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With the proliferation of new video streaming OTT service applications, content providers must guarantee an efficient, effective and satisfactory interaction between the user and the service application, to measure this they use the quality of experience (QoE). QoE in the context of telecommunications can be understood as the acceptability of a service perceived by end users. However, given the variability of the network and the different factors that can intervene during the service, this perception can be altered and one of these causes is stalling events. It is necessary to have an accurate method to detect stalling events, allowing content providers to make better decisions in the design of their OTT applications and thus reduce customer desertion and the economic losses of service or content providers. For this reason, in this paper firstly we show a comparative analysis of supervised algorithms showing its invalidity given the imbalance of the data despite the high levels of accuracy. Therfore, we propose as a contribution a novel method based on algorithms provided by SSAD (Semi Supervised Anomaly Detection) for the detection of stalling events. Finally, we observe that in our method the Isolation Forest model has the best performance, closer to 1 and we will show more detail about its performance in future works. [ABSTRACT FROM AUTHOR]

Reaching close-to-optimal bandwidth utilization in dynamic adaptive streaming over HTTP (DASH) systems can, in theory, be achieved with a small discrete set of bit rate representations. This includes typical bit rate ladders used in state-of-the-art DASH systems. In practice, however, we demonstrate that bandwidth utilization, and consequently the quality of experience (QoE), can be improved by offering a continuous set of bit rate representations, i.e., a continuous bit rate slide (COBIRAS). Moreover, we find that the buffer fill behavior of different standard adaptive bit rate (ABR) algorithms is sub-optimal in terms of bandwidth utilization. To overcome this issue, we leverage COBIRAS' flexibility to request segments with any arbitrary bit rate and propose a novel ABR algorithm MinOff, which helps maximizing bandwidth utilization by minimizing download off-phases during streaming. To avoid extensive storage requirements with COBIRAS and to demonstrate the feasibility of our approach, we design and implement a proof-of-concept DASH system for video streaming that relies on just-in-time encoding (JITE), which reduces storage consumption on the DASH server. Finally, we conduct a performance evaluation on our testbed and compare a state-of-the-art DASH system with few bit rate representations and our JITE DASH system, which can offer a COBIRAS, in terms of bandwidth utilization and video QoE for different ABR algorithms. [ABSTRACT FROM AUTHOR]

Background and purpose: The relationship between dietary patterns and cirrhosis is undeniable. The present study aimed to investigate the association between the Dietary Approaches to Stop Hypertension (DASH) diet and the risk of mortality in patients with cirrhosis prospectively. Methods: In this cohort study, 121 cirrhotic patients were enrolled and followed up annually for four years. Nutritional status and dietary intakes were assessed initially, and the DASH score was calculated accordingly. Crude and multivariable-adjusted hazard ratios (HR) with 95% confidence intervals (CI) were estimated using Cox proportional hazard analyses. Results: DASH components including fruits, vegetables, legumes, nuts and seeds, and low-fat dairy products were significantly associated with lower mortality risk in cirrhotic patients. Also, a higher DASH score was significantly associated with a reduction in the risk of mortality in patients with cirrhosis, so that after adjusting for all confounders, the risk of mortality in the upper tertile was 89% lower than the first tertile (HR = 0.11, 95% CI: 0.03–0.42, P trend < 0.001). The 4-year survival rate among patients across tertiles of DASH was 32%, 37%, and 46%, respectively (P = 0.005). Conclusion: It can be concluded that a higher DASH diet score may be associated with a reduced risk of mortality in cirrhotic patients. However, larger studies are needed to confirm the findings and determine their potential mechanisms. [ABSTRACT FROM AUTHOR]

Aims: Steroid injections are used for subacromial pain syndrome and can be administered via the anterolateral or posterior approach to the subacromial space. It is not currently known which approach is superior in terms of improving clinical symptoms and function. This is the protocol for a randomized controlled trial (RCT) to compare the clinical effectiveness of a steroid injection given via the anterolateral or the posterior approach to the subacromial space. Methods: The Subacromial Approach Injection Trial (SAInT) study is a single-centre, parallel, two-arm RCT. Participants will be allocated on a 1:1 basis to a subacromial steroid injection via either the anterolateral or the posterior approach to the subacromial space. Participants in both trial arms will then receive physiotherapy as standard of care for subacromial pain syndrome. The primary analysis will compare the change in Oxford Shoulder Score (OSS) at three months after injection. Secondary outcomes include the change in OSS at six and 12 months, as well as the Pain Numeric Rating Scale (0 = no pain, 10 = worst pain), Disabilities of Arm, Shoulder and Hand questionnaire (DASH), and 36-Item Short-Form Health Survey (SF-36) (RAND) at three months, six months, and one year after injection. Assessment of pain experienced during the injection will also be determined. A minimum of 86 patients will be recruited to obtain an 80% power to detect a minimally important difference of six points on the OSS change between the groups at three months after injection. Conclusion: The results of this trial will demonstrate if there is a difference in shoulder pain and function after a subacromial space steroid injection between the anterolateral versus posterior approach in patients with subacromial pain syndrome. This will help to guide treatment for patients with subacromial pain syndrome. Cite this article: Bone Jt Open 2024;5(9):729–735.

Abstract Background and purpose The relationship between dietary patterns and cirrhosis is undeniable. The present study aimed to investigate the association between the Dietary Approaches to Stop Hypertension (DASH) diet and the risk of mortality in patients with cirrhosis prospectively. Methods In this cohort study, 121 cirrhotic patients were enrolled and followed up annually for four years. Nutritional status and dietary intakes were assessed initially, and the DASH score was calculated accordingly. Crude and multivariable-adjusted hazard ratios (HR) with 95% confidence intervals (CI) were estimated using Cox proportional hazard analyses. Results DASH components including fruits, vegetables, legumes, nuts and seeds, and low-fat dairy products were significantly associated with lower mortality risk in cirrhotic patients. Also, a higher DASH score was significantly associated with a reduction in the risk of mortality in patients with cirrhosis, so that after adjusting for all confounders, the risk of mortality in the upper tertile was 89% lower than the first tertile (HR = 0.11, 95% CI: 0.03–0.42, P trend

Abstract Background Handwriting is a commonly reported functional limitation for children with juvenile idiopathic arthritis (JIA). The aim of this study was to evaluate handwriting in children with JIA. Findings Twelve children (mean age 13.0 years, SD = 1.9; range 9.1 to 15.6 years) with JIA completed the Detailed Assessment of Speed of Handwriting (DASH). The presence of hand and wrist arthritis, grip strength, disability, pain, and quality of life (QOL) was also assessed. The mean DASH score was 34.5th percentile (SD = 22.5). Eight (75%) scored below the 50th centile. DASH scores were negatively associated with grip strength (r = -0.31). Conclusions Handwriting difficulties are common in children with JIA. Handwriting assessment may be helpful to direct treatments, and advocate for support and accommodations in school.

Background. Single Assessment Numeric Evaluation (SANE) Score is a single-answer scale widely used within the global medical community. However, to date, it has not been adapted and validated into Russian, particularly as a tool to assess orthopedic shoulder conditions. The aim of the study is to conduct a cross-cultural adaptation and validation of the Russian version of the SANE score as an assessment tool of orthopedic shoulder conditions. Methods. The study included a total of 160 patients with various shoulder pathologies, of which 101 (63%) males and 59 (37%) females. The median age was 45 (37-52) years. At the first stage of the study, we performed cross-cultural adaptation of the SANE score into Russian. The second stage was the validation of the obtained score. Its reliability, validity and responsiveness were evaluated. Reliability was assessed by “test-retest” method. It allowed to measure an intra-class correlation coefficient (ICC) between the SANE score results obtained at the time of the first appointment and again in 14 days. The validity assessment was based on the comparison of the SANE and ASES (have already been adapted into Russian) score results. Responsiveness was assessed using statistical analysis for two dependent samples and calculation of the Guyatt’s Responsivity Index (GRI). Floor and ceiling effects were evaluated as the percentage of patients who reported either minimum or maximum scores. Results. The psychometric properties assessment has revealed good indicators of reliability (ICC = 0.77), validity (a strong direct correlation between SANE and ASES scores = 0.707; a moderate strength inverse correlation with ASES “Intensity of pain” subsection = 0.542) and responsiveness (GRI = 1.861). Floor and ceiling effects accounted for 1% and 3%, respectively, (all below 15%). Conclusions. Adapted to assess the shoulder conditions, the Russian version of the SANE score has good psychometric properties. Its advantage is the combination of completion speed and ease of use with a high-quality integrated subjective assessment of the patients’ set of complaints.

