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Introduction: Eating disorders (EDs) represent a significant mental health challenge globally, particularly among young adults, including university students. This study investigates the prevalence of ED and associated factors among Moroccan university students to inform targeted interventions and support mechanisms within the university environment. Methods: Using a cross-sectional design, including students from eight institutions affiliated with Abdelmalek Essaadi University in Tangier, Morocco, were randomly selected through stratified sampling. A questionnaire comprising sections on demographics, childhood history, and the Mini-International Neuropsychiatric Interview (MINI) was employed. The MINI included subscales for anorexia nervosa, bulimia nervosa, and binge ED. Results: Study included 1168 predominantly female students (59.1%) with a mean age of 20 years. The estimated prevalence of probable ED cases was 2.1% (95% confidence interval [CI]: 1.3–3), with bulimia showing the highest prevalence at 1.9% (95% CI: 1.2–2.8), followed by anorexia and binge eating at 0.3% each. Factors significantly associated with ED included medical history, treatment for anxiety/depression/addiction, sleep medication use, judicial history, psychological violence, sexual violence, and negative events during childhood/adolescence. Coexistence with mood, anxiety, and psychotic disorders was also noted. Multivariate analysis showed strong association between undergoing treatment for anxiety, depression, and/or addiction (P < 0.003), judicial history (P < 0.001), and sexual violence (

Background: In karate, the ability to execute high-velocity movements, particularly kicks and punches, is heavily dependent on the strength and power of the lower limb muscles, especially the knee extensors. As such, this study aimed to evaluate the effects of an 8-week eccentric training program utilizing the reverse Nordic exercise (RNE) integrated into karate training compared with regular karate training only on measures of physical fitness in youth karate athletes. Methods: Twenty-seven youth karatekas were recruited and allocated to either RNE group (n = 13; age = 15.35 ± 1.66 years; 7 males and 6 females) or an active control group ([CG]; n = 14; 7 males and 7 females; age = 15.30 ± 1.06 years). To track the changes in measures of physical fitness before and after training, tests to assess linear sprint speed (i.e., 10 m), change of direction (CoD) speed (i.e., modified 505 CoD), vertical jumping (i.e., countermovement jump [CMJ] height) and horizontal jumping distance (i.e., standing long jump [SLJ]), and lower-limb asymmetry score (i.e., the difference between SLJ-dominant and non-dominant legs) were carried out. Results: The results indicated significant group-by-time interactions in all measures of physical fitness (effect size [ES] = 1.03 to 2.89). Post-hoc analyses revealed significant changes in the RNE group across all performance measures (effect size [ES] = 0.33 to 1.63). Additionally, the asymmetry score exhibited a moderate decrease from pre to posttest (∆46.96%, ES = 0.64). In contrast, no significant changes were observed in the CG across all fitness measures. Moreover, the individual response analysis indicated that more karatekas from the RNE group consistently achieved improvements beyond the smallest worthwhile change threshold across all fitness measures. Conclusions: In summary, RNE training is an effective approach to enhance various physical fitness measures besides lower-limb asymmetry scores in youth karatekas and is easy to incorporate into regular karate training. Practitioners are therefore encouraged to consistently integrate RNE training to enhance essential physical fitness components in young karatekas.

Intracranial dural arteriovenous fistulas (DAVFs) are rare lesions accounting for 10 to 15% of intracranial arteriovenous malformations. They involve an anomalous shunt between meningeal arteries, intracranial (venous sinuses and/or cortical veins), or medullary veins. The DAVFs are usually acquired, implying previous aggression of the dura mater. Thus, they are associated with dural sinus thrombosis, previous craniotomy, and trauma. However, they are idiopathic in most instances and have no evident cause. Their clinical presentation is variable, with symptoms depending on their location and venous drainage pattern. However, lesions with cortical venous drainage have the highest risk of causing the most significant morbidity and mortality. High clinical suspicion alongside noninvasive cross-sectional imaging techniques such as computed tomography and magnetic resonance imaging help establish the diagnosis. Digital subtraction angiography is the gold standard for diagnosis and accurate classification, permitting the evaluation of the feeding vessels, cortical venous drainage, and venous ectasia. Accordingly, a prompt diagnosis and precise classification of these lesions are essential. Endovascular treatment is nowadays the primary therapeutic modality for DAVFs. The access route can be divided into transarterial, transvenous, and combined approaches based on angioarchitecture, venous drainage model, and location. Surgical resection and stereotactic radiosurgery may be considered in some cases. A personalized case-by-case approach accomplishes a high complete treatment grade with a low complication rate. This review highlights the epidemiology, pathogenesis, clinical presentation, classification, diagnosis, and endovascular treatment of patients with intracranial DAVFs.

