions. Overall, in Spain there is an upward trend in the number of hate crime victimizations motivated by sexual identity or orientation. The effectiveness of data collection, thanks to better training and awareness of police forces regarding hate crimes and the processes of data cleansing and consolidation contributes to a greater visibility of hate crimes against LGTBI people.

The Effect on Pregnant Women Assisted Towards Attitude and Behavior Changes to Stunting Prevention

Background: East Kotawaringin and Pulang Pisau Regency have highest prevalence of stunting, respectively, in Central Kalimantan Province. One of the efforts made through the assistance to improve the knowledge and skills of pregnant women. The study was aimed at analyzing the effectiveness of assistance on behavior and attitudes among pregnant women in the Pulang Pisau Regency. It also aimed to analyze the behavior of pregnant women shifting upon stunting.Method: It is a quasi-experimental study (n:60), with pre-posttest group comparison. There are two groups, namely conventional (n:30) and assisted through pocket book (n:30). Socio-economic data was collected to draw the characteristics of the study subjects through questionnaire. A 2x2 chi-square and paired t-test was run in SPSS v. 18 for Windows.Results: The characteristics of the study respondents did not show any significant differences in attitudes and behaviors of stunting prevention in the Pulang Pisau district. The average change in attitude score shows a significant difference in the assisted group with a pretest of 65.8 ± 7.8, increased during the post-test of 75.7 ± 2.7. It is also an increase in understanding (n: 21). We concluded that pocket-book treatment is more effective in improving the attitude of pregnant women towards preventing stunting.

Impact of Injection Protocol Selection by Retina Specialists on Clinical Outcomes in Patients with Diabetic Macular Edema

Intravitreal anti-VEGF injections are the current gold standard for treating diabetic macular edema (DME). However, injection practice patterns of retina specialists have varied markedly based on physician discretion. This retrospective study analyzes the impact of injection protocol selection on change in best-corrected visual acuity (BCVA) and central macular thickness (CMT) in 170 eyes treated by 4 retina specialists practicing a pro re nata (PRN) strategy between 2010 and 2020. DME patients received an average of 7.25 injections every 6.24 weeks over 56.6 weeks. There were significant differences between retina specialists in mean number of injections (p = 0.0001) and mean length of treatment (p = 0.0007) but not in mean interval between injections. Over the treatment period, average change in BCVA was −0.053 logMAR, and average change in CMT was −51.1 µm, neither of which had significant differences between retina specialists. BCVA and CMT at initial visit were found to be significantly associated with improved BCVA and CMT over the treatment period (p < 0.001). Number of injections administered and interval between injections were not found to be significant factors affecting change in BCVA or CMT. Despite significant differences in injection dosing regimen, retina specialists achieved similar outcomes in change in BCVA and CMT over the treatment period.

A Study on Near Real-Time Carbon Emission of Roads in Urban Agglomeration of China to Improve Sustainable Development under the Impact of COVID-19 Pandemic

In order to achieve the goal of carbon neutrality and explore the impact of COVID-19 on urban road carbon emission, this study applied and improved a near real-time road carbon emission estimation method for typical Chinese urban agglomeration to improve the rapid evaluation of sustainable development. As a result, we recorded the daily road carbon emission for 12 cities in the Beijing–Tianjin–Hebei (JJJ) region under the impact of the epidemic, exploring the road carbon reduction effect caused by COVID-19. Singular value decomposition method was used to analyze the temporal and spatial characteristics of road carbon emission changes among cities and to explore the urban resilience oriented to public events. The results show: (1) In the JJJ region, the carbon reduction effect caused by COVID-19 is significant, but it lasted for a short time. In the three periods—before the epidemic, strict lockdown period, and post-lockdown period for prevention and control—the total daily road carbon emissions in the 12 cities were 170,000–190,000 tons, 90,000–110,000 tons, and 160,000–180,000 tons, respectively. (2) Cities in the JJJ region showed different road carbon reduction potential under short-term administrative control. During the “strict lockdown period” (23 January–25 February 2020), the average change rate of road carbon emissions in Beijing was −78.72%, which had great potential for reduction. However, the average change rates of Xingtai and Zhangjiakou were only −7.53% and −8.66%, respectively. (3) There are spatiotemporal differences in carbon emissions of urban roads in the JJJ region under the impact of the epidemic. During the gradual reduction of COVID-19 restrictions, great differences between cities on weekends and holidays arise, showing the road carbon emissions in Beijing on weekends and holidays are far lower than that in other cities. (4) In the face of public emergencies, the larger the city is and the more complex the function of the city is, the more difficult for the city is to maintain a steady state. This study not only provides an idea for the dynamic monitoring of urban carbon emissions to improve the rapid evaluation of urban sustainable development in post- and pre-lockdown but also fills the gap in the research on the differences in the response of cities to sudden security incidents from the perspective of road carbon emissions.

