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Introduction: Ulcerative Colitis (UC) is an Inflammatory Bowel Disease (IBD). Surgery is required in cases of severe acute colitis, massive hemorrhage, toxic megacolon, and perforation; in such cases colectomy and JpouchIleoanal anastomosis (IPAA) are performed. The aim of this study was to evaluate functional outcome, and patient satisfaction and Quality of Life (QoL) after surgery. Material and methods: Questionnaires were administered to 24 patients with UC undergoing surgery from 2011 to 2022. Results: Mean age at IPAA was 10.8 years. Twenty patients underwent IPAA in 3 operations, 4 patients in 2. All patients underwent laparoscopic surgery. 6 months after surgery mean level of satisfaction was 8.7/10, perception of health status was 7.4. Twenty-three patients (95.8%) recommended IPAA. For 20 patients (83.3%) surgery did not cause delay in education, while 14 patients (58.3%) played sport. The lowest number of evacuations was 9.2 per day, the highest 13.3. Seventeen patients (70.8%) had no incontinence and 15 patients (62.5%) were not affected by pouchitis. After 12 months mean satisfaction level raised up to 9.2/10, perception of health status to 8.5. School absences decreased and no other patients showed any delay in education. Seventeen (70.8%) patients played sports. The number of evacuations decreased: the lowest number was 5.1 per day, the highest 7.5. Twenty patients (83.3%) were continent and 12 (50%) did not use antibiotics. Conclusion: Most patients show a good functional outcome in defecation frequency and continence, which has improved through time, number of pouchitis episodes has increased. Patients appear satisfied after surgery. [ABSTRACT FROM AUTHOR]

Parenthood, particularly motherhood, is known to impact the structure and function of the brain in the short term, but the long-term effects of parenthood and their impacts on well-being are still poorly understood. This study explores the potential longer-term associations between parenthood and the brain, parenthood and well-being, and the potential role of brain modifications in influencing mothers' well-being. Using data from the UK Biobank, which includes brain imaging information from individuals aged 45–82 at the MRI scanning, we discovered differences in brain structure between mothers and non-mothers, with mothers exhibiting widely distributed higher gray matter density, particularly strong in frontal and occipital regions. No brain changes were observed in fathers. Parents reported a higher sense of life's meaning compared to their childless counterparts. Gray matter changes did not mediate the relationship between motherhood and well-being. This suggests that the alterations in gray matter associated with motherhood do not play a deterministic role in shaping long-term changes in well-being. [ABSTRACT FROM AUTHOR]

Moral features are essential components of TV series, helping the audience to engage with the story, exploring themes beyond sheer entertainment, reflecting current social issues, and leaving a long-lasting impact on the viewers. Their presence shows through the language employed in the plot description. Their detection helps regarding understanding the series writers' underlying message. In this paper, we propose an approach to detect moral features in TV series. We rely on the Moral Foundations Theory (MFT) framework to classify moral features and use the associated MFT dictionary to identify the words expressing those features. Our approach combines that dictionary with word embedding and similarity analysis through a deep learning SBERT (Sentence-Bidirectional Encoder Representations from Transformers) architecture to quantify the comparative prominence of moral features. We validate the approach by applying it to the definition of the MFT moral feature labels as appearing in general authoritative dictionaries. We apply our technique to the summaries of a selection of TV series representative of several genres and relate the results to the actual content of each series, showing the consistency of results. [ABSTRACT FROM AUTHOR]

Background: Health care routinely fails Indigenous peoples and anti-Indigenous racism is common in clinical encounters. Clinical training programs aimed to enhance Indigenous cultural safety (ICS) rely on learner reported impact assessment even though clinician self-assessment is poorly correlated with observational or patient outcome reporting. We aimed to compare the clinical impacts of intensive and brief ICS training to control, and to assess the feasibility of ICS training evaluation tools, including unannounced Indigenous standardized patient (UISP) visits. Method: Using a prospective parallel group three-arm randomized controlled trial design and masked standardized patients, we compared the clinical impacts of the intensive interactive, professionally facilitated, 8- to10-h Sanyas ICS training; a brief 1-h anti-bias training adapted to address anti-Indigenous bias; and control continuing medical education time-attention matched to the intensive training. Participants included 58 non-Indigenous staff physicians, resident physicians and nurse practitioners from family practice clinics, and one emergency department across four teaching hospitals in Toronto, Canada. Main outcome measures were the quality of care provided during UISP visits including adjusted odds that clinician would be recommended by the UISP to a friend or family member; mean item scores on patient experience of care measure; and clinical practice guideline adherence for NSAID renewal and pain assessment. Results: Clinicians in the intensive or brief ICS groups had higher adjusted odds of being highly recommended to friends and family by standardized patients (OR 6.88, 95% CI 1.17 to 40.45 and OR 7.78, 95% CI 1.05 to 58.03, respectively). Adjusted mean item patient experience scores were 46% (95% CI 12% to 80%) and 40% (95% CI 2% to 78%) higher for clinicians enrolled in the intensive and brief training programs, respectively, compared to control. Small sample size precluded detection of training impacts on clinical practice guideline adherence; 100% of UISP visits were undetected by participating clinicians. Conclusions: Patient-oriented evaluation design and tools including UISPs were demonstrated as feasible and effective. Results show potential impact of cultural safety training on patient recommendation of clinician and improved patient experience. A larger trial to further ascertain impact on clinical practice is needed. Trial registration: Clinicaltrials.org NCT05890144. Retrospectively registered on June 5, 2023. [ABSTRACT FROM AUTHOR]

A macro-thyroid-stimulating hormone (macro-TSH) is an infrequent yet noteworthy phenomenon in the thyroid field. A 69-year-old patient presented with persistently elevated thyroid-stimulating hormone (TSH) levels ranging from 30 to 50 mIU/L, paradoxically accompanied by normal thyroid hormone levels and normal thyroid ultrasound, with no findings on pituitary magnetic resonance. Laboratory studies were conducted to investigate potential interferences impacting the accuracy of TSH measurements. After excluding other potential causes, polyethylene glycol (PEG) precipitation technique was used, which led us to the diagnosis of macro-TSH. This result was confirmed through chromatography. Macro-TSH, although rare, emerged as the key contributor to the patient's unexplained increase in TSH levels. This case highlights the importance of considering macro-TSH as a potential etiology in cases characterized by unexplained TSH elevation, offering insights into diagnostic protocols and expanding our understanding of thyroid function anomalies. [ABSTRACT FROM AUTHOR]

