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Significant opportunities exist to connect more directly sexuality research to urbanisation research in the global South. This article considers such connections in relation to the informal sector, the state, and urban health. It highlights how such connections can help surface the strategic and pragmatic choices made by same-sex communities in the face of persistent urban challenges in the global South. The article draws on examples from sub-Saharan Africa, a region that exhibits significant sexuality-based discrimination and which has had significant urban research attention. [ABSTRACT FROM AUTHOR]

The article discusses the issue of conflict of interest (COI) about the concept of sports medicine among physicians. Topics discussed include the clinical decision making and confidentiality as the areas for potential ground of conflict, the evolution of the relationships among professional team physician, and the role of physicians in protecting the long-term health of patient.

Previous findings suggest that professional American football players have higher blood pressures (BP) and a higher prevalence of pre–hypertension and hypertension than the general population. We sought to determine whether race is associated with differences in BP and prevalence of pre–hypertension and hypertension among a large sample of professional football players. BP was measured at 2009 team mini–camps for 1484 black (n = 1007) and white (n = 477) players from 27 National Football League (NFL) teams. Players were categorized into three position groups based on body mass index (BMI). There was no racial difference in mean systolic or diastolic BP in any of the three position groups. There were no racial differences in prevalence of hypertension (99 [9.8%] black players vs. 39 [8.2%] white players; P = .353) or pre–hypertension (557 [55.3%] black players vs. 264 [55.3%] white players; P = 1.0). Contrary to findings in the general population, BP and prevalence of pre–hypertension/hypertension did not vary with race in a large population of active NFL players. [ABSTRACT FROM AUTHOR]

Rational and Objectives The objective of this study was to compare the stationary digital breast tomosynthesis (s-DBT) system to a conventional mammography system in a study of breast specimens. Radiologist evaluation of image quality was assessed in a reader study. This study represents the first human tissue imaging with the novel carbon nanotube–based s-DBT device. Materials and Methods Thirty-nine patients, with known breast lesions (Breast Imaging Reporting and Data System 4 or 5) by conventional mammography and scheduled for needle localization biopsy, were recruited under an institutional review board–approved protocol. Specimen images were obtained using a two-dimensional (2D) mammography system with a ×1.8 magnification factor and an s-DBT system without a high magnification factor. A reader study was performed with four breast fellowship-trained radiologists over two separate sessions. Malignancy scores were recorded for both masses and microcalcifications (MCs). Reader preference between the two modalities for MCs, masses, and surgical margins was recorded. Results The s-DBT system was found to be comparable to magnified 2D mammography for malignancy diagnosis. Readers preferred magnified 2D mammography for MC visualization ( P < .05). However, readers trended toward a preference for s-DBT with respect to masses and surgical margin assessment. Conclusions Here, we report on the first human data acquired using a stationary digital breast tomosynthesis system. The novel s-DBT system was found to be comparable to magnified 2D mammography imaging for malignancy diagnosis. Given the trend of preference for s-DBT over 2D mammography for both mass visibility and margin assessment, s-DBT could be a viable alternative to magnified 2D mammography for imaging breast specimens. [ABSTRACT FROM AUTHOR]

• The initial week of the stay-at-home order in Connecticut had a large increase in the rate of single vehicle crashes. • Crash rates started to return to average during the post-stay-at-home order in Connecticut. • Fatal crash rates were unchanged during and after the stay-at-home order. Recent research suggests that COVID-19 associated stay-at-home orders, or shelter-in-place orders, have impacted intra-and-interstate travel as well as motor vehicle crashes (crashes). We sought to further this research and to understand the impact of the stay-at-home order on crashes in the post order period in Connecticut. We used a multiple-comparison group, interrupted time-series analysis design to compare crashes per 100 million vehicle miles traveled (VMT) per week in 2020 to the average of 2017–2019 from January 1-August 31. We stratified crash rate by severity and the number of vehicles involved. We modeled two interruption points reflecting the weeks Connecticut implemented (March 23rd, week 12) and rescinded (May 20th, week 20) its stay-at-home order. During the initial week of the stay-at-home order in Connecticut, there was an additional 28 single vehicle crashes compared to previous years (95% confidence interval (CI): [15.8, 36.8]). However, the increase at the order onset was not seen throughout the duration. Rescinding the stay-at-home order by and large did not result in an immediate increase in crash rates. Crash rates steadily returned to previous year averages during the post-stay-at-home period. Fatal crash rates were unaffected by the stay-at-home order and remained similar to previous year rates throughout the study duration. The initial onset of the stay-at-home order in Connecticut was associated with a sharp increase in the single vehicle crash rate but that increase was not sustained for the remainder of the stay-at-home order. Likely changes in driver characteristics during and after the order kept fatal crash rates similar to previous years. [ABSTRACT FROM AUTHOR]

