<h4>Objective</h4>The purpose of this study was to examine the effect of emotion regulation on shooting performance in shooting athletes.<h4>Method</h4>Ecological momentary assessment was used to track and examine the dynamic relationship between pre-competition and in-competition emotions, emotion regulation strategy selection and use, and shooting performance in 57 shooting athletes.<h4>Results</h4>Female athletes used more regulation strategies than male athletes and had lower mean shooting scores when using disengagement strategies and lower good ten-ring percentages when using engagement strategies compared to male athletes. Elite athletes had a higher percentage of ten-ring scores when using engagement strategies than did first-level athletes, but a lower percentage of ten-ring scores when using disengagement strategies. The use of emotion regulation strategies and situational demands were not strongly related. Athletes had low flexibility in emotion regulation and were better at using disengagement strategies, but disengagement strategies were not beneficial for shooting performance.<h4>Conclusions</h4>First-level athletes have a higher contextual demand for emotion regulation and tend to use disengagement strategies more frequently to regulate emotions. Elite-level athletes have higher average ring values and ten-ring ratios when using engagement strategies under lower contextual demand and using disengagement strategies under higher contextual demand. Enhancing flexible emotional regulation training that improves situation-strategy fit may be beneficial for enhancing sports performance.
Abstract A cost-effective and large-scale method for synthesizing ZnCo2O4 nanoflowers with surface oxygen vacancies as electrode materials for supercapacitors is presented. The existence of oxygen vacancies on the surface of the ZnCo2O4 nanoflowers has been confirmed through X-ray photoelectron spectroscopy (XPS). The energy bands and density of states (DOS) of ZnCo2O4 are examined using density functional theory, revealing that treatment with NaBH4 reduces the band gap of ZnCo2O4 while increasing the DOS near the Fermi level compared to pristine ZnCo2O4. Furthermore, the specific capacitance of reduced ZnCo2O4 is nearly double that of its unmodified counterpart. This straightforward and practical approach significantly enhances both conductivity and specific capacitance in metal oxides, making it applicable to other similar materials.
Materials of engineering and construction. Mechanics of materials
Visual search experiments typically involve participants searching simple displays with two potential response options: 'present' or 'absent'. Here we examined search behavior and decision-making when participants were tasked with searching ambiguous displays whilst also being given a third response option: 'I don't know'. Participants searched for a simple target (the letter 'o') amongst other letters in the displays. We made the target difficult to detect by increasing the degree to which letters overlapped in the displays. The results showed that as overlap increased, participants were more likely to respond 'I don't know', as expected. RT analyses demonstrated that 'I don't know' responses occurred at a later time than 'present' responses (but before 'absent' responses) when the overlap was low. By contrast, when the overlap was high, 'I don't know' responses occurred very rapidly. We discuss the implications of our findings for current models and theories in terms of what we refer to as 'information stagnation' during visual search.
Yan Luo, Elizabeth M. Mullin, Kathleen T. Mellano
et al.
The Behavioral Regulation in Exercise Questionnaire (BREQ) was revised to its third iteration (BREQ-3) and has been widely used to measure different types of exercise motivation, including amotivation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic motivation. However, the Chinese version has not been similarly revised. The aim of this study was to develop and examine the psychometric properties of the Chinese BREQ-3 using alternative structural equation models. Specifically, this study aimed to translate the English BREQ-3 into Chinese to examine the best representation of the factor configuration of Chinese BREQ-3, measurement invariance for the best-fitted model, and the concurrent validity evidence and reliability for the Chinese BREQ-3. Undergraduate students (N = 825) from mainland China completed a battery of online questionnaires. After including two general motivation factors (controlled motivation and autonomous motivation), we discovered that the majority of items on the identified regulation, integrated regulation, and intrinsic motivation subscales no longer loaded on or had very low loadings on their specific factors, implying that these items essentially represent a unidimensional construct. Invariance testing supported the comparison between latent factor means across gender based on the bi-factor exploratory structural equation model (BESEM). Concurrent validity evidence was found for amotivation, controlled motivation, and autonomous motivation. The hierarchical omega, explained common variance (ECV), item explained common variance (I_ECV), and percentage of uncontaminated correlations (PUC) indicated that the external regulation and introjected regulation subscales had a multidimensional structure, while the identified regulation, integrated regulation, and intrinsic motivation subscales had a unidimensional structure (autonomous motivation). We advocate calculating amotivation, external regulation, introjected regulation, and a single autonomous motivation (excluding item 19) score when utilizing the Chinese BREQ-3.
