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To identify the risk factors associated with all medical encounters (MEs) and serious/life-threatening MEs (SLMEs) during the Comrades Marathon. Prospective cohort study, with cross-sectional analyses. During the 2014–2019 Comrades Marathon, all MEs (including SLMEs) were recorded in 103,131 starters. For both all MEs and SLMEs, the following risk factors were explored: sex, age, route ("up" vs. "down" race), previous Comrades experience (yes/no), wet-blub globe temperature (WBGT) and race pace. Incidence (per 1000 starters; 95%CI), and the incidence ratio (IR; 95%CI) are presented. For all MEs, being female was a significant risk factor (females vs. males IR = 1.47, p < 0.0001), and age was only marginally significant (p = 0.0167). Therefore factors for all MEs were adjusted for sex. Other factors significantly associated with all MEs were: higher WBGT (highest WBGT compared to lowest, IR = 1.33, p = 0.0003), race pace (highest risk for those who finish either among the first quarter [IR = 1.49] or last quarter [IR = 1.46] compared to middle pace; p < 0.0001) and the route ("down" vs. "up": IR = 1.11; p = 0.0181). Factors associated with higher risk for SLMEs were: females (IR = 1.9; p = 0.0003), "down" vs. "up" route (IR = 1.37; p = 0.0306) and race pace (slower and faster runners vs. mid (6.4–7.1 min/km) race pace category (IR > 2.1, p < 0.0001)). Intrinsic (female, faster and slower race pace) and extrinsic (higher WBGT and the "down" route) are novel risk factors associated with all MEs at this event. These can be considered by the race organizers and the medical team to develop and implement prevention strategies. [ABSTRACT FROM AUTHOR]

• Total number of acute symptoms is the most significant factor associated with prolonged return to full performance after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in athletes. • Number of systemic symptoms is also strongly associated with prolonged return to full performance. • Females, endurance athletes, and those with a history of co-morbidities also experienced a prolonged return to full performance. The aim of the study was to identify factors associated with prolonged time to return to full performance (RTFP) in athletes with recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Prospective cohort study with cross sectional analysis. A total of 84 athletes with confirmed SARS-CoV-2 infection assessed at a coronavirus disease 2019 recovery clinic gave a history of age, sex, type/level of sport, co-morbidities, pre-infection training hours, and 26 acute SARS-CoV-2 symptoms from 3 categories ("nose and throat", "chest and neck", and "whole body"/systemic). Data on days to RTFP were obtained by structured interviews. Factors associated with RTFP were demographics, sport participation, history of co-morbidities, pre-infection training history, and acute symptoms (type, number). Outcomes were: (a) days to RTFP (median, interquartile range (IQR)) in asymptomatic (n = 7) and symptomatic athletes (n = 77), and (b) hazard ratios (HRs; 95% confidence interval) for symptomatic athletes with vs. without a factor (univariate, multiple models). HR < 1 was predictive of higher percentage chance of prolonged RTFP. Significance was p < 0.05. Days to RTFP were 30 days (IQR: 23–40) for asymptomatic and 64 days (IQR: 42–91) for symptomatic participants (p > 0.05). Factors associated with prolonged RTFP (univariate models) were: females (HR = 0.57; p = 0.014), endurance athletes (HR = 0.41; p < 0.0001), co-morbidity number (HR = 0.75; p = 0.001), and respiratory disease history (HR = 0.54; p = 0.026). In symptomatic athletes, prolonged RTFP (multiple models) was significantly associated with increased "chest and neck" (HR = 0.85; p = 0.017) and "nose and throat" (HR = 0.84; p = 0.013) symptoms, but the association was more profound between prolonged RFTP and increased total number of "all symptoms" (HR = 0.91; p = 0.001) and "whole body"/systemic (HR = 0.82; p = 0.007) symptoms. A larger number of total symptoms and specifically "whole body"/systemic symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged RTFP. [Display omitted] [ABSTRACT FROM AUTHOR]

• Mild to moderate stage Alzheimer's Disease patients are more prone to falls. • Both clinical balance test scores and posturograhic balance measures are lower in mild to moderate Alzheimer's Disease patients than healthy peers. • Early screening for balance and falls in mild to moderate Alzheimer's Disease patients is crucial. The aim of the study was to compare balance performance in mild-moderate stage Alzheimer's disease (AD) patients and healthy peers using clinical balance tests and computerized posturography. We recruited 95 patients and divided them into two groups; 51 patients (62 % (n=32) female) in AD group and 44 patients in healthy controls group (50 % (n=22) female). Berg Balance Scale (BBS) and Timed Up & Go (TUG) test were performed. Computerized posturography was performed. The mean age was 77.2±5.5 years in the AD group and 73.8±4.4 years in the control group (p<0.001). Sensory organization test composite equilibrium score (60[30-81], p<0.001), step quick turn-sway velocity (69.2 [38.2-95.8], p<0.001) and step quick turn-time (3.8 [1.6-8.4], p<0.001) were significantly impaired in mild-moderate stage AD patients. Berg Balance Scale (50 [32-56], p<0.001) and TUG test (13.0 [7.0-25.7], p<0.001) results were worse in AD. Computerized posturography measures were impaired in mild-moderate AD patients. The results highlight importance of early screening for balance and fall risk in AD patients. The study provides multi-dimensional and holistic assessment of balance performance in early-stage AD patients. Alzheimer's disease patients at earlier stages are prone to fall risk and should be evaluated accordingly. [ABSTRACT FROM AUTHOR]