Introduction: Vascular access recirculation during hemodialysis is associated with reduced effectiveness and worse survival outcomes. To evaluate recirculation, an increase in pCO2 in the blood of the arterial line during hemodialysis (threshold of 4.5 mmHg) was proposed. The blood returning from the dialyzer in the venous line has significantly higher pCO2, so in the presence of recirculation, pCO2 in the arterial blood line may increase (ΔpCO2) during hemodialysis sessions. The aim of our study was to evaluate ΔpCO2 as a diagnostic tool for vascular access recirculation in chronic hemodialysis patients. Methods: We evaluated vascular access recirculation with ΔpCO2 and compared it with the results of a urea recirculation test, which is the gold standard. ΔpCO2 was obtained from the difference in pCO2 in the arterial line at baseline (pCO2T1) and after 5 min of hemodialysis (pCO2T2). ∆pCO2 = pCO2T2–pCO2T1. Findings: In 70 hemodialysis patients (mean age: 70.52 ± 13.97 years; hemodialysis vintage of 41.36 ± 34.54, KT/V 1.4 ± 0.3), ∆pCO2 was 4 ± 4 mmHg, and urea recirculation was 7% ± 9%. Vascular access recirculation was identified using both methods in 17 of 70 patients, who showed a ∆pCO2 of 10 ± 5 mmHg and urea recirculation of 20% ± 9%; time in months of hemodialysis was the only difference between vascular access recirculation and non‐vascular access recirculation patients (22 ± 19 vs. 46 ± 36, p: 0.05). In the non‐vascular access recirculation group, the average ΔpCO2 was 1.9 ± 2 (p: 0.001), and the urea recirculation % was 2.8 ± 3 (p: 0.001). The ΔpCO2 correlated with the urea recirculation % (R: 0.728; p < 0.001). Discussion: ΔpCO2 in the arterial blood line during hemodialysis is an effective and reliable diagnostic tool for identifying recirculation of the vascular access but not its magnitude. The ΔpCO2 test application is simple and economical and does not require special equipment. [ABSTRACT FROM AUTHOR]

Celiac disease (CeD) is a T-cell-mediated immune disease, in which gluten-derived peptides activate lamina propria effector CD4+ T cells. While this effector T cell subset produces proinflammatory cytokines, which cause substantial tissue injury in vivo, additional subsets of T cells exist with regulatory functions (Treg). These subsets include CD4+ type 1 regulatory T cells (Tr1) and CD4+ CD25+ T cells expressing the master transcription factor forkhead box P3 (Foxp3) that may have important implications in disease pathogenesis. In this review, we provide an overview of the current knowledge about the effects of immunomodulating cytokines on CeD inflammatory status. Moreover, we outline the main Treg cell populations found in CeD and how their regulatory activity could be influenced by the intestinal microenvironment. Finally, we discuss the Treg therapeutic potential for the development of alternative strategies to the gluten-free diet (GFD). [ABSTRACT FROM AUTHOR]

The probability distribution of the interevent time between two successive earthquakes has been the subject of numerous studies for its key role in seismic hazard assessment. In recent decades, many distributions have been considered, and there has been a long debate about the possible universality of the shape of this distribution when the interevent times are properly rescaled. In this work, we aim to discover if there is a link between the different phases of a seismic cycle and the variations in the distribution that best fits the interevent times. To do this, we consider the seismic activity related to the M w 6.1 L'Aquila earthquake that occurred on 6 April 2009 in central Italy by analyzing the sequence of events recorded from April 2005 to July 2009, and then the seismic activity linked to the sequence of the Amatrice-Norcia earthquakes of M w 6 and 6.5, respectively, and recorded in the period from January 2009 to June 2018. We take into account some of the most studied distributions in the literature: q-exponential, q-generalized gamma, gamma and exponential distributions and, according to the Bayesian paradigm, we compare the value of their posterior marginal likelihood in shifting time windows with a fixed number of data. The results suggest that the distribution providing the best performance changes over time and its variations may be associated with different phases of the seismic crisis. [ABSTRACT FROM AUTHOR]

Respondent-driven sampling (RDS) is used to measure trait or disease prevalence in populations that are difficult to reach and often marginalized. The authors evaluated the performance of RDS estimators under varying conditions of trait prevalence, homophily, and relative activity. They used large simulated networks (N = 20,000) derived from real-world RDS degree reports and an empirical Facebook network (N = 22,470) to evaluate estimators of binary and categorical trait prevalence. Variability in prevalence estimates is higher when network degree is drawn from real-world samples than from the commonly assumed Poisson distribution, resulting in lower coverage rates. Newer estimators perform well when the sample is a substantive proportion of the population, but bias is present when the population size is unknown. The choice of preferred RDS estimator needs to be study specific, considering both statistical properties and knowledge of the population under study. [ABSTRACT FROM AUTHOR]

Purpose: To compare toxicity of radiotherapy (RT) with concomitant chemotherapy (CHT) in patients (pts) with anal cancer treated with simultaneous integrated boost (SIB) versus sequential boost (SeqB). Methods: Sixty-six patients were treated from 2007 to 2021. Thirty patients underwent to SeqB concurrent to CHT and 37 to SIB-group. Toxicity assessment has been considered in acute and in late toxicities for gastrointestinal (GI), genitourinary (GU), cutaneous (CU) districts, according to Common Terminology Criteria for Adverse Events (CTCAE), Version 5.0. The Wexner scale among summary scoring systems has been used as a tool to measure fecal incontinence. The chi-square test for ordinal variables were used to evaluate the association between patient and treatment characteristics and acute or late severe toxicity. Univariable logistic regression models were fit to evaluate predictive factors associated with fecal incontinence. Results: Median follow-up was 61.5 months (IQR, 27.1–121.7 months) for all patients. Severe acute toxicity (≥ G2) was observed in 49 patients (74.2%). Late toxicity (≥ G2) occurred in 13 cases (19.6%). In assessment of cutaneous toxicity, there was also a significant reduction in ≥ G1 in SIB group with 29 patients (80.5%) vs SeqB group with 29 patients (96.6%) (p-value = 0.046). Of both groups 11 patients (16.6%) developed fecal incontinence, 8 (22%) in the SIB group and 3 (10%) in the SeqB. Conclusion: SIB for anal cancer treatment results in reduced acute and late cutaneous toxicity compared to SeqB. According to our results the rate of other acute and late toxicities are low and comparable between the two groups. [ABSTRACT FROM AUTHOR]

