Search

Key Clinical Message With syphilis resurgence, physicians should be more vigilant to infection‐induced cerebral vasculitis in high‐risk patients presenting with neurological symptoms. In this case, neurosyphilis should not be missed. Thorough serologic screening and lumbar puncture are crucial for diagnosis, and further research is needed for safe and effective treatments in these populations.

IntroductionThe global healthcare burden of COVID-19 pandemic has been unprecedented with a high mortality. Metabolomics, a powerful technique, has been increasingly utilized to study the host response to infections and to understand the progression of multi-system disorders such as COVID-19. Analysis of the host metabolites in response to SARS-CoV-2 infection can provide a snapshot of the endogenous metabolic landscape of the host and its role in shaping the interaction with SARS-CoV-2. Disease severity and consequently the clinical outcomes may be associated with a metabolic imbalance related to amino acids, lipids, and energy-generating pathways. Hence, the host metabolome can help predict potential clinical risks and outcomes.MethodsIn this prospective study, using a targeted metabolomics approach, we studied the metabolic signature in 154 COVID-19 patients (males=138, age range 48-69 yrs) and related it to disease severity and mortality. Blood plasma concentrations of metabolites were quantified through LC-MS using MxP Quant 500 kit, which has a coverage of 630 metabolites from 26 biochemical classes including distinct classes of lipids and small organic molecules. We then employed Kaplan-Meier survival analysis to investigate the correlation between various metabolic markers, disease severity and patient outcomes.ResultsA comparison of survival outcomes between individuals with high levels of various metabolites (amino acids, tryptophan, kynurenine, serotonin, creatine, SDMA, ADMA, 1-MH and carnitine palmitoyltransferase 1 and 2 enzymes) and those with low levels revealed statistically significant differences in survival outcomes. We further used four key metabolic markers (tryptophan, kynurenine, asymmetric dimethylarginine, and 1-Methylhistidine) to develop a COVID-19 mortality risk model through the application of multiple machine-learning methods.ConclusionsMetabolomics analysis revealed distinct metabolic signatures among different severity groups, reflecting discernible alterations in amino acid levels and perturbations in tryptophan metabolism. Notably, critical patients exhibited higher levels of short chain acylcarnitines, concomitant with higher concentrations of SDMA, ADMA, and 1-MH in severe cases and non-survivors. Conversely, levels of 3-methylhistidine were lower in this context.

Article accepted. The article will be published here soon. Pending final quality checks.

The study aims to measure the level of knowledge of the international law of table tennis among physical education teachers in Al-Karak. The researcher used the descriptive approach, and the study sample consisted of 110 Physical Education teachers in Al-Karak, who are registered within the official restrictions in the directorates of education in Al-Karak for the academic year 2021/2022. The researcher used the self-developed study tool, based on the international law of table tennis, consisting of thirty questions distributed over three topics. The results showed that the arithmetic averages of the level of knowledge of the international law of table tennis among Physical Education teachers in Al-Karak overall reached a very low level. The results showed that there were statistically significant differences in the estimations of the study sample members in the level of knowledge of the international law of table tennis among Physical Educationteachers in Al-Karak, according to the gender variable and in favor of males. The results showed that there were differences in the estimates of the study sample members in the level of knowledge according to the variable of experience and in favor of a group of less than five. The researcher recommended the necessity of holding training courses to raise the awareness of Physical Education teachers of the international law of table tennis for both genders and for those with longer experience.