Patellofemoral pain (PFP) is a common cycling-related injury, and independent factors need to be identified to enable effective injury prevention strategies. We aim to determine factors associated with PFP in cyclists entering mass community-based events. Cross-sectional study. 2016–2020 Cape Town Cycle Tour. Consenting race entrants. 62758 consenting race entrants completed a pre-race medical questionnaire, and 323 reported PFP. Selected factors associated with PFP (demographics, cycling experience and training, chronic disease history) were explored using multivariate analyses. Prevalence ratio (PR) of PFP was similar for sex and age groups. Independent factors associated with PFP (adjusted for sex and age) were history of chronic disease [Composite Chronic Disease Score (0-10)(PR = 2.0, p < 0.0001) and any allergies (PR = 2.0, p < 0.0001)]. A history of chronic diseases and allergies is associated with PFP in cyclists. Practical clinical recommendations are: 1) that prevention programs for PFP be considered when cycling is prescribed as a physical activity intervention for patients with chronic disease, and 2) that older cyclists presenting with PFP be assessed for the presence of risk factors or existing chronic disease. • A history of chronic diseases is associated with PFP in cyclists. • A history of allergies is associated with PFP in cyclists. • The prevalence of PFP was not significantly different by sex or age groups. • Training and racing variables were not associated with PFP (multivariate model). [ABSTRACT FROM AUTHOR]

The analysis is generally conducted in stationary receiver and transmitter models in a diffusion environment for the fundamental Molecular communication (MOC) models. However, a mobile MOC model is employed in this study, deviating from the existing literature. This mobile MOC model considers the mobility of all variables in the diffusion environment, including the transmitter, receiver, and molecules. Firstly, a novel MOC model is proposed, departing from the conventional normal distribution for the mobility of variables. Instead, alternative distribution functions such as the Pareto distribution, extreme value distribution, t -distribution, and generalized extreme value distribution are employed. Furthermore, the system's performance is enhanced by optimizing the distribution function and model parameters, such as the diffusion coefficient, using the optimization of optimization (OtoO) approach. In this approach, the Multi-Verse Optimization (MVO) algorithm serves as the primary algorithm, while the Grey Wolf Optimization (GWO) algorithm functions as the auxiliary algorithm. Essentially, the MVO algorithm optimizes the parameters of the MOC model, while simultaneously, the GWO algorithm optimizes the impact of the optimization processes of MVO on the parameters ''p'' and ''N'' as well as the constant parameter of the distribution function. By optimizing both the parameters of the MOC model and the distribution function, the number of received molecules is significantly increased. Therefore, this study not only improves the results of the MOC model structure based on different distribution functions but also optimizes all parameters of the proposed model using the MVO-GWO OtoO approach. [ABSTRACT FROM AUTHOR]

Response data for COVID-19 vaccines in immunosuppressed individuals are typically limited to standard dosing in small populations. Adjusting number or interval of doses may impact immune responses based on HIV status. This phase 2 randomised, observer-blinded, placebo-controlled South African study (2019nCoV-505/NCT05112848) enrolled medically stable people living with HIV (PLWH) and HIV-uninfected participants aged 18–65 years. PLWH were randomised 1:1:1 to receive NVX-CoV2373 on day 0 (D0) and either D21 (2-Dose D0/D21) or D70 (2-Dose D0/D70), or on D0, D21, and D70 (3-Dose). HIV-uninfected participants were randomised 1:1 to each 2-Dose regimen. PLWH were stratified into well-controlled and less–well-controlled subgroups. The primary immunologic endpoint included serum IgG and neutralising antibody responses (per geometric mean fold rise [GMFR] in titre and seroconversion rate) to ancestral SARS-CoV-2 at D35 (2-Dose D0/D21) and D84 (2-Dose D0/D70 and 3-Dose). The primary safety endpoints were participants with an unsolicited adverse event through D84, at D120, and at D180, or reactogenicity ≤7 days post-vaccination. Of 288 PLWH, 98, 96, and 94 were randomised into the 2-Dose D0/D21 , 2-Dose D0/D70 , and 3-Dose groups, respectively; 96 HIV-uninfected participants were randomised to the 2-Dose D0/D21 (n = 47) or 2-Dose D0/D70 (n = 49) regimens. Most (>85%) of the population were SARS-CoV-2 positive at baseline. Ancestral anti-spike IgG GMFRs in PLWH and HIV-uninfected participants, respectively, were 12·4 and 12·9 (D35) and 12·2 and 13·6 (D84). Comparable outcomes occurred across dosing regimens and in well-controlled and less–well-controlled PLWH. Microneutralization GMFRs at D84 in PLWH and HIV-uninfected participants, respectively, were: 6·9 and 10·1 (2-Dose D0/D21), 11·0 and 11·3 (2-Dose D0/D70), and 17·2 (PLWH 3-Dose). Antibody responses against BA.1 trended similar to those against the ancestral virus. Safety outcomes were comparable among PLWH and HIV-uninfected participants. This study demonstrated that NVX-CoV2373 produced consistent immunogenicity responses to SARS-CoV-2 among PLWH and HIV-uninfected participants, with no new safety signals. [ABSTRACT FROM AUTHOR]