Frailty and comorbidities are important outcome determinants in older patients (age ≥65) with burns. A Geriatric Burn Bundle (Geri-B) was implemented in 2019 at a regional burn center to standardize care for older adults. Components included frailty screening and protocolized geriatric co-management, malnutrition screening with nutritional support, and geriatric-centered pain regimens. This study aimed to qualitatively evaluate the implementation of Geri-B using the Proctor Framework. From June-August 2022, older burn-injured patients, burn nurses, and medical staff providers (attending physicians and advanced practice providers) were surveyed and interviewed. Transcribed interviews were coded and thematically analyzed. From May 2022 to August 2023, the number of inpatient visits aged 65 + with a documented frailty screening was monitored. The study included 23 participants (10 providers, 13 patients). Participants highly rated Geri-B in all implementation domains. Most providers rated geriatric care effectiveness as 'good' or 'excellent' after Geri-B implementation. Providers viewed it as a reminder to tailor geriatric care and a safeguard against substandard geriatric care. Staffing shortages, insufficient protocol training, and learning resources were reported as implementation barriers. Many providers advocated for better bundle integration into the hospital electronic health record (EHR) (e.g., frailty screening tool, automatic admission order sets). Most patients felt comfortable being asked about their functional status with strong patient support for therapy services. The average frailty screening completion rate from May 2022 to August 2023 was 86%. Geri-B was perceived as valuable for the care of older burn patients and may serve as a framework for other burn centers. • Geri-burn bundle includes frailty screening, protocolized geriatric co-management. • Also geriatric-centered pain regimens and malnutrition screening with supplements. • Strong provider support, viewed as a reminder and safeguard for geriatric care. • Patients support physical therapy, frailty screening; dislike nutrition supplements. • Future improvements: protocol training, integration into electronic health record. [ABSTRACT FROM AUTHOR]

