Notes

[Performance of the MEDUC-PG14 device to judge instructing functionality in healthcare residence programs].
Dietary fat is discussed to be critical in the development of non-alcoholic fatty liver disease. Here, we assess the effect of exchanging dietary fat source from butterfat to extra virgin olive oil on the progression of an already existing diet-induced non-alcoholic fatty liver disease in mice. Female C57BL/6J mice were fed a liquid butterfat-, fructose- and cholesterol-rich diet (BFC, 25E% from butterfat) or control diet (C, 12%E from soybean oil) for 13 weeks. In week 9, fat sources of some BFC- and C-fed mice were switched either to 25E% or 12E% olive oil (OFC and CO). Glucose and insulin tolerance tests were performed, and markers of liver damage and glucose metabolism were assessed. After 6 weeks of feeding, BFC-fed mice had developed marked signs of insulin resistance, which progressed to week 12 being not affected by the exchange of fat sources. Liver damage was similar between BFC- and OFC-fed mice. Markers of lipid metabolism and lipid peroxidation in liver and of insulin signaling in liver and muscle were also similarly altered in BFC- and OFC-fed mice. Taken together, our data suggest that exchanging butterfat with extra virgin olive oil has no effect on the progression of non-alcoholic fatty liver disease and glucose tolerance in mice.
Olympic weightlifting requires technical skills, explosive power, strength, and coordination. Weightlifters can be competitive within a range of morphological characteristics due to competition body weight classes. To date no studies have examined when sex differences arise in weightlifting and the impact of body mass on performances at different ages.

To examine when sex-related differences emerge, to quantify the influence of body mass on performances at different ages, and to estimate the age at peak performance.

Competitions results from USA Weightlifting National Championships, Youth, Junior, and Senior from 2014 to 2019 were collected for weightlifters aged 6 to 30.

At age 10 the median total weight lifted was 51kg and 54kg, respectively, for girls and boys. From age 10 to 12 a gender gap emerges with a sex difference of 11.7% at age 14 at 55kg body mass. At age 25 the sex-related performance difference is smaller for lighter athletes (23.6% at 69kg body mass) and larger for heavier athletes (29ght at younger ages has less impact on performance compared to older ages, and boys and girls perform similarly. When reaching the ages typically associated with the onset of puberty, boys' performances rapidly increase and the gap between genders widens. Women achieve peak performance at a similar age than men. Such results may help to establish progression trajectories for talented athletes and inform coaches, athletes and national governing bodies.[This corrects the article DOI 10.1371/journal.pone.0235784.].
Early sexual activity, often defined as initiation before the age of 16, is a risk behaviour associated with negative health outcomes in adulthood. The objective of this study was to explore links between early sexual activity and individual and contextual characteristics in Canadian youth, and whether these differ for girls and boys.

Data were from the 2018 Canadian Health Behaviour in School-aged Children (HBSC) survey administered in classrooms across Canada to students in grades 6 to 10 (ages 11 to 16). The sample includes the 7882 students in grades 9 and 10 who were asked about sexual activity. Individual and contextual measures used included emotional well-being, socioeconomic status, participation in team sports, body image, social media use, family structure, and family support. Descriptive data overall and separately for girls and boys are presented, followed by Poisson regression models to estimate relative risks and associated 95% confidence intervals for strength of associations between charaefit to subsequent researchers, policy makers and those who care for youth.The dose of progressive active mobilization is still uncertain. The purpose of this study is to identify if the addition of a protocol of progressive active mobilization with dose and training load control to usual care is effective in reducing the length of stay in intensive care unit (ICU) and the improvement of the functioning, incidence of ICU-acquired weakness (ICUAW), mechanical ventilation duration and mortality rate in patients hospitalized in ICU. It is Double-blind randomised clinical trial. The setting for this trial will be medical and surgical ICU of a university hospital. The study participants will be 118 patients aged> 18 years admitted to ICU for less than 72 hours. Participants will be randomized to either an experimental or control group. The experimental group will undertake addition of a protocol of progressive active mobilization with dose and training load control to usual care, while the control group will undertake only usual care. The primary outcome will be length of ICU stay. The secondary outcomes will be Cross-sectional area and muscle thickness of the rectus femoris and biceps brachii, Change in muscle strength from the baseline, Functional Status, incidence of ICUAW, Days with mechanical ventilation and Mortality. All statistical analyses will be conducted following intention-to-treat principles. It has a detailed description of the dose of exercise, was designed with the strictest methodological criteria. These characteristics allow to investigate with greater certainty the results progressive active mobilization in critical patients, allowing replication and future combinations in meta-analyzes.
Mutations in STK11 (STK11m) and frequently co-occurring KRAS mutations (KRASm/STK11m) are associated with poor survival in metastatic NSCLC (mNSCLC) immuno-oncology trials. There are limited data regarding the prognostic significance of these mutations in a real-world setting.

