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The recent surge in studies on collaborative writing (CW) has provided valuable insights into the product and process of writing. When writing together, adults tend to produce better texts and generate and resolve a large number of language-related episodes (LREs). Also, analyses of the dialogues of collaborative writers show that learners are able to co-construct knowledge and mainly focus their attention on the generation of ideas. As for young learners (YLs), the very few studies comparing jointly and individually written texts have not identified any advantages in the use of collaboratively written drafts.Furthermore, while YLs also produce and resolve LREs in CW tasks, no study to date has provided a thorough analysis of their dialogues. To address these gaps, this study compares the products of primary school learners of English as a foreign language (EFL) aged 11–12 writing in pairs (n = 20) and individually (n = 19) and provides a thorough analysis of pair talk (process). Results suggest that collaborative writers produced more accurate texts and focused most of their efforts on the generation of ideas and on the discussion and successful resolution of LREs. In light of these results the implementation of CW with YLs is encouraged. [ABSTRACT FROM AUTHOR]

Background: The effects of SARS-CoV-2 have varied between significant waves of hospitalization. Research question: Are cardiovascular complications different among the first, delta and omicron waves of hospitalized COVID-19 pneumonia patients? Study design and methods: This was a multi-centre retrospective study of patients hospitalized with SARS-CoV-2 pneumonia: 632 were hospitalized during the first wave (March–July 2020), 1013 during the delta wave (September 2020–March 2021), and 323 during the omicron wave (January 2022–July 2022). Patients were stratified by wave and occurrence of cardiovascular events. Results: Among all hospitalized patients with cardiovascular events, patients in the omicron wave were younger (62.4 ± 14 years) than patients in the first wave (67.4 ± 7.8 years) and the delta wave (66.9 ± 12.6 years) and had a higher proportion of non-Hispanic White people than in the first wave (78.6% vs. 61.7%). For COVID19 patients who suffered from cardiovascular events, the omicron wave patients had significantly higher neutrophil/lymphocyte ratio, white blood cell and platelet counts when compared to the first wave. Omicron wave patients had significantly lower albumin and B-type natriuretic peptide levels (only 5.8% of the first wave and 14.6% of the delta wave) when compared to either the first wave or delta wave patients. In COVID-19 patients who suffered cardiovascular events during hospitalization, mortality rate in the omicron wave (26.8%) was significantly lower than the first wave (48.3%), time to mortality for non-survivors of COVID-19 patients who suffered cardiovascular events was significantly longer in the omicron wave (median 16 days) than in the first wave (median 10 days). Conclusions: Younger and white patients were affected with cardiovascular complications more often by the omicron variant. Despite higher neutrophil/ lymphocyte ratio and WBC counts, the omicron patients with cardiovascular events showed lower heart injuries, lower mortality and longer time to mortality for non-survivors when compared to the first and delta waves. [ABSTRACT FROM AUTHOR]

As the aging populations, both nationwide and worldwide, rapidly increase, falls leading to unintentional injury and death subsequently increase. Thus, developing an understanding of biomechanical postural control strategies used to maintain balance in aging healthy adults, and those that have suffered stroke, are critical. Here, we were interested in how one's body segments stabilize relative to one another, and in space, in order to maintain balance. To accomplish this goal, we studied 30 healthy individuals and 8 survivors of stroke between 60 and 85 years old, both before and after several weeks of sensory training. Motion capture data were acquired to assess participants' body kinematics during walking: forward (easiest), forward-tandem, backward, and backward-tandem walking (most challenging). Deviations (via the observation of the absolute angle with deviations, or AADs) of the head, thorax, and lumbar areas relative to an earth vertical reference, as well as how one body segment stabilized in space or relative to the inferior body segment (via the observation of anchoring indices, or AIs), were explored. The results provide metrics (AADs and AIs) that can assess aging posture. Further, the results show an initial indication that, for aging individuals, training could lead to improved head and body stabilization in space. [ABSTRACT FROM AUTHOR]

This study aimed to determine the minimum number of repetitions for a high reliability of movement timing in fundamental physical fitness exercises using inertial sensors. Fifteen young men and fifteen women performed eight exercises (two-leg hop, forward lunge, squat, sit-up, shoulder abduction, hip abduction, back extension, and push-up) (preferred tempo, 3 trials, 20 repetitions per trial). The movement timing (cycle of movement in seconds and its phases in seconds and %tcycle) was tested for intra- and inter-trial reliability (SPSS 28.0, p ≤ 0.05). Just two repetitions were adequate for excellent intra- and inter-trial relative reliability (ICCs ≥ 0.75, isolated exceptions only for durations expressed as %tcycle, in only three out of the eight exercises: hip abduction, back extension, and push-up), as well as for high absolute intra- and inter-trial reliability (average SEM% at 5.9%, respectively, and 6.8% and average MDC95% at 13.7% and 15.9%, respectively, which was consistently higher than the upper boundary limit of SEM%, and a rather low CV% ranging from 1.5% to 4.9% and averaging at 3.1%). A total of four repetitions, excluding the initial and the final one, appears adequate for high overall reliability of movement timing in the eight physical fitness exercises examined. [ABSTRACT FROM AUTHOR]

While psychotherapy incorporating equine interaction (PIE) has proven to be a viable therapeutic intervention, it is not a common mental health service found on college campuses. Nevertheless, with the rise of mental health challenges on campuses after the COVID-19 pandemic, a need for effective therapeutic solutions is warranted. Therefore, the objective of this study was to determine the effect of a collegiate recovery community (CRC) PIE program for substance abuse disorder (SUD) compared to that of traditional cognitive behavioral therapy (CBT) and to determine whether physiological synchronization occurs between the human and horse during the therapy process. College-aged adults were recruited during the COVID-19 pandemic for two types of short-term SUD therapeutic interventions, CRC-PIE and CBT. Both groups completed a self-reporting survey assessing emotional safety. Vital signs measurements for human and horse participants within the CRC-PIE were collected prior to and after the first and last therapeutic sessions. Results concluded that although emotional safety did not improve significantly for PIE participants by the last therapy session (p = 0.85), emotional safety scores were significantly different between therapy types, with lower post-therapy scores for PIE (p = 0.04). As for physiological measures for PIE participants, respiratory rates (Human: p = 0.01; Horse: p = 0.01) and pain rating scores (Human: p = 0.03; Horse: p = 0.01) significantly decreased post-therapy and a strong positive correlation (R = 0.73, R2 = 0.53) associated with vital signs was observed between humans and horses. This human–horse physiological synchronization during the therapeutic intervention suggests that the horse may be a viable tool within campus CRC programs for the development of therapeutic alliances within the therapy process. [ABSTRACT FROM AUTHOR]

Background: Poisoning is one of the most common medicolegal problems in India. It is the second most important cause of suicide, followed by hanging in India. Aims and objectives: The current study is designed to determine the sociodemographic profile of the poisoning patients and their outcomes at a tertiary care hospital in Northern India. Materials and methods: All the acute poisoning patients considering inclusion and exclusion criteria, were admitted to the medicine emergency of a tertiary care hospital during the period of June-November 2019 and were enrolled after prior permission from the Institute Ethics Committee. A structured pro forma was filled regarding the patient's demographic information, incidence of poisoning, cause and type of poisoning, clinical presentation of patients, duration of respiratory support, intensive care unit (ICU) stay, hospital stay, and final outcomes. Descriptive statistics were used to analyze the data. Results: Maximum cases were observed in the age group of 21-30 (33.87%). The incidence of poison consumption was marginally higher in females (51.6%). Unemployed (22.6%), housewives (19.4%), and students (17.7%) were the distribution as per occupation. The majority (90.3%) of the patients in all the groups ingested poison with the intent to suicide. Overall, there was 61% pesticide poisoning. The highest mortality (38%) was seen amongst the patients with aluminum phosphide poisoning. Conclusion: Pesticides were the major cause of poisoning in the Northern region. Based on these findings' preventive measures like rationed supply and restricted sale of poisonous agents, improvement of legislature, and provision of license to the sale persons is the need for the hour. [ABSTRACT FROM AUTHOR]