• Ocular parameters (Johns Drowsiness Scores, JDS) could detect real-time drowsiness in HVDs on the road. • The risk of drowsiness in HVDs was measured by the occurrence of drowsiness events (JDS ≥ 2.6 events/hour) and assessed by logistic regression models. • Night-time drive, shift start time in the early afternoon, prolonged work hours, short break durations (7–9 h) and short sleep time (<6 h) increased the risk of drowsiness after controlling for the effects of other work schedule metrics. • The magnitude of driver drowsiness was measured using hourly rates of drowsiness events (JDS ≥ 2.6 events/hour) and assessed by mixed linear regression models. • Night-time drive, shift start time in the early morning, prolonged work hours, break times (<9 h), and shift of 8–15 h increased the hourly rate of drowsiness events after adjusting for the effects of other work schedules metrics. • Night-time drives (9 pm- 2 am), 18 to 21 h into the shift, or breaks shorter than 7 h elevated drowsiness event rates substantially relative to "alert state (4.9 events/hour) after controlling for the effects of other work schedule metrics. While drowsiness contributes to 20% of heavy vehicle crashes, the impact of work schedules on heavy vehicle driver (HVD) drowsiness is unclear. This study explored the impact of work schedules on drowsiness (measured by infrared oculography) in HVDs. Work and drowsiness monitoring (Optalert, Australia) of ten HVDs, aged 37–62 years collected nearly 2430 h of work and 1068 h of oculography data during four weeks of naturalistic drives. Drowsiness events were defined as a John's Drowsiness Scores ≥ 2.6. Nine HVDs slept for 5.82 ± 1.37 h during five weeks of actigraphy. Association of driving schedule characteristics and drivers' continuous eye-blink parameters were observed using logistic and mixed linear regression analyses. Combination of time of day (10 pm- 2 am), shift start time (2 pm-3 pm), hours into the shift (16–21 h), break duration (7–9 h), and sleep time (<6 h) increased the likelihood of drowsiness events when controlling for other covariates. A combination of night times (6 pm to 2 am), 18 to 21 h into the shift, shift start times (6 am to 7 am), shifts lengths (8 to15 h) and break times (<7 to 9 h) increased the hourly rate of drowsiness significantly when adjusting for other covariates. The combination of prolonged work hours, night-time drives, early-morning shift starts and short breaks increase drowsiness rates in HVDs. Large datasets are needed to examine the interplay between sleep time, consecutive shifts and shift order and type with this combination. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: We assessed whether low-density lipoprotein particle concentration (LDL-P) and high-sensitivity C-reactive protein [hs-CRP] can identify subclinical atherosclerosis better than traditional cholesterol parameters in retired National Football League (NFL) players. Background: It is not known whether LDL-P and the biomarker hs-CRP can identify subclinical atherosclerosis better than low-density lipoprotein cholesterol (LDL-C) or non-high-density-lipoprotein cholesterol (non-HDL-C) in retired NFL players, given high prevalence of metabolic syndrome in these players. Methods: Carotid artery plaque screening was performed with traditional lipids, LDL-P, and hs-CRP in 996 retired players. Logistic regression analyses comparing highest with the lowest quartile were performed. Results: Carotid artery plaques were seen in 41%. LDL-C (odds ratio [OR] 1.66, 95% confidence interval [CI] 1.06–2.59), non-HDL-C (OR 1.67, 95% CI 1.04–2.67), and LDL-P (OR 2.21, 95% CI 1.35–3.62) were associated with plaques in adjusted models. Among 187 retired players with metabolic syndrome, LDL-C (OR 1.40, 95% CI 0.53–3.72) was not associated with carotid plaques, whereas LDL-P (OR 3.71, 95% CI 1.16–11.84) and non-HDL-C (OR 2.63, 95% CI 0.91–7.63, p =0.07; borderline significant) were associated with carotid plaques. hs-CRP (OR 1.13, 95% CI 0.71–1.79) was not associated with carotid plaques. Conclusion: Carotid artery plaques were common in retired NFL players and were strongly associated with LDL-P, especially among those with metabolic syndrome. hs-CRP was not associated with carotid plaques in this cohort. [Copyright &y& Elsevier]

• Heavy vehicle drivers on average had 5.1-hours sleep during a 7-hour rest break. • Heavy vehicle drivers on average had 6.5-hours sleep during an 11-hour rest break. • Subjective sleepiness was reduced after the 11- vs. 7-hour rest break. • Objective alertness when driving was improved after the 11- vs. 7-hour rest break. • Some driving performance metrics were improved after the 11- vs. 7-hour rest break. An inadequate rest break between shifts may contribute to driver sleepiness. This study assessed whether extending the major rest break between shifts from 7-hours (Australian industry standard) to 11-hours, improved drivers' sleep, alertness and naturalistic driving performance. 17 heavy vehicle drivers (16 male) were recruited to complete two conditions. Each condition comprised two 13-hour shifts, separated by either a 7- or 11-hour rest break. The initial 13-hour shift was the drivers' regular work. The rest break and following 13-hour shift were simulated. The simulated shift included 5-hours of naturalistic driving with measures of subjective sleepiness, physiological alertness (ocular and electroencephalogram) and performance (steering and lane departures). 13 drivers provided useable data. Total sleep during the rest break was greater in the 11-hour than the 7-hour condition (median hours [25th to 75th percentile] 6.59 [6.23, 7.23] vs. 5.07 [4.46, 5.38], p = 0.008). During the simulated shift subjective sleepiness was marginally better for the 11-hour condition (mean Karolinska Sleepiness Scale [95th CI] = 4.52 [3.98, 5.07] vs. 5.12 [4.56, 5.68], p = 0.009). During the drive, ocular and vehicle metrics were improved for the 11-hour condition (p<0.05). Contrary to expectations, mean lane departures p/hour were increased during the 11-hour condition (1.34 [−0.38,3.07] vs. 0.63 [−0.2,1.47], p = 0.027). Extending the major rest between shifts substantially increases sleep duration and has a modest positive impact on driver alertness and performance. Future work should replicate the study in a larger sample size to improve generalisability and assess the impact of consecutive 7-hour major rest breaks. [ABSTRACT FROM AUTHOR]