Abstract Background It is unclear if improving diet quality after midlife could reduce the risk of physical frailty at late life. We aimed to associate changes in diet quality after midlife with physical frailty at late life. Methods Diet quality in 12,580 participants from the Singapore Chinese Health Study was assessed with the Dietary Approaches to Stop Hypertension (DASH) scores at baseline (1993–1998; mean age 53 years) and follow-up 3 (2014–2016; mean age 73 years). Physical frailty was assessed using the modified Cardiovascular Health Study phenotype at follow-up 3. Multivariable logistic regressions examined associations between DASH scores and physical frailty. Results Comparing participants in extreme quartiles of DASH scores, the odds ratios (OR) [95% confidence interval (CI)] for physical frailty were 0.85 (0.73,0.99) at baseline and 0.49 (0.41, 0.58) at follow-up 3. Compared to participants with consistently low DASH scores, participants with consistently high scores (OR 0.74, 95% CI: 0.59, 0.94) and those with > 10% increase in scores (OR 0.78, 95% CI: 0.64, 0.95) had lower odds of frailty. Compared to those in the lowest DASH tertiles at both time-points, significantly lower odds of physical frailty were observed in those who were in the highest DASH tertiles at both time points [0.59 (0.48, 0.73)], and in those who improved their scores from the lowest [0.68 (0.51, 0.91)] or second tertile at baseline [0.61 (0.48, 0.76)] to the highest tertile at follow-up 3. Conclusions Maintaining a high diet quality or a substantial improvement in diet quality after midlife could lower the risk of physical frailty at late life.

Background: Handwriting is a commonly reported functional limitation for children with juvenile idiopathic arthritis (JIA). The aim of this study was to evaluate handwriting in children with JIA. Findings: Twelve children (mean age 13.0 years, SD = 1.9; range 9.1 to 15.6 years) with JIA completed the Detailed Assessment of Speed of Handwriting (DASH). The presence of hand and wrist arthritis, grip strength, disability, pain, and quality of life (QOL) was also assessed. The mean DASH score was 34.5th percentile (SD = 22.5). Eight (75%) scored below the 50th centile. DASH scores were negatively associated with grip strength (r = -0.31). Conclusions: Handwriting difficulties are common in children with JIA. Handwriting assessment may be helpful to direct treatments, and advocate for support and accommodations in school. [ABSTRACT FROM AUTHOR]

A healthy diet prevents overweight problems and hypertension. We investigated the associations of a healthy diet with the body mass index (BMI) and blood pressure (BP) in early childhood. In the GECKO birth cohort, height, weight, and BP were measured at 5 and 10 years of age. Diet was evaluated at 3 years using three diet scores: the Dietary Approaches to Stop Hypertension (DASH), the Mediterranean Diet Score (MDS), and the Lifelines Diet Score (LLDS). Linear and logistic regression models assessed the associations of diet scores with the BMI and BP. Of the 1077 children included, 10.8% were overweight or obese at 5 years. That number was 16.5% at 10 years. In addition, 34.5% had elevated BP at 5 years. That number was 23.9% at 10 years. Higher DASH, MDS, and LLDS, which indicate healthier diets, were all associated with lower BMI z-scores at 10 years of age. Higher DASH is related to lower overweight risk at 10 years. None of the diet scores were associated with BP or elevated BP at either 5 or 10 years. Also, in an overweight subset, diet was not related to BP. A healthy diet in early childhood is related to children being less overweight but not having lower BP at 10 years of age. [ABSTRACT FROM AUTHOR]

The value of open research data (ORD), a key feature of open science, lies in their reuse. However, the mere online availability of ORD does not guarantee their reuse by other researchers. Specifically, previous meta-scientific research has indicated that the underutilization of ORD is related to barriers at the level of the ORD themselves, potential reusers of ORD, and the broader academic ecosystem. At the same time, sharing large datasets in an understandable and transparent format that motivates researchers to explore these datasets remains a fundamental challenge. With the present work, we propose interactive data apps (IDAs) as innovative ORD supplements that provide a means to lower barriers of ORD reuse. We demonstrate the use of two open-source Python libraries (Dash, Gradio) for IDA development using two psychological research use cases. The first use case pertains to an experimental quantitative dataset acquired in a clinical psychology setting. The second use case concerns the familiarization with data analysis workflows that are characteristic of natural language processing (NLP). For both use cases, we provide easy-to-adapt Python code that can form the basis for IDA development in similar scenarios. [ABSTRACT FROM AUTHOR]

This study aims to investigate the association between the MIND index (Mediterranean- Dietary approaches to Stop Hypertension diet Intervention for Neurodegenerative Delay) and attention-deficit hyperactivity disorder (ADHD) in the Iranian children. It builds upon existing research that highlights the role of dietary antioxidants in alleviating psychological disorders, cognitive impairments, and memory deficits. Additionally, previous studies have separately explored the beneficial effects of the Mediterranean and DASH diets on these issues. A case-control study was undertaken in Iran, involving a sample of 360 children and adolescents aged 7–13 years. Participants were divided into two groups, namely the case group (n = 120) and the control group (n = 240), with age and sex being matched between the groups. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR) was employed for the diagnosis of ADHD. The MIND diet score was computed using the food intake data acquired from the Food Frequency Questionnaire (FFQ) completed by the subjects. The mean ± SD for the age and BMI of the study population was 8.76 ± 1.64 years and 16.90 ± 3.58 kg/m2, respectively. The mean score of MIND in this study was 27.93. After adjustment for potential confounder in the final model, subjects in highest compared to the lowest quartile of MIND diet score had significantly lower odds of ADHD (OR = 0.59, 95% CI 0.37–0.83; P-trend = 0.019). This study provides valuable evidence suggesting that adherence to the MIND diet is associated with decreased odds of ADHD. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting many women of reproductive age. This systematic review was performed with aim to determine the effects of the Dietary Approaches to Stop Hypertension (DASH) on metabolic outcomes, oxidative stress, inflammatory factors and sex hormones in patients with PCOS. Methods: In this systematic review, the keywords related to PCOS, lipid profile, glycemic status, anthropometric factors, oxidative stress, inflammatory factors, sex hormones, and DASH were searched in databases including Medline, Scopus, Embase, Science Direct, Magiran, ISD, ISC, and Cochrane in both Persian and English languages until January 2024. Results: Four original research articles with a clinical trial design and an intervention period of 8-12 weeks using the DASH in PCOS patients were analyzed. The findings of these studies showed that following the DASH led to weight loss, reduced body mass index, waist circumference, and hip circumference. It also resulted in lower serum levels of triglycerides, very low density lipoproteins, insulin resistance, androstenedione, antimullerin hormone, free androgen index, malondialdehyde, and high-sensitivity C-reactive protein. Additionally, it was associated with improved sensitivity to insulin, increased total plasma antioxidant capacity, higher levels of total glutathione, sex hormone-binding globulin, and nitric oxide in the blood. Conclusion: Following the DASH is associated with various health benefits, including weight loss, improved lipid profile, antioxidant status, sex hormones, insulin sensitivity, and markers of oxidative stress and inflammation in PCOS patients. [ABSTRACT FROM AUTHOR]

