University of Manitoba Scholarship

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This collection contains open access research publications authored or co-authored by University of Manitoba researchers. Content within this collection includes pre and post-print versions of articles and book chapters, conference proceedings and technical reports. MSpace is where faculty and students can deposit their research output to meet the open access requirements of grant funding agencies and other related mandates. Deposit is subject to copyright compliance, distribution license and other license restrictions that may be imposed on the work.

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Access status: Open Access ,
The impact of COVID-19 vaccine distribution channels on equity-deserving populations: a Canadian population-based cohort study using administrative data
(BMC, 2026-01-09) Katz, Alan; Aubrey-Bassler, Kris; Aghajafari, Fariba; Fransoo, Gillian; Ivers, Noah M.; Kwong, Jeffrey C.; Moineddin, Rahim; Nguyen, Lena; Saj, Danielle; Taylor, Carole; Upshur, Ross E. G.; Woodrow, Jennifer; Wong, Sabrina T.; Xiong, Hui; Aggarwal, Monica
Background: Uptake of COVID-19 vaccines among equity-deserving populations was a challenge throughout the Canadian vaccination campaign. This necessitated the implementation of vaccine distribution strategies that targeted specific populations. As a result, different vaccine channels were introduced in each province. The purpose of this study is to examine the effect of COVID-19 vaccine distribution channels on short-term vaccination rates amongst equity-deserving populations. Methods: Retrospective, population-based cohort using linked administrative claims data based in the Canadian provinces of Manitoba, Ontario, and Newfoundland and Labrador. The study population included all residents, 12 years and older, who were living in one of the three provinces with at least 1 day of health coverage between Jan 1, 2021, and Dec 31, 2021. The index event was receiving one COVID-19 vaccination. Difference-in-differences analyses were used to evaluate the impact of various COVID-19 vaccine distribution channels, such as directed at-risk, mass vaccination clinics, pharmacies, primary care offices, and long-term care facilities, on the gap in vaccination coverage between select equity-deserving and non-equity deserving populations. The equity-deserving populations included having lower household income, identifying as a visible minority, being a recent immigrant, and being an adult without a high school diploma. Results: The total COVID-19-vaccinated population as of December 31, 2021 was 998,906 (85% of total population) in Manitoba, 10,866,548 (89% of total population) in Ontario, and 485,901 (99% of total population) in Newfoundland and Labrador. The analyses were limited by significant data challenges; data on where (which channel) specific individuals received their vaccination were limited. Though findings were mixed, in general, the COVID-19 vaccine coverage one month after the initiation of a new vaccine distribution channel increased less for the equity deserving groups than those of the general population. Conclusion: An increase in the observed equity gaps immediately after new vaccine channel introductions may be explained by new channels providing vaccines at a lower volume than mass-vaccination clinics or may reflect limitations in the data infrastructure. The collection of uniform data across Canada should be prioritized to facilitate comprehensive evaluation of the health system response to future pandemics, including the ability to monitor the impact of the response on population inequities.
Access status: Open Access ,
Religion and public health: conceptualization and collaboration from a public health perspective
(BMC, 2026-01-29) Arora, Anish K.; Ehsani, Johnathon; Resnick, Beth; Dechtiar, Yovania; Hatala, Andrew
Background: Religion and public health, when understood in their broadest sense, are systems of knowledge and practice that seek to improve the wellbeing of people and populations. With over 75.8% of the global population identifying with some form of religious belief, understanding how the public health community conceptualizes religion and engages with it is essential for meaningful collaboration. The purpose of this study is to explore the conceptualizations of and relationships between religion and public health, focusing on public health practitioners’ experiences in engaging with religious communities. Methods: This qualitative study involved interviews with 15 North American public health practitioners across diverse religious and ethnic backgrounds, examining their perspectives on religion’s role in health interventions, with a particular focus on the COVID-19 pandemic. Results: Using a framework analysis, three key thematic areas emerged, including: (1) Conceptualizations of religion and how it contributes to individual and collective wellbeing; (2) Current relationship between public health and religion; and (3) Opportunities for and strategies to establish deeper collaboration. The results reveal a strong perception among public health professionals that religious communities are being engaged in an instrumental and transactional manner to achieve public health’s agenda, rather than as true partners that co-design health interventions. While some religious communities are compliant with such interactions, many are reluctant in engaging with public health communities. To move away from instrumental and transactional interactions to meaningful engagement, interviewees share numerous strategies consistent with the principles of community-engaged research (e.g., engaging with religious communities with sincerity, humility, transparency, and valuing the knowledge these communities possess). Discussion: The findings suggest that the prerequisites for effective engagement between public health and religious communities is based on foundational principles such as trust, transparency, and the need to identify points of commonality in order to organically work towards improving the health and wellbeing of communities. Putting these principles into practice raises questions about concepts such as expertise, access to knowledge, problem identification, and prioritization. In addition, it challenges the current structures and financing mechanisms for public health practice. Integration of religion into public health education could serve as a foundation to foster more inclusive and integrative public health practice. While more research must be conducted with broader samples, insights from this study underscore the potential for more inclusive public health approaches that better address the diverse spiritual and cultural landscapes of global populations.