The utility of flexibility as a standard component of physical fitness has recently been questioned, sparking a heated debate among scientists. More specifically, it has recently been proposed to retire flexibility as a major component of physical fitness and as a result de-emphasis stretching from exercise prescriptions. The aim of this narrative review was to summarize and discuss the most recent evidence related to the chronic effects of static stretching (SS) on muscle strength, muscle power, muscle hypertrophy, and injury prevention in healthy individuals. A literature search was conducted using the electronic databases PubMed, SPORTDiscus, Web of Science, and Google Scholar up to November 2022. We only considered studies written in English that addressed the chronic effects of SS exercises on flexibility, muscle strength, muscle power, muscle hypertrophy, or injury prevention in healthy individuals. With reference to the existing knowledge, we concluded that flexibility deserves to be further considered as a standard component of physical fitness. This is based on the findings that in addition to flexibility, long-term SS training induces positive effects on muscle strength, muscle power, and muscle hypertrophy, irrespective of age and sex. There are also indications that long-term SS training could mitigate the risk of injury, although this remains a debatable topic. Furthermore, promising evidence shows that combining resistance training with SS exercises constitutes an effective approach benefiting muscle strength and hypertrophy more than resistance training alone. In conclusion, we would not support the recent suggestion that flexibility should be retired as a standard component of physical fitness and we would advocate for a continuous emphasis on the prescription of stretching exercises.

Introduction: To identify if there is an association between Severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) vaccination and the duration of symptoms in patients with mild-to-moderate Coronavirus disease-2019 (COVID-19). Materials and Methods: We conducted a prospective observational cohort study which included patients with mild-to-moderate COVID-19 that was confirmed via biological and/or radiological methods (reverse transcription-polymerase chain reaction, TAG-rapid, and chest computed tomography) and who were treated as outpatients from August 2021 to September 2021. The duration of symptoms was defined as the interval between the onset of symptoms and their resolution. We compared the symptom duration between unvaccinated, partially vaccinated, and fully vaccinated patients. The other variables were also adjusted. Results: We included 283 patients with positive SARS-CoV-2 test results. Among these participants, 28.6% were fully vaccinated, 25.1% were partially vaccinated, and 46.3% were unvaccinated. The median duration of symptoms was 10 days, interquartile range [(IQR) (7-13)] in vaccinated patients and 13 days [IQR (9-15)] in unvaccinated patients. After adjusting for confounding factors, a short duration of symptoms was significantly associated with age

IntroductionThis study examined the effects of an 8-week backward running (BR) vs. forward running (FR) training programmes on measures of physical fitness in young female handball players.MethodsTwenty-nine players participated in this study. Participants were randomly assigned to a FR training group, BR training group, and a control group.Results and discussionWithin-group analysis indicated significant, small-to-large improvements in all performance tests (effect size [g] = 0.36 to 1.80), except 5-m forward sprint-time in the BR group and 5- and 10-m forward sprint-time in the FR group. However, the CG significantly decreased forward sprint performance over 10-m and 20-m (g = 0.28 to 0.50) with no changes in the other fitness parameters. No significant differences in the amount of change scores between the BR and FR groups were noted. Both training interventions have led to similar improvements in measures of muscle power, change of direction (CoD) speed, sprint speed either forward or backward, and repeated sprint ability (RSA) in young female handball players, though BR training may have a small advantage over FR training for 10-m forward sprint time and CoD speed, while FR training may provide small improvements over BR training for RSAbest. Practitioners are advised to consider either FR or BR training to improve various measures of physical fitness in young female handball players.