Michael Gilmartin, MD, Jack Collins, MD, Sabina Mason, BSc (Hons), LLB
et al.
OBJECTIVES:. Patients discharged from the ICU post-COVID-19 pneumonitis may experience long-term morbidity related to their critical illness, the treatment for this and the ICU environment. The aim of this study was to characterize the cognitive, psychologic, and physical consequences of COVID-19 in patients admitted to the ICU and discharged alive.
DESIGN:. Prospective cohort study.
SETTING:. Post-intensive care syndrome (PICS) follow-up clinic at Tallaght University Hospital, a tertiary referral center with a 16-bed mixed medical-surgical ICU, including critical care physicians, a psychologist, a physiotherapist, and a research nurse.
PATIENTS:. Patients who had been admitted to the ICU in our tertiary referral center with COVID-19 pneumonitis 6 months earlier.
INTERVENTIONS:. None.
MEASUREMENTS AND MAIN RESULTS:. A total of 22 patients attended the 6-month PICS follow-up clinic following admission to ICU with COVID-19 pneumonitis. Mean grip strength was low at the 6-month follow-up at 24.1 pounds (sd 9.8) with a minimally active median metabolic equivalent (MET) of 970 METs/wk (interquartile range, 0–7,794 METs/wk). Only 59% of patients were independent with regard to their activities of daily living. Eight of 14 patients (57%) had returned to work by 6 months post-ICU discharge. Their mean Intensive Care Psychological Assessment Tool (IPAT) score was 6.6 (sd 4.6) with a Post-Traumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders-5th Edition (PCL-5) score of 21.1 (sd 17.5) and a mean Montreal Cognitive Assessment (MoCA) score of 24 (sd 8.4); suggestive of mild cognitive impairment. In a multivariable regression model, only Acute Physiology and Chronic Health Evaluation II score was significantly independently associated with MoCA score as a cognitive PICS outcome (beta-coefficient, –1.6; se, 0.6; p = 0.04). None of the predictor variables were significantly independently associated with IPAT and PCL-5 as psychologic outcomes, nor with International Physical Activity Questionnaire-Short Form as a physical PICS outcome.
CONCLUSIONS:. In this single-center prospective cohort study, we found that patients have a high burden of physical and psychologic impairment at 6 months following ICU discharge post-COVID-19 pneumonitis; in many cases requiring specialist referrals for long-term input. We advocate for increased resources for this much needed follow-up multidisciplinary intervention for an ever-growing population of patients.
Medical emergencies. Critical care. Intensive care. First aid
Christie A. Befort, Kathryn M. Ross, David M. Janicke
et al.
Abstract Objective The transition to parenthood is associated with worsening health behaviors, yet the impact of parental status on successful weight loss has rarely been examined. The purpose of this study was to examine the effect of parental status of minor children on weight loss and behavioral adherence in a rural community‐based weight loss intervention. Methods Five hundred and twenty‐eight adults (age 21–75 years, body mass index [BMI] 30–45 kg/m2) were enrolled in a group‐based weight loss intervention consisting of 16 weekly sessions delivered in face‐to‐face group sessions at Cooperative Extension Service (CES) offices. Participants who were parents with at least one minor child (≤18 years old) in the home were compared to participants with no minor children in the home. Measures included percent weight loss, session attendance, adherence to self‐monitoring, and achieving calorie and physical activity goals. Results Compared to participants without minor children, parents with minor children lost significantly less weight (7.5% vs. 6.2%, respectively; p = 0.01), and were less likely to lose ≥5% of baseline weight (59.2% vs. 70.2%, respectively; p = 0.02). In addition, parents with minor children attended significantly fewer sessions, had lower adherence to self‐monitoring, and met calorie and step goals less often (all ps < 0.001). The association between parental status and percent weight loss was not significantly moderated by gender of the parent. Conclusions Parents of minor children had greater difficulty adhering to intervention goals and lost less weight than participants without minor children. Future research should investigate whether tailoring intervention to meet the unique needs of parents can enhance outcomes, especially given the large segment of the population represented by this group.
