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The long-term health effects of football (soccer) have received significant attention in recent years. While brain health is currently the focus of this interest, potential long-term risks or benefits related to cardiovascular and metabolic diseases and cancer are also of interest to sports medicine professionals. However, studies assessing the overall health risks for professional football players remain scarce. We introduce ‘SoccHealth’, a satellite project to the German National Cohort (NAKO), Germany’s largest population-based cohort study. SoccHealth examined 348 former professional football players aged 40–69 using the infrastructure and comprehensive examination programme of NAKO. The German Statutory Accidental Insurance for Professional Athletes identified and invited male players, while female players were recruited among former national team members. Details of the examination programme and the sociodemographic and career-related characteristics of the participants are described. The identical examination programme for the NAKO participants provides the opportunity to draw general population controls according to various definitions and focus on the respective research question to be analysed. This report delineates one approach to evaluate the long-term health effects of football across a broad range of diseases.

CHANG-ES (Continuum Halos in Nearby Galaxies—an EVLA Survey) is an ambitious project to target 35 nearby disk galaxies that are edge-on to the line of sight. The orientation permits both the disk and halo regions to be studied. The observations were initially at 1.5 GHz (L-band) and 6.0 GHz (C-band) in a variety of VLA array configurations, and in all four Stokes parameters, which allowed for spatially resolved images in total intensity plus polarization. The inclusion of polarization is unique to an edge-on galaxy survey and reveals the galaxies’ halo magnetic fields. This paper will summarize the results to date, some of which are new phenomena, never seen prior to CHANG-ES. For example, we see that ‘X-type’ fields, as well as rotation measure reversals, are common features of spiral galaxies. Further observations at 3.0 GHz (S-band) as well as future scientific opportunities will also be described.

We have carried out spatially resolved thermal–nonthermal separation on two edge-on galaxies, NGC 3044 and NGC 5775, using only radio data. Narrowband imaging within a frequency band that is almost contiguous from 1.25 to 7.02 GHz ( L band, S band, and C band) has allowed us to fit spectra and construct thermal, nonthermal, and nonthermal spectral index maps. This method does not require any ancillary H α and IR data or rely on dust corrections that are challenging in edge-on galaxies. For NGC 3044, at 15″ resolution, we find a median thermal fraction of ∼13% with an estimated uncertainty in this fraction of ∼50% at 4.13 GHz. This compares well with the H α mixture method results. We uncovered evidence for a vertical outflow feature reaching at least z ∼ 3.5 kpc in projection above the plane, reminiscent of M82's starburst wind. For the higher star formation rate galaxy, NGC 5775, at 12″ resolution, we find a median thermal fraction of 44% at 4.13 GHz with an estimated error on this fraction of 17%. Both galaxies show a change of slope (flattening) in L band. These results suggest that a radio-only method for separating thermal from nonthermal emission is not only feasible, but able to reveal new features that might otherwise be obscured in edge-on disks.

We have investigated the properties (e.g., age, metallicity) of the stellar populations of a ringlike tidal stellar stream (or streams) around the edge-on galaxy SPRC047 ( z = 0.031) using spectral energy distribution (SED) fits to integrated broadband aperture flux densities. We used visual images in six different bands and Spitzer/IRAC 3.6 μ m data. We have attempted to derive best-fit stellar population parameters (metallicity, age) in three noncontiguous segments of the stream. Due to the very low surface brightness of the stream, we have performed a deconvolution with a Richardson–Lucy–type algorithm of the low spatial resolution 3.6 μ m IRAC image, thereby reducing the effect of the point-spread function aliased emission from the bright edge-on central galaxy at the locations of our three stream segments. Our SED fits that used several different star formation (SF) history priors, from an exponentially decaying SF burst to continuous SF, indicate that the age–metallicity–dust degeneracy is not resolved, most likely because of inadequate wavelength coverage and low signal-to-noise ratios of the low surface brightness features. We also discuss how future deep visual–near-infrared observations, combined with absolute flux calibration uncertainties at or below the 1% level, complemented by equally well absolute flux-calibrated observations in ultraviolet and mid-infrared bands, would improve the accuracy of broadband SED fitting results for low surface brightness targets, such as stellar streams around nearby galaxies that are not resolved into stars.