Poor sleep quality, a global public health concern, poses a significant burden on individuals, particularly health care university students facing intense academic stress. A three-center cross-sectional study was conducted at the Higher Institute of Nursing and Health Sciences in Tetouan (Morocco), Faculty of Medicine in Tangier (Morocco) and Faculty of Nursing in Valencia (Spain). We collected various data using a sociodemographic questionnaire, the Pittsburgh sleep quality questionnaire, the international physical activity questionnaire (IPAQ) and the smartphone addiction questionnaire short-version (SAS-SV). A total of 1210 students were included in our study (mean age 20.4 years, 67.2% female, nursing students (66.2%) and medical students (33.8%), 76.1% students from Morocco and 33.9% from Spain). Analysis revealed a higher prevalence of poor sleep quality among Moroccans students compared to Spanish ones (p < 0.001), that nursing students showed less favorable sleep quality than medical students (p < 0.011) and that living with a chronic disease was linked to less favorable sleep quality (p < 0.001). Lastly, intense or weak physical activity and smartphone addiction were correlated with poor sleep quality (p < 0.001). In the multivariate analysis, an association persisted between poor sleep quality and factors such as the country of study (Odds ratio (OR): 6.25 [95% Confidence Interval (CI): 4.34–9.09]), involvement in nursing studies (OR: 3.50 [95% CI: 2.36–5.27]), and the presence of chronic diseases (OR: 2.70 [95% CI: 1.72–4.16]), (p < 0.01 each). Our findings highlight the multifaceted factors affecting sleep quality in young university students. The implications underscore the imperative of interventions tailored to this demographic group.

Background: In karate, the ability to execute high-velocity movements, particularly kicks and punches, is heavily dependent on the strength and power of the lower limb muscles, especially the knee extensors. As such, this study aimed to evaluate the effects of an 8-week eccentric training program utilizing the reverse Nordic exercise (RNE) integrated into karate training compared with regular karate training only on measures of physical fitness in youth karate athletes. Methods: Twenty-seven youth karatekas were recruited and allocated to either RNE group (n = 13; age = 15.35 ± 1.66 years; 7 males and 6 females) or an active control group ([CG]; n = 14; 7 males and 7 females; age = 15.30 ± 1.06 years). To track the changes in measures of physical fitness before and after training, tests to assess linear sprint speed (i.e., 10 m), change of direction (CoD) speed (i.e., modified 505 CoD), vertical jumping (i.e., countermovement jump [CMJ] height) and horizontal jumping distance (i.e., standing long jump [SLJ]), and lower-limb asymmetry score (i.e., the difference between SLJ-dominant and non-dominant legs) were carried out. Results: The results indicated significant group-by-time interactions in all measures of physical fitness (effect size [ES] = 1.03 to 2.89). Post-hoc analyses revealed significant changes in the RNE group across all performance measures (effect size [ES] = 0.33 to 1.63). Additionally, the asymmetry score exhibited a moderate decrease from pre to posttest (∆46.96%, ES = 0.64). In contrast, no significant changes were observed in the CG across all fitness measures. Moreover, the individual response analysis indicated that more karatekas from the RNE group consistently achieved improvements beyond the smallest worthwhile change threshold across all fitness measures. Conclusions: In summary, RNE training is an effective approach to enhance various physical fitness measures besides lower-limb asymmetry scores in youth karatekas and is easy to incorporate into regular karate training. Practitioners are therefore encouraged to consistently integrate RNE training to enhance essential physical fitness components in young karatekas. [ABSTRACT FROM AUTHOR]

