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Improving the learning process requires to improve the cognitive traits of individuals with low mental skills. The artificial intelligence (AI) has been used to support the different individuals with impairments. People with Down syndrome fall in intellectual impairment. Different AI techniques of convolution neural network, artificial neural network and decision tree are widely applied to address the different cognitive traits. We have summarized the artificial intelligence review utilized for such individuals. The aim of this research article is investigate the usability of computational intelligence for addressing the deficits of cognitive skills and other traits. The individuals with cognitive impairment survive with limited mental challenge, therefore, they hardly perform daily life assignments. The individuals with down syndrome face mild to severe cognitive challenges that affects to their daily life activities, education and performing employment. So, they can have reduced the social and economic burden of their family and to make their live productive. Achieving these goals requires improvement in their cognitive challenge. A survey of (N = 50) of the individuals of Down syndrome has been carried out with the support of team of psychologists and teachers of homogeneous education system.

ObjectivesTo evaluate the difference between female and male sports medicine physicians regarding disrespectful attitudes and sexual harassment perceived from athletes, coaches, physicians, athletic trainers (ATs) and organisations/administrations.Methods and study designanonymous survey was distributed to sports medicine physicians practicing in 51 countries. χ2analysis was used to detect differences between female and male sports medicine physicians and logistic regression analysis was used to determine the independent variables that affect disrespectful attitudes and sexual harassment from sports participants.Results1193 sports medicine physicians (31.9% female) participated from 51 countries. The survey revealed that female physicians, compared with male physicians, perceive significantly more disrespect or have their judgement questioned more by the following categories: male and female athletes, male and female coaches, female physicians with more years of experience, male physicians (regardless of years of experience), male and female ATs and organisation/administrations (all pConclusionsFemale sports medicine physicians around the world experience disrespectful attitudes, questioning of their judgement and are sexually harassed significantly more often than male counterparts.

For a graph G, we define a total k-labeling ϕ as a combination of an edge labeling ϕe(x) → {1, 2, . . . , ke} and a vertex labeling ϕv(x) → {0, 2, . . . , 2kv}, such that ϕ(x) = ϕv(x) if x ∈ V (G) and ϕ(x) = ϕe(x) if x ∈ E(G), where k = max {ke, 2kv}. The total k-labeling ϕ is called an edge irregular reflexive k-labeling of G, if for every two edges xy, x0y0of G, one has wt(xy) 6=wt(x0y0), where wt(xy) = ϕv(x) + ϕe(xy) + ϕv(y). The smallest value of k for which such labeling exists is called a reflexive edge strength of G. In this paper, we study the edge irregular reflexive labeling on plane graphs and determine its reflexive edge strength.

The Indus Suture Zone preserves the ophiolitic remnants of the eastern part of the Neo-Tethys Ocean. Parts of these ophiolitic remnants are exposed along the Khangral-Chiktan and Dras-Kargil road sections of western Ladakh. The observed rock types include ultramafic-mafic cumulates, gabbros, and volcanics emplaced as faulted blocks over the Mesozoic Dras arc complex. Geochemically, these rocks show sub-alkaline tholeiitic characteristics with basalt to basaltic-andesite compositional variation. Based on modal mineralogy, the ultramafic cumulates classify as olivine-websterite, the mafic cumulates as olivine-norite, and the gabbros as norite to hornblende-gabbro. The ultramafic cumulates depict depleted chondrite normalized REE patterns [(La/Yb)N = 0.6–1.1] while the mafic cumulates display depleted to enriched REE patterns [(La/Yb)N = 0.6–3.2]. Fractionated patterns are observed in gabbros [(La/Yb)N = 1.6–4.1], while flat and enriched chondrite normalized REE-patterns in volcanics [(La/Yb)N = 1.0–12.3] similar to NMORB, and EMORB. The multi-element patterns depict subduction-related geochemical characteristics such as enriched LILE and depleted HFSE compared to the primitive mantle. Presence of Mg-rich olivines, orthopyroxenes, and clinopyroxenes while Ti-poor clinopyroxenes in ultramafic-mafic cumulates reflect their derivation from previously depleted mantle sources at high-pressure and temperature comparable to the base of modern intra-oceanic island arc tholeiitic sequences. The studied rocks exhibit close similarity to an intra-oceanic subduction system contemporaneous to the Dras-Shergol-Suru-Thasgam ophiolitic slices of western Ladakh.

Supporting female sports medicine physicians to simultaneously be mothers and pursue professional careers is crucial to maintain gender diversity in sports medicine physicians. The purpose of this study is to understand the attitudes toward female sports medicine physicians during pregnancy and postpartum.An anonymous online survey was distributed to sports medicine physicians practicing in 51 different countries. They were asked how comfortable they felt with female sports medicine physicians working on the sidelines of sporting events during pregnancy, if the female sports medicine physicians were as productive as their male counterparts after giving birth, and how satisfied they were with the percentage of female sports medicine physicians in their country. Data were analyzed using the chi-square test, and multivariate logistic regression analysis was performed to identify independent variables.In total, 1193 physicians (380 [31.9%] female) were included for analysis. Physicians in Asia were the least comfortable with pregnant sports medicine physicians working on the sidelines and those in North America were the most comfortable (odds ratio = 0.28 and 2.51, 95% confidence interval 0.18-0.44 and 1.55-4.06, respectively). More experienced sports medicine physicians (odds ratio = 1.01, 95% confidence interval 1.00-1.03; p 0.05) and divorced physicians (odds ratio = 0.33, 95% confidence interval 0.12-0.91; p 0.05) were less comfortable with pregnant female sports medicine physicians working on sidelines, and those trained in orthopedics were less likely to agree that female sports medicine physicians were equally as productive as male counterparts postpartum (odds ratio = 0.29, 95% confidence interval 0.10-0.88; p 0.05). Female physicians were less satisfied with the percentage of female sports medicine physicians in their country (odds ratio = 0.41, 95% confidence interval 0.27-0.60; p 0.01) than their male counterparts.Female sports medicine physicians may experience bias in their practice during pregnancy and postpartum.