BackgroundAlcohol use disorder (AUD) is a significant public health concern worldwide. Alcohol consumption is a leading cause of death in the United States and has a significant negative impact on individuals and society. Relapse following treatment is common, and adjunct intervention approaches to improve alcohol outcomes during early recovery continue to be critical. Interventions focused on increasing physical activity (PA) may improve AUD treatment outcomes. Given the ubiquity of smartphones and activity trackers, integrating this technology into a mobile app may be a feasible, acceptable, and scalable approach for increasing PA in individuals with AUD. ObjectiveThis study aims to test the Fit&Sober app developed for patients with AUD. The goals of the app were to facilitate self-monitoring of PA engagement and daily mood and alcohol cravings, increase awareness of immediate benefits of PA on mood and cravings, encourage setting and adjusting PA goals, provide resources and increase knowledge for increasing PA, and serve as a resource for alcohol relapse prevention strategies. MethodsTo preliminarily test the Fit&Sober app, we conducted an open pilot trial of patients with AUD in early recovery (N=22; 13/22, 59% women; mean age 43.6, SD 11.6 years). At the time of hospital admission, participants drank 72% of the days in the last 3 months, averaging 9 drinks per drinking day. The extent to which the Fit&Sober app was feasible and acceptable among patients with AUD during early recovery was examined. Changes in alcohol consumption, PA, anxiety, depression, alcohol craving, and quality of life were also examined after 12 weeks of app use. ResultsParticipants reported high levels of satisfaction with the Fit&Sober app. App metadata suggested that participants were still using the app approximately 2.5 days per week by the end of the intervention. Pre-post analyses revealed small-to-moderate effects on increase in PA, from a mean of 5784 (SD 2511) steps per day at baseline to 7236 (SD 3130) steps per day at 12 weeks (Cohen d=0.35). Moderate-to-large effects were observed for increases in percentage of abstinent days (Cohen d=2.17) and quality of life (Cohen d=0.58) as well as decreases in anxiety (Cohen d=−0.71) and depression symptoms (Cohen d=−0.58). ConclusionsThe Fit&Sober app is an acceptable and feasible approach for increasing PA in patients with AUD during early recovery. A future randomized controlled trial is necessary to determine the efficacy of the Fit&Sober app for long-term maintenance of PA, ancillary mental health, and alcohol outcomes. If the efficacy of the Fit&Sober app could be established, patients with AUD would have a valuable adjunct to traditional alcohol treatment that can be delivered in any setting and at any time, thereby improving the overall health and well-being of this population. Trial RegistrationClinicalTrials.gov NCT02958280; https://www.clinicaltrials.gov/ct2/show/NCT02958280

BackgroundAlcohol use disorder (AUD) is associated with severe chronic medical conditions and premature mortality. Expanding the reach or access to effective evidence-based treatments to help persons with AUD is a public health objective. Mobile phone or smartphone technology has the potential to increase the dissemination of clinical and behavioral interventions (mobile health interventions) that increase the initiation and maintenance of sobriety among individuals with AUD. Studies about how this group uses their mobile phone and their attitudes toward technology may have meaningful implications for participant engagement with these interventions. ObjectiveThis exploratory study examined the potential relationships among demographic characteristics (race, gender, age, marital status, and income), substance use characteristics (frequency of alcohol and cannabis use), and clinical variables (anxiety and depression symptoms) with indicators of mobile phone use behaviors and attitudes toward technology. MethodsA sample of 71 adults with AUD (mean age 42.9, SD 10.9 years) engaged in an alcohol partial hospitalization program completed 4 subscales from the Media Technology Usage and Attitudes assessment: Smartphone Usage measures various mobile phone behaviors and activities, Positive Attitudes and Negative Attitudes measure attitudes toward technology, and the Technological Anxiety/Dependence measure assesses level of anxiety when individuals are separated from their phone and dependence on this device. Participants also provided demographic information and completed the Epidemiologic Studies Depression Scale (CES-D) and the Generalized Anxiety Disorder (GAD-7) scale. Lastly, participants reported their frequency of alcohol use over the past 3 months using the Drug Use Frequency Scale. ResultsResults for the demographic factors showed a significant main effect for age, Smartphone Usage (P=.003; ηp2=0.14), and Positive Attitudes (P=.01; ηp2=0.07). Marital status (P=.03; ηp2=0.13) and income (P=.03; ηp2=0.14) were associated only with the Technological Anxiety and Dependence subscale. Moreover, a significant trend was found for alcohol use and the Technological Anxiety/Dependence subscale (P=.06; R2=0.02). Lastly, CES-D scores (P=.03; R2=0.08) and GAD symptoms (P=.004; R2=0.13) were significant predictors only of the Technological Anxiety/Dependence subscale. ConclusionsFindings indicate differences in mobile phone use patterns and attitudes toward technology across demographic, substance use, and clinical measures among patients with AUD. These results may help inform the development of future mHealth interventions among this population.