Objectives: To describe the incidence and transmission of SARS-CoV-2 infections in South African professional rugby union players in different phases of return-to-competition during a pandemic.Design: Prospective cohort study.Methods: Players reported their history of SARS-CoV-2 infection before/during a national competition, using an online questionnaire (physician verified). Three periods of return to training/competition after a nation-wide complete lockdown during a pandemic were studied: 1) non-contact training, 2) contact training, 3) competition. The total period was 184 days (20/07/2020-20/01/2021) including 45 matches. Outcomes were: 1) incidence of SARS-CoV-2 infection (I: per 1000 player days; 95%CI) in each period (calculated using a Poisson distribution), 2) player symptoms, 3) median days to return-to-training following SARS-CoV-2 infection, 4) method of transmission, and 5) percentage matches cancelled due to SARS-CoV-2 infections.Results: 185 players had 42 physician verified positive SARS-CoV-2 infections (I = 1.23; 95%CI: 0.86-1.61). Incidences during the three periods were: non-contact training = 0, contact training (I = 1.04; 0.36-1.71; mostly forwards), and competition (I = 1.54; 1.00-2.10). 83 % of the infected players were symptomatic and 52 % of the 42 positive players had systemic symptoms. Median return-to-training was 14 days. 22 (52 %) SARS-CoV-2 infections were rugby-related: 13 off-field (31 %), 9 on-field (21 %). 11 % of matches were cancelled due to SARS-CoV-2 infections.Conclusions: As contact in rugby was introduced back into the game following lockdowns there was an increasing incidence of SARS-CoV-2 infection. On-field rugby activities were responsible for 21 % of SARS-CoV-2 infections and 11 % of matches had to be cancelled, indicating the need for risk mitigation strategies. [ABSTRACT FROM AUTHOR]

• Clinicians are now able to identify a specific sub-group of runners who are at higher risk of multiple injuries (average > 1 injury/year) (multiple injury risk (MIR) runners). • The prevalence of MIR runners is 0.4% (1 in 250 race entrants). • Independent risk factors predictive of MIR runners are older age (> 40 years), a longer history of running recreationally (> 20 years), and longer race distances (ultra-marathons). • Novel risk factors predictive of MIR runners are histories of chronic diseases and histories of allergies. There are limited data on factors that predict an increased risk of multiple injuries among distance runners. The objective of this study was to determine risk factors that are predictive of individual runners with a high annual multiple injury risk (MIR). A retrospective, cross-sectional study at 4 annual (2012–2015) Two Oceans 21.1 km and 56.0 km races in South Africa with 75,401 consenting race entrants. Running-related injury data were collected retrospectively through an online pre-race medical screening questionnaire. The average number of injuries for each runner every year was calculated by taking a runner's race entry history and injury history into account and categorizing entrants into 4 MIR categories (high, intermediate, low, and very low (reference)). Multiple logistic regression modeling (odds ratios) was used to determine whether the following factors were predictive of a high MIR (average > 1 injury/year): demographics, training and racing, chronic-disease history (composite chronic disease score (CCDS)), and history of allergies. Of all entrants, 9.2% reported at least 1 injury, and 0.4% of entrants were in the high MIR category; the incidence rate was 2.5 injuries per 10 runner-years (95% confidence interval (95%CI): 2.4–2.7). Significant factors predictive of runners in the high MIR category were: running for > 20 years: OR = 2.0 (95%CI: 1.3–3.1; p = 0.0010); a higher CCDS: OR = 2.2 (95%CI: 2.0–2.4; p < 0.0001); and a history of allergies: OR = 2.8 (95%CI: 2.0–3.8; p < 0.0001). Runners who have been running recreationally for > 20 years and those with multiple chronic diseases or a history of allergies were at higher risk of multiple running-related injuries. This high-risk group can be targeted for further study and possible injury-prevention interventions. [Display omitted] [ABSTRACT FROM AUTHOR]

Objectives: To document incidence rate and severity of specific sub-categories of respiratory tract illness (RTill) in rugby players during the Super Rugby tournament.Design: Cross-sectional study.Methods: Team physicians completed daily illness logs in 537 professional male rugby players from South African teams participating in the Super Rugby Union tournaments (2013-2017) (1141 player-seasons, 102,738 player-days). The incidence rate (IR: illness episodes/1000 player-days) and severity [%RTill resulting in time-loss, illness burden (IB: days lost to illness/1000 player-days) and days until return-to-play (DRTP)/single illness (mean: 95% Confidence Intervals)] are reported for the following specific sub-categories of RTill: non-infective respiratory tract illness (RTnon-inf), respiratory tract infections (RTinf), influenza-like illness, infective sinusitis, upper respiratory tract infections (URTinf), lower respiratory tract infections (LRTinf).Results: The overall IR of RTill was 2.9 (2.6-3.3). IR was higher for RTinf (2.5; 2.2-2.9) vs. RTnon-inf (0.4; 0.3-0.6) (p < 0.001). For sub-categories the highest IR was in URTinf (1.9; 1.7-2.2), while the % illness causing time-loss was influenza-like illness (100%), LRTinf (91.7%), infective sinusitis (55.6%), and URTinf (49.0%). IB was highest for URTinf (2.0; 1.6-2.5), and the DRTP/single illness was highest for LRTinf (3.2; 2.3-4.4), and influenza-like illness (2.1; 1.6-2.8).Conclusions: RTinf accounted for >57% of all illness during the Super Rugby tournament, and mostly URTinf. Influenza-like illness. LRTinf caused time-loss in >90% cases. URTinf, LRTinf and influenza-like illness resulted in the highest burden of illness and LRTinf caused the highest DRTP. Prevention strategies should focus on mitigating the risk of RTinf, specifically URTinf, LRTinf and influenza-like illness. [ABSTRACT FROM AUTHOR]

