Search

As club sports become more prominent at the university and youth sport levels, it is important to investigate their effects on students' moral reasoning as this may further support the existence of these programs as going beyond simply building sport skills. Even though there have been numerous studies suggesting that individuals' moral reasoning differs between sport and everyday contexts, it is still not understood if influences on moral reasoning in sport are associated with different levels of moral reasoning in everyday life. This study sought to determine if athlete moral decisions in parallel moral dilemmas were treated the same in their outcome decision making. The results of this study suggest that as club sport athletes progress through their time in school, their moral reasoning in sport progresses to a higher level and becomes more similar to their moral reasoning in daily life situations. This contradicts previous studies in collegiate varsity athletics that have suggested that athletes' moral reasoning in sport situations decreases as they get older.

Short-term faculty-led study abroad programs have been offered in various institutions across the United States. Despite the many program offerings, students who are interested in the niche marketplace have been experiencing limited program participation. Therefore, the purpose of this paper is to introduce the use of online communication platforms in delivering a multi-institutional Paralympic study abroad experience among students from nine different universities across the United States and Canada. Specifically, this document intends to guide instructors in implementing a multi-institutional study abroad program. In addition, the paper shares thoughts on the beneficial opportunities study abroad trips can create for students who have a passion in the field of disability sport.

Food insecurity affects 11.1% of households in the United States, leaving many families susceptible to poor diet quality (Coleman-Jensen et al., 2021). Food insecurity, as defined by the U. S. Department of Agriculture, can range from a decrease in the quality, variety, or desirability of the diet to disrupted eating patterns and reduced food intake (Coleman-Jensen et al., 2021). The percentage may be even higher among college students, up to one-third of that population, especially given the financial instability and unique living conditions that many students face. In some studies, up to 48% of college students were classified as food insecure (Coleman-Jensen et al., 2021; El Zein et al., 2018; Payne-Sturges et al., 2018; Twill et al., 2016). Food insecurity can contribute to a decline in health, especially when combined with other stressors from school, work, and relationships (Leung et al., 2014; Watson et al., 2017). Food insecurity puts both the students and their schools at risk.

Sona Jobarteh, the first woman to achieve an international profile playing the kora, is a singular figure in the pantheon of twenty-first-century African artists. Read Banning Eyre's profile of her [...]

Background Aortic stenosis is a life-limiting condition for which transcatheter aortic valve implantation (TAVI) is an established therapy. Coronary artery disease (CAD) is frequently found in this patient group and optimal management in these patients remains uncertain.Objectives We sought to examine the association of coexistent CAD on mortality and hospital readmission in patients undergoing TAVI.Methods In this observational cohort study, we examined patients who underwent TAVI and segregated them by the presence of obstructive epicardial CAD. The primary outcome was 3-year mortality with secondary outcomes being readmission for (1) all-causes, (2) a MACE (Major Adverse Cardiovascular Event) composite endpoint and (3) acute coronary syndrome. Subsidiary outcomes included patient angina and breathlessness scores.Results 898 patients underwent TAVI, of which 488 (54.3%) had unobstructed coronary arteries and 410 (45.7%) had obstructive CAD. Overall, n=298 (33.2%) patients experienced the primary mortality endpoint with no significant difference when stratified according to CAD (n=160 (32.9%) vs n=136 (33.2%), HR 0.98, CI 0.78 to 1.24). After multivariate analysis, the presence of CAD had no effect on the primary outcome (HR 0.98, CI 0.68 to 1.40). There was no significant difference in readmission for any cause (n=181, 37.1% (CAD) vs n=169, 41.2% (no CAD), p=0.23), including no significant difference on readmission for MACE (n=48, 9.8% (CAD) vs n=45, 11.0% (no CAD), p=0.11). CAD at the time of TAVI also did not alter breathlessness or angina scores before/after TAVI (p>0.05).Conclusion Coexistent CAD had no significant association with mortality, any-cause readmission or symptoms for patients undergoing TAVI in our cohort.

Background In patients with distal bifurcation left main stem lesions requiring intervention, the European Bifurcation Club Left Main Coronary Stent Study trial found a non-significant difference in major adverse cardiac events (MACEs, composite of all-cause death, non-fatal myocardial infarction and target lesion revascularisation) favouring the stepwise provisional strategy, compared with the systematic dual stenting.Aims To estimate the 1-year cost-effectiveness of stepwise provisional versus systematic dual stenting strategies.Methods Costs in France and the UK, and MACE were calculated in both groups to estimate the incremental cost-effectiveness ratio (ICER). Uncertainty was explored by probabilistic bootstrapping. The analysis was conducted from the perspective of the healthcare provider with a time horizon of 1 year.Results The cost difference between the two groups was €−755 (€5700 in the stepwise provisional group and €6455 in the systematic dual stenting group, p value