Introduction Leadership curricula in medical student education require assessment - to determine if leadership skills can be taught to medical students and applied during clinical and medical team interactions to aid in medical student leadership development. Objectives To examine whether medical students applied principles of their pre-clerkship leadership curriculum (character, competence, context, and communication elements across four levels: personal, interpersonal, team, and organizational) during an internal medicine clerkship. Methods Using art as a prompt, Uniformed Services University (USU) internal medicine clerkship students completed a structured reflection on a critical incident. Medical student essays written during a 10-week internal medicine clerkship at USU in 2019 were collected. 158 medical student submissions were de-identified and analyzed. Results Sixty-four submissions (40.5%) focused on leadership or leadership and professionalism. Students identified as male (n = 34, 53%), female (21, 33%), or not reported (9, 14%). Most, 48 (75%), did not describe PITO explicitly in their essay. They instead focused on personal and interpersonal aspects (17, 27%) of leadership, the attending physicians they worked with (33, 52%), and effective leadership strategies (46, 72%). The most common themes written about were responsibility (30, 47%), teamwork (18, 28%), competence (17, 27%), and character/integrity (15, 23%). Conclusion Although the students’ explicit use of the PITO model was limited, student essays centered on themes that reflected leadership concepts taught in pre-clerkship years, such as character, competence, and responsibility. This study demonstrates that an internal medicine clerkship rotation can feasibly implement a leadership reflection.

Seeds of sweet cherry (Prunus avium) possess a strong endodormancy response that traditionally requires months of stratification before germination can occur. Accelerating artificial dormancy release could be an important aspect of improving progress in a sweet cherry breeding program by increasing the first season growth period. In this study, seeds were exogenously treated with ethephon, 1-aminocyclopropane-1-carboxylic acid (ACC), kinetin, hydrogen peroxide, and acidified nitrite to attempt to induce germination with reduced stratification times. Findings showed that ethephon, ACC, and hydrogen peroxide all significantly increase early seed germination rates. Stratification time had the largest effect on increasing germinations, with significantly higher germination percentages accompanying increased stratification times that plateaued at 3 months of stratification. Stratification is vital for proper seedling development because plants grown from seeds with no stratification are significantly shorter and have reduced internode lengths compared with seeds with 4 weeks of stratification.

Students dropping out of high school is a nationwide problem in the United States, plaguing communities and often greatly reducing the prospects of a quality life for those students who do not complete their high school education. The state of Louisiana consistently has among the highest public high school dropout rates in the United States and, often, the highest. This massive dataset of school variables covering a duration of five academic years (2014–2015 to 2018–2019) was originally compiled with the intention of identifying the factors that correlate with high school dropouts in Louisiana public high schools, specifically. However, it can be useful to any researchers interested in analyzing school-level data concerning a wide range of variables beyond merely dropout rates. This dataset also contains socioeconomic demographics, financial variables, class size, and much more. The correlation analyses ultimately revealed many intriguing insights into the relationships between the tested variables and the dropout rates.

