Disentangling Gender and Relative Age Effects in Women's and Girls' Rugby Union.

Relative age effects (RAEs) within sports refer to the overrepresentation of athletes born earlier in the selection year and the underrepresentation of those born later in the selection year. Research examining RAEs in women's and girls' rugby union remains limited in comparison to the male literature, whilst the impacts of RAEs on the youth-senior transition are yet to be explored in a female sport context. As such, the purpose of this study was to examine RAEs during entry into the women's and girls' premiership and international rugby union pathways in England, as well as to compare them to their respective senior cohort (n = 1367): (a) U18 England Rugby Centre of Excellence Player (n = 325) vs. Senior Premiership Player (n = 868), and (b) U18 England Player (n = 49) vs. Senior England Player (n = 125). Chi-square (χ2) analyses compared birth quarter (BQ) distributions against expected distributions. The findings revealed no significant difference in BQ distributions at either youth or senior levels, as well as no significant differences in the BQ distributions of those who were likely to transition from youth to senior levels (all p > 0.05). Importantly, though, descriptive statistics showed a skewed birthdate distribution in both U18 England Rugby Centre of Excellence Player (BQ1 = 30% vs. BQ4 = 20%) and U18 England Player cohorts (BQ1 = 33% vs. BQ4 = 18%). We highlight the gender-specific mechanisms that potentially explain the variations between male and female RAEs in rugby union, including developmental differences, sport popularity, and sociocultural norms. We also warn against a 'copy and paste' template from the male provision to ensure the recent growth of female rugby union does not fall victim to the same RAEs in the future.

Menstrual cycle alterations in reproductive age women after anti COVID-19 vaccination. A survey in 419 Italian women and quality of life and sexual function evaluation.

BACKGROUND: Pharmacovigilance agencies did not collect data regarding menstrual changes after COVID-19 vaccination even if many women experienced it. Our aim was to evaluate whether COVID-19 vaccination is associated with secondary changes in menstrual cycle and to assess both quality of life (QoL) and sexual function (SF). METHODS: This study is a retrospective analysis referred to our Department from January 2021 to December 2021. The study cohort responded to same questionnaires before the second dose of vaccination (referring to previous 3 months) and 3 months after that (referring to three menstrual cycles after full-dose vaccination). The surveys administered were FSFI, FSDS, SF-36, MEDI-Q and the VAS-scale for dysmenorrhea. RESULTS: Four-hundred-nineteen vaccinated women were included in the study. The survey did not show a significant change in menstrual cycle length before and after COVID-19 vaccine (5.88±3.67 vs. 4.97±2.89, P=0.21); the interval between periods was significantly higher after a full-cycle vaccination (28.32±7.34 vs. 32.38±7.45, P<0.02); 32 patients (7.6%) developed amenorrhea after the second dose; VAS Scale did not change significantly (median range 3 (3-5) vs. 4 (3-6), P=0.20). MEDI-Q did not show significant variations before and after the vaccination (43.21±11.65 vs. 40.28±9.88, P=0.35). QoL and SF did not change significantly (FSFI median 27 [24-29] vs. 28 [25-30], P=0.12, FSDS median 9 [5-11] vs. 8 [4-12], P=0.22), SF-36 median 81 [70-85] vs. 82 [72-86], P=0.43). CONCLUSIONS: COVID-19 vaccination is associated with a significant change in intervals between menstrual cycles without other alterations in menstrual characteristics, in QoL or SF.

