Adapting to compromised routines: Parental perspectives on physical activity and health for children and adolescents with type 1 diabetes in the UK during COVID-19 lockdown

\ua9 2024 The Author(s)Purpose: To determine how COVID-19 lockdown impacted physical activity (PA) levels, wellbeing, and diabetes management in children (aged 0–17 years) with type 1 diabetes (T1D), from the perspectives of their parent/guardian. Design and methods: This qualitative descriptive study is part of a larger, parallel mixed-methods design study, which incorporated a cross-sectional survey and semi-structured one-to-one interviews. Interviewees were recruited from the survey, which was distributed to parents of children/adolescents with T1D in the UK. Interviews explored diabetes management, mental and physical wellbeing, changes in PA levels, sleep quality before/during lockdown, and the effects of lockdown on the individual and their family. The interviews were transcribed and the data were analysed thematically. Results: 14 interviews were conducted with parents. Thematic analysis generated a central theme of routine disruption, with four further themes on diabetes management routines, harnessing the opportunities of lockdown, weighing up risk, and variable impact on wellbeing. Conclusions: Maintaining or increasing PA during COVID-19 lockdown was associated with better diabetes management, sleep, and wellbeing for children/adolescents with T1D, despite significant disruption to established routines. Use of technology during the pandemic contributed positively to wellbeing. Practice implications: It is crucial to emphasize the significance of maintaining a well-structured routine when treating patients with type 1 diabetes. A consistent routine, incorporating regular physical exercise and good sleep hygiene, will help with managing overall diabetes control

Serum Müllerian inhibiting substance levels are lower in premenopausal women with breast precancer and cancer

<p>Abstract</p> <p>Background</p> <p>In preclinical studies, müllerian inhibiting substance (MIS) has a protective affect against breast cancer. Our objective was to determine whether serum MIS concentrations were associated with cancerous or precancerous lesions. Blood from 30 premenopausal women was collected and serum extracted prior to their undergoing breast biopsy to assess a suspicious lesion found on imaging or physical examination. Based on biopsy results, the serum specimens were grouped as cancer (invasive or ductal carcinoma <it>in situ</it>), precancer (atypical hyperplasia or lobular carcinoma <it>in situ</it>), or benign.</p> <p>Findings</p> <p>Serum from women with cancer and precancer (p = .0009) had lower MIS levels than serum from women with benign disease.</p> <p>Conclusion</p> <p>Our findings provide preliminary evidence for MIS being associated with current breast cancer risk, which should be validated in a larger population.</p

The effect of high dose antibiotic impregnated cement on rate of surgical site infection after hip hemiarthroplasty for fractured neck of femur : a protocol for a double-blind quasi randomised controlled trial

Background: Mortality following hip hemiarthroplasty is in the range of 10-40% in the first year, with much attributed to post-operative complications. One such complication is surgical site infection (SSI), which at the start of this trial affected 4.68% of patients in the UK having this operation. Compared to SSI rates of elective hip surgery, at less than 1%, this figure is elevated. The aim of this quasi randomised controlled trial (RCT) is to determine if high dose antibiotic impregnated cement can reduce the SSI in patients at 12-months after hemiarthroplasty for intracapsular fractured neck of femur. Methods: 848 patients with an intracapsular fractured neck of femur requiring a hip hemiarthroplasty are been recruited into this two-centre double-blind quasi RCT. Participants were recruited before surgery and quasi randomised to standard care or intervention group. Participants, statistician and outcome assessors were blind to treatment allocation throughout the study. The intervention consisted of high dose antibiotic impregnated cement consisting of 1 gram Clindamycin and 1 gram of Gentamicin. The primary outcome is Health Protection Agency (HPA) defined deep surgical site infection at 12 months. Secondary outcomes include HPA defined superficial surgical site infection at 30 days, 30 and 90-day mortality, length of hospital stay, critical care stay, and complications. Discussion: Large randomised controlled trials assessing the effectiveness of a surgical intervention are uncommon, particularly in the speciality of orthopaedics. The results from this trial will inform evidence-based recommendations for antibiotic impregnated cement in the management of patients with a fractured neck of femur undergoing a hip hemiarthroplasty. If high dose antibiotic impregnated cement is found to be an effective intervention, implementation into clinical practice could improve long-term outcomes for patients undergoing hip hemiarthroplasty

