Search

To explore collegiate student-athletes? preferences of coaching leadership behaviours in strength and conditioning (SC) coaching and evaluate differences between the preferences of coaching leadership behaviours based on task dependence. Method a total of 145 National Collegiate Athletic Association student-athletes (independent sports athletes = 48, interdependent sports athletes = 97), aged 18-25 years, with a mean = 3 (SD = ±1) SC sessions per week, participated. Participants completed an electronic questionnaire involving the athletes? preference version of the Revised Leadership Scale for SC. Results summary statistics revealed that the most favoured behaviour was 'training and instruction', median = 4.5 (IQR = 1.0), while the least favoured was ?autocratic?, median = 2.0 (IQR = 0.5). Independent sports athletes preferred training and instruction more (median = 5.0, IQR = 0.6) than interdependent sports athletes (median = 4.5, IQR = 1.0). Interdependent sports athletes preferred social support more (median = 3.5, IQR = 1.0) than independent sports athletes (median = 3.0, IQR = 0.6). The observation of a marginal statistically significant difference for social support suggests task-dependence-based variations (p = 0.018). However, small effect sizes indicate that differences are not practically significant. Conclusion and recommendation: this study presents insights into the preferences of coaching leadership behaviours among student-athletes in SC coaching. It highlights key behaviours such as training and instruction, positive feedback, situational considerations, and social support. These findings inform coaching practice and provide a foundation for further research into coaching leadership behaviours in SC coaching.

BackgroundDigital health interventions increase access to multiple sclerosis (MS)–related knowledge for people living with MS; however, our understanding of factors associated with engagement in web-based learning is limited. ObjectiveThis study aims to examine associations between participant sociodemographic, health, and lifestyle-related characteristics and the commencement and completion of the Multiple Sclerosis Online Course (MSOC) in a randomized controlled trial (RCT). MethodsAn intervention course was developed based on the Overcoming MS Program—an evidence-based lifestyle modification program for MS, and a standard care course was developed based on international MS website information. An RCT was conducted to compare the effectiveness of the intervention course versus the standard care course in improving health outcomes in people living with MS. Participant data were collected from a baseline survey. Associations between baseline participant characteristics and MSOC commencement and completion, respectively, were assessed using multivariate log-binomial regression. ResultsOverall, 1893 participants enrolled in the RCT, and 45.27% (n=857) completed the baseline survey: 23.5% (n=444) in the intervention course and 21.8% (n=413) in the standard care course. Of these 857 participants, 631 (73.6%) commenced the standard care course or intervention course, and 49.1% (218/444) and 54.2% (224/413) completed the intervention course and standard care course, respectively. University education, partnered relationship status, and higher mental and physical quality of life were associated with 19%, 12%, 20%, and 22% higher rates of course commencement, respectively. Clinically significant fatigue was associated with a 10% reduction in the likelihood of commencement. Strongest associations with intervention course completion included middle and older adulthood, male sex, fatigue, and preexisting adherence to a diet program, with 96%, 27%, 24%, and 19% higher rates of completion observed, respectively, whereas higher self-efficacy was associated with up to 35% lower intervention course completion. Associations with standard care course completion included practicing meditation (20% higher completion), whereas employment was associated with 22% lower completion. ConclusionsSociodemographic and clinical factors, as well as lifestyle-related factors, were important factors in MSOC commencement and completion. These data may help guide the design and enhancement of digital health interventions tailored for people living with MS. Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12621001605886; https://tinyurl.com/2vyve9p9 International Registered Report Identifier (IRRID)RR2-10.1186/s12883-023-03298-0

Many martial arts systems have their own revered heroes, such as mythical founders and leaders of notable schools. The paper draws on ethnographic research conducted on The Blade Academy, an expanding historical European martial arts (HEMA) school in the United Kingdom. Among pedagogic strategies used by the lead instructors and their core followers are narratives about historic figures whose heroic beliefs and deeds should be respected and even emulated by practitioners. This article explores the case study of 12-13th century Norman-English knight William Marshal, who is used as a principal model for leadership, martial valour, economic success and moral activity by the lead instructor. We examine idealised models of chivalry that such modern martial artists aspire to follow despite them living within very different societies and value systems. We conclude by considering the merits of revisiting historical figures who might act as role models for modern teachers and their students.

The NFT phenomenon has disrupted the traditional notion of digital ownership. As distinct digital assets, NFTs serve as proof of ownership for crypto assets, for example, art, music, trading cards, or in-game items. The NFT market experienced unprecedented growth in 2021, with NFTs solidifying their position as a transformative technology in the digital realm. The market growth peaked during the boom period in January 2022, and has since declined, experiencing a major slump in June 2022. The market is not yet commonplace for everyone. Within the market, the initial sales market is more challenging to enter than the subsequent sales market since the former requires a higher seller entry cost. This paper decouples the initial and subsequent sales markets on the largest NFT market platform, OpenSea, and examines the markets across the two distinct periods in the NFT market history: the boom period of January 2022 and the slump period of June 2022. For the study dataset, sales transaction records are extracted from Opensea. This study discovers many properties which are invariant between the boom and slump: higher pricing in subsequent sales than in initial sales, rapid market movement (more in the initial sales), skewed revenue generation, and statistically strong regressors from Linear Discriminant Analysis (LDA) to distinguish between different resale return types, ranging from large loss to large profit. The finding indicates that the initial and subsequent sales markets are not identical. However, the composition and behaviour of the markets listed prior would be scale-free to the markets’ economics stages. When we simulated a resale return with a zero hidden cost, the number of profit returns in resale inflated, suggesting that hidden costs should be surfaced and/or minimised to improve an investor’s experience in the subsequent sales market. Our study sheds light on the dynamics of the NFT initial and subsequent sales markets across the boom and slump periods. By evaluating the two market types separately, we contribute to demystifying the subsequent sales market, which can be veiled without the market type distinction due to the initial sales market’s over-representation. Ordinary people, who are generally incapable of affording a seller’s entry cost in the initial NFT sales market, would notably benefit from this study. Since the study covers the two extreme periods, its finding will provide certainty, even in an atypical period.