Evaluation of the newborn hearing screening program in the University of Santo Tomas Hospital based on the joint committee on infant hearing 2019 position statement on quality indicators for screening and confirmation of hearing loss

Objective@#To evaluate the newborn hearing screening program in the University of Santo Tomas Hospital based on the quality indicators set by the Joint Committee on Infant Hearing (JCIH) 2019 position statement.@*Methods@#Design: Cross-sectional study Setting: Tertiary Private Training Hospital Participants: All newborns delivered in 2019 at the University of Santo Tomas (UST) Hospital were considered for inclusion@*Results@#The UST Hospital had 778 newborns in 2019, of which 687 (88.3%) completed newborn hearing screening by 1 month of age. There were 81 (10.4%) who failed initial hospitalbased screening and required outpatient re-screening while 11 (1.4%) of those who failed initial screening also failed subsequent rescreening. Forty-five (5.7%) newborns failed initial screening and subsequently passed re-screening. None of the eleven (0/11) patients completed comprehensive audiologic evaluation thus, patients necessitating referral for intervention were not identified. There were a total of 67 (8.6%) dropouts throughout the hearing evaluation process. Fifteen (15) infants were not screened due to unavailability of trained personnel at time of referral, four (4) infants were advised third screening while two (2) were advised observation instead of proceeding to confirmatory test.@*Conclusion@#The University of Santo Tomas Hospital newborn hearing screening program has yet to reach the quality indicators set by the Joint Committee on Infant Hearing 2019 for screening and confirmation of hearing loss. Among identified areas for improvement are the availability of trained personnel, insufficient means to ensure compliance, reluctance to pursue further testing and practices among healthcare providers.

Adult Glottic Hemangioma: A case report

@#Glottic hemangioma is a benign vascular tumor that is rarely seen in the adult population. We report a rare Filipino case of glottic hemangioma in a 65-year-old female presenting with 2 weeks history of hoarseness and a smooth, pedunculated, bluish mass at the anterior one-third of the right vocal cord in flexible laryngoscopy. Direct suspension laryngoscopy showed a pedunculated mass that was paler-looking, similar to the color of the surrounding mucosa, exhibiting the Phonation sign of Menzel. The patient underwent microlaryngeal excision and histopathology showed findings consistent with cavernous hemangioma.

Post mortem computed tomography as a complementary tool for diagnosing cholangiohepatitis in a giant panda (Ailuropoda melanoleuca).

A geriatric female giant panda developed grave signs of illness and was diagnosed with suspected hepatobiliary tract obstruction or other severe hepatic disease such as advanced cholangiohepatitis. The giant panda was euthanized and post mortem computed tomography was performed prior to necropsy. Common bile duct obstruction at the major duodenal papilla by a mineral attenuating calculus causing dilatation of common bile and gallbladder with concurrent multiple areas of liver abscess were detected by postmortem computed tomography. These were confirmed with gross necropsy. This is the first case report of common bile duct obstruction by mineral calculus with concurrent severe cholangiohepatitis in a giant panda.

Oncological Care During First Peruvian National Emergency COVID-19 Pandemic: A Multicentric Descriptive Study.

Purpose: The aim of this study is to evaluate the oncological care during the first state of national emergency due to the COVID-19 pandemic in several public cancer hospitals in Peru. Materials and Methods: A multicentric cross-sectional descriptive study was conducted by interviewing adult cancer patients diagnosed and treated between January 2019 and February 2020 from 18 hospitals. This study was carried out in September 2020, the last month of the first state of national emergency. Demographic and clinical characteristics were evaluated, including COVID-19 status and cancer treatment features. Results: A total of 1472 patients were included; the median age was 55 years (range 19-97). Most patients (85.8%, n = 1263) had solid neoplasia, 13.5% (n = 198) hematologic neoplasia, and 0.7% (n = 11) others. SARS-CoV-2 infection was confirmed in 8.6% (n = 126), 1.2% (n = 18) were probable, 1.6% (n = 24) suspected, and 88.6% (n = 1304) negative cases. Overall, 51.6% of patients (n = 759) had cancer treatment delays, 42.5% (n = 626) changed treatment delivery (endovenous to oral systemic therapy), and 12.6% (n = 185) of cases cancer therapy was discontinued. In total, 10.3% (n = 117) of patients whose disease was controlled or in remission, experienced progression of disease during the state of emergency. A total of 6.7% (n = 98) of patients died, of whom 73.5% (n = 72) died from disease progression; 18.4% (n = 18) from SARS-CoV-2 infection and 8.1% (n = 8) from undetermined causes. Patients with hematological malignancies [hazard ratio (HR): 5.11 (95% confidence interval (CI): 1.99-13.07)] and no response to therapy before the onset of the pandemic [5.01 (1.44-17.42)] had an increased risk of death among COVID-19 infected individuals, whereas advanced clinical stage [5.09 (2.37-10.95)] and discontinuation of treatment [3.66 (1.97-6.78)] were risk factors among non-COVID-19 patients. Conclusion: Our study suggests that the COVID-19 pandemic has an adverse impact on the outcomes of Peruvian cancer patients. In our cohort, cancer mortality was higher than COVID-19 disease mortality.