Supermodeling Improving Predictions with an Ensemble of Interacting Models

The modeling of weather and climate has been a success story. The skill of forecasts continues to improve and model biases continue to decrease. Combining the output of multiple models has further improved forecast skill and reduced biases. But are we exploiting the full capacity of state-of-the-art models in making forecasts and projections? Supermodeling is a recent step forward in the multimodel ensemble approach. Instead of combining model output after the simulations are completed, in a supermodel individual models exchange state information as they run, influencing each other's behavior. By learning the optimal parameters that determine how models influence each other based on past observations, model errors are reduced at an early stage before they propagate into larger scales and affect other regions and variables. The models synchronize on a common solution that through learning remains closer to the observed evolution. Effectively a new dynamical system has been created, a supermodel, that optimally combines the strengths of the constituent models. The supermodel approach has the potential to rapidly improve current state-of-the-art weather forecasts and climate predictions. In this paper we introduce supermodeling, demonstrate its potential in examples of various complexity, and discuss learning strategies. We conclude with a discussion of remaining challenges for a successful application of supermodeling in the context of state-of-the-art models. The supermodeling approach is not limited to the modeling of weather and climate, but can be applied to improve the prediction capabilities of any complex system, for which a set of different models exists

Duplication cyst of pyloroduodenal canal: a rare cause of neonatal gastric outlet obstruction: a case report

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

QCD-like theories at nonzero temperature and density

We investigate the properties of hot and/or dense matter in QCD-like theories with quarks in a (pseudo)real representation of the gauge group using the Nambu-Jona-Lasinio model. The gauge dynamics is modeled using a simple lattice spin model with nearest-neighbor interactions. We first keep our discussion as general as possible, and only later focus on theories with adjoint quarks of two or three colors. Calculating the phase diagram in the plane of temperature and quark chemical potential, it is qualitatively confirmed that the critical temperature of the chiral phase transition is much higher than the deconfinement transition temperature. At a chemical potential equal to half of the diquark mass in the vacuum, a diquark Bose-Einstein condensation (BEC) phase transition occurs. In the two-color case, a Ginzburg-Landau expansion is used to study the tetracritical behavior around the intersection point of the deconfinement and BEC transition lines, which are both of second order. We obtain a compact expression for the expectation value of the Polyakov loop in an arbitrary representation of the gauge group (for any number of colors), which allows us to study Casimir scaling at both nonzero temperature and chemical potential.Comment: JHEP class, 31 pages, 7 eps figures; v2: error in Eq. (3.11) fixed, two references added; matches published versio

Clustering daily patterns of human activities in the city

Data mining and statistical learning techniques are powerful analysis tools yet to be incorporated in the domain of urban studies and transportation research. In this work, we analyze an activity-based travel survey conducted in the Chicago metropolitan area over a demographic representative sample of its population. Detailed data on activities by time of day were collected from more than 30,000 individuals (and 10,552 households) who participated in a 1-day or 2-day survey implemented from January 2007 to February 2008. We examine this large-scale data in order to explore three critical issues: (1) the inherent daily activity structure of individuals in a metropolitan area, (2) the variation of individual daily activities—how they grow and fade over time, and (3) clusters of individual behaviors and the revelation of their related socio-demographic information. We find that the population can be clustered into 8 and 7 representative groups according to their activities during weekdays and weekends, respectively. Our results enrich the traditional divisions consisting of only three groups (workers, students and non-workers) and provide clusters based on activities of different time of day. The generated clusters combined with social demographic information provide a new perspective for urban and transportation planning as well as for emergency response and spreading dynamics, by addressing when, where, and how individuals interact with places in metropolitan areas.Massachusetts Institute of Technology. Dept. of Urban Studies and PlanningUnited States. Dept. of Transportation (Region One University Transportation Center)Singapore-MIT Alliance for Research and Technolog

High-resolution radiation hybrid mapping in wheat: an essential tool for the construction of the wheat physical maps

ArtigoO poema épico da época moderna nasce na literatura portuguesa como oceânico logo a partir da sua gestação. Este estudo enquadra a sua génese num contexto europeu.Università di Roma, La Sapienz