Abstract Background People living with multiple sclerosis (plwMS) seek access to information on evidence-based lifestyle-related risk factors associated with multiple sclerosis (MS). As the internet has made delivery of lifestyle information increasingly accessible and cost-effective, we designed the Multiple Sclerosis Online Course (MSOC) to deliver a multimodal lifestyle modification program for plwMS. Two MS online courses were developed: the intervention course based on lifestyle recommendations of the Overcoming Multiple Sclerosis (OMS) program and the standard-care course representing standard lifestyle recommendations from other MS websites. We examined for feasibility in a pilot randomised controlled trial (RCT), where satisfactory completion and accessibility were achieved across both study arms. From this success, a protocol for a larger RCT was developed to examine the effectiveness of MSOC in improving health-related quality of life (HRQoL) and other health outcomes in plwMS. Methods/design This single-blinded RCT will recruit n = 1,054 plwMS. Participants in the intervention arm will receive access to a MSOC with seven modules providing evidence-based information on the OMS program. Participants in the control group will receive access to a MSOC of identical format, with seven modules providing general MS-related information and lifestyle recommendations sourced from popular MS websites, e.g. MS societies. Participants will complete questionnaires at baseline and at 6, 12, and 30 months after course completion. The primary endpoint is HRQoL, as measured by MSQOL-54 (both physical and mental health domains) at 12 months following course completion. Secondary outcomes are changes to depression, anxiety, fatigue, disability, and self-efficacy as measured by Hospital Anxiety and Depression Scale, Patient-Determined Disease Steps and University of Washington Self-Efficacy Scale, respectively, assessed at each timepoint. Further assessments will include quantitative post-course evaluation, adoption and maintenance of behaviour change from follow-up survey data, and qualitative analysis of participants’ outcomes and reasons for course completion or non-completion. Discussion This RCT aims to determine whether an online intervention course delivering evidence-based lifestyle modification recommendations based on the Overcoming Multiple Sclerosis program to plwMS is more effective at improving HRQoL, and other health outcomes post-intervention, compared with an online standard-care course. Trial registration This trial was registered prospectively with the Australian New Zealand Clinical Trials Registry, www.anzctr.org.au , identifier ACTRN12621001605886. Date of registration 25 November 2021.

Abstract Background The Multiple Sclerosis Quality of Life-54 (MSQOL-54) is one of the most commonly-used MS-specific health-related quality of life (HRQOL) measures. It is a multidimensional, MS-specific HRQOL inventory, which includes the generic SF-36 core items, supplemented with 18 MS-targeted items. Availability of an adaptive short version providing immediate item scoring may improve instrument usability and validity. However, multidimensional computerized adaptive testing (MCAT) has not been previously applied to MSQOL-54 items. We thus aimed to apply MCAT to the MSQOL-54 and assess its performance. Methods Responses from a large international sample of 3669 MS patients were assessed. We calibrated 52 (of the 54) items using bifactor graded response model (10 group factors and one general HRQOL factor). Then, eight simulations were run with different termination criteria: standard errors (SE) for the general factor and group factors set to different values, and change in factor estimates from one item to the next set at

Category: Ankle; Basic Sciences/Biologics Introduction/Purpose: Extracorporeal shockwave therapy (ESWT) is a non-invasive treatment modality that is utilized in the treatment of chronic Achilles tendinopathy (AT). The purpose of this study was to retrospectively assess outcomes following ESWT for both NAT and IAT at greater than 1-year follow-up, and to identify potential predictors of outcomes. Methods: Chart review was conducted to identify patients who underwent ESWT for AT with a minimum of 1-year follow-up. Data collected and assessed included: patient demographics, pathological characteristics, treatment characteristics, Victorian Institute of Sports Assessment-Achilles (VISA-A) and visual analog scale (VAS) scores and failures. Linear regression was performed to identify potential predictors of outcomes. Survival analysis was conducted using Kaplan Meier curves. Fifty-two cases of IAT and 34 cases of NAT were included. The mean follow-up in the NAT cohort was 22.3±10.2 months and the mean follow-up time in the IAT cohort was 26.8±15.8 months. Results: Improvements in VISA-A and VAS scores were observed in the NAT cohort at 6 months follow-up and at final follow-up (p < 0.01). Improvements in VISA-A scores and VAS scores were recorded in the IAT cohort at 6 months follow-up which subsequently deteriorated at final follow-up. In the NAT cohort, the failure rate at 6 months follow-up was 11.8% which increased to 29.4% at final follow-up. In the IAT cohort, the failure rate at 6 months follow-up was 32.7% which increased to 59.6% at final follow-up. Predictors of poor outcomes in the NAT cohort included pre-ESWT subjective clinical score, male, presence of cardiovascular risk factor, and increasing MRI severity. Predictors of poor outcomes in the IAT cohort included pre-ESWT subjective clinical score and increasing MRI severity. Conclusion: This study found that superior subjective clinical outcomes together with a lower failure rate maintained over 1 year in the NAT cohort compared to the IAT cohort. This may implicate ESWT as a temporising treatment in IAT and a longer term solution in patients with NAT.

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.

Engaging in martial combat, whether for military, self-defence or cultivation purposes, is taken to sensitise practitioners towards existential issues which in turn enliven potential religio-spiritual experiences and awakenings. In this paper, we draw on Girard’s (1977) Violence and the Sacred, and in particular his proposition that, “religion shelters us from violence just as violence seeks shelter in religion” (Girard, [1977] 2005: 25) to examine sacralisation processes in the traditional martial arts with a particular focus on highlighting how violence, sacralised through sacred imagery, is used as a structuring force to instill dispositions that counter ubiquitous human tendencies towards unfettered violence and violent vengeance. We highlight the phenomenon and function of sacred imagery used in martial arts with very different cultural, ethnic, and spiritual influences, specifically: Japanese Karate, Korean Taekwondo, Brazilian Capoeira and Mexican Xilam. For authenticity, each section is written by an experienced scholar-practitioner of the art and combines literary, empirical, and biographical reflection. Despite these variations, we identify two modalities of sacred imagery use. The first is representational imagery used as sacred signifiers which embed the art in a tradition of sacred attachment. The second form of sacred imagery is metaphorical discourse which is designed to invoke creative visualisations aligning practitioners with idealised experiential states taken to have sacred (as well as practical) value in relation to combat. We conclude that the use of sacred imagery in these ways becomes part of an affective body pedagogy used by the traditionalist martial arts to transfer valued knowledge through the corporeal medium to offset and sacralise violent tendencies. It is qualified that in practice, this sacralisation process involves complex entanglements of the cultural origins, practitioner interpretation and the contemporary context of the martial art in question. The outcome is an evolving sacralisation process which rests in constant tension with the underlying problems initiated by the ubiquitous body-in-conflict problem and the propensity for violence and violent vengeance that the learning of combative skills might otherwise unleash in the body and onto society.