Background: Although sedentary behavior (SB) before and during COVID-19 has been studied, mental activity-based SB patterns have been overlooked. This secondary analysis investigated the patterns of mentally active vs. passive SB in adults post-COVID-19 pandemic and examined sex differences. Methods: Adults (n = 1255; 45% males; 50% aged between 20 and 29 years old) self-reported general characteristics, anthropometric and socioeconomic variables, and mentally active and passive SB (weekdays and weekend days) using a structured web-based survey. Adjusted ANCOVA on Ranks tests assessed differences between mentally active and mentally passive SB during the day, on weekdays, and weekend days. Adjusted Quade Nonparametric ANCOVA tests evaluated these differences in males vs. females. Results: Adults significantly spent greater time in mentally active vs. passive SB (5.61 ± 4.57 vs. 2.50 ± 3.25; p < 0.001). Mentally active SB was more prevalent on weekdays than on weekends (6.00 ± 5.00 vs. 5.00 ± 5.00; p < 0.001). No significant difference was observed for mentally passive SB (p > 0.05). Males significantly accumulated more mentally active SB compared to females (p < 0.001 for all). Females significantly spent more time in mentally passive SB on weekdays than males (p < 0.05). Conclusion: Our results highlight the need for individualized SB reduction strategies based on mental activity to obtain the most benefits of SB reduction interventions and promoting overall health post-COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Objective This study aims to determine the pain experienced by adult patients during the bloodletting procedure and to reveal the effect of visual and auditory methods on the level of pain compared to routine bloodletting procedures. Material and Method The study was conducted as a randomized controlled trial. The study was carried out in a blood collection unit of a hospital on 15.01.2022. A total of ninety-nine patients were randomized into three groups (visual, auditory, and control groups). Visual Group patients were asked to focus on the nature photograph on the screen, and the Auditory Group patients were asked to focus on the nature sounds they listened to. Data were collected using the Personal Information Form and the Visual Analog Scale (VAS). In the analysis of the data, descriptive statistical methods, KruskalWallis, Pearson Chi-Square, and Monte Carlo Exact Tests were used. The significance level was taken as p<0.05 and p<0.001. Results No statistically significant difference was found between the visual and auditory groups (p>0.05). However, the pain levels of the patients in the visual and auditory groups were found lower than the pain levels of the patients in the control group (p<0.001). Conclusion This study reveals the positive effect of distraction on the level of acute pain in adults. The study proves that visual and audial methods can be used safely within the scope of distraction methods and presents evidence-based information. [ABSTRACT FROM AUTHOR]

Adults' performances on the dot-perspective task showed a consistency effect: participants were slower to judge their own visual perspective when their own perspective and others' perspective were different compared to when both perspectives were the same. This effect has been explained by two competing accounts: the implicit mentalising account suggests the effect arises from relatively automatic tracking of others' visual perspectives, whereas the submentalising account suggests the effect arises from domain-general attentional orienting. We conducted three experiments to adjudicate between the two competing accounts. Experiment 1 manipulated eye–head directional cues (gaze-averted-face versus head-averted-face) and measured its effect on implicit mentalising (in the dot-perspective task) and attentional orienting (in the Posner task). Eye–head directional cues modulated attentional orienting but not implicit mentalising, supporting the importance of visual access and the existence of implicit mentalising in the dot-perspective task. Experiment 2 compared the effect of gaze-averted versus finger-pointing agents. Finger-pointing direction might induce attentional orienting effects on both tasks. Experiment 3 combined finger-pointing with manipulation of the agent's visual access (eyes-sighted versus eyes-covered) on the dot-perspective task. Visual access did not modulate the consistency effect when finger-pointing was simultaneously displayed. The findings of Experiments 2 and 3 indicated the contribution of the sub-mentalistic process to the dot-perspective task. Overall, the findings suggest that implicit mentalising and submentalising may co-exist in human social perceptual processes. Visual access appears to play a dominant role in modulating implicit mentalising on the dot-perspective task, but the process may be interfered with by finger-pointing cues (more salient than gaze cues) via a sub-mentalistic attentional-orienting mechanism. [ABSTRACT FROM AUTHOR]

Background: One in three adults over the age of 65 and one in two adults over the age of 80 will experience a fall a year. Falls account for a considerable cost burden for the National Health Services. Preventing falls in elderly care homes is a significant public health policy goal in the United Kingdom. The 2004 National Institute for Health and Care Excellence Clinical Guideline (CG21) recommends risk detection and multifactorial fall prevention interventions. Digital technology allows individualised monitoring and interventions. However, there is no certainty of the impact of multifactorial interventions on the rate of falls. Methods: A mixed methods Real-World Validation incorporating a retrospective multi-centre case–control study using real-world data and qualitative study to assess the effectiveness of a falls prevention application in 32 care homes in the Northwest of England. The study aims to assess if a multifactorial fall-prevention digital App reduces falls and injurious falls in care homes. The primary outcome measures were the rate of patient falls per 1000 occupied bed days in care homes for 12 months. A digital multifactorial risk assessment and a tailored fall prevention plan linking each risk factor with the appropriate preventive interventions were implemented/reviewed monthly. For the intervention group two datasets were used. The first set was data recorded in the App on falls and resulting injury levels, multifactorial risk assessments, and number of falls. Sociodemographic variables (gender and age) of care homes residents were also collected for this group. Data for the first twelve months of use of the intervention were collected for early adopter intervention homes. Less than twelve months data was obtainable from care home adopting the intervention later in the study. The second dataset was constituted by intervention and comparable control anonymised data extracted from the care home residents' registries from Borough 1 Council and Borough 2 Clinical Commissioning Group, including quantitative data on the number of falls, number of injurious falls, and outcomes, with emergency room and hospital records for Borough 2. For the qualitative study, twelve video interviews conducted by Safe Steps were analysed thematically to identify user perceptions of various aspects of the App including need, development, implementation, use and benefits. Results: The secondary outcome was the rate of injurious falls per 1000 occupied bed days. There were 2.23 fewer falls per 1000 occupied bed days in the Intervention group (M = 6.46, SD = 3.65) compared with Control (M = 8.69, SD = 6.38) (t(2.67) = -2.686, p = 0.008). The intervention had 3.5 fewer low harm injurious falls ratio per 1000 occupied bed days (M = 3.14, SD = 4.08) (M = 6.64, SD = 6.22) (t(144) = -3588, p < 0.01). There were significant differences between Intervention and Control on injurious falls resulting in ambulance calls (t(31.18) = -3.09, p = 0.04); and patients arriving at Accident & Emergency (t(17.25) = -3.71, p = 0.002). Thematic analysis of the video interviews identified the following six themes: Alleviation of staff workload; the impact of falls on both the individual and on the health care system; achievement of health outcome benefits, including reduced hospital visits for falls and improved quality of life for the patients living in care homes; the improvement over paper-based risk assessments for staff; the uniqueness of the person-centred approach of the App; and the ability of the approach to track patients across boundaries in the health and social care system. Conclusions: In this real-world validation, the implementation of a multifactorial fall-prevention digital app was associated with a significant reduction in falls and injurious falls, and was perceived to be highly beneficial by care home residents, staff, management and care commissioners where the approach was implemented. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD) is a leading cause of death in the United States. Overall COPD prevalence declined during 1999-2011. Trends in COPD prevalence during the previous decade have not been reported. CDC analyzed 2011-2021 Behavioral Risk Factor Surveillance System data to assess trends and differences in self-reported physician-diagnosed COPD prevalence among U.S. adults aged =18 years. Age-standardized prevalence of COPD did not change significantly from 2011 (6.1%) to 2021 (6.0%). Prevalence was stable for most states and subgroups; however, it decreased significantly among adults aged 18-44 years (average annual percent change [AAPC] = -2.0%) and increased significantly among those aged =75 years (AAPC = 1.3%), those living in micropolitan counties (0.8%), and among current (1.5%) or former (1.2%) smokers. COPD prevalence remained elevated in the following groups: women, adults aged =65 years, those with a lower education level, unable to work, living in rural areas, and who ever smoked. Evidence-based strategies, especially those tailored for adults disproportionately affected, can reduce COPD prevalence, and address the continued need for prevention, early diagnosis, treatment, and management. [ABSTRACT FROM AUTHOR]