This retrospective cohort study analyzed de-identified electronic medical records from the Flatiron Clinico-Genomic database to identify patients with mNSCLC who had initiated first-line immunotherapy (IO; alone or in combination) or chemotherapy under routine care between January 1, 2013 and June 30, 2017. The primary objectives were to assess the prevalence of STK11m and KRASm/STK11m and to determine associations of these mutations with overall and progression-free survival (OS, PFS).

Of 2407 patients with mNSCLC, STK11m and KRASm/STK11m were present in 13.6% and 6.5% of patients, respectively. Worse OS outcomes were observed in patients with STK11m versus STK11wt mNSCLC receiving IO (first-line, HR [95% CI], 1.4 [0.9-2.3; p = 0 population that would benefit from new treatment options.In a clinical decision support system, the purpose of case-based reasoning is to help clinicians make convenient decisions for diagnoses or interventional gestures. Past experience, which is represented by a case-base of previous patients, is exploited to solve similar current problems using four steps-retrieve, reuse, revise, and retain. The proposed case-based reasoning has been focused on transcatheter aortic valve implantation to respond to clinical issues pertaining vascular access and prosthesis choices. The computation of a relevant similarity measure is an essential processing step employed to obtain a set of retrieved cases from a case-base. A hierarchical similarity measure that is based on a clinical decision tree is proposed to better integrate the clinical knowledge, especially in terms of case representation, case selection and attributes weighting. A case-base of 138 patients is used to evaluate the case-based reasoning performance, and retrieve- and reuse-based criteria have been considered. The sensitivity for the vascular access and the prosthesis choice is found to 0.88 and 0.94, respectively, with the use of the hierarchical similarity measure as opposed to 0.53 and 0.79 for the standard similarity measure. Ninety percent of the suggested solutions are correctly classified for the proposed metric when four cases are retrieved. Using a dedicated similarity measure, with relevant and weighted attributes selected through a clinical decision tree, the set of retrieved cases, and consequently, the decision suggested by the case-based reasoning are substantially improved over state-of-the-art similarity measures.The carbonate system in two contrasting fjords, Rivers Inlet and Bute Inlet, on the coast of British Columbia, Canada, was evaluated to characterize the mechanisms driving carbonate chemistry dynamics and assess the impact of anthropogenic carbon. Differences in the character of deep water exchange between these fjords were inferred from their degree of exposure to continental shelf water and their salinity relationships with total alkalinity and total dissolved inorganic carbon, which determined seawater buffering capacity. Seawater buffering capacity differed between fjords and resulted in distinct carbonate system characteristics with implications on calcium carbonate saturation states and sensitivity to increasing anthropogenic carbon inputs. Saturation states of both aragonite and calcite mineral phases of calcium carbonate were seasonally at or below saturation throughout the entire water column in Bute Inlet, while only aragonite was seasonally under-saturated in portions of the water column in Rivers Inlet. Phospho(enol)pyruvic acid monopotassium supplier The mean annual saturation states of aragonite in Rivers Inlet and calcite in Bute Inlet deep water layers have declined to below saturation within the last several decades due to anthropogenic carbon accumulation, and similar declines to undersaturation are projected in their surface layers as anthropogenic carbon continues to accumulate. This study demonstrates that the degree of fjord water exposure to open shelf water influences the uptake and sensitivity to anthropogenic carbon through processes affecting seawater buffering capacity, and that reduced uptake but greater sensitivity occurs where distance to ocean source waters and freshwater dilution are greater.Organizational effectiveness is contingent upon employees' contributions; however, the role of employee voice behavior as a critical component of employees' contribution to the organization has not been sufficiently acknowledged. Based on proactive behavior theory, we present a model to investigate employee voice behavior as an underlying mechanism in the relationship between supervisor delegation and perceived workplace inclusion. Using the SEM (structural equation modeling) method, we test our model's hypotheses with data from 271 employee-supervisor questionnaires administered in state-owned enterprises in the telecommunications industry. The results show that supervisor delegation is positively related to employees' promotive and prohibitive voice behavior. Promotive voice significantly influences perceived workplace inclusion, but prohibitive voice behavior was not found to have any impact on perceived workplace inclusion. Moreover, both dimensions of voice behavior, i.e., promotive and prohibitive voice behavior, significantly mediate the relationship between supervisor delegation and perceived workplace inclusion.
Less than 10 percent of the more than one million people vulnerable to HIV are using pre-exposure prophylaxis (PrEP). Practitioners are critical to ensuring the delivery of PrEP across care settings. In this study, we target a group of prescribers focused on providing HIV care and seeking up-to-date information about HIV. We assessed their experiences prescribing PrEP, whether these experiences differed by clinical specialty, and examined associations between willingness to prescribe PrEP as a "best first step" and different hypothetical prescribing scenarios.

Between March and May 2015, we circulated a paper survey to 954 participants ((652 of whom met our inclusion criteria of being independent prescribers and 519 of those (80%) responded to the survey)) at continuing medical education advanced-level HIV courses in five locations across the US on practitioner practices and preferences of PrEP. We employed multivariable logistic regression analysis for binary and collapsed ordinal outcomes.

Among this highly motivated group of practitioners, only 54% reported ever prescribing PrEP.
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