Ventilation throughout life is dependent on the formation of pulmonary alveoli, which create an extensive surface area in which the close apposition of respiratory epithelium and endothelial cells of the pulmonary microvascular enables efficient gas exchange. Morphogenesis of the alveoli initiates at late gestation in humans and the early postnatal period in the mouse. Alveolar septation is directed by complex signaling interactions among multiple cell types. Here, we demonstrate that IGF1 receptor gene (Igf1r) expression by a subset of pulmonary fibroblasts is required for normal alveologenesis in mice. Postnatal deletion of Igf1r caused alveolar simplification, disrupting alveolar elastin networks and extracellular matrix without altering myofibroblast differentiation or proliferation. Moreover, loss of Igf1r impaired contractile properties of lung myofibroblasts and inhibited myosin light chain (MLC) phosphorylation and mechanotransductive nuclear YAP activity. Activation of p-AKT, p-MLC, and nuclear YAP in myofibroblasts was dependent on Igf1r. Pharmacologic activation of AKT enhanced MLC phosphorylation, increased YAP activation, and ameliorated alveolar simplification in vivo. IGF1R controls mechanosignaling in myofibroblasts required for lung alveologenesis.
Birte Marie Albrecht, Imke Stalling, Carina Recke
et al.
BACKGROUND:Meteorological conditions are potential determinants of physical activity (PA). A profound understanding of the determinants of PA behaviour is required for PA promotion. This study examined the association between accelerometer-assessed PA and meteorological conditions among older adults. METHODS:This cross-sectional study included data of 577 adults aged 65-75 years living in Bremen, Germany (52% female; 3278 days). PA was measured with accelerometers for seven consecutive days (10/15-08/16). A threshold of 240 lx was used to differentiate between outdoor physical activity (OPA) and indoor physical activity (IPA). Linear mixed models estimated the association between PA (daily accelerometer counts per minute (CPM)) and meteorological factors (temperature, cloud cover, wind, and no precipitation) derived by principal component analysis. RESULTS:The analyses showed associations between PA in CPM and the meteorological factors temperature (93.7; 95%-CL: 64.9, 122.5) and no precipitation (48.4; 95%-CL: 19.8, 77.0) in women and wind (-40.3; 95%-CL: -59.7, -20.8) and no precipitation (30.1; 95%-CL: 5.6, 54.6) in men. After distinguishing in OPA and IPA for a subsample of 128 participants (473 days), the sex differences were no longer present. OPA in CPM was associated with temperature (women: 174.5; 95%-CL: 81.3, 267.6; men: 183.3; 95%-CL: 81.2, 285.4), cloud cover (women: -153.0; 95%-CL: -200.3, -105.7; men: -123.2; 95%-CL: -174.7, -71.7), and wind (women: -118.6; 95%-CL: -189.6; -47.7; men: -96.9; 95%-CL: -177.0, -16.7). No association between OPA and no precipitation was found (women: 2.9; 95%-CL: -89.0, 94.8; men: -17.1; 95%-CL: -116.7, 82.4). CONCLUSIONS:The results of this study emphasize the importance of meteorological conditions as environmental determinants of PA among older adults. Meteorological conditions should be accounted for in the unbiased assessment of habitual PA and the development of PA promotion programs. Future research should focus on the associations of OPA and IPA with meteorological conditions in different climatic regions.