Objective: Young adults’ music-listening behaviours may put them at risk of developing permanent hearing loss and tinnitus. This study aimed to assess knowledge of permanent tinnitus and whether this knowledge may influence listening behaviours to a greater degree than knowledge of hearing loss. Materials and Methods: A two-group (between subjects), randomised post-test only, single-factor experimental design was used to determine the effects of health message focus (permanent tinnitus vs. permanent hearing loss) on the main outcome measure of protective behavioural intention. The sample included 109 male and 287 female adults, aged 18 to 25 years, living in the United Kingdom. The young adults’ existing knowledge of either permanent hearing loss or permanent tinnitus was measured, and after exposure to a health message, their perceptions and resultant behavioural intentions were assessed and compared. The pooled data were used to test a proposed model of factors influencing hearing protective behavioural intention using path analysis. Results: Whilst 83% knew about the link with hearing loss, only 75% knew that loud music may cause permanent tinnitus. The participants viewed tinnitus as closer temporally than hearing loss, perceived themselves as equally susceptible to both, but perceived hearing loss as more severe. There was no significant difference in behavioural intention between the groups. Conclusion: Perceived susceptibility and severity have a positive effect on behavioural intentions. In light of these results, recommendations for future noise-damage prevention campaigns are made. [ABSTRACT FROM AUTHOR]

In many countries, adult clinics specifically dedicated to adult patients with lysosomal storage diseases (LSDs) do not exist. In Turkey, these patients are managed either by pediatric metabolic specialists or adult physicians who do not specifically specialize in LSDs. In this study, we aimed to identify the unmet clinical needs of these adult patients and their suggestions. The focus group participants were 24 adult LSD patients. Interviews were conducted in person. A total of 23 LSD patients and parents of a patient with mucopolysaccharidosis type-3b with intellectual deficit were interviewed, with 84.6% of patients diagnosed after the age of 18 years and 18% of patients diagnosed before the age of 18 years desiring management by adult physicians. Patients with particular physical characteristics or severe intellectual deficit declined the transition. Patients reported structural problems in the hospital and social problems associated with pediatric clinics. They made suggestions to facilitate the possible transition. With improved care, more patients with LSDs survive into adulthood or receive the diagnosis in adulthood. Children with chronic diseases need to transition to the care of adult physicians when they reach adulthood. Thus, there is an increasing need for adult physicians to manage these patients. In this study, most LSD patients accepted a well-planned and organized transition. Problems were related to stigmatization and social isolation in the pediatric clinic or adult issues with which pediatricians are not familiar. There is a need for adult metabolic physicians. Thus, health authorities should adopt necessary regulations for training of physicians in this field. [ABSTRACT FROM AUTHOR]

Background: Mixed-type total anomalous pulmonary venous connection is a rare condition in which the pulmonary veins possess multiple drainage sites. In the treatment of multiple lesions, it is sometimes necessary to treat only the main lesion first and repair additional residual lesions during follow-up. Case presentation: We report a case of additional repair of a remaining type Ia lesion in a 19-year-old woman with mixed-type total anomalous pulmonary venous connection who had previously been treated for a type IIa lesion alone. The vertical vein was used as a free graft in the surgery, and the reconstruction was successful without turbulence or kinking. Conclusions: Our results suggest that the use of the vertical vein as a free graft for the repair of residual type Ia lesions in adulthood allows reliable reconstruction regardless of the spatial relationship between the left atrial appendage and the left superior pulmonary vein. [ABSTRACT FROM AUTHOR]

Food protein induced enterocolitis syndrome (FPIES) belongs to a group of IgE-independent food allergies. It is the domain of paediatric patients, but it can also occur in adults. In this disease there is a life-threatening risk resulting from the possibility of a severe course of the disease and the development of hypovolemic shock. The disease was first defined in the mid-1970s. Knowledge about this disease is extremely low, we do not know its exact frequency, and the disease itself usually appears between 2 and 7 months of age. FPIES occurs mainly in formula-fed infants, typically 1-4 weeks after formula introduction, very rarely in breastfed infants, but may also develop in adults. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in late 2019, and is the infectious agent that caused the coronavirus disease 2019 (COVID-19) pandemic. Although respiratory and gastrointestinal manifestations of SARS-CoV-2 are well defined, the spectrum of neurological involvement is less defined. The classic type of Guillain–Barré syndrome (GBS) progresses over days to weeks and has a monophasic course. Areflexia/hyporeflexia and ascending and symmetrical paralysis are observed clinically in patients. It is an autoimmune process that typically leads to the destruction of myelin after infection. There have been numerous reports of adult patients with the coexistence of GBS disease and active COVID-19 illness, but this number is lacking for children. In this study, we present a literature review of the etiological correlation between SARS-CoV-2 and GBS and describe the cases of two pediatric patients with acute monophasic Guillain–Barré syndrome (GBS) during active COVID-19 infection. [ABSTRACT FROM AUTHOR]

Purpose: Renal arterial anatomy has a great clinical importance during surgical and endovascular procedures. However, comprehensive data on renal arterial variations in the Bulgarian population has not yet been provided. The aim of this study was to conduct a detailed research about the normal anatomy and variations of the renal arteries in the Bulgarian population. Methods: Five hundred sixty-one patients underwent contrast-enhanced multidetector computed tomography scans for the period 2016–2021. The images were retrospectively reviewed. Number, branching pattern, origin level and course of the renal arteries were noted. Data were categorized on the basis of laterality, gender and symmetry. Results: Only 46.3% of the patients exhibited normal renal arterial anatomy. Variations were observed in 301 patients (53.7%). The most common variant was the presence of accessory renal arteries (ARA), discovered in 41.2% of the subjects. There was no significant difference based on gender and laterality (p > 0.05). Hilar ARA (72.6%) were significantly more common than polar ARA (p < 0.001). The most common origin location of the main renal arteries and ARA was the aorta, followed by the common iliac arteries. Early division was observed in 21.7% of the patients, significantly more common on the right. Precaval course was found in 0.5% of the right main renal arteries and in 30% of ARA and the difference was significant (p < 0.001). Conclusion: These results show novel insight into the prevalence of renal arterial variations in the Bulgarian population. Anatomic renal vasculature variants are common therefore awareness is crucial for the success of surgical and interventional procedures. [ABSTRACT FROM AUTHOR]