Severe Tricuspid Valve Endocarditis: A Tale of 2 Circuits.

A 25-year-old woman with severe tricuspid valve endocarditis and septic pulmonary emboli required VA-ECMO for recurrent hypoxemia-induced cardiac arrest. We present the clinical challenges requiring ECMO circuit reconfiguration and a percutaneous approach for vegetation debulking. (Level of Difficulty: Intermediate.).

Geographic disparities in transplantation.

PURPOSE OF REVIEW: The Final Rule clearly states that geography should not be a determinant of a chance of a potential candidate being transplanted. There have been multiple concerns about geographic disparities in patients in need of solid organ transplantation. Allocation policy adjustments have been designed to address these concerns, but there is little evidence that the disparities have been solved. The purpose of this review is to describe the main drivers of geographic disparities in solid organ transplantation and how allocation policy changes and other potential actions could impact these inequalities. RECENT FINDINGS: Geographical disparities have been reported in kidney, pancreas, liver, and lung transplantation. Organ Procurement and Transplant Network has modified organ allocation rules to underplay geography as a key determinant of a candidates' chance of receiving an organ. Thus, heart, lung, and more recently liver and Kidney Allocation Systems have incorporated broader organ sharing to reduce geographical disparities. Whether these policy adjustments will indeed eliminate geographical disparities are still unclear. SUMMARY: Modern allocation policy focus in patients need, regardless of geography. Innovative actions to further reduce geographical disparities are needed.

Self-adaptive and efficient propulsion of Ray sperms at different viscosities enabled by heterogeneous dual helixes.

We disclose a peculiar rotational propulsion mechanism of Ray sperms enabled by its unusual heterogeneous dual helixes with a rigid spiral head and a soft tail, named Heterogeneous Dual Helixes (HDH) model for short. Different from the conventional beating propulsion of sperm, the propulsion of Ray sperms is from both the rotational motion of the soft helical tail and the rigid spiral head. Such heterogeneous dual helical propulsion style provides the Ray sperm with high adaptability in viscous solutions along with advantages in linearity, straightness, and bidirectional motion. This HDH model is further corroborated by a miniature swimming robot actuated via a rigid spiral head and a soft tail, which demonstrates similar superiorities over conventional ones in terms of adaptability and efficiency under the same power input. Such findings expand our knowledge on microorganisms' motion, motivate further studies on natural fertilization, and inspire engineering designs.

Survival implications of prescription opioid and benzodiazepine use in lung transplant recipients: Analysis of linked transplant registry and pharmacy fill records.