Background: FTY720 (Fingolimod) is a drug having immune-regulatory properties. It is a structurally analogous to Sphingosine-1-phosphate. S1P is a biologically active lipid mediator in various inflammatory pathways. Aim: To investigate the effects of FTY720 on myocardial ischemia reperfusion (IR) injury in cardiac surgery. Study design: Experimental study Place and duration of study: Aga Khan University, Karachi and Khyber Medical University, Peshawar Pakistan from 1st January 2017 to 31st December 2020 with collaboration of University of Verona, Italy. Methodology: Twenty Sprague-Dawley rats were segregated into two groups; treatment and control. In treatment group received FTY720 at 1 mg/kg, intravenously 15 minutes prior to the experiment. Both groups were exposed to myocardial ischemia (30 m) reperfusion (2 h). Blood gas analysis, lymphocyte count, myeloperoxidase assay and TUNEL assay were performed and analyzed to observe the effect of FTY720 on neutrophil infiltration and apoptosis. Results: FTY720 treated group had improvement in blood gas levels in contrast to the control, treatment group also experienced decrease in neutrophil infiltration, lymphocyte count and myeloperoxidase enzyme expression. Conclusions: FTY720 pre-treatment reduce lymphocyte count that leads to reduce the level of apoptosis and salvage the myocardial damage incurred by ischemia reperfusion. Keywords: Fingolimod, Cardiopulmonary bypass, Lymphocyte, Neutrophil, Myeloperoxidase

Due to its scale, the complexity of its products and manufacturing processes, and the capital-intensive nature of the semiconductor business, efficient product architecture design integrated with supply chain planning is critical to Intel’s success. In response to an exponential increase in complexities, Intel has used advanced analytics to develop an innovative capability that spans product architecture design through supply chain planning with the dual goals of maximizing revenue and minimizing costs. Our approach integrates the generation and optimization of product design alternatives using genetic algorithms and device physics simulation with large-scale supply chain planning using problem decomposition and mixed-integer programming. This corporate-wide capability is fast and effective, enabling analysis of many more business scenarios in much less time than previous solutions, while providing superior results, including faster response time to customers. Implementation of this capability over the majority of Intel’s product portfolio has increased annual revenue by an average of $1.9 billion and reduced annual costs by $1.5 billion, for a total benefit of $25.4 billion since 2009, while also contributing to Intel’s sustainability efforts.

The diagnosis of a potentially lethal cardiovascular disease in a young athlete presents a complex dilemma regarding athlete safety, patient autonomy, team or institutional risk tolerance and medical decision-making. Consensus cardiology recommendations previously supported the ‘blanket’ disqualification of athletes with hypertrophic cardiomyopathy (HCM) from competitive sport. More recently, epidemiological studies examining the relative contribution of HCM as a cause of sudden cardiac death (SCD) in young athletes and reports from small cohorts of older athletes with HCM that continue to exercise have fueled debate whether it is safe to play with HCM. Shared decision-making is endorsed within the sports cardiology community in which athletes can make an informed decision about treatment options and potentially elect to continue competitive sports participation. This review critically examines the available evidence relevant to sports eligibility decisions in young athletes diagnosed with HCM. Histopathologically, HCM presents an unstable myocardial substrate that is vulnerable to ventricular tachyarrhythmias during exercise. Studies support that young age and intense competitive sports are risk factors for SCD in patients with HCM. We provide an estimate of annual mortality based on our understanding of disease prevalence and the incidence of HCM-related SCD in different athlete populations. Adolescent and young adult male athletes and athletes participating in a higher risk sport such as basketball, soccer and American football exhibit a greater risk. This review explores the potential harms and benefits of sports disqualification in athletes with HCM and details the challenges and limitations of shared decision-making when all parties may not agree.

The role of the sports medicine physician has been challenged in several ways during the COVID-19 pandemic, potentially eroding a sense of well-being. Four universal human needs related to flourishing and a sense of life satisfaction are the framework we use to examine the effects of a pandemic on sports medicine clinicians. We offer two evidence-based practices to promote well-being and resilience within each of the four universal needs.