ABSTRACTSexual transmission of enteric pathogens among men who have sex with men (MSM) is well documented, although whether providers are cognizant of this risk when MSM patients present with gastrointestinal symptoms has not been studied. Over 34 months at a major tertiary metropolitan medical system, this study retrospectively analyzed 436 BioFire FilmArray Gastrointestinal results from 361 patients documented as MSM. An extensive chart review was performed, including specific sexual behaviors, socioeconomic risk factors, and whether providers charted a sexual history when a patient presented for care. Overall BioFire positivity rate was 62% with no significant difference in positivity between persons living with HIV and those without. Patients charted as sexually active had a significantly increased odds ratio (OR) of a positive result compared to those who were not. Anilingus had the highest OR. Providers charted any type of sexual history in 40.6% of cases, and HIV/infectious disease providers were significantly more likely to do this compared to other subspecialties. Sexual transmission of enteric pathogens within MSM is ongoing, and patients are at risk regardless of living with HIV. Not all sexual behaviors have the same associated risk, highlighting opportunities to decrease transmission. Increased provider vigilance and better patient education on sexual transmission of enteric pathogens are needed to reduce the disease burden.IMPORTANCEOur work adds several key findings to the growing body of literature describing the epidemiology of enteric pathogens as sexually transmitted infections among men who have sex with men (MSM). We analyzed clinical test results, housing status, provider awareness, sexual behaviors, and symptoms for 361 patients. We found that any sexual activity was associated with an increased risk of diarrheal pathogen detection, whereas being unhoused was not a risk factor. These findings suggest separate transmission networks between unhoused persons, who are also at risk of infectious diarrhea, and MSM. Moreover, our study suggested low awareness among patient-facing clinicians that diarrheal pathogens can be sexually transmitted. Together, our findings indicate an important opportunity to disrupt transmission cycles by educating clinicians on how to assess and counsel MSM patients.

Background: The assessment of coronary microvascular dysfunction (CMD) using invasive methods is a field of growing interest, however the preferred method remains debated. Bolus and continuous thermodilution are commonly used methods, but weak agreement has been observed in patients with angina with non-obstructive coronary arteries (ANOCA). This study examined their agreement in revascularized acute coronary syndromes (ACS) and chronic coronary syndromes (CCS) patients. Objective: To compare bolus thermodilution and continuous thermodilution indices of CMD in revascularized ACS and CCS patients and assess their diagnostic agreement at pre-defined cut-off points. Methods: Patients from two centers underwent paired bolus and continuous thermodilution assessments after revascularization. CMD indices were compared between the two methods and their agreements at binary cut-off points were assessed. Results: Ninety-six patients and 116 vessels were included. The mean age was 64 ± 11 years, and 20 (21 %) were female. Overall, weak correlations were observed between the Index of Microcirculatory Resistance (IMR) and continuous thermodilution microvascular resistance (Rµ) (rho = 0.30p = 0.001). The median coronary flow reserve (CFR) from continuous thermodilution (CFRcont) and bolus thermodilution (CFRbolus) were 2.19 (1.76–2.67) and 2.55 (1.50–3.58), respectively (p

Abstract There are currently no approved pharmacological treatment options for aortic stenosis (AS), and there are limited identified drug targets for this chronic condition. It remains unclear whether inflammation plays a role in AS pathogenesis and whether immunomodulation could become a therapeutic target. We evaluated the potentially causal association between inflammation and AS by investigating the genetically proxied effects of tocilizumab (IL6 receptor, IL6R, inhibitor), canakinumab (IL1β inhibitor) and colchicine (β-tubulin inhibitor) through a Mendelian randomisation (MR) approach. Genetic proxies for these drugs were identified as single nucleotide polymorphisms (SNPs) in the gene, enhancer or promoter regions of IL6R, IL1β or β-tubulin gene isoforms, respectively, that were significantly associated with serum C-reactive protein (CRP) in a large European genome-wide association study (GWAS; 575,531 participants). These were paired with summary statistics from a large GWAS of AS in European patients (653,867 participants) to then perform primary inverse-variance weighted random effect and sensitivity MR analyses for each exposure. This analysis showed that genetically proxied tocilizumab was associated with reduced risk of AS (OR 0.56, 95% CI 0.45–0.70 per unit decrease in genetically predicted log-transformed CRP). Genetically proxied canakinumab was not associated with risk of AS (OR 0.80, 95% CI 0.51–1.26), and only one suitable SNP was identified to proxy the effect of colchicine (OR 34.37, 95% CI 1.99–592.89). The finding that genetically proxied tocilizumab was associated with reduced risk of AS is concordant with an inflammatory hypothesis of AS pathogenesis. Inhibition of IL6R may be a promising therapeutic target for AS management.