Risk factors related to Gradual onset injuries (GOIs) in cyclists need to be identified to enable effective injury prevention strategies. We aim to determine risk factors related to GOIs in cyclists participating in mass community-based events. Cross-sectional study. Cape Town Cycle Tour. Race entrants (n = 35,914) Completion of pre-race medical questionnaires. 21,824 consenting cyclists (60.8%) were studied. 617 cyclists reported GOIs. Selected risk factors associated with GOIs: demographics, training/racing history, chronic disease history, and medication use, were explored using multi-variate analyses. Prevalence ratio (PR) of GOIs was similar in males and females, but higher in older age categories [>50 yrs vs. categories: ≤30yrs (PR = 1.6); 31 to ≤40yrs (PR = 1.5); 41 to <50yrs (PR = 1.4)] (p < 0.0001). Intrinsic risk factors associated with GOIs (adjusted for gender and age) were: 1) increased weekly training/racing frequency (PR = 1.1, p = 0.0003), 2) chronic disease history [cardiovascular disease symptoms (PR = 2.3, p = 0.0026), respiratory disease (PR = 1.6, p < 0.0001), nervous system/psychiatric disease (PR = 1.5, p = 0.0082)], and 3) history of analgesic/anti-inflammatory medication (AAIM) used before/during racing (PR = 5.1, p < 0.0001). Increased training frequency, chronic disease and AAIM use are risk factors associated with GOIs in cyclists. A novel finding is that in recreational cyclists, chronic disease history could be considered when managing GOIs and implementing prevention programs. • Increased weekly training/racing frequency is associated with gradual onset cycling injuries. • Gradual onset injuries in cyclists are associated with a history of chronic disease. • Gradual onset injuries in cyclists are associated with analgesic anti-inflammatory drugs use. [ABSTRACT FROM AUTHOR]

Prevalence, clinical characteristics and severity of gradual onset injuries (GOIs) in cyclists are poorly documented. We determine the prevalence, anatomical regions/sites affected and severity of GOIs among entrants in a community-based mass participation event. Cross-sectional study; Cape Town Cycle Tour; Race entrants. Of 35,914 entrants, 27,349 completed pre-race medical questionnaires. We studied 21,824 consenting cyclists (60.8% of entrants). Crude lifetime prevalence, retrospective annual incidence, anatomical region/sites, specific GOI, tissue type and GOI severity is reported. The lifetime prevalence of GOIs was 2.8%, with an annual incidence of 2.5%. More common anatomical regions affected by GOIs were lower limb (43.4%), upper limb (19.8%), and lower back (11.5%). The knee (26.3%), shoulder (13%), and lower back (11.5%) regions were mostly affected. The most common GOI was anterior knee pain (14.2%). Of the GOIs, 55% were in soft tissue. 50% of cyclists reported symptom duration >12 months, and 37.3% of GOIs were severe enough to reduce/prevent cycling. 2.5% recreational cyclists report a GOI annually. >50% of GOIs affect the knee, lower back and shoulder. GOIs negatively affect cycling. Risk factors related to GOIs in cyclists need to be determined to develop and implement prevention programs. • We describe the epidemiology of gradual onset injuries in 21,824 recreational cyclists. • About 2.8% (1 in 35) of recreational cyclists report ever suffering from a gradual onset injury. • The knee (26%), shoulder (13%) and lower back (11%) are common sites of gradual onset injury. • More than 37% of gradual onset injuries are severe enough to affect training and competition. • More than 50% of cyclists report a symptom duration >12 months for gradual onset injuries. [ABSTRACT FROM AUTHOR]

X-ray imaging technologies find applications across various domains, including medical imaging in health institutions or security in military facilities and public institutions. X-ray images acquired from diverse sources necessitate analysis by either trained human experts or automated systems. In cases where concealed electronic cards potentially pose threats, such as in laptops harboring explosive triggering circuits, conventional analysis methods are challenging to detect, even when scrutinized by skilled. The present investigation is centered on the utilization of deep learning algorithms for the analysis of X-ray images of laptop computers, with the aim of identifying concealed hazardous components. To construct the dataset, some control cards such as Arduino, Raspberry Pi and Bluetooth circuits were hidden inside the 60 distinct laptop computers and were subjected to X-ray imaging, yielding a total of 5094 X-ray images. The primary objective of this study is to distinguish laptops based on the presence or absence of concealed electronic cards. To this end, a suite of deep learning models, including EfficientNet, DenseNet, DarkNet19, DarkNet53, Inception, MobileNet, ResNet18, ResNet50, ResNet101, ShuffleNet and Xception were subjected to training, testing, and comparative evaluation. The performance of these models was assessed utilizing a range of metrics, encompassing accuracy, sensitivity, specificity, precision, f-measure, and g-mean. Among the various models examined, the ShuffleNet model emerged as the top-performing one, yielding superior results in terms of accuracy (0.8355), sensitivity (0.8199), specificity (0.8530), precision (0.8490), f-measure (0.8322), and g-mean (0.8352). • A new image classification problem has been introduced. • A new X-ray image dataset for the problem has been created. • The deep learning algorithms have been applied to the classification problems. • The results obtained by the algorithms are compared with each other. • The experimental results show that there is a challenging in the problem dealt with the study. [ABSTRACT FROM AUTHOR]

Although there have been many studies on the link between chronic pain and suicidality, surprisingly little research has focused on resilience and recovery among those in chronic and disabling pain who have had suicidal thoughts. The objectives of this study were to identify the prevalence and correlates of recovery from suicidal thoughts among those in chronic pain. A secondary analysis of a nationally representative sample of Canadians in chronic and disabling pain who had ever had serious suicidal thoughts (N = 635) was conducted to identify the prevalence and characteristics of those who are no longer considering suicide. Data were drawn from the Canadian Community Health Survey-Mental Health. Three in five Canadians in chronic pain (63%) who had seriously considered suicide at some point in their life had been free of these thoughts in the past year. Those free of suicidal ideation were significantly more likely to be older, women, white, better educated, with a confidant, and to use spirituality to cope, but less likely to have low household incomes, difficulties meeting basic expenses, and a history of depression and anxiety disorders. PERSPECTIVE: Almost two-thirds of formerly suicidal Canadians with chronic pain were free from suicidal thoughts in the past year. These findings provide a hopeful message of resilience and recovery in the context of disabling pain and help to improve targeted outreach to those most at risk for unremitting suicidality. [ABSTRACT FROM AUTHOR]

