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Catheter-associated urinary tract infections (CAUTIs) cause serious complications among hospitalized patients due to biofilm-forming microorganisms which make treatment ineffective by forming antibiotic-resistant strains. As most CAUTI-causing bacterial pathogens have already developed multidrug resistance, there is an urgent need for alternative antibacterial agents to prevent biofilms on catheter surfaces. As a trial to find out such a potential agent of natural origin, the bark of Tamarix ericoides Rottl., a little-known plant from the Tamaricaceae family, was examined for its antibacterial and antibiofilm activities against one of the major, virulent, CAUTI-causing bacterial pathogens: Enterococcus faecalis. The methanolic T. ericoides bark extract was analyzed for its antibacterial activity using the well diffusion method and microdilution method. Killing kinetics were calculated using time–kill assay, and the ability of biofilm formation and its eradication upon treatment with the T. ericoides bark extract was studied by crystal violet assay. GC-MS analysis was performed to understand the phytochemical presence in the extract. A in vitro bladder model study was performed using extract-coated catheters against E. faecalis, and the effect was visualized using CLSM. The changes in the cell morphology of the bacterium after treatment with the T. ericoides bark extract were observed using SEM. The biocompatibility of the extract towards L929 cells was studied by MTT assay. The anti-E. faecalis activity of the extract-coated catheter tube was quantified by viable cell count method, which exposed 20% of growth after five days of contact with E. faecalis. The anti-adhesive property of the T. ericoides bark extract was studied using CLSM. The extract showed potential antibacterial activity, and the lowest inhibitory concentration needed to inhibit the growth of E. faecalis was found to be 2 mg/mL. The GC-MS analysis of the methanolic fractions of the T. ericoides bark extract revealed the presence of major phytochemicals, such as diethyl phthalate, pentadecanoic acid, methyl 6,11-octadecadienoate, cyclopropaneoctanoic acid, 2-[(2-pentylcyclopropyl) methyl]-, methyl ester, erythro-7,8-bromochlorodisparlure, etc., that could be responsible for the antibacterial activity against E. faecalis. The killing kinetics of the extract against E. faecalis was calculated and the extract showed promising antibiofilm activity on polystyrene surfaces. The T. ericoides bark extract effectively reduced the E. faecalis mature biofilms by 75%, 82%, and 83% after treatment with 1X MIC (2 mg/mL), 2X MIC (4 mg/mL), and 3X MIC (6 mg/mL) concentrations, respectively, which was further confirmed by SEM analysis. The anti-adhesive property of the T. ericoides bark extract studied using CLSM revealed a reduction in the biofilm thickness, and the FDA and PI combination revealed the death of 80% of the cells on the extract-coated catheter tube. In addition, SEM analysis showed extensive damage to the E. faecalis cells after the T. ericoides bark extract treatment, and it was not cytotoxic. Hence, after further studies, T. ericoides bark extract with potential antibacterial, antibiofilm, and anti-adhesive activities can be developed as an alternative agent for treating CAUTIs.

Introduction: Infected diabetic foot ulcers may lead to serious complications if not recognised in the early stage. Diagnosis of infection is particularly challenging at that stage; thus, a sensitive inflammatory biomarker may be helpful. We aimed to evaluate the role of procalcitonin (PCT) as an early biomarker for infected diabetic foot ulcers (IDFU). Materials and method: This cross-sectional study was conducted at Klinik Rawatan Keluarga (KRK), Orthopedic clinic and wards in Hospital Universiti Sains Malaysia (USM) from May 2020 to December 2020. A total of 264 participants were recruited and divided into three groups: 50 diabetic patients with no ulcers (control), 107 patients with non-infected diabetic foot ulcers (NIDFU), and 107 patients with infected diabetic foot ulcers (IDFU). The level of PCT was taken for all patients. Total white count (TWC) and C- reactive protein (CRP) were taken only for IDFU patients. Diagnosis of infection was based on the Infectious Disease Society of America-International Working Group of Diabetic Foot (IDSA-IMWGDF), and the severity of infection was graded according to the Wagner Classification. Results: The level of PCT was higher in IDFU than in NIDFU and diabetic patient, with a median (IQR) of 0.355 (0.63) ng/mL, 0.077 (0.15) ng/mL and 0.028 (0.02) ng/mL, respectively. PCT and CRP showed moderate positive correlations in IDFU patients (p

Catheter-associated urinary tract infections (CAUTIs) cause serious complications among hospitalized patients due to biofilm-forming microorganisms which make treatment ineffective by forming antibiotic-resistant strains. As most CAUTI-causing bacterial pathogens have already developed multidrug resistance, there is an urgent need for alternative antibacterial agents to prevent biofilms on catheter surfaces. As a trial to find out such a potential agent of natural origin, the bark of Tamarix ericoides Rottl., a little-known plant from the Tamaricaceae family, was examined for its antibacterial and antibiofilm activities against one of the major, virulent, CAUTI-causing bacterial pathogens: Enterococcus faecalis. The methanolic T. ericoides bark extract was analyzed for its antibacterial activity using the well diffusion method and microdilution method. Killing kinetics were calculated using time–kill assay, and the ability of biofilm formation and its eradication upon treatment with the T. ericoides bark extract was studied by crystal violet assay. GC-MS analysis was performed to understand the phytochemical presence in the extract. A in vitro bladder model study was performed using extract-coated catheters against E. faecalis, and the effect was visualized using CLSM. The changes in the cell morphology of the bacterium after treatment with the T. ericoides bark extract were observed using SEM. The biocompatibility of the extract towards L929 cells was studied by MTT assay. The anti-E. faecalis activity of the extract-coated catheter tube was quantified by viable cell count method, which exposed 20% of growth after five days of contact with E. faecalis. The anti-adhesive property of the T. ericoides bark extract was studied using CLSM. The extract showed potential antibacterial activity, and the lowest inhibitory concentration needed to inhibit the growth of E. faecalis was found to be 2 mg/mL. The GC-MS analysis of the methanolic fractions of the T. ericoides bark extract revealed the presence of major phytochemicals, such as diethyl phthalate, pentadecanoic acid, methyl 6,11-octadecadienoate, cyclopropaneoctanoic acid, 2-[(2-pentylcyclopropyl) methyl]-, methyl ester, erythro-7,8-bromochlorodisparlure, etc., that could be responsible for the antibacterial activity against E. faecalis. The killing kinetics of the extract against E. faecalis was calculated and the extract showed promising antibiofilm activity on polystyrene surfaces. The T. ericoides bark extract effectively reduced the E. faecalis mature biofilms by 75%, 82%, and 83% after treatment with 1X MIC (2 mg/mL), 2X MIC (4 mg/mL), and 3X MIC (6 mg/mL) concentrations, respectively, which was further confirmed by SEM analysis. The anti-adhesive property of the T. ericoides bark extract studied using CLSM revealed a reduction in the biofilm thickness, and the FDA and PI combination revealed the death of 80% of the cells on the extract-coated catheter tube. In addition, SEM analysis showed extensive damage to the E. faecalis cells after the T. ericoides bark extract treatment, and it was not cytotoxic. Hence, after further studies, T. ericoides bark extract with potential antibacterial, antibiofilm, and anti-adhesive activities can be developed as an alternative agent for treating CAUTIs. [ABSTRACT FROM AUTHOR]