الأهداف: هدفت الدراسة التعرف إلى مستوى المهارات النفسية وعلاقتها بنتائج الفرق المشاركة في بطولة كرة الطاولة التي نظمها الاتحاد الرياضي للجامعات الأردنية في ضوء متغيرات (الجنس، الجامعة، عدد سنوات اللعب). المنهجية: استخدمت الدراسة المنهج الوصفي الارتباطي، وتكونت العينة من (87) لاعباً ولاعبة من بين (128) فردا من مجتمع الدراسة. تم استخدم مقياس المهارات النفسية الخاص بالرياضة (PSIS-R-5) المعتمد من قبل M. J. Mahoney, T.J Gabriel and T. S. Perkins كأداة لجمع البيانات، اشتمل على (41) فقرة موزعة على ستة أبعاد هي: مهارات السيطرة على القلق (6 فقرات)، ومهارات الثقة بالنفس (7 فقرات)، ومهارات التحضير الذهني (6 فقرات)، والدافعية (7 فقرات)، ومهارات روح الفريق (6 فقرات)، ومهارات التركيز (7 فقرات). تم معالجة البيانات من خلال حساب المتوسطات الحسابية، والانحرافات المعيارية، والتكرارات والنسب المئوية. وتم استخدام تحليل التباين (ANOVA)، ومعاملات الارتباط (coloration coefficient’s). النتائج: أظهرت النتائج أن مستوى المهارات النفسية لدى اللاعبين جاء متوسطاً على المقياس ككل. ووجود فروق ذات دلالة إحصائية في مستوى المهارات النفسية لدى اللاعبين تبعاً لمتغيري الجامعة لصالح فريق الجامعة الهاشمية، وعدد سنوات اللعب لصالح الفئة (11) سنة فأكثر، وعدم وجود فروق ذات دلالة إحصائية في مستوى المهارات النفسية تبعاً لمتغير الجنس، ووجود علاقة ارتباطية بين مستوى المهارات النفسية في جميع أبعادها ونتائج الفرق المشاركة في البطولة. الخلاصة: أوصت الدراسة بضرورة توجيه مدربي كرة الطاولة وألعاب المضرب الأخرى في الجامعات الأردنية لتفعيل دورهم في تحسين أداء ونتائج لاعبيهم خلال المنافسات، وذلك بتوظيف التدريب على المهارات النفسية كجزء من برامج التدريب.

Cervical cancer is preventable due to effective screening to detect pre‐malignant lesion, and vaccination against its causative organism namely human papillomavirus (HPV). This review article described current situation of cervical cancer in Malaysia. There is decreasing cervical cancer incidence in the country, with age‐standardized rate of 10.3, versus 14.1 and 7.5 per 100 000 for worldwide and high‐income countries, respectively. School‐based HPV vaccination is part of national immunization since 2010, with yearly coverage rate of 83%–91%. The figure declined during coronavirus disease‐19 pandemic due to scarce vaccine supply and movement‐control order, resulting in about 500 000 students missing their course, with catch‐up program currently onboard. Opportunistic cervical screening program started in 1960s with cervical smear cytology, which is succeeded by HPV DNA screening since 2020. Cervical cytology remains indispensable screening method in healthcare facility without access to HPV test kit, and used to triage high‐risk HPV positive with abnormal cytology that require urgent colposcopy. Computed tomography is the main imaging modality to assess local and distal extent of cervical cancer. Primary surgical treatment for early‐stage cancer is performed by trained gynecologic oncologist, with long waiting list for radiation therapy in locally advanced disease due to limited available public facility. There is restricted access to targeted therapy due to high treatment cost. In conclusion, Malaysia is heading toward cervical cancer elimination through rigorous investment in primary and secondary prevention, and increase in public engagement with the support of government policy enforcement. [ABSTRACT FROM AUTHOR]

Copyright of Sport & Tourism Central European Journal / Sport i Turystyka Srodkowoeuropejskie Czasopismo Naukowe is the property of Jan Dlugosz University in Czestochowa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study aimed to investigate and compare the effects of employing the command style and the reciprocal style on the accuracy of the backhand low serve skill in badminton. The experimental method was used, and the study sample consisted of 40 students from the Department of Physical Education, enrolled in badminton and table tennis courses. The participants were purposefully selected and divided into two equivalent experimental groups: the first experimental group (20 students) used the command style, and the second experimental group (20 students) used the reciprocal style. Pre-tests were conducted, followed by the implementation of the instructional program for duration of 6 weeks, with three weekly teaching units, each lasting 60 minutes. Posttests were conducted, and the necessary statistical analyses were performed. The results revealed that the first experimental group (command style) showed improvement in post-test performance compared to pre-test performance, indicating the effectiveness of the command style in enhancing the learning of accuracy in the backhand low serve skill. Similarly, the second experimental group (reciprocal style) demonstrated enhanced post-test performance compared to pre-test performance, highlighting the effectiveness of the reciprocal style in enhancing accuracy in the backhand low serve skill. Furthermore, the results showed that the second experimental group (reciprocal style) outperformed the first experimental group (command style) in terms of average performance in the post-test, emphasizing the efficacy of the reciprocal style in improving accuracy in the backhand low serve skill in badminton. In conclusion, the study recommended using the command style for teaching and developing accuracy in the backhand low serve skill in badminton. [ABSTRACT FROM AUTHOR]