Late Exercise Tolerance Testing Using a Dynamic High Intensity Interval Multidirectional Movement Protocol

ObjectiveAnalyze the utility of a 5-step exertional rehab protocol (ERP) that included High Intensity Interval Multi-Directional Movement (HIIT-MD) or step 5. We assessed the incidence and etiologies of exercise intolerance (EI) during Step 5 in concussed patients who tolerated maximal linear exertion.BackgroundExertional testing can be used to determine appropriate levels of exercise tolerance (ET) in concussed patients. Traditionally linear modalities have been used to determine max ET prior to clearance. HIIT-MD protocols can be the next appropriate step to bridge clearance for more dynamic activities.Design/MethodsRetrospective chart review included 130 step 5 trials for EI; of those, 72 had pre/postexercise King Devick (KD) and force plate (FP) testing. Patients were 10–59 years old and clinic visits occurred 2019–2020. EI rate was recorded and failure reason was documented by our clinic's concussion specialist. The difference between pre/post exercise KD and FP was investigated.ResultsOf 130 step 5 trials, 21.54% failed due to EI. Reason for EI included the onset of symptoms (82.1%), followed by signs of dysautonomia (39.3%). Symptoms and dysautonomia combined were noted in 35.7% of those with EI. Symptoms appeared in combination with another marker 69.6% of the time. The average change in KD times pre/post exercise testing was +2.52 seconds longer in the EI group compared to −2.45 seconds shorter in the ET group (p = 0.62). The EI group demonstrated an average change of 0.36 deg/sec sway velocity increase after exercise compared to 0.13 deg/sec in the ET group (p = 0.93).ConclusionsThere is evidence for the utility of a HITT-MD protocol for dynamic exercise/sports clearance. Exercise testing progression and concussion clearance should include a dynamic HITT-MD protocol to ascertain no late phase dynamic EI. Dysautonomia and/or vestibulocular aggravation may be contributors to late phase EI. If EI exists, identifying and targeting underlying causes can aid optimal recovery.

Subclinical Vestibular Deficits Illustrated in Patients With Exercise Intolerance After mTBI Using Force Plate Protocols

ObjectiveInvestigate the changes in sway velocity vestibular markers in mTBI patients with exercise intolerance (EI) during exertional testing as part of a 5-Step Exertional Rehab Protocol (ERP).BackgroundExertional testing can be used to determine one's therapeutic exercise threshold. A number of systems have been shown to be related to Exercise Intolerance (EI) including autonomic, cervical, and vestibular, and visual. Vestibular function can be measured before and after exercise and may shed light into its impact on EI.Design/MethodsRetrospective review of 342 trials of exertional testing in mTBI patients, ages 10–60, in 2020. Exertional testing was completed with pre/post force plate sway velocity calculated. Protocol A involved single leg stances, while protocol B involved 2 feet stances. A concussion specialist determined exercise tolerance (ET) by evaluating for the onset of signs/symptoms or cardiovagal dysautonomia.ResultsOf 342 exertional test trials, 34.8% exhibited EI due to symptom exacerbation and/or signs of autonomic dysfunction. Vestibular Force Plate sway velocities in both protocol A and B were significantly worsened in the EI group by an average change of 0.32 deg/sec, compared to those in the ET group who exhibited only an average change of 0.03 deg/sec sway velocity (p = 0.0004). The EI group using protocol A, showed an average change of 0.86 deg/sec compared to those in the ET group using protocol A, who exhibited only an average change of 0.03 deg/sec sway velocity (p = 0.0041). EI group using protocol B, showed an average change of 0.12 deg/sec sway velocity compared to those in the ET group using protocol B, who also exhibited an average change of 0.03 deg/sec (p = 0.0013).ConclusionsSubclinical vestibular markers such as sway velocity measures may be used to identify etiologies for EI in mTBI. Furthermore, these vestibular testing may be a subclinical measure that can aid exercise and sport clearance decisions.