Introduction: Recent evidence has suggested that there has been an increase in suicidal ideation during the COVID-19 pandemic. Our objectives were to estimate the likelihood of suicidal ideation among adults in Canada who experienced pandemic-related impacts and to determine if this likelihood changed during the pandemic. Methods: We analyzed pooled data for 18 936 adults 18 years or older from two cycles of the Survey on COVID-19 and Mental Health collected from 11 September to 4 December 2020 and from 1 February to 7 May 2021. We estimated the prevalence of suicidal ideation since the pandemic began and conducted logistic regression to evaluate the likelihood of suicidal ideation by adults who experienced pandemic-related impacts, and by factors related to social risk, mental health status, positive mental health indicators and coping strategies. Results: Adults who had adverse pandemic-related experiences were significantly more likely to experience suicidal ideation; a dose-response relationship was evident. People who increased their alcohol or cannabis use, expressed concerns about violence in their home or who had moderate to severe symptoms of depression, anxiety or posttraumatic stress disorder also had significantly higher risk of suicidal ideation. The risk was significantly lower among people who reported high self-rated mental health, community belonging or life satisfaction, who exercised for their mental and/or physical health or who pursued hobbies. Conclusion: The COVID-19 pandemic has influenced suicidal ideation in Canada. Our study provides evidence for targeted public health interventions related to suicide prevention. [ABSTRACT FROM AUTHOR]

Background: Recent studies support magnetic resonance angiography (MRA) as a diagnostic tool for pulmonary arterial disease. Purpose: To determine MRA image quality and reproducibility, and the dependence of MRA image quality and reproducibility on disease severity in patients with chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF). Material and Methods: Twenty patients with COPD (mean age 66.5 ± 8.9 years; FEV1% = 42.0 ± 13.3%) and 15 with CF (mean age 29.3 ± 9.3 years; FEV1% = 66.6 ± 15.8%) underwent morpho-functional chest magnetic resonance imaging (MRI) including time-resolved MRA twice one month apart (MRI1, MRI2), and COPD patients underwent non-contrast computed tomography (CT). Image quality was assessed visually using standardized subjective 5-point scales. Contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were measured by regions of interest. Disease severity was determined by spirometry, a well-evaluated chest MRI score, and by computational CT emphysema index (EI) for COPD. Results: Subjective image quality was diagnostic for all MRA at MRI1 and MRI2 (mean score = 4.7 ± 0.6). CNR and SNR were 4 43.8 ± 8.7 and 50.5 ± 8.7, respectively. Neither image quality score nor CNR or SNR correlated with FEV1% or chest MRI score for COPD and CF (r = 0.239–0.248). CNR and SNR did not change from MRI1 to MRI2 (P = 0.434–0.995). Further, insignificant differences in CNR and SNR between MRA at MRI1 and MRI2 did not correlate with FEV1% nor chest MRI score in COPD and CF (r = −0.238–0.183), nor with EI in COPD (r = 0.100–0.111). Conclusion: MRA achieved diagnostic quality in COPD and CF patients and was highly reproducible irrespective of disease severity. This supports MRA as a robust alternative to CT in patients with underlying muco-obstructive lung disease. [ABSTRACT FROM AUTHOR]

Distal tibiofibular syndesmosis injuries can be stabilized with syndesmotic screws or suture-buttons. The objective was to compare ankle motion during gait and a step-down task between patients that had syndesmotic screw or suture-button fixation and healthy adults. This case series included two participants who received a syndesmotic screw and two participants that received a suture-button to fixate the distal tibiofibular syndesmosis. Time from surgery was 2 to 5 years. Ankle angles were measured during gait and a step-down task using an optical motion capture system and force plates. Peak angles and angle waveforms were compared to healthy adults (gait n=56, step-down n=14) using descriptive statistics. There was decreased ankle plantarflexion during gait for one participant that had a syndesmotic screw and one participant that had a suture-button compared to healthy adults. During step-down, there was decreased ankle dorsiflexion in three participants (1 suture-button, 2 syndesmotic screw) and decreased ankle eversion for both participants that had syndesmotic screws. There was no clear pattern of which surgical technique resulted in improved ankle motion. Other factors likely played a role in limiting ankle motion such as injury severity. Future studies should further compare ankle motion during functional activities between these surgical techniques in larger samples. [ABSTRACT FROM AUTHOR]

In recent years, it has been determined that SOT sensitivity is insufficient in patients who develop vestibular compensation and therefore the Head Shake Sensory Organization Test (HS-SOT) has been developed. How differs the balance performance of healthy adults that is tested with HS-SOT according to age and test planes? What is the test-retest reliability level of the HS-SOT in three planes? Our prospective study, which has a methodological research design, included 80 participants divided into three groups by age range (Group 1: 20–39 years (n = 30); Group 2: 40–49 years (n = 30) and Group 3: 50–64 years (n = 20)). SOT and HSSOT (yaw, pitch, roll) were performed to all participants. To investigate the testretest reliability of the HS-SOT, a total of 27 participants were re-evaluated one week later. The HS-SOT performance of the participants was compared between age groups and test planes. Intra-class correlation coefficient and minimum detectable change values (MDC) was calculated to test-retest reliability of HS-SOT. HS-SOT scores (HS-2 and HS-5) did not differ significantly between age groups. The balance performance of individuals for the pitch plane was lower than other planes. Only the HS-5 score showed a significant difference between the sessions. HS-5 scores were higher in the re-test; for the first group in the pitch plane and for the third group in the yaw plane. The test-retest reliability level of these conditions was "moderate-good" for both groups. The corresponding MDC value was highest (14.01) for the HS-5 (yaw) score of the elderly group. The findings from this study demonstrated that the test plane influences the HS-SOT, a learning/practice effect may occur because of repeated HS-SOT evaluation, and this effect is more explicit in the elderly. This study provides a perspective for the evaluation and follow-up processes of patients with balance problems. • Inclusion of head movements complicates the classical sensory organization test. • The plane of head motion affects postural stability in the HS-SOT. • Perspective on the potential use of HS-SOT for vestibular rehabilitation. • Learning effect becomes apparent as age increases. • The test-retest reliability of the HS-SOT differs for three planes. [ABSTRACT FROM AUTHOR]

This study aims to explore the differences in psychopathological symptoms that may exist in the general adult population with or without psychotic-like experiences (PLEs), depending on the age range. The presence of PLEs, selfreported general psychopathological symptomatology, and different sociodemographic and psychosocial characteristics were assessed in 216 participants without any record of personal psychiatric antecedents. The sample was divided into young adults (18-35 years) and mature adults (36-60 years). The young adults showed a higher expression of PLEs (33.6%). The mature adults with PLEs presented more psychopathological symptoms in the dimensions of hostility-anger, somatization, depression, and anxiety than mature adults without PLEs. Young adults with PLEs showed significantly more symptoms in the same dimensions, and in the obsession-compulsion dimensions, paranoid ideation, and psychoticism, than participants of this age without PLEs. PLEs are more frequent in people between 18-35 years old; however, PLEs can be present in different age ranges and could serve as an alert to high levels of affective and anger-hostility symptoms. [ABSTRACT FROM AUTHOR]