Abstract Background Alcohol use disorder (AUD) constitutes a major public health problem and is associated with a substantial amount of disability and premature death worldwide. Several treatment and self-help options including Alcoholics Anonymous (AA) meetings are available. Nevertheless, factors associated with AA affiliation in some disadvantaged groups such as justice-involved women are not well understood. The purpose of this study is to report on previously unexamined correlates of past year AA affiliation among women in pretrial jail detention. Methods The current study used cross-sectional data from 168 women with DSM-5 diagnosis of AUD in pretrial jail detention. The study examined factors related to women’s concept of self and others (i.e., disbelief that others are trustworthy, lack of autonomy to choose who they interact with, experience of violent victimization, low investment in self-care, higher stress levels, and homelessness) as correlates of past-year AA affiliation, controlling for severity of AUD and demographic factors. Results Women who believe that others are inherently trustworthy, women who met less AUD criteria, and women who are older reported more past-year AA affiliation in both univariate and multivariate analyses. Conclusion Introducing AA outreach and alternative interventions for younger, less severely addicted women might improve AUD outcomes. Moreover, designing more individualized treatment plan for women who believe others are not trust worthy might help AUD treatment engagement in this population. Trial registration NCT01970293, 10/28/2013.

Abstract Background Spitz nevi are uncommon melanocytic neoplasms found in children. Historically, the diagnosis and management of these tumors has lacked consensus among oncologists, pathologists, plastic surgeons, and dermatologists. Once interpreted and treated as a “juvenile melanoma”, many have argued for the benignancy of such tumors in certain patient age groups, encouraging a conservative approach. The lack of consensus surrounding the diagnosis and perceived malignant potential of these tumors has led physicians to approach them on a case-by-case basis and institutional protocols. To date, no evidence-based management guideline exists. The objective of this systematic review is to both collect and appraise the evidence on the diagnosis and management of these tumors. Methods A comprehensive electronic literature search will be conducted in PubMed, MEDLINE, Embase, and the Cochrane Library from inception to December 2016. Our search involved collaborating with a healthcare librarian to create a strategy for the OVID/MEDLINE databases. A search of electronic databases for oncology, pathology, plastic surgery, and dermatology abstracts will be performed. Key search terms will include, among several others, “Spitz nevi,” “Spitzoid melanoma,” “juvenile tumor,” and “pediatric”. The language of publication will be restricted to English and French. Wherever data allows, meta-analyses will be used to assess differences between Spitz nevi and the tumor of comparison. Additionally, data extraction and summarization using tables will be performed. This review has been registered with PROSPERO (CRD42016034045). Conclusions This review will systematically and comprehensively review diagnostic and management practices associated with the Spitz nevus. This overview of current literature will hopefully provide the foundation for future standardization of clinical practice. Systematic review registration PROSPERO CRD42016034045

Instances of dwarfism in the fossil record are of interest to palaeontologists because they often provide insight into aspects of palaeoecology. Fossil species of Australian-Pacific mekosuchine genus Mekosuchus have been described as dwarf, primarily terrestrial crocodiles, in contrast with the nearly ubiquitous semi-aquatic habitus of extant crocodilians (Willis 1997). This hypothesis has been difficult to test because of limited knowledge of the cranial and postcranial skeleton of extinct taxa and the continuous nature of crocodilian growth. New crocodilian vertebral material from Riversleigh, northwestern Queensland, tentatively referred to Mekosuchus whitehunterensis Willis, 1997, displays morphological maturity indicative of adult snout-vent length little over a half-meter, proportionally smaller than extant dwarf taxa. Further, this material displays morphology that indicates a relatively large epaxial neck musculature for its body-size. These attributes suggest this dwarf mekosuchine employed unusual feeding behaviours. The ability to perform normal death-roll, de-fleshing behaviours would be limited in a mekosuchine of such small size. Given the powerful neck muscles and other anatomical features, it is more likely that this mekosuchine killed and/or dismembered its prey using a relatively forceful lifting and shaking of the head.