By using AFM as a nanografting tool, we grafted micrometer-sized DNA platforms into inert alkanethiol SAMs. Tuning the grafting conditions (surface density of grafting lines and scan rate) allowed us to tailor the molecular density of the DNA platforms. Following the nanografting process, AFM was operated in the low perturbative Quantitative Imaging (QI) mode. The analysis of QI AFM images showed the coexistence of molecular domains of different heights, and thus different densities, within the grafted areas, which were not previously reported using contact AFM imaging. Thinner domains corresponded to low-density DNA regions characterized by loosely packed, randomly oriented DNA strands, while thicker domains corresponded to regions with more densely grafted DNA. Grafting with densely spaced and slow scans increased the size of the high-density domains, resulting in an overall increase in patch height. The structure of the grafted DNA was compared to self-assembled DNA, which was assessed through nanoshaving experiments. Exposing the DNA patches to the target sequence produced an increase in the patch height, indicating that hybridization was accomplished. The relative height increase of the DNA patches upon hybridization was higher in the case of lower density patches due to hybridization leading to a larger molecular reorganization. Low density DNA patches were therefore the most suitable for targeting oligonucleotide sequences. [ABSTRACT FROM AUTHOR]

• An alternative way to perform underwater laser ablation without submersion was achieved. • An innovative approach to laser cleaning of gilded bronze was successfully demonstrated. • A novel tool to obtain localized water vesicles during laser cleaning was developed. A group of twenty-eight fragments of monumental bronze statues from the Roman Age, recently underwent a series of conservation treatments at the Opificio delle Pietre Dure (OPD) in Florence, Italy. These fragments had never been investigated or cleaned before. During this restoration, supported by an extensive diagnostic campaign, an attempt was made to understand the conservation issues of each fragment and to identify the most suitable cleaning treatment in order to guarantee the removal of concretions and alteration products without damaging these precious artworks. In particular, two large scale fragments, depicting the two sides of a horse's maned neck, and identified as part of an equestrian monument, showed traces of gilding emerging from a thick layer of mineralization and sand encrustations. The bronzes were then subjected to cleaning tests by means of laser ablation to reveal any further remains of gilding. Among the different application methods of laser cleaning, irradiation in water has demonstrated its effectiveness in this case, offering operational advantages due to cavitation-mediated processes. Due to the size and shape of the artefacts (characterized by protruding details such as the mane, etc.), and the general state of conservation, it was impossible to submerge them completely or apply plastic films on their surface to create "pocket pools" filled with deionized water. In this paper we present a new tool for underwater laser cleaning application based on the modification of a water brush pen capable of creating an extremely localized water vesicle, avoiding placing any containment system on the surface. This method has proved to be very powerful in removing the mineralized layer without affecting the underlying gold leaf, leaving only a few traces of the deposits. [ABSTRACT FROM AUTHOR]

Patients on haemodialysis (HD) suffer a high mortality rate linked to developing subclinical hypoxic parenchymal stress during HD sessions. The oxygen extraction ratio (OER), an estimate of the oxygen claimed by peripheral tissues, might represent a new prognostic factor in HD patients. This study evaluated whether the intradialytic change in OER (ΔOER) identified patients with higher mortality risks. We enrolled chronic HD patients with permanent central venous catheters with available central venous oxygen saturation (ScvO2) measurements; the arterial oxygen saturation was measured with peripheral oximeters (SpO2). We measured OER before and after HD at enrolment; deaths were recorded during two-years of follow-up. In 101 patients (age: 72.9 ± 13.6 years, HD vintage: 9.6 ± 16.6 years), 44 deaths were recorded during 11.6 ± 7.5 months of follow-up. Patients were divided into two groups according to a 40% ΔOER threshold (ΔOER < 40%, n = 56; ΔOER ≥ 40%, n = 45). The ΔOER ≥ 40% group showed a higher incidence of death (60% vs. 30%; p = 0.005). The survival curve (log-rank-test: p = 0.0001) and multivariate analysis (p = 0.0002) confirmed a ΔOER ≥ 40% as a mortality risk factor. This study showed the intradialytic ΔOER ≥ 40% was a mortality risk factor able to highlight critical hypoxic damage. Using a ΔOER ≥ 40% could be clinically applicable to characterise the most fragile patients. [ABSTRACT FROM AUTHOR]

The use of kaolin foliar treatments in olive growing is a well-established approach that aims at protecting crops from the negative impacts of environmental stresses and from insect pests. The use of zeolite particle films is a far more recent technique. The experimentation was carried out on Correggiolo cv. cultivated in the Emilia-Romagna region (Italy). Foliar treatments were performed in summer until olive harvest. Ripening index, weight, and the oil content of olives were measured. Acidity, peroxide numbers, K232, K270 and total phenols were evaluated as well as fatty acid profiles, determined via GC-FID and phenolic compounds; vitamins and pigments were determined via HPLC-DAD. Quantitative descriptive analysis (QDA) sensory analysis and taint tests were performed. Olives treated with zeolite showed higher oil contents, and the oil obtained exhibited higher contents of total phenols, tyrosol and deacetoxy oleuropein aglycon with respect to the oils produced with kaolin and the control oil. Oils produced from kaolin-treated olives showed sensory profiles characterized by notes of berries (that are not typical of the Correggiolo cultivar). In the scenario of environment-friendly oil production, treatments employing zeolitite particle films represent both a valid alternative to chemical insecticide against olive fly attack and a practice that has a positive influence on the overall oil quality. [ABSTRACT FROM AUTHOR]

In addition, in pre-dialysis chronic kidney disease (CKD) a small intervention trial reported a reduction of vascular calcification progression in patients treated with oral magnesium oxide [[2]]. Observational studies in hemodialysis patients describe a negative association between magnesium body stores and all-cause and cardiovascular mortality [[1]]. If its reliability were confirmed, in one or more of these different conditions, any future clinical study evaluating the relationship between magnesium and vascular calcification in renal patients should include the MDS score. Oral magnesium supplementation in chronic kidney disease stages 3 and 4: efficacy, safety, and effect on serum calcification propensity-a prospective randomized double-blinded placebo-controlled clinical trial. [Extracted from the article]

Objective: Maintaining healthy glucose levels is critical for the management of type 1 diabetes (T1D), but the most efficacious and cost-effective approach (capillary self-monitoring of blood glucose [SMBG] or continuous [CGM] or intermittently scanned [isCGM] glucose monitoring) is not clear. We modeled the population-level impact of these three glucose monitoring systems on diabetes-related complications, mortality, and cost-effectiveness in adults with T1D in Canada.Research Design and Methods: We used a Markov cost-effectiveness model based on nine complication states for adults aged 18-64 years with T1D. We performed the cost-effectiveness analysis from a single-payer health care system perspective over a 20-year horizon, assuming a willingness-to-pay threshold of CAD 50,000 per quality-adjusted life-year (QALY). Primary outcomes were the number of complications and deaths and the incremental cost-effectiveness ratio (ICER) of CGM and isCGM relative to SMBG.Results: An initial cohort of 180,000 with baseline HbA1c of 8.1% was used to represent all Canadians aged 18-64 years with T1D. Universal SMBG use was associated with ∼11,200 people (6.2%) living without complications and ∼89,400 (49.7%) deaths after 20 years. Universal CGM use was associated with an additional ∼7,400 (4.1%) people living complications free and ∼11,500 (6.4%) fewer deaths compared with SMBG, while universal isCGM use was associated with ∼3,400 (1.9%) more people living complications free and ∼4,600 (2.6%) fewer deaths. Relative to SMBG, CGM and isCGM had ICERs of CAD 35,017/QALY and 17,488/QALY, respectively.Conclusions: Universal use of CGM or isCGM in the Canadian T1D population is anticipated to reduce diabetes-related complications and mortality at an acceptable cost-effectiveness threshold. [ABSTRACT FROM AUTHOR]

