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Background Even though the COVID-19 vaccination roll-out in general can be considered as one of the most successful public health campaigns in the history of medicine, general vaccination hesitancy has remained an issue of concern throughout the world. We add to a deeper understanding of vaccination hesitancy by identifying what drives primary vaccination and booster uptake, as well as adherence to simple preventive measures such as physical distancing by investigating the role of Dark Triad personality traits, i.e. Machiavellianism, narcissism, and psychopathy. Methods We investigate data from Germany and the United Kingdom from the European Covid Survey which was collected from 23 December 2021 to 10 January 2022. Logit regressions and random effects regressions were performed to study the effect of dark personality traits on COVID-19-related prevention. Results We find a statistically significant association between Dark Triad personality traits and prevention efforts, primary vaccinations, and booster uptake against COVID-19. Specifically, individuals scoring high in psychopathy are associated with a lower likelihood of having received primary immunization. The marginal effect amounts to 3.31%-points. High narcissistic personality traits are correlated with a substantially higher likelihood (4.52%-points) to refuse booster shots after having received the primary vaccinations. Dark Triad personality traits may be relevant factors associated with vaccine-related decision-making. In addition, individuals with higher psychopathic tendencies report significantly lower engagement in other simple preventive behavior, while higher scores in narcissism are associated with higher reported adherence to simple preventive measures. Conclusions Our findings highlight the crucial role that personality plays in pandemic-related prevention. Policymakers, health professionals, and those in charge of health messaging may take these factors into account when devising communication strategies to improve the vaccination uptake and adherence to preventive behaviors. Future pandemics and public health crises would benefit from targeted, nuanced approaches to public health messaging to promote greater public adherence and public health.

School-based programs can effectively prevent substance use; however, systematic reviews and consultation with stakeholders identified a need for effective, culturally inclusive programs for Aboriginal and/or Torres Strait Islander (hereafter Aboriginal) youth. This paper describes the development of Strong & Deadly Futures, a six-lesson, curriculum-aligned wellbeing and substance use prevention program that was designed for, and with, the Aboriginal youth. Formative reviews and consultation recommended that the program (i) combine effective components of mainstream prevention with cultural elements, highlighting Aboriginal cultural strengths; (ii) avoid stigma and celebrates the cultural diversity by catering to both Aboriginal and non-Aboriginal students; and (iii) use digital technology to enhance engagement, implementation and scalability. Guided by an Appreciative Inquiry approach, the program was developed in partnership with an Indigenous Creative Design Agency, and four schools in New South Wales and Queensland, Australia. Aboriginal (n = 41) and non-Aboriginal students (n = 36) described their role models, positive aspects of their community and reasons to avoid substance use; these formed the basis of an illustrated story which conveyed the key learning outcomes. Feedback from teachers, students and content experts supported the acceptability of the program, which will be evaluated in a subsequent randomised controlled trial.

Purpose To estimate the prevalence, distribution, and co-occurrence of mental ill-health and substance use among gender and sexuality diverse young people relative to their cisgender and heterosexual peers in Australia using population-level, nationally representative data. Methods We utilised Wave 8 (2018) data from the Longitudinal Study of Australian Children ( N  = 3037, M age = 18.4) collected via an assessment protocol comprising interviews, direct observations, and assessments (on average 60 min per survey occasion). Weighted prevalence ratios and logistic regression models adjusted for demographic confounders were used to estimate the prevalence and distribution of mental ill-health (psychological distress, past 12-month self-harm thoughts and behaviours, past 12-month suicidal ideation, planning, attempt/s) and substance use outcomes (past 12-month cigarette, alcohol, and marijuana use) across gender identity (trans vs. cisgender), sexuality (gay/lesbian, bisexual, queer [those identifying with an ‘other’ sexuality identity that is not ‘gay’, ‘lesbian’, ‘bisexual’, or ‘heterosexual’] vs. heterosexual) and sexuality diversity status (sexuality diverse vs heterosexual) subgroups. Sex-stratified prevalence rates and accompanying adjusted logistic regression models were also used to assess mental ill-health and substance use disparities by sexuality diversity status. Adjusted multinominal logistic regression models were used to test disparities in co-occurring outcomes by sexuality identity) sexuality status sub-groups, and Fisher’s Exact Test of Independence for co-occurring disparities by gender identity (due to small sample size). All analyses used Wave 8 sample weights and adjusted for postcode-level clustering. Results Among gender and sexuality diverse participants, 59 − 64% reported high or very high levels of psychological distress, 28 − 46% reported past 12-month self-harm ideation or attempts, and 26 − 46% reported past 12-month suicidal ideation, planning, or behaviour. We found significant disparities in high/very high levels of psychological distress, self-harm behaviours and suicidal behaviours among trans participants (adjusted odds ratios (aORs) ranged from 3.5 to 5.5) and sexuality diverse participants (aORs ranged from 3.5 to 3.9), compared with cisgender and heterosexual participants, respectively. Highest disparities in any past 12-month self-harm and suicidal behaviours appeared most pronounced among trans participants and queer participants compared with their cisgender, heterosexual counterparts. Minor differences by sex among sexuality diverse participants were observed for select mental ill-health outcomes. Sexuality diverse participants, and particularly sexuality diverse females, were significantly more likely to report past 12-month cigarette use and past 12-month marijuana use (adjusted odds ratio (aORs) ranging 1.4–1.6). Trans young people were at significantly elevated risk of mental ill-health in co-occurrence with cigarette and marijuana use compared with their cisgender peers (Fisher’s Exact Test of Independence p  < 0.05 for all), whereas sexuality diverse young people were at greater risk of co-occurring mental ill-health and cigarette co-use and marijuana co-use, compared with their non-sexuality diverse peers (adjusted multinomial odds ratios (aMORs) ranging 2.2-6.0). Conclusion Mental ill-health, substance use, and their co-occurrence disproportionately affects gender and sexuality diverse young people in Australia. Further research should study the longitudinal development of these disparities through adolescence, with close attention to the social, embodied contexts of substance use among LGBTQ + young people with the view to building LGBTQ + affirming models of harm reduction.

