Shanthi Gretta Pasanha, Annica Andersson, Beth Herbel-Eisenmann
et al.
This paper investigates storylines from newcomers’ perspectives on their experiences of learning mathematics in an introductory mathematics classroom setting in Norway. We engaged in participatory research at a school over time. The data in this article come from observations and conversational interviews. Positioning theory guided our analysis in identifying storylines and related positionings. Our analysis provided us with the following four storylines: (1) newcomers find mathematics easy because they are also learning a new language; (2) newcomers experience tensions when learning mathematics in a new language; (3) newcomers find math teachers extra kind and find that they extend their help to them more than usual; (4) newcomers seek alternative resources for learning advanced mathematics. The identified storylines serve as a valuable resource to understand the newcomers’ wishes and desires for their mathematics education in a context of not yet knowing the language of instruction and educational culture. We recommend listening to newcomers’ perspectives of their experiences and recognizing the strengths they bring to the classroom to understand how they navigate their situation while learning mathematics in multilingual mathematics learning settings.
Michelle H. Lee, Eveline Febriana, Maybritte Lim
et al.
Summary: Background: Postprandial glucose concentration 1-h (1 h-PG) after an oral glucose tolerance test (OGTT) has similar or superior performance to 2 h-PG in predicting type-2 diabetes mellitus (T2DM) in several populations, and is simpler to obtain in clinical practice. However, studies in Asians are scarce. We investigated the utility of elevated baseline 1 h-PG in predicting T2DM incidence within three years, and its relationship with β-cell function in 1250 non-diabetic Asian participants. Methods: Participants underwent an OGTT, an intravenous glucose challenge and a hyperinsulinemic-euglycemic clamp to determine glucose tolerance, acute insulin response (AIR) and insulin sensitivity at baseline. OGTTs were repeated every six months until study completion to monitor T2DM conversion. Findings: The area under the receiver operating characteristic curve of 1 h-PG was not significantly different from 2 h-PG (AUC1h-PG = 0.883 vs. AUC2h-PG = 0.907; ΔAUC = −0.024, P = 0.124) and the optimal 1 h-PG cut-off was ≥10.7 mmol/L. When groups of high/low 1 h-PG and 2 h-PG at baseline were compared, AIR and disposition index were significantly lower in groups with high 1 h-PG, and both had a stronger correlation with 1 h-PG, indicating that impaired β-cell function was more strongly associated with elevated 1 h-PG than 2 h-PG. Interpretation: The ability of 1 h-PG to detect Asians at risk of developing T2DM within three years is on par with 2 h-PG and the optimal cut-off is 10.7 mmol/L. Elevated 1 h-PG is associated with β-cell dysfunction. We conclude that 1 h-PG can be considered as a primary OGTT time point to identify Asians at risk for T2DM, allowing for screening at a reduced time and cost, and with lower patient burden. Funding: National Medical Research Council (NMRC), Ministry of Health (MOH; Singapore) Industry Alignment Fund [NMRC/MOHIAFCat1/0048/2016] and Janssen Pharmaceuticals Inc. (USA).
Abstract Background Sleep quality decreased can result in a major health issue in older people with age. While not all sleep changes are pathological in older people’s life, severe disturbances may lead to depression, cognitive impairments, deterioration of quality of life, significant stresses for careers and increased healthcare costs. Despite the known benefits of exercise for improving sleep quality, it is necessary to identify the optimal exercise type and dose. Objective This systematic review and network meta-analysis (NMA) combined to examine evaluated the existing evidence on the effectiveness of different exercises, and to examine the dose and response relationship between overall and specific types with improving sleep quality in older people. Methods PubMed, Cochrane Central, Web of Science, and Embase were systematically searched for this review, including studies up to April 2025. Only randomized controlled trials were included. Studies involved at least one type of exercise intervention and reported changes in sleep quality assessments. To address the limitations of relying solely on statistical significance, we also calculated the minimal clinically important difference (MCID) to determine the smallest meaningful improvement in sleep quality among older people, both overall and across different exercise doses. Data analysis and visualization were conducted using the “meta”, “netmeta”, “MBNMA”, and “ggplot2” packages in the R environment. Results A total of 62 RCTs involving 5005 older adults were included. Overall, exercise significantly improved sleep quality, with clinically meaningful improvements achieved from as early as 5 weeks of intervention. The optimal exercise type was combined aerobic and resistance training, followed by aerobic exercise, resistance training, walking, and yoga. The estimated optimal exercise dose was around 660 to 990 METs*min/week, with longer durations at 15 weeks producing the greatest benefits. Improvements were more pronounced among participants with poorer baseline sleep quality. Conclusion If older people receive the most appropriate exercise intervention, they can obtain clinically meaningful benefits of improving sleep in the elderly within the WHO guidelines for exercise doses. The results support the WHO recommendation that combine aerobic exercise and resistance training should be an important part of interventions for the older people. Protocol registration PROSPERO registration number: CRD42024566751. Graphical Abstract
Tasneem Sabir, Thomas Allen, Michael J. Callaghan
et al.