Background and Objectives: Despite few reports on the influence of ambient acoustic noise on auditory brainstem response (ABR) to click stimuli, its effects on ABR to level-specific (LS) stimuli have not been systematically investigated. This study aimed to investigate the influence of ambient acoustic noise on ABR findings using both LS chirp and click stimuli. Subjects and Methods: Twelve normal-hearing adults participated in this repeated measure design study. The ABRs were acquired at 80, 50, and 30 dBnHL using two stimuli (LS chirp and click) under two conditions (quiet and noise). The ABRs under noise conditions were acquired using babble noise and white noise. The noise level was set at 55 dBA. Two-way repeated measure analysis was used to identify the main effects of the test conditions, stimulus types, and their interactions at a 95% confidence level. Results: No significant influence of ambient acoustic noise on ABR findings was identified at all intensity levels. No significant difference was found in the number of signal averages to reach the 0.04 µV residual noise as stopping criteria among the ABRs recorded with different types of stimuli and test conditions. The ABR waves I and V amplitudes were larger with LS chirp than with click stimulus. Conclusions: Ambient acoustic noise has no significant influence on ABR findings and the ABR test time based on the 55 dBA noise level used in this study. [ABSTRACT FROM AUTHOR]

Introduction: Developmental stuttering is a neurological disorder commonly manifested as a motor problem. Cognitive theories, however, hold that poorly developed cognitive abilities are the origins of stuttering. This study aimed to compare the visual and auditory working memory in adults with and without stutter. Materials and Methods: This research was performed at the Speech Therapy Clinic of Ibn-e-Sina Hospital and Psychiatry and Behavioral Sciences Research Center of in Mashhad University of Medical Sciences, Iran, in 2019-2020. In this study, Adults Who Stutter (AWS) (N= 60) and Adults Who No Stutter (AWNS) (N= 60), aged between 17-37 years, with no history of mental and sensory, lingual, hearing, articulatory, motor, and psychiatry defects, were recruited. The N-Back test evaluated the participants' visual working memory abilities. In addition, the Wechsler test (Digit span) was used to evaluate the auditory working memory abilities. Data analyzed through SPSS 25 software. Results: The results revealed no significant difference between groups in the digit naming task (P> 0.05). However, a significant difference was seen between the two groups during the 2-Back task (P= 0.02). Analysis showed that AWS had more false alarms due anxiety while responding due to increased attentional demands. On the other hand, it could be a sign of working memory deficits during a difficult task. Conclusion: Adults with stutter perform poorly than normal adults, even though their performance is still within the normal range. [ABSTRACT FROM AUTHOR]

A Monteggia fracture is a proximal ulnar fracture with proximal radioulnar ligamentous instability. While there is no precise definition, Monteggia-equivalent fractures are generally considered Monteggia fractures accompanied by radial head fractures. These are rare. In this study, we report a rare variation of a Bado type IV Monteggia-equivalent lesion (fracture of proximal ulnar shaft, proximal radial shaft, and radial head) and its management. [ABSTRACT FROM AUTHOR]

Walking workstations may counteract sedentarism in working adults; however, performing dual-task walking may affect gait or work performance. The purpose of this study was to examine gait symmetry parameters and work performance while completing a fine motor dexterity task during walking workstation use. Gait function, quantified as gait symmetry, was used to identify attentional resource allocation of the co-occurring tasks during the dual-task conditions. Eighteen college-aged students performed the Purdue Pegboard Test (PPT) with left and right hands separately while using a walking workstation at a self-selected speed. Gait symmetry indices were computed on stride length and lower extremity angular joint positions and were analyzed for a comparison of the baseline and PPT dual-task conditions. No asymmetries were found in stride length or lower extremity angular joint positions at any sub-phase of gait during walking workstation use. PPT scores decreased significantly in the walking condition compared to the seated and standing conditions. Overall, gait symmetry did not change at any lower extremity angular joint position at any sub-phase; however, there was a decrease in PPT performance, which may relate to decreased work performance. However, increased exposure to the PPT task while using a walking workstation may improve work performance over time. [ABSTRACT FROM AUTHOR]

Computerized cognitive training (CCT) is a computer-based intervention that targets cognitive functioning that has become increasingly popular in the recent decade. We examined the effectiveness of RehaCom as a standard computerized cognitive training on the executive functions of healthy adults in this preliminary study. The study was a quasi-experimental study using a pretest-posttest experimental design without a control group. The participants included 10 healthy adults. The participants were evaluated before and after the intervention using Trail Making Test (TMT), Intra-Extra Dimensional Set Shift (IED), and Stockings of Cambridge (SOC) computerized tasks. The subjects trained by RehaCom software for 45 minutes per day, one day per week, for a total of four sessions over one month. Data were analyzed in the SPSS software (version 26) using the paired t-test test. Results show significant enhancement in participants' central executive functioning (p < 0.01), shifting (p<0.05), and planning (p<0.05). A computerized cognitive training program can improve cognitive functions of healthy adults. [ABSTRACT FROM AUTHOR]

The risk of obstructive sleep apnea (OSA) in patients with resistant hypertension (RH) has not been well-quantified. We sought to evaluate the risk of OSA in patients with RH compared to those with treated but non-resistant hypertension (non-RH) using a time-dependent-exposure analysis. We conducted a retrospective cohort study of patients with treated hypertension (hypertension diagnosis + ≥2 antihypertensive drug claims within 1 year) using the IBM MarketScan® commercial claims database from January 2008 to December 2019. We excluded patients without 12 months of continuous enrollment before the second antihypertensive fill date (index date of cohort entry) and those having the outcome (OSA) in the 12-month pre-index period. We employed Cox proportional hazard regression with OSA as the dependent variable, and time-dependent exposure (non-RH vs. RH) and baseline covariates as independent variables. Of the 1,375,055 patients with treated hypertension, 13,584 patients were categorized as exposed to RH. In the multivariable Cox proportional hazards model, exposure with RH was associated with a 60% increased risk of OSA (adjusted hazard ratio (aHR): 1.60; 95% CI, 1.52–1.68) compared to non-RH exposure. Findings of the study suggest that exposure with RH, compared to non-RH, is associated with a higher risk of incident OSA. [ABSTRACT FROM AUTHOR]

Introduction: There is a paucity of data comparing remote magnetic navigation (RMN) to manual catheter navigation (MCN) in the ablation of accessory pathways (AP) in adult patients. Methods: A retrospective analysis of AP ablations performed in adults (>18 years old) at our institution was conducted from January 2015 to June 2020. Results: Over the five-and-a-half-year study period, there were 114 patients with a total of 132 APs ablated. Of the 114 patients, 14 required a second ablation and 2 required a third ablation. Of the 132 AP ablations, 114 were performed using MCN and 18 were performed using RMN. The mean age among all patients was 38.1 ± 14.5 years (p = 0.984) with 53.8% being male (p = 0.172). Mean follow up was 459.9 ± 435.4 days with no statistical difference between groups. The acute success of all ablations was 84.1% (111/132) with a significant difference in favor of the RMN group (100% vs 81.6%; p = 0.047). Number of lesions (RMN 12, IQR 5-17 vs MCN 7.5, IQR 3-13; p = 0.016), ablation time (RMN 368 sec, IQR 215-572 vs MCN 259 sec, IQR 133.5-461.25; p = 0.031), and procedure time (RMN 230.89 ± 79.42 vs MCN 183.26 ± 64.88; p = 0.006) as well as the cost per procedure (RMN $8,915 ± $2,552.11 vs MCN $6,675.35 ± $1,737.31; p = 0.001) were all significantly higher in the RMN group compared to the MCN group. Of the redo ablations, 100% (6/6) were successful using RMN while only 83.3% (10/12) were successful using MCN. Conclusion: Compared to manual navigation, remote magnetic navigation was more successful in first time and redo accessory pathway ablations. [ABSTRACT FROM AUTHOR]