Banana is an important fruit crop in the tropics and subtropics; however, limited information on biomarkers and signature volatiles is available for selecting commercial cultivars. Clonal fidelity is a major contributor to banana yield and aroma; however, there are no useful biomarkers available to validate clonal fidelity. In this study, we performed the molecular profiling of 20 banana cultivars consisting of diploid (AA or AB) and triploid (AAA or AAB or ABB) genomic groups. We screened 200 molecular markers, of which 34 markers (11 RAPD, 11 ISSR, and 12 SSR) yielded unequivocally scorable biomarker profiles. About 75, 69, and 24 allelic loci per marker were detected for RAPD, ISSR, and SSR markers, respectively. The statistical analysis of molecular variance (AMOVA) exhibited a high genetic difference of 77% with a significant FST value of 0.23 (p

Background: Sickle cell trait (SCT) has been associated with an increased risk of sudden death in athletes during strenuous exercise. In August 2010, the National Collegiate Athletic Association (NCAA) began requiring athletes to be screened for SCT, provide proof of SCT status, or sign a waiver and launched an educational campaign for athletes, coaches, and medical staff. The impact of this program is unknown. The purpose of this study was to determine the incidence of death associated with sickle cell trait (daSCT) in NCAA athletes before and after legislation. Hypothesis: NCAA SCT legislation will decrease the incidence of daSCT. Study Design: Observational study. Level of Evidence: Level 2. Methods: A database of NCAA athlete deaths from 2000 to 2019 was reviewed for daSCT. A total of 8,309,050 athlete-years (AY) were included. Incidence of death was calculated before and after legislation. Results: The incidence of daSCT in Division I (DI) football athletes before legislation (n = 9) was 1:28,145 AY and after legislation (n = 1) was 1:250,468 AY (relative risk [RR], 0.112; 95% CI, 0.003-0.811; P = 0.022), an 89% reduction in risk after legislation was enacted. The incidence of daSCT in African American DI football athletes before legislation (n = 9) was 1:12,519 AY and after legislation (n = 1) was 1:118,464 AY (RR, 0.106; 95% CI, 0.002-0.763; P = 0.017), also an 89% risk reduction after legislation was enacted. For all NCAA athletes, the incidence of daSCT was 1:489,749 AY before legislation (n = 10) and 1:1,705,780 AY after legislation (n = 2) (RR, 0.288; 95% CI, 0.031-1.347; P = 0.146). Conclusion: The incidence of daSCT in DI football athletes has decreased significantly since legislation was enacted. Cases of daSCT outside of football are rare. It is unclear whether the decrease is related to screening for SCT, education, or both. Clinical Relevance: This is the first evidence that NCAA SCT legislation may save lives.

Assessing physical activity is an opportunity to encourage lifestyle-based tactics for reducing cardiovascular risk. These handy tables serve as practical guides.

Background and Objectives: Despite the prevalence of published opinions about the use of professional academic writers to help disseminate the results of clinical research, particularly opinions about the use of ghost writers, very little information has been published on the possible roles for professional writers within academic medical departments or the mechanisms by which these departments can hire and compensate such writers. To begin addressing this lack of information, the Association of Departments of Family Medicine hosted an online discussion and a subsequent webinar in which we obtained input from three departments of family medicine in the United States regarding their use of academic writers. This discussion revealed three basic models by which academic writers have benefitted these departments: (1) grant writing support, (2) research and academic support for clinical faculty, and (3) departmental communication support. Drawing on specific examples from these institutions, the purpose of this paper is to describe the key support activities, advantages, disadvantages, and funding opportunities for each model for other departments to consider and adapt.

Heterojunction of molybdenum oxide with silicon is used as an effective hole collector in Si based carrier selective solar cells. Although the deposition of MoOX on Si is a low temperature process, the subsequent processes involved in the fabrication of the solar cell can impact the hole collection efficiency of Si/MoOX junction. In this manuscript we address the influence of post-deposition fabrication processes the subsequent processes involved in the fabrication of the solar cell can impact the hole collection efficiency of Si/MoOX junction. In this work we have found that the necessary annealing and sputtering steps have a degrading impact on the heterojunction. The underlying reasons are identified and widely described. Furthermore, to gain insight into the unique transport mechanism of heterojunction, a quantitative band diagram is obtained based on the empirical data (electron spectroscopy, optical and electrical measurements). The workfunction of thermally evaporated MoOX is found to be strongly substrate dependent and the electron affinity is deduced and measured to be 5.09 eV. The doping of MoOX films due to oxygen vacancies is found to be non-uniform as the oxygen content of the film decreases rapidly, from MoOX surface to Si/MoOX interface. Lastly, we report Si/MoOX heterojunction solar cells with high short circuit current of 33.9 mA/cm2, an open circuit voltage (VOC) of 585 mV, and an efficiency of 12.8%.

Although a number of studies have been conducted on the environmental Kuznets curve (EKC) and the pollution halo hypothesis (PHH), few researchers have assessed the scope in the light of the BRICS— Brazil, Russia, India, China, and South Africa—nations. Therefore, the current research assesses the income-induced EKC as well as the role of technological innovation and renewable energy consumption utilizing a dataset stretching from 1990 to 2018. The present research utilized the novel method of moments quantile regression (MMQR) developed by Machado and Silva (2019) to assess these interrelationships. The empirical outcomes from the MMQR affirmed an inverted U-shaped interrelationship between CO2 emissions and economic growth across all quantiles (first to ninth) for the BRICS nations, thus confirming the presence of the EKC hypothesis. Furthermore, we affirmed the PHH, thus confirming the negative interrelationship between globalization and ecological footprint across all quantiles (first to ninth). Moreover, it was found that renewable energy use plays a vital role in curbing the emissions of CO2 across all quantiles (first to ninth), while no evidence of significant connection was established between technological innovation and ecological footprint across all quantiles. In addition, the Granger causality outcomes revealed a feedback causality between income and ecological footprint, while a unidirectional causality was established from globalization and renewable energy use to ecological footprint. Copyright © 2021 Dingru, Ramzan, Irfan, Gülmez, Isik, Adebayo and Husam.