Abstract With growing support for more active healthier lifestyles, focus on injury prevention and treatment solutions is rising. One debated topic is the use of knee braces for knee injuries. Evidence and clinical recommendations in preventing and treating knee injuries have changed with the development and refinement of knee braces. Given the various knee braces available, this paper explores potential opportunities and recommendations for future research. The ten questions paper examines the use of braces and the relationship between user experience, design and performance. It further explores challenges and issues associated with knee braces. It offers a fresh perspective into redesigning braces with the latest innovations in materials and sensors. Through these questions, we hope to offer a fresh perspective on knee bracing and advance understanding of future opportunities to improve knee brace design.
Cody Ashy MD, Paul Pottanat MD, Harris Slone MD
et al.
Background: Anterior shoulder instability is associated with Hill-Sachs lesions (HSLs) in 40% to 90% of cases. When addressing anterior shoulder instability, unaddressed engaging or “off-track” HSL have a recurrence rate of 75%. Remplissage is a known technique to address recurrent instability in the setting of an engaging HSL. In this video, we demonstrate that a double-anchor-pulley technique may be used to address recurrent instability in the setting of engaging HSL. Indications: Patients with recurrent anterior shoulder instability with off-track HSL in patients with glenoid bone loss <20% are candidates for arthroscopic Remplissage. Technique Description: Patients are placed in the lateral decubitus position. Examination under anesthesia is performed to assess for degree of instability and engagement of HSL. Posterior, anterosuperior, and anteroinferior portals are established. Routine diagnostic arthroscopy is performed with identification of the HSL. While viewing from an anterosuperior portal and working through the posterior portal, the HSL bed is prepared with curettage and a bur. A 5.5-mm accessory Cannula is used through an accessory posterior portal. Two knotless all-suture self-tensioning anchors are placed in the anterior and inferior aspect of the defect, passed through the cannula, and tagged for later identification. Bankart stabilization is performed. The knotless anchors are linked to each other to perform a knotless repair with a broad area of compression. Results: Results are excellent with only a 5.6% failure rate, significant patient improvement, low complication rate, and 95.5% return to play. Discussion: We demonstrate the technical aspects of an all-arthroscopic Remplissage technique using all-suture knotless anchors to provide a simple and reproducible method of performing a Remplissage. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
BackgroundUnderstanding the factors that influence walking is important as quantitative walking assessments have potential to inform health risk assessments. Wearable technology innovation has enabled quantitative walking assessments to be conducted in different settings. Understanding how different settings influence quantitative walking performance is required to better utilize the health-related potential of quantitative walking assessments.Research questionHow does spatiotemporal walking performance differ during walking in different settings at different speeds for young adults?MethodsForty-two young adults [21 male (23 ± 4 years), 21 female (24 ± 5 years)] walked in two laboratory settings (overground, treadmill) and three non-laboratory settings (hallway, indoor open, outdoor pathway) at three self-selected speeds (slow, preferred, fast) following verbal instructions. Six walking trials of each condition (10 m in laboratory overground, 20 m in other settings) were completed. Participants wore 17 inertial sensors (Xsens Awinda, Movella, Henderson, NV) and spatiotemporal parameters were computed from sensor-derived kinematics. Setting × speed × sex repeated measures analysis of variance were used for statistical analysis.ResultsRegardless of the speed condition, participants walked faster overground when compared to while on the treadmill and walked faster in the indoor open and outdoor pathway settings when compared to the laboratory overground setting. At slow speeds, participants also walked faster in the hallway when compared to the laboratory overground setting. Females had greater cadence when compared to males, independent of settings and speed conditions.SignificanceParticularly at slow speeds, spatiotemporal walking performance was different between the settings, suggesting that setting characteristics such as walkway boundary definition may significantly influence spatiotemporal walking performance.
Leonardo Hernandes de Souza Oliveira, Eduardo Pinto Machado, Alan Camargo Silva
INTRODUÇÃO: A morte súbita caracteriza-se por uma parada cardiorrespiratória repentina que leva o praticante a óbito, em geral, quando alcança níveis altos de esforço físico. Em atletas de todas as idades, inclusive no futebol, nota-se um aumento do número de casos, mesmo diante de um investimento médico-tecnológico em estratégias preventivas. Este ensaio não desconsidera as implicações biológicas da morte súbita, mas visa investigá-la pela ótica das Ciências Humanas e Sociais, mais precisamente pelas perspectivas teórico-metodológicas de Michel Foucault e Nikolas Rose. Assim, objetivou-se analisar como especificamente a morte súbita do jogador de futebol Christian Eriksen pode revelar questões sobre as diferentes racionalidades de saúde e risco presentes nas práticas corporais e esportivas.