Abstract Aims The aim of this paper is to provide population-based data from California on: (a) the prevalence and the odds of diabetes among non-obese South Asian (SA) Americans compared to non-Hispanic Whites (NHW); (b) to assess the prevalence and odds of optimal medical care including regular eye exams, foot exams, and the monitoring of hemoglobin A1C blood glucose levels; and (c) To identify the factors that are associated with diabetes among SA Americans. Methods The combined 2007, 2009, and 2011 waves of the adult California Health Interview Survey (CHIS) was used to analyze a non-obese (BMI<30) sample of 1251 SA and 72,072 NHW. Chi-square and logistic regression analyses were performed using Stata. Results Non-obese SA had more than twice the odds of diabetes in comparison to NHW (OR = 2.50; 1.66, 3.76), even after adjusting for sociodemographic characteristics. Despite their higher propensity for diabetes, there were no significant ethnic differences in the level of optimal care received by those with diabetes. Among non-obese South Asian Americans, the odds of diabetes were higher for older respondents, those without a post-secondary degree, those who were foreign-born, those who had ever smoked, and those with BMI from 25 to 29.99. Conclusions Non-obese SA in California experience a disproportionately higher prevalence of diabetes than their NHW counterparts. [ABSTRACT FROM AUTHOR]

• Science practices at home within the scope of open inquiry-based science laboratory practices had a significant effect on the critical thinking dispositions of pre-service science teachers. • Science practices at home within the scope of open inquiry-based science laboratory practices had a significant effect on the science learning skills of pre-service science teachers. • The science process skills, creative thinking skills, critical thinking skills, research skills, questioning skills, problem-solving, and communication skills of preservice teachers have improved in science practices at home within the scope of open inquiry-based science laboratory practices. • Pre-service teachers actively carried out research and inquiry and that they took responsibility for time management, learning outcomes, and learning experience. • Home science practices within the scope of open inquiry-based science laboratory practices have a positive effect on the scientific inquiry skills of prospective science teachers. • The characteristics of individuals with accommodating learning style such as planning, executing decisions, and making new experiences come to the fore. • Prospective teachers' reflections on designing experiments on the kitchen table that enhance novelty and critical thinking. The aim of this study is to investigate the effect of home science practices on science teacher candidates' critical thinking dispositions, science learning skills, scientific inquiry skills, and learning styles within the scope of open inquiry-based science laboratory practices. For this purpose, the opinions of prospective science teachers within the scope of home science laboratory practices are explored. Participants included 79 third-grade elementary school level (i.e., 8+ year olds) science teacher candidates. Convergent parallel mixed design from mixed methods was used in the study. As a result of the quantitative analysis of the research, a statistically significant difference was found between the pre-test and post-test results of the science teacher candidates' critical thinking dispositions and science learning skills of home science practices. Within the scope of open research inquiry-based science laboratory practices, science teacher candidates' home science practices increased in the informed category at the end of the term in all sub-dimensions of scientific inquiry skills. It was concluded that science teacher candidates experienced shifts in their learning styles relating to (i.e., Diverging, Assimilating, Converging, and Accommodating) their home science practices. The qualitative results of the study were examined based on the following themes: skills, learning environment, application process, and affective changes. [ABSTRACT FROM AUTHOR]

Lowering the BMI overweight cut point to 23 for Asian Americans (AA) is helpful, but careful monitoring for diabetes across the whole BMI spectrum is still required for AA; One in every 17 AA with a BMI < 23 has diabetes. Twenty one percent of all AA with diabetes has a BMI < 23. [ABSTRACT FROM AUTHOR]

Tennis elbow (TE) is a painful and debilitating condition of the elbow. Recently, the use of orthobiologics, such as platelet-rich-plasma (PRP), has been proposed to promote tendon regeneration. Despite their popularity, there is a paucity of updated reviews on the use of PRP compared with other treatment modalities for treating TE. The aim of this review is to summarise high quality studies that compare the use of PRP therapy with other therapies for TE and to identify areas where further research is warranted. This systematic review was performed in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A comprehensive literature search of PubMed, Scopus and Cochrane Library databases was undertaken in May 2021. Articles were screened for the following criteria: randomised control trials (RCTs) involving PRP in at least one of the treatment arms for tennis elbow. The quality of the RCTs included were analysed for their risk of bias using the modified Cochrane Collaboration Risk of Bias Assessment Tool for randomised trials. A total of 20 RCTs of which 1520 TE patients were analysed. The RCTs included in this review compared PRP with various treatment modalities routinely used in clinical practice such as physiotherapy, steroid injections, Autologous Whole Blood (AWB) and surgical interventions. With regards to the quality of RCTs, collectively, selection bias was found to be low risk however, performance bias in terms of blinding of participants and personnel performed poorly. Of the 20 RCTs, only 5 studies were classified as low risk of bias. In these 5 studies, 2 RCTs compared PRP with steroids and reported contrasting results, 1 RCT compared PRP with AWB injections which reported both to be similarly efficacious, 3 RCTs included a placebo group and only 1 reported superior effects with PRP. There are 2 main types of PRP classified according to the number of pro-inflammatory leukocyte i.e. leukocyte-rich and leukocyte-poor PRP. However, only 8 studies documented the formulation of PRP used. While the heterogeneity of PRP formulations could in-part explain the reported differences in outcomes, overall there is limited robust evidence to recommend PRP therapy for TE. Further research is required to establish the optimal formulation and administration of PRP injections. Proper documentation of TE patients need to be standardised before concrete recommendations on the use of PRP therapy may be offered. [ABSTRACT FROM AUTHOR]