Introduction: The benefits of physical activity (PA) are widely recognized; American medical schools have begun to emphasize PA, but the effectiveness of these changes is unclear. Methods: We performed a cross-sectional analysis of medical students enrolled in US osteopathic and allopathic medical schools between August 2019 and May 2020. All participants completed an electronic survey about PA instruction across the 4 years of medical school. Objective information including hours and format of PA instruction was collected. Subjectively, participants reported their relative comfort discussing various aspects of PA education with patients. Results: A total of 480 medical students completed the survey, representing 82 of the 192 US medical schools (69 allopathic, 13 osteopathic). Students are more comfortable discussing overall exercise benefits than exercise testing, exercise prescription, and exercise physiology (P

The wide disparity in coronavirus disease (COVID-19)-related death rates based upon the ethnic origin is well established by now. The higher incidence of COVID-19 deaths amongst the healthcare staff belonging to black and minority ethnic (BAME) communities living in the United Kingdom has generated a great deal of concern and anxiety in clinicians. Public Health England (PHE) has outlined mitigation strategies after immense pressure from professional organisations and influential clinical leaders. Although seemingly well thought through, these measures fall short of addressing the professional, moral and emotional dilemma faced by the BAME clinicians who feel that they are being expected to choose between their duty towards their patients and the profession, and their responsibility to look after their own health.

Background: The physical activity vital sign (PAVS) is a simple, validated tool for assessing physical activity in adults that has not been previously studied in pediatrics. Hypothesis: Reported physical activity utilizing the PAVS in pediatric patients should vary according to known associations with physical activity, such as age, sex, blood pressure, and body mass index (BMI). Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: All patients within a family medicine residency clinic were assessed via the PAVS from October 1, 2015, to October 31, 2016, including 255 consecutive pediatric patients aged 5 to 18 years. Associations were examined between PAVS, age, sex, blood pressure, and BMI using 1-way analysis of variance. Results: The average PAVS reported for youth (5-11 years) was 384.9 ± 218.1 minutes per week, with 69.5% reporting sufficient physical activity (≥300 minutes per week). Adolescents (12-18 years) reported a mean PAVS of 278.3 ± 199.6 minutes per week, with 51.1% reporting sufficient physical activity. Physical activity was lower in older participants ( P < 0.0001) and was higher in male patients ( P < 0.03). Higher BMI was associated with lower PAVS ( P < 0.005), while lower systolic blood pressure was associated with a greater number of days per week of physical activity ( P < 0.005). Conclusion: The PAVS successfully identifies accepted associations between age, sex, and BMI in a pediatric population. Clinical Relevance: The correlation of the PAVS with age, sex, BMI, and blood pressure may inform future strategies to address and prevent cardiometabolic disease in pediatric patients.

Context: Viscosupplementation is widely used for management of knee osteoarthritis. Many formulations of hyaluronic acid (HA) are available, ranging from a single injection to a series of up to 5 injections per treatment. Objective: To compare efficacy between single and multiple HA injection formulations. Data Sources: MEDLINE, EMBASE, Cochrane, Web of Science, Scopus databases were all searched. Study Selection: Full-text prospective randomized and nonrandomized controlled human trials, cohort studies, and cost-effectiveness evaluations in the English language comparing different injection regimens of viscosupplementation were included. Study Design: Systematic review. Level of Evidence: Level 1. Data Extraction: Data were collected using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Four databases were searched by a librarian and the principal investigator, identifying 6196 articles for screening. Results: Eleven studies met the inclusion criteria. Of the studies comparing single- with multiple-injection formulations of HA for treatment of knee osteoarthritis, there was no consistent difference in patient-reported outcomes. Furthermore, 5-injection formulations do not appear to be superior to 3-injection formulations. Conclusion: There are limited head-to-head trials comparing viscosupplementation formulations that differ based on number of injections, and in particular, there is a paucity of trials evaluating single-injection formulations. Based on the currently available data, there appears to be similar efficacy with the possibility for greater cost-effectiveness and less patient inconvenience with single-injection formulations.

Background and Objectives: Clinic First residency curricular approaches hold promise as models to successfully prepare primary care residents for future practice. The objective of our study was to estimate the prevalence of the Clinic First model in current family medicine residency training environments, and assess beliefs surrounding curricular structure and postgraduate practice. Methods: An eight-question survey was conducted among Association of Family Medicine Residency Directors (AFMRD) members in 2017. Data were grouped and analyzed for statistical significance and correlation using analysis of variance, Kendall’s τ, χ2, and Fisher exact test. Results: Two hundred-eleven AFMRD members responded to the survey; 27% described their current curriculum as Clinic First; 68% stated that their ideal curriculum is Clinic First. Residents in Clinic First programs spend more half-days in continuity clinic per week compared with traditional programs during PGY1 (1.79, 1.39, P=0.001) and PGY2 (3.18, 2.90, P=0.024). In group analyses, 63% of Clinic First respondents prioritized clinic in developing resident schedules, compared with 8% of traditional respondents (P