ATP-binding cassette (ABC) transport systems are crucial for bacteria to ensure sufficient uptake of nutrients that are not produced de novo or improve the energy balance. The cell surface of the pathobiont Streptococcus pneumoniae (pneumococcus) is decorated with a substantial array of ABC transporters, critically influencing nasopharyngeal colonization and invasive infections. Given the auxotrophic nature of pneumococci for certain amino acids, the Ami ABC transporter system, orchestrating oligopeptide uptake, becomes indispensable in host compartments lacking amino acids. The system comprises five exposed Oligopeptide Binding Proteins (OBPs) and four proteins building the ABC transporter channel. Here, we present a structural analysis of all the OBPs in this system. Multiple crystallographic structures, capturing both open and closed conformations along with complexes involving chemically synthesized peptides, have been solved at high resolution providing insights into the molecular basis of their diverse peptide specificities. Mass spectrometry analysis of oligopeptides demonstrates the unexpected remarkable promiscuity of some of these proteins when expressed in Escherichia coli, displaying affinity for a wide range of peptides. Finally, a model is proposed for the complete Ami transport system in complex with its various OBPs. We further disclosed, through in silico modelling, some essential structural changes facilitating oligopeptide transport into the cellular cytoplasm. Thus, the structural analysis of the Ami system provides valuable insights into the mechanism and specificity of oligopeptide binding by the different OBPs, shedding light on the intricacies of the uptake mechanism and the in vivo implications for this human pathogen., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Alcorlo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Co-curricular activities equip students with essential skills and knowledge for personal and professional growth. Despite their importance, many students exert minimal effort to complete the assigned tasks. Instructors perceive that the lack of emphasis on final exams in co-curricular subjects reduces student effort and commitment. Moreover, poor time management and lack of effort in completing tasks have increased across various subjects in recent years. Therefore, it is important to investigate the factors that contribute to student commitment towards co-curricular subjects. In this study, the submission status of 339 tasks was retrieved from the student learning system to measure student commitment based on whether tasks were submitted on time, delayed, or not submitted. A chi-square test f was used to investigate the relationship between students' demographic characteristics and their commitment. The findings revealed a significant association between student commitment and the type of task given (p < 0.001). Students were more likely to submit presentations on time compared to written assignments. Projects were more likely to be delayed, while written assignments had a high frequency of no submission. Age was a significant predictor of commitment (p < 0.05), with students over 20 more likely to submit on time and students under 20 more likely to ignore submission. Gender was also a significant predictor of commitment (p < 0.001), with female students having a higher percentage and frequency of on-time submissions while male students having a higher number of no submissions. However, no significant association was found between the study year and commitment (p > 0.05), indicating that the year of the study could not determine the level of commitment to the course. Overall, these findings could be used to guide the preparation of tasks and assignments in co-curricular subjects to enhance student commitment and holistic development., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

The identification and prediction of athletic talent are pivotal in the development of successful sporting careers. Traditional subjective assessment methods have proven unreliable due to their inherent subjectivity, prompting the rise of data-driven techniques favoured for their objectivity. This evolution in statistical analysis facilitates the extraction of pertinent athlete information, enabling the recognition of their potential for excellence in their respective sporting careers. In the current study, we applied a logistic regression-based machine learning pipeline (LR) to identify potential skateboarding athletes from a combination of fitness and motor skills performance variables. Forty-five skateboarders recruited from a variety of skateboarding parks were evaluated on various skateboarding tricks while their fitness and motor skills abilities that consist of stork stance test, dynamic balance, sit ups, plank test, standing broad jump, as well as vertical jump, were evaluated. The performances of the skateboarders were clustered and the LR model was developed to classify the classes of the skateboarders. The cluster analysis identified two groups of skateboarders: high and low potential skateboarders. The LR model achieved 90% of mean accuracy specifying excellent prediction of the skateboarder classes. Further sensitivity analysis revealed that static and dynamic balance, lower body strength, and endurance were the most important factors that contributed to the model's performance. These factors are therefore essential for successful performance in skateboarding. The application of machine learning in talent prediction can greatly assist coaches and other relevant stakeholders in making informed decisions regarding athlete performance., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ab Rasid et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The success and enjoyment of a football match depend heavily on referees and their ability to ensure fair play and uphold the rules of the game. However, there is limited research investigating the disciplinary measures and booking activities of referees in top European football leagues. In the current investigation, we explored the disciplinary measures and booking activities of top-European football league referees. The dataset of the referee activities concerning 15 indicators containing 602 matches from five consecutive seasons across the five top European leagues, namely, the English Premier League, Spanish Laliga, Italian Serie A, French Ligue1, and German Bundesliga were utilized for this study. K-means cluster analysis was used to define the activity levels of the referees. The Mann-Whitney U test was employed to determine the differences in the levels of the referees' activity with respect to the disciplinary measures, while binary regression analysis was applied to examine the association between the disciplinary measures and the activity levels of the referees. Two groups of activities were defined by k-means, that is, high and low activity. The Mann-Whitney U test revealed statistically significant differences in all 15 indicators examined between high and low activity. However, the regression model demonstrated that only fouls, yellow cards, and air challenges could significantly describe referees' activity levels. These indicators appear to be predictors of high referee activity in elite European Football. Specific training on dealing with increased aggression and foul behaviour coupled with improved game organisational management could be further incorporated into referees' training programmes amongst other measures., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Nuclear Magnetic Resonance (NMR) spectra of human serum and plasma show, besides metabolites and lipoproteins, two characteristic signals termed GlycA and B arising from the acetyl groups of glycoprotein glycans from acute phase proteins, which constitute good markers for inflammatory processes. Here, we report a comprehensive assignment of glycoprotein glycan NMR signals observed in human serum, showing that GlycA and GlycB signals originate from Neu5Ac and GlcNAc moieties from N-glycans, respectively. Diffusion-edited NMR experiments demonstrate that signal components can be associated with specific acute phase proteins. Conventionally determined concentrations of acute phase glycoproteins correlate well with distinct features in NMR spectra (R 2 up to 0.9422, p-value <0.001), allowing the simultaneous quantification of several acute phase inflammation proteins. Overall, a proteo-metabolomics NMR signature of significant diagnostic potential is obtained within 10-20 min acquisition time. This is exemplified in serum samples from COVID-19 and cardiogenic shock patients showing significant changes in several acute phase proteins compared to healthy controls., (© 2023 The Authors. Angewandte Chemie International Edition published by Wiley-VCH GmbH.)