Objectives: We examined the association between obesity and early-onset cryptogenic ischemic stroke (CIS) and whether fat distribution or sex altered this association.Materials and Methods: This prospective, multi-center, case-control study included 345 patients, aged 18-49 years, with first-ever, acute CIS. The control group included 345 age- and sex-matched stroke-free individuals. We measured height, weight, waist circumference, and hip circumference. Obesity metrics analyzed included body mass index (BMI), waist-to-hip ratio (WHR), waist-to-stature ratio (WSR), and a body shape index (ABSI). Models were adjusted for age, level of education, vascular risk factors, and migraine with aura.Results: After adjusting for demographics, vascular risk factors, and migraine with aura, the highest tertile of WHR was associated with CIS (OR for highest versus lowest WHR tertile 2.81, 95%CI 1.43-5.51; P=0.003). In sex-specific analyses, WHR tertiles were not associated with CIS. However, using WHO WHR cutoff values (>0.85 for women, >0.90 for men), abdominally obese women were at increased risk of CIS (OR 2.09, 95%CI 1.02-4.27; P=0.045). After adjusting for confounders, WC, BMI, WSR, or ABSI were not associated with CIS.Conclusions: Abdominal obesity measured with WHR was an independent risk factor for CIS in young adults after rigorous adjustment for concomitant risk factors. [ABSTRACT FROM AUTHOR]

Objective: Bronchiectasis continues to be a major cause of morbidity and mortality in developing countries. The purpose of this study was to present the results of our 14 years of surgical experience to re-evaluate our indications for using surgical therapy and to analyze several factors that might affect the outcome and postoperative complications of this disease. Method: Age, sex, etiologic factors, symptoms, the duration of symptoms, radiologic and radionuclide examinations, preoperative evaluation, surgical procedures, postoperative morbidity and mortality, and the follow-up results from 143 patients operated on for bronchiectasis between January 1992 and January 2006, were reviewed retrospectively. Results: One hundred forty-three patients underwent 148 operations for bronchiectasis. The mean age was 23.4 years. Complete resection was achieved in 118 patients. The morbidity rate was 23.0% and the mortality rate was 1.3%. Postoperatively, 75.9% of the patients were free of symptoms, 15.7% were improved, and 8.2% showed no improvement or were worse. The logistic regression analysis showed that a history of tuberculosis and incomplete resection were independent predictors of the operative result. Moreover, the lack of a preoperative bronchoscopic examination, a forced expiratory volume in 1 second of less than 60% of the predicted value, a history of tuberculosis, and incomplete resection were independent predictors of postoperative complications. Conclusions: A history of tuberculosis and incomplete resection were risk factors both for postoperative complications and for a worse operative result. The lack of a preoperative bronchoscopic examination and a low forced expiratory volume in 1 second were risk factors for postoperative complications. Surgery for multiple segments on different lobes should be performed whenever possible. [Copyright &y& Elsevier]

LAWRIE, K. C., MERNAGH, T. P., RYAN, C. G., VAN ACHTERBERGH, E., & BLACK, L. P. 2007. Chemical fingerprinting of hydrothermal zircons: an example from the Gidginbung high sulphidation Au–Ag–(Cu) deposit, New South Wales, Australia. Proceedings of the Geologists’ Association, 118, 37–46. Hydrothermal zircons occur as an integral component of the alteration and mineralization assemblage in the Gidginbung high sulphidation Au–Ag–(Cu) deposit in the Lachlan Fold Belt, Australia. Their hydrothermal origin is demonstrated by (1) their paragenetic relationships to ore and mineral assemblages within the orebodies, (2) the higher concentration of zircon within the orebody relative to that of the host rocks, (3) the presence of ore and alteration minerals as solid mineral inclusions within the zircons, (4) similar fluid inclusion compositions in these zircons and the associated ore and gangue minerals, and (5) their trace element composition and zonation as measured by the CSIRO–GEMOC nuclear microprobe. The trace element chemistry and mineral inclusion assemblage of these hydrothermal zircons differ markedly from those in coeval intrusive, volcanic and sedimentary lithologies. This chemical ‘fingerprinting’ permits the hydrothermal character of the zircons and their association with mineralization to be demonstrated unequivocally, thereby enabling the mineralizing event to be dated with confidence and precision at 436.4±3.1 Ma. Isotopic dating of hydrothermal zircons may have particular application where related ore deposits have been overprinted by later magmatic, hydrothermal, metamorphic, deformation and/or crustal weathering processes that disturb isotopic systems in other less stable minerals. This account shows that uncritical acceptance of U–Pb zircon ages as dating primary igneous events is unwise. [ABSTRACT FROM AUTHOR]