Designing thermal protection systems (TPS) for ballistic reentry capsules requires both reliable numerical tools and experimental facilities to evaluate surface ablation and its shape change. Low-temperature ablators, such as camphor, can be employed in low-enthalpy wind tunnels to overcome limitations of standard hypersonic experimental facilities, which cannot induce the actual TPS ablation due to limits in inflow total enthalpy, velocity, or test time duration. However, the flight relevance of such an experiment needs to be accurately assessed, as both the capsule dimension and the ablative material during the test differ from the flying ones. The main goal of this work is to perform numerical simulations in order to assess the flight relevance of the ground tests. Computational fluid dynamics (CFD) simulations have been performed for both low-enthalpy wind-tunnel conditions for a camphor scaled-down capsule and actual reentry flight conditions, assuming a carbon-based heat shield. Moreover, numerical analyses have been improved by coupling the CFD solver with a material response code named PATO, which models the heating transient process. The obtained results show how the CFD/material response coupling has a more important effect for the on-ground testing conditions considered, resulting in a more favorable agreement with the available experimental data. Finally, the shape change relevance of the analyzed low-temperature ablator has been verified by providing a similitude criterion between the on-ground and in-flight capsule recession. In particular, a few seconds of exposure are sufficient to generate the same shape change that is expected in flight. [ABSTRACT FROM AUTHOR]

Background Graves' disease occurrence during pregnancy is not a frequent event, showing an incidence of 0.2-0.4% in unselected pregnant women. Depending on their functional properties, TSH-receptor antibodies can induce hypothyroidism or hyperthyroidism. Recognizing the signs of altered thyroid function is essential to prevent possible complications on the fetus. Materials and methods The case of a pregnant woman without previous history of thyroid disease presenting with severe overt hypothyroidism during the first trimester is reported. Levothyroxine therapy was started and 6 weeks later overt hyperthyroidism was observed. TRAb were detected at high titers. Levothyroxine was withdrawn and low dose methimazole was started. Serial obstetric ultrasound scans were negative for indirect signs of fetal thyroid dysfunctions and no fetal goiter was visualized throughout pregnancy. Spontaneous delivery occurred without complications at 39 weeks of gestation. In the post-partum, severe overt hypothyroidism recurred, thus methimazole was discontinued and levothyroxine was restarted. TRAb persisted at high levels. The infant experienced a transient thyrotoxicosis, which fully resolved in three months with normalization of thyroid function and negativization of TRAb levels. Results The present case report allows us to overview the challenges related to the management of hypo and hyperthyroidism in patients with high TRAb levels, requiring strict monitoring aimed at early detection of both maternal and fetal consequences. Conclusions This case underlines the importance of close follow-up and the need of collaboration in a multidisciplinary team when Graves's disease is diagnosed in a pregnant woman to prevent adverse neonatal outcomes. [ABSTRACT FROM AUTHOR]

In recent years, there has been increasing interest in theoretical descriptions of seismicity in terms of statistical physics. Most aspects of these studies are encompassed by the concept of 'intermittent criticality', in which a region alternately approaches and retreats from a critical point. In this study, we analyse a descriptor of seismic activity that acts as a measure of the criticality of a system, such that its variations can be associated with changes in the state of the system. As some classical methods of analysis are not suitable for dealing with some of the features of complex systems such as the Earth's crust, we derive the probability distribution of the magnitude by maximizing a non-extensive generalization of the Boltzmann–Gibbs entropy given by the Tsallis entropy. In particular, the shape parameter q of this distribution, called the entropic index, characterizes the subadditive q > 1 and superadditive q < 1 regimes. Following the Bayesian approach for parameter estimation, we examine the seismic activity that has affected two seismogenic areas in central Italy that were hit recently by destructive earthquakes: L'Aquila in 2009, and Amatrice–Norcia in 2016. To analyse in detail the variations of the q index and the entropy, we estimate these for time windows of a fixed number of events that shift at each new event. Both the q index and the Tsallis entropy show significant and lasting decreases before the first strong earthquake in the sequences, and sudden increases after them. This indicates that these quantities can be considered as indicators of the level of concentration of energy, and hence of the activation state of the systems. More reliable results need to come from further studies of different cases in different seismotectonic settings. [ABSTRACT FROM AUTHOR]

Non-celiac wheat sensitivity (NCWS) is a clinical entity induced by the ingestion of gluten that leads to intestinal and/or extraintestinal symptoms, and is diagnosed when celiac disease and wheat allergy have been ruled out. In addition to gluten, other grains' components, including amylase trypsin inhibitors (ATIs) and fermentable short-chain carbohydrates (FODMAPs), may trigger symptoms in NCWS subjects. Several studies suggest that, compared with tetraploid and hexaploid modern wheats, ancient diploid wheats species could possess a lower immunogenicity for subjects suffering from NCWS. This review aims to discuss available evidence related to the immunological features of diploid wheats compared to common wheats, and at outlining new dietary opportunities for NCWS subjects. [ABSTRACT FROM AUTHOR]

Douglas, AS, Rotondi, MA, Baker, J, Jamnik, VK, and Macpherson, AK. A comparison of on-ice external load measures between subelite and elite female ice hockey players. J Strength Cond Res 36(7): 1978–1983, 2022—This study quantified and examined differences in measures of on-ice external load for subelite and elite female ice hockey players. External load variables were collected from subelite (N = 21) and elite (N = 24) athletes using Catapult S5 monitors during the preseason. A total of 574 data files were analyzed from training and competition during the training camp. Significant differences between groups were found across all variables. Differences in training between the 2 groups ranged from trivial (forwards PlayerLoad, p = 0.03, effect-size [ES] = 0.18) to large (forwards Explosive Efforts [EEs], p < 0.001, ES = 1.64; defense EEs, p < 0.001, ES = 1.40). Match comparisons yielded similar results, with differences ranging from small (defense Low Skating Load [SL], p = 0.05, ES = 0.49; Medium SL, p = 0.04, ES = 0.52) to very large (forwards PlayerLoad, p < 0.001. ES = 2.25; PlayerLoad·min−1, p < 0.001, ES = 2.66; EEs, p < 0.001, ES = 2.03; Medium SL, p < 0.001, ES = 2.31; SL·min−1, p < 0.001, ES = 2.67), respectively. The differences in external load measures of intensity demonstrate the need to alter training programs of subelite ice athletes to ensure they can meet the demands of elite ice hockey. As athletes advance along the development pathway, considerable focus of their off-ice training should be to improve qualities that enhance their ability to perform high-intensity on-ice movements. [ABSTRACT FROM AUTHOR]

