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Background: Non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics are used frequently by athletes either prophylactically for the prevention of pain, or to accelerate recovery following an injury. However, these types of pain management strategies have been shown to inhibit signalling pathways (e.g., cyclooxygenase-2) that may hinder muscular adaptations such as hypertrophy and strength. Nutraceuticals such as palmitoylethanolamide (PEA) have analgesic properties that act via different mechanisms to NSAIDS/analgesics. Furthermore, PEA has been shown to have a positive effect on sleep and may contribute positively to muscle hypertrophy via PKB activation. Although PEA has not been widely studied in the athletic or recreationally active population, it may provide an alternative solution for pain management if it is found not to interfere with, or enhance training adaptations. Therefore, the study aim is to investigate the effects of daily PEA supplementation (Levagen + ®) with resistance training on lean body mass, strength, power and physical performance and outcomes of recovery (e.g., sleep) compared to placebo., Methods: This double-blind, randomised controlled study will take place over an 11-week period (including 8-weeks of progressive resistance training). Participants for this study will be 18-35 years old, healthy active adults that are not resistance trained. Participants will attend a familiarisation (week 0), pre-testing (week 1) and final-testing (week 11). At the pre-testing and final-testing weeks, total lean body mass (dual-energy X-ray absorptiometry; DXA), total mid-thigh cross sectional area (pQCT), maximal muscular strength (1 repetition maximum bench press, isometric mid-thigh pull) and power (countermovement jump and bench throw) will be assessed. Additionally, circulating inflammatory cytokines and anabolic hormones, sleep quality and quantity (ActiGraph), pain and subjective wellbeing (questionnaires) will also be examined., Discussion: This study is designed to investigate the effects that PEA may have on pre-to post intervention changes in total body and regional lean muscle mass, strength, power, sleep, subjective wellbeing, and pain associated with resistance training and menstruation compared with the placebo condition. Unlike other NSAIDs and analgesics, which may inhibit muscle protein synthesis and training adaptations, PEA which provides analgesia via alternative mechanisms may provide an alternative pain management solution. It is therefore important to determine if this analgesic compound interferes with or enhances training adaptations so that athletes and active individuals can make an informed decision on their pain management strategies., Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR: ACTRN12621001726842p)., (© 2023. The Author(s).)

Opto-electronic oscillators are sources of microwave-frequency tones that may reach very low noise levels. Much effort is being dedicated to the realization of oscillators based on photonic integrated devices. In this work, we propose and demonstrate a thermo-elastic opto-electronic oscillator at 2.213 GHz frequency based on a standard silicon-photonic integrated circuit. A microwave-frequency electrical signal modulates an optical pump wave carrier. The modulated waveform launches surface acoustic waves in a silicon-on-insulator substrate, through absorption in a metallic grating and thermo-elastic actuation. The waveform is reconverted to the optical domain through photoelastic modulation of an optical probe wave carrier in a standard racetrack resonator waveguide. Both the thermo-elastic actuation and the photoelastic modulation are radio-frequency selective. The output probe wave is detected, and the receiver voltage is amplified and fed back to modulate the optical pump input. Sufficient gain drives the loop into oscillations. The oscillator does not involve piezoelectricity and can be realized on any substrate. Long acoustic delays may be implemented in compact devices. The frequency of operation is scalable to tens of GHz. The principle may be useful in integrated microwave-photonic signal processing and in the elastic analysis of surfaces and thin layers.