Access status: Open Access ,
The INITIATE (Initial Test for Fall Risk Assessment in the Elderly) prospective cohort study: baseline results
(BMC, 2025-12-06) Saunders, Stephanie; Kuspinar, Ayse; Sibley, Kathryn; D’Amore, Cassandra; Noble, Tara; Griffith, Lauren E.; Raina, Parminder; Richardson, Julie; Speechley, Mark; Beauchamp, Marla K.
Background: Fall prevention recommendations include mobility or balance testing to identify older adults with high fall risk who require further intervention. However, there is no consensus on the best tests or optimal cut-off values. The Initial Test for Fall RIsk Assessment in The Elderly (INITIATE) study was designed to determine the optimal screening test(s) for predicting falls among community-dwelling older adults. Here we describe the study protocol, sample characteristics, and baseline differences between participants with and without a history of falling. Methods: We undertook a 1-year prospective cohort study of community-dwelling older adults (≥ 65 years) able to walk 10 m without assistance at baseline and living in Ontario, Canada. Participants underwent a 2-hour baseline visit where 7 validated balance and mobility tests (Timed up and go (TUG) usual pace, TUG fast pace, TUG with a cognitive dual task, Brief Balance Evaluation Systems Test (BESTest), 5 times sit-to-stand (5TSTS), single leg stance, gait speed) were administered. Falls were tracked for 12 months using monthly diaries and follow-up calls for context. Participants received quarterly calls to monitor general wellbeing, healthcare utilization, and changes to mobility. Descriptive statistics were calculated and differences by 12-month fall history were tested using t-tests, chi square tests, and Wilcox Rank Sum tests as appropriate. Results: From 3211 contacted older adults, 514 (19%) consented. The mean age was 76.4 years (SD 6.7), 64% were female, 68% had a postsecondary degree/diploma, and 231(45%) reported a fall in the last 12 months. Means(SD) for the performance-based tests were as follows: TUG = 11.8s(4.0), TUG fast pace = 9.2s(3.4), TUG cog = 14.2s(5.9), Brief BESTest = 15.9 score(5.3), 5TSTS = 12.5s(4.3), single leg stance = 14.1s(16.3), gait speed = 1.14 m/s(0.28). Comparisons between baseline fallers and non-fallers showed no differences in age, sex, income, or education(p > 0.05) but did show differences in all 7 tests(p < 0.05). Conclusions: Participants are representative of community-dwelling older adults with fall risk. Balance and mobility test differences between fallers and non-fallers support the need for prospective comparisons of their predictive validity. Follow-up results, expected in late 2025, will help inform future updates to fall risk assessment and prevention guidelines.
Access status: Open Access ,
Genome-wide identification of ethylene receptor protein-coding gene families in wheat and their regulated expression during development and under multiple abiotic stresses
(BMC, 2026-01-26) Koramutla, Murali K.; NEGI, MANISHA ; Sharma, Deepak; Ayele, Belay T.
Background: Ethylene regulates many plant growth and developmental processes and mediates plant-environment interactions. Ethylene signal in plants is perceived by transmembrane ethylene receptor proteins (ETRs), which initiate a cascade downstream signaling events that regulate the expression of ethylene responsive genes. However, the identity and roles of ETRs in wheat remain to be investigated. This study performed genome-wide identification and characterization of ETR genes in hexaploid wheat (Triticum aestivum L.) and its tetraploid and diploid progenitors. Results: A total of 18 homoeologues of six TaETR genes were identified in the genome of hexaploid wheat, namely TaERS1, TaERS2, TaETR2, TaETR3, TaETR4 and TaETR5, which are distributed unevenly over 4 chromosomes in each of the three subgenomes. These genes typically consist of 1 to 7 exons and 0 to 6 introns, and the exons/introns number in TaETR homoeologues varies with their subgenome origin. The TaETR proteins consist of a minimum of 5 and a maximum of 7 domains, of which cGMP phosphodiesterases/adenylyl cyclases/FhlA (GAF) is a conserved domain. Analysis of the promoter sequences of TaETR genes revealed the presence of eight groups of cis-regulatory elements, which includes hormone and stress responsive elements. Using publicly available transcriptomic data and qRT-PCR, we found that TaETR genes exhibit tissue and stage specific expression patterns during wheat development and differential response to multiple abiotic stresses. The study also characterized ETR genes from the tetraploid and diploid progenitors of hexaploid wheat, T. turgidum ssp. dicoccoides and Aegilops tauschii, respectively. Conclusion: Ethylene is an important regulator of crop traits of agronomic and economic importance. This study identified ETR genes of wheat and predicted their potential roles during wheat growth and development as well as its interaction with the surrounding environment.