Brightness scaling (BS) is an emerging and promising technique with outstanding energy efficiency on mobile video streaming. However, existing BS-based approaches totally neglect the inherent interaction effect between BS factor, video bitrate and environment context. Their combined impact on user's visual perception in mobile scenario, leading to inharmonious between energy consumption and user's quality of experience (QoE). In this paper, we propose PEO, a novel user-Perception-based video Experience Optimization for energy-constrained mobile video streaming, by jointly considering the inherent connection between a device's state of motion, video quality and the resulting user-perceived quality. Specifically, by capturing the motion of the on-the-run device, PEO first infers the optimal bitrate and BS factor, therefore avoiding bitrate-inefficiency for energy saving while guaranteeing the user-perceived QoE. On that basis, we formulate the device motion-aware and user perception-aware video streaming as an optimization problem where we present an optimal algorithm to maximize the object function and adapt to user preference, and thus propose an online bitrate selection algorithm. Our evaluation (based on trace analysis and user study) shows that, compared with state-of-the-art techniques, PEO can raise the perceived quality by 23.8%-41.3% and save up to 25.2% energy consumption. [ABSTRACT FROM AUTHOR]

Background: It is unclear if improving diet quality after midlife could reduce the risk of physical frailty at late life. We aimed to associate changes in diet quality after midlife with physical frailty at late life. Methods: Diet quality in 12,580 participants from the Singapore Chinese Health Study was assessed with the Dietary Approaches to Stop Hypertension (DASH) scores at baseline (1993–1998; mean age 53 years) and follow-up 3 (2014–2016; mean age 73 years). Physical frailty was assessed using the modified Cardiovascular Health Study phenotype at follow-up 3. Multivariable logistic regressions examined associations between DASH scores and physical frailty. Results: Comparing participants in extreme quartiles of DASH scores, the odds ratios (OR) [95% confidence interval (CI)] for physical frailty were 0.85 (0.73,0.99) at baseline and 0.49 (0.41, 0.58) at follow-up 3. Compared to participants with consistently low DASH scores, participants with consistently high scores (OR 0.74, 95% CI: 0.59, 0.94) and those with > 10% increase in scores (OR 0.78, 95% CI: 0.64, 0.95) had lower odds of frailty. Compared to those in the lowest DASH tertiles at both time-points, significantly lower odds of physical frailty were observed in those who were in the highest DASH tertiles at both time points [0.59 (0.48, 0.73)], and in those who improved their scores from the lowest [0.68 (0.51, 0.91)] or second tertile at baseline [0.61 (0.48, 0.76)] to the highest tertile at follow-up 3. Conclusions: Maintaining a high diet quality or a substantial improvement in diet quality after midlife could lower the risk of physical frailty at late life. [ABSTRACT FROM AUTHOR]

Introduction: Distal radius fracture (DRF) is one of the three most common fractures of the human body with increasing incidences in all groups of age. Known causes of increasing incidence, such as ageing of the population or increased obesity, have been described and discussed. So far, literature reports ambivalent effects of body mass index (BMI) on bone physiology. It is worthwhile to examine the influence of BMI on the outcome of fractures more detailed. This study aims to investigate the influence of an abnormal BMI on fracture severity and treatment, as well as clinical, radiological, and functional outcome to improve clinical decision making. Materials and methods: A retrospective observational study was conducted on data obtained from patients, who underwent open reduction and internal fixation (ORIF) of a DRF at a local Level 1 Trauma Center between May 2018 and October 2021. Follow-up examinations were performed approximately 1 year after surgical fracture treatment, during which various questionnaires and functional measurements (CMS, DASH, NRS, ROM) were applied. In addition, postoperative complications were recorded and radiological examinations of the affected hand were performed. After excluding incomplete data sets and applying set exclusion criteria, the complete data of 105 patients were analyzed. Results: 74 patients were female and 31 male with significant difference in mean BMI [p = 0.002; female: 23.8 (SD ± 3.3), men: 26.2 (SD ± 3.9)]. Patients with higher BMI had significantly more severe fractures (p = 0.042). However, there was no significant difference in surgery time for fracture management. At follow-up, patients with lower BMI showed a smaller difference in hand strength between the fractured and the other hand (p = 0.017). The BMI had no significant effect on the clinical and radiological outcome. Conclusion: Despite the ambivalent effects of BMI on the skeletal system, our findings indicate that a higher BMI is associated with more severe DRF. Thereby BMI does not correlate with surgery time for fracture treatment. Furthermore, no evidence of an influence on the clinical and radiological outcome could be detected. [ABSTRACT FROM AUTHOR]

Osteoporosis (OP) and low bone mass can be debilitating and costly conditions if not acted on quickly. This disease is also difficult to diagnose as the symptoms develop unnoticed until fracture occurs. Therefore, gaining understanding of the genetic risk associated with these conditions could be beneficial for health-care professionals in early detection and prevention. The Boston Puerto Rican Osteoporosis (BPROS) study, an ancillary study to the Boston Puerto Rican Health Study (BPRHS), collected information regarding bone and bone health. All bone measurements were taken during regular BPROS visits using dual-energy X-ray absorptiometry. The OP was defined as T-score ≤ −2.5 (≥2.5 SDs below peak bone mass). Dietary variables were collected at the second wave of the BPRHS via a food frequency questionnaire. We conducted genome-wide associations with bone outcomes, including BMD and OP for 978 participants. We also examined the interactions with dietary quality on the relationships between genotype and bone outcomes. We further tested if candidate genetic variants described in previous GWAS on OP and BMD contribute to OP risk in this population. Four variants were associated with OP: rs114829316 (IQ motif containing J gene), rs76603051, rs12214684 (melanin-concentrating hormone receptor 2 gene), and rs77303493 (Ras and Rab interactor 2 gene), and 2 variants were associated with BMD of lumbar spine (rs11855618, cingulin-like 1 gene) and hip (rs73480593, NTRK2), reaching the genome-wide significance threshold of P ≤ 5E-08. In a gene–diet interaction analysis, we found that 1 SNP showed a significant interaction with the overall Dietary Approaches to Stop Hypertension (DASH) score, and 7 SNPs with sugar-sweetened beverages (SSBs), a major contributor to the DASH score. This study identifies new genetic markers related to OP and BMD in older Hispanic adults. Additionally, we uncovered unique genetic markers that interact with dietary quality, specifically SSBs, in relation to bone health. These findings may be useful to guide early detection and preventative care. [ABSTRACT FROM AUTHOR]

Malnutrition is common in older adults, and its risk is greater in those living with dementia. Relative to cognitively healthy peers, the prevalence of malnutrition is also increased in individuals with early stages of cognitive disorders owing to pathophysiological, cognitive, and psychosocial changes related to cognitive impairment. Malnutrition is associated with adverse health outcomes, including faster cognitive and functional decline. Here, we provide an overview of the prevention, assessment, and management of malnutrition in older adults, with a special focus on the aspects that are important to consider in individuals with early stages of cognitive disorders. Strategies to prevent malnutrition include systematic screening for malnourishment using validated tools to detect those at risk. If the screening reveals an increased risk of malnutrition, a detailed assessment including the individual's nutritional, medical, and functional status as well as dietary intake should be performed. The management of malnutrition in the early stages of cognitive disorders should be based on the findings of a comprehensive assessment and be personalized according to the individual's specific characteristics. In the article, we also provide an overview of the evidence on vitamin supplements and specific dietary patterns to prevent cognitive decline or attenuate its progression. [ABSTRACT FROM AUTHOR]