The spectacular finds at Turkey’s Göbekli Tepe have fired the imaginations of archaeologists and the general public alike. Reflecting on developments at and about the site since the 2011 publication of a critique of the site’s dominant interpretation as a hunter-gatherer cult centre, this article shows that some elements of that critique, including assertions about roofing and a residential population, have gained traction, while others have fallen on deaf ears. Göbekli Tepe has also become the locus of discussion and speculation in disciplines ranging from astronomy and religion to psychology and architectural history, while also inspiring pseudoscientific claims that associate the site with the Garden of Eden, a supposed technologically sophisticated pre-Holocene civilization or extraterrestrial visitors.

Introduction: We studied the accuracy of the automatic speech recognition (ASR) software by comparing ASR scores with manual scores from a verbal learning test (VLT) and a semantic verbal fluency (SVF) task in a semiautomated phone assessment in a memory clinic population. Furthermore, we examined the differentiating value of these tests between participants with subjective cognitive decline (SCD) and mild cognitive impairment (MCI). We also investigated whether the automatically calculated speech and linguistic features had an additional value compared to the commonly used total scores in a semiautomated phone assessment. Methods: We included 94 participants from the memory clinic of the Maastricht University Medical Center+ (SCD N = 56 and MCI N = 38). The test leader guided the participant through a semiautomated phone assessment. The VLT and SVF were audio recorded and processed via a mobile application. The recall count and speech and linguistic features were automatically extracted. The diagnostic groups were classified by training machine learning classifiers to differentiate SCD and MCI participants. Results: The intraclass correlation for inter-rater reliability between the manual and the ASR total word count was 0.89 (95% CI 0.09–0.97) for the VLT immediate recall, 0.94 (95% CI 0.68–0.98) for the VLT delayed recall, and 0.93 (95% CI 0.56–0.97) for the SVF. The full model including the total word count and speech and linguistic features had an area under the curve of 0.81 and 0.77 for the VLT immediate and delayed recall, respectively, and 0.61 for the SVF. Conclusion: There was a high agreement between the ASR and manual scores, keeping the broad confidence intervals in mind. The phone-based VLT was able to differentiate between SCD and MCI and can have opportunities for clinical trial screening.

Abstract Background Endometrial cancer (EC) is the most common gynecologic malignancy in developed countries, with overall incidence increasing, particularly high‐grade disease. There is sparse information regarding quality of life (QOL) in EC survivors with a focus on grade of disease. Methods A total of 259 women with EC diagnosed between 2016 and 2020 were identified via the Metropolitan Detroit Cancer Surveillance System and consented to enroll in the Detroit Research on Cancer Survivors cohort study (if African American, n = 138) or completed the baseline interview (if non‐Hispanic white, n = 121). Each respondent provided information about their health history, educational attainment, health behaviors, and demographics. The Functional Assessment of Cancer Therapy‐General (FACT‐G) and Endometrial‐specific (FACT‐En) were used to assess QOL. Results Women diagnosed with high‐grade (n = 112) and low‐grade (n = 147) EC participated in this study. EC survivors with high‐grade disease reported significantly lower QOL compared to survivors with low‐grade disease (85 vs. 91, respectively, p value = 0.025) as assessed by the FACT‐G. This difference was driven by lower physical and functional subscales among women with high‐grade disease compared to those with low‐grade disease (p value = 0.016 and p = 0.028, respectively). Interestingly, EC‐specific QOL measures, as assessed by the FACT‐En, did not differ by grade. Conclusion Grade of disease impacts QOL in EC survivors, as well as socioeconomic, psychological, and physical factors. Most of these factors are amenable to interventions and should be assessed in patients after an EC diagnosis.

Objective Takotsubo syndrome (TTS) is an acute heart failure syndrome which resembles acute coronary syndrome (ACS) at presentation. Differentiation requires coronary angiography, but where this does not occur immediately, cardiac biomarkers may provide additional utility. We performed a meta-analysis to compare troponin and natriuretic peptides (NPs) in TTS and ACS to determine if differences in biomarker profile can aid diagnosis.Methods We searched five literature databases for studies reporting NPs (Brain NP (BNP)/NT-pro-BNP) or troponin I/T in TTS and ACS, identifying 28 studies for troponin/NPs (5618 and 1145 patients, respectively).Results Troponin was significantly lower in TTS than ACS (standardised mean difference (SMD) −0.86; 95% CI, −1.08 to −0.64; p

In transitioning a 3-day in-person soccer camp for veterans with disabilities to a virtual format due to the COVID-19 pandemic, one of our greatest concerns was that veterans would lose the opportunity to establish social connections, which had heightened importance to this population because of the social isolation brought on by restrictions on social gatherings. During each of our virtual camps, we successfully carried out a virtual dinner in which meals were delivered to 20+ participants across 3 different time zones within 15 minutes of each other so that participants could enjoy visiting with each other and establishing friendships over dinner after a day of learning together in camp. In future in-person camps, we will utilize what we learned from the virtual dinners by having a student in charge of all meal logistics (a great programming experience and resume builder), and by having meals pre-ordered to further support the opportunity for networking.