DESENVOLVIMENTO: O encaminhamento teórico fundamentou-se nas teorizações (pós-) foucaultianas sobre controle e gestão dos corpos para pensar o viver e o morrer, principalmente nas interconexões entre espetáculo e biopolítica e no controle exercido por dispositivos artificiais e tecnológicos. Esta perspectiva teórica sobre morte súbita pela via biopolítica assume importância significativa para a Educação Física, pois entende-se que a regulação dos corpos em movimento não pode se resumir a lógica da racionalidade biomédica, incorporando outras sensibilidades discursivas sobre práticas de exercícios e saúde.
CONCLUSÃO: Em suma, captou-se como as noções de vida-morte e os mecanismos médico-tecnológicos são regulados e gerenciados em prol de um sujeito de performance que, a todo instante, se torna autocontrolado sob verdades que modulam o biológico no contexto das práticas corporais e esportivas. A potência analítica deste ensaio leva as reflexões para além da mera consideração da “finitude da vida” ao examinar como estruturas de poder, controle e discursos moldam as compreensões da morte e as múltiplas práticas de cuidado em distintos espaços sociais.
Juliane Hannemann, Juliane Hannemann, Julius Freytag
et al.
Introduction: High altitude exposure may lead to high altitude pulmonary hypertension (HAPH) and high altitude pulmonary edema (HAPE). The pathophysiologic processes of both entities have been linked to decreased nitric oxide (NO) availability.Methods: We studied the effect of acute high altitude exposure on the plasma concentrations of asymmetric (ADMA) and symmetric dimethylarginine (SDMA), L-arginine, L-ornithine, and L-citrulline in two independent studies. We further investigated whether these biomarkers involved in NO metabolism were related to HAPH and HAPE, respectively. Fifty (study A) and thirteen (study B) non-acclimatized lowlanders were exposed to 4,559 m for 44 and 67 h, respectively. In contrast to study A, the participants in study B were characterized by a history of at least one episode of HAPE. Arterial blood gases and biomarker concentrations in venous plasma were assessed at low altitude (baseline) and repeatedly at high altitude. HAPE was diagnosed by chest radiography, and HAPH by measuring right ventricular to atrial pressure gradient (RVPG) with transthoracic echocardiography. AMS was evaluated with the Lake Louise Score (LLS) and the AMS-C score.Results: In both studies SDMA concentration significantly increased at high altitude. ADMA baseline concentrations were higher in individuals with HAPE susceptibility (study B) compared to those without (study A). However, upon high altitude exposure ADMA only increased in individuals without HAPE susceptibility, while there was no further increase in those with HAPE susceptibility. We observed an acute and transient decrease of L-ornithine and a more delayed but prolonged reduction of L-citrulline during high altitude exposure. In both studies SDMA positively correlated and L-ornithine negatively correlated with RVPG. ADMA was significantly associated with the occurrence of HAPE (study B). ADMA and SDMA were inversely correlated with alveolar PO2, while L-ornithine was inversely correlated with blood oxygenation and haemoglobin levels, respectively.Discussion: In non-acclimatized individuals ADMA and SDMA, two biomarkers decreasing endothelial NO production, increased after acute exposure to 4,559 m. The observed biomarker changes suggest that both NO synthesis and arginase pathways are involved in the pathophysiology of HAPH and HAPE.
Daniel Dalos, Theresa Dachs, Constantin Gatterer
et al.
<h4>Background</h4>Data on cardiac remodeling in veteran athletes are conflicting but of clinical importance.<h4>Methods</h4>Sixty-nine clinically stable and healthy individuals >50 years were identified (median 55 (IQR 52-64), 26% female). Echocardiographic features were identified in individuals, who have performed endurance sports at 70% of their maximum heart rate for at least 1 hour 3 times/ week over the previous 5 years.<h4>Results</h4>Median training time in all participants was 6 hours per week. Therefore, based on these 6 hours of weekly training, participants were grouped into 45 ambitious endurance-trained amateur athletes (EAA) and 24 recreationally active endurance-trained athletes (RAP) training ≥6 hours (6-10) and <6 hours (3.5-5), respectively. Left ventricular (LV) diameters were slightly larger in EAA than in RAP (27 mm/m2 (25-28) vs. 25 mm/m2 (24-27), p = 0.023) and EAA showed preserved diastolic function (p = 0.028) with lower E/E' ratio (7 (6-9) vs. 9 (7-10), p = 0.039). Interventricular septal thickness and relative wall thickness ratio were similar. Global right ventricular and LV strain were similar, but left atrial (LA) reservoir strain was higher in EAA than in RAP (27% (22-34) vs. 20% (15-29), p = 0.002).<h4>Conclusions</h4>Endurance training in healthy athletes >50 years is not associated with chamber dilatation or LV hypertrophy. A weekly training duration of ≥6 hours seems beneficial to preserve diastolic function associated with an increased LA reservoir function.