Background: Dietary quality plays an important role in disease development and prognosis, and diet is also a key contributor to disparities in many chronic diseases and health conditions. Objectives: This study aimed to assess racial and ethnic disparities experienced by veterans; we examined food intake and dietary quality across different racial and ethnic groups of United States veterans. Methods: The study included 420,730 males and females aged 19–107 y (91.2% males) enrolled in the Veterans Affairs Million Veteran Program with plausible dietary intake measured by food frequency questionnaire. Dietary quality was evaluated with dietary approaches to stop hypertension (DASH) score. Dietary intakes of various race and ethnicity groups were standardized to the age distribution of non-Hispanic White participants, separately for males and females. Differences across race and ethnicity groups were compared using general linear regression models after adjustment for socioeconomic and lifestyle factors as well as military service. Results: Compared to non-Hispanic White males, non-Hispanic Black males had a relatively lower DASH score, higher red and processed meats, higher sugar-sweetened beverages (SSBs), and lower low-fat dairy intakes. Non-Hispanic Asian males had a relatively higher DASH score as compared to non-Hispanic White males with relatively higher intakes of fruits and vegetables and relatively lower intakes of sodium, red meat and SSBs. Age-standardized DASH scores of Hispanic males and “Other” race/ethnicity groups were not statistically different from non-Hispanic White males. Similar race and ethnicity dietary patterns were found in females, although not all reached a statistically significant level. Conclusions: A modest difference in overall dietary quality (i.e., DASH score) was observed, but unique differences in food preferences across the different racial/ethnic groups were identified. Findings from our study may provide insight for the potential development of specific interventions to help address nutritional disparities experienced among veterans.

Background: Distal radius fractures are the most common fractures of upper limb. It accounts nearly 15- 20% of all fractures. Many surgical modalities are available for treatment of the same. It ranges from closed reduction &K-wiring to open reduction & fixation using plates. Objectives: To compare the radiological outcomes of distal radius fractures treated with various operative interventions by parameters like radial inclination, radial height and radial tilt. To find out appropriate modality of management for all varieties of distal end radius fracture. Correlation of the functional and radiological outcomes of various operative modalities and its comparison between different types of fractures. Methods: 110 patients were called for functional and radiological assessment. All the cases were classified according to fracture patterns for comparison of x-rays of operated and opposite wrist joint to analyse the radiological and functional outcomes. Result: Overall 110 patients were operated with slightly male preponderance, 62 male patients (56%) and 48 female patients (44%).Plating had superior outcomes followed by K-wiring. Conclusion: Distal radius fractures are increasingly common. Goal of treating distal radius fracture should be to achieve a painless, congruous wrist joint with anatomic reduction of the fracture along with faster and optimum recovery of functions which can be effectively assessed by radiological parameters.

BACKGROUND: Phthalates are endocrine-disrupting chemicals linked to a higher risk of numerous chronic health outcomes. Diet is a primary source of exposure, but prior studies exploring associations between dietary patterns and phthalate exposure are limited. OBJECTIVES: We evaluated the associations between dietary patterns and urinary phthalate biomarkers among a subset of postmenopausal women participating in the Womens Health Initiative (WHI). METHODS: We included WHI participants selected for a nested case-control study of phthalates and breast cancer (N = 1240). Dietary intake was measured via self-administered food frequency questionnaires at baseline and year-3. We used these data to calculate scores for alignment with the Dietary Approach to Stop Hypertension (DASH), alternative Mediterranean (aMed), and Dietary Inflammatory Index (DII) diets. We measured 13 phthalate metabolites and creatinine in 2-3 urine samples per participant collected over 3-years when all participants were cancer-free. We fit multivariable generalized estimating equation models to estimate the cross-sectional associations. RESULTS: DASH and aMed dietary scores were inversely associated with the sum of di(2-Ethylhexyl) phthalate (-6.48%, 95% CI -9.84, -3.00; -5.23%, 95% CI -8.73, -1.60) and DII score was positively associated (9.00%, 95% CI 5.04, 13.11). DASH and aMed scores were also inversely associated with mono benzyl phthalate and mono-3-carboxypropyl phthalate. DII scores were positively associated with mono benzyl phthalate and the sum of di-n-butyl phthalate. DISCUSSION: Higher dietary alignment with DASH and aMed dietary patterns were significantly associated with lower concentrations of certain phthalate biomarkers, while an inflammatory diet pattern was associated with higher phthalate biomarker concentrations. These findings suggest that dietary patterns high in fruits, vegetables, and low-fat foods and low in processed foods may be useful in avoiding exposure to phthalates.

Purpose: Diabetes can cause nerve damage, vascular issues, and reduced blood flow to organs such as the feet, leading to foot deformities and ulcers due to high glucose levels. A healthy dietary pattern like DASH can improve insulin sensitivity and weight loss. Due to limited data and rare evidence, our study aims to investigate the relationship between DASH diet adherence and anthropometric, cardiovascular, and foot ulcer indicators. Methods: The study included 339 diabetic patients with foot ulcers (122 females and 217 males). The study gathered data on patient dietary intake, anthropometric measurements, biochemistry, foot ulcers, and novel atherogenic risk factors per international definitions. Results: The average BMI of the participants was 29.2 ± 5.0, 28.1 ± 4.3, and 28.2 ± 4.2 in the tertiles of DASH index (P-value: 0.18). By increasing the adherence to the DASH index, the monofilament score did not change significantly OR: 1.47; CI: (0.81-2.67). Also, foot ulcer area did not change significantly between DASH tertiles OR: 1.01; CI: (0.56-1.83). Atherogenic risk factors also decreased among the DASH tertiles, but statistically not significant. Conclusion: DASH adherence did not change neuropathy score and cholindex and cardiovascular risk factors significantly and has no significant effect on foot ulcer size. [ABSTRACT FROM AUTHOR]

Purpose: 3- and 4-part proximal humeral fractures are frequently treated conservatively. This study aims to combine radiographic, and patient reported outcome data to identify factors leading to poor outcomes following conservative treatment. Methods: A retrospective local database analysis identified 3- and 4-part fractures. Radiographic and functional outcomes including Oxford Shoulder Score (OSS), QuickDash (QD), Subjective Shoulder Score (SSV) and VAS pain scores were collected. Results: 104 patients were included at mean follow-up of 55 months. Analysis highlighted significant OSS differences in 3- versus 4-part (p = 0.027), dominant arm injury (p = 0.046), age > 65 (p = 0.006), varus coronal neck-shaft angle < 115 versus 115–155 degrees (p = 0.008), posterior head tilt > 155 degrees (p = 0.005), greater tuberosity (GT) displacement > 5 mm (p = 0.001), GT comminution (p = 0.01), medial calcar hinge displacement > 2 mm (p = 0.032). According to QD scores; age > 65 (p = 0.012), varus neck-shaft angle (p = 0.01), GT displacement > 5 mm (p = 0.001), GT comminution (p = 0.01), medial calcar hinge displacement > 2 mm (p = 0.006). SSV varied significantly with 3- versus 4-part fractures (p = 0.005), age > 65 (p = 0.04), varus neck-shaft angle (p = 0.001), posterior head tilt (p = 0.005), GT displacement > 5 mm (p = 0.001), GT comminution (p = 0.003), and medial calcar hinge displacement > 2 mm (p = 0.001). Conclusion: We highlight risk factors for unfavourable outcomes following conservative management, aiding surgeons in shared decision-making and patient expectation management. [ABSTRACT FROM AUTHOR]

Background: More is to be explored between dietary patterns and sleep quality in the Chinese adult population. Methods: A cross-sectional study including 7987 Shanghai suburban adults aged 20–74 years was conducted. Dietary information was obtained using a validated food frequency questionnaire. Adherence to a priori dietary patterns, such as the Chinese Healthy Eating Index (CHEI), Dietary Approaches to Stop Hypertension (DASH) diet and Mediterranean diet (MD), was assessed. Sleep quality was assessed from self-reported responses to the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Logistic regression models adjusting for confounders were employed to examine the associations. Results: The overall prevalence of poor sleep (PSQI score ≥ 5) was 28.46%. Factor analysis demonstrated four a posteriori dietary patterns. Participants with a higher CHEI (ORQ4 vs. Q1: 0.81, 95% CI: 0.70–0.95), DASH (ORQ4 vs. Q1: 0.70, 95% CI: 0.60–0.82) or MD (ORQ4 vs. Q1: 0.75, 95% CI: 0.64–0.87) had a lower poor sleep prevalence, while participants with a higher "Beverages" score had a higher poor sleep prevalence (ORQ4 vs. Q1: 1.18, 95% CI: 1.02–1.27). Conclusions: In Shanghai suburban adults, healthier dietary patterns and lower consumption of beverages were associated with better sleep quality. [ABSTRACT FROM AUTHOR]

