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We aimed to calculate interrater reliability of the Test of Gross Motor Development--Third Edition (TGMD-3) after raters reached a consensus regarding measurement criteria. Three raters measured the fundamental movement skills of 25 children on the TGMD-3 at two different times: (a) once when simply following the measurement criteria in the TGMD-3 manual and (b) after a 9-month washout period, following the raters' consensus building for the measurement criteria for each skill. After calculating and comparing the interrater reliability of these three raters across these two rating times, we found improved interrater reliability after the raters' consensus-building discussions on ratings of both locomotor skills (moderate-to-good reliability on two of six skills initially and at least moderate-to-excellent on four of six skills following criteria consensus building) and ball skills (moderate-to-good reliability on one of seven skills initially and at least moderate-to-excellent reliability on four of seven skills following criteria consensus building). For subtest scores and overall test scores, raters achieved at least moderate-to-good reliability on their second, postconsensus-building ratings. Based on this improved reliability following consensus building, we recommend that researchers include rater consensus building before assessing children's fundamental movement skills or guiding curriculum interventions in physical education from TGMD-3 data.

The objective of this study is to evaluate the effectiveness and safety of ozone therapy (OT) in the treatment of knee osteoarthritis (KOA), which is the most common form of the disease. We analysed systematic reviews (SRs) of randomised controlled trials (RCTs) using the “A MeaSurement Tool to Assess systematic Reviews” (AMSTAR2) instrument to evaluate their quality. We developed a narrative synthesis report with eight SRs (15 RCTs/3,685 patients) to summarise the findings. The AMSTAR2 analysis indicated that all reviews had critically low confidence ratings. Statistically significant effects in pain reduction using OT compared to placebo groups were reported in three SRs. OT was shown to be comparable to other therapies in one SR and not superior in the other five. Six SRs highlighted the need for additional RCTs with improved methodological quality to confirm the efficacy of OT for KOA. SRs found fewer consistent effects for improving joint function. Regarding safety, seven SRs reported a low prevalence of minor adverse events linked with OT. Finally, this umbrella review highlights the beneficial effects and safety of OT in the treatment of KOA, particularly in pain control. The low methodological quality of RCTs and SRs limits the possibility of drawing conclusions on the effectiveness of the procedure in comparison to other therapies. Ensure adequate compliance with guidelines such as Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and AMSTAR2 has the ability to improve the quality of SRs in this area.

Background: Motor skill assessment is time-consuming and some difficulties are inherent in the administration of motor tests, especially in children with neurodevelopment disorders. Purpose: This study aimed to develop and investigate the face, content, and criterion validity of a Motor Skills Sequential Pictures (MSSP) for the Test of Gross Motor Development -- 3 (TGMD-3) to be animated and used in a mobile application (App). Methods: The MSSP was created representing each of the 13 TGMD-3 skills, performance criteria and accuracy was assessed by 23 experts, 52 undergraduate students, and 66 children (range 3-10 years; n = 48 with neurotypical development, n = 18 with Autism Spectrum Disorder, ASD). We conducted two rounds of MSSP expert evaluations to improve the MSSP accuracy. Content validity was conducted with the experts' results using percentage of agreement, content validity coefficient (CVC), kappa, and Chi[superscript 2] tests for the first and final version of the MSSP. University students participated in the face validity evaluation of the MSSP final version using percentage of agreement. Further content validity was conducted with experts and university students' scores using Chi[superscript 2]. Children participated in the last phase of the study and were requested to identify and perform the skills, and if unsuccessful, they received verbal support based on the motor performance criteria. Results: For content validity results associated with the experts' agreement, scores were high and increased from the first to the second round (CVC from 87.0% to 96.1%; Kappa coefficient >0.60, p > 0.0001). High agreement was obtained for the face validity of all skills (range 94.1-100%). Further, significant associations were found for experts and university students scores for the MSSP final version (p [less than or equal to] 0.002), providing further evidence for the MSSP content validity. The results for children with neurotypical development showed that children aged 3-4 had more difficulties in identifying the skills compared to older children. Developmental criterion validity was found for several skills (hop, jump, slide, one-hand strike, two-hand strike; p values from <0.0001 to .050); the MSSP was a more robust support as children age. In the ASD group, identifying skills was difficult for all ages, but mainly in locomotor skills. Furthermore, an inverse trend was found for the developmental validity criteria for children with ASD for several skills (sSkip, jump, slide, catch, kick; p values from .016 to .050), younger children relied more on the MSSP support to identify the skills. Conclusion: The MSSP, mainly ball skills, proved to be valid to illustrate the TGMD-3 motor performance criteria and may be useful as a visual pedagogical support for children to facilitate skill understanding. Future directions will be to evaluate whether the MSSP animation, in an app-based program, will improve children's motor skill performance.