Bone morphogenetic protein (BMP)-9 is considered a member of the transforming growth factor (TGF)β superfamily. It was first found as an inducer of bone and cartilage formation and then discovered that this factor mediates several physiologic functions and hemostasis. Besides physiological conditions, BMP9 has also been elucidated that it is involved in several pathological situations, especially cancer. In various cancers, dysregulation of BMP9 has raised the issue that BMP9 might play a conflicting role in tumour development. BMP9 binding to its receptors (BMPRs), including ALKs and BMPRII, induces canonical SMAD-dependent and non-canonical PI3K/AKT and MAPK signalling pathways in tumour cells. BMP9, via inducing apoptosis, inhibiting tumour-promoting cell signalling pathways, suppressing epithelial-mesenchymal transition (EMT) process, blocking angiogenesis, and preventing cross-talk in the tumour microenvironment, mainly exerts tumour-suppressive functions. In contrast, BMP9 triggers tumour-supportive signalling pathways, promotes EMT, and enhances angiogenesis, suggesting that BMP9 is also involved in tumour development. It has been demonstrated that modulating BMP9 expression and functions might be a promising approach to cancer treatment. It has also been indicated that evaluating BMP9 expression in cancers might be a biomarker for predicting cancer prognosis. Overall, BMP9 would provide a promising target in cancer management.

In the present work, a WC particle-reinforced CoCrFeMnNi high-entropy alloy (HEA) was fabricated by laser melting deposition (LMDed). The LMDed CoCrFeMnNi high-entropy alloy (CoCrFeMnNi) composite is primarily comprised of a face-centered cubic (FCC) crystal structure. However, in the case of CoCrFeMnNi with 2.5 wt.% WC, it exhibits a combination of an FCC matrix and a ceramic phase known as M 23 C 6 . The corrosion behavior of CoCrFeMnNi and CoCrFeMnNi with 2.5 wt.% WC particle in 0.5 M H 2 SO 4 was comparatively investigated. Compared with CoCrFeMnNi, the passive film formed on the CoCrFeMnNi with 2.5 wt.% WC had a more stable and stronger protective property. The corrosion current density of the CoCrFeMnNi with 2.5 wt.% WC dropped by 149.1% compared to that of the CoCrFeMnNi, indicating that the CoCrFeMnNi with 2.5 wt.% WC had better corrosion resistance than that of the CoCrFeMnNi.

Introduction: The objective of this study was to investigate the effect of convalescent plasma (CP) transfusion on clinical and serial laboratory parameters in severe COVID-19 patients. The Coronavirus Disease 2019 (COVID-19) pandemic presents a challenge to the healthcare system worldwide due to the limited treatment options available. The body of evidence reported that CP containing anti- COVID-19 antibodies could be effective against the infection., Materials and Methods: This was a cross-sectional study that involved retrospective data collection of severe COVID-19 adult patients who received CP transfusion along with the best-of-care (CP group, n: 53) and best-of-care only (control group, n: 53). An age, gender, and comorbidity were manually matched approximately at a 1:1 ratio., Results: The prevalence of adverse transfusion reactions was 5.7%. A shorter duration of oxygen support (median: 12 days vs 14 days, P=0.030) and a shorter duration of mechanical ventilation (median: 6 days vs 10 days, P=0.048) were found in the CP group. The laboratory parameters were also improved. However, there was no significant difference in the mechanical ventilation rate, length of hospital stay, length of intensive care unit (ICU) stay, and mortality rate across both groups (P = 0.492, 0.614, 0.793, 0.374)., Conclusion: CP transfusion is safe and effective in the treatment of severe COVID-19 patients. However, a revision of our approaches such as early CP transfusion and use of a high-titre anti-COVID-19 neutralising antibody (nAb) unit is necessary to unlock the full potential benefits of CP transfusion among COVID-19 patients.

Artemisia is a perennial wild shrub with large branches and compound leaves. Artemisia contains about 400 types, and its medical importance is due to the presence of many active substances and compounds such as volatile oils, alkaloids and flavonoids, glycosides, saponins, tannins, and coumarins. This study was designed to study the effect of the aqueous extract of the fruit of the Artemisia plant on the organs of the body, as well as to know its ability to activate the hepatic enzyme alanine transaminase (ALT/GPT). The fruit of this shrub was extracted using the measurement technique gas chromatography-mass spectrometry (GC/MASS) and organic solvent hexane and ethyl acetate in one to one ratio. It contained 21 compounds, a high percentage of their terpenes, essential aromatic oils, alkaloids, and phenolic compounds. The results showed a significant improvement in the enzyme (ALT/GPT) level after adding different concentrations of hot aqueous extract to the fruit of the Artemisia plant. The fruit of the Artemisia plant can be used to treat many diseases and improve the activity of liver enzymes., Competing Interests: The authors declare that they have no conflict of interest.