Over the last half-century, radiation therapy has evolved to become one of the cornerstones of treatment for various types of cancers. It is estimated that more than 50% of patients with cancer are treated with radiotherapy. Patients with early stages of some cancers can even achieve a cure with radiotherapy alone. Radiation-induced heart disease is a well-recognized cause of mortality and morbidity in cancer survivors as a late complication of radiotherapy, often occurring more than a decade after radiotherapy. We describe a case of a middle-aged female who presented to the hospital with syncopal episodes. She was in remission from non-Hodgkin's lymphoma having received mediastinal radiotherapy 20 years, previously. Her initial workup such as laboratory investigations and 12 lead electrocardiogram were largely unremarkable. Cardiac monitoring over the course of the next few days was consistent with complete heart block with evidence of ventricular standstill. Her symptoms resolved following the implantation of a dual-chamber cardiac pacemaker. This case highlights the significance of clinical history taking and putting together all relevant facts to come to a differential diagnosis. In our case, this could have been easily overlooked as radiation therapy was given many years previously. We review and present an up-to-date albeit brief literature review on long-term cardiovascular complications of radiotherapy. Radiation-induced cardiac complications are an important cause of mortality and morbidity in cancer survivors. This article aims to raise awareness amongst clinicians of cardiac adverse effects occurring several years after the radiation therapy. This case also highlights the need for further research to better understand the pathophysiology of cardiovascular disease post-radiotherapy in order to develop effective prevention strategies and improve clinical outcomes.

Background: Seeking complementary and alternative medicine (CAM) remains one of the common approaches in dealing with health-related issues among the patients in India. Its use has also been identified by oncologists as one of the potential reasons for the delay in seeking medical attention, however, limited research in this field of oncology makes it challenging to verify such assumptions. This study aims to understand the interaction of psycho-social variables with use, prevalence and pattern of complementary and alternative medicines (CAM) among Indian cancer patients. Methodology: A qualitative descriptive design was adopted for the study. Using a purposive sampling method, patients (N=303, M: 146 & F: 157) who were undergoing cancer treatment in Rajiv Gandhi Cancer Hospital and Research Center, New Delhi, India; aged between 15 to 88 years were included. An in-depth interview was carried out using a structured interview schedule which was recorded. Patients were also screened using Distress Thermometer (DT) developed by NCCN. The interviews were transcribed and analyzed. Results: Out of 104 participants who responded positively on taking CAM therapies, (61%) had taken these therapies alternatively, before coming to the hospital for conventional treatment and (39%) were still taking these therapies in complimentary manner. Ayurveda was the most preferred form of therapy chosen by (85%) for both groups. Significant psychological distress was found in (79%) of all patients and women tend to have slightly higher distress then men. Awareness of cancer diagnosis and its prognosis was found to relieve psychological distress, on the other hand highly distressed patients were found to opt for CAM therapies more than their counterparts. Top influencing factors for taking CAM therapies were ads on radio, TV, the Internet and Newspaper (44%), suggestions from family and relatives (31%) and suggestions by fellow patients (19%). Although, majority (81%) of the patients felt that there were no side effects associated with CAM therapies, however surprisingly enough, less than half of them (40%) were satisfied with such therapies and moreover the use of such therapies is completely shielded from treating oncologists by almost all of them and oncologists on their part never enquire about CAM with their patients. Conclusion: Ayurveda remains the most popular form of alternative therapy among cancer patients in India and is taken before, during and after conventional cancer treatment. Majority of cancer patients in India face significant psychological distress, requiring professional interventions and also highly distressed patients tend to take CAM therapies as compared to their counterparts. Nearly half of the Indian patients are influenced by media for its popularity and half of them are either influenced by family and relatives or by suggestions from fellow patients. Although majority of the patients believe that there are no side effects of alternative medicines and however majority of them feel completely dis-satisfied with such therapies; moreover, no patient-doctor communication exists for the moment, in oncology setup, when it comes to CAM therapies. Funding Statement: None to declare. Declaration of Interests: None to declare. Ethics Approval Statement: The Institutional board of Rajiv Gandhi Cancer Institute and Research Centre approved this study.

Actinidia arguta (Sieb. et Zucc.) Planch. ex Miq. is abundant of vitamin C and bioactive compounds with high antioxidant activities. In this study, eight wild A. arguta accessions from different areas in Northeast China were collected. Some bioactive compounds were examined on the different tissues of different germplasms including four kinds of leaves, petioles and fruits. The method of UPLC-MS was used to detect the flavonoid compounds. The results showed that some bioactive compounds including vitamin C, soluble sugar, free amino acid, total phenolics and flavonoids content showed significant differences between six tissues of A. arguta accessions and showed significant variability with maturity. In eight accessions, the highest vitamin C content was found in young apical leaves of ‘CBS-6’ (7.47 mg/g fresh weight), and the highest soluble sugar content was in fruits of ‘CJ-1’ (196.52 mg/g fresh weight) and the highest total phenolic content and total flavonoids content were in young apical leaves of ‘CBS-11’ (3.48 mg/g fresh weight) and of ‘CBS-3’ (2.00 mg/g fresh weight), respectively. Ten flavonoid compounds including kaempferol, isorhamnetin and quercetin were detected in leaves, petioles and fruits. The total content of flavonoids were highest in young apical leaves (10219.84 µg·g-1) and the lowest in fruits (78.75 µg·g-1). Based on the comparison of the contents of several bioactive compounds, the two accessions ‘CJ-1’ and ‘CBS-8’ had relatively outstanding performance, and in the comprehensive evaluation of the antioxidant activity among different tissues, the young leaves had the strongest antioxidant activity. These results highlighted the antioxidant potentialities of A. arguta leaves as a major source of phenolics and vitamin C as well as flavonoids. It provided a theoretical basis for the utilization of leaves of A. arguta.