This study aimed to develop the optimal allometric body size/shape and a biological maturity model that predicted the change of direction (CoD) mean speed performance in youth male soccer players. One-hundred and fifteen youth soccer players (age: 12.4 [1.3] y) participated in this study. The 505 test was used to assess CoD mean speed performance. Anthropometric measurements comprised body height (cm), sitting height (cm), body mass (kg), fat mass (kg), lower limb length (cm), thigh length (cm), leg length (cm), foot length (cm), thigh girth (cm), and calf girth (cm). The maturity status was determined based on the maturity offset method. To identify size/shape and maturity characteristics associated with CoD speed performance, we computed a multiplicative allometric log-linear regression model. which was refined using backward elimination. The multiplicative allometric model exploring the association between 505 CoD mean speed performance and the different anthropometric characteristics in youth soccer players estimated that fat mass (P < .001), sitting height (P =.02), and maturity offset (P = .004) are the key predictors. More specifically, youths who are more mature and have a lower fat mass and a shorter trunk length, are likely to achieve a better CoD mean speed performance. These findings highlight the relevance of considering anthropometric and maturity characteristics in youth soccer players to support talent identification. [ABSTRACT FROM AUTHOR]

BackgroundThe frequency of heart failure (HF) in Tunisia is on the rise and has now become a public health concern. This is mainly due to an aging Tunisian population (Tunisia has one of the oldest populations in Africa as well as the highest life expectancy in the continent) and an increase in coronary artery disease and hypertension. However, no extensive data are available on demographic characteristics, prognosis, and quality of care of patients with HF in Tunisia (nor in North Africa). ObjectiveThe aim of this study was to analyze, follow, and evaluate patients with HF in a large nation-wide multicenter trial. MethodsA total of 1700 patients with HF diagnosed by the investigator will be included in the National Tunisian Registry of Heart Failure study (NATURE-HF). Patients must visit the cardiology clinic 1, 3, and 12 months after study inclusion. This follow-up is provided by the investigator. All data are collected via the DACIMA Clinical Suite web interface. ResultsAt the end of the study, we will note the occurrence of cardiovascular death (sudden death, coronary artery disease, refractory HF, stroke), death from any cause (cardiovascular and noncardiovascular), and the occurrence of a rehospitalization episode for an HF relapse during the follow-up period. Based on these data, we will evaluate the demographic characteristics of the study patients, the characteristics of pathological antecedents, and symptomatic and clinical features of HF. In addition, we will report the paraclinical examination findings such as the laboratory standard parameters and brain natriuretic peptides, electrocardiogram or 24-hour Holter monitoring, echocardiography, and coronarography. We will also provide a description of the therapeutic environment and therapeutic changes that occur during the 1-year follow-up of patients, adverse events following medical treatment and intervention during the 3- and 12-month follow-up, the evaluation of left ventricular ejection fraction during the 3- and 12-month follow-up, the overall rate of rehospitalization over the 1-year follow-up for an HF relapse, and the rate of rehospitalization during the first 3 months after inclusion into the study. ConclusionsThe NATURE-HF study will fill a significant gap in the dynamic landscape of HF care and research. It will provide unique and necessary data on the management and outcomes of patients with HF. This study will yield the largest contemporary longitudinal cohort of patients with HF in Tunisia. Trial RegistrationClinicalTrials.gov NCT03262675; https://clinicaltrials.gov/ct2/show/NCT03262675 International Registered Report Identifier (IRRID)DERR1-10.2196/12262

Introduction: Assessment of left ventricular ejection fraction (LVEF) is one of the primary objectives of echocardiography. The gold standard assessment technique in emergency medicine is eyeballing. A new tool is now available on pocket ultrasound devices (PUD): automatic LVEF. The primary aim of this study was to evaluate the concordance between LVEF values estimated by automatic LVEF with PUD and by cardiac magnetic resonance imaging (MRI). Materials: This was a prospective, monocentric, and observational study. All adult patients with an indication for cardiac MRI underwent a point-of-care ultrasound. Blinded to the MRI results, the emergency physician assessed LVEF using the automatic PUD tool and by visual evaluation. Results: Sixty patients were included and analyzed. Visual estimation of LVEF was feasible for all patients and automatic evaluation for 52 (87%) patients. Lin's concordance correlation coefficient between automatic ejection fraction with PUD and by cardiac MRI was 0.23 (95% CI, 0.03–0.40). Conclusion: Concordance between LVEF estimated by the automatic ejection fraction with PUD and LVEF estimated by MRI was non-existent. [ABSTRACT FROM AUTHOR]