Access status: Open Access ,
Study protocol for a pragmatic, cluster, randomized controlled trial of a multifaceted fracture prevention model for long-term care: the PREVENT trial
(BMC, 2026-01-09) Papaioannou, Alexandra; Feldman, Sidney; Katz, Paul; Costa, Andrew P.; Kennedy, Courtney C.; Adachi, Jonathan D.; Boyd, Hugh; Giangregorio, Lora; Heckman, George; Hewston, Patricia; Hirdes, John; Holroyd-Leduc, Jayna; Howard, Michelle; Ho, Joanne; Jaglal, Susan; Kaasalainen, Sharon; Kristof, Lorand; Lau, Arthur; Lee, Justin; McArthur, Caitlin; Marr, Sharon; O’Donnell, Denis; Rodrigues, Isabel B.; Shankardass, Kanwal; Siu, Henry; Straus, Sharon; Thrall, Samuel; Tarride, Jean-Eric; Thabane, Lehana; Hafid, Shuaib; Tung, Jennifer; Hillier, Loretta M.; Kane, Lauren L.; Azizudin, Ashlee M.; Desinghe, Teshan D.; Ioannidis, George
Background: Each year, half of all long-term care (LTC) residents will sustain a fall, and many will sustain a fall-related fracture. Fifty percent of all fractures in this vulnerable cohort occur at the hip, which is a life-changing health event leading to hospitalization, impaired physical functioning, and increased risk of premature mortality. National osteoporosis guidelines for the prevention of fractures are not consistently used in LTC homes. Improving osteoporosis guideline implementation may prevent hip fractures and other fractures. This study will examine whether the PREVENT (Person-centered Routine fracture prEVENTion) model can reduce hip fracture rates over one year compared to usual care in LTC homes. Methods: Our study design is a pragmatic, cluster, randomized controlled trial. We will recruit 122 for-profit and not-for-profit LTC homes across Ontario, Canada. Homes will be randomized in a 1:1 ratio to intervention (PREVENT model) or control (usual care) arms. Eligibility criteria include a minimum of 50 occupied beds and access to the PointClickCare (PCC) electronic medical record system. One or two local opinion leader(s) and a leadership team consisting of five to ten healthcare providers will be recruited within each LTC home to support the implementation of the fracture prevention knowledge translation (KT) intervention. Generalized estimating equations (GEE) will be used to examine the effect of the PREVENT intervention vs usual care on hip fracture incidence (primary outcome), adjusting for important resident and LTC home characteristics; and secondary outcomes, including new osteoporosis medication prescriptions, non-hip fracture rates, falls, hospitalizations, death, LTC quality indicators, pain, mobility, responsive behaviors, and healthcare utilization costs. The Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) statement was used to guide the development of this study protocol. Discussion: Preventing hip fractures in LTC has significant health, economic, and personal benefits. To our knowledge, the PREVENT trial is the first KT study of its kind in LTC to measure hip fracture as the primary outcome. If the PREVENT trial successfully improves hip fracture rates, it may lead the way for implementing a standardized approach to preventing hip fractures in LTC homes across Canada and internationally. Trial registration: ClinicalTrials.gov NCT04947722. Registered on July 1, 2021.
Access status: Open Access ,
The rheumatoid arthritis citrullinome is enriched in antigenic complement proteins
(BMC, 2026-01-28) Navarette, Mario; Trivedi, Khushali; Klenke, Clarissa; Zheng, Zihao; Kim, Jun; Maisha, Jeba Atkia; Semenenko, Alina; Meng, Xiaobo; Okeke, Obinna Innocent; Muñoz Grajales, Carolina; Peschken, Christine; Shelef, Miriam A.; El-Gabalawy, Hani; O’Neil, Liam J.
Objectives: Citrullination is a post-translational modification that serves as an autoantigen in Rheumatoid Arthritis (RA). It remains unclear whether there is an excess production of specific citrullinated proteins in RA patients that is driving the autoantibody response. The aim of this study was to undertake an unsupervised proteomic analysis of the circulating RA citrullinome, and determine the consequences of citrullination in RA. Methods: Citrullinated serum proteins were isolated and measured by mass spectrometry from 10 anti-citrullinated protein antibody (ACPA) positive RA patients and 10 controls. Cit-proteins and cit-immune complexes (IC) were measured in a larger cohort of unaffected first-degree relatives (FDR, ACPA- n = 31, ACPA+ n = 26) and RA (n = 31). Autoantibodies to citrullinated C9, and linear peptides of citrullinated C9 were measured. Structural changes imparted by citrullination were studied in-silico using Alphafold 3.0. Results: Differential analysis of the RA citrullinome revealed a higher expression of complement proteins. Validation studies revealed that the levels of cit-C9 (p = 0.02) and cit-CFI (Complement Factor I, p = 0.019) were higher in RA than controls. Cit-C9 IgG, but not cit-CFI, immune complexes were elevated in ACPA+ FDR (p < 0.0001) and RA (p < 0.0001) compared to ACPA- FDR. Autoantibodies to cit-C9 were also higher in ACPA+ FDR (p = 0.01) and RA (p = 0.002). Reactivity to linear peptides of cit/homocit C9 were enriched in RA patients compared to controls. In-silico modelling revealed structural changes to the monomeric and multimeric structure of cit-C9. Conclusion: This analysis of the circulating citrullinome in RA reveals the generation of citrullinated complement proteins that serve as autoantigens.
Access status: Open Access ,
Deferred consent in emergency neurocritical research: experience from two prospective cohorts
(BMC, 2026-02-21) Alcock, Susan; Blackwood, Benjamin; Ayroso, Marco; Shankar, Jai
Access status: Open Access ,
Implications of virus-induced stress granules in tauopathies
(BMC, 2026-02-12) Sharma, Snigdda; Vandenakker, Alex; Cortés-Pérez, Claudia; Milne, Sarah; Douville, Renée N.