Public trust in governmental policies concerning public health measures is often now questioned. This is an acute problem with respect to vaccinations and particularly true regarding concerns around vaccination of children. Vaccination against COVID-19 is a particularly acute issue with many conspiracy theories circulating. These can almost certainly be countered by a strong evidence base. However, what if a policy is not based on strong evidence but on a judgement call? There is a strong evidence base concerning the beneficial and lifesaving attributes of immunization of adult and particularly vulnerable elderly groups against COVID-19. But what about young children? Here the benefit of immunization is not borne out by any publicly available data and would appear to be led by opinion, not evidence. The language used and vague statements giving a public justification for childhood vaccination COVID-19 immunization could be interpreted as misleading. Given a prevailing mistrust of government public health mandates, could these policies discourage childhood immunization and cost lives of children from other diseases? [ABSTRACT FROM AUTHOR]

Our study bridges literatures on the health effects of job loss and life course employment trajectories to evaluate the selection into employment pathways and their associations with health in the short and medium terms. We apply sequence analysis to monthly employment calendars from a population-based sample of working-age women and men observed from 2009 to 2013 (N = 737). We identify six distinct employment status clusters: stable full-time employment, stable part-time employment, stably being out of the labor force, long-term unemployment, transition out of the labor force, and unstable full-time employment. After adjustment for sociodemographic characteristics and health at baseline, those who transitioned out of the labor force showed significantly poorer self-rated health at follow-up, whereas steadily part-time employed respondents still showed a greater risk of meeting criteria for major or minor depression. The findings have important implications for how social scientists conceptualize and model the relationship between employment status and health. [ABSTRACT FROM AUTHOR]

Background The objective of this study is to systematically review the results of different studies related to the management of hip deformities secondary to Perthes' disease in adults. Patients and methods Thirteen studies matching the inclusion and exclusion criteria, totaling 316 adults including 326 hips that underwent 119 surgical hip dislocation (SHD), 49 periacetabular osteotomy, 111 SHD with periacetabular osteotomy, 16 intertrochanteric osteotomy with acetabular roof plasty, and 31 adductor tenotomy with cheilectomy of the femoral head. Their age was in the range from 19 to 42 years with clinical follow-up range (16-135 months). The degree of pain, function, range of movements, and deformities were evaluated. Results The SHD approach has a 360° view allowing full dynamic evaluation of the hip joint, identification, and correction of the most common residual deformations, leading to functional improvement and pain relief with low complication rates. Harris hip score was a common clinical parameter in a lot of studies and showed improvement from the average range (60-68.5) before surgery to 72-95 after it. In all, 188 hips were reported to have reduction in pain at last follow-up, but adequate clinical follow-up were not available for 112 hips. However, 26 patients were reported as a failure (defined as total hip arthroplasty or persistent or increased pain). Onset osteoarthritis advancement cannot be prevented in hips. Conclusion SHD provides the opportunity to achieve any kind of simultaneous femoral and acetabular osteotomies leading to functional improvement and pain relief with low complication rates. [ABSTRACT FROM AUTHOR]

This study aimed to identify the effects of the COVID-19 pandemic on the mental health of adult populations and verify the assessment resources employed. From a systematic review according to PRISMA recommendations, 1,158 articles were identified in the databases Pubmed, PsycINFO, PePSIC and Scielo, of which 54 met the eligibility criteria for analysis. The populations surveyed included adults in general, health professionals and elderly adults; symptoms of anxiety and depression were the most reported; there was expressive diversity in the assessment resources applied online. Prevention policies, promotion of mental health for the most vulnerable populations, as well as the development of evaluation tests with evidence of validity for on-line application, are a pressing reality. [ABSTRACT FROM AUTHOR]

Introduction: Data on the relationship between Coronavirus disease-2019 (COVID-19) and acute pancreatitis are limited. This study aimed to investigate the possible role of COVID-19 in the etiology of acute pancreatitis in a tertiary-care educational university hospital by retrospectively evaluating the incidence of acute pancreatitis in adult hospitalized patients with COVID-19. Materials and Methods: Severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) polymerase chain reaction (PCR)-positive adult inpatients from March 15, 2020, to February 1, 2021, constituted the study group in our hospital. This cohort was analyzed for acute pancreatitis criteria, including acute abdominal pain, increased amylase and/or lipase more than three times the normal value, and radiological finding supporting the disease. Patients who met at least two of the acute pancreatitis diagnostic criteria were determined, and those who met the criteria during or after SARS-CoV-2 PCR positivity detection were included in the study. These patients were further analyzed for COVID-19-related data and pancreatitis severity status. Results: Our hospital had 1227 inpatients with COVID-19 diagnosis in one year. A total of four cases met the inclusion criteria. Acute pancreatitis rates were detected at 0.3% and 1.07% for all cohorts (n=1227) and the pancreatic enzyme-tested group (n=372), respectively. Of these four patients, two (50%) were females (50%) and the mean age was 70.7 (range: 64-79) years. There was no correlation between COVID-19 pneumonia and pancreatitis severity scores, including Ranson, Acute Physiologic Assessment and Chronic Health Evaluation 2, and modified computed tomography severity scores. Conclusion: COVID-19 is a rare risk factor for acute pancreatitis and did not affect the pancreatitis severity or mortality in our cohort. [ABSTRACT FROM AUTHOR]

Introduction: Using the rapid antigen test (RAT) before exhausting the reverse transcriptase-polymerase chain reaction (RT-PCR) test's capacity is crucial to enhance suitable detection of patients and timely reception of results. Therefore, this study was done to evaluate the sensitivity and specificity of RAT and compare it with the RT-PCR method in the diagnosis of Coronavirus disease-2019 (COVID-19). Materials and Methods: This study was performed on 634 individuals referred to public sampling centers performing the COVID-19 test in Shiraz City, Fars Province, Southern Iran. The sampling process was done following a multi-stage stratified protocol. The COVITECH® one-step real-time RT-PCR kit method as the reference standard test was compared with the RAT using E-Health Barakat Company® rapid antigen kit in the pharyngeal specimens. The trained personnel collected the data. Sensitivity, specificity, positive predictive value (PPV), negative predictive value, and the accuracy of the RAT were calculated using the MedCalc software. Moreover, the Kappa value was used to assess the level of agreement between RT-PCR and RAT. Results: According to the results of the RT-PCR method as a reference test; sensitivity, specificity, Kappa value, and accuracy of the RAT were 81.82%, 92.28%, 63.8%, and 91.01%, respectively in the diagnosis of COVID-19. In asymptomatic individuals, the specificity and the PPV of the RAT were 100%. Conclusion: In conclusion, our results suggested that a positive RAT provides considerable information for diagnosing COVID-19 in adults. As a result, in general, due to the high sensitivity, specificity, and accuracy of the RAT, it can be replaced with the RT-PCR test considering factors such as time, cost, and speed. [ABSTRACT FROM AUTHOR]