We performed this cohort study to test whether further analysis of intrathecal inflammation can be omitted if the free light chain kappa (FLCκ) quotient is within the reference range in the corresponding quotient diagram. FLCκ concentrations were measured in serum and cerebrospinal fluid (CSF) samples. The intrathecal fraction (IF) of FLCκ was calculated in relation to the hyperbolic reference range. 679 patient samples were used as a discovery cohort (DC). The sensitivity and negative predictive value (NPV) of the FLCκ-IF for the detection of an intrathecal humoral immune response (CSF-specific OCB and/or IF IgG/A/M > 0%) was determined. Based on these data, a diagnostic algorithm was developed and prospectively validated in an independent validation cohort (VC, n = 278). The sensitivity of the FLCκ-IF was 98% in the DC and 97% in the VC with a corresponding NPV of 99%. The use of the FLCκ-IF as a first line analysis would have reduced the Ig and OCB analysis by 62% in the DC and 74% in the VC. The absence of a FLCκ-IF predicts the absence of a humoral intrathecal immune response with a very high NPV of 99%. Thus, integration of our proposed algorithm into routine CSF laboratory analysis could help to reduce analytical efforts.

Preventive strategies involving the use of pneumococcal conjugate vaccines (PCVs) are known to drastically reduce pneumococcal disease. However, PCV vaccination has been plagued with serotype replacement by non-PCV serotypes. In this study, we describe the prevalence and molecular characteristics of non-PCV13 serotypes (non-vaccine serotypes, NVTs) from pneumococcal carriage isolates obtained from children < 5 years old in Cape Coast, Ghana, after PCV introduction. The isolates were subjected to antibiotic susceptibility testing and multilocus sequence typing (MLST), and molecular techniques were used to detect the presence of virulence genes. Serotypes 11A, 13, 15B, 23B, and 34 formed the top five of the 93 NVT isolates. As such, 20 (21.5%), 49 (48.4%), and 70 (74.3%) isolates were non-susceptible to penicillin, tetracycline, and cotrimoxazole, respectively. Sixteen (17.2%) multidrug-resistant isolates were identified. However, non-susceptibility to ceftriaxone and erythromycin was low and all isolates were fully susceptible to levofloxacin, linezolid, and vancomycin. Whereas pcpA, pavB, lytA, and psrP genes were detected in nearly all serotypes, pilus islet genes were limited to serotypes 11A, 13, and 23B. MLST for predominant serotype 23B isolates revealed three known and seven novel sequence types (STs). ST172 and novel ST15111 were the most dominant and both STs were related to PMEN clone Columbia23F-26 (ST338). In conclusion, non-PCV13 serotype 23B was the most prevalent, with characteristics of rapid clonal expansion of ST172 and ST15111, which are related to international clones of the pneumococcus. Continuous monitoring of NVTs in Ghana is, therefore, essential, as they have the potential to cause invasive disease, show high antibiotic resistance, and attenuate the effects of PCV vaccination.

The study aims to examine the moderating effect of self-efficacy on supervisory support and organizational citizenship behavior (OCB). An individual's self-efficacy is defined as their belief in their own ability to successfully complete a goal or task, which influences their motivation, persistence, and decision-making. This study is based on the Conservation of Resource Theory, which holds that personal resources such as self-efficacy can influence employees' perceived support and extra-role behavior (OCB). The data were collected from 618 employees in four public sector organizations in Putrajaya, Malaysia through a questionnaire survey and analyzed using the partial least squares structural equation modeling (PLS-SEM) technique. Resultantly, supervisory support demonstrated a significant positive relationship with OCB. The results suggested that personal resources, such as self-efficacy increase the level of OCB with lower or higher perceived supervisory support. The results highlighted that self-efficacy strengthens supervisory support relations with OCB when supported by employees' self-belief and confidence. It is critical to investigate the role of self-efficacy because industries must constantly change, and employees must have self-efficacy resources to continuously improve and sustain their performance level. The findings can contribute to the literature and open new avenues for future research., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Abdullah and Wider.)

The non-complexity of tennis, coupled with its health benefits, renders it appealing and encourages varying competitions at different levels of age, gender, and expertise. However, the rapid increase in the participation rates witnesses a surge in injury occurrences, prompting the need for in-depth analysis to facilitate immediate intervention. We employed a media content analysis technique in which tennis-associated articles published in the last 5 years were examined. A total of 207 news reports were gathered and screened for analysis. Subsequently, 71 articles were excluded from the study due to content duplications or summary updates of existing news articles, while 23 news articles were also excluded from the study due to inappropriateness. Finally, 113 news reports directly related to injury in tennis were coded and analyzed. We examined various types of injuries reported from the screened articles with respect to their status (fresh, recurrent, and recovery) across expertise levels i.e., elite, or amateur. Similarly, the incidence of injury occurrences based on the types of tournaments the players engage in was also investigated. A chi-square analysis was employed to achieve the objectives of the study. Occurrences of tennis-associated injuries are disseminated across expertise levels [ χ ( 18 ) 2 = 16.542; p = 0.555], with knee, hip, elbow, and shoulder injuries being highly prevalent in both elite and amateur players. Nevertheless, it was noted that elite players suffered a staggering 72.60% of injury-related problems, while amateur players sustained 27.40% of injuries. Moreover, the status of injury spreads based on types of tournaments [ χ ( 4 ) 2 = 3.374; p = 0.497], with higher occurrences of fresh and recurrent injuries, while low recovery rates were observed. The findings further demonstrated that injuries are sustained regardless of tournament types [ χ ( 36 ) 2 = 39.393; p = 0.321]. However, most of the injuries occurred at international tournaments (85%). Whereas, only 5.30% of the injuries occurred at national/regional tournaments while 9.70% were unidentified. It could be deduced from the findings of this investigation that elite players are more prone to injuries compared with amateur players. Furthermore, the most common tennis-related injuries affect the lower, trunk, and upper regions of the body, respectively. A large number of the reported tennis injuries are fresh and recurrent, with a few recoveries. The international tennis tournaments are highly attributed to injury occurrences as opposed to the national/regional tournaments. The application of the media-based data mining technique is non-trivial in projecting injury-related problems that could be used to facilitate the development of an injury index peculiar to the tennis sport for prompt intervention., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Musa, Hassan, Abdullah, Latiff Azmi, Abdul Majeed and Abu Osman.)