Tauopathies are characterized by aberrant tau structure and function, which is associated with neurodegenerative dementias, such as Alzheimer’s disease, Pick’s disease, and frontotemporal dementia, as well as the motor neuron disease amyotrophic lateral sclerosis. Consistent association of these neurodegenerative conditions with viruses suggests an interplay between viral activity and the development of tauopathy. In this review, we explore how tau dysregulation may facilitate viral activity, and conversely, how viruses may drive tauopathy. We further discuss how stress granules (SGs) are a likely hub for the interactions between tau and viral components, leading to tau deregulation. Within the network of SG proteins analyzed, 15 proteins were identified to be both tau interactors and implicated in viral processes, having dual functionality. These SG proteins are further discussed in terms of their relationship with tauopathy, viral replication, and neurodegeneration. Concrete examples of synergistic and competing effects between tau and viruses are highlighted, revealing both pathological and protective mechanisms. This dichotomy underscores a complexity that is both disease- and virus-specific, within the context of SG biology and tau pathology. While the viral involvement in tauopathies could be considered detrimental, it may provide insights into antiviral therapeutics to target the accumulation and misfolding of tau in these neurodegenerative diseases. Graphical abstract
Access status: Open Access ,
Effect of lateral positioning on ventilation in patients with blunt thoracic injury during pressure support ventilation: the VICTORY study
(Springer, 2026-02-25) phoophiboon, vorakamol; Rodrigues, Antenor; Ko, Matthew; Menga, Luca S.; Vieira, Fernando; Docci, Mattia; Sharifi, Kiana; Schreiber, Annia; Sousa, Mayson L. A.; Goffi, Alberto; Rigamonti, Andrea; Brochard, Laurent
Background: In patients with blunt thoracic injury requiring mechanical ventilation lateral positioning is routinely performed. Whether it modifies ventilation distribution and aeration is unclear. Study design and methods: Patients receiving pressure support ventilation (PSV) were positioned 30 degrees on each side for 30 min. Electrical impedance tomography (EIT) was used to quantify the percentage of right and left ventilation. Secondary outcomes included right and left tidal volume and the modified lung ultrasound score. At baseline, patients were categorized according to ventilation distribution: symmetrical (right lung receiving 50–55% of total ventilation) or asymmetrical. Results: Twenty-four patients were included (mean age 51 ± 20 years, 79% male) under median PSV 5 cmH2O [25–75% IQR: 5–8] and PEEP 8 [5–8] cmH2O. Trauma mechanisms included motor vehicle collision (50%) and fall (29%); 54% had bilateral rib fractures and 8% a flail chest. The duration of ventilation and ICU stay were 9 [5–19] and 13 [8–21] days, respectively. Regional right-lung ventilation increased slightly when the lung was dependent [53% (44–58%)], decreased when non-dependent [47% (44–53%)], compared to supine [50% (45–54%)] (p = 0.022). These effects were observed in patients with symmetrical baseline ventilation (n = 8, p = 0.011), but not in those with asymmetrical ventilation (n = 16, p = 0.391), nor in patients with low respiratory system compliance (< 50 ml/cmH2O, n = 9, p = 0.539). In patients with symmetrical distribution, the right-lung and right-basal ultrasound score increased when dependent (p < 0.05), whereas no changes were observed in the left lung. There were no differences in respiratory mechanics or global ventilation from the beginning to the end of the session once patients were returned to supine. Conclusion: In blunt thoracic injury, lateral positioning during PSV is associated with a modest increase in regional ventilation of the dependent lung, but this effect is limited to patients with symmetrical ventilation distribution and normal compliance. In others, longer duration or higher degree of lateralization may be required.
Access status: Open Access ,
Can flaxseed “milk” prevent anthracycline mediated cardiotoxicity in women with breast cancer (CANFLAX-BC)?
(BMC, 2026-01-08) Arya, Vibhuti; Mackic, Lana; Langdon, Sara M. T.; Cheung, David Y. C.; Haasbeek, Paris R.; Eastman, Skyler; Castagna, Lauren; Grandy, Scott; Heinze, Stefan S.; Desautels, Danielle; Gordon, Vallerie; Graham, Jeffrey; Green, Susan; Grenier, Debjani; Kim, Christina A.; Thiessen, Maclean; Pitz, Marshall; Jassal, Davinder S.