BACKGROUND: Prescription opioid and benzodiazepine use have been associated with morbidity and mortality among some groups of solid organ transplant recipients, but implications for outcomes among lung transplant patients are not well described. METHODS: We conducted a retrospective cohort study using linked national transplant registry and pharmaceutical records to characterize the associations between benzodiazepine and opioid prescription fills in the years before and after lung transplant (2006-2017), with risk-adjusted posttransplant survival (adjusted hazard ratio, LCLaHRUCL). RESULTS: Among 11,568 recipients, 33.7% filled an opioid prescription, and 25.8% filled a benzodiazepine prescription before transplant. Compared to patients without prescriptions, those who filled both short- and long-acting benzodiazepine prescriptions before transplant had 2-fold higher mortality in the first year posttransplant (aHR, 1.392.123.21), after adjustment for baseline factors and opioid fills, while pretransplant opioid fills were not associated with posttransplant mortality after adjustment for benzodiazepine fills. Pretransplant opioid and benzodiazepine use strongly predicted more use after transplant. Fills of both short- and long-acting benzodiazepines in the first year posttransplant were associated with 77% increased mortality >1-to-2 years posttransplant (aHR, 1.061.772.96). Compared with no posttransplant opioid fills, there was a dose-dependent association between first-year opioid fills and subsequent adjusted mortality risk (level 2: aHR, 1.171.501.92 to level 4: aHR, 1.562.012.59). These effects were independent, and interactions were not detected. CONCLUSIONS: Benzodiazepine prescription fills before and after lung transplant, and opioid fills after transplant, are independently associated with posttransplant mortality. Review of benzodiazepine and opioid use history is relevant to risk-stratifying patients before and after lung transplant.

An International survey on living kidney donation and transplant practices during the COVID-19 pandemic.

The scope of the impact of the Coronavirus disease 19 (COVID-19) pandemic on living donor kidney transplantation (LDKT) practices across the world is not well-defined. We received survey responses from 204 transplant centers internationally from May to June 2020 regarding the impact of the COVID-19 pandemic on LDKT practices. Respondents represented 16 countries on five continents. Overall, 75% of responding centers reported that LDKT surgery was on hold (from 67% of North American centers to 91% of European centers). The majority (59%) of centers reported that new donor evaluations were stopped (from 46% of North American centers to 86% of European centers), with additional 23% of centers reporting important decrease in evaluations. Only 10% of centers reported slight variations on their evaluations. For the centers that continued donor evaluations, 40% performed in-person visits, 68% by video, and 42% by telephone. Center concerns for donor (82%) and recipient (76%) safety were the leading barriers to LDKT during the pandemic, followed by patients concerns (48%), and government restrictions (46%). European centers reported more barriers related to staff limitations while North and Latin American centers were more concerned with testing capacity and insufficient resources including protective equipment. As LDKT resumes, 96% of the programs intend to screen donor and recipient pairs for coronavirus infection, most of them with polymerase chain reaction testing of nasopharyngeal swab samples. The COVID-19 pandemic has had broad impact on all aspects of LDKT practice. Ongoing research and consensus-building are needed to guide safe reopening of LDKT programs.

Gender differences in instep soccer kicking biomechanics, investigated through a 3D human motion tracker system.

BACKGROUND: This study aims at describing and comparing each other male and female soccer players kicking instep a stationary ball. The different measures we collected by the 3D motion capture system Movit G1 and the High-Speed Camera (240 fps) were considered as dependent variables, whereas the gender was considered as the independent one. METHODS: Twenty soccer well trained non-professional players: 10 men (age: 25.3±6.5 yrs; height 1.80±0.07 m; body mass 76.9±13.2 kg) and 10 women (age: 19±3.34 yrs; height 1.64±0.07 m; body mass 58.2±7.2 kg) volunteered to participate in the study. RESULTS: Gender differences were found, with a statistical significance (P<0.05) or interesting magnitude (Cohen d>0.5). The most relevant ones were the differences in hip extension of the kicking leg when the foot of the supporting one touches the ground, just before the impact on the ball (independent sample t-Test; P=0.03; Cohen d=1.64) and the speed of the ball, reached immediately after kicking (P<0.001;d=1.23). CONCLUSIONS: These results, together with the greater pelvic acceleration shown by men compared to women, highlight the need to develop a gender-differentiated training model, in order to customize the kicking technique in women and to reduce the likelihood, currently higher than for men, of kicking related injuries.