The role of the sports medicine physician has been challenged in several ways during the COVID-19 pandemic, potentially eroding a sense of well-being. Four universal human needs related to flourishing and a sense of life satisfaction are the framework we use to examine the effects of a pandemic on sports medicine clinicians. We offer two evidence-based practices to promote well-being and resilience within each of the four universal needs.

Penelitian ini bertujuan untuk mengembangkan media meja lompat pada latihan handspring. Populasi dalam penelitian ini adalah 15 orang atlet senam junior sumatera utara. Pengembangan media yang telah dibuat terlebih dahulu divalidasi oleh 2 orang ahli, 1 ahli materi dan 1 ahli media/alat, dimana persentase validitasnya adalah 86.66%-92.5%. Metode yang digunakan adalah metode penelitian pengembangan (Research and Development/R&D). Hasil uji coba skala kecil melibatkan 5 orang atlet senam junior sumatera menunjukkan bahwa media modifikasi meja lompat memenuhi kriteria untuk dilanjutkan dalam uji coba skala besar karena persentase skor dari setiap aspek antara 95%-98.75%. Hasil Uji coba skala besar terhadap 10 orang atlet senam junior sumatera utara bahwa media modifikasi meja lompat sudah memenuhi kriteria untuk melanjutkan dalam pembuatan produk massal karena persentase dari setiap aspek antara 90%-95.%. Dapat disimpulkan bahwa media meja lompat ini sangat dibutuhkan untuk menjadikan latihan handspring lebih efektif dan efisien, karena hal tersebut sangat penting dalam menunjang prestasi atlet, selain itu agar latihan tersebut tidak membosankan serta jadi bahan masukan kepada para pelatih senam di seluruh Indonesia.Kata Kunci: Pengembangan, meja lompat, handspring, senam

Penelitian ini bertujuan untuk mengetahui latihan manakah yang lebih berpengaruh antara latihan Curving Line Trajectory dan latihan Zig – zag Line Trajectory, terhadap Peningkatan Kemampuan Menggiring Bola. Metode yang digunakan penelitian yang digunakan dalam penelitian ini adalah metode exsperiment, dengan pelaksanaan latihan yaitu Curving Line Trajectory dan latihan Zig – zag Line Trajectory. Penelitian dilaksanakan pada bulan januari-februari 2015. Subyek penelitian adalah siswa SSB Karisma medan yang berjumlah 20 orang. Analisis hipotesis I, sebesar 6,05 serta 1,83 dengan α = 0,05 ( > ) berarti diterima. Dengan kesimpulan, latihan Curving Line Trajectory secara signifikan berpengaruh terhadap peningkatan kemampuan menggiring bola. Analisis hipotesis II, diperoleh sebesar 11,23 serta sebesar 1,83 dengan α = 0,05 ( > ) berarti diterima. Jadi, latihan Zig – zag Line Trajectory secara signifikan berpengaruh terhadap peningkatan kemampuan menggiring bola. Analisis hipotesis III, diperoleh sebesar 0,52 serta 1,73 dengan α = 0,05 ( < ) berarti diterima dan ditolak. Jadi, latihan Curving Line Trajectory tidak lebih besar pengaruhnya daripada latihan Zig – zag Line Trajectory terhadap peningkatan kemampuan menggiring bola dalam permainan Sepakbola Pada SSB KARISMA Usia 14- 15 Tahun 2013 Medan. Jadi, untuk membuktikan latihan Curving Line Trajectory tidak lebih besar pengaruhnya daripada latihan Zig – zag Line Trajectory dibuktikan dengan beda rata-rata sebesar 1,15 dengan 1,02. Kata Kunci: Curving line trajectory, zig – zag line trajectory, menggiring bola

Kawasaki disease (KD) was first reported by Dr. Tomisaku Kawasaki in 1967 and is classified as an autoimmune vasculitis of small- and medium-sized arteries. It is usually a self-limited condition occurring in childhood, but it can have complications such as coronary artery aneurysms, myocardial ischemia, and arrhythmias with significant morbidity and mortality presenting later in life. We report a case of a KD presenting in adulthood with late cardiovascular sequelae managed with coronary artery bypass graft.

Training in the medical specialty of sport and exercise medicine (SEM) is available in many, but not all countries. In 2015, an independent Delphi group, the International Syllabus in Sport and Exercise Medicine Group (ISSEMG), was formed to create a basic syllabus for this medical specialty. The group provided the first part of this syllabus, by identifying 11 domains and a total of 80 general learning areas for the specialty, in December 2017. The next step in this process, and the aim of this paper was to determine the specific learning areas for each of the 80 general learning areas. A group of 26 physicians with a range of primary medical specialty qualifications including, Sport and Exercise Medicine, Family Medicine, Internal Medicine, Cardiology, Rheumatology and Anaesthetics were invited to participate in a multiple round online Delphi study to develop specific learning areas for each of the previously published general learning areas. All invitees have extensive clinical experience in the broader sports medicine field, and in one or more components of sports medicine governance at national and/or international level. SEM, Family Medicine, Internal Medicine, Cardiology, Rheumatology and Anaesthetics were invited to participate in a multiple round online Delphi study to develop specific learning areas for each of the previously published general learning areas. All invitees have extensive clinical experience in the broader sports medicine field, and in one or more components of sports medicine governance at national and/or international level. The hierarchical syllabus developed by the ISSEMG provides a useful resource in the planning, development and delivery of specialist training programmes in the medical specialty of SEM.