Background: Cardio-Oncology focuses on the prevention, diagnosis, and management of individuals with cancer who are at risk of developing cardiovascular complications as a result of their anti-cancer treatment. The aim of the “Can flaxseed “milk” prevent chemotherapy mediated cardiotoxicity in women with breast cancer (CANFLAX-BC) study” was to investigate whether consumption of flaxseed (FLX) “milk” can prevent cardiac dysfunction in women with breast cancer treated with anthracyclines. Methods: In this small pilot double-blinded, single centre, prospective randomized controlled clinical trial, women with breast cancer were randomized to oral consumption of either placebo oat fiber “milk” or FLX “milk” for a total of 4 months while receiving anthracycline-based chemotherapy. Serial echocardiography and cardiac biomarkers were measured at baseline, 4-months, and 6-months follow-up. Results: Between 2021 and 2023, a total of 21 women with early-stage breast cancer (mean age 48 ± 10 years, BMI 28 ± 5 kg/m2), treated with an anthracycline based chemotherapy regimen, were enrolled in the CANFLAX-BC study. During the 4-month intake period, a total of 8 women received oat fibre “milk” and 13 women received FLX “milk” while receiving anthracyclines, with a comparable adherence rate of 70% for both groups. At baseline, 4-months, and 6-months follow-up, the LVEF was 68±4%, 69±3%, and 66±4%, respectively, for the oat fibre “milk” group and 67±5%, 68±4%, and 66±5%, respectively, for the FLX “milk” group (p = NS). Although the mean global longitudinal strain (GLS) was comparable between both groups at baseline, the GLS was lower at -13.8 ± 0.3% (4 months) and − 15.1 ± 0.3% (6 months) for the oat fibre “milk” group as compared to a GLS of -18.4 ± 0.3% (4 months) and − 18.5 ± 0.2% (6 months) for the FLX “milk group (p < 0.05). Conclusion: In women receiving an anthracycline based chemotherapy regimen for breast cancer, this small pilot study suggests that FLX “milk” consumption may prevent early cardiotoxicity as reflected by preservation of GLS parameters.
Access status: Open Access ,
Association of SP Educators (ASPE) Physical Examination Teaching Associate (PETA) Standards of Best Practice (SOBP)
(BMC, 2026-02-19) Hopkins, Holly; Webster, Tim; Lewis, Karen; Smith, Cathy M.; Yelen, Marsha E.
Physical Examination Teaching Associates (PETAs) instruct healthcare professional learners to perform accurate and respectful physical examinations. PETAs are trained to teach physical examination techniques to learners in a standardized manner while providing ongoing feedback to the learner based on the PETA’s experience receiving the examination with their own body. While PETAs fall under the broad umbrella of standardized/simulated patient/participant (SP) methodology, their distinct role necessitates specific Standards of Best Practice (SOBP) tailored to PETA programs. To address this need, the Association of SP Educators (ASPE) used the Delphi process, involving thirteen PETA methodology experts from four countries. The five Domains of the ASPE SOBP as well as the accompanying Principles and Practices were revised to align with the needs of PETA programs. There were modifications to terms and content to reflect the unique scope of PETA practice. The ASPE PETA SOBP is designed for programs where PETAs are involved in formative instructional sessions with learners. As with the prior ASPE SOBP, this aspirational document provides flexibility to adapt to diverse program contexts and will continue to evolve.
Access status: Open Access ,
Data ownership judgments in childhood
(Springer, 2026-02-22) Nancekivell, Shaylene E.; Vanstone, Abby; Nishikiori, Kazuki
As adults, we experience discomfort when we hear about how our data has not been safeguarded by apps. Despite this being a common experience, the psychological processes that underlie people’s reasoning about data ownership and rights are poorly understood. Using a developmental approach, the current investigation examines the psychology of data ownership. We test the specific proposal that people have a coherent theory of ownership that leads them to view data as owned and under owners’ control at the same developmental time point. In both studies (N = 218), children ages 5–12 were told about a user who shares personal and general information with an app. Children then had to decide who it belongs to (Study 1) and who is in charge of it (Study 2). During middle childhood, children view users as owners of personal information and therefore entitled to control it suggesting coherence in their representations of non-physical property types. Findings also suggest that by 8-years-old children have the cognition in place to think of data as property and therefore understand their data rights online.
Access status: Open Access ,
Evidence-based therapist guided introduction to online heavy cannabis use treatment in Canadian adults: a Randomized Controlled Trial (RCT)
(BMC, 2026-01-17) Rysen, Karli; Carusone, Julian M.; Wardell, Jeffrey D.; Schaub, Michael P.; Wenger, Andreas; Wallbridge, Harold R.; Edgerton, Jason D.; Kruk, Richard; Mackenzie, Corey S.; Keough, Matthew T.
Background: Many people who engage in heavy cannabis use do not seek treatment, and those who do are often met with long treatment wait times or high cost of services. Online treatment programs reduce barriers to accessing treatment in a timely manner. Online cannabis use treatment programs are effective, showing moderate effect sizes, particularly with text-based therapist support. Literature suggests brief therapist-guided introductions (i.e., self-completed interventions offered with the support of a therapist) informed by Motivational Enhancement Therapy (MET) may help to bolster and maintain program gains. The current evaluation of MET-informed therapist-guided introduction was conducted with a sample of Canadians who report heavy cannabis use, using a new Canadian version of CANreduce, an online treatment program for heavy cannabis use. Method: The intervention was pre-registered on clinicaltrials.gov for traceability (ID: NCT04965012). Participants (N = 152) were randomized into one of three conditions: MET-therapist guided introduction plus 6-week, online, self-guided treatment program; non-MET research assistant introduction plus 6-week, online, self-guided treatment program; or a psychoeducational control condition. Module content to reduce cannabis use was informed by cognitive behavioural therapy and motivational interviewing approaches. Participants completed assessments at baseline, end of treatment (i.e., 6 weeks), and at follow up (i.e., 10 weeks). Data were analyzed using Generalized Estimating Equations. Results: All participants reduced their cannabis consumption frequency (use days in the past week), as well as cannabis-related problems, at end of treatment and follow up. Participants in the MET-therapist condition showed significantly greater reductions in quantity of cannabis used over time compared to the waitlist control. Participants in the non-MET research assistant condition showed significantly greater reductions in cannabis problems compared to waitlist control. There were no significant differences between MET-therapist guided conditions and non-MET research assistant conditions. There was no significant effect of condition on cannabis consumption days in the past week, anxiety, depression or quality of life. Conclusion: The present study provides preliminary support for the CANreduce program in addition to the MET-therapist guided introduction.