IntroductionIncreasingly, dietary improvements have been shown to have positive associations with health outcomes in people with multiple sclerosis (pwMS). However, adhering to a MS-specific or high-quality diet may be a challenge. We therefore assessed the level of diet-adherence necessary to improve health outcomes of depression, fatigue, and disability.MethodsData from an international population of pwMS followed over 7.5 years (n = 671) were analyzed. Self-reported diet quality via diet habits questionnaire (DHQ), and adherence to six MS-diets [Ashton Embry Best Bet, McDougall, Overcoming MS (OMS), Paleolithic (Paleo), Swank, and Wahls] were queried at two timepoints. Four levels of diet adherence were assessed: non-adherence at either timepoint; ceased at second timepoint; commenced at second timepoint; and ongoing at both timepoints. Associations between adherence to OMS and high-quality diet (DHQ score > median) with depression, fatigue, and disability, were assessed by log-binomial regression models adjusted for confounders.ResultsForty-two percent of pwMS reported ongoing-adherence to a MS-diet at both timepoints, OMS (33%), Swank (4%), Wahls (1.5%), other (

In a precarious occupation, martial arts instructors must be inspiring and build a shared philosophy. Drawing on Taijiquan and Capoeira, which have their philosophical or epistemological roots in Asia and Africa, this article explores core concepts that feature in students’ enculturation. These concepts are grounded in epistemologies contrasting with Papineau’s work on popular and elite sport, Knowing the Score. More specifically, the philosophical approach used builds upon Papineau’s chapters on focus, cheating and racism, although these martial practices are not grounded in the Judeo-Christian Western epistemologies underlying Papineau’s thinking. Indeed, one of the attractions for Western Capoeira and Taijiquan students is precisely their “strange” or exotic philosophical concepts driving specific pedagogical practices. Ethnographic fieldwork in Britain and written and oral accounts of embodied expertise are used to explore the practical uses of these non-Western epistemologies by teachers to build shared cultures for their students. Specifically, we examine the concepts of axé (life force) and malicia (artful trickery) in Capoeira, noting its contrast to Western ideas of energy and fair play. We then examine Taijiquan and the concepts of song (鬆 or “letting go”) and ting (听 or “focused listening”), considering the movement skill of systematic relaxation and the focus on specific components of human anatomy and body technique among adults unlearning embodied tension built throughout their lives. We close with considerations for projects examining the diverse, alternative southern, non-Western, and potentially decolonial and subaltern epistemologies in such martial activities.

Martial arts are concerned with continuous technical practice and refinement over a lifetime, while scholarship is ordinarily undertaken by active learners and experienced (occasionally veteran) practitioners. These martial arts scholar–practitioners tend to be positioned according to specific types, from a more distant (and sometimes critical) scholar with less combat acumen to an instructor keen to read and engage in collaborative research. This article introduces a typology of ten martial arts scholar–practitioner types: (1) Supportive Scholar; (2) Former Practitioner; (3) Practitioner on Stand-by; (4) Immersed Apprentice; (5) Budding Scholar–Practitioner; (6) Established Scholar–Practitioner; (7) Temporary Practitioner–Researcher; (8) Experimental Leader; (9) Inquisitive Teacher; and (10) Curious Practitioner. The types are examined using Capoeira, one of the most academically studied martial arts. Drawing on the Spannungsfeld—the “field of tension” between science and practice—we reveal the specific strengths and limitations of each type while illustrating the common transition between positions across a career or research project. Finally, we consider some practical solutions to mitigate the relative weaknesses and oversights of the specific types, including the ability to form teams of scholar–practitioners from different positions in academia and martial arts. We close with suggestions for empirical research to test and refine our methodological model.

Xilam es un arte marcial moderno inspirado en las culturas guerreras mesoamericanas prehispánicas, especialmente en la cosmovisión azteca. Como sistema de desarrollo humano, Xilam pretende formar una joven generación de mexicanos dignos como guerreros modernos, orgullosos de su herencia y ascendencia indígena. Su filosofía también hace hincapié en la naturaleza étnica y cultural híbrida de México, mezclando influencias indígenas, europeas y asiáticas. Este artículo utiliza un enfoque crítico y poscolonial de la tesis posrevolucionaria La raza cósmica del filósofo mexicano José Vasconcelos para analizar los posibles significados filosóficos de prácticas concretas dentro del Xilam. Examinando datos de entrevistas y vídeos recogidos hacia el final de un proyecto etnográfico, se adopta el arte de escuchar para mostrar cómo Xilam reinterpreta la raza cósmica en el siglo XXI. Nuestra investigación encuentra paralelismos entre las ideas de los practicantes de Xilam y a la tesis de Vasconcelos. Destaca cómo la recuperación de las nociones filosóficas prehispánicas da lugar a formas “otras” de problematizar el racismo en México sin el mesianismo utópico de Vasconcelos. En este sentido, “remover la piel” (Dzilam) se presenta como una alternativa a “la raza cósmica”; “Diversópolis” como una alternativa a “Universópolis”.

Category: Sports; Other Introduction/Purpose: Depending upon the site of injury, Achilles tendinopathy (AT) can be either Insertional (IAT) or Non- Insertional (nIAT). AT has long been managed by conservative measures such as eccentric exercises, but now extracorporeal shock wave therapy (ESWT) has emerged as a non-invasive treatment to stimulate self-repair. However, the native biology at the insertion of the Achilles tendon and mid-substance are intrinsically different, with the mid-substance (2 to 6 cm above the insertion) being significantly less perfused. Thus, we performed a systematic review of the literature on shockwave therapy to determine if there was a difference in efficacy for patients who have undergone ESWT for IAT and nIAT. Methods: In January 2022, the MEDLINE and EMBASE databases were systematically reviewed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We included randomized controlled trials, prospective and retrospective studies, published in English, with pre- and post-operative scores for at least either Visual Analogue Scale (VAS) or Victorian Institute of Sport Assessment - Achilles (VISA-A). We excluded basic science studies, systematic reviews and meta- analyses, retrospective studies, case reports, studies without pre-operative scores, studies that don't differentiate IAT and nIAT. The LoE and QoE of the included studies were evaluated using the Journal of Bone and Joint Surgery Criteria and the Modified Coleman Methodology Score, respectively. We calculated weighted mean values for age, body mass index (BMI), the number of ESWT sessions and their frequency, duration of symptoms prior to ESWT, follow-up time, as well as for each outcome score. Results: 16 studies were included in this review, six with Level I evidence, four with Level II, five with Level III, and one with Level IV. There were 505 cases of AT: 325 patients with IAT and 180 with nIAT. For the IAT cohort, the weighted mean (WM) duration of symptoms prior to treatment was 18.1 months, and WM follow-up was 8.1 months. For the nIAT cohort, the WM duration of symptoms prior to treatment was 15.0 months, and WM follow-up was 11.6 months. In terms of outcome scores, for VAS, the WM pre-operative scores were 6.89 for IAT and 7.76 for nIAT and the WM post-operative scores were 2.76 for IAT and 2.49 for nIAT. For VISA-A, the WM pre-operative scores were 49.3 for IAT and 42.8 for nIAT, and the WM post-operative scores were 75.4 for IAT and 75.7 for nIAT. Conclusion: As the mid-substance portion of the Achilles tendon has diminished blood supply compared to the insertional portion, we expected outcomes after ESWT to be inferior for the nIAT cohort. Interestingly, the VAS pain scores and VISA-A functional scores displayed similar positive results for both cohorts. We see that the virtually equivalent functional and pain outcomes mean that ESWT is stimulating cellular components of the tendon to promote healing regardless of injury location.