Background: The Rockall scoring system was developed in unselected patients, the majority of whom did not receive endoscopic therapy. The aim of this study was to assess the validity of the Rockall system in high-risk patients who undergo endoscopic therapy for peptic ulcer hemorrhage. Methods: Rockall scores were calculated in 247 patients with major peptic ulcer bleeding entered into a randomized trial of endoscopic therapy. The observed rates of recurrent bleeding and mortality after endoscopic therapy were compared with predicted rates derived from Rockall''s study group. The validity of the Rockall system was assessed in terms of calibration and discrimination. Results: Rates of recurrent bleeding and mortality after endoscopic therapy increased with an increasing Rockall score. Observed rates of recurrent bleeding and mortality were below predicted rates, and calibration of the Rockall system was poor (Mantel-Haenszel chi square = 25.8, p < 0.0001 for recurrent bleeding; Mantel-Haenszel chi square = 15.1, p < 0.0001 for death). For the prediction of recurrent bleeding, the area under the receiver operating characteristic curve was low (63.4%), but the system was satisfactory when predicting mortality (area under the resulting curve, 84.3%). Conclusions: After endoscopic therapy for a bleeding peptic ulcer, the Rockall scoring system can identify patients at high risk of death, but it is inadequate for the prediction of recurrent bleeding. [Copyright &y& Elsevier]

• A progressive neurodegenerative condition caused by the early death of dopaminergic neurons in Parkinson's disease. • A new system based on deep learning is proposed for the detection of PD by using speech signals. • Mel-spectrograms that have very effective results in sound processing are used instead of spectrograms in the time frequency domain. • The effectiveness of combined pre-trained deep networks and LSTM model in PD classification has been revealed. Parkinson's disease (PD) can cause many non-motor and motor symptoms such as speech and smell. One of the difficulties that Parkinson's patients can experience is a change in speech or speaking difficulties. Therefore, the right diagnosis in the early period is important in reducing the possible effects of speech disorders caused by the disease. Speech signal of Parkinson patients shows major differences compared to normal people. In this study, a new approach based on pre-trained deep networks and Long short-term memory (LSTM) by using mel-spectrograms obtained from denoised speech signals with Variational Mode Decomposition (VMD) for detecting PD from speech sounds is proposed. The proposed model consists of four steps. In the first step, the noise is removed by applying VMD to the signals. In the second step, mel-spectrograms are extracted from the enhanced sound signals with VMD. In the third step, pre-trained deep networks are preferred to extract deep features from the mel-spectrograms. For this purpose, ResNet-18, ResNet-50 and ResNet-101 models are used as pre-trained deep network architecture. In the last step, the classification process is occurred by giving these features as input to the LSTM model, which is designed to define sequential information from the extracted features. Experiments are performed with the PC-GITA dataset, which consists of two classes and is widely used in the literature. The results obtained from the proposed method are compared with the latest methods in the literature, it is seen that it has a better performance in terms of classification performance. [ABSTRACT FROM AUTHOR]

Background: The prevalence of placenta accreta spectrum is rising worldwide. The severe end of the spectrum where the placenta has invaded other organs is fortunately rare, however, few surgical techniques for such a complex hysterectomy have been described in the literature.Objective: This study aimed to describe a stepwise, systematic technique for radical cesarean hysterectomy for placenta accreta spectrum to investigate outcomes for women with severe, invasive placenta accreta spectrum who were hysterectomized using this technique.Study Design: This was a retrospective cohort study undertaken at a large UK tertiary referral center. A total of 24 cases of elective primary cesarean hysterectomy with a confirmed intrapartum diagnosis of severe percreta (Federation of Gynecology and Obstetrics grades 3b and 3c) were identified between 2011 and 2020. Among those cases, 16 had standard care (surgical technique dependent on surgeon's preference), and 8 had a radical peripartum hysterectomy using the Soleymani-Alazzam-Collins technique as described. Nonparametric testing was used because of sample size.Results: The Soleymani-Alazzam-Collins technique resulted in significantly less blood loss (P=.032), more transverse incisions (P=.009), and less intensive care unit admissions (P=.046). Furthermore, there was no significant difference in theater time.Conclusion: The Soleymani-Alazzam-Collins technique demonstrated a significant improvement in outcomes for women with severe placenta accreta spectrum, without increasing surgical time. [ABSTRACT FROM AUTHOR]

Abstract: The lung is one of the most sensitive organs to ionizing radiation, and damage to normal lung tissue remains a major dose limiting factor for patients receiving radiation to the thorax. Radiation induced lung injury (RILI) which is also named as “radiation pneumonpathy” is a continuous process and regarded as the result of an abnormal healing response. It has been shown that transforming growth factor β-1 (TGF-β1) plays an integral role in the radiation induced lung fibrosis formation by promoting the chemoattraction of fibroblasts and their conversion to myofibroblasts. Halofuginone is a, low molecular weight plant derived alkaloid, isolated from the Dichroa febrifuga plant that exhibits antifibrotic activity and inhibition of type I collagen synthesis. Halofuginone has been shown to protect against radiation induced soft tissue fibrosis by virtue of inhibiting various members of TFG-β signaling pathway. By the light of these findings, we hypothesize that Halofuginone may be able to ameliorate the radiation induced lung fibrosis. [Copyright &y& Elsevier]