Access status: Open Access ,
Cannabis use among Canadian veterans: associations with the use of other substances, chronic pain conditions, mental disorders, suicide behaviours, and help-seeking
(BMC, 2026-01-19) Taillieu, Tamara; Salmon, Samantha; Stewart-Tufescu, Ashley; Sareen, Jitender; Enns, Murray; Mota, Natalie; Bolton, Shay-Lee; Carleton, R. N.; Stein, Murray B.; afifi, tracie
Background: A substantial proportion of Veterans experience mental and physical health difficulties, including post-traumatic stress disorder and chronic pain, for which cannabis is sometimes medically authorized. However, relatively little is known about cannabis use among Canadian Veterans. Information on the prevalence of use, as well as the mental health profiles and help-seeking behaviours of Veterans who use cannabis, is important for developing more targeted prevention and intervention services and supports. Methods: The current study used data from Veteran respondents (n = 1992) of the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey. Descriptive statistics and logistic regression models were used to examine associations between past 12-month cannabis use and concurrent mental disorders, chronic pain conditions, use of other substances, suicide behaviours, perceived need for care, and help-seeking behaviours. Results: Several participating Veterans (16.7%) reported using cannabis in the past 12-months. Infrequent use of cannabis in the past 12 months was associated with statistically significantly increased odds of current smoking, binge drinking, and post-traumatic stress disorder in fully adjusted models (Adjusted odds ratios [AOR-2] = 1.93, 2.58, and 2.37, respectively). Regular use of cannabis in the past 12 months was associated with statistically significantly increased odds of current tobacco smoking, arthritis and any chronic pain condition, several mental health disorders, and suicide ideation in fully adjusted models (AOR-2 ranged from 1.61 to 3.99). Veterans who used cannabis both infrequently and regularly were also statistically significantly more likely to perceive a need for care (AOR-2 = 2.15 and 4.85, respectively) and report professional help-seeking (AOR-2 = 2.25 and 5.56, respectively) in the past 12-months compared to Veterans who did not use cannabis. Conclusions: The strong association of past 12-month cannabis use with nicotine, chronic pain, mental disorders, and suicide ideation suggests that Veterans who use cannabis regularly may represent a population with complex needs who may benefit from additional services and supports. Cannabis using Veterans were also more likely to perceive a need for and seek professional help, which provides opportunities for more timely identification and intervention.
Access status: Open Access ,
Effects of transtheoretical model of change-based interventions on physical activity among older adults: a systematic review of randomised controlled and non-randomised controlled trials
(BMC, 2025-12-02) Fawole, Henrietta O.; Itua, Serena A.; Idowu, Opeyemi A.; Adandom, Israel I.; Kolawole, Francis O.; Adeniji, Tolulope; Obaseki, Chigozie O.; Oni, Olusola M.; Akinrolie, Olayinka
Background: Physical inactivity in older adults is a major public health concern associated with numerous non-communicable chronic conditions. Several behaviour theories have been advanced to address the issue of physical inactivity including Transtheoretical Model (TTM) of Change among older adults. The study aimed to primarily assess the cumulative effect of TTM-based interventions on physical activity and secondarily on self-efficacy among older adults. Methods: A systematic search of electronic databases (including Cochrane Library, AgeLine, Medline, Scopus, PsycINFO, and Web of Science Core Collections) was searched from inception to August 2024. Inclusion criteria comprised studies investigating TTM-based interventions on PA in individuals aged 60 and above, randomised controlled trials (RCTs) and non-RCTs. Risk of bias was assessed using Cochrane Collaboration’s tool for RCTs while ROBIN-I was used for non-RCTs. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the certainty of the evidence. Study findings were narratively synthesised in line with the Synthesis Without Meta-analysis framework. Results: Three studies (two RCTs and one non-RCT) met the inclusion criteria, comprising 1,474 participants (65–89 years; 71% females). TTM interventions showed low certainty of evidence of no significant effects on physical activity or self-efficacy for the RCTs. In contrast, the non-RCT showed very low-certainty evidence for the significant effects of TTM on physical activity among participants in the under-maintenance and maintenance stages, with long-term benefits limited only to those already in the maintenance stage. For self-efficacy, there was very low certainty of evidence for the significant effects of TTM only among participants in the under-maintenance stage. Conclusion: This review highlights the limited, inconsistent and low level of evidence of the effects of TTM-based interventions in promoting physical activity among older adults. Whilst for self-efficacy, there is limited, mixed and low to very low level of evidence for the beneficial effects of TTM interventions. More RCTs are needed to identify the most effective components of the TTM and understand the impact of different intervention delivery methods (e.g., digital versus face-to-face) for physical activity promotion in the older adult population.