Background: Migraine is a debilitating neurological discomfort characterized by moderate to severe unilateral headaches. Adherence to healthy dietary patterns like the DASH diet has been considered a complementary solution to migraine management. Objective: In this study, we assessed the relation of adherence to the DASH diet with migraine attack frequency and pain intensity in women with migraine. Methods: 285 female women with migraine were recruited in the current study. Migraine was diagnosed by a single neurologist based on the third edition of the International Classification of Headache Disorders (ICHD-III). Migraine attack frequency was determined based on the number of attacks per month. Pain intensity was assessed by the Visual Analogue Scale (VAS) and migraine index. Last year dietary intakes of women were collected using a semiquantitative food frequency questionnaire (FFQ). Results: Almost 91% of the women had migraine without aura. Most of the participants reported more than 15 attacks per month (40.7%) and pain intensity in the range of 8-10 in every attack (55.4%). Based on the ordinal regression, those in the first tertile of the DASH score had significantly higher odds for attack frequency (OR = 1.88; 95% CI: 1.11-3.18; P = .02) and migraine index score (OR = 1.69; 95% CI: 1.02-2.79; P = .04, respectively) than those in the third tertile. Conclusion: This study showed that a higher DASH score is associated with a lower migraine attack frequency and migraine index score in female sufferers. [ABSTRACT FROM AUTHOR]

In order to cope with the fluctuation of network bandwidth and provide smooth video services, adaptive video streaming technology is proposed. In particular, the adaptive bitrate (ABR) algorithm is widely used in dynamic adaptive streaming over HTTP (DASH) to improve quality of experience (QoE). However, existing ABR algorithms still ignore the inherent visual sensitivity of human visual system (HVS). As the final receiver of video, HVS has different sensitivity to the quality distortion of different video content, and video content with high visual sensitivity needs to allocate more bitrate resources. Therefore, existing ABR algorithms still have limitations in reasonably allocating bitrate and maximizing QoE. To solve this problem, this paper designs an adaptive bitrate strategy from the perspective of user vision, studies the modeling of visual sensitivity, and proposes a visual sensitivity aware ABR algorithm. We extract a set of content features and attribute features from the video, and consider the simulation of HVS to establish a totalmasking effectmodel that reflects the visual sensitivity more accurately. Further, the network status, buffer occupancy, and visual sensitivity are comprehensively considered under a deep reinforcement learning framework to select the appropriate bitrate for maximizing QoE. We implement the proposed algorithm over a realistic trace-driven evaluation and compare its performance with several latest algorithms. Experimental results show that our algorithm can align ABR strategy with visual sensitivity to achieve better QoE in high visual sensitivity content, and improves the average perceptual video quality and overall user QoE by 18.3% and 22.8%, respectively. Additionally, we prove the feasibility of our algorithm through subjective evaluation in the real environment. [ABSTRACT FROM AUTHOR]

Abstract Background The Disability of the Arm, Shoulder and Hand Outcome Measure (DASH) is a validated patient-reported outcome measure (PROM) for many upper extremity musculoskeletal disorders. In patients with severe traumatic conditions, limited evidence exists regarding the equivalence between DASH and its shortened version, QuickDASH, which is more feasible in clinical practice. The rationale of this study was to analyze the concurrent validity of QuickDASH with respect to DASH in patients with traumatic upper extremity amputation. Methods This study is based on a consecutive cohort of traumatic upper extremity amputation patients treated with replantation or revision (completion) amputation at Tampere University Hospital between 2009 and 2019. We estimated the concurrent validity of QuickDASH with respect to DASH by correlation coefficients, mean score differences, Bland–Altman plots, and distribution density. Additionally, we assessed internal reliability with Cronbach’s alpha coefficients and item-total correlations. Results We found a very strong linear correlation between DASH and QuickDASH scores (r = 0.97 [CI 95% 0.97–0.98], p

Despite numerous advances in all areas of cardiovascular care, cardiovascular disease (CVD) is the leading cause of death in the United States (US). There is compelling evidence that interventions to improve diet are effective in cardiovascular disease prevention. This clinical practice statement emphasizes the importance of evidence-based dietary patterns in the prevention of atherosclerotic cardiovascular disease (ASCVD), and ASCVD risk factors, including hyperlipidemia, hypertension, diabetes, and obesity. A diet consisting predominantly of fruits, vegetables, legumes, nuts, seeds, plant protein and fatty fish is optimal for the prevention of ASCVD. Consuming more of these foods, while reducing consumption of foods with saturated fat, dietary cholesterol, salt, refined grain, and ultra-processed food intake are the common components of a healthful dietary pattern. Dietary recommendations for special populations including pediatrics, older persons, and nutrition and social determinants of health for ASCVD prevention are discussed.

HTTP Adaptive Streaming (HAS), the most prominent technology for streaming video over the Internet, suffers from high end-to-end latency when compared to conventional broadcast methods. This latency is caused by the content being delivered as segments rather than as a continuous stream, requiring the client to buffer significant amounts of data to provide resilience to variations in network throughput and enable continuous playout of content without stalling. The client uses an Adaptive Bitrate (ABR) algorithm to select the quality at which to request each segment to trade-off video quality with the avoidance of stalling to improve the Quality of Experience (QoE). The speed at which the ABR algorithm responds to changes in network conditions influences the amount of data that needs to be buffered, and hence to achieve low latency the ABR needs to respond quickly. Llama (Lyko et al. 28) is a new low latency ABR algorithm that we have previously proposed and assessed against four on-demand ABR algorithms. In this article, we report an evaluation of Llama that demonstrates its suitability for low latency streaming and compares its performance against three state-of-the-art low latency ABR algorithms across multiple QoE metrics and in various network scenarios. Additionally, we report an extensive subjective test to assess the impact of variations in video quality on QoE, where the variations are derived from ABR behaviour observed in the evaluation, using short segments and scenarios. We publish our subjective testing results in full and make our throughput traces available to the research community. [ABSTRACT FROM AUTHOR]

HTTP Adaptive Streaming (HAS) plays a key role in over-the-top video streaming with the ability to reduce the video stall duration by adapting the quality of transmitted video segments to the network conditions. However, HAS still suffers from two problems. First, it incurs variations in video quality because of throughput fluctuation. Adaptive bitrate (ABR) algorithms at the HAS client usually select a low-quality segment when the throughput drops to avoid stall events, which impairs the Quality of Experience (QoE) of the end-users. Second, many ABR algorithms choose the lowest-quality segments at the beginning of a video streaming session to ramp up the playout buffer early on. Although this strategy decreases the startup time, clients can be annoyed as they have to watch a low-quality video initially. To address these issues, we introduced the H2BR technique (H TTP/2-B ased R etransmission) (Nguyen et al. 33) that utilizes certain features of HTTP/2 (including server push, multiplexing, stream priority, and stream termination) for late transmissions of higher-quality versions of video segments already in the client buffer, in order to improve video quality. Although H2BR was shown to enhance the QoE, limited streaming scenarios were considered resulting in a lack of general conclusions on H2BR's performance. Thus, this article provides a profound evaluation to answer three open questions: (i) how H2BR's performance is impacted by parameters at the server side (i.e., various encoding specifications), at the network side (i.e., packet loss rate), and at the client side (i.e., buffer size) on the performance of H2BR; (ii) how H2BR outperforms other state-of-the-art approaches in different configurations of the parameters above; (iii) how to effectively utilize H2BR on top of ABR algorithms in various streaming scenarios. The experimental results show that H2BR's performance increases with the buffer size and decreases with increasing packet loss rates and/or video segment duration. The number of quality levels can negatively or positively impact on H2BR's performance, depending on the ABR algorithm deployed. In general, H2BR is able to enhance the video quality by up to 17% and 14% in scalable video streaming and in non-scalable video streaming, respectively. Compared with an existing retransmission technique (i.e., SQUAD Wang et al., ACM Trans Multimed Comput Commun Applic (TOMM) 13(3s): 45, 49), H2BR shows better results with more than 10% in QoE and 9% in the average video quality. [ABSTRACT FROM AUTHOR]