Novel SCN5A Frameshift Mutation in Brugada Syndrome Associated With Complex Arrhythmic Phenotype.

In this case report, we characterize a novel inherited frameshift mutation c.4700_4701del (p.Phe1567Cysfs*221) in a single copy of the SCN5A gene and its association with Brugada syndrome (BrS). The proband experienced a life-threatening ventricular arrhythmia successfully treated with DC-shock and he also suffered from supraventricular tachycardia. Ajmaline test confirmed the BrS diagnosis. No other mutation nor low frequency variants in the other 23 analyzed genes were detected. The same mutation was found in the father and sister, who were both diagnosed with BrS. We hypothesize that this mutation could be responsible for BrS and potentially linked to supraventricular tachycardias. Further studies are needed to confirm this observation and to assess the clinical relevance of this mutation, in terms of risk-stratification.

Recovery of the Cholangiocytes After Ischemia and Reperfusion Injury: Ultra-Structural, Hystological and Molecular Assessment in Rats.

INTRODUCTION: Ischemia-reperfusion (I/R) injury of the liver is a common area of interest to transplant and hepatic surgery. Nevertheless, most of the current knowledge of I/R of the liver derives from the hepatocyte and little is known of what happens to the cholangiocytes. Herein, we assess the sequence of early events involved in the I/R injury of the cholangiocytes. METHODS: Sixty Wistar rats were randomized in a SHAM group and I/R group. Serum biochemistry, histopathology, immunohistochemistry, transmission electron microscopy (TEM) and laser capture microdissection (LCM) were used for group comparison. RESULTS: There was peak of alkaline phosphatase 24 h after IR injury, and an increase of aspartate aminotransferase and alanine aminotransferase after 6 h of reperfusion, followed by a return to normal levels 24 h after injury. The I/R group presented the liver parenchyma with hepatocellular degeneration up to 6 h, followed by hepatocellular necrosis at 24 h. TEM showed cholangiocyte injury, including a progressive nuclear degeneration and cell membrane rupture, beginning at 6 h and peaking at 24 h after reperfusion. Cytokeratin-18 and caspase-3-positive areas were observed in the I/R group, peaking at 24-h reperfusion. Anti-apoptotic genes Bcl-2 and Bcl-xl activity were expressed from 6 through 24 h after reperfusion. BAX expression showed an increase for 24 h. CONCLUSIONS: I/R injury to the cholangiocyte occurs from 6 through 24 h after reperfusion and a combination of TEM, immunohistochemistry and LCM allows a better isolation of the cholangiocyte and a proper investigation of the events related to the I/R injury. Apoptosis is certainly involved in the I/R process, particularly mediated by BAX.

SUCCESSFUL TREATMENT OF GENERALIZED DEMODICOSIS IN RED-HANDED TAMARINS ( SAGUINUS MIDAS) USING A SINGLE ADMINISTRATION OF ORAL FLURALANER.

Two adult sibling red-handed tamarins ( Saguinus midas) presented with weight loss and multifocal skin masses. A skin biopsy revealed pyogranulomatous dermatitis with intrafollicular Demodex sp. mites. Subsequent skin scrapes confirmed the presence of live mites within lesions. Initial treatment with topical and oral ivermectin was unsuccessful, and lesions continued to progress. A single dose of fluralaner (Bravecto®, Merck Animal Health, Kenilworth, New Jersey, 07033, USA; 28.125 mg po) was administered to each animal approximately 5 mo after initial presentation. Lesions resolved over the next 3 mo, and all follow-up skin scrapes were negative for both animals. No adverse effects were noted. A single oral administration of fluralaner at 30-35 mg/kg appears adequate and safe for the treatment of generalized demodicosis in red-handed tamarins.

Fear of falling and activities of daily living function: mediation effect of dual-task ability.