Access status: Open Access ,
Toward an effective theory of the volume modulus
(Springer Nature, 2026-01-21) Agarwal, Naman; Frey, Andrew R.; Underwood, Bret
We investigate the 4-dimensional effective theory of the warped volume modulus in the presence of stabilizing effects from gaugino condensation by analyzing the linearized 10-dimensional supergravity equations of motion. Warping is generally expected to scale down the masses of bulk modes to the IR scale at the tip of a throat. We find that the mass of the warped volume modulus evades expectations and is largely insensitive to the effects of warping, even in strongly warped backgrounds. Instead, the mass is parametrically tied to the 4-dimensional AdS curvature scale $${m}^{2}\sim \mathcal{O}\left(1\right)\left|{\widehat{R}}_{\text{AdS}}\right|$$ , presenting a challenge for scale separation in these backgrounds. We trace this effect to a universal contribution arising from the 10-dimensional equations of motion, and comment on the importance of a 10-dimensional treatment of the warped volume modulus for effective field theories and model building.
Access status: Open Access ,
LL-37 and citrullinated-LL-37 enhances oxylipins: citrullination attenuates LL-37-mediated COX-2-dependent chemokine response in human bronchial epithelial cells
(BMC, 2026-01-14) Ramotar, Padmanie; Hemshekhar, Mahadevappa; Altieri, Anthony; M van der Does, Anne; Pascoe, Christopher D.; Mookherjee, Neeloffer
Background: During airway inflammation, chemokines, oxylipins (bioactive lipids) and cationic host defence peptides (CHDP) are enhanced in the lungs. However, the interplay of these molecules in the process of airway inflammation is not fully resolved. The human cathelicidin CHDP, LL-37, can enhance the expression of chemokines which is turn facilitates influx of leukocytes into the lungs. Moreover, LL-37 can be citrullinated during inflammation and the effect of this post-translational modification on LL-37-mediated immunomodulatory functions remains unclear. Therefore, in this study we aimed to define the impact of LL-37 and citrullinated-LL-37 (citLL-37) on oxylipins and its association with downstream chemokine production in human bronchial epithelial cells (HBEC), and its functional impact on leukocyte influx. Methods: We used a lipidomics approach to identify oxylipins that are enhanced in response to LL-37 and citLL-37 in HBEC. We further examined the role of selected oxylipins in LL-37- and citLL-37-mediated chemokine production by ELISA, and related leukocyte migration using a transwell migration assay. Results: We showed that LL-37, but not citLL-37, enhances oxylipins that are known to promote inflammation such as prostaglandins regulated by the cyclooxygenase (COX pathway). LL-37-mediated increase in COX-2 expression was significantly higher than that mediated by citLL-37. We showed that upregulation of COX-2 expression was dependent on the P2X7 purinergic receptor. Our mechanistic studies revealed that LL-37-mediated increase in chemokines, GROα, IL-8 and MIP-3α, was dependent on the COX-2 pathway, and that this was significantly attenuated by citrullination of the peptide. Our results also indicated that COX-2-induced PGE2 may act in an autocrine manner signaling through its EP receptors to facilitate LL-37-induced chemokine production. We functionally confirmed that factors secreted from HBEC in response to LL-37, but not citLL-37, promotes neutrophil migration which is COX-2 dependent. Conclusion: The results of this study indicate that pro-inflammatory responses mediated by LL-37 is attenuated by citrullination of the peptide. The findings of this study underscore the role of LL-37 in influencing the enhancement of bioactive lipids and metabolic pathways such as COX-2 and its link to the peptide-mediated immunomodulatory functions in the lungs.
Access status: Open Access ,
EnLeM: ensemble learning-based model to detect phishing websites
(Springer Nature, 2025-12-05) Yeasmin, Most N.; Refat, Md Abu Rumman; Singh, Bikash C.; Alom, Zulfikar; Aung, Zeyar; Azim, Mohammad
Phishing involves manipulating individuals into revealing private data, e.g., user IDs, bank details, and passwords. The observed surge in fraud is related to increased deception, impersonation, and advanced online attacks. Thus, effective phishing detection methods are required to mitigate escalating global phishing threats. Existing methods (e.g., heuristics-based, signature-based, and visual similarity-based methods) attempt to detect phishing sites, and machine learning (ML) and deep learning (DL) methods are effective in the cybersecurity context in terms of learning from data, offering insights, and forecasting. However, independent ML algorithms are limited when handling complex data, and DL techniques surpass traditional ML methods in terms of performance but require more data and time. To tackle these challenges, we present EnLeM, an ensemble learning model designed specifically for phishing website detection. EnLeM brings together three well-known machine learning classifiers—decision tree, random forest, and k-nearest neighbor—using a hard voting mechanism, and further strengthens efficiency with Mutual Information–based feature selection. When tested on the UCI phishing dataset, EnLeM delivered strong results, reaching 97.21% accuracy and a 97.51% F1-score. Compared to individual ML classifiers, it consistently performed better, and it also proved more efficient than deep learning models such as CNN and LSTM. Notably, EnLeM maintained stable accuracy across different feature subsets while cutting execution time by roughly 13%. By striking a balance between accuracy, speed, and interpretability, EnLeM stands out as a practical and scalable solution for real-time phishing detection without the heavy resource demands of deep learning approaches.