Learners’ engagement is shown to be a major predictor of learning, performance, and course completion as well as course satisfaction. It is easier to engage learners in a face-to-face teaching and learning format since the teacher can observe and interpret the learner’s facial expression and body language. However, in a virtual setting with the students sitting behind cameras, it is difficult to ascertain engagement as the students might be absent-mindedly attending the class. Henceforth, with the rapid transition to online learning, designing course content that could actively engage the students towards achieving the said elements is, therefore, necessary. We applied a data-driven approach in designing a virtual physical education and sport science−related course via a learner engagement model. A fully online course catering to 132 students that runs for a total of 14 weeks was used as a case study to develop the course. The study was conducted during the 2020/2021 academic year, which was the period of the peak COVID-19 pandemic in Malaysia. The delivery of the course content was implemented in stages to achieve three essential educational outcomes namely, skill and knowledge acquisition, and personal development as well as course satisfaction. We hypothesised that the developed learners’ engagement approach will promote the students’ acquisition of skills and knowledge and foster the personal development of the students through fitness improvement. It is also hypothesised that the students will be satisfied with the course developed upon successful completion. A chi-square analysis projected a statistically significant difference in the skill and knowledge acquisition before and after the programme (p < 0.001). A Wilcoxon rank-sum test demonstrated personal improvement in the overall fitness of the student upon completing the prescribed activity of the course content. Moreover, a total of 96.2%, 95.5% and 93.2% of students expressed their satisfaction with the clarity of the learning objectives, good organisational and course content plan, and appropriate workload of the course designed, respectively. There is sufficient evidence to accept all hypotheses formulated, and hence, we postulated that, since students spend more time outside the classroom, out-of-class learners’ engagement activity should be considered when designing a virtual course to promote lifelong learning, experience, and higher-order thinking. The techniques presented herein could be useful to academics, professionals, and other relevant stakeholders in developing virtual course content within a specific domain of interest.

Anthropometric variables (AV) are shown to be essential in assessing health status and to serve as markers for evaluating health-related risks in different populations. Studying the impact of physical activity (PA) on AV and its relationship with smoking is a non-trivial task from a public health perspective. In this study, a total of 107 healthy male smokers (37 ± 9.42 years) were recruited from different states in Malaysia. Standard procedures of measurement of several anthropometric indexes were carried out, and the International Physical Activity Questionnaire (IPPQ) was used to ascertain the PA levels of the participants. A principal component analysis was employed to examine the AV associated with physical activity, k-means clustering was used to group the participants with respect to the PA levels, and discriminant analysis models were utilized to determine the differential variables between the groups. A logistic regression (LR) model was further employed to ascertain the efficacy of the discriminant models in classifying the two smoking groups. Six AV out of twelve were associated with smoking behaviour. Two groups were obtained from the k-means analysis, based on the IPPQ and termed partially physically active smokers (PPAS) or physically nonactive smokers (PNAS). The PNAS were found to be at high risk of contracting cardiovascular problems, as compared with the PPAS. The PPAS cluster was characterized by a desirable AV, as well as a lower level of nicotine compared with the PNAS cluster. The LR model revealed that certain AV are vital for maintaining good health, and a partially active lifestyle could be effective in mitigating the effect of tobacco on health in healthy male smokers.

Antibiotic resistance in pneumococci contributes to the high pneumococcal deaths in children. We assessed the molecular characteristics of multidrug-resistant (MDR) pneumococci isolated from healthy vaccinated children under five years of age in Cape Coast, Ghana. A total of 43 MDR isolates were selected from 151 pneumococcal strains obtained from nasopharyngeal carriage. All isolates were previously serotyped by multiplex PCR and Quellung reaction. Susceptibility testing was performed using either the E-test or disk diffusion method. Virulence and antibiotic resistance genes were identified by PCR. Molecular epidemiology was analyzed using multilocus sequence typing (MLST). Vaccine-serotypes 23F and 19F were predominant. The lytA and pavB virulence genes were present in all isolates, whiles 14-86% of the isolates carried pilus-islets 1 and 2, pcpA , and psrP genes. Penicillin, tetracycline, and cotrimoxazole resistance were evident in >90% of the isolates. The ermB , mefA , and tetM genes were detected in (n = 7, 16.3%), (n = 4, 9.3%) and (n = 43, 100%) of the isolates, respectively. However, >60% showed alteration in the pbp2b gene. MLST revealed five novel and six known sequence types (STs). ST156 (Spain 9V -3) and ST802 were identified as international antibiotic-resistant clones. The emergence of international-MDR clones in Ghana requires continuous monitoring of the pneumococcus through a robust surveillance system.

The popularity of modern tennis has contributed to the increasing number of participants at both recreational and competitive levels. The influx of numerous tennis participants has resulted in a wave of injury occurrences of different types and magnitudes across both male and female players. Since tennis injury harms both players' economic and career development, a better understanding of its epidemiology could potentially curtail its prevalence and occurrences. We used online-based tennis-related injury reports to study the prevalence, location types, and injury intensities in both male and female tennis players for the past five years. It is demonstrated from the chi-square analysis that injury occurrences are significantly associated with a specific gender (χ2(18) = 50.773; p = 0.001), with male players having a higher risk of injury manifestation (68.10%) as compared with female players (31.90%). Nonetheless, knee, hip, ankle, and shoulder injuries are highly prevalent in both male and female players. Moreover, the injury intensities are distributed across gender (χ2(2) = 0.398; p = 0.820), with major injuries being dominant, followed by minor injuries, whilst a few cases of career-threatening injuries were also reported. It was similarly observed that male players recorded a higher degree of both major, minor, and career-threatening injuries than female players. In addition, male players sustained more elbow, hip, knee, shoulder, and thigh injuries than female players. Whereas, female players mostly suffered from Achilles and back injuries, ankle and hamstring injuries affected both genders. The usage of online newspaper reports is pivotal in characterizing the epidemiology of tennis-related injuries based on locations and gender to better understand the pattern and localization of injuries, which could be used to address the problem of modern tennis-related injuries.

Respiratory infection caused by Streptococcus pneumoniae is a leading cause of morbidity and mortality in older adults. Acquired CD4 + T cell mechanism are essential for the protection against colonization and subsequent development of infections by S. pneumoniae . In this study, we hypothesized that age-related changes within the CD4 + T-cell population compromise CD4 + T-cell specific responses to S. pneumoniae , thereby contributing to increased susceptibility at older age. To this end, we interrogated the CD4 + T-cell response against the immunogenic pneumococcal protein AliB, part of the unique oligopeptide ABC transporter system responsible for the uptake of nutrients for the bacterium and crucial for the development of pneumococcal meningitis, in healthy young and older adults. Specifically, proliferation of CD4 + T cells as well as concomitant cytokine profiles and phenotypic markers implied in immunosenescence were studied. Older adults showed decreased AliB-induced CD4 + T-cell proliferation that is associated with an increased frequency of regulatory T cells and lower levels of active CD25 + CD127 + CTLA-4 - TIGIT - CD4 + T cells. Additionally, levels of pro-inflammatory cytokines IFNy and IL-17F were decreased at older age. Our findings indicate that key features of a pneumococcal-specific CD4 + T-cell immune response are altered at older age, which may contribute to enhanced susceptibility for pneumococcal infections., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor declared a shared consortium with one of the authors (C.V.E) at time of review., (Copyright © 2021 He, van de Garde, Pieren, Poelen, Voß, Abdullah, Hammerschmidt and van Els.)