In this paper, we propose a novel learning-aided sphere decoding (SD) scheme for large multiple-input-multiple-output systems, namely, deep path prediction-based sphere decoding (DPP-SD). In this scheme, we employ a neural network (NN) to predict the minimum metrics of the “deep” paths in sub-trees before commencing the tree search in SD. To reduce the complexity of the NN, we employ the input vector with a reduced dimension rather than using the original received signals and full channel matrix. The outputs of the NN, i.e., the predicted minimum path metrics, are exploited to determine the search order between the sub-trees, as well as to optimize the initial search radius, which may reduce the computational complexity of SD. For further complexity reduction, an early termination scheme based on the predicted minimum path metrics is also proposed. Our simulation results show that the proposed DPP-SD scheme provides a significant reduction in computational complexity compared with the conventional SD algorithm, despite achieving near-optimal performance.
Purpose: Dry needling is an advanced practice skill that many athletic trainers are being trained to perform. The purpose of this study is to determine the degree to which the current athletic training educational competencies and standards prepare practitioners for the performance of dry needling tasks. Methods: An expert panel review was used to verify which of the dry needling tasks are currently taught through entry-level athletic education as defined by the 5th edition competencies and 2020 standards. Results: Results demonstrated that 11% of the tasks were dry needling specific and these were regarded as not provided through entry-level education. However, 89% of the tasks were provided through entry-level education. Conclusions: It is clear that current athletic training education adequately prepares an athletic trainer to learn dry needling as an advance practice skill as a large number of the Competencies for Dry Needling are taught within athletic training entry-level education.
Scalable production of avian cell lines exhibits a valuable potential on therapeutic application by producing recombinant proteins and as the substrate for virus growth due to the special glycosylation occurs in avian species. Chicken primordial germ cells (cPGCs), a germinal pluripotent avian cell type, present the ability of self-renewal, an anchorage-independent cell growth and the ability to be genetically modified. This cell type could be an interesting bioreactor system for industrial purposes. This study sought to establish an expandable culture system with defined components for three-dimensional (3D) culture of cPGCs. cPGCs were cultured in medium supplemented with the functional polymer FP003. Viscoelasticity was low in this medium but cPGCs did not sediment in culture and efficiencies of space and nutrient utilization were thus enhanced and consequently their expansion was improved. The total number of cPGCs increased by 17-fold after 1 week of culture in 3D-FAot medium, an aseric defined medium containing FP003 polymer, FGF2 and Activin A as growth factors and Ovotransferrin as protein. Moreover, cPGC cell lines stably expressed the germline-specific reporter VASA:tdTOMATO, as well as other markers of cPGCs, for more than 1 month upon culture in 3D-FAot medium, indicating that the characteristics of these cells are maintained. In summary, this novel 3D culture system can be used to efficiently expand cPGCs in suspension without mechanical stirring, which is available for long-term culture and no loss of cellular properties was found. This system provides a platform for large-scale culture of cPGCs.
Dmytro Unukovych, MD, PhD, Edward J. Caterson, MD, PhD, Matthew J. Carty, MD
et al.
Background:. The incidence of bilateral mastectomies is increasing along with the rates of breast reconstructions. A substantial number of patients will present with abdominal scars after Cesarean section, laparoscopy, laparotomy, and so on. The aim of this study was to evaluate the impact of prior abdominal scars on complication rates in abdominal bilateral free flap breast reconstruction.
Methods:. All consecutive patients with autologous free flap breast reconstruction between 2007 and 2014 were eligible. The relevant demographic and clinical data were prospectively collected into a study-specific database. Complications and reoperations were prospectively registered after postoperative outpatient visits.