The neuroprotective effects of dietary patterns have been reported in previous studies. This study aimed to examine the association between the dietary approach to stop hypertension (DASH), the Mediterranean diet (MeDi), and the Mediterranean‐DASH intervention for neurodegenerative delay (MIND) with the severity and risk of Parkinson's disease (PD). In this comparative cross‐sectional study, 120 patients with PD and 50 healthy participants participated. Adherence to DASH, MeDi, and MIND dietary patterns was determined according to the dietary intake data using a food frequency questionnaire (FFQ). The Severity of PD was determined by the Unified Parkinson's Disease Rating Scale (UPDRS). The mean score of the DASH was significantly lower in the PD group compared to the healthy group (p =.006), but the mean score of MeDi and MIND did not significantly differ between the two groups (p >.05). Also, the mean score of the DASH was significantly lower in men than in women in the healthy group (p =.018). High adherence to the DASH diet decreased the risk of PD by 15% (OR = 0.856, 95% CI: 0.751, 0.976, p =.020). Participants in quartiles 3 and 4 of the DASH dietary pattern had 86% (p =.003) and 87% (p =.007), respectively, lower risk of PD. MeDi and MIND diets were not significantly associated with the risk of PD. There was no significant association between dietary patterns and the severity of PD. The findings indicate that high adherence to the DASH dietary pattern may protect against PD. [ABSTRACT FROM AUTHOR]

Background: The Disability of the Arm, Shoulder and Hand Outcome Measure (DASH) is a validated patient-reported outcome measure (PROM) for many upper extremity musculoskeletal disorders. In patients with severe traumatic conditions, limited evidence exists regarding the equivalence between DASH and its shortened version, QuickDASH, which is more feasible in clinical practice. The rationale of this study was to analyze the concurrent validity of QuickDASH with respect to DASH in patients with traumatic upper extremity amputation. Methods: This study is based on a consecutive cohort of traumatic upper extremity amputation patients treated with replantation or revision (completion) amputation at Tampere University Hospital between 2009 and 2019. We estimated the concurrent validity of QuickDASH with respect to DASH by correlation coefficients, mean score differences, Bland–Altman plots, and distribution density. Additionally, we assessed internal reliability with Cronbach's alpha coefficients and item-total correlations. Results: We found a very strong linear correlation between DASH and QuickDASH scores (r = 0.97 [CI 95% 0.97–0.98], p < 0.001). The mean difference between DASH and QuickDASH was minor (MD = -1, SD 4 [CI95% from -1 to 0] p = 0.02). The mean sub-score for the activity domain was higher for QuickDASH than DASH (MD = -3 [CI95% from -4 to -3] p < 0.000) and lower for the symptom domain (MD = 7 [CI95% from 6 to 9] p < 0.000). The Bland and Altman plot showed good agreement between DASH and QuickDASH scores, but there was measurement error in QuickDASH with high scores (r = -0.20, [CI95% from -0.31 to -0.09], p = 0.001). Conclusion: QuickDASH demonstrates higher total scores than the full DASH and emphasizes rating of activity over symptoms. Still, on average the differences in total scores are likely less than the MCID of DASH, and consequently, this study shows that QuickDASH can be recommended instead of the full DASH when assessing a traumatic condition. Trial registration: Retrospectively registered. [ABSTRACT FROM AUTHOR]

The aim of the current study is to compare the clinical outcomes of cast immobilization (CI) versus surgical treatment after 1 year for distal radius fractures (DRFs) in the elderly population. The cohort included patients aged 70–89 who suffered an acute, closed, and displaced DRF and who were treated conservatively or surgically at our clinic between August 2018 and January 2022. Those who had pathological fractures, open fractures, concomitant ulna fractures (except ulna styloid fractures), were not between the ages of 70 and 89, or refused to participate were excluded from the study. The study gathered data on patient demographics, initial radiological measurements, clinical measurements after 1 year, treatment models employed, and rates of complications. Of the total number of patients (276), CI was used on 77.2% (213), whereas the other 25 had volar‐locked plates (VLP), 25 received external fixators with percutaneous pinning (EFPP), and 13 had isolated percutaneous pinning (IPP). 19 of 276 individuals had complications, with Complex Regional Pain Syndrome and Carpal Tunnel Syndrome being the most often documented. EFPP resulted in significantly higher Disability of the Arm, Shoulder, and Hand (DASH) score values than VLP and IPP at the 1st postoperative year (p < 0.05). No statistically significant difference was found between the DASH score and ROM values at the 1st postoperative year for patients who received CI versus those who underwent surgery (p > 0.05). In the first postoperative year, CI still retains its validity and performs similarly to surgery for DRFs in older individuals. VLPP and IPP methods outperformed EFPP surgeries. [ABSTRACT FROM AUTHOR]

This systematic review analysed the available evidence on the clinical outcomes of total wrist arthroplasty (TWA) in patients with inflammatory and non-inflammatory arthritis. After screening, 12 studies met the inclusion criteria. They involved 359 patients with 378 TWA implants. The results showed that TWA significantly improved Disabilities of the Arm, Shoulder and Hand (DASH)/Quick-DASH scores and pain visual analogue scale scores in both arthritis groups compared with preoperative values. However, there was no statistically significant difference in the outcome scores between the two groups. Three studies reported Patient-Rated Wrist Evaluation (PRWE) scores, and TWA significantly improved PRWE scores in non-inflammatory arthritis but not in inflammatory arthritis, with no significant difference in postoperative outcome scores between the two groups. Although the included studies have limitations, the review suggests that TWA may be a successful treatment for wrist pain in individuals with either inflammatory or non-inflammatory arthritis. However, further high-quality trials are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Purpose: Mental and sleep disorders are global public health problems, especially in Middle Eastern countries, and are significantly associated with circadian rhythm. This study sought to investigate the association between the dietary approaches to stop hypertension (DASH) and Mediterranean diet scores and mental health, sleep quality, and circadian rhythm. Methods: We enrolled 266 overweight and obese women, and depression, anxiety, and stress scale (DASS) score, Pittsburgh Sleep Quality Index (PSQI), and Morning–Evening Questionnaire (MEQ), were assessed. The Mediterranean and DASH diet score was measured using a validated semi-quantitative Food Frequency Questionnaire (FFQ). The physical activity was evaluated using the International Physical Activity Questionnaire (IPAQ). Analysis of variance and analysis of covariance, chi-square, and multinomial logistic regression tests were used as appropriate. Results: Our results showed that there was a significant inverse association between adherence to the Mediterranean diet and mild and moderate anxiety scores (p < 0.05). In addition, there was an inverse association between adherence to the DASH diet and the risk of severe depression and extremely severe stress scores (p < 0.05). Moreover, higher adherence to both dietary scores was associated with good sleep quality (p < 0.05). There was a significant relationship between circadian rhythm and the DASH diet (p < 0.05). Conclusion: A significant association exists between a DASH and Mediterranean diet with sleep status, mental health, and chronotype in women of childbearing age with obesity and overweight. Level of evidence: Level V, Cross-sectional observational study. [ABSTRACT FROM AUTHOR]

