Emotional experiences in youth tennis

Abstract Objectives To explore adolescents' emotional experiences in competitive sport. Specifically, this study sought to identify, 1) The emotions adolescents' experience at tennis tournaments, 2) The precursors of the emotions they experience, and, 3) How adolescents attempt to cope with these emotions. Design Case-study. Method Four adolescent tennis players competed in four or five tennis matches under the observation of a researcher. Immediately following each match, participants completed a post-match review sheet and a semi-structured interview. A further semi-structured interview was completed at the end of the tournament. Review sheets, notes from match observations, and video recordings of matches were used to stimulate discussions during final interviews. All data were analyzed following the procedures outlined by Miles and Huberman (1994). Results Participants cited numerous positively and negatively valenced emotions during matches and tournaments. Participants' emotions seemed to be broadly influenced by their perceptions of performance and outcomes, as well as their opponent's behavior and player's perceptions of their own behavior. Participants described various strategies to cope with these emotions, such as controlling breathing rate, focusing on positive thoughts, and individualized routines. Further, if participants perceived them to be facilitative, negative emotions could be beneficial for performance. Conclusion This study provided original insights into the complexity of adolescent athletes' emotional experiences at competitions and highlights the critical need for further in-depth examinations of youth sport to fully comprehend the experiences of young people. Most notably, the findings highlight the necessity of considering the impact of both intra- and interpersonal influences on adolescents' emotional experiences, while also accounting for temporal changes

Extramammary Paget disease of the perianal region:the potential role of imiquimod in achieving disease control

Extramammary Paget disease (EMPD) is a rare perineal neoplasia associated with a high rate of local recurrence. Surgical excision is the standard treatment; however, this has high rates of post-operative morbidity in combination with potentially mutilating results. Previous literature has demonstrated good response with imiquimod 5% cream in patients with vulval EMPD, yet its effectiveness in primary perianal disease is unknown. We describe the case of a 40-year-old woman presenting with EMPD of the perianal region, providing detailed histological and pictoral evidence of its response to topical imiquimod 5% cream over a 16-week period, which initially resulted in remission prior to metastatic lymph node recurrence. This case demonstrates the potential for topical imiquimod cream to avoid major surgery and its associated complications in patients presenting with EMPD of the perianal region. We discuss the current evidence for treating this rare condition with medical therapy, how this case adds to current literature and possible future directions

The ecology of microbial communities associated with Macrocystis pyrifera

Kelp forests are characterized by high biodiversity and productivity, and the cycling of kelp-produced carbon is a vital process in this ecosystem. Although bacteria are assumed to play a major role in kelp forest carbon cycling, knowledge of the composition and diversity of these bacterial communities is lacking. Bacterial communities on the surface of Macrocystis pyrifera and adjacent seawater were sampled at the Hopkins Marine Station in Monterey Bay, CA, and further studied using 454-tag pyrosequencing of 16S RNA genes. Our results suggest that M. pyrifera-dominated kelp forests harbor distinct microbial communities that vary temporally. The distribution of sequence tags assigned to Gammaproteobacteria, Alphaproteobacteria and Bacteriodetes differed between the surface of the kelp and the surrounding water. Several abundant Rhodobacteraceae, uncultivated Gammaproteobacteria and Bacteriodetes-associated tags displayed considerable temporal variation, often with similar trends in the seawater and the surface of the kelp. Bacterial community structure and membership correlated with the kelp surface serving as host, and varied over time. Several kelp-specific taxa were highly similar to other bacteria known to either prevent the colonization of eukaryotic larvae or exhibit antibacterial activities. Some of these kelp-specific bacterial associations might play an important role for M. pyrifera. This study provides the first assessment of the diversity and phylogenetic profile of the bacterial communities associated with M. pyrifera

Regulatory interactions of αβ and γλ T cells in glomerulonephritis

Regulatory interactions of αβ and γλ T cells in glomerulonephritis.BackgroundSeveral lines of evidence suggest that cellular immune mechanisms contribute to glomerulonephritis.MethodsThe roles of αβ and γλ T cells in the pathogenesis of glomerulonephritis were investigated in a model of nephrotoxic nephritis in mice deficient in either T-cell population [T-cell receptor (TCR)β and TCRλ knockout mice]. The model, induced by the injection of rabbit anti-mouse glomerular basement membrane antibody, is characterized by the development of proteinuria and glomerular damage over a 21-day observation period in wild-type mice.ResultsMice deficient in either αβ or γλ T cells developed minimal proteinuria and glomerular lesions and had a significant reduction in macrophage accumulation compared with wild-type mice. In γλ T-cell–deficient mice, circulating levels and glomerular deposition of autologous IgG were comparable to wild-type levels, while αβ T-cell–deficient mice had no autologous IgG production. Autologous antibody production was not required for the development of glomerulonephritis since mice that lack IgG and B cells (μ-chain-/-) developed similar proteinuria to that observed in wild-type mice.ConclusionsThese studies suggest a proinflammatory role for both αβ and γλ T cells in glomerular injury, independent of the humoral response. This is the first demonstration, to our knowledge, that both T-cell subsets contribute to the progression of a disease, and it suggests that complex regulatory interactions between αβ and γλ T cells play a role in glomerular injury

Global variation in postoperative mortality and complications after cancer surgery : a multicentre, prospective cohort study in 82 countries

Background 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings Between April 1, 2018, and jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3.72, 95% CI 1.70-8.16) and for colorectal cancer in low-income or lower-middle-income countries (4.59, 2.39-8.80) and upper-middle-income countries (2.06,1.11-3.83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6.15, 3.26-11.59) and upper-middle-income countries (3.89, 2- 08-7- 29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Does advice based on biomarkers of liver injury or non-invasive tests of liver fibrosis impact high-risk drinking behaviour: A systematic review with meta-analysis

Background: Alcohol dependence affects over 240 million people worldwide and attributed to 3 million deaths annually. Early identification and intervention are key to prevent harm. We aim to systematically review literature on the effectiveness of adding advice based on biomarkers of liver injury or non-invasive tests of liver fibrosis (intervention-based advice ) to prevent alcohol misuse. Methods: Electronic search was conducted on Ovid Medline, PubMed, EMBASE, Psychinfo and CINAHL for articles published up to end of February 2020. Additionally, we searched study citations, Scopus, Ethos and Clinical trials. The primary outcome measure was changed in self-reported alcohol consumption analysed by random-effects meta-analysis. Secondary outcomes included change to liver blood markers and alcohol-related health outcomes.Results: 14 RCT and 2 observational studies comprising n=3763 participants were included. Meta-analyses showed a greater reduction in alcohol consumption and liver biomarkers for the intervention compared to control group: mean difference for weekly alcohol intake was -74.4 gram/week (95%CI -126.1, -22.6, p=0.005); and mean difference for GGT -19.7 IU/L (95% CI -33.1, -6.4, p=0.004). There was a higher incidence of alcohol attributed mortality, number of days spent in the hospital, physician visits and sickness absence in the non-intervention group. The quality of the included studies was moderate for RCT’s and high for observational studies. Conclusions: The review confirmed a significant association between the addition of intervention-based advice in routine care to the reduction of harmful alcohol consumption, GGT and alcohol-related mortality. The findings support the inclusion of this type of advice in routine alcohol care