We aimed to validate the CMPS-SF according to COSMIN and GRADE guidelines. Four trained evaluators assessed 208 videos (pre-operative-M1, peak of pain-M2, 1 h after the peak of pain and analgesia (rescue)-M3, and 24 h post-extubation-M4) of 52 dogs, divided into negative controls (n = 10), soft tissue surgeries (n = 22), and orthopedic surgeries (n = 20). The videos were randomized and blinded as to when they were filmed, and were evaluated in two stages, 21 days apart. According to confirmatory analysis, the CMPS-SF is a unidimensional scale. Intra-observer reliability was between 0.80 and 0.99 and inter-observer reliability between 0.73 and 0.86. Criterion validity was confirmed by the correlation between the CMPS-SF and other unidimensional scales (≥0.7). The differences between the scores were M2 ≥ M3 > M4 > M1 (responsiveness), and the scale presented construct validity (higher postoperative pain scores in dogs undergoing surgery versus control). Internal consistency was 0.7 (Cronbach’s α) and 0.77 (McDonald’s ω), and the item-total correlation was between 0.3 and 0.7, except for “A(ii)—Attention to wound”. Specificity and sensitivity were 78–87% and 74–83%, respectively. The cut-off point for rescue analgesia was ≥5 or ≥4 excluding item B(iii) mobility, and the GRADE classification was high, confirming the validity of the scale.

Frustrated Lewis Pairs (FLP) have found exciting access in catalysis and small molecule activation. Here, we describe the potential of two vanadium(V) oxido complexes with monoanionic bidentate N,O donors, [VOCl(LCF3)2] (1 a), [VOCl(LH)2] (1 b) as bases in FLPs. Upon reaction of 1 a with the Lewis acid B(C6F5)3 the FLP [VOCl(LCF3)2]/B(C6F5)3 (1 a/B(C6F5)3) was observed. Addition of Ph3SiH led to the reduction of VV to VIV under formation of the adduct [V{OB(C6F5)3}(LCF3)2] (2 a) while FLP reactivity was not observed. Dissolving 2 a in CH3CN leads to the VIV oxido complex, [VO(LCF3)2] (3 a). In contrast, when 1 b was reacted with B(C6F5)3, a VIV oxido complex [VO(LH)2] (3 b) was obtained. Upon addition of B(C6F5)3 to 3 b no reaction leading to the expected adduct such as 2 a could be observed. Only few crystals deriving from a disproportion reaction could be identified as an adduct dimer [V{OB(C6F5)3}LH(μ‐O)]2. While FLP reactivity could not be found yet with the described systems, the redox labile nature and versatility of the metal complexes are demonstrated. [ABSTRACT FROM AUTHOR]

The first years of life are an optimal time for developing motor competence. However, the evidence regarding motor competence in early childhood is fragmented and needs to be clearly synthesized and presented. To establish effective evidence-based decision making in research, practice, and policy for the early years, this expert statement, on behalf of the International Motor Development Research Consortium, draws together what is currently known about 3- to 5-year-old children on (a) how skilled are children around the world, (b) the link between motor competence and healthy developmental outcomes, and (c) the capacity to improve children's motor competence through intervention. This expert statement presents a summary of recent evidence for each of these specific points, followed by recommendations for researchers, practitioners, and policymakers. [ABSTRACT FROM AUTHOR]