Abstract Background MSQOL-54 is a multidimensional, widely-used, health-related quality of life (HRQOL) instrument specific for multiple sclerosis (MS). Findings from the validation study suggested that the two MSQOL-54 composite scores are correlated. Given this correlation, it could be assumed that a unique total score of HRQOL may be calculated, with the advantage to provide key stakeholders with a single overall HRQOL score. We aimed to assess how well the bifactor model could account for the MSQOL-54 structure, in order to verify whether a total HRQOL score can be calculated. Methods A large international database (3669 MS patients) was used. By means of confirmatory factor analysis, we estimated a bifactor model in which every item loads onto both a general factor and a group factor. Fit of the bifactor model was compared to that of single and two second-order factor models by means of Akaike information and Bayesian information criteria reduction. Reliability of the total and subscale scores was evaluated with Mc Donald’s coefficients (omega, and omega hierarchical). Results The bifactor model outperformed the two second-order factor models in all the statistics. All items loaded satisfactorily (≥ 0.40) on the general HRQOL factor, except the sexual function items. Omega coefficients for total score were very satisfactory (0.98 and 0.87). Omega hierarchical for subscales ranged between 0.22 to 0.57, except for the sexual function (0.70). Conclusions The bifactor model is particularly useful when it is intended to acknowledge multidimensionality and at the same time take account of a single general construct, as the HRQOL related to MS. The total raw score can be used as an estimate of the general HRQOL latent score.

Since the outbreak of the COVID-19 pandemic, the physical and mental health of older adults has been threatened. Promoting physical and mental health through physical activity has therefore become a strategy for healthy aging. In order to better understand the impact of the participation of older adults in physical activity, this paper selects different types of physical activity, and examines the relationship between them and subjective well-being through the analysis of the mediation effect of outdoor exercise environment and the regulating effect of exercise form. In this cross-sectional study, a questionnaire survey was conducted in mainland China. The main data come from 903 older adults in five urban areas in Chengdu, Sichuan Province. The surveys were carried out using the Physical Activity Rating Scale, Newfoundland Subjective Well-Being Scale, Exercise Environment Scale, and Exercise Form Scale. SPSS was used for statistical analysis, linear regression analysis was adopted for processing data, and AMOS was used to establish a mediation model. The mediating variable is the outdoor exercise environment, and the moderating variable is exercise form; gender, age, education level, and monthly income were used as control variables. The study results showed that different physical activities (tai chi; health qigong; walking and jogging) were significantly, positively correlated with the subjective well-being of older adults (tai chi: R = 0.351, p

The western pond turtle (WPT) was formerly considered a single species (Actinemys or Emys marmorata) that ranged from southern British Columbia, Canada to Baja California, México. More recently it was divided into a northern and a southern species. WPTs are found primarily in streams that drain into the Pacific Ocean, although scattered populations exist in endorheic drainages of the Great Basin and Mojave deserts. Populations in the Mojave Desert were long thought to be restricted to the Mojave River, but recently another population was documented in Piute Ponds, a terminal wetland complex associated with Amargosa Creek on Edwards Air Force Base. WPT fossils in the Mojave Desert are known from the Miocene to the Pleistocene. Recently, Pleistocene fossils have been found as far into the desert as Salt Springs, just south of Death Valley. The oldest fossil records suggest that WPTs were present in wetlands and drainages of the geological feature known as the Mojave block prior to the uplift of the Sierra Nevada Range about 8 Ma and prior to the ~ 3 Ma uplift of the Transverse Ranges. Archaeological records document use of turtles by Native Americans for food and cultural purposes 1,000 or more years ago at the Cronese Lakes on the lower Mojave River and Oro Grande on the upper river. The first modern publication documenting their presence in the Mojave River was 1861. Museum specimens were collected as early as 1937. These fossil and early literature records support the indigenous status of WPTs to the Mojave River. However, mtDNA-based genetic evidence shows that Mojave River turtles share an identical haplotype with turtles on the California coast. Limited nuclear data show some minor differences. Overdraft of water from the Mojave River for municipal and agricultural uses, urban development, and saltcedar expansion are threats to the continued survival of WPTs in the Mojave River.

Abstract Background Here, we report an atypical HIV-vacuolar myelopathy and search the available medical literature about atypical presentations of human immunodeficiency virus associate vacuolar myelopathy (HIV-VM) and immunoglobulin therapy response. Case A 26-year-old lady who was 4 weeks postpartum presented to us with acute flaccid quadriparesis, with no sensory level. Extensive workup ruled out other causes of myelopathy. She developed a stage 3 acute kidney injury, and MRI showed diffuse cord atrophy involving the lower cervical and thoracic cord. The patient received IV-immunoglobulin, ARVs, and supportive therapy with inadequate response. Unfortunately, she developed nosocomial pneumonia and died. Discussion In HIV-VM, there is spinal cord atrophy, which mainly involves the thoracic cord. In our case, this pathological process also affected the spinal cord's cervical region, leading to flaccid tetraplegia, with high CD4 level, without response to the treatment, including intravenous immunoglobulin. Keynotes Vacuolar myelopathy, HIV, Immunoglobulin therapy, flaccid tetraplegia, hypokalaemia. Renal failure.

As social robots are increasingly introduced into health interventions, one potential area where they might prove valuable is in supporting people’s psychological health through conversation. Given the importance of self-disclosure for psychological health, this study assessed the viability of using social robots for eliciting rich disclosures that identify needs and emotional states in human interaction partners. Three within-subject experiments were conducted with participants interacting with another person, a humanoid social robot, and a disembodied conversational agent (voice assistant). We performed a number of objective evaluations of disclosures to these three agents via speech content and voice analyses and also probed participants’ subjective evaluations of their disclosures to three agents. Our findings suggest that participants overall disclose more to humans than artificial agents, that agents’ embodiment influences disclosure quantity and quality, and that people are generally aware of differences in their personal disclosures to three agents studied here. Together, the findings set the stage for further investigation into the psychological underpinnings of self-disclosures to artificial agents and their potential role in eliciting disclosures as part of mental and physical health interventions.

BackgroundDigital health interventions have revolutionized multiple sclerosis (MS) care by supporting people with MS to better self-manage their disease. It is now understood that the technological elements that comprise this category of digital health interventions can influence participant engagement in self-management programs, and people with MS can experience significant barriers, influenced by these elements, to remaining engaged during a period of learning. It is essential to explore the influence of technological elements in mitigating attrition. ObjectiveThis study aimed to examine the study design and technological elements of documented digital health interventions targeted at people with MS—digital health interventions that were intended to support a program of engagement over a defined period—and to explore how these correlated with attrition among participants of randomized controlled trials (RCTs). MethodsWe conducted a systematic review and meta-analysis of RCTs (n=32) describing digital health self-management interventions for people with MS. We analyzed attrition in included studies, using a random-effects model and meta-regression to measure the association between potential moderators. ResultsThere were no measured differences in attrition between the intervention and control arms; however, some of the heterogeneity observed was explained by the composite technological element score. The pooled attrition rates for the intervention and control arms were 14.7% and 15.6%, respectively. ConclusionsThis paper provides insight into the technological composition of digital health interventions designed for people with MS and describes the degree of attrition in both study arms. This paper will aid in the design of future studies in this area, particularly for digital health interventions of this type.