H-deficient phenotype individuals with absent or weak anti-H activity may remain undetected on standard routine blood grouping. We report a case of a 59-year-old-man presented with symptomatic anaemia secondary to upper gastrointestinal bleed with haemoglobin level of 68 g/L who required two units of packed red blood cells. He was previously grouped as O Rh D positive and had a history of uneventful multiple blood transfusions. His latest pre-transfusion investigations showed ABO discrepancy between forward and reverse blood grouping, pan-agglutination in both antibody screening and identification with negative direct Coombs test and autocontrol. Further testing including anti-H lectin test and saliva secretor study confirmed that the patient blood group was para-Bombay B RhD positive. This case highlights that the para-Bombay phenotype can be mistakenly labelled as "O" if further investigations are not performed., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

In this work, the stabilities of secondary phases, including carbides, brittle phases, and inclusions, were simulated by computational thermodynamics. Calphad strategical optimization is preferable for all steel alloys regarding energy resource consumption during manufacturing and processing. The alloy composition has been changed to enhance the strength, hardenability, and longevity of a reactor pressure vessel (RPV) steel by computing the phase equilibrium calculations and predicting mechanical properties such as yield and tensile strengths hardness and martensitic and bainitic volume fractions. The stabilities of the pro-eutectoid carbides (cementite), inclusions, and brittle phases in SA508 steel are critical to the toughness and fatigue life related to the crack initiation and expansion of this steel. Overall, the simulations presented in this paper explain the mechanisms that can affect the fatigue resistance and toughness of steel and offer a possible solution to controlling these properties at elevated temperatures by optimizing the steel composition and heat treatment process parameters.

Mechanically ventilated patients are at risk of contracting pneumonia. Therefore, these patients often receive prophylactic systemic antimicrobial therapy. Intriguingly however, a previous study showed that antimicrobial activity in bronchoalveolar aspirates (here referred to as "sputa") from ventilated patients was only partially explained by antibiotic therapy. Here we report that sputa from these patients presented distinct proteome signatures depending on the presence or absence of antimicrobial activity. Moreover, we show that the same distinction applied to antibodies against Streptococcus pneumoniae , which is a major causative agent of pneumonia. Specifically, the investigated sputa that inhibited growth of S. pneumoniae , while containing subinhibitory levels of the antibiotic cefotaxime, presented elevated levels of proteins implicated in innate immune defenses, including complement and apolipoprotein-associated proteins. In contrast, S. pneumoniae -inhibiting sputa with relatively high cefotaxime concentrations or noninhibiting sputa contained higher levels of proteins involved in inflammatory responses, such as neutrophil elastase-associated proteins. In an immunoproteomics analysis, 18 out of 55 S. pneumoniae antigens tested showed significantly increased levels of IgGs in inhibiting sputa. Hence, proteomics and immunoproteomics revealed elevated levels of antimicrobial host proteins or S. pneumoniae antigen-specific IgGs in pneumococcal growth-inhibiting sputa, thus explaining their anti-pneumococcal activity. IMPORTANCE Respiratory pathogens like Streptococcus pneumoniae can cause severe pneumonia. Nonetheless, mechanically ventilated intensive care patients, who have a high risk of contracting pneumonia, rarely develop pneumococcal pneumonia. This suggests the presence of potentially protective antimicrobial agents in their lung environment. Our present study shows for the first time that bronchoalveolar aspirates, "sputa," of ventilated patients in a Dutch intensive care unit were characterized by three distinct groups of proteome abundance signatures that can explain their anti-pneumococcal activity. Importantly, this anti-pneumococcal sputum activity was related either to elevated levels of antimicrobial host proteins or to antibiotics and S. pneumoniae -specific antibodies. Further, the sputum composition of some patients changed over time. Therefore, we conclude that our study may provide a novel tool to measure changes that are indicative of infection-related conditions in the lungs of mechanically ventilated patients., (Copyright © 2021 Seinen et al.)

Nucleotides are important for RNA and DNA synthesis and, despite a de novo synthesis by bacteria, uptake systems are crucial. Streptococcus pneumoniae, a facultative human pathogen, produces a surface-exposed nucleoside-binding protein, PnrA, as part of an ABC transporter system. Here we demonstrate the binding affinity of PnrA to nucleosides adenosine, guanosine, cytidine, thymidine and uridine by microscale thermophoresis and indicate the consumption of adenosine and guanosine by 1 H NMR spectroscopy. In a series of five crystal structures we revealed the PnrA structure and provide insights into how PnrA can bind purine and pyrimidine ribonucleosides but with preference for purine ribonucleosides. Crystal structures of PnrA:nucleoside complexes unveil a clear pattern of interactions in which both the N- and C- domains of PnrA contribute. The ribose moiety is strongly recognized through a conserved network of H-bond interactions, while plasticity in loop 27-36 is essential to bind purine- or pyrimidine-based nucleosides. Further, we deciphered the role of PnrA in pneumococcal fitness in infection experiments. Phagocytosis experiments did not show a clear difference in phagocytosis between PnrA-deficient and wild-type pneumococci. In the acute pneumonia infection model the deficiency of PnrA attenuated moderately virulence of the mutant, which is indicated by a delay in the development of severe lung infections. Importantly, we confirmed the loss of fitness in co-infections, where the wild-type out-competed the pnrA-mutant. In conclusion, we present the PnrA structure in complex with individual nucleosides and show that the consumption of adenosine and guanosine under infection conditions is required for virulence., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The stiffness response or load-deformation/displacement behavior is the most important mechanical behavior that frequently being utilized for validation of the mathematical-physical models representing the mechanical behavior of solid objects in numerical method, compared to actual experimental data. This numerical study aims to investigate the linear-nonlinear stiffness behavior of carbon fiber-reinforced polymer (CFRP) composites at material and structural levels, and its dependency to the sets of individual/group elastic and damage model parameters. In this regard, a validated constitutive damage model, elastic-damage properties as reference data, and simulation process, that account for elastic, yielding, and damage evolution, are considered in the finite element model development process. The linear-nonlinear stiffness responses of four cases are examined, including a unidirectional CFRP composite laminate (material level) under tensile load, and also three multidirectional composite structures under flexural loads. The result indicated a direct dependency of the stiffness response at the material level to the elastic properties. However, the stiffness behavior of the composite structures depends both on the structural configuration, geometry, lay-ups as well as the mechanical properties of the CFRP composite. The value of maximum reaction force and displacement of the composite structures, as well as the nonlinear response of the structures are highly dependent not only to the mechanical properties, but also to the geometry and the configuration of the structures.