OBJECTIVE: The aim of the study was to explore the association between fear of falling (FOF), dual-task ability during a mobility task, and the activities of daily living (ADL) in a sample of older adults. METHODS: Seventy-six older adults (mean age M = 70.87 ± 5.16 years) participated in the study. Data on FOF (using the Falls Self-Efficacy Scale-International), walking ability during both single- and dual-task performances and ADL were collected. RESULTS: Mediation analysis demonstrated the mediation effect of dual-task ability (ß = 0.238, p = 0.011) between FOF and ADL level (ß = 0.559, p < 0.001). Moreover, significantly lower performances were observed during dual-task condition [F (2, 73) = 7.386, p < 0.001], and lower ADL levels were also found in older adults with FOF [F (2, 73) = 13.734, p < 0.001]. CONCLUSION: The study underlines the relationship between FOF, dual-task ability and ADL level. These results could be used to develop specific intervention programmes for successful ageing.

The Desire of Parenthood: Intuitive Co-parental Behaviors and Quality of Couple Relationship among Italian and Belgian Same-Sex and Opposite-Sex Couples.

Studies that focused on family issues have allowed a great understanding of the aspects related to its subsystems, such as parenting desire and its expectations, couples' satisfaction and quality of child's outcomes. All these aspects are greatly interconnected and contribute to the creation of specific family dynamics, such as the quality of family interactions. The present study focuses on intuitive co-parental behaviors and the quality of couple relationship observed during the decision process (intention and desire) to be (or become) parents. Our first goal was to explore these aspects in a cross-national sample made of Italian and Belgian heterosexual, lesbian and gay couples. We then aimed to evaluate if the degree of internalized homophobia affects co-parental alliance. The quality of couple relationship and co-parental behaviors have been evaluated through the recruitment of a group of 115 stable heterosexual, gay and lesbian couples (230 individuals, 20-50 years of age) without children, who wanted to become parents. We used the Prenatal Lausanne Trilogue Play to evaluate the Co-parental Alliance; the couple's satisfaction was assessed with the Dyadic Adjustment Scale and the Internalized Homophobia with the MISS-LG. In line with the existent literature, the analysis did not find any difference between lesbian, gay and heterosexual couples in terms of co-parental alliance. High levels of couple adjustment lead to better parental performances among both Italian and Belgian couples. The results suggest also that sexual stigma differs from one country to another, and it has an impact on the capability of managing co-parenting. Clinical implications should be verified in further longitudinal studies in order to observe the impact on the inter-generational transmission of psychopathology.

Impact of continuous training through distributed practice for acquisition of minimally invasive surgical skills.

BACKGROUND: Minimally invasive surgery (MIS) requires the mastery of manual skills and a specific training is required. Apart from residencies and fellowships in MIS, other learning opportunities utilize massive training, mainly with use of simulators in short courses. A long-term postgraduate course represents an opportunity to learn through training using distributed practice. OBJECTIVE: The objective of this study is to assess the use of distributed practice for acquisition of basic minimally invasive skills in surgeons who participated in a long-term MIS postgraduate course. METHODS: A prospective, longitudinal and quantitative study was conducted among surgeons who attended a 1-year postgraduate course of MIS in Brazil, from 2012 to 2014. They were tested through five different exercises in box trainers (peg-transfer, passing, cutting, intracorporeal knot, and suture) in the first (t0), fourth (t1) and last, eighth, (t2) meetings of this course. The time and penalties of each exercise were collected for each participant. Participant skills were assessed based on time and accuracy on a previously tested score. RESULTS: Fifty-seven surgeons (participants) from three consecutive groups participated in this study. There was a significant improvement in scores in all exercises. The average increase in scores between t0 and t2 was 88% for peg-transfer, 174% for passing, 149% for cutting, 130% for intracorporeal knot, and 120% for suture (p < 0.001 for all exercises). CONCLUSION: Learning through distributed practice is effective and should be integrated into a MIS postgraduate course curriculum for acquisition of core skills.