Malaysia has recently noted a steady increase in the use of enhanced learning for web-related innovation and assertion. The current conditions of mobile learning in Malaysia have been analyzed to provide an important method for the imminent improvement of college e-learning in Malaysia. The powers of the information carried are logical and current location including issues of disobedience from the perspective of spoken mental learning. In this exploration, highlights will be examined and identified that recognize the new computed form that was absent in the main application and highlight the element that takes care of case declaration. The problem of exploration is the lack of examination on students' disappointment with mobile training on the issue of application interface used in mobile phones and the way most fashion designers are more familiar with the printed drafting plan and website pages than with the user interface plan; Specifically, optimizing versatile hotspots is something new and, as such, no prior engagement in this area. The examination applied the quantifiable methodology in the initial stage, and the public opinion polls will top and fall within the scope of the review. To determine the example size, I used Steven K. Thompson's condition to determine the example size. The review audience consisted of (9272) students of Governor Sultan Zain Al-Abidin University (UniSZA), who was determined to sort out the primary perspectives from their point of view on versatile learning and consider assumptions, ideas, and level of alternative student agreement with portable learning among students. From UniSZA, the revision test consisted of (369) students. In this review, the specialist will rely on the use of the Statistical Package Software (SPSS). Results show that students are disappointed with portable capture attributable to the perspective associated with 'social expectations' while students expect that they will no longer include versatile learning, will not want to engage in mobile learning from now on, and accept that they will not continue to Involving versatile applications later, they did not intend to include versatile learning from now on, and they did not want to use versatile applications instead of traditional technologies. However, it was found that casual respondents deal with an important issue and deterrent that was the point of interaction of the versatile e-learning application and is the issue that this review will focus on. [ABSTRACT FROM AUTHOR]

Background Identifying patients with BRCA mutations is clinically important to inform on the potential response to treatment and for risk management of patients and their relatives. However, traditional referral routes may not meet clinical needs, and therefore, mainstreaming cancer genetics has been shown to be effective in some high-income and high health-literacy settings. To date, no study has reported on the feasibility of mainstreaming in low-income and middle-income settings, where the service considerations and health literacy could detrimentally affect the feasibility of mainstreaming. Methods The Mainstreaming Genetic Counselling for Ovarian Cancer Patients (MaGiC) study is a prospective, two-arm observational study comparing oncologist-led and genetics-led counselling. This study included 790 multiethnic patients with ovarian cancer from 23 sites in Malaysia. We compared the impact of different method of delivery of genetic counselling on the uptake of genetic testing and assessed the feasibility, knowledge and satisfaction of patients with ovarian cancer. Results Oncologists were satisfied with the mainstreaming experience, with 95% indicating a desire to incorporate testing into their clinical practice. The uptake of genetic testing was similar in the mainstreaming and genetics arm (80% and 79%, respectively). Patient satisfaction was high, whereas decision conflict and psychological impact were low in both arms of the study. Notably, decisional conflict, although lower than threshold, was higher for the mainstreaming group compared with the genetics arm. Overall, 13.5% of patients had a pathogenic variant in BRCA1 or BRCA2, and there was no difference between psychosocial measures for carriers in both arms. Conclusion The MaGiC study demonstrates that mainstreaming cancer genetics is feasible in low-resource and middle-resource Asian setting and increased coverage for genetic testing. [ABSTRACT FROM AUTHOR]

We report a case of recurrent pericarditis as an immune-related adverse event in a 47-year-old man with de novo metastatic renal cell carcinoma. After first-line treatment with sunitinib failed, he received three cycles of nivolumab and developed pericarditis following each cycle. The third cycle was accompanied by colchicine as a secondary prophylaxis. Pericarditis is an uncommon and potentially life-threatening immune-related adverse event, if not managed promptly. [ABSTRACT FROM AUTHOR]