The metabolism of endothelial cells during vessel sprouting remains poorly studied. Here we report that endothelial loss of CPT1A, a rate-limiting enzyme of fatty acid oxidation (FAO), causes vascular sprouting defects due to impaired proliferation, not migration, of human and murine endothelial cells. Reduction of FAO in endothelial cells did not cause energy depletion or disturb redox homeostasis, but impaired de novo nucleotide synthesis for DNA replication. Isotope labelling studies in control endothelial cells showed that fatty acid carbons substantially replenished the Krebs cycle, and were incorporated into aspartate (a nucleotide precursor), uridine monophosphate (a precursor of pyrimidine nucleoside triphosphates) and DNA. CPT1A silencing reduced these processes and depleted endothelial cell stores of aspartate and deoxyribonucleoside triphosphates. Acetate (metabolized to acetyl-CoA, thereby substituting for the depleted FAO-derived acetyl-CoA) or a nucleoside mix rescued the phenotype of CPT1A-silenced endothelial cells. Finally, CPT1 blockade inhibited pathological ocular angiogenesis in mice, suggesting a novel strategy for blocking angiogenesis. This study identifies a crucial role for fatty acid oxidation (FAO) in endothelial cells during angiogenesis, and reveals that fatty-acid-derived carbons are used for the de novo synthesis of nucleotides, and hence FAO stimulates vessel sprouting by increasing endothelial cell proliferation. Fatty acids a carbon source for angiogenesis Peter Carmeliet and colleagues identify a crucial role for the oxidation of fatty acids in endothelial cells during angiogenesis. They show that fatty acids provide the carbons for the de novo synthesis of nucleotides, and hence fatty acid oxidation stimulates vessel sprouting by increasing endothelial cell proliferation. Pharmacological blockade of fatty acid oxidation can reduce pathological angiogenesis in a mouse model of retinopathy of prematurity.

The clinical management of breech presentations at term is still a controversially discussed issue among clinicians. Clear predictive criteria for planned vaginal breech deliveries are desperately needed to prevent adverse fetal and maternal outcomes and to reduce elective cesarean section rates. The green-top guideline considers an estimated birth weight of 3.8 kg or more an indication to plan a cesarean section despite the lack of respective evidence. To compare maternal and neonatal outcome of vaginal intended breech deliveries of births with children with a birth weight of 2.5 kg- 3.79 kg and children with a birth weight of 3.8 kg and more. Prospective cohort study. All vaginal intended deliveries out of a breech position of newborns weighing between 2.5 kg and 4.5 kg at the Obstetrics department at Goethe University Hospital Frankfurt from January 2004 until December 2016. Neonatal and maternal outcome of a light weight group (LWG) (< 3.8 kg) was compared to and a high weight group (HWG) (≥ 3.8 kg) using Pearson's Chi Square test and Fishers exact test. A logistic regression analysis was performed to detect an association between cesarean section rates, fetal outcome and the birth weight. No difference in neonatal morbidity was detected between the HWG (1.8%, n = 166) and the LWG (2.6%, n = 888). Cesarean section rate was significantly higher in the HWG with 45.2% in comparison to 28.8% in the LWG with an odds ratio of 1.57 (95% CI 1.29-1.91, p<0.0001). In vaginal deliveries, a high birth weight was not associated with an increased risk of maternal birth injuries (LWG in vaginal deliveries: 74.3%, HWG in vaginal deliveries: 73.6%; p = 0.887; OR = 1.9 (95% CI 0.9-1.1)). A fetal weight above 3.79 kg does not predict increased maternal or infant morbidity after delivery from breech presentation at term. Neither the literature nor our analyses document evidence for threshold of estimated birth weight that is associated with maternal and/or infant morbidity. However, patients should be informed about an increased likelihood of cesarean sections during labor when attempting vaginal birth from breech position at term in order to reach an informed shared decision concerning the birth strategy. Further investigations in multi center settings are needed to advance international guidelines on vaginal breech deliveries in the context of estimated birth weight and its impact on perinatal outcome.