OBJECTIVE To determine the association between the physical activity vital sign (PAVS) and markers of cardiometabolic disease. DESIGN Patients were assessed through the PAVS, a validated tool self-reporting the frequency and duration of physical activity. Patients were categorized into 3 groups: inactive (0 minutes per week), underactive (1-149 minutes per week), and active (>150 minutes per week). Associations were tested between the PAVS and the cardiometabolic disease biomarkers of body mass index, hemoglobin A1c (A1c), blood pressure, and low-density lipoprotein (LDL) using one-way analyses of variance. SETTING High-risk family medicine residency clinic. PARTICIPANTS Two thousand three hundred twenty-one adult patients (age ≥ 18 years). RESULTS Participants reported a mean of 97.87 (SD = 149.35) minutes per week of exercise. Overall, 50.1% reported physical inactivity, 25.7% were underactive, and 24.3% were active. Younger individuals (P < 0.001) and men (P < 0.05) reported more physical activity than older individuals and women. Patients who reported being active were significantly less likely to be overweight (P < 0.05), obese (P < 0.05), or hypertensive (P < 0.05), but there was no association with A1c or LDL levels. CONCLUSIONS This is the first investigation to examine the PAVS in a high-risk population. In these patients, reported levels of physical inactivity are 150% higher than other clinical settings, and the PAVS is only associated with improvements in 2 of 4 major cardiometabolic risk factors. For this group, self-reported levels of physical activity may need to be higher for cardiovascular benefits to be realized in all 4 cardiometabolic domains. The PAVS offers health professionals an opportunity to encourage lifestyle-based interventions to reduce cardiovascular risk, but refinements may be necessary to address this population.

Mental health complaints present a significant burden to the healthcare system. In the United States, roughly 20% of adults experience a mental health disorder each year. Long-term adherence to traditional pharmacologic and psychiatric therapies is poor; the time commitment, cost, and pharmacologic side effects of therapy can be substantial. Physical activity as an alternative or adjuvant strategy to promote mental health and treat mental illness shows comparable outcomes in depression and anxiety treatment, without negative side effects.

This study explores the deposition and post-deposition treatment of TiO2 films in the context of using those films as electron selecting layers in diffusion-free solar cells. The passivation provided by TiO2 films is known to improve after annealing. Therefore, the effect of annealing on electrical performance of the films is analyzed in this study. The study reveals that annealing may lead to a formation of thin interfacial silicon oxide which may impede the transport of electrons to the desired contact. It is also noted that annealing does not contribute significantly to lowering of reverse saturation current, and the ideality factor values also remain the same. Interestingly, while annealing improves the lifetime, the same is not reflected in electrical behavior of diodes. A plausible explanation of this behavior is given on the basis of numerical modeling of the fabricated device. Finally using the as-deposited TiO2 film as electron collecting contact and MoO3 as a hole quencher, solar cells are fabricated with an efficiency of 5.52%.

Tujuan penelitian ini adalah menghasilkan model dan layanan wisata pendidikan Olahraga tradisional untuk siswa sekolah dasar sebagai sport industry di lingkungan Universitas Negeri Medan sebagai produk Badan Layanan Umum. Perkembangan wisata pendidikan di lingkungan Universitas Negeri Medan adalah dengan wahana bermain dan pendirian galeri olahraga tradisional sebagai langkah penyeimbang teknologi dengan pencegahan kepunahan olahraga tradisional dengan konsep penyelematan dan menginventarisir olahraga-olahraga tradisional. Metode yang akan digunakan adalah metode research and development (R&D) desain Redesign Design. Kajian prosedur pengembangan metode Richey and Klein yang digunakan adalah level 3 yaitu meneliti dan menguji untuk mengembangkan produk melalui teknik pengumpulan data dilakukan dengan menggunakan pengamatan, wawancara, dan instrumen. Keabsahan data penelitian ini dilakukan melalui triangulasi yaitu instrumen, pengamatan, dan wawancara untuk memperoleh kesesuaian data dan ketepatan hasil analisis. Hasil penelitian yang diperoleh produk model dan layanan wisata pendidikan berupa wahana bermain dan galeri olahraga tradisional di lingkungan Universitas Negeri Medan dengan tingkat kelayakan 82% dengan kategori baik. Kesimpulan adalah produk memiliki kelayakan yang baik untuk dikembangkan sebagai wisata edukasi pada tingkat Lembaga Pendidikan dan Tenaga Kependidikan sehingga menumbuhkan pengembangan pengetahuan dan pengelaman permainan rakyat dan olahraga tradisional.

Introduction: Renal biopsy is an integral part of clinical nephrology practice that helps in the diagnosis of various renal diseases. Across the globe, it is performed by nephrologists and/or surgeons under ultrasound guidance. Lately, this novel procedure has been performed more frequently by the interventional radiologist (IR) as compared to nephrologists and surgeons. Methods: We completed a retrospective review of 378 consecutive renal biopsies performed at our university hospital in the city center of Philadelphia, Pennsylvania, between September 2008 and June 2011 for various indications. Baseline characteristics were comparable except systolic blood pressure (SBP), prothrombin time (PT), and international normalized ratio (INR) which was higher. Hemoglobin was lower in patients who underwent biopsy by the IR compared to those who were biopsied by nephrologists and/or surgeons. Results: The primary outcome showed the average number of glomeruli obtained with each biopsy was significantly lower by nephrology or surgical teams, 9.09 ± 5.17 vs. 19.17 ± 11.11 obtained by the interventional radiology team, p-value

