Effects of early feeding on growth velocity and overweight/obesity in a cohort of HIV unexposed South African infants and children

BACKGROUND: South Africa has the highest prevalence of overweight/obesity in Sub-Saharan Africa. Assessing the effect of modifiable factors such as early infant feeding on growth velocity and overweight/obesity is therefore important. This paper aimed to assess the effect of infant feeding in the transitional period (12 weeks) on 12–24 week growth velocity amongst HIV unexposed children using WHO growth velocity standards and on the age and sex adjusted body mass index (BMI) Z-score distribution at 2 years. METHODS: Data were from 3 sites in South Africa participating in the PROMISE-EBF trial. We calculated growth velocity Z-scores using the WHO growth standards and assessed feeding practices using 24-hour and 7-day recall data. We used quantile regression to study the associations between 12 week infant feeding and 12–24 week weight velocity (WVZ) with BMI-for-age Z-score at 2 years. We included the internal sample quantiles (70th and 90th centiles) that approximated the reference cut-offs of +2 (corresponding to overweight) and +3 (corresponding to obesity) of the 2 year BMI-for-age Z-scores. RESULTS: At the 2-year visit, 641 children were analysed (median age 22 months, IQR: 17–26 months). Thirty percent were overweight while 8.7% were obese. Children not breastfed at 12 weeks had higher 12–24 week mean WVZ and were more overweight and obese at 2 years. In the quantile regression, children not breastfed at 12 weeks had a 0.37 (95% CI 0.07, 0.66) increment in BMI-for-age Z-score at the 50th sample quantile compared to breast-fed children. This difference in BMI-for-age Z-score increased to 0.46 (95% CI 0.18, 0.74) at the 70th quantile and 0.68 (95% CI 0.41, 0.94) at the 90th quantile . The 12–24 week WVZ had a uniform independent effect across the same quantiles. CONCLUSIONS: This study demonstrates that the first 6 months of life is a critical period in the development of childhood overweight and obesity. Interventions targeted at modifiable factors such as early infant feeding practices may reduce the risks of rapid weight gain and subsequent childhood overweight/obesity.Scopu

Integrating Mobile Devices with Cohort Analysis into Personalised Weather-Based Healthcare

Mobile healthcare applications can empower users to self-monitor their health conditions without the need to visit any medical centre. However, the lack of attention on engagement aspects of mobile healthcare applications often result in users choosing to uninstall the application after the first usage experience. This results in failure of effective prolonged personalised healthcare, especially for users with chronic disease related to weather conditions such as asthma and eczema which require long-term monitoring and self-care. Therefore, this paper aims to identify the pattern of application user engagement with a weather-based mobile healthcare application through cohort retention analysis. Enhancement features for improving the engagement of personalised healthcare can provide meaningful insight. The proposed application allows the patient to conduct disease control tests to check the severity of their condition on a daily basis. To measure the application engagement, we distribute the mobile application designed for primary testing over a period of ten days. Based on the primary testing, data related to retention rate and the number of control test reported were collected via Firebase Analytic to determine the application engagement. Subsequently, we apply cohort analysis using a machine learning clustering technique implemented in Python to identify the pattern of the engagement by application users. Finally, useful insights were analysed and implemented as enhancement features within the application for improving the personalised weather-based mobile healthcare. The findings in this paper can assist machine learning facilitators design effective use policies for weather-based mobile healthcare with fundamental knowledge enhanced with personalisation and user engagement

The local iron age pottery from selected strata at Tel Yin'am, eastern lower Galilee, Israel

Tel Yin’am and nearby Khirbet Beit Gan are the only excavated sites in the Yavne’el Valley, which constituted part of an ancient international highway that connected the hinterland of the Hauran (modern-day Syria) with the Mediterranean coast. As one of the few multi-occupational, small rural sites excavated in the Eastern Lower Galilee, Tel Yin’am, which was occupied intermittently from the Neolithic period to the Roman period (6500 BCE-325 CE), provides a critical link in the occupation history and material culture of northern (modern-day) Israel. Concentrating on critical selected Iron Age strata (1200-732 BC), this study focuses on the mostly unpublished domestic pottery assemblages, subjecting the various ceramic forms to classification and development analysis, and comparing them to contemporary pottery assemblages from proximate and distant, rural and urban sites in Cisjordan and Transjordan. Through diachronic and synchronic analyses, I succeeded in: 1) developing a picture of the ceramic history of domestic types at Tel Yin’am during the Iron Age; 2) providing both relative and absolute dates for this ceramic assemblage; 3) placing the assemblage into the broader ceramic context of the Iron Age in northern Cisjordan and Transjordan; 4) highlighting the important role of roads and ancient highways and how they impacted on the history of Tel Yin’am and its material culture in the Iron Age, thereby closing a gap in the knowledge of the history of rural life and culture in the Yavne’el Valley in the Iron Age; and 5) gaining an understanding of the approximately 500-year history of consistent and changing points of contact between Tel Yin’am and other sites that lay along the highways traversing the northern Lower Galilee.Middle Eastern Studie

Combined ACL and Peripheral Instability: The Western Experience

Knee ligament injuries are very common and are frequently sports related, although they may arise from trauma experienced during everyday activities. This book provides in-depth descriptions of the extra articular surgical techniques that may be employed when performing ligament reconstruction in patients with injuries involving the posterolateral and posteromedial corners of the knee. It is intended as a practical, “how to” manual that will be of value for both the trainee and the more experienced surgeon. Many of the techniques relate to the central pivot of the knee, i.e. the anterior and posterior cruciate ligaments. For each technique, indications, presurgical planning, postsurgical follow-up and complications are discussed in addition to the surgical details. Numerous tips and pearls are provided and the techniques are clearly depicted in informative high-quality illustrations

International Olympic Committee Consensus Statement: Methods for Recording and Reporting of Epidemiological Data on Injury and Illness in Sports 2020 (Including the STROBE Extension for Sports Injury and Illness Surveillance (STROBE-SIIS))

Background: Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport- or setting-specific consensus statements on sports injury (and, eventually, illnesses) epidemiology to date. Objective: To further strengthen consistency in data collection, injury definitions, and research reporting through an updated set of recommendations for sports injury and illness studies, including a new Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist extension. Study Design: Consensus statement of the International Olympic Committee (IOC). Methods: The IOC invited a working group of international experts to review relevant literature and provide recommendations. The procedure included an open online survey, several stages of text drafting and consultation by working groups, and a 3-day consensus meeting in October 2019. Results: This statement includes recommendations for data collection and research reporting covering key components: defining and classifying health problems, severity of health problems, capturing and reporting athlete exposure, expressing risk, burden of health problems, study population characteristics, and data collection methods. Based on these, we also developed a new reporting guideline as a STROBE extension-the STROBE Sports Injury and Illness Surveillance (STROBE-SIIS). Conclusion: The IOC encourages ongoing in- and out-of-competition surveillance programs and studies to describe injury and illness trends and patterns, understand their causes, and develop measures to protect the health of the athlete. The implementation of the methods outlined in this statement will advance consistency in data collection and research reporting

Arthroscopic intra- and extra-articular anterior cruciate ligament reconstruction with gracilis and semitendinosus tendons: a review

The purposes of this paper are to summarize the concepts relating to the use of a combined intra-articular and extra-articular reconstructive procedure in the arthroscopic treatment of a torn ACL and to review several operative techniques utilizing gracilis and semitendinosus tendons that are currently in use to treat this instability. The highly satisfactory results obtained over the time show that a combination of intra- and extra-articular procedures for ACL reconstruction is a valid surgical option