Magdalena Choina, Kinga Pożarowska, Gracjan Rudziński
et al.
Introduction: Celiac disease (CD) is an autoimmune disease that affects genetically predisposed individuals. In course of the disease, consumption of gluten causes damage to the small intestine. Due to various clinical manifestations, diagnosing CD poses a challenge to clinicians. It has been proven by several study groups that the diagnostic delay in CD is still too long and provokes severe health complications.
Purpose: The aim of the study is to highlight the importance of diagnostic delay in CD, its consequences and possible solutions.
Description of the state of knowledge: The diagnosis of CD is based on the clinical picture, serological test, duodenal mucosal biopsies and genetic tests. Many cases of CD remain undiagnosed in spite of published guidelines for CD diagnosis. Consequently, the diagnosis is significantly delayed: the mean duration of the diagnostic process in Poland was 7.3 years. In other countries, patients the time from the onset of the symptoms to establishing CD diagnosis was up to 10 years. The diagnostic delay leads to reduced quality of life and the development of severe complications, such as neoplastic disease.
Summary: Diagnostic delay in CD is an issue of great importance. Because of the reduced quality of life and the possibility of neoplasm, it is crucial to take action in order to shorten the diagnostic process of CD.
Aristides I. Cruz, Jr., MD, MBA, Jennifer J. Beck, MD, Matthew D. Ellington, MD
et al.
Background:. Graft choice for pediatric anterior cruciate ligament reconstruction (ACLR) is determined by several factors. There is limited information on the use and outcomes of allograft ACLR in pediatric patients. The purpose of this systematic review and meta-analysis was to quantify reported failure rates of allograft versus autograft ACLR in patients ≤19 years of age with ≥2 years of follow-up. We hypothesized that there would be higher rates of failure for allograft compared with autograft ACLR in this population.
Methods:. PubMed/MEDLINE and Embase databases were systematically searched for literature regarding allograft and autograft ACLR in pediatric/adolescent patients. Articles were included if they described a cohort of patients with average age of ≤19 years, had a minimum of 2 years of follow-up, described graft failure as an outcome, and had a Level of Evidence grade of I to III. Qualitative review and quantitative meta-analysis were performed to compare graft failure rates. A random-effects model was created to compare failure events in patients receiving allograft versus autograft in a pairwise fashion. Data analysis was completed using RevMan 5.3 software (The Cochrane Collaboration).
Results:. The database search identified 1,604 studies; 203 full-text articles were assessed for eligibility. Fourteen studies met the inclusion criteria for qualitative review; 5 studies were included for quantitative meta-analysis. Bone-patellar tendon-bone (BTB) represented 58.2% (n = 1,012) of the autografts, and hamstring grafts represented 41.8% (n = 727). Hybrid allografts (autograft + supplemental allograft) represented 12.8% (n = 18) of all allograft ACLRs (n = 141). The unweighted, pooled failure rate for each graft type was 8.5% for BTB, 16.6% for hamstring, and 25.5% for allograft. Allografts were significantly more likely than autografts to result in graft failure (odds ratio, 3.87; 95% confidence interval, 2.24 to 6.69).
Conclusions:. Allograft ACLR in pediatric and adolescent patients should be used judiciously, as existing studies revealed a significantly higher failure rate for allograft compared with autograft ACLR in this patient population. Additional studies are needed to improve the understanding of variables associated with the high ACLR failure rate among pediatric and adolescent patients.
Level of Evidence:. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
This study questions the repercussions of the development of an initial vocational training system for student civil servant trainees in Physical and Sports Education on their ability to use the situated normative experiences lived as dancers in a university center during their teaching activity dance in schools. Finding its theoretical justifications within a research program conducted in cultural anthropology, this study allows more precisely to support the hypothesis of an “experiential substratification” between the experiences lived by the students over the different training and job. By way of discussion, the training circumstances at the origin of this experiential substratification are discussed. Avenues for renewing student training methods are being considered (i) learning ENS as dancers, (ii) learning ENS as a future teacher integrating aspects of ENS practice in dance and (iii) teach these ENS carriers of substratification in a modified work situation.