This paper analyzes the link between foreign aid for family planning services and a broad set of health outcomes. More specifically, it documents the harmful effects of the so-called “Mexico City Policy” (MCP), which restricts US funding for nongovernmental organizations that provide abortion-related services abroad. First enacted in 1985, the MCP is implemented along partisan lines; it is enforced only when a Republican administration is in office and quickly rescinded when a Democrat wins the presidency. Although previous research has shown that MCP causes significant disruption to family planning programs worldwide, its consequences for health outcomes, such as mortality and HIV rates, remain underexplored. The independence of the MCP’s implementation from the situation in recipient countries allows us to systematically study its impact. Using country-level data from 134 countries between 1990 and 2015, we first show that the MCP is associated with higher maternal and child mortality and HIV incidence rates. These effects are magnified by dependence on US aid while mitigated by funds from non-US donors. Next, we complement these results using individual-level data from 30 low- and middle-income countries and show that, under the MCP, women have less access to modern contraception and are less exposed to information on family planning and AIDS via in-person channels. Moreover, pregnant women are more likely to report that their pregnancy is not desired. Our findings highlight the importance of mitigating the harmful effects of MCP by redesigning or counteracting this policy. [ABSTRACT FROM AUTHOR]

Wheat consumption can represent one of the nutritional factors involved in the onset of diabetes. We specifically investigated the potential diabetogenic effects of Hammurabi, a T. monococcum wheat cultivar, in non-obese diabetic (NOD) mice and analysed the levels of resistant starch in pasta manufactured with Hammurabi after in vitro gastroduodenal digestion. NOD mice were fed with Hammurabi, bread wheat or rice flour to evaluate diabetes incidence and insulitis score. An enzymatic method was applied to compare the content of resistant starch in Hammurabi pasta and durum wheat pasta (control). In NOD mice, the Hammurabi-based diet significantly delayed diabetes onset (p = 0.0042) and reduced insulitis score compared to rice or wheat-based diet. Furthermore, the resistant starch value following in vitro digestion of Hammurabi pasta was significantly higher (4.08%) than that of durum wheat pasta (2.28%). Taken together, these results highlighted the potential positive effects of the Hammurabi-based diet on diabetes incidence. [ABSTRACT FROM AUTHOR]

Background: In adult population, Growth Hormone Deficiency (GHD) is a complex clinical condition with heterogeneity of causes and duration. Growth Hormone (GH) replacement therapy has beneficial effects entailing a chronic and expensive use. Therefore, entity, appropriateness and standardization of GHD treatment need to be accurately analysed. In Italy, the epidemiological surveillance on somatropin therapy is entrusted to the National Register of Growth Hormone Therapy (Registro Nazionale degli Assuntori dell'Ormone della Crescita-RNAOC) by the Italian Regulation, in accordance of which the RNAOC-database is collecting the notifications of somatropin prescriptions. Methods: Aim of this study is to analyse data on somatropin-treated adult population communicated to the RNAOC by the specialist centres of 15 Italian regions and 2 autonomous provinces. Results: From 2011 to 2019, the somatropin-treated adults were 970 with 4061 examinations (1.21 ± 0.33 visits/year). The diagnoses were: hypopituitarism (n = 579); hypophysectomy (n = 383); and congenital GHD (n = 3). Five subjects were addressed with diagnoses not included in the regulation. The starting posology of somatropin was 0.320 (± 0.212) mg/day, 0.292 (± 0.167) mg/day in male and 0.360 (± 0.258) in female patients, with 7 administrations/week in 70.31% of the prescriptions. The differences in posology by gender persisted at 10th year of the follow-up. Starting dosage was higher in patients diagnosed with adult GHD before the age of 30 (0.420 ± 0.225 mg/day), with a progressive decrease of the dosage during the follow-up. Conclusions: This is the first report on adult GH treatment, describing numbers, diagnoses, and pharmaceutical prescriptions associated to somatropin therapy in a large cohort of Italian GHD-adults. [ABSTRACT FROM AUTHOR]

We study the non-monetary costs of terrorist attacks in France, Belgium and Germany between 2010 and 2017. Using four waves of the European Social Survey, we find that individual well-being is significantly reduced in the aftermath of a terrorist attack. We explore possible mechanisms, finding that terrorist attacks are negatively correlated with generalized trust, institutional trust, satisfaction with democracy and satisfaction with the government. Terrorist attacks are also found to be positively correlated with negative attitudes towards migrants and perceived discrimination. Contrary to expectations, the negative relationship between terrorism and well-being is less strong for Muslim immigrants. We interpret this finding as an indication that immigrants benefit more than natives from the institutional reaction following terrorist attacks. [ABSTRACT FROM AUTHOR]

Background: Heavy metals are well known to be associated with cancer outcomes, but its association with obesity and cardiometabolic risk outcomes requires further study.Methods: Adult data from the National Health and Examination Survey (NHANES Continuous 1999-2016, n = 12,636 to 32,012) with data for blood or urinary metals concentrations and body mass index were used. The study aim was twofold: (1) to determine the association between heavy metals and obesity and (2) to examine the influence of heavy metals on the relationship between obesity and hypertension, type 2 diabetes, and dyslipidemia. Logistic regression was used to examine the main effects and interaction effects of metals and obesity for the odds of prevalent hypertension, type 2 diabetes, and dyslipidemia. Models were adjusted for age, gender, ethnicity, smoking status, physical active status, and poverty-income ratio, with additional adjustment for creatinine in models with the urinary measures of heavy metals. High-low concentration categories were defined by grouping metal quintiles with the most similar associations with obesity.Results: Blood lead had a negative linear association with obesity (odds ratio (OR)  = 0.42, 95% confidence interval (CI) = 0.37-0.47). In those with obesity, high blood lead was associated with lower risk of prevalent dyslipidemia, while no association was found in those without obesity. The study observed a curvilinear relationship between urinary antimony and obesity with the moderate group having the highest odds of obesity (OR = 1.36, 1.16-1.59). However, the relationship between urinary antimony and prevalent hypertension and dyslipidemia risk was linear, positive, and independent of obesity. While not associated with prevalent obesity risk, high urinary uranium was associated with 30% (P=0.01) higher odds for prevalent type 2 diabetes.Conclusions: The impact of environmental factors on obesity and health may be complex, and this study reinforces the heterogeneous relationship between various metals, obesity, and obesity-related metabolic diseases even at levels observed in the general population. [ABSTRACT FROM AUTHOR]