Abstract Background Single-cell RNA-sequencing (scRNA-seq) relies on PCR amplification to retrieve information from vanishingly small amounts of starting material. To selectively enrich mRNA from abundant non-polyadenylated transcripts, poly(A) selection is a key step during library preparation. However, some transcripts, such as mitochondrial genes, can escape this elimination and overwhelm libraries. Often, these transcripts are removed in silico, but whether physical depletion improves detection of rare transcripts in single cells is unclear. Results We find that a single 16S ribosomal RNA is widely enriched in planarian scRNA-seq datasets, independent of the library preparation method. To deplete this transcript from scRNA-seq libraries, we design 30 single-guide RNAs spanning its length. To evaluate the effects of depletion, we perform a side-by-side comparison of the effects of eliminating the 16S transcript and find a substantial increase in the number of genes detected per cell, coupled with virtually complete loss of the 16S RNA. Moreover, we systematically determine that library complexity increases with a limited number of PCR cycles following CRISPR treatment. When compared to in silico depletion of 16S, physically removing it reduces dropout rates, retrieves more clusters, and reveals more differentially expressed genes. Conclusions Our results show that abundant transcripts reduce the retrieval of informative transcripts in scRNA-seq and distort the analysis. Physical removal of these contaminants enables the detection of rare transcripts at lower sequencing depth, and also outperforms in silico depletion. Importantly, this method can be easily customized to deplete any abundant transcript from scRNA-seq libraries.

A healthy diet prevents overweight problems and hypertension. We investigated the associations of a healthy diet with the body mass index (BMI) and blood pressure (BP) in early childhood. In the GECKO birth cohort, height, weight, and BP were measured at 5 and 10 years of age. Diet was evaluated at 3 years using three diet scores: the Dietary Approaches to Stop Hypertension (DASH), the Mediterranean Diet Score (MDS), and the Lifelines Diet Score (LLDS). Linear and logistic regression models assessed the associations of diet scores with the BMI and BP. Of the 1077 children included, 10.8% were overweight or obese at 5 years. That number was 16.5% at 10 years. In addition, 34.5% had elevated BP at 5 years. That number was 23.9% at 10 years. Higher DASH, MDS, and LLDS, which indicate healthier diets, were all associated with lower BMI z-scores at 10 years of age. Higher DASH is related to lower overweight risk at 10 years. None of the diet scores were associated with BP or elevated BP at either 5 or 10 years. Also, in an overweight subset, diet was not related to BP. A healthy diet in early childhood is related to children being less overweight but not having lower BP at 10 years of age.

The article analyzes the functions of the dash in literary German-language texts. The purpose of the study is to clarify and describe the various functions of the dash, to determine its role in the transmission of the communicative intention of the author of the written text. It is established that the dash is a multifunctional punctuation mark which complicates and specifies its functions depending on the contextual conditions of its use and the communicative situation. Two main groups of functions were identified and described: structural-semantic and expressive. Within the framework of structural and semantic functions, the dash is an indicator of logical relations in an utterance – causal and contrast ones. Being a means of a written text division, the dash performs compositional functions: it signals the transition from one type of speech transmission to another, to a new microtheme, a change of the addressee-addresser of speech. The dash is a graphic means of creating expressiveness, marking expressive syntactic constructions (inserts, separations, introductory structures, attachments, parentheses), pauses in a character’s speech, contributing to the compression of the utterance, the effect of emotional tension, the incompleteness of the utterance. The dash is one of those punctuation marks that have a vivid stylistic potential and are widely used by the authors in order to create a special artistic effect. This applies both to cases where the current punctuation rules allow one to choose between a dash and another character, and when the rules do not require any character at all. The choice of the dash depends on the author’s communicative intention and can be explained based on the context, or by the predominant use of the dash, which is one of the elements of the author’s style.

Abstract Background Whether diet has beneficial effects on cardiovascular disease (CVD) in childhood cancer survivors as in the general population is unknown. Therefore, we examined associations between dietary patterns and risk of CVD in adult survivors of childhood cancer. Methods Childhood cancer survivors, 18–65 years old in the St Jude Lifetime Cohort (1882 men and 1634 women) were included in the analysis. Dietary patterns were defined by the adherence to the Healthy Eating Index (HEI)–2015, Dietary Approaches to Stop Hypertension (DASH), and alternate Mediterranean diet (aMED) based on a food frequency questionnaire at study entry. CVD cases (323 in men and 213 in women) were defined as participants with at least one grade 2 or higher CVD-related diagnosis at baseline. Multivariable logistic regression adjusted for confounders was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of CVD. Results Greater adherence to HEI-2015 (OR=0.88, 95% CI: 0.75–1.03, per 10 score increment), DASH (OR=0.85, 95% CI: 0.71–1.01, per 10 score increment), and aMED (OR=0.92, 95% CI: 0.84–1.00, each score increment) were, albeit trending towards significance, associated with a lower risk of CVD in women. HEI-2015 was associated with a non-significantly lower risk of CVD in men (ORQ5 vs. Q1=0.80, 95% CI: 0.50–1.28). These dietary patterns were also associated with a lower risk of CVD in survivors with high underlying CVD risk. Conclusions As recommended to the general population, a diet rich in plant foods and moderate in animal foods needs to be a part of CVD management and prevention in childhood cancer survivors.

Abstract Background The Oxford Elbow Score (OES) and the short version of Disabilities of Arms, Shoulder and Hand (QuickDASH) are common patient-reported outcomes for people with elbow problems. Our primary objective was to define thresholds for the Minimal Important Difference (MID) and Patient-Acceptable Symptom State (PASS) for the OES and QuickDASH. The secondary aim was to compare the longitudinal validity of these outcome measures. Methods We recruited 97 patients with clinically-diagnosed tennis elbow for a prospective observational cohort study in a pragmatic clinical setting. Fifty-five participants received no specific intervention, 14 underwent surgery (11 as primary treatment and 4 during follow-up), and 28 received either botulinum toxin injection or platelet rich plasma injection. We collected OES (0 to 100, higher is better) and QuickDASH (0 to 100, higher is worse), and global rating of change (as an external transition anchor question) at six weeks, three months, six months and 12 months. We defined MID and PASS values using three approaches. To assess the longitudinal validity of the measures, we calculated the Spearman’s correlation coefficient between the change in the outcome scores and external transition anchor question, and the Area Under the Curve (AUC) from a receiver operating characteristics (ROC) analysis. To assess signal-to-noise ratio, we calculated standardized response means. Results Depending on the method, MID values ranged from 16 to 21 for OES Pain; 10 to 17 for OES Function; 14 to 28 for OES Social-psychological; 14 to 20 for OES Total score, and − 7 to -9 for QuickDASH. Patient-Acceptable Symptom State (PASS) cut offs were 74 to 84 for OES Pain; 88 to 91 for OES Function; 75 to 78 with OES Social-psychological; 80 to 81 with OES Total score and 19 to 23 with Quick-DASH. OES had stronger correlations with the anchor items, and AUC values suggested superior discrimination (between improved and not improved) compared with QuickDASH. OES also had superior signal-to-noise ratio compared with QuickDASH. Conclusion The study provides MID and PASS values for OES and QuickDASH. Due to better longitudinal validity, OES may be a better choice for clinical trials. Trial registration ClinicalTrials.gov NCT02425982 (first registered April 24, 2015).