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We evaluated the ability of vedolizumab to induce endoscopic and histologic remission in patients with Crohn's disease (CD). We performed a prospective study of 110 patients with active CD, based on CD activity index (CDAI) scores >220 and mucosal ulcerations, who received open-label vedolizumab (300 mg) infusions at weeks 0, 2, and 6, and every 8 weeks thereafter through week 52 at tertiary centers in Europe. Patients received an additional infusion at week 10 if their CDAI score had not decreased by 70 points. Patients underwent ileocolonoscopy with collection of biopsies at baseline and weeks 26 and 52; a local and central reader determined simple endoscopic index for CD (SES-CD) scores. Histologic features were assessed by a blinded pathologist at week 26. Serum concentrations of vedolizumab were measured at serial time points. The primary outcome was endoscopic and histologic remission in patients with active CD treated with vedolizumab for 52 weeks. At weeks 26 and 52, 36 patients (29%) and 34 patients (31%), respectively, were in corticosteroid-free clinical remission (CDAI score <150), respectively. Based on intent-to-treat analysis, endoscopic remission (SES-CD score <4) was achieved by 36 patients (33%) and 40 patients (36%) at weeks 26 and 52. Endoscopic responses (decrease in SES-CD score ≥50%) occurred in 44 patients (40%) at week 26 and 5 patients (45%) at week 52. Serum concentrations of vedolizumab were higher at weeks 2, 10, and 22 in patients with lower SES-CD scores. Histologic remission at week 26 was observed in 43 (64%) of 67 patients based on Geboes Score and 37 (66%) of 56 patients based on Robarts Histopathology Index scores in analyses of paired biopsies with inflammation at baseline. Serum concentrations of vedolizumab above 10 mg/L at week 22 were associated with endoscopic remission at week 26. In a prospective trial, we found that approximately one-third of patients with CD achieve endoscopic remission after 52 weeks of treatment with vedolizumab and two-thirds achieve histologic remission at week 26. Higher serum concentrations of vedolizumab were associated with better outcomes. EUDRACT no: 2014–005376–29. [ABSTRACT FROM AUTHOR]

Background The chimney technique has been successfully used to treat juxtarenal aortic aneurysms. The two main issues with this technique are gutter formation and chimney graft (CG) compression, which induce a risk for type Ia endoleaks and stent thrombosis, respectively. In this benchtop study, the geometry and renal artery flow of chimney endovascular aneurysm repair configurations were compared with chimney configurations with endovascular aneurysm sealing (ch-EVAS). Methods Seven flow phantoms were constructed, including one control and six chimney endovascular aneurysm repairs (Endurant [Medtronic Inc, Minneapolis, Minn] and AFX [Endologix Inc, Irvine, Calif]) or ch-EVAS (Nellix, Endologix) configurations, combined with either balloon-expandable or self-expanding CGs with an intended higher positioning of the right CG in comparison to the left CG. Geometric analysis was based on measurements at three-dimensional computed tomography angiography and included gutter volume and CG compression, quantified by the ratio between maximal and minimal diameter (D-ratio). In addition, renal artery flow was studied in a physiologic flow model and compared with the control. Results The average gutter volume was 343.5 ± 142.0 mm 3 , with the lowest gutter volume in the EVAS-Viabahn (W. L. Gore & Associates, Flagstaff, Ariz) combination (102.6 mm 3 ) and the largest in the AFX-Advanta V12 (Atrium Medical Corporation, Hudson, NH) configuration (559.6 mm 3 ). The maximum D-ratio was larger in self-expanding CGs than in balloon-expandable CGs in all configurations (2.02 ± 0.34 vs 1.39 ± 0.13). The CG compression had minimal influence on renal volumetric flow (right, 390.7 ± 29.4 mL/min vs 455.1 mL/min; left, 423.9 ± 28.3 mL/min vs 410.0 mL/min in the control). Conclusions This study showed that gutter volume was lowest in ch-EVAS in combination with a Viabahn CG. CG compression was lower in configurations with the Advanta V12 than with Viabahn. Renal flow is unrestricted by CG compression. [ABSTRACT FROM AUTHOR]

Background: The combination of the qualitative fetal fibronectin test and cervical length measurement has a high negative predictive value for preterm birth within 7 days; however, positive prediction is poor. A new bedside quantitative fetal fibronectin test showed potential additional value over the conventional qualitative test, but there is limited evidence on the combination with cervical length measurement.Objective: The purpose of this study was to compare quantitative fetal fibronectin and qualitative fetal fibronectin testing in the prediction of spontaneous preterm birth within 7 days in symptomatic women who undergo cervical length measurement.Study Design: We performed a European multicenter cohort study in 10 perinatal centers in 5 countries. Women between 24 and 34 weeks of gestation with signs of active labor and intact membranes underwent quantitative fibronectin testing and cervical length measurement. We assessed the risk of preterm birth within 7 days in predefined strata based on fibronectin concentration and cervical length.Results: Of 455 women who were included in the study, 48 women (11%) delivered within 7 days. A combination of cervical length and qualitative fibronectin resulted in the identification of 246 women who were at low risk: 164 women with a cervix between 15 and 30 mm and a negative fibronectin test (<50 ng/mL; preterm birth rate, 2%) and 82 women with a cervix at >30 mm (preterm birth rate, 2%). Use of quantitative fibronectin alone resulted in a predicted risk of preterm birth within 7 days that ranged from 2% in the group with the lowest fibronectin level (<10 ng/mL) to 38% in the group with the highest fibronectin level (>500 ng/mL), with similar accuracy as that of the combination of cervical length and qualitative fibronectin. Combining cervical length and quantitative fibronectin resulted in the identification of an additional 19 women at low risk (preterm birth rate, 5%), using a threshold of 10 ng/mL in women with a cervix at <15 mm, and 6 women at high risk (preterm birth rate, 33%) using a threshold of >500 ng/mL in women with a cervix at >30 mm.Conclusion: In women with threatened preterm birth, quantitative fibronectin testing alone performs equal to the combination of cervical length and qualitative fibronectin. Possibly, the combination of quantitative fibronectin testing and cervical length increases this predictive capacity. Cost-effectiveness analysis and the availability of these tests in a local setting should determine the final choice. [ABSTRACT FROM AUTHOR]