Background: The Gait Assessment and Intervention Tool (GAIT) provides a valid and reliable gait quality measure for adults with stroke, however a minimal clinically important difference (MCID) is yet to be determined.Research Question: What is the GAIT MCID in community dwelling adults with a stroke diagnosis?Methods: The GAIT scores for a consecutive series of 63 adults with stroke, referred for video gait assessment within an outpatient rehabilitation program, were retrospectively identified from a gait laboratory database. Patients were classified by Functional Ambulation Category (FAC) and had walking speed measured, which classified them into one of three walking speed-based ambulatory levels (I.e. household, limited community or community ambulator). Linear regression models were fitted to assess the association between GAIT score and FAC level and GAIT score and ambulatory level. MCIDs were determined based on estimates calculated in the two models RESULTS: The FAC of patients ranged from 3 to 5. GAIT score was negatively correlated with FAC level and ambulatory level (ρ = -0.73, p < 0.001 and ρ =-0.69, p < 0.001, respectively). Pairwise comparisons from the models showed absolute mean differences between estimated GAIT scores of 10.84 (95% confidence interval 7.59-14.09) for changes from FAC level 3-4 and 12.13 (8.90-15.36) for household to limited community ambulator, and 5.90 (3.44-8.37) for changes from FAC level 4-5 and 4.39 (2.01-6.76) for limited community to community ambulator. The proposed MCID for FAC level 3 or household ambulators is 11.48, and for FAC level 4 and 5 or limited community/community ambulators is 5.19.Significance: The proposed MCIDs represent real changes in gait quality measured by the GAIT for adults with stroke who exhibit lower or higher functional mobility levels. The MCIDs will assist clinicians and researchers using the tool to determine if meaningful change in gait quality has taken place for adults with stroke undergoing rehabilitation. [ABSTRACT FROM AUTHOR]

Muscular strength and muscle mass are considered key factors for healthy ageing. Modification of body composition and redistribution of adipose tissue has been described in advanced age. Muscle strength has an important predictive role for health outcomes. However, little is known regarding the relationship between muscle strength and epicardial fat. In a cohort of healthy adults following physical capacity evaluations, anthropometric measurements, handgrip strength (HGS), echocardiography and bioimpedance analysis (BIA) were performed. Kruskal-Wallis test, Spearman's correlation and regression analysis adjusted for confounders were applied. A total population of 226 adults, age range 18–83 years, were included. Epicardial fat thickness resulted significantly associated with age p < 0.001, HGS (p < 0.001). Regression analysis adjusted for confounders revealed an independent relationship between handgrip strength and epicardial fat thickness: regression coefficient: -1.34; R2 = 0.27 and p = 0.044. The relationship between epicardial fat and muscle strength is inverse and independent. Implementation of HGS measurement may be useful for the identification of subjects with excessive epicardial fat and cardiovascular risk. Measurement of epicardial fat could be helpful in the early detection of physical decline associated to ageing. • The relationship between epicardial fat and muscle strength is inverse and independent • Advanced age is characterized by reduced muscle strength and increased epicardial fat • Handgrip strength could serve as a valuable tool for identifying individuals with excessive epicardial fat in primary care • Measurement of epicardial fat could be helpful in the early detection of physical decline associated to ageing [ABSTRACT FROM AUTHOR]

Objective: Explore perceptions of health technology use among emerging adults with type 1 diabetes (T1D) and their interactions with romantic partners about their diabetes. Background: Dating and the formation of romantic relationships are key features of emerging adulthood. However, emerging adults with T1D may experience dating relationships in a unique way due to managing T1D. Health technology use may play an important role in those dating relationships. Method: Twelve emerging adults with T1D (average time since diagnosis = 9 years) participated in two focus groups during a weekend program with the College Diabetes Network in Boston, MA. Findings: Qualitative analysis revealed an overarching context of health technology use in relation to dating relationships among emerging adults with T1D. Within this context, three descriptive themes emerged: sensitivity to the perceptions of others, an emphasis on boundaries and independence, and T1D partner support. Conclusion: Technology plays a central role in the way that emerging adults with T1D interact with romantic partners. Insulin pumps, body sites, continuous glucose monitoring devices, and the sharing of technology all factor into decisions and methods of concealing and disclosing and the development of digitally supported intimacy. Implications for Emerging Ideas: T1D may place individuals in unique circumstances within romantic relationships. Professionals could educate those with T1D about technological and social aspects of T1D management. [ABSTRACT FROM AUTHOR]

Introduction: Many Canadians report decreased mental health during the COVID-19 pandemic, and concerns have been raised about possible increases in suicide. This study investigates the pandemic's potential impact on adults' suicide ideation. Methods: We compared self-reported suicide ideation in 2020 versus 2019 by analyzing data from the Survey on COVID-19 and Mental Health (11 September to 4 December 2020) and the 2019 Canadian Community Health Survey. Logistic regression was conducted to determine which populations were at higher risk of suicide ideation during the pandemic. Results: The percentage of adults reporting suicide ideation since the pandemic began (2.44%) was not significantly different from the percentage reporting suicide ideation in the past 12 months in 2019 (2.73%). Significant differences in the prevalence of recent suicide ideation in 2020 versus 2019 also tended to be absent in the numerous sociodemographic groups we examined. Risk factors of reporting suicide ideation during the pandemic included being under 65 years, Canadian-born or a frontline worker; reporting pandemic-related income/job loss or loneliness/isolation; experiencing a lifetime highly stressful/traumatic event; and having lower household income and educational attainment. Conclusion: Evidence of changes in suicide ideation due to the pandemic were generally not observed in this research. Continued surveillance of suicide and risk/protective factors is needed to inform suicide prevention efforts. [ABSTRACT FROM AUTHOR]

Introduction: Canadian surveys from spring/summer 2020 suggest the prevalence of some positive mental health (PMH) outcomes has declined compared to pre-pandemic levels. However, less is known about the state of PMH during the second wave of the COVID-19 pandemic. Methods: We compared adults' self-rated mental health (SRMH), community belonging and life satisfaction in Fall 2020 versus 2019 in the overall population and across sociodemographic characteristics using cross-sectional data from the Survey on COVID-19 and Mental Health (September-December, 2020) and the 2019 Canadian Community Health Survey. We also conducted regression analyses to examine which sociodemographic factors were associated with reporting in Fall 2020 that one's mental health was about the same or better compared to before the pandemic. Results: Fewer adults reported high SRMH in Fall 2020 (59.95%) than in 2019 (66.71%) and fewer reported high community belonging in Fall 2020 (63.64%) than in 2019 (68.42%). Rated from 0 (very dissatisfied) to 10 (very satisfied), average life satisfaction was lower in Fall 2020 (7.19) than in 2019 (8.08). Females, those aged under 65 years, those living in a population centre, and those absent from work due to COVID-19 had lower odds of reporting that their mental health was about the same or better in Fall 2020. Conclusion: The PMH of adults was lower during the pandemic's second wave. However, the majority of individuals still reported high SRMH and community belonging. The findings identify certain sociodemographic groups whose mental health appears to have been more negatively impacted by the pandemic. Continued surveillance is important in ensuring mental health builds back better and stronger in Canada after the pandemic. [ABSTRACT FROM AUTHOR]