Introduction: Elevated luteinizing hormone (LH) in combination with low-normal testosterone (mild Leydig cell insufficiency) is common in testicular cancer (TC) survivors and is associated with impaired insulin sensitivity and metabolic syndrome. The aim was to evaluate if testosterone replacement therapy (TRT) improves metabolic health in this subgroup of TC survivors., Patients and Methods: This was a single-center, double-blind, randomized, controlled trial. The main eligibility criterion was LH above the age-adjusted upper limit of normal in combination with free testosterone in the lower half of the age-adjusted normal range (mild Leydig cell insufficiency) >1 year after TC treatment. Eligible patients were randomly assigned (1:1) to 12 months transdermal TRT (Tostran, gel, 2%) or placebo with a maximum daily dose of 40 mg. The primary outcome was difference in Δ2 hour glucose measured with oral glucose tolerance test between groups assessed at 12 months. Outcomes were assessed after 6-, 12- and 3 months post-treatment. The study was registered at www., Clinicaltrial: gov (NCT02991209) and ended June 2019., Results: Between October 2016 and February 2018, 140 patients were screened for eligibility and 69 were randomized to testosterone (n = 35, 51%) or placebo (n = 34, 49%). TRT was not associated with a statistically significant difference in Δ2 hour glucose compared to placebo after 12 months of treatment (0.04 mmol/L (95% CI: -0.53, 0.60)). There was no statistically significant difference in Δ2 hour insulin between the groups after 12 months of treatment (28.23 pmol/L (95% CI: -34.40, 90.86)). Similarly, TRT was not associated with significant improvement in components of metabolic syndrome. TRT was associated with a decrease in fat mass after 12 months compared to placebo (-1.35 kg, (95% CI: -2.53, -0.18))., Conclusion: In TC survivors with mild Leydig cell insufficiency, TRT was not associated with improvement of metabolic health. These findings do no not support routine use of TRT in these patients., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

The analysis of thin layers deposited on various substrates is widely employed in thickness monitoring, materials research and development and quality control. Measurements are often performed based on changes to acoustic resonance frequencies of quartz micro-balance devices. The technique is extremely sensitive, but it is restricted to hundreds of MHz frequencies and requires electrical connectivity. In this work we propose and demonstrate the analysis of elastic properties of thin layers deposited on surface acoustic wave-photonic devices in standard silicon-on-insulator. The devices operate at 2.4 GHz frequency, and their interfaces are fiber-optic. The radio-frequency transfer functions of the devices are modified by sub-percent level changes to the group velocity of surface acoustic waves following deposition of layers. Layers of aluminum oxide and germanium sulfide of thickness between 10-80 nm are characterized. The analysis provides estimates for Young's modulus of the layers.

Summary: The First World War, mankind's first high-technology conflict, resulted in unprecedented mass mortality. Medical services were confronted with overwhelming challenges in treating casualties from mobile warfare, trench warfare, battles on different fronts and infectious diseases. In this article, we give an overview of the organization of the German army medical service using contemporary reports in order to describe surgical and medical developments that originated from the experience. Consulting physicians ( beratende arzte ), many of whom were internationally known specialists, had a great impact; some of their innovations remain in use today, including the scientific evaluation of contemporary conflicts, the implementation of different echelons of care with a fast movement of patients, and the treatment of penetrating wounds. This article includes an appendix, available at canjsurg.ca/005118-a1, with more information.

Background: High-risk human papilloma virus (HR-HPV) infection is associated with the development of cervical cancer. HPV vaccination reduces the risk of developing malignant lesions and is expected to change the dynamics of HPV transmission. Data from non-vaccinated women may provide an important benchmark to allow the impact of HPV vaccination programs to be assessed.This study was designed to prospectively determine the changing dynamics of HR-HPV infection and associated genital diseases in young women, most of whom were non-vaccinated., Methods: Data from a population-based cohort study, comprising women of two predefined birth cohorts (women born in 1983/84 or 1988/89), were analyzed between 19 October 2009 and 31 December 2010 to determine risk factors for high-risk HPV infection and the association between specific HR-HPV types and atypical Pap smear test results. HPV status was determined by Hybrid Capture 2 (HC2) assay and genotyping., Results: The prevalence of HR-HPV was 22.8% in the 1983/84 cohort (150/659) and 23.7% in the 1988/99 cohort (142/599). Only the number of sexual partners was a significant risk factor for HPV infection (odds ratios 22.687 and 6.124 for more than five versus one partner 84 cohort,/84 and 1988/89 cohorts, respectively) in multivariate analysis. HPV16 positive-women were significantly more likely to have abnormal Pap smears of any degree than HPV16-negative women (22.0% versus 3.61%, p < 0.0001 for the 1983/84 cohort and 9.09% versus 2.52%, p = 0.0482 for the 1988/89 cohort). CIN3 was diagnosed in six women 84 cohort,/84 cohort and two in the 1988/89 cohort. All women with CIN3 tested positive for HC2-HR and all six CIN3 cases 84 cohort,/84 cohort tested positive for HPV16. In the 1988/89 cohort, the rate of HPV16 infection was significantly lower in vaccinated than non-vaccinated women (1.59% versus 8.88%; p = 0.003)., Conclusions: HR-HPV infection was highly prevalent in both cohorts and associated with an increased risk of abnormal Pap smears and biopsy proven CIN2+. HPV16 infection was associated with a high risk of clinically relevant lesions. HPV vaccination significantly decreased the risk of HPV16 infection.