Sufficient postoperative dietary intake is crucial for ensuring a better surgical outcome. This study aimed to investigate the postoperative dietary intake achievement and predictors of postoperative dietary intake among gynecologic cancer patients. A total of 118 participants were included in this secondary analysis. Postoperative dietary data was pooled and re-classified into early postoperative dietary intake achievement (EDIA) (daily energy intake (DEI) ≥ 75% from the estimated energy requirement (EER)) and delay dietary intake achievement (DDIA) (DEI < 75% EER) There was a significant difference in postoperative changes in weight (p = 0.002), muscle mass (p = 0.018), and handgrip strength (p = 0.010) between the groups. Postoperative daily energy and protein intake in the EDIA was significantly greater than DDIA from operation day to discharged (p = 0.000 and p = 0.036). Four significant independent postoperative dietary intake predictors were found: preoperative whey protein-infused carbohydrate loading (p = 0.000), postoperative nausea vomiting (p = 0.001), age (p = 0.010), and time to tolerate clear fluid (p = 0.016). The multilinear regression model significantly predicted postoperative dietary intake, F (4, 116) = 68.013, p = 0.000, adj. R2 = 0.698. With the four predictors' recognition, the integration of a more specific and comprehensive dietitian-led supportive care with individualized nutrition intervention ought to be considered to promote functional recovery. [ABSTRACT FROM AUTHOR]

Epilepsy is a devastating disease, currently treated with medications, surgery or electrical stimulation. None of these approaches is totally effective and our ability to control seizures remains limited and complicated by frequent side effects. The emerging revolutionary technique of optogenetics enables manipulation of the activity of specific neuronal populations in vivo with exquisite spatiotemporal resolution using light. We used optogenetic approaches to test the role of hippocampal excitatory neurons in the lithium-pilocarpine model of acute elicited seizures in awake behaving rats. Hippocampal pyramidal neurons were transduced in vivo with a virus carrying an enhanced halorhodopsin (eNpHR), a yellow light activated chloride pump, and acute seizure progression was then monitored behaviorally and electrophysiologically in the presence and absence of illumination delivered via an optical fiber. Inhibition of those neurons with illumination prior to seizure onset significantly delayed electrographic and behavioral initiation of status epilepticus, and altered the dynamics of ictal activity development. These results reveal an essential role of hippocampal excitatory neurons in this model of ictogenesis and illustrate the power of optogenetic approaches for elucidation of seizure mechanisms. This early success in controlling seizures also suggests future therapeutic avenues.

The article discusses the reactivation in ventral striatum during hippocampal ripples. Research on primates and rodents has corroborated the essential role of the hippocampus in transforming new memories into stable representations elsewhere in the brain. Many theories of memory consolidation propose the reactivation of behavioral experiences, typically during periods of sleep or rest. Electrophysiological evidence for such theories has been recorded in hippocampal place cells in rats.

Enhanced Recovery after Surgery (ERAS) with sole carbohydrate (CHO) loading and postoperative early oral feeding (POEOF) shortened the length of postoperative (PO) hospital stays (LPOHS) without increasing complications. This study aimed to examine the impact of ERAS with preoperative whey protein-infused CHO loading and POEOF among surgical gynecologic cancer (GC) patients. There were 62 subjects in the intervention group (CHO-P), which received preoperative whey protein-infused CHO loading and POEOF; and 56 subjects formed the control group (CO), which was given usual care. The mean age was 49.5 ± 12.2 years (CHO-P) and 51.2 ± 11.9 years (CO). The trial found significant positive results which included shorter LPOHS (78.13 ± 33.05 vs. 99.49 ± 22.54 h); a lower readmission rate within one month PO (6% vs. 16%); lower weight loss (−0.3 ± 2.3 kg vs. −2.1 ± 2.3 kg); a lower C-reactive protein–albumin ratio (0.3 ± 1.2 vs. 1.1 ± 2.6); preserved muscle mass (0.4 ± 1.7 kg vs. −0.7 ± 2.6 kg); and better handgrip strength (0.6 ± 4.3 kg vs. −1.9 ± 4.7 kg) among CHO-P as compared with CO. However, there was no significant difference in mid-upper arm circumference and serum albumin level upon discharge. ERAS with preoperative whey protein-infused CHO loading and POEOF assured better PO outcomes. [ABSTRACT FROM AUTHOR]

This study will look at how this process occurs among the Orang Laut (Kuala) in Johor. This study was carried out to analyse the restructuring of the community and the identification of indigeneous ethnic (Orang Laut) socialcultural interactions in Rengit, Minyak Beku and Kota Masai Johor. In particular, the study will involve aspects of the sociocultural life of the Orang Kuala Rengit, Minyak Beku and Kota Masai Johor, which include languages, economic activities, customs, and practices that are still practiced and things that have been modified in accordance with the factors around them. Analysing the process of adaptation is done closely by relating the process of interactions within groups, local communities, government agencies and the adaptation patterns that occurred. Besides that, the sustainability and the preservation of ethnic cultures of Orang Kuala in the social system as a whole and their impact on the development of the structure of community are examined. Qualitative method is used assisted by other study materials obtained such as field work, observation, ethnographic which are reinforced with library research such as documents and other materials related. This paper will cover the restructuring process by explaining the concepts, books and previous research reviewed by the researcher.