Results:. Overall, 493 patients underwent abdominally based breast reconstruction during the study period: unilateral (n = 250; 50.7%) or bilateral (n = 243; 49.3%). In the bilateral group, the abdominal scar locations were Pfannenstiel (n = 73; 30.1%), midline (n = 16; 6.6%), lower oblique (n = 17; 7.0%), upper oblique (n = 5; 2.1%), and laparoscopic (n = 69; 28.4%). Four (1.7%) flap failures (including 1 converted to a pedicled transverse rectus abdominis flap) were registered, all occurring in patients from the scar group: 3 with Pfannenstiel incision and 1 patient with prior laparoscopy. Pfannenstiel scar was associated with higher risk of hematoma at the recipient site when compared with no scar group (13.7% versus 2.2%; P = 0.006). Partial flap necrosis, infection, and seroma occurred in 14 (5.9%), 8 (3.4%), and 5 (2.1%) patients, respectively, and no differences between the scar groups were identified.
Conclusion:. Surgical outcomes of bilateral reconstructions in patients with abdominal scars are generally comparable with ones in patients without prior surgery; however, some problems have been identified. These procedures might have some intraoperative considerations and often require increased operative times. Apart from the traditional preoperative computed tomography angiography, intraoperative imaging (e.g., fluorescence angiography) may be advocated in patients with abdominal scars.
BackgroundLower muscle mitochondrial energy production may contribute to impaired walking endurance in patients with peripheral arterial disease. A borderline ankle‐brachial index (ABI) of 0.91 to 1.10 is associated with poorer walking endurance compared with higher ABI. We hypothesized that in the absence of peripheral arterial disease, lower ABI is associated with lower mitochondrial energy production. Methods and ResultsWe examined 363 men and women participating in the Baltimore Longitudinal Study of Aging with an ABI between 0.90 and 1.40. Muscle mitochondrial energy production was assessed by post‐exercise phosphocreatine recovery rate constant (kPCr) measured by phosphorus magnetic resonance spectroscopy of the left thigh. A lower post‐exercise phosphocreatine recovery rate constant reflects decreased mitochondria energy production.The mean age of the participants was 71±12 years. A total of 18.4% had diabetes mellitus and 4% were current and 40% were former smokers. Compared with participants with an ABI of 1.11 to 1.40, those with an ABI of 0.90 to 1.10 had significantly lower post‐exercise phosphocreatine recovery rate constant (19.3 versus 20.8 ms−1, P=0.015). This difference remained significant after adjusting for age, sex, race, smoking status, diabetes mellitus, body mass index, and cholesterol levels (P=0.028). Similarly, post‐exercise phosphocreatine recovery rate constant was linearly associated with ABI as a continuous variable, both in the ABI ranges of 0.90 to 1.40 (standardized coefficient=0.15, P=0.003) and 1.1 to 1.4 (standardized coefficient=0.12, P=0.0405). ConclusionsAn ABI of 0.90 to 1.10 is associated with lower mitochondrial energy production compared with an ABI of 1.11 to 1.40. These data demonstrate adverse associations of lower ABI values with impaired mitochondrial activity even within the range of a clinically accepted definition of a normal ABI. Further study is needed to determine whether interventions in persons with ABIs of 0.90 to 1.10 can prevent subsequent functional decline.
Diseases of the circulatory (Cardiovascular) system
Christopher Yakacki PhD, Patrick Terrill BS, Robert Carpenter PhD
et al.