Work-related injuries among nurses are a complex and costly problem. To thoughtfully approach this issue, one medical center developed a set of injury-reduction strategies and related tools based on a review of research literature and locally obtained evidence. This article describes the evidence-based approach to prevention of work-related musculoskeletal injuries. It also covers research-based observations about prevention strategies; provides a description of selected interventions, such as a patient handling guide; and includes sample tools that enable collection of meaningful data about local patient handling practices.

The influence of selenium (Se) restriction on disposition in plasma and urine fractions of infused (74)Se (selenite) was studied when adult males (Enshi City, Hubei Province, PRC) whose habitual daily Se intake is approximately 480 microg per day were transferred to Lichuan County, where the daily intake is approximately 30 microg. The subjects received an infusion (106 microg Se) on the day before consuming foods low in Se and a second infusion (113 microg Se) 63 days later. Blood and 24-hour urine samples were collected each day for 7 days after the first infusion and on days 22, 43, and 62 following the first infusion. Urine and blood were also collected daily for the next 7 days after the second infusion. Plasma total Se concentration increased for 7 days after each of the two infusions and urine Se decreased exponentially following both the first and second infusions. The excretion of trimethylselenonium followed the same pattern as the total urinary Se. Surprisingly, there was not a significant difference in selenite retention between the two infusion periods, and the data indicated that, regardless of the chemical form of Se present in various organs, its catabolism leading to excretion in urine followed the same pathway as that of selenite. Labeled Se was incorporated predominantly in the plasma selenoprotein P fraction and the half-life of Se in this fraction was determined to be 1.9 to 2.9 days. Thus, a longer depletion period is required in these subjects to obtain more significant changes.

Following the presentation of the evolution of the medieval public assistance for the poor to the modern "Beggar--and Poor-Decrees" in the German language area with special consideration to Bavarian measures, the problem of medical care for the needy is considered. Here, special focus is on the Bavarian "poor people's physician" in the first half of the nineteenth century with his duties and problems.

Fifteen to 20% of premature infants weighing below 1500 g develop variable degrees of acute retrolental fibroplasia (RLF). Approximately 5% of those infants who develop RLF can be expected to become blind. A prospective study was carried out to evaluate if early cryopexy can prevent this blindness. The study showed that, among 533 infants admitted to the neonatal intensive care unit between July 1976 and December 1978, 55 had some degree of active RLF. In 18 eyes of 9 infants in whom the retinopathy progressed beyond active stage II cryopexy treatment was applied to the avascular retina. In all the treated eyes the active retinopathy regressed, and there were no complications due to the procedure. The long-term follow-up showed that in 15 eyes there was good vision and that the remaining 3 eyes had some impairment of vision but were not blind. These results suggest that cryotherapy may prove useful in treating premature infants with RLF who show progression of their active stage, without the danger of further visual loss or complete blindness.

Three premature babies with advanced stages of retrolental fibroplasia underwent retinal surgery by buckling procedures, with satisfactory results. The indications and surgical technical problems are discussed.