Introduction: We compared smoking initiation and cessation in Quebec versus the rest of Canada as possible underpinnings of the continued higher cigarette smoking prevalence in Quebec. Methods: Data were drawn from the Canadian Community Health Survey (CCHS). We compared average and sex-stratified prevalence estimates of (1) current cigarette smoking in persons aged 15 years and older; (2) past-year initiation of cigarette smoking in those aged 12 to 17 and 18 to 24 years; and (3) past-year cessation in adults aged 25 years and older in Quebec versus the other nine Canadian provinces in each two-year CCHS cycle from 2007/08 to 2017/18. Results: The prevalence of current smoking decreased from 25% to 18% among adults aged 15 years and older in Quebec from 2007/08 to 2017/18, and from 22% to 16% in the rest of Canada. Initiation among those aged 12 to 17 years decreased from 9% to 5% in Quebec, and from 7% to 3% in the rest of Canada. Neither initiation among people aged 18 to 24 (at 6% and 7%, respectively) nor cessation among adults aged 25 and older (approximately 8%) changed over time in Quebec or in the rest of Canada. In each two-year CCHS cycle, past-year initiation among those 12 to 17 years of age was consistently higher in Quebec than in the rest of Canada, but there were no substantial or sustained differences in initiation among people aged 18 to 24 or in past-year cessation. Findings were similar when stratified by sex. Conclusion: Higher levels of smoking initiation among youth aged 12 to 17 years could be a proximal underpinning of the continuing higher prevalence of smoking in Quebec versus the rest of Canada. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the stability, over a 12-month period, in the use and non-use of a public park to physical activity (PA) practice among adults from Canguçu (RS, Brazil). A second aim was to evaluate the association of this stability with sociodemographic, behavioral, nutritional and health variables. Through an accidental sampling process, 109 users and 109 non-users of the public park were selected and answered a questionnaire. About 12 months after the first data collection, the subjects were searched and answered the same questionnaire. The association between the status of use of the park and the independent variables was assessed by the Chi-square test. Most participants were male (54.1%) and aged between 18 and 29 years (77.5%). As for the status of use of the public park, 70.7% of users continued to attend the park and 34.3% of the non-users started using the park. Public policies designed to promote physical activity should take these results into account, which can help to increase the number of individuals practicing PA in the park, as well as practice of those who already use it. [ABSTRACT FROM AUTHOR]

Objectives: Patients with univentricular hearts who require permanent pacing systems typically require placement of epicardial leads. It is frequently difficult to find a position with good thresholds due to epimyocardial fibrosis or fat. The goal of the study is to assess the progression of capture thresholds (CT), sensing parameters (P waves and R waves), and impedances (imp) of steroid eluting epicardial pacing leads in young adults who underwent Fontan conversion and a pacemaker implant. Methods: All patients undergoing Fontan conversion in two institutions were retrospectively identified. Demographic data, congenital heart defects, pacing leads used, and pacing parameters were analyzed at implant, at 6 weeks and 12 months after implant. Results: Twenty patients were identified (twelve males); mean age at conversion was 24.9 ± 5.4 years (range 18-35). Epicardial bipolar steroid eluting leads were used. The site of implant both in the atria and the ventricles varied depending on the parameters. At implant, mean atrial and ventricular impedances were 617 ± 171 O and 1061 ± 771 O, respectively, mean P wave amplitude was 2 ± 0.7 mV, and mean R wave amplitude was 12.5 ± 7.7 mV. Mean CT was 1.7 ± 0.8 V at 0.5 ms for the atrium and 2.2 ± 1.2 V at 0.5 ms for the ventricle. Ventricular CT and impedance showed an improvement within the first 12 months after implant, with four patients having a decrease in threshold of more than 2 V. Conclusion: In patients undergoing Fontan conversion, implant ventricular CT and impedances are frequently higher than expected but typically improve during follow-up. Acceptance of higher initial threshold values may be a potential strategy in this patient population. [ABSTRACT FROM AUTHOR]

Aim: Like cancer and myocardial infarction, the cerebrovascular accident causes death and morbidity in adults. Ischemic stroke is the most common type of stroke. Predisposing conditions to other cardiovascular diseases similarly play a facilitating role for stroke. The association of ABO blood types with several illnesses as described in previous studies. In this retrospective observational study, our purpose is to show the contribution of ABO blood types in ischemic stroke patients. Our study is important because it is a rare analysis elucidating the link between ABO blood groups with IS risk in the Turkish population. Materials and Methods: 1,540 cases diagnosed with ischemic stroke and 20,863 healthy subjects determined as the control group was included in this research. Ischemic stroke cases and the healthy subjects were between 45-90 years old. Both these groups were examined for blood group analysis. Results: When the patients and healthy subjects were examined in terms of blood group distributions, the blood group type distribution within each group had similar characteristics. In terms of Rh status and Blood type distribution, Ischemic stroke cases, and the healthy subjects were not statistically different from each other. Conclusion: We were not able to show any relation between ischemic stroke and ABO blood type in our study. [ABSTRACT FROM AUTHOR]

Previous studies have suggested that the pneumococcal niche changes from the nasopharynx to the oral cavity with age. We use an Experimental Human Pneumococcal Challenge model to investigate pneumococcal colonisation in different anatomical niches with age. Healthy adults (n = 112) were intranasally inoculated with Streptococcus pneumoniae serotype 6B (Spn6B) and were categorised as young 18–55 years (n = 57) or older > 55 years (n = 55). Colonisation status (frequency and density) was determined by multiplex qPCR targeting the lytA and cpsA-6A/B genes in both raw and culture-enriched nasal wash and oropharyngeal swab samples collected at 2-, 7- and 14-days post-exposure. For older adults, raw and culture-enriched saliva samples were also assessed. 64% of NW samples and 54% of OPS samples were positive for Spn6B in young adults, compared to 35% of NW samples, 24% of OPS samples and 6% of saliva samples in older adults. Many colonisation events were only detected in culture-enriched samples. Experimental colonisation was detected in 72% of young adults by NW and 63% by OPS. In older adults, this was 51% by NW, 36% by OPS and 9% by saliva. The nose, as assessed by nasal wash, is the best niche for detection of experimental pneumococcal colonisation in both young and older adults. [ABSTRACT FROM AUTHOR]

Background: The spread of COVID-19 has affected people's daily lives, and the lockdown may have led to a disruption of daily activities and a decrease of people's mental health. Aim: To identify correlates of adults' mental health during the COVID-19 lockdown in Belgium and to assess the role of meaningful activities in particular. Methods: A cross-sectional web survey for assessing mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), meaning in activities (Engagement in Meaningful Activities Survey), and demographics was conducted during the first Belgian lockdown between April 24 and May 4, 2020. The lockdown consisted of closing schools, non-essential shops, and recreational settings, employees worked from home or were technically unemployed, and it was forbidden to undertake social activities. Every adult who had access to the internet and lived in Belgium could participate in the survey; respondents were recruited online through social media and e-mails. Hierarchical linear regression was used to identify key correlates. Results: Participants (N = 1781) reported low mental health (M = 14.85/36). In total, 42.4% of the variance in mental health could be explained by variables such as gender, having children, living space, marital status, health condition, and resilience (β = −.33). Loss of meaningful activities was strongly related to mental health (β = −.36) and explained 9% incremental variance (R2 change =.092, p <.001) above control variables. Conclusions: The extent of performing meaningful activities during the COVID-19 lockdown in Belgium was positively related to adults' mental health. Insights from this study can be taken into account during future lockdown measures in case of pandemics. [ABSTRACT FROM AUTHOR]

Individuals with Down's syndrome rely on caregivers to support lifestyle behaviour change. It is therefore important to understand how caregivers put health recommendations into practice. Through conducting semi-structured interviews, the present study sought to understand the facilitators and barriers that caregivers faced when implementing health promotion advice. Five interviews were conducted with paid support staff and four with family carers of individuals attending a specialist multidisciplinary Down's syndrome health promotion screening clinic. Three main themes emerged in their accounts, including active promotion of weight management by caregivers, benefits of working practices such as record keeping and communication channels and the importance of having access to social care services and recreational activities. These findings have important implications for professionals working in specialised healthcare settings who may be able to tailor communication and services to better meet the needs of individuals with Down's syndrome and their caregivers. [ABSTRACT FROM AUTHOR]