Abstract The relationship between serial changes in soluble tumor necrosis factor receptor type 1 (TNFR1) levels and an early decline in estimated glomerular filtration rate (eGFR) decline remains to be defined. We found that in patients with an early decline in renal function (n = 30), soluble TNFR1 values increased (2,595 ± 683 vs 3,596 ± 1,203 pg/mL, P

Understanding the dietary characteristics of people living with multiple sclerosis (plwMS) may assist in the planning of nutrition interventions for multiple sclerosis; yet dietary assessment methods in existing studies are not well established. The aim of this study was to validate the psychometric properties (construct validity and internal consistency) of the Dietary Habits Questionnaire (DHQ) against repeated online 24-h recall dietary assessments. The DHQ is a 24-item tool that is scored using ten dietary sub-scores. Total DHQ scores can range from 20–100 and are considered indicative of the quality of dietary intake with higher scores reflecting increased quality. People living with a relapsing-remitting MS phenotype who had completed a modified DHQ were recruited from the international Health Outcomes and Lifestyle In a Sample of people with Multiple sclerosis (HOLISM) cohort. Repeated 24-h recall via the online Automated Self-administered Assessment-24 (ASA-24) tool were modelled to reflect usual dietary intakes using the Multiple Source Method. DHQ scores of eight sub-scores: three key nutrients, three food groups and two food preparation practices, were calculated and statistically compared with ASA-24 usual intake data. Principal component analysis of the ASA-24 data was undertaken to understand dietary patterns of the sample. Of the 105 participants, valid 24-h recall data were available for 96 plwMS (n = 66 1 day, n = 30 ≥ 2 day). The median total DHQ score was 84.50 (IQR: 77.04, 91.83) points. The highest absolute correlations were between the DHQ scores and ASA-24 data for cereal (r = 0.395, p < 0.001), fruit and vegetables (r = 0.436, p < 0.001), and total dietary fiber (r = 0.482, p < 0.001). Five dietary patterns emerged from the data explaining 42.12% variance and reflecting exposure of plwMS to the influence of ‘MS diets’. The DHQ appears to be appropriate for screening participants with relapsing-remitting MS. Evidence-based dietary models focusing on food are required to monitor the quality of an overall dietary pattern and set priorities for the planning nutrition interventions for plwMS.

“Martial arts and combat sports” (MACS) are a myriad of systems of embodied movements and underlying philosophy and pedagogies. Due to the intrinsic complexity of MACS, they have the potential to both reshape practitioners’ selves and improve their wellbeing, as well as to hamper the pursuit of sustainable, healthy lifestyles. This article provides an interdisciplinary theoretical framework to critically approach both the “light” and the “dark” sides of martial pedagogies. The model we propose develops the Foucauldian notion of “the care of the self,” which has been considerably overlooked in martial arts scholarship. Furthermore, by viewing health as a goal for cultivation, this proposal places the situated practices linked to materiality and discourses at the centre of the theoretical and empirical analyses. The article thus takes into account the internal diversity and cross-institutional variance of martial pedagogies by allowing scholars to explore four forms of cultivation (self, shared, social, ecological) prompted on a day-to-day basis. To conclude, we discuss the main methodological implications for multimodal research arising from the framework in order to foster future inquiries.

Martial arts organisations increasingly blend online and offline activity in order to cultivate specific qualities, skills and virtues. Students and instructors use blogs, chat fora, videos and podcasts to supplement their self- and shared cultivation, and this expanded with the COVID-19 lockdown in Britain. Martial arts schools have been closed and even disbanded while governments control people’s physical interactions through social distancing measures. This article draws on case studies of two British martial arts schools (Taijiquan and historical fencing) in order to examine how they have adapted to the lockdown. It offers these case studies to narrate the developments of how teachers and their localised communities have been creative during this moment of international crisis – from instructor-led online, live training sessions and lectures to student-led chat fora and movie nights for continued sociability and identity construction. In so doing, this article makes use of martial arts theories: Shared Cultivation (Jennings, 2010) and Martial Creation (Jennings, 2019) to explain how martial artists continue to develop through creative online endeavours and through their moving bodies within the confines of their homes. Finally, I argue that this creative martial arts cultivation during the COVID-19 pandemic might be extended to wider physical culture.

Abstract Background Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease in the Western world. Early and accurate identification of DKD offers the best chance of slowing the progression of kidney disease. An important method for evaluating risk of progressive DKD is abnormal albumin excretion rate (AER). Due to the high variability in AER, most guidelines recommend the use of more than or equal to two out of three AER measurements within a 3- to 6-month period to categorise AER. There are recognised limitations of using AER as a marker of DKD because one quarter of patients with type 2 diabetes may develop kidney disease without an increase in albuminuria and spontaneous regression of albuminuria occurs frequently. Nevertheless, it is important to investigate the long-term intra-individual variability of AER in participants with type 2 diabetes. Methods Consecutive AER measurements (median 19 per subject) were performed in 497 participants with type 2 diabetes from 1999 to 2012 (mean follow-up 7.9 ± 3 years). Baseline clinical characteristics were collected to determine associations with AER variability. Participants were categorised as having normo-, micro- or macroalbuminuria according to their initial three AER measurements. Participants were then categorised into four patterns of AER trajectories: persistent, intermittent, progressing and regressing. Coefficients of variation were used to measure intra-individual AER variability. Results The median coefficient of variation of AER was 53.3%, 76.0% and 67.0% for subjects with normo-, micro- or macroalbuminuria at baseline. The coefficient of variation of AER was 37.7%, 66% and 94.8% for subjects with persistent, intermittent and progressing normoalbuminuria; 43%, 70.6%, 86.1% and 82.3% for subjects with persistent, intermittent, progressing and regressing microalbuminuria; and 55.2%, 67% and 82.4% for subjects with persistent, intermittent and regressing macroalbuminuria, respectively. Conclusion High long-term variability of AER suggests that two out of three AER measurements may not always be adequate for the optimal categorisation and prediction of AER.