Despite their several nutritional and functional properties, local products, such as carob, have been underexploited in Tunisia. In the context of valorization of these resources, the current study investigates the use of carob as a functional ingredient on physicochemical, microbiological, and sensory characteristics of new dietary carob-based ice cream. Following preliminary tests, eight different samples were initially produced which differ by the amount of added carob. The mixture plan of the optimized formula was then determined according to 5 responses: flavour, odour, overall acceptability, antioxidant activity and viscosity of the ice cream. The addition of carob gave the ice cream nutritional and energy boosting values without being too caloric (153.12 kcal/100g) and with no added sugar. The optimized formula with 3.6 % of fat content makes it fall to the dietetic products category. Moreover, the addition of carob gave the ice cream antioxidant properties which is manifested by an antiradical activity of the order of 91.01% and a total antioxidant activity equal to 44.72mg EAA/g DM. Viscosity and microbiological properties were not affected by the use of carob which meets the prescribed standards of ice creams. This successful preparation of high-quality nutritional and functional carob-based ice cream had a positive response on sensory level, and it had natural dark tint and fragrance without any added chemicals. Therefore, the incorporation of carob significantly improved the functional, nutritional, physicochemical, rheological, and organoleptic quality of the obtained product, stabilizing its microbial quality and viscosity. [ABSTRACT FROM AUTHOR]

The NATURE-HF registry was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). This is a prospective, multicenter, observational survey conducted in Tunisian Cardiology centers. A total of 2040 patients were included in the study. Of these, 1632 (80%) were outpatients with chronic HF (CHF). The mean hospital stay was 8.7 ± 8.2 days. The mortality rate during the initial hospitalization event for AHF was 7.4%. The all-cause 1-year mortality rate was 22.8% among AHF patients and 10.6% among CHF patients. Among CHF patients, the older age, diabetes, anemia, reduced EF, ischemic etiology, residual congestion and the absence of ACEI/ ARBs treatment were independent predictors of 1-year cumulative rates of rehospitalization and mortality. The female sex and the functional status were independent predictors of 1-year all-cause mortality and rehospitalization in AHF patients. This study confirmed that acute HF is still associated with a poor prognosis, while the mid-term outcomes in patients with chronic HF seems to be improved. Some differences across countries may be due to different clinical characteristics and differences in healthcare systems.

Poor sleep quality, a global public health concern, poses a significant burden on individuals, particularly health care university students facing intense academic stress. A three-center cross-sectional study was conducted at the Higher Institute of Nursing and Health Sciences in Tetouan (Morocco), Faculty of Medicine in Tangier (Morocco) and Faculty of Nursing in Valencia (Spain). We collected various data using a sociodemographic questionnaire, the Pittsburgh sleep quality questionnaire, the international physical activity questionnaire (IPAQ) and the smartphone addiction questionnaire short-version (SAS-SV). A total of 1210 students were included in our study (mean age 20.4 years, 67.2% female, nursing students (66.2%) and medical students (33.8%), 76.1% students from Morocco and 33.9% from Spain). Analysis revealed a higher prevalence of poor sleep quality among Moroccans students compared to Spanish ones (p < 0.001), that nursing students showed less favorable sleep quality than medical students (p < 0.011) and that living with a chronic disease was linked to less favorable sleep quality (p < 0.001). Lastly, intense or weak physical activity and smartphone addiction were correlated with poor sleep quality (p < 0.001). In the multivariate analysis, an association persisted between poor sleep quality and factors such as the country of study (Odds ratio (OR): 6.25 [95% Confidence Interval (CI): 4.34–9.09]), involvement in nursing studies (OR: 3.50 [95% CI: 2.36–5.27]), and the presence of chronic diseases (OR: 2.70 [95% CI: 1.72–4.16]), (p < 0.01 each). Our findings highlight the multifaceted factors affecting sleep quality in young university students. The implications underscore the imperative of interventions tailored to this demographic group. [ABSTRACT FROM AUTHOR]