Objective: Indeterminate cytological result at fine-needle aspiration cytology (FNAC) remains a clinical challenge for endocrinologists. Aim of the present study was to evaluate whet her a coexistent chronic autoimmune thyroiditis (CAT) might affect the diagnostic accuracy of fine-needle aspiration cy tology for thyroid nodules. Design and methods: A retrospective cohort study was designed including all nodules receiving an indeterminate cytology result (TIR3A or TIR3B) undergoing thyroid surgery and subsequent histological confirmation. Patients were stratified into two groups according to the presence or absence of CAT. The hypothesis to be tested was whether follicular cell alterations induced by CAT might increase the r ate of indeterminate cytological results in histologically benign thyroid nodules. Additional control groups were represen ted by nodules with determinate cytology, either benign (TIR 2) or malignant (TIR5). Results: One hundred and eighty-nine indeterminate thyroid nodules were included (67 TIR3A and 122 TIR3B). At post-surgical histology, 46 nodules (24.3%) were malignant. No significant differences were observed in the rate of histologically proven malignancy between patients without CAT a nd patients with CAT in the TIR3B (29.4% vs 32.4%; P = 0.843) nor TIR3A (13.0% vs 11.4%; P = 1.000) nodules. The rate of coexistent CAT was similar between TIR3B and TIR5 nodules harboring PTC at histology (30.4% vs 39.4%, P = 0.491) and between indeterminate nodules and a control group of TIR2 nodules (39.2% vs 37.0%; P = 0.720). Conclusions: The similar rates of histologically proven malignancy found in cytologically indeterminate nodules in the presence or absence of concomitant CAT would not support that C AT itself affects the diagnostic accuracy of fineneedle aspiration cytology. [ABSTRACT FROM AUTHOR]

The Internet has revolutionized our economies, societies, and everyday lives. Many social phenomena are no longer the same as they were in the pre‐Internet era: they have been "Internetized." We define the Internetization of international migration, and we investigate it by exploring the links between the Internet and migration outcomes all along the migration path, from migration intentions to actual migration. Our analyses leverage a number of sources, both at the micro‐ and the macro‐level, including the Gallup World Poll, the Arab Barometer, data from the International Telecommunication Union, the Italian population register, and unique register data from a migrant reception center in Southern Italy. We also distinguish between economic migrants—those who leave their country of origin with the aim of seeking better economic opportunities elsewhere—and political migrants—those who are forced to leave their countries of origin for political or conflict‐related reasons. Our findings point to a consistently positive relationship between the diffusion of the Internet, migration intentions, and migration behaviors, supporting the idea that the Internet is not necessarily a driving force of migration per se, but rather an enabling "supportive agent." These associations are particularly relevant for economic migrants, at least for migration intentions. Further analyses underscore the importance of the Internet in providing a key informational channel which helps to define clearer migration trajectories. [ABSTRACT FROM AUTHOR]

Intradialytic hypotension (IDH) is a hemodynamic phenomenon recently associated with decreased blood oxygen saturation (SO2). The ratio between peripheral oxygen saturation (SpO2) and central venous SO2 (ScvO2) or Oxygen Extraction Ratio (OER), which represents a roughly estimate of the amount of oxygen claimed by peripheral tissues, might be used to estimate haemodialysis (HD) related hypoxic stress. Aim of this pilot study was to evaluate the relationship between OER increments during dialysis sessions (ΔOER) and episodes of IDH. We enrolled chronic HD patients with permanent central venous catheter (CVC) and no fistula, in whom ScvO2 measurement is at hand. OER ([(SpO2 − ScvO2)/SpO2] × 100) was measured in three consecutive HD sessions (HD OER sessions) before HD, after 15′, 30′ and 60′ min and at the end of HD. Then, a one-year follow-up was planned to record the number of IDH episodes. In the 28 enrolled patients (age 74 ± 2.6 years), during 12 ± 1.2 months of follow up, incidence of IDH was 3.6%. We divided patients into two groups, above or below the median value of ΔOER at the end of HD, which was 36%. In these groups, the average incidence of IDH was 7% and 2% respectively (p < 0.01), while OER values before HD were not different. Notably, in the high ΔOER group the OER increment was evident since after 15′ and was significantly higher than in the low ∆OER group (∆OER-15′ = 19 ± 3.0% vs. 9.0 ± 3.0%; p < 0.05). By comparison, blood volume changes overlapped in the two groups (average change − 9 ± 0.8%). Values of ∆OER > 19% after only 15′ of HD treatment or > 36% at the end of the session characterize patients with higher rates of hypotension. Intradialytic ∆OER, a parameter of tissue hypoxic stress, identifies more fragile patients at greater risk of IDH. [ABSTRACT FROM AUTHOR]

A large library of saccharin and acesulfame derivatives has been synthesised and evaluated against four isoforms of human carbonic anhydrase, the two off-targets hCA I/II and the tumour related isoforms hCA IX/XII. Different strategies of scaffold modification have been attempted on both saccharin as well as acesulfame core leading to the obtainment of 60 compounds. Some of them exhibited inhibitory activity in the nanomolar range, albeit some of the performed changes led to either micromolar activity or to its absence, against hCA IX/XII. Molecular modelling studies focused the attention on the binding mode of these compounds to the enzyme. The proposed inhibition mechanism is the anchoring to zinc-bound water molecule. Docking studies along with molecular dynamics also underlined the importance of the compounds flexibility (e.g. achieved through the insertion of methylene group) which favoured potent and selective hCA inhibition. [ABSTRACT FROM AUTHOR]

Eristalinus (Eristalodes) taeniops (Wiedemann, 1818) is a pollinator hoverfly native to the Old World that has spread through several countries in America. We determine the current distribution of this species in Argentina by using records from scientific literature and citizen science websites. In addition, we report the first three specimens collected in Córdoba province. Eristalinus taeniops is present in 10 provinces in Argentina and seems to be more frequent in anthropized habitats. Likewise, the specimens we collected were exclusively captured within the city of Córdoba. Our results confirm the occurrence of E. taeniops in central Argentina and contribute to determining the actual geographic distribution of this species in the country. Our new data could help to evaluate the potential invasiveness of E. taeniops in ecosystems. [ABSTRACT FROM AUTHOR]