Background: Identifying patients with BRCA mutations is clinically important to inform on the potential response to treatment and for risk management of patients and their relatives. However, traditional referral routes may not meet clinical needs, and therefore, mainstreaming cancer genetics has been shown to be effective in some high-income and high health-literacy settings. To date, no study has reported on the feasibility of mainstreaming in low-income and middle-income settings, where the service considerations and health literacy could detrimentally affect the feasibility of mainstreaming., Methods: The Mainstreaming Genetic Counselling for Ovarian Cancer Patients (MaGiC) study is a prospective, two-arm observational study comparing oncologist-led and genetics-led counselling. This study included 790 multiethnic patients with ovarian cancer from 23 sites in Malaysia. We compared the impact of different method of delivery of genetic counselling on the uptake of genetic testing and assessed the feasibility, knowledge and satisfaction of patients with ovarian cancer., Results: Oncologists were satisfied with the mainstreaming experience, with 95% indicating a desire to incorporate testing into their clinical practice. The uptake of genetic testing was similar in the mainstreaming and genetics arm (80% and 79%, respectively). Patient satisfaction was high, whereas decision conflict and psychological impact were low in both arms of the study. Notably, decisional conflict, although lower than threshold, was higher for the mainstreaming group compared with the genetics arm. Overall, 13.5% of patients had a pathogenic variant in BRCA1 or BRCA2, and there was no difference between psychosocial measures for carriers in both arms., Conclusion: The MaGiC study demonstrates that mainstreaming cancer genetics is feasible in low-resource and middle-resource Asian setting and increased coverage for genetic testing., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

A total of 1,661 pregnant women aged between 13 and 45 years were screened for bacteriuria by urine culture. Of the 1,661 culture results, 615 (37%) yielded no growth; 728 (43.8%) yielded no significant growth (presence of <10(5) organisms/ml urine of one or more types of bacteria); 286 (17.2%) yielded mixed growth (presence of >10(5) organisms/ml urine of more than one type of bacteria) and only 32 (1.9%) showed significant growth (presence of >10(5) organisms/ml urine of a single bacterium). Urine microscopy was also conducted. Two hundred and twenty-four (13.5%) specimens had >10 white blood cells/ml urine, of which 66 had >100 white blood cells; 13 were from the significant growth group. Three hundred and seventy-four (22.5%) specimens showed the presence of bacteria, 42 (2.5%) had red blood cells, 370 (22.3%) had epithelial cells, 58 (3.5%) had crystals, and 14 (0.8%) had yeasts. The most common bacterium isolated was Escherichia coli (12; 40%); the others included group B Streptococcus (5; 15%), Klebsiella spp (5; 15%), Diphtheroids (2), and Candida albicans (2). Fifty-two percent of tested strains were sensitive to ampicillin; 24 of 28 strains (85.7%) were sensitive to ciprofloxacin; all 7 strains tested were sensitive to nitrofurantoin and all 20 strains tested were sensitive to cotrimoxazole; 14/20 (70%) and 16/17 (94.1%) were sensitive to cephalexin and cefuroxime respectively. This study shows that asymptomatic bacteriuria does occur in pregnant women, albeit at a very low rate in an urban setting like Cheras. Urine microscopy is not specific and only serves as a guide to bacteriuria. The commonest causative organisms are those from the gastrointestinal tract and vagina. The antibiogram showed that cefuroxime and cephalexin are likely to be effective in treating bacteriuria: ampicillin must be reserved for Gram-negative organisms. For Gram-positive organisms, of which Group B Streptococcus is important, ampicillin is still effective in vitro. Nitrofurantion and cotrimoxazole have excellent activity in vitro and should be considered for therapy. 17.2% of the urine culture yielded mixed growth: likely to indicate that contamination of urine specimens still happens despite the strict instructions given to patients about the collection of a midstream urine specimen. Proper collection, appropriate transport, and the early processing of urine specimens remain essential.