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The main concern with concrete at high temperatures is loss of strength and explosive spalling, which are more pronounced in high-strength concretes, such as Ultra-High Performance Concrete (UHPC). The use of polymeric fibers in the mixture helps control chipping, increasing porosity and reducing internal water vapor pressure, but their addition can impact its mechanical properties and workability. This study evaluated the physical and mechanical properties of UHPC with metallic and PVA fibers under high temperatures using a 23 central composite factorial design. The consistency of fresh UHPC and the compressive strength and elasticity modulus of hardened UHPC were measured. Above 300 °C, both compressive strength and elasticity modulus decreased drastically. Although the addition of PVA fibers reduced fluidity, it decreased the loss of compressive strength after exposure to high temperatures. The response surface indicates that the ideal mixture—1.65% steel fiber and 0.50% PVA fiber—achieved the highest compressive strength, both at room temperature and at high temperatures. However, PVA fibers did not protect UHPC against explosive spalling at the levels used in this research. [ABSTRACT FROM AUTHOR]

Background: With the arrival of disease-modifying treatments, it is mandatory to find new cognitive markers that are sensitive to Alzheimer's disease (AD) pathology in preclinical stages. Objective: To determine the utility of a newly developed Learning and Associative Memory face test: LAM test. This study examined the relationship between AD cerebrospinal fluid (CSF) biomarkers and performance on LAM test, and assessed its potential clinical applicability to detect subtle changes in cognitively healthy subjects at risk for AD. Methods: We studied eighty cognitively healthy volunteers from the Valdecilla cohort. 61% were women and the mean age was 67.34 years (±6.416). All participants underwent a lumbar puncture for determination of CSF biomarkers and an extensive neuropsychological assessment, including performance on learning and associative memory indices of the LAM-test after 30 min and after 1 week, and two classic word lists to assess verbal episodic memory: the Rey Auditory Verbal Learning Test (RAVLT) and the Free and Cued Selective Reminding Test (FCSRT). We analyzed cognitive performance according to amyloid status (A+ versus A–) and to ATN model (A–T–N–; A+T–N–; A+T+N–/A+T+N+). Results: Performance on the LAM-test was significantly correlated with CSF Aβ ratio. A+ participants performed worse on both learning (mean difference = 2.19, p = 0.002) and memory LAM measures than A– (mean difference = 2.19, p = 0.004). A decline in performance was observed along the Alzheimer's continuum, with significant differences between ATN groups. Conclusions: Our findings suggest that LAM test could be a useful tool for the early detection of subjects within the AD continuum, outperforming classical memory tests. [ABSTRACT FROM AUTHOR]

This study aimed to review the prevalence of developmental coordination disorder (DCD) in individuals born preterm and systematically explore this prevalence according to gestational age and different assessment cut‐offs and compare it to full‐term peers. The eligibility criteria were observational and experimental studies reporting the prevalence of DCD in preterm individuals. A systematic search was performed in databases from inception until March 2022. Two independent reviewers performed the selection. Study quality assessment was performed using the checklists from Joanna Briggs Institute (JBI). Data analysis was performed on Excel and Review Manager Software 5.4. Among the 1774 studies identified, 32 matched the eligibility criteria. The pooled estimate rate of the DCD rate in preterm was 21% (95% confidence interval [CI] 17.8–24.3). The estimate rates were higher as gestational age decreased, and preterm children are two times more likely to have DCD than their full‐term peers risk ratio (RR) 2.2 (95% CI 1.77–2.79). The limitation was high heterogeneity between studies; the assessment tools, cut‐off points and age at assessment were diverse. This study provided evidence that preterm children are at higher risk for DCD than full‐term children, and the risks increased as gestational age decreased. [ABSTRACT FROM AUTHOR]