Extent and Rate of Deforestation and Forest Degradation (1986–2016) in West Bugwe Central Forest Reserve, Uganda

Understanding the extent of land cover change and the forces behind land cover changes is essential in designing appropriate restoration strategies. Land cover changes at local scales or the factors that lead to cover change have not been documented for much of Uganda. We undertook this study in West Bugwe Central Forest Reserve (WBCFR) to fill this gap. We used remote sensing to determine land cover changes for a 30-year period, 1986–2016, and an interview survey to investigate the drivers of these changes. Our results show that the forest in this reserve has declined extensively by over 82% from 1,682 ha to 311 ha corresponding to an average change of −1.18% per year. The wetland has also been extensively degraded. Both the forest and wetland have transitioned into shrub land. The key drivers that have been highlighted by the survey are poverty (86%), population growth (56%), and associated harvesting of woody products (86%) for subsistence and income generation. We conclude that the forest in WBCFR has been extensively and rapidly deforested and degraded by humans.

Bone Microstructure Changes due to Once-/Twice-Weekly Teriparatide Administration: A Report of Five Cases Using High-Resolution Peripheral Quantitative Computed Tomography

This study was conducted with the aim of presenting cases in which high-resolution peripheral quantitative computed tomography (HR-pQCT) was used to investigate changes in bone microstructure due to once-weekly/twice-weekly administration of teriparatide (TPTD). Of osteoporosis patients who participated in a non-inferiority trial (TWICE study: once-weekly vs twice-weekly TPTD) with lumbar bone mineral density (BMD) as the primary endpoint, five cases scanned by HR-pQCT before TPTD administration were analyzed. Two cases were given once-weekly TPTD, three were given twice-weekly TPD, and HR-pQCT was repeated after 48 weeks. A sufficient anabolic effect of once-weekly/twice-weekly TPTD on the trabecular and cortical bone at the tibia was obtained. In addition, the average change in cortical porosity (Ct.Po) was only 0.3% in the tibia and 0.2% in the radius. These findings indicate that once-weekly and twice-weekly TPTD can be expected to improve bone microstructure, and the increase in Ct.Po may be suppressed.

Effect of Tibial Slope on Coronal Alignment in Total Knee Arthroplasty

Malalignment of total knee arthroplasty (TKA) components affects function and survivorship. Common practice is to set coronal alignment prior to adjusting slope. With improper jig placement, adjustment of the slope may alter coronal alignment. The purpose of this study was to quantify the change in coronal alignment with increasing posterior tibial slope while comparing two methods of jig fixation. A prospective consecutive series of 100 patients underwent TKA using computer navigation. Fifty patients had the extramedullary cutting jig secured proximally with one pin and 50 patients had the jig secured proximally with two pins. Coronal alignment (CA) was recorded with each increasing degree of posterior slope (PS) from 0 to 7 degrees. Mean CA and change in CA were compared between cohorts. Utilizing one pin, osteotomies drifted into varus with an average change in CA of 0.34 degrees per degree PS. At 4 degrees PS, patients started to have >3 degrees of varus with 12.0% having >3 degrees of varus at 7 degrees PS. Utilizing two pins, osteotomies drifted into valgus with an average change of 0.04 degrees in CA per degree PS. No patients in the two-pin cohort fell outside 3 degrees varus/valgus CA. CA was significantly different at all degrees of PS between the cohorts. Changes in PS influenced CA making verification of tibial cut intraoperative critical. Use of >1 pin and computer navigation were beneficial to prevent coronal plane malalignment. This relationship may explain why computer navigation has been shown to improve alignment as well as survivorship and outcomes in some patients, especially those <65 years.

Grammatical Verb Errors: Differences Between English Learners With and Without Diagnosed Language-Based Learning Disabilities

Purpose: This study examines the written language samples of fifth grade English learner (EL) students with and without diagnosed language-based learning disabilities (LLDs) in an effort to explore the utility of such supplemental materials for aiding in differential diagnosis of ELs with and without LLDs. Method: This sample of 127 fifth grade students consisted of ELs without identified disabilities ( n = 89) and ELs diagnosed with LLDs ( n = 38). Written language samples from a classroom-based expository writing task were coded for grammaticality and specific verb type of errors. An analysis of variance (ANOVA) between the groups that differed by language abilities was conducted at two time points to compare the frequency of errors and the average change in grammaticality from the beginning of the school year to the end of the school year. Results: EL students with and without LLDs performed similarly at the beginning of the school year. ELs without LLDs showed greater average change in accuracy across the school year. Significantly, higher proportions of verb tense and verb omission errors were demonstrated by ELs with LLDs when compared with their EL peers at the end of the school year. Overall grammatical accuracy was also lower for ELs with LLDs. Conclusions: Group differences at the end of the school year were confirmed in types and rate of verb errors. Results support the potential clinical utility of monitoring verb errors in writing samples over time as a supplemental tool in diagnostic evaluations and assessments for progress monitoring.