In conclusion, the adoption of a visual clots score is useful and allows personalizing the therapy with LMWH effectively, without complications for the patient or additional workload for the staff. Prevention of the extracorporeal circuit clotting has been one of the most important advances in the development and expansion of hemodialytic treatment. [Extracted from the article]

Objective: The association between chronic autoimmune thyroiditis (CAT) a nd differentiated thyroid cancer (DTC) remains controversial. The incidence of DTC increases when scre ening procedures are implemented, as typically occurs in CAT patients being routinely submitted to thyroid ult rasound (US). The aim of this study was to longitudinally evaluate the long-term development of DTC in patients with CAT. Design and methods: A retrospective longitudinal cohort study was designed. For th e study, 510 patients with chronic autoimmune thyroiditis (CAT) with a 10-year follow-up were enro lled. Patients were divided in two groups according to the presence (CAT+ NOD+; n = 115) or absence (CAT+ NOD-; n = 395) of co-existent nodules at diagnosis. The main outcome measures were appearance of new thyroid-nodules and dev elopment of DTC during follow-up. Results: During a 10-year median follow-up period, new thyroid-nodules were detected in 34/115 (29.5%) patients in the CAT+ NOD+ group and in 41/395 (10.3%) in the CAT+ NOD - group (P < 0.001). Logistic regression analysis showed that thyroid-volume at diagnosis and belonging to the CAT+ NOD+ group significantly predicted the appearance of a new thyroid nodule during follow-up, independently of baseline age and sex. Among the 75 patients experiencing the appearance of a new nodule, 27 (39%) met the criteria for fine-n eedle-aspiration-cytology (FNAC). A benign cytological diagnosis was rendered in all cases. Conclusions: In our series of CAT patients, the appearance of new thyroid-n odules was frequent, but none of them were found to be malignant. The presence of CAT appears to be a ssociated with a negligible risk of developing clinically overt DTC. [ABSTRACT FROM AUTHOR]

For billions of people across the globe, mobile phones enable relatively cheap and effective communication, as well as access to information and vital services on health, education, society, and the economy. Drawing on context-specific evidence on the effects of the digital revolution, this study provides empirical support for the idea that mobile phones are a vehicle for sustainable development at the global scale. It does so by assembling a wealth of publicly available macro- and individual-level data, exploring a wide range of demographic and social development outcomes, and leveraging a combination of methodological approaches. Macro-level analyses covering 200+ countries reveal that mobile-phone access is associated with lower gender inequality, higher contraceptive uptake, and lower maternal and child mortality. Individual-level analyses of survey data from sub-Saharan Africa, linked with detailed geospatial information, further show that women who own a mobile phone are better informed about sexual and reproductive health services and empowered to make independent decisions. Payoffs are larger among the least-developed countries and among the most disadvantaged micro-level clusters. Overall, our findings suggest that boosting mobile-phone access and coverage and closing digital divides, particularly among women, can be powerful tools to attain empowerment-related sustainable development goals, in an ultimate effort to enhance population health and well-being and reduce poverty. [ABSTRACT FROM AUTHOR]

Background: We sought to report the prevalence of fragility fracture patients who were screened at high falls risk using a large provincial database, and to determine the characteristics associated with being screened at high falls risk.Methods: The study population included fragility fracture patients 50+ years of age who were screened at 35 hospital fracture clinics in Ontario over a 3.5 year period. The outcome was based on two screening questions measuring the risk of falling, both adapted from the STEADI (Stopping Elderly Accidents, Deaths & Injuries) tool. Multivariable associations of sociodemographic, fracture-related, and health-related characteristics were evaluated using logistic regression.Results: Of the sample, 9735 (44.5%) patients were classified as being at high falls risk, and 12,089 (55.3%) were not. In the multivariable logistic regression, being 80+ years of age (vs. 50-64 years of age), non-community dwelling (vs. living with spouse, family member, roommate), having a mental/physical impairment (vs. none), and taking multiple medications, were all strongly associated with being screened at high falls risk.Conclusions: Living in a non-community dwelling and taking 4+ medications were the variables most strongly associated with being screened at high falls risk. These are potentially modifiable characteristics that should be considered when assessing falls risk in fragility fracture patients, and particularly when designing interventions for preventing subsequent falls. Ongoing work to address the higher risk of falls in the fragility fracture population is warranted. [ABSTRACT FROM AUTHOR]

Background End-stage renal disease (ESRD) is associated with a broad spectrum of morphological and functional thyroid disorders. Recent studies have shown that low free triiodothyronine (fT3) levels are related to inflammatory status and endothelial activation in ESRD patients on haemodialysis (HD). Limited data exist about a possible relationship between dialysis regimen, namely long nocturnal haemodialysis (LNHD), and thyroid function parameters. The aim of this study was to evaluate the relationship between dialysis regimen and thyroid function, and consequently with the main patient outcomes. Methods To this purpose, we performed a retrospective, single-centre cohort study including 220 incident chronic HD patients treated during an 8-year period (from January 2010 to December 2017). The main clinical and haematochemical parameters, including thyroid function, were evaluated and related to the main patient outcomes. Results Patients with low fT3 levels (<3.05 ng/mL) showed significantly lower survival rates than patients with normal fT3 levels (>3.05 ng/mL) (P   <   0.001), although there were no substantial differences in the demographic and clinical characteristics between the two groups. After propensity score 1:3 matching of 25 patients treated with nocturnal HD to 75 patients treated with diurnal HD, LNHD patients showed significantly higher survival rates (88.0% versus 61.3%, P  =  0.001) and lower incidence of cardiovascular events than patients on diurnal dialysis (8.0% versus 40.0%, P  =  0.001). Moreover, an 8-year time-dependent analysis showed that at any time, except for baseline, the rate of patients with fT3 levels >3.05 ng/mL was significantly higher in LNHD patients than in patients treated with diurnal dialysis. Conclusions Our data suggest that the application of alternative dialysis regimens, also reducing the frequency of low T3, could ameliorate outcomes and therefore reduce the incidence of cardiovascular events in HD patients. [ABSTRACT FROM AUTHOR]