The P-wave terminal force in lead V1 (PTFV1) on the 12-lead electrocardiogram (ECG) quantifies left atrial (LA) structural and electrophysiologic abnormalities. We aimed to evaluate the association between PTFV1 and cerebrovascular accident (CVA) as well as LA structure and function in patients with atrial fibrillation (AF). We conducted a cross-sectional study of 229 patients with AF (60 ± 10years, 72% men) with (n = 21) and without (n = 208) a history of CVA, who underwent preablation ECG and cardiac magnetic resonance in sinus rhythm. PTFV1 was defined as the duration (in milliseconds) of the downward deflection of the P wave in lead V1 multiplied by the absolute value of its amplitude (in microvolts) on ECG. PTFV1 is associated with LA minimum volume (Vmin) and left ventricular ejection fraction but not associated with the extent of LA fibrosis quantified by cardiac magnetic resonance late gadolinium enhancement. In addition, PTFV1 is associated with CVA independent of the CHA2DS2-VASc score and LA Vmin (odds ratio 1.23; 95% confidence interval 1.08 to 1.40; p = 0.002). Furthermore, PTFV1 has an incremental value over the CHA2DS2-VASc score as a marker of CVA (p

ObjectiveThe IOC recommends periodic cardiovascular screening of athletes, but the adoption of these recommendations is unknown. The purpose of this investigation was to evaluate and compare cardiovascular screening practices of countries participating in the Rio 2016 Olympic Games.MethodsA list of chief medical officers (CMOs) was compiled by the IOC during the 2016 Olympic Games. CMOs were requested to complete an online survey about cardiovascular screening of their countries’ Olympic athletes. Comparisons of screening practices were made by categorising countries by continent, gross domestic product (GDP) per capita and size of athlete delegation.ResultsCMOs for 117/207 (56.5%) countries participating in the 2016 Olympic Games were identified. 94/117 countries (80.3%) completed the survey, representing 45.4% of all countries and 8805/11 358 (77.5%) of all 2016 Olympic athletes. Most of the countries surveyed (70.2%) perform annual cardiovascular screening. Among the survey respondents, all or most athletes from each country were screened at least once with the following components: personal history (86.2% of countries), family history (85.1%), physical examination (87.2%), resting ECG (74.5%), echocardiogram (31.9%) and stress test (30.8%). Athletes were more likely to be screened with ECG in countries with relatively larger athlete delegation (OR 2.05, 95% CI 1.10 to 3.80, p=0.023) and with higher GDP per capita (OR 1.69, 95% CI 1.11 to 2.57, p=0.014).ConclusionMost of the responding countries perform annual cardiovascular screening of Olympic athletes, but there are differences in the components used. Athletes from countries with larger athlete delegations and higher GDP per capita were more likely to be screened with ECG.

Measure Accurately, Act Rapidly, and Partner With Patients (MAP) is an evidence‐based protocol implemented to improve hypertension control in a clinic for underserved patients (49.9% Medicaid and 50.2% black). Patients with hypertension seen during the year before intervention and with at least one visit during the 6‐month intervention (N = 714) were included. If initial attended blood pressure (BP; standard aneroid manometer) was ≥140/≥90 mm Hg, unattended automated office BP was measured in triplicate and averaged (Measure Accurately) using an Omron HEM‐907XL. When automated office BP was ≥140/≥90 mm Hg, Act Rapidly included intensification of antihypertensive medications, assessed by therapeutic inertia. Partner With Patients included BP self‐monitoring, reducing pill burden, and minimizing medication costs, which was assessed by systolic BP change per therapeutic intensification. Between baseline and the last study visit, BP control to

Physical inactivity is one of the biggest public health threats of this century and greatly increases the risk of non-communicable diseases. This is especially true for our children and youth, where fallout from current pandemic lockdowns has disrupted access to physical activity and sport. Virtual classrooms translated into forfeited recess and free play while kids were thrown in front of computer screens and confined to a sedentary lifestyle. In large urban centres with many living in high rises, lockdowns on playgrounds and parks removed options for running or playing. Prior to the pandemic, physical inactivity was already a critical issue—a WHO survey of 1.6 million participants in 146 countries revealed that 81% of children and adolescents aged 11–17 were not active enough for optimal health.1 In response, WHO created the global action plan on physical activity, a call to action for policy change and effective implementation, where school-based policy initiatives are an essential component to create a more active society.2 In a recent …

The elliptic flow, v2, of muons from heavy-flavour hadron decays at forward rapidity (2.5 < y < 4) is measured in Pb–Pb collisions at √sNN = 2.76 TeV with the ALICE detector at the LHC. The scalar product, two- and four-particle Q cumulants and Lee–Yang zeros methods are used. The dependence of the v2 of muons from heavy-flavour hadron decays on the collision centrality, in the range 0–40%, and on transverse momentum, pT, is studied in the interval 3 < pT < 10 GeV/c. A positive v2 is observed with the scalar product and two-particle Q cumulants in semi-central collisions (10–20% and 20–40% centrality classes) for the pT interval from 3 to about 5 GeV/c with a significance larger than 3σ, based on the combination of statistical and systematic uncertainties. The v2 magnitude tends to decrease towards more central collisions and with increasing pT. It becomes compatible with zero in the interval 6 < pT < 10 GeV/c. The results are compared to models describing the interaction of heavy quarks and open heavy-flavour hadrons with the high-density medium formed in high-energy heavy-ion collisions.