In 2012, Ghana introduced PCV13 into its childhood immunization program. To monitor the pneumococcus after PCV13 vaccination, we analyzed serotypes, antibiotic resistance, and virulence genes of pneumococcal carriage isolates among children under five years of age. We obtained nasopharyngeal swabs from 513 children from kindergartens and immunization centers in Cape Coast, Ghana. Pneumococcal serotypes were determined by multiplex-PCR and Quellung reaction. Antibiotic resistance and virulence genes prevalence were determined by disc diffusion and PCR respectively. Overall, carriage prevalence was 29.4% and PCV13 coverage was 38.4%. Over 60% of the isolates were non-PCV13 serotypes and serotype 23B was the most prevalent. One isolate showed full resistance to penicillin, while 35% showed intermediate resistance. Resistance to erythromycin and clindamycin remained low, while susceptibility to ceftriaxone, levofloxacin and vancomycin remained high. Penicillin resistance was associated with PCV13 serotypes. Forty-three (28.5%) strains were multidrug-resistant. Virulence genes pavB , pcpA , psrP , pilus-1 , and pilus-2 were detected in 100%, 87%, 62.9%, 11.9%, and 6.6% of the strains, respectively. The pilus islets were associated with PCV13 and multidrug-resistant serotypes. PCV13 vaccination had impacted on pneumococcal carriage with a significant increase in non-PCV13 serotypes and lower penicillin resistance. Including PcpA and PsrP in pneumococcal protein-based vaccines could be beneficial to Ghanaian children.

These datasets described the data of the Motor Performance Index for 7 years old kids in Malaysia based on Malaysia's physical fitness test SEGAK. This database has been designed and created with data analysis to create the index from the factor and variable of the test and the test was conducted in the majority of the national primary school in Malaysia. Gender, state of origin, and residential location of the school were the factors used to categorize the participant of the test. The factor of age, weight, height, body mass index (BMI), power, flexibility, coordination, and speed were used for the measurement to relate with the participant's physical fitness. Kids Motor Performances Index data can be reused for talent identification in sport talent scout and to create a baseline for kid's biology growth specifically in gross motor skills and cognitive growth measurement., Competing Interests: The authors confirm that they have no established conflicting financial interests or personal relationships that have influenced the research reported in this article, or may be perceived to have influenced it., (© 2020 The Authors.)

Several sites, Z-7L, Z-5 and Z-14, in Sibu district, Sarawak, Malaysia, experienced intense dengue transmission in 2014 that continued into 2015. A pilot study with Bacillus thuringiensis israelensis (Bti) to control Aedes aegypti (L.) and Ae. albopictus (Skuse) was evaluated in Z-7L, a densely populated site of 12 ha. Bti treatments were conducted weekly from epidemiology week (EW) 24/2015 for 4 weeks, followed by fortnight treatments for 2 months, in addition to the routine control activities. Bti was directly introduced into potable containers and the outdoor artificial and natural containers were treated via a wide area spray application method using a backpack mister. Aedes indices significantly reduced during the treatment and post treatment phases, compared to the control site, Z-5 (p<0.05). A 51 fold reduction in the incidence rate per 100,000 population (IR) was observed, with one case in 25 weeks (EW 29-52). In Z-5 and Z-14, control sites, a 6 fold reduction in the IR was observed from EW 29-52. However, almost every week there were dengue cases in Z-14 and until EW 44 in Z-5. In 2016, dengue cases resurfaced in Z-7L from EW 4. Intensive routine control activities were conducted, but the IR continued to escalate. The wide area Bti spray misting of the outdoor containers was then included from EW 27 on fortnight intervals. A 6 fold reduction in IR was observed in the Bti treatment phase (EW 32-52) with no successive weekly cases after EW 37. However, in the control sites, there were dengue cases throughout the year from EW 1-52, particularly in Z-14. We feel that the wide area Bti spray application method is an integral component in the control program, in conjunction with other control measures carried out, to suppress the vector population in outdoor cryptic containers and to interrupt the disease transmission., Competing Interests: One of the authors, Seleena Benjamin, is a Manager from Valent BioSciences LLC, the manufacturer of the bacterial larvicide, VectoBac WG. The commercial affiliation DOES NOT ALTER our adherence to PLOS ONE policies on sharing data and materials.

The present study aims to identify the essential technical and tactical performance indicators that could differentiate winning and losing performance in the Asian elite beach soccer competition. A set of 20 technical and tactical performance indicators namely; shot back-third, shot mid-third, shot front-third, pass back-third, pass mid-third, pass front-third, shot in box, shot outbox, chances created, interception, turnover, goals scored 1st period, goals scored 2nd period, goals scored 3rd period, goals scored extra time, tackling, fouls committed, complete save, incomplete save and passing error were observed during the beach soccer Asian Football Confederation tournament 2017 held in Malaysia. A total of 23 matches from 12 teams were notated using StatWatch application in real-time. Discriminant analysis (DA) of standard, backward as well stepwise modes were used to develop a model for the winning (WT) and losing team (LT) whilst Mann-Whitney U test was utilized to ascertain the differences between the WT and LT with respect to the performance indicators evaluated. The standard backward, forward and stepwise discriminates the WT and the LT with an excellent accuracy of 95.65%, 91.30% and 89.13%, respectively. The standard DA model discriminated the teams from seven performance indicators whilst both the backward and forward stepwise identified two performance indicators. The Mann-Whitney U test analysis indicated that the WT is statistically significant from the LT based on the performance indicators determined from the standard mode model of the DA. It was demonstrated that seven performance indicators namely; shot front-third, pass front-third, chances created, goals scores at the 1st period, goals scored at the 2nd period, goals scored at 3rd period were directly linked to a successful performance whilst the incomplete save by the keeper attribute towards the poor performance of the team. The present finding could serve useful to the coaches as well as performance analysts as a measure of profiling successful performance and enables team improvement with respect to the associated performance indicators., Competing Interests: The authors have declared that no competing interests exist.