Access status: Open Access ,
Microclimates, land cover, and socioeconomic vulnerability shape Anopheles hotspots in Maryland, USA
(BMC, 2026-01-20) Ibebuchi, Chibuike C.; Onwah, Somtochukwu S.; Abu, Itohan-Osa
Background: Anopheles mosquitoes pose notable public health concerns as competent vectors of malaria and other diseases. Although malaria is no longer endemic in the United States, recent locally acquired cases in states including Maryland highlight the need to better understand Anopheles dynamics in the region. This study aimed to identify geographic hotspots of Anopheles presence in Maryland and evaluate how land cover, microclimatic conditions, and socioeconomic vulnerability shape their spatial and temporal distribution. Methods: Monthly Anopheles occurrence data (1999–2024) from Global Biodiversity Information Facility (GBIF) were aggregated at county and Census Block Group (CBG) scales. Counties were ranked by mean annual presence to identify hotspots. Associations with land cover, microclimatic, and socioeconomic conditions were assessed using Spearman’s rank correlation (ρ; P < 0.05). At the CBG scale, significantly correlated variables (|ρ| ≥ 0.25) were used to fit an Extreme Gradient Boosting model to quantify the relative importance of environmental and socioeconomic predictors. Spatial dependence was addressed through blocked cross-validation, and model interpretability was evaluated with SHapley Additive exPlanations (SHAP) values. Results: Prince George’s and Anne Arundel Counties emerged as primary hotspots of presence with highest observer effort during the analysis period. Seasonal analysis revealed an annual cycle, with peak presence from May to September, coinciding with warmer conditions favorable to vector proliferation. SHAP analysis at the CBG-scale identified habitat availability as the most influential predictor (33.1% of total model impact for low impervious surface percentage) with woody wetland emerging as the most preferred habitat; followed by humid conditions (24.6%), and low elevation (18.2%). Notably, cooler and more humid microclimates within the warm season provide optimal habitat, reflecting fine-scale environmental controls on Anopheles distribution. Therefore, CBG-level analysis within Prince George’s County revealed a negative correlation between Area Deprivation Index and Anopheles presence (ρ = –0.35), indicating fine-scale ecological drivers—such as woody wetland habitat, low impervious surface, and humid cooler microclimates—more prevalent in affluent suburban residential neighborhoods. Conclusions: This study demonstrates that fine-scale habitat characteristics and warm-season microclimates structure Anopheles mosquito presence in Maryland. These insights support more spatially targeted vector control and improved public health surveillance strategies.
Access status: Open Access ,
Value of Emerging and Existing Pre-prophylaxis and Therapeutic Options for COVID-19 in Transplant Recipients: A Systematic Review of Economic Evaluations
(Springer Nature, 2026-01-29) Grant, Alyssa; Kabbani, Dima; Vuong, Andrew; Skidmore, Becky; Hsu, Amy T.; Sanmugalingham, Geetha; de Vries, Rienk; Logan, Sherrie; Gongal, Patricia; Piotrowski, Caroline; Thavorn, Kednapa
Background: High-risk populations, including transplant recipients, are at increased risk of severe Coronavirus disease 2019 (COVID-19) outcomes. Certain treatments and pre-exposure prophylaxis (PrEP) have been approved to reduce the risk of severe illness. However, data on the cost effectiveness of currently approved COVID-19 therapeutics and preventative treatments are limited for those at high-risk of severe disease. Objective: The aim of this study was to systematically review the cost effectiveness of COVID-19 treatments and PrEP in high-risk, immunocompromised, and transplant populations. Methods: Electronic databases were searched from inception to September 2025 for studies comparing costs and effectiveness of monoclonal antibodies PrEP or COVID-19 therapeutics in high-risk, immunocompromised or transplant populations. Two reviewers independently screened studies, extracted data, and critically appraised them using the Joanna Briggs Institute checklist for economic evaluations. Cost data are presented in 2025 US dollars. Results: Of 8905 studies identified, 60 met inclusion criteria, with seven focused on or including transplant populations. Most studies were cost-utility analyses published between 2020 and 2025. Nirmatrelvir-ritonavir, tixagevimab-cilgavimab, casirivimab-imdevimab, sotrovimab, remdesivir, molnupiravir, and fluvoxamine were compared with no prophylaxis or standard of care. Among transplant populations, the incremental cost-effectiveness ratio (ICER) for tixagevimab-cilgavimab PrEP following vaccination was US$76,024 per quality-adjusted life year (QALY), while ICERs for COVID-19 therapeutics ranged from US$440 to US$126,676 per QALY. Conclusion: Cost effectiveness varied widely across studies due to differences in variant periods, population risk profiles, model assumptions, and healthcare systems. Future research should integrate variant-specific effectiveness, real-world vaccine responsiveness, long-term COVID-19 outcomes, and adverse events to better inform resource allocation for transplant and other high-risk populations.

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