The incense stick or agarbatti stick is used exclusively for religious purposes in almost every home in India, but now it is being used worldwide for its medicinal values. Bamboo, popularly known as green gold or poor man’s timber, is a multipurpose, fast-growing woody species, which occupies an essential place in the people’s diverse phases of life and culture. The primary concern of the different stakeholders of the bamboo sector is identifying the right choice of raw material to maximize incense sticks’ production. On the other hand, the market functionaries take advantage of farmers’ lack of knowledge of the demand–supply situation and make substantial margin money. Therefore, the paper evaluates the preference for the notable species, age, and the part of the culm of bamboo used for the industrial production of incense sticks. In Tripura, India, the investigation indicated that all study parameters were significantly different among the species, viz., Bambusa polymorpha, Bambusa vulgaris, Bambusa cacherensis, Bambusa tulda, Bambusa balcooa, Melocanna baccifera, Dendrocalamus asper, and Dendrocalamus longispathus. Among the bamboo species, Bambusa tulda is the most preferred one having a mean Likert scale of 4.89, followed by Dendrocalamus longispathus (4.06), B. cacharensis (3.54), B. polymorpha (3.50), etc. The most preferred age of bamboo culm is three-year-old culm (4.32), followed by four- and two-year-old culms. Therefore, it can be concluded that the middle portion of three-year-old culms of B. tulda should be preferably harvested to become the raw material for the agarbatti industry for better outturn and profit.

Purpose: Physical activity (PA) is considered essential for the treatment of morbid obesity and the optimization of bariatric surgery outcomes. The objective of this article was to identify the facilitators and barriers that bariatric patients perceived to do PA one year after finishing a PA programme for the promotion of a long-term active lifestyle. This objective was addressed from a socio-ecological and qualitative perspective. Methods: Nine patients (eight women and one man), aged between 31 and 59 years, participated in semi-structured interviews directly following the PA programme and one year after it. A content analysis was carried out to analyze the qualitative data. Results: Weight loss, improvement of physical fitness, perceived competence, and enjoyment were the main facilitators of PA. Complexes related to skin folds, osteoarthritis, perceived unfavourable weather conditions, lack of social support and economic resources, long workdays, lack of specific PA programmes, and other passive leisure preferences were the main barriers to participate in PA. Conclusions: Results highlight the important interplay between personal, social environmental, and physical environmental factors to explain (in)active behaviours of bariatric patients. The findings of this article could be useful for future research and interventions aimed at promoting PA in bariatric patients.

Background: Acute poisonings are common presentations to emergency departments (EDs) worldwide and require rapid assessment. Consultant emergency physicians (EPs) faced with various toxicological presentations must initiate rapid investigations and empirical management. This study aimed to determine emergency department doctors’ level of knowledge and confidence in toxicological presentations, and factors that predicted these outcomes. Methods: Target participants included members of the Australasian College for Emergency Medicine (ACEM) and readers of the emergency medicine website, “Life in the Fast Lane”. The survey was distributed electronically via the ACEM bulletin and posted on Life in the Fast Lane. A survey was designed based on toxicology multiple choice questions (MCQs). The questionnaire comprised 59 items: 10 demographic items; 20 items about confidence; 28 MCQs assessing knowledge of common and serious toxicological presentations. Results: There were 467 consenting respondents from 31 countries, with most residing in Australia (306/467, 66%). Respondents comprised similar proportions of consultant emergency physicians (196/467, 42.0%), and trainees (197/467, 42.2%). Almost two-thirds (292/467; 62.1%) had received formal training in toxicological emergencies, while a third (166/467, 35.5%) had participated in a relevant conference or workshop. A total of 284/339 (83.8%) participants completing all items achieved a knowledge test score >50%. More than 65% incorrectly answered questions on pharmacology of serotonin syndrome and lithium toxicity, and more than half incorrectly answered questions on use of 12 lead ECG in toxicology, calcium channel antagonist or tricyclic antidepressant toxicities. Predictors of overall knowledge for toxicology were receipt of formal toxicology education, and clinicians’ experience and seniority. Conclusion: The knowledge and confidence of doctors working in emergency departments is varied, yet correlated. Emergency medicine training programs should consider the benefit of reviewing current toxicological education, including the provision of further educational support to regional and rural hospitals.

Kung Fu associations are often understood as ‘families’ forming broader ‘family trees’ or lineages operating across centuries of history as well as transcultural associations. In an effort contributing to interdisciplinary martial arts studies, this paper presents data from two qualitative studies of Western practitioners of traditionalist Chinese martial arts (TCMA) in both the West and Asia by a phenomenological psychologist and an anthropological sociologist. We assess the use of the term ‘Kung Fu family’, what it means to the practitioners and how it impacts on their practice and their relationships with other martial artists. We argue that the conceptual metaphor of family offers a sense of belonging and solidarity within a diverse community in terms of age, ethnicity, gender, religion and social class. Meanwhile, we explore the metaphor in terms of the micro-political power dynamics that accompany martial arts collectives. Overall, the ideal of family can illuminate how identity can transcend across time (‘generations’ of practitioners) and place (from and to cultures and contingents). It is thus a way of understanding the organisation, spread and transcendence of Chinese martial arts.

Diabetic kidney disease is a common complication of type 1 and type 2 diabetes and is the primary cause of end-stage renal disease in developed countries. Early detection of diabetic kidney disease will facilitate early intervention aimed at reducing the rate of progression to end-stage renal disease. Diabetic kidney disease has been traditionally classified based on the presence of albuminuria. More recently estimated glomerular filtration rate has also been incorporated into the staging of diabetic kidney disease. While albuminuric diabetic kidney disease is well described, the phenotype of non-albuminuric diabetic kidney disease is now widely accepted. An association between markers of inflammation and diabetic kidney disease has previously been demonstrated. Effector molecules of the innate immune system including C-reactive protein, interleukin-6, and tumor necrosis factor-α are increased in patients with diabetic kidney disease. Furthermore, renal infiltration of neutrophils, macrophages, and lymphocytes are observed in renal biopsies of patients with diabetic kidney disease. Similarly high serum neutrophil and low serum lymphocyte counts have been shown to be associated with diabetic kidney disease. The neutrophil–lymphocyte ratio is considered a robust measure of systemic inflammation and is associated with the presence of inflammatory conditions including the metabolic syndrome and insulin resistance. Cross-sectional studies have demonstrated a link between high levels of the above inflammatory biomarkers and diabetic kidney disease. Further longitudinal studies will be required to determine if these readily available inflammatory biomarkers can accurately predict the presence and prognosis of diabetic kidney disease, above and beyond albuminuria, and estimated glomerular filtration rate.

The 4th International Coaching Conference held at Cardiff Metropolitan University, UK, showcased a range of studies concerning pedagogy in martial arts (MA). They varied in regards to their underpinning discipline, theory and method, but were united by a concern for enhancing practice in both pedagogy (the science) and pedagogies (the objects of study). One theoretical talk advocated a study of individual practices (techniques of the body and their corresponding methods) via praxiography in relation for a balanced, critical health pedagogy examining the duality of ‘dark’ and ‘light’ aspects. This in turn was applied by an emerging study looking at rapid weight loss practices in Judo and other combat sports that is beginning to scrutinise policies in order to regular this problem. Meanwhile, an investigation into the mental toughness of Karate practitioners uncovered similarly alarming findings on extreme training methods among veteran Welsh Karateka, while another study of a British context of Savate and Capoeira shared ways of studying MA pedagogies in their total form through traditional approach to ethnography. Together, these papers exemplify the increasing corpus of knowledge on teaching and learning in MA that could support that of coaching alongside sport and body pedagogy.