IntroductionSevere acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) infection triggers inflammatory clinical stages that affect the outcome of patients with coronavirus disease 2019 (COVID-19). Disease severity may be associated with a metabolic imbalance related to amino acids, lipids, and energy-generating pathways. The aim of this study was to characterize the profile of amino acids and acylcarnitines in COVID-19 patients. A multicenter, cross-sectional study was carried out. A total of 453 individuals were classified by disease severity. Levels of 11 amino acids, 31 acylcarnitines, and succinylacetone in serum samples were analyzed by electrospray ionization–triple quadrupole tandem mass spectrometry. Different clusters were observed in partial least squares discriminant analysis, with phenylalanine, alanine, citrulline, proline, and succinylacetone providing the major contribution to the variability in each cluster (variable importance in the projection >1.5). In logistic models adjusted by age, sex, type 2 diabetes mellitus, hypertension, and nutritional status, phenylalanine was associated with critical outcomes (odds ratio=5.3 (95% CI 3.16-9.2) in the severe vs. critical model, with an area under the curve of 0.84 (95% CI 0.77-0.90). In conclusion the metabolic imbalance in COVID-19 patients might affect disease progression. This work shows an association of phenylalanine with critical outcomes in COVID-19 patients, highlighting phenylalanine as a potential metabolic biomarker of disease severity.

Aims: The COVID-19 pandemic has had a significant impact on the provision of orthopaedic care across the UK. During the pandemic orthopaedic specialist registrars were redeployed to “frontline” specialties occupying non-surgical roles. The impact of the COVID-19 pandemic on orthopaedic training in the UK is unknown. This paper sought to examine the role of orthopaedic trainees during the COVID-19 and the impact of COVID-19 pandemic on postgraduate orthopaedic education. Methods: A 42-point questionnaire was designed, validated, and disseminated via e-mail and an instant-messaging platform. Results: A total of 101 orthopaedic trainees, representing the four nations (Wales, England, Scotland, and Northern Ireland), completed the questionnaire. Overall, 23.1% (23/101) of trainees were redeployed to non-surgical roles. Of these, 73% (17/23) were redeployed to intensive treatment units (ITUs), 13% (3/23) to A/E, and 13%(3/23%) to general medicine. Of the trainees redeployed to ITU 100%, (17/17) received formal induction. Non-deployed or returning trainees had a significant reduction in sessions. In total, 42.9% (42/101) % of trainees were not timetabled into fracture clinic, 53% (53/101) of trainees had one allocated theatre list per week, and 63.8%(64/101) of trainees did not feel they obtained enough experience in the attached subspecialty and preferred repeating this. Overall, 93% (93/101) of respondents attended at least one weekly online webinar, with 79% (79/101) of trainees rating these as useful or very useful, while 95% (95/101) trainees attended online deanery teaching which was rated as more useful than online webinars (p = 0.005) Conclusion: Orthopaedic specialist trainees occupied an important role during the COVID-19 pandemic. COVID-19 has had a significant impact on orthopaedic training. It is imperative this is properly understood to ensure orthopaedic specialist trainees achieve competencies set out in the training curriculum.

Multinuclear complexes of heavy metals, such as tungsten, have demonstrated considerable potential as candidates for advanced radiocontrast agents. Of particular interest is the development of stable non-ionic compounds with high metal content and reasonably low osmolality in solution. Accordingly, we have synthesized a series of neutral W(V) complexes that contain the W2O2(µ-O)2 core and amino acids or disubstituted EDTA derivatives as ligands. The compounds were prepared from the oxalatotungstate(V) complex via a convenient procedure utilizing microwave heating. Their detailed characterization was accomplished by electrospray ionization high-resolution mass spectrometry (ESI-HRMS), 1H and 13C NMR spectroscopy, elemental analysis, and X-ray crystallography. Further experiments to evaluate the utility of the complexes as radiocontrast media were precluded by their poor aqueous solubility.