Category: Ankle, Hindfoot Introduction/Purpose: Tibiotalocalcaneal (TTC) arthrodesis is a salvage procedure for patients with severe osteoarthritis and other degenerative ankle conditions. Oftentimes, an intramedullary (IM) nail is implanted across the joints and then fixed with tibial and calcaneal screws. Maintaining compression and load sharing are both largely desired to promote fusion via primary bone healing; however, compression can be lost due to small amounts of bone resorption and IM nails are now being made from carbon-fiber epoxy to minimize stress shielding. To date, no one has been able to directly characterize or compare the specific amount of these parameters across nails in a single model. The purpose of this study is to compare influence of nail design and materials for compressive and load-sharing properties using a patient-specific finite-element model. Methods: A titanium nail, a pseudoelastic nickel-titanium nail, and carbon fiber-epoxy nail were investigated for (1) load sharing between the nail body and tibia under gait loading and (2) compression loss as a function of resorption in the talus. A patient- specific model of the ankle, both in geometry and material properties, was generated from a quantitative computed tomography (QCT) scan of a healthy leg. The models were segmented and meshed using SCANIP and exported into ABAQUS for finite- element analysis. Compression in the nickel-titanium nail was simulated by pre-stretching the pseudoelastic compressive element. Conversely, compression in the titanium and carbon-fiber nails were generated by giving the nail jacket an orthotropic contraction coefficient in the model. After compression was set, each nail was subjected to an applied gait load that peaked at 1121 N. Resorption was simulated using a thin compressible layer of bone in the talus and decreasing the modulus and Poisson’s ratio. Results: Surprisingly, the carbon-fiber nail showed similar stress shielding to the titanium nail, with 72% and 77% of the stress being transferred through the devices instead of the ankle, respectively. Even though carbon fiber-epoxy has a significantly lower modulus than titanium (75 GPa vs 110 GPa), the overall stiffness of the nails was still much greater than that of bone (~30,000 N/mm vs. ~44,000 N/mm vs. ~3,000 N/mm, respectively). The pseudoelastic nail only shielded 32% of the stress values by comparison. For the titanium and carbon-fiber nails, over 85% of the initial compression provided by the nail drops with 0.10 mm of resorption. The pseudoelastic nail maintained 90% of its initial compression after 0.10 mm of resorption. Conclusion: IM nail design and materials played a significant role in maintaining compression and load sharing. The pseudoelastic nail had the lowest degree of stress-shielding (32%) and maintained compression for over 0.10 mm of simulated resorption. Constant compression and the avoidance of “resorption gapping” is paramount to drive primary bone healing in joint fusions due to lack of periosteal/endosteal anatomy crossing the fusion site, thus impairing the ability for secondary bone healing (callus healing). This model allows for direct comparison between devices and can be used pre-operatively to predict patient-specific performance and help aid in device selection for TTC fusion.
Claire Chaumont, Jenny Hsi, Christine Bohne
et al.
Abstract Despite economic growth and increased global commitment to health financing in the past decades, the health needs of some of the world's most vulnerable people remain overlooked. In particular, middle‐income countries (MICs) often face the conundrum of receiving reduced development assistance for health (DAH) while still being home to most of the world's poor and the majority of the global burden. We believe that this reflects shortcomings in the global DAH system's architecture, which operate on principles that do not respond well to current realities. Hence, we propose a novel mechanism for international health financing and action that specifically addresses the newly emerged strengths and needs of MICs. The Incentives for Health (I4H) Alliance will offer MICs flexible incentives in exchange for their making and meeting health‐related commitments in their countries. Countries can set their own health targets, in alignment with the existing Sustainable Development Goals' framework, and those that achieve them will be subsequently rewarded with financial or other incentives, which are not restricted to the health sector. We believe that the I4H Alliance will promote greater MIC involvement towards global health financing both as incentive providers and recipients; encourage collaboration between Ministries of Health and Finance; and provide a needed complement to traditional DAH mechanisms. We advocate for the creation of I4H at a MICs‐oriented financing institution such as the New Development Bank. We intend I4H to spark new thinking around innovative health financing approaches to ensure that the “golden age” of global health remains ahead.
Tanjew Dittgen, Claudia Pitzer, Christian Plaas
et al.
Granulocyte-colony stimulating factor (G-CSF) improves outcome after experimental SCI by counteracting apoptosis, and enhancing connectivity in the injured spinal cord. Previously we have employed the mouse hemisection SCI model and studied motor function after subcutaneous or transgenic delivery of the protein. To further broaden confidence in animal efficacy data we sought to determine efficacy in a different model and a different species. Here we investigated the effects of G-CSF in Wistar rats using the New York University Impactor. In this model, corroborating our previous data, rats treated subcutaneously with G-CSF over 2 weeks show significant improvement of motor function.