Dynamic adaptive video streaming over HTTP (DASH) plays a crucial role in delivering video across networks. Traditional adaptive bitrate (ABR) algorithms adjust video segment quality based on network conditions and buffer occupancy. However, these algorithms rely on fixed rules, making it challenging to achieve optimal decisions considering the overall context. In this paper, we propose a novel deep-reinforcement-learning-based approach for DASH streaming, with the primary focus of maintaining consistent perceived video quality throughout the streaming session to enhance user experience. Our approach optimizes quality of experience (QoE) by dynamically controlling the quality distance factor between consecutive video segments. We evaluate our approach through a comprehensive simulation model encompassing diverse wireless network environments and various video sequences. We also conduct a comparative analysis with state-of-the-art methods. The experimental results demonstrate significant improvements in QoE, ensuring users enjoy stable, high-quality video streaming sessions. [ABSTRACT FROM AUTHOR]

Background: Single-cell RNA-sequencing (scRNA-seq) relies on PCR amplification to retrieve information from vanishingly small amounts of starting material. To selectively enrich mRNA from abundant non-polyadenylated transcripts, poly(A) selection is a key step during library preparation. However, some transcripts, such as mitochondrial genes, can escape this elimination and overwhelm libraries. Often, these transcripts are removed in silico, but whether physical depletion improves detection of rare transcripts in single cells is unclear. Results: We find that a single 16S ribosomal RNA is widely enriched in planarian scRNA-seq datasets, independent of the library preparation method. To deplete this transcript from scRNA-seq libraries, we design 30 single-guide RNAs spanning its length. To evaluate the effects of depletion, we perform a side-by-side comparison of the effects of eliminating the 16S transcript and find a substantial increase in the number of genes detected per cell, coupled with virtually complete loss of the 16S RNA. Moreover, we systematically determine that library complexity increases with a limited number of PCR cycles following CRISPR treatment. When compared to in silico depletion of 16S, physically removing it reduces dropout rates, retrieves more clusters, and reveals more differentially expressed genes. Conclusions: Our results show that abundant transcripts reduce the retrieval of informative transcripts in scRNA-seq and distort the analysis. Physical removal of these contaminants enables the detection of rare transcripts at lower sequencing depth, and also outperforms in silico depletion. Importantly, this method can be easily customized to deplete any abundant transcript from scRNA-seq libraries. [ABSTRACT FROM AUTHOR]

This study proposes a system for predicting the recovery status of patients with shoulder damage by estimating the results of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire using an Adaptive Neuro-Fuzzy Inference System (ANFIS). The study aimed to answer two primary research questions: First, is it possible to accurately predict the recovery status of patients with shoulder damage using the proposed system during treatment? Second, how does this estimation contribute to the treatment process? A literature review indicates that artificial intelligence is often used in rehabilitation to help patients perform exercises correctly. However, previous studies have typically focused solely on exercise execution, without addressing recovery prediction. In contrast, this study aims to predict the recovery status of patients and integrate it into a physiotherapy application, allowing for real-time observation of patient progress. To develop the recovery prediction model, we collected data on the treatment processes of 105 shoulder patients at Bilecik State Hospital and estimated the results of the DASH questionnaire using an ANFIS-based model. The developed model has a mean square error of 9.4E − 3 for the training data and a mean square error of 2.56E − 2 for the test data. The proposed model was integrated into a physiotherapy application using the best weight values from 1000 runs. In this way, it is ensured that successfully predicted recovery status can be observed in real-time. The findings of this study have important implications for shoulder injury rehabilitation. By integrating recovery prediction into a physiotherapy application, healthcare providers can monitor patient progress more effectively and make more informed decisions about the timing and intensity of rehabilitation exercises. [ABSTRACT FROM AUTHOR]

Background & Objective: Hypertension during pregnancy is associated with significant negative outcomes. In this study, we evaluated the effectiveness of dietary approaches to stop hypertension (DASH) on pregnancy outcomes of pregnant women with gestational and chronic hypertension. Materials & Methods: This randomized controlled clinical trial study was conducted on 60 pregnant women with a diagnosis of gestational hypertension and chronic hypertension. Women were randomly divided into the control (n=30) and the DASH diet (n=30) groups for 2 months and were followed until delivery. The outcomes of maternal pregnancy including the incidence of preeclampsia, placental abruption and preterm delivery (<37 weeks) were assessed during follow-up examinations. Birth weight and minute 1 and minute 5 Apgar score of the infant were also assessed. Results: After 1 and 2 months of intervention, systolic and diastolic blood pressure in the DASH diet group was significantly lower than the control group (P<0.05). The incidence of preeclampsia (P=0.035), preterm delivery (P=0.020) and placental abruption (P=0.007) in the DASH diet group was significantly lower than the control group. The mean gestational age at the time of termination of pregnancy was not significantly different between the two groups (P = 0.467). There was no significant difference between minute 1 and minute 5 Apgar scores of the infants and the mean birth weight of the infants was not significantly different between the DASH and control groups (P = 0.756, P = 0.115 and P = 0.101, respectively). Conclusion: The DASH diet could be used as an effective strategy to improve the clinical outcomes of pregnant women with gestational and chronic hypertension. [ABSTRACT FROM AUTHOR]

BackgroundUromodulin modulates the sodium-potassium-two-chloride transporter in the thick ascending limb of the loop of Henle, and its overexpression in murine models leads to salt-induced hypertension. We hypothesized that individuals with higher baseline levels of urine uromodulin would have a greater increase in systolic blood pressure (SBP) for the same increase in sodium compared with those with lower uromodulin levels.MethodsWe used data from 157 subjects randomized to the control diet of the Dietary Approaches to Stop Hypertension (DASH)-Sodium trial who were assigned to 30 days of low (1,500 mg/d), medium (2,400 mg/d), and high salt (3,300 mg/d) diets in random order. Blood pressure was measured prerandomization and then weekly during each feeding period. We evaluated the association of prerandomization urine uromodulin with change in SBP between diets, as measured at the end of each feeding period, using multivariable linear regression.ResultsBaseline urine uromodulin stratified by tertiles was ≤17.64, 17.65-31.97, and ≥31.98 µg/ml. Across the tertiles, there were no significant differences in SBP at baseline, nor was there a differential effect of sodium diet on SBP across tertiles (low to high, P = 0.81). After adjusting for age, sex, body mass index, and race, uromodulin levels were not significantly associated with SBP change from low to high sodium diet (P = 0.42).ConclusionsIn a randomized trial of different levels of salt intake, higher urine uromodulin levels were not associated with a greater increase in blood pressure in response to high salt intake.

Abstract Background The association between the Mediterranean-DASH diet Intervention for Neurodegenerative Delay (MIND) diet, odds, and severity of anxiety disorders (AD) is still unclear. We aimed to investigate whether adherence to MIND diet is associated with odds and severity of AD. Methods The present case–control study carried out on 85 patients who were group matched by gender with 170 healthy subjects. Data for dietary intake was assessed by using a 147-item validated food frequency questionnaire (FFQ). Anthropometric measures were collected using standard methods. The MIND diet score was calculated using FFQ. We assessed anxiety disorder severity using the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. Multivariate odds ratios (OR) with 95% confidence intervals (CI) were used to investigate the association of MIND diet and anxiety disorder. Results We observed that higher adherence to MIND diet was associated with the lower GAD-7 score (p

Summary: Background and aim: Given the importance of dietary habits in the immune system, the current study aimed at investigating the association between Dietary Approach to Stop Hypertension (DASH) diet and risk of hospitalization due to COVID-19. Methods: Dietary data of 141 patients with COVID-19 were collected using 147-item food frequency questionnaire. DASH score in this cross-sectional study was calculated based on eight components, including fruits, vegetables, legumes and nuts and seeds, whole grains, low-fat dairy, red or processed meats, sweetened beverages, and sodium. Multivariable logistic regression models were applied to estimate the OR and 95% CI for hospitalization due to COVID-19 in each tertile of DASH score. Results: Mean ± SD of DASH score in inpatients (n=74) and outpatients (n= 87) was 22.5 ± 4.57 and 25.34 ± 4.23, respectively. The risk of hospitalization in the highest tertile of DASH score was 81% lower than the lowest tertile (OR=0.19, 95%CI: 0.07–0.55, P trend = 0.001 after adjustment for age, sex, BMI, energy intake). Also, more intake of fruits, vegetables and low-fat dairy products and less intake of sodium, red and processed meat were each significantly associated with reduced risk of hospitalization due to COVID-19. Conclusions: Our data provide evidence that adherence to DASH-style diet was associated with lower risk of hospitalization due to COVID-19.