The dynamic relationships between “martial arts”, society and health remain unclear, particularly due to research that typically views health in a purely biomedical and compartmentalized way. Martial arts and combat sports (MACS) offer a diversity of disciplines with their own intended training outcomes and techne. The traditionalist Chinese martial arts (TCMAs), such as Taijiquan (Tai Chi Chuan) and Wing Chun Kung Fu, stress health promotion/preservation, personal development and lifelong practice. Adopting a structurationist framework, this article explores the connections between three distinct philosophies of health and TCMAs, institutions spreading such discourse, and the personal narratives of transformation and self-cultivation through these embodied art forms. Taking a perspective starting from the practitioners themselves, I explore the interplay between discourse and narrative as applied in everyday British society. Following detailed qualitative analysis, “Western scientific”, “contemporary Daoist” and “New Age” health philosophies are identified as explored via three detailed, reflexive cases of long-term practitioner-instructors, their schools and documents that connect them to international exponents across time. This article thus contributes to sociological knowledge on MACS and health, while considering the connections between health philosophies, discourse and narrative.

The 3rd Annual Martial Arts Studies Conference held at Cardiff University (11-13 July, 2017) was an eclectic collection of keynotes, papers, workshops, networking and social events. It connected PhD students, established professors and practitioner-instructors in university lecture rooms, public parks and music halls across three days of academic, social and physical activities. From historical studies of Chinese martial arts to the performance of Indian styles, it brought together scholars, practitioner-researchers and martial artists for a supportive, but also scholarly, gathering – one which was both thematically open but at the same united by an exploration of the communication of embodied research and knowledge. In sum, the conference demonstrated that martial arts studies, as a still young field, shows a wealth of promise, with emerging leaders, topics and debates that will stimulate future research, cross-continental collaboration and intercultural dialogue.

In this article, we present a case study analysis of data gathered on the practice of the art of Taijiquan (Tai Chi Chuan) in one UK context. Our interest in looking at this physical culture was in exploring if/how physical cultures of shared embodied experience and practice may help “sow the seeds of environmental awareness”. In so doing, we illustrate certain affinities between this interpretation of the art and Beck’s idea of a “cosmopolitan vision of ecology”. We present an analysis of documentary and interview data of one English Taijiquan organisation and how it currently promotes the idea of interconnectedness, wellbeing and an alternative meta-narrative for living through the practice of Taijiquan. We conclude that, while further research is needed, there is evidence that a cosmopolitan vision for ecology is emerging in physical cultures such as Taijiquan.

There are numerous ways to theorise about elements of civilisations and societies known as ‘body’, ‘movement’, or ‘physical’ cultures. Inspired by the late Henning Eichberg’s notions of multiple and continually shifting body cultures, this article explores his constant comparative (trialectic) approach via the Mexican martial art, exercise, and human development philosophy—Xilam. Situating Xilam within its historical and political context and within a triad of Mesoamerican, native, and modern martial arts, combat sports, and other physical cultures, I map this complexity through Eichberg’s triadic model of achievement, fitness, and experience sports. I then focus my analysis on the aspects of movement in space as seen in my ethnographic fieldwork in one branch of the Xilam school. Using a bare studio as the setting and my body as principle instrument, I provide an impressionist portrait of what it is like to train in Xilam within a communal dance hall (space) and typical class session of two hours (time) and to form and express warrior identity from it. This article displays the techniques; gestures and bodily symbols that encapsulate the essence of the Xilam body culture, calling for a way to theorise from not just from and on the body but also across body cultures.

JUSTIFICATIVA E OBJETIVOS: Em 2000, foi publicado o II Consenso Brasileiro de Ventilação Mecânica. Desde então, o conhecimento na área da ventilação mecânica avançou rapidamente, com a publicação de inúmeros estudos clínicos que acrescentaram importantes informações para o manuseio de pacientes críticos em ventilação artificial. Além disso, a expansão do conceito de Medicina Baseada em Evidências determinou a hierarquização das recomendações clínicas, segundo o rigor metodológico dos estudos que as embasaram. Essa abordagem explícita vem ampliando a compreensão e a aplicação das recomendações clínicas. Por esses motivos, a AMIB - Associação de Medicina Intensiva Brasileira - e a SBPT - Sociedade Brasileira de Pneumologia e Tisiologia - julgaram conveniente a atualização das recomendações descritas no Consenso anterior. Dentre os tópicos selecionados a Fisioterapia durante a Ventilação Mecânica foi um dos temas propostos. O objetivo foi descrever os pontos mais importantes relacionados à atuação do fisioterapeuta no ambiente da terapia Intensiva com ênfase na ventilação mecânica. MÉTODO: Objetivou-se chegar a um documento suficientemente sintético, que refletisse a melhor evidência disponível na literatura. A revisão bibliográfica baseou-se na busca de estudos através de palavras-chave e em sua gradação conforme níveis de evidência. As palavras-chave utilizadas para a busca foram: mechanical ventilation e physical therapy. RESULTADOS: São apresentadas recomendações quanto aos principais procedimentos fisioterápicos, as técnicas e suas aplicações. CONCLUSÕES: A fisioterapia ocupa hoje papel relevante no ambiente da terapia intensiva, principalmente para os pacientes sob ventilação mecânica invasiva ou não invasiva.BACKGROUND AND OBJECTIVES: The II Brazilian Consensus Conference on Mechanical Ventilation was published in 2000. Knowledge on the field of mechanical ventilation evolved rapidly since then, with the publication of numerous clinical studies with potential impact on the ventilatory management of critically ill patients. Moreover, the evolving concept of evidence - based medicine determined the grading of clinical recommendations according to the methodological value of the studies on which they are based. This explicit approach has broadened the understanding and adoption of clinical recommendations. For these reasons, AMIB - Associação de Medicina Intensiva Brasileira and SBPT - Sociedade Brasileira de Pneumologia e Tisiologia - decided to update the recommendations of the II Brazilian Consensus. Physical therapy during mechanical ventilation has been one of the updated topics. This objective was described the most important topics on the physical therapy during mechanical ventilation. METHODS: Systematic review of the published literature and gradation of the studies in levels of evidence, using the key words: mechanical ventilation and physical therapy. RESULTS: Recommendations on the most important techniques applied during mechanical ventilation. CONCLUSIONS: Physical therapy has a central role at the Intensive Care environment, mainly in patients submitted to a mechanical ventilatory support invasive or non invasive.