To increase access to HIV testing, the WHO and CDC have recommended implementing provider-initiated HIV testing (PITC). To address the resource limitations of the PITC setting, WHO and CDC suggest that patient-provider interactions during PITC may need to focus on providing information and referrals, instead of engaging patients in client-centered counselling, as is recommended during client-initiated HIV testing. Providing HIV prevention information has been shown to be less effective than client-centered counselling in reducing HIV-risk behaviour and STI incidence. Therefore, concerns exist about the efficacy of PITC as an HIV prevention approach. However, reductions in HIV incidence may be greater if more people know their HIV status through expanded availability of PITC, even if PITC is a less effective prevention intervention than is client-initiated HIV testing for individual patients. In the absence of an answer to this public health question, adaptation of effective brief client-centered counselling approaches to PITC should be explored along with research assessing the efficacy of PITC.

Background: Arteriovenous malformations (AVMs) are high-flow lesions with abnormal connections between arteries and veins without an intervening capillary bed. Infrequently, the radiographic diagnosis of a vascular lesion will not support the clinical diagnosis of an AVM. These “discrepant” lesions are not adequately captured within the current classification system and represent a treatment dilemma. The purpose of this study is to review our center’s experience with vascular malformations where incongruity in a patient’s clinical and radiographic presentation produces a diagnostic and therapeutic challenge. Methods: A retrospective chart review of patients with atypical AVM pre sen ta tions was performed. Parameters reviewed included patient history and demogra phics, clinical presentation, radiological imaging, and treatment modalities. Results: Over a 15-year period, we identified 7 cases of vascular malformations with discrepant clinical and radiological findings concerning flow characteristics. All patients were treated based on their radiological diagnosis and most were managed with sclerotherapy. No lesions evolved into a high-flow process, and there was no recurrence at a minimum of 24 months of follow-up. Conclusions: We have identified and described a unique subcategory of vascular malformations that have clinical features of high-flow malformations but radiological features of low-flow malformations. These lesions behave like low-flow malformations and should be treated as such. We propose that complex vascular malformations are best evaluated by both clinical and specialized diagnostic radiological means; the radiologic diagnoses should supplant what is found clinically, and ultimately treatment should be preferentially based on a radiological diagnosis.

Research has shown no consistent findings about how scanning techniques differ between experienced and inexperienced helicopter pilots depending on mission demands. To explore this question, 33 military pilots performed two different landing maneuvers in a flight simulator. The data included scanning data (eye tracking) as well as performance, workload, and a self-assessment of scanning techniques (interviews). Fifty-four percent of scanning-related differences between pilots resulted from the factor combination of expertise and mission demands. A comparison of eye tracking and interview data revealed that pilots were not always clearly aware of their actual scanning techniques. Eye tracking as a feedback tool for pilots offers a new opportunity to substantiate their training as well as research interests within the German Armed Forces.

Den Schwerpunkt dieses Beitrags bildet die Umsetzung von siedlungs-strukturellen Maßnahmen im ländlichen Raum mit dem Zeil einer nachhaltigen Flächenhaushaltspolitik. Im ersten Teil werden Begriffe definiert, Zusammenhänge zwischen dem Prinzip der Nachhaltigkeit, der Siedlungsstruktur und dem ländlichen Raum erklärt und ihre Bedeutung für diese Arbeit begründet. Im zweiten Teil werden Prinzipien einer nachhaltigen Siedlungsstruktur und das hieraus abgeleitete „Siedlungskonzept Rügen” erläutert, um dann in dritten Teil die Instrumente darzustellen, die zur Umsetzung zur Verfügung stehen bzw. stehen müßten. Teil vier zeigt Umsetzungsschwierigkeiten auf und stellt Lösungsmöglichkeiten hierzu vor. Im Fazit wird ein Ausblick und eine zusammenfassende Einschätzung auch über die vorher dargestellten Lösungsansätze hinaus gegeben. Der entscheidende Ansatz zu einem nachhaltigen Siedlungskonzept ist der haushälterische Umgang mit der Ressource Boden. Die Einführung und Umsetzung des beschriebenen Siedlungsmodells ist daher als wesentlicher Beitrag zu einer an der naturräumlichen Tragfähigkeit orientierten Siedlungsstruktur anzusehen. Die Umsetzung des Konzepts erfordert die Überwindung vielfältiger gesellschaftlicher Blockaden. Diese sind nicht zu unterschätzen, doch bieten sich bereits unter den bestehenden Rahmenbedingungen zukunftsweisende, reformorientierte Handlungsoptionen.