k-nearest neighbour (k-NN) has been shown to be an effective learning algorithm for classification and prediction. However, the application of k-NN for prediction and classification in specific sport is still in its infancy. The present study classified and predicted high and low potential archers from a set of physical fitness variables trained on a variation of k-NN algorithms and logistic regression. 50 youth archers with the mean age and standard deviation of (17.0 ± 0.56) years drawn from various archery programmes completed a one end archery shooting score test. Standard fitness measurements of the handgrip, vertical jump, standing broad jump, static balance, upper muscle strength and the core muscle strength were conducted. Multiple linear regression was utilised to ascertain the significant variables that affect the shooting score. It was demonstrated from the analysis that core muscle strength and vertical jump were statistically significant. Hierarchical agglomerative cluster analysis (HACA) was used to cluster the archers based on the significant variables identified. k-NN model variations, i.e., fine, medium, coarse, cosine, cubic and weighted functions as well as logistic regression, were trained based on the significant performance variables. The HACA clustered the archers into high potential archers (HPA) and low potential archers (LPA). The weighted k-NN outperformed all the tested models at itdemonstrated reasonably good classification on the evaluated indicators with an accuracy of 82.5 ± 4.75% for the prediction of the HPA and the LPA. Moreover, the performance of the classifiers was further investigated against fresh data, which also indicates the efficacy of the weighted k-NN model. These findings could be valuable to coaches and sports managers to recognise high potential archers from a combination of the selected few physical fitness performance indicators identified which would subsequently save cost, time and energy for a talent identification programme., Competing Interests: The authors have declared that no competing interests exist.

Streptococcus pneumoniae is endowed with a variety of surface-exposed proteins representing putative vaccine candidates. Lipoproteins are covalently anchored to the cell membrane and highly conserved among pneumococcal serotypes. Here, we evaluated these lipoproteins for their immunogenicity and protective potential against pneumococcal colonisation. A multiplex-based immunoproteomics approach revealed the immunogenicity of selected lipoproteins. High antibody titres were measured in sera from mice immunised with the lipoproteins MetQ, PnrA, PsaA, and DacB. An analysis of convalescent patient sera confirmed the immunogenicity of these lipoproteins. Examining the surface localisation and accessibility of the lipoproteins using flow cytometry indicated that PnrA and DacB were highly abundant on the surface of the bacteria. Mice were immunised intranasally with PnrA, DacB, and MetQ using cholera toxin subunit B (CTB) as an adjuvant, followed by an intranasal challenge with S. pneumoniae D39. PnrA protected the mice from pneumococcal colonisation. For the immunisation with DacB and MetQ, a trend in reducing the bacterial load could be observed, although this effect was not statistically significant. The reduction in bacterial colonisation was correlated with the increased production of antigen-specific IL-17A in the nasal cavity. Immunisation induced high systemic IgG levels with a predominance for the IgG1 isotype, except for DacB, where IgG levels were substantially lower compared to MetQ and PnrA. Our results indicate that lipoproteins are interesting targets for future vaccine strategies as they are highly conserved, abundant, and immunogenic.

Support Vector Machine (SVM) has been shown to be an effective learning algorithm for classification and prediction. However, the application of SVM for prediction and classification in specific sport has rarely been used to quantify/discriminate low and high-performance athletes. The present study classified and predicted high and low-potential archers from a set of fitness and motor ability variables trained on different SVMs kernel algorithms. 50 youth archers with the mean age and standard deviation of 17.0 ± 0.6 years drawn from various archery programmes completed a six arrows shooting score test. Standard fitness and ability measurements namely hand grip, vertical jump, standing broad jump, static balance, upper muscle strength and the core muscle strength were also recorded. Hierarchical agglomerative cluster analysis (HACA) was used to cluster the archers based on the performance variables tested. SVM models with linear, quadratic, cubic, fine RBF, medium RBF, as well as the coarse RBF kernel functions, were trained based on the measured performance variables. The HACA clustered the archers into high-potential archers (HPA) and low-potential archers (LPA), respectively. The linear, quadratic, cubic, as well as the medium RBF kernel functions models, demonstrated reasonably excellent classification accuracy of 97.5% and 2.5% error rate for the prediction of the HPA and the LPA. The findings of this investigation can be valuable to coaches and sports managers to recognise high potential athletes from a combination of the selected few measured fitness and motor ability performance variables examined which would consequently save cost, time and effort during talent identification programme., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: We examined the parental perception and accuracy of the Mandarin translation of the Parents' Evaluation of Developmental Status, a screening questionnaire for parent concerns about children's various developmental skills., Methods: The questionnaire was translated into Mandarin. Upon enrollment, caregivers completed the Mandarin PEDS and answered four questions about its acceptability and usefulness, and its ease of understanding and completion. The Mandarin PEDS was independently evaluated by a pediatrician and a community nurse, and classified as high risk (≥two predictive concerns), medium risk (one predictive concern), low risk (any non-predictive concerns) or no risk (if no concern) for developmental delays. The caregivers repeated Mandarin PEDS at a 2 week interval for test-retest reliability, while the children underwent testing for accuracy using a developmental assessment test., Results: The majority (≥85%) of the 73 caregivers perceived the Mandarin PEDS as acceptable and useful, as well as easy to understand and complete. Fifteen (20.5%) and 24 responses (33.9%) were classified as high and moderate risk, respectively. The test-retest and inter-rater reliabilities were excellent, with an intra-class correlation coefficient of 0.812 (95% CI: 0.701-0.881, P < 0.001) and a kappa value of 0.870 (P < 0.001), respectively. Mandarin PEDS was 80.0% sensitive and 83.8% specific for those in the high-risk category (adjusted OR, 64.68; 95% CI: 1.33-3,139.72; P = 0.035)., Conclusion: Mandarin PEDS was well received by the caregivers, and was reliable and accurate in detecting developmental delays in the Mandarin-speaking subjects. We recommend it for early detection of children with developmental and behavioral problems., (© 2017 Japan Pediatric Society.)