The pathogenesis of diabetes mellitus (DM) is variable, comprising different inflammatory and immune responses. Proteome analysis holds the promise of delivering insight into the pathophysiological changes associated with diabetes. Recently, we identified and validated urinary proteomics biomarkers for diabetes. Based on these initial findings, we aimed to further validate urinary proteomics biomarkers specific for diabetes in general, and particularity associated with either type 1 (T1D) or type 2 diabetes (T2D).Therefore, the low-molecular-weight urinary proteome of 902 subjects from 10 different centers, 315 controls and 587 patients with T1D (n = 299) or T2D (n = 288), was analyzed using capillary-electrophoresis mass-spectrometry. The 261 urinary biomarkers (100 were sequenced) previously discovered in 205 subjects were validated in an additional 697 subjects to distinguish DM subjects (n = 382) from control subjects (n = 315) with 94% (95% CI: 92-95) accuracy in this study. To identify biomarkers that differentiate T1D from T2D, a subset of normoalbuminuric patients with T1D (n = 68) and T2D (n = 42) was employed, enabling identification of 131 biomarker candidates (40 were sequenced) differentially regulated between T1D and T2D. These biomarkers distinguished T1D from T2D in an independent validation set of normoalbuminuric patients (n = 108) with 88% (95% CI: 81-94%) accuracy, and in patients with impaired renal function (n = 369) with 85% (95% CI: 81-88%) accuracy. Specific collagen fragments were associated with diabetes and type of diabetes indicating changes in collagen turnover and extracellular matrix as one hallmark of the molecular pathophysiology of diabetes. Additional biomarkers including inflammatory processes and pro-thrombotic alterations were observed.These findings, based on the largest proteomic study performed to date on subjects with DM, validate the previously described biomarkers for DM, and pinpoint differences in the urinary proteome of T1D and T2D, indicating significant differences in extracellular matrix remodeling.

Abstract Many factors are involved in determining the latitudinal and altitudinal spread of the important tick vector Ixodes ricinus (Acari: Ixodidae) in Europe, as well as in changes in the distribution within its prior endemic zones. This paper builds on published literature and unpublished expert opinion from the VBORNET network with the aim of reviewing the evidence for these changes in Europe and discusses the many climatic, ecological, landscape and anthropogenic drivers. These can be divided into those directly related to climatic change, contributing to an expansion in the tick’s geographic range at extremes of altitude in central Europe, and at extremes of latitude in Scandinavia; those related to changes in the distribution of tick hosts, particularly roe deer and other cervids; other ecological changes such as habitat connectivity and changes in land management; and finally, anthropogenically induced changes. These factors are strongly interlinked and often not well quantified. Although a change in climate plays an important role in certain geographic regions, for much of Europe it is non-climatic factors that are becoming increasingly important. How we manage habitats on a landscape scale, and the changes in the distribution and abundance of tick hosts are important considerations during our assessment and management of the public health risks associated with ticks and tick-borne disease issues in 21st century Europe. Better understanding and mapping of the spread of I. ricinus (and changes in its abundance) is, however, essential to assess the risk of the spread of infections transmitted by this vector species. Enhanced tick surveillance with harmonized approaches for comparison of data enabling the follow-up of trends at EU level will improve the messages on risk related to tick-borne diseases to policy makers, other stake holders and to the general public.

Purpose: Accurate assessment of chronic pain and functional disability in children and adolescents is imperative for guiding pain management interventions. Parents have multifaceted roles in their child's pain experience and frequently provide parent-proxy reports of pain-related functioning. However, cross-informant variance is often observed with limited understanding of contributing factors. This study aims to examine the degree of alignment between child and parent-proxy reports for Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference domain among children with chronic pain and to identify factors associated with improved child-parent agreement., Methods: This study includes a sample of 127 youth (66.1% female) with mixed etiology chronic pain, ranging in age from 8 to 17 (M = 12.24; SD = 1.598), and their parent. Data was collected at an interdisciplinary pediatric pain clinic and online peer support groups. Measures of demographic, pain intensity, and functioning were collected., Results: Means of parent-proxy reports were significantly lower than child self-reports on the PROMIS (p < 0.05). A statistically significant association between child's pain intensity (β = 0.953, P < 0.05) and the difference between child self-reported and parent-proxy reported PROMIS functional interference scores was found., Conclusion: Parents underestimated pain-related functional disability relative to children's self-reports. The difference between the paired child self-report and parent-proxy report of functional disability was significantly associated with greater child self-reported pain intensity. Although parent-proxy reports in pediatric chronic pain is often used in research and practice, findings underscore the importance of incorporating child and adolescent self-report, when possible, to comprehensively capture the child's pain experience and best inform clinical interventions., (© 2024. The Author(s).)

We report a two-layer microfluidic device to study the combined effect of confinement and chemical gradient on the motility of wild-type E. coli . We track individual E. coli in 50 μm and 10 μm wide microchannels, with a channel height of 2 μm, to generate quasi-2D conditions. We find that contrary to expectations, bacterial trajectories are superdiffusive even in the absence of a chemical (glucose) gradient. The superdiffusive behaviour becomes more pronounced upon introducing a chemical gradient or strengthening the lateral confinement. Run length distributions for weak lateral confinement in the absence of chemical gradients follow an exponential distribution. Both confinement and chemoattraction induce deviations from this behaviour, with the run length distributions approaching a power-law form under these conditions. Both confinement and chemoattraction suppress large-angle tumbles as well. Our results suggest that wild-type E. coli modulates both its runs and tumbles in a similar manner under physical confinement and chemical gradient. Our findings have implications for understanding how bacteria modulate their motility behaviour in natural habitats.

We report the development of a portable absorption (PortAbs)-based pathogen nucleic acid detection system using peptide nucleic acid (PNA) and a cyanine dye, DiSc 2 (5). When the dye binds to the PNA-DNA hybrid, it results in a characteristic ∼110 nm shift in the dye absorbance, which we measure using PortAbs. The protocol involves amplification of the target DNA, PNA-DNA hybridization and dye complexing steps followed by absorption measurement. The system is built using a broad-spectrum photodiode whose output is amplified and then measured by a high resolution (24 or 32 bit) analog-to-digital converter. The excitation pulses of light are delivered by a color-changing LED. The sequence of excitation, measurement and display of results are all controlled by an embedded Raspberry-Pi board (or alternatively a laptop). At higher concentrations of the target amplicon (∼200 ng), the color change can be detected visually. At lower concentrations, PortAbs outperforms a plate reader and can detect target DNA as low as 30 ng or approximately 10 nM which is at least 10 fold better than previously reported studies. We validate the methodology using SARS-CoV-2 clinical samples containing about 1000 copies of the viral RNA and show that the entire workflow takes about 90 min. The cost of the complete standalone system is less than INR 40 000 (approx. 500 USD).