Background Doppler ultrasound (DU) monitoring early after arteriovenous fistula (AVF) creation allows the identification of low blood flow (Qa) requiring prompt revision, but it is costly (needs skilled operators and technical instruments) and is not available in all dialysis units. Therefore alternative first-line methods to measure Qa would be welcomed. We reasoned that once an AVF is created, an increment in central venous oxygen saturation (ScvO2) is predictable and proportional to Qa. Methods Accordingly, in patients receiving dialysis through a central venous catheter (CVC) in whom an AVF was created, we measured, by means of blood gas analysis, the ScvO2 increment before and after manual compression of the arteriovenous shunt and verified its correlation with DU-measured Qa. Results We sampled blood gas in 18 patients with CVC and AVF before and after 30 s manual compression of the AVF. ScvO2 averaged 70.5 ± 3% before and 65.2 ± 3% after AVF closure, with an average drop of 5.1 ± 3% (range 1–12). AVF Qa, which was measured within 24 h by means of DU, averaged 635 ± 349 mL/min (range 50–1300) and was strictly and positively correlated with ΔScvO2 (r = 0.954, P < 0.0001). Conclusions Therefore we suggest that in patients with CVC and a newly created AVF, it is possible to monitor AVF Qa without DU by simply measuring blood gas and ΔScvO2. This technique is simple, cheap, repeatable, non-invasive and operator independent and represents a new useful screening test to detect delayed AVF access maturation deserving prompt DU measurement and surgical revision. It helps to quickly identify patients in urgent need of DU verification and possible surgical revision. Regrettably, it is applicable only in patients with CVC. [ABSTRACT FROM AUTHOR]

A large library of derivatives based on the scaffold of 2-(benzylsulfinyl)benzoic acid were synthesised and tested as atypical inhibitors against four different isoforms of human carbonic anhydrase (hCA I, II, IX and XII, EC 4.2.1.1). The exploration of the chemical space around the main functional groups led to the discovery of selective hCA IX inhibitors in the micromolar/nanomolar range, thus establishing robust structure-activity relationships within this versatile scaffold. HPLC separation of some selected chiral compounds and biological evaluation of the corresponding enantiomers was performed along with molecular modelling studies on the most active derivatives. [ABSTRACT FROM AUTHOR]

• Post-WWII political forces wanted to dismantle most of the state-owned enterprises. • Saraceno sketches out a pragmatic approach to economic policy-making. • He provides valuable insights on economic growth in a mixed economy. • Economic policy should merge the political sphere and the managerial one. • Competence, accountability, civicness are useful reference also in today's debate on the role of the entrepreneurial state. This paper aims to depict, through the interweaving of facts and theories, the debate in Italy on economic growth policies and on the consolidation of a mixed economy. By identifying and analysing significant phases, we will show that the theme of structural growth and economic development covers a broad temporal spectrum and reveals different positions on state capitalism. Pasquale Saraceno (1903–1991) was a key figure in shaping many of the significant phases of Italian economic policy, especially in the post-WWII period. He played a central role and provided important insights in the debates on the role of public companies and the emergence of a state-led market economy in the economic development process. [ABSTRACT FROM AUTHOR]

Insects in the order Hymenoptera are considered useful indicators of environmental changes, and yellow pantraps constitute one of the most used sampling methods to collect them. Here, we analyze the influence of microsite features on the flying Hymenoptera communities obtained using yellow pan-traps, through a short time of exposure in three microsites of fragmented forest: interior (I), north (NB) and south facing (SB) borders. We compared values of richness and abundance of total Hymenoptera, as well as parasitoids, predators and pollinators among microsites using rarefaction and extrapolation curves and Generalized Linear Mixed Models. Number of individuals obtained in NB were two-fold and 74% greater than the ones obtained in SB and in I respectively, whereas estimated total species richness was higher in the forest interior, followed by SB and ultimately by NB. Parasitoids and predators were more frequently trapped in NB. Even when data were obtained through a short period of sampling in five sampling sites, our results emphasize the need to consider the influence of the location (border vs interior) and the geographic orientation of edges in which pan-traps are placed in order to correctly assess the abundance of flying Hymenoptera in fragmented forest landscapes. [ABSTRACT FROM AUTHOR]

Background: Emergency department visits and hospitalizations (EDVH) place a large burden on patients and the health care system. The presence of informal caregivers may be beneficial for reducing EDVH among patients with specific diagnoses. Our objective was to determine whether the presence of an informal caregiver was associated with the occurrence of an EDVH among clients 50 years of age or older.Methods: Using a database accessed through the Toronto Central Community Care Access Centre (CCAC), we identified 479 adults over 50 years of age who received home care in Toronto, Canada. Exposure variables were extracted from the interRAI health assessment form completed at the time of admission to the CCAC. EDVH data were linked to provincial records through the CCAC database. Data on emergency room visits were included for up to 6 months after time of admission to home care. Multiple logistic regression analysis was used to identify factors associated with the occurrence of an EDVH.Results: Approximately half of all clients had an EDVH within 180 days of admission to CCAC home care. No significant association was found between the presence of an informal caregiver and the occurrence of an EDVH. Significant factors associated with an EDVH included: Participants having a poor perception of their health (adjusted OR = 1.68, 95% CI: 1.11-2.56), severe cardiac disorders (adjusted OR = 1.54, 95% CI: 1.04-2.29), and pulmonary diseases (adjusted OR = 1.99, 95% CI: 1.16-3.47).Conclusions: The presence of an informal caregiver was not significantly associated with the occurrence of an EDVH. Future research should examine the potential associations between length of hospital stay or quality of life and the presence of an informal caregiver. In general, our work contributes to a growing body of literature that is increasingly concerned with the health of our aging population, and more specifically, health service use by elderly patients, which may have implications for health care providers. [ABSTRACT FROM AUTHOR]

Both chronic and recurrent spinal pain alter sensorimotor integration (SMI), which is demonstrated using complex neurophysiological techniques. Currently, there is no patient-reported outcome measure that documents and/or assesses SMI in populations with spinal problems. The purpose of this study was to develop the Sensory–Motor Dysfunction Questionnaire (SMD-Q) and assess its test–retest reliability and internal consistency in individuals with recurrent spinal pain. The SMD-Q was developed based on the existing literature on motor control disturbances associated with disordered SMI. The initial SMD-Q drafts underwent review by two separate panels of subject matter experts and a focus group with subclinical spine pain. Their suggestions were incorporated into the questionnaire prior to reliability testing. The questionnaire was administered twice at a seven-day interval using QualtricsTM. A total of 20 participants (14 females and 6 males; 20.95 ± 2.46 years of age) completed the study. Quadratic weighted kappa (Kw) was used to assess test–retest reliability and Cronbach's alpha (α) was used to assess internal consistency. Four items had a Kw < 0.40, seven had a 0.40 < Kw < 0.75, and one had a Kw > 0.75 (excellent agreement), with excellent internal consistency (α > 0.90). The pilot SMD-Q appears to reliably measure altered SMI, suggesting that revisions and testing with a larger sample are worth pursuing. [ABSTRACT FROM AUTHOR]