Lactate Testing Revisited: A Reliable Indicator of Training Progress for All Swimmers.

We examined the use of lactate testing to monitor training progress in swimming at a small liberal arts college, using an inexpensive handheld lactate analyzer. The tests were carried out by undergraduates as part of their investigative learning curriculum in exercise science. Twelve female athletes participated in a 2-year program of periodic testing using a 5 × 200 swim of increasing intensity. Blood lactate values were measured from a sample obtained 2-4 min after each swim, plotted against swim time, and the maximal lactate steady state (MLSS) was identified. MLSS improved significantly throughout the training period (higher by 0.56 mmol/L and lower by 5.92 s, p \u3c .05), accompanied by significant improvements in swim performance in middle distances. We conclude that the use of a handheld lactate analyzer is an effective method to monitor training progress in swimming. The low cost of the procedure and the participation of undergraduate students were novel applications of established protocols

Ascertainment of vaccination status by self-report versus source documentation: Impact on measuring COVID-19 vaccine effectiveness

BACKGROUND: During the COVID-19 pandemic, self-reported COVID-19 vaccination might facilitate rapid evaluations of vaccine effectiveness (VE) when source documentation (e.g., immunization information systems [IIS]) is not readily available. We evaluated the concordance of COVID-19 vaccination status ascertained by self-report versus source documentation and its impact on VE estimates. METHODS: Hospitalized adults (≥18 years) admitted to 18 U.S. medical centers March-June 2021 were enrolled, including COVID-19 cases and SARS-CoV-2 negative controls. Patients were interviewed about COVID-19 vaccination. Abstractors simultaneously searched IIS, medical records, and other sources for vaccination information. To compare vaccination status by self-report and documentation, we estimated percent agreement and unweighted kappa with 95% confidence intervals (CIs). We then calculated VE in preventing COVID-19 hospitalization of full vaccination (2 doses of mRNA product ≥14 days prior to illness onset) independently using data from self-report or source documentation. RESULTS: Of 2520 patients, 594 (24%) did not have self-reported vaccination information to assign vaccination group; these patients tended to be more severely ill. Among 1924 patients with both self-report and source documentation information, 95.0% (95% CI: 93.9-95.9%) agreement was observed, with a kappa of 0.9127 (95% CI: 0.9109-0.9145). VE was 86% (95% CI: 81-90%) by self-report data only and 85% (95% CI: 81-89%) by source documentation data only. CONCLUSIONS: Approximately one-quarter of hospitalized patients could not provide self-report COVID-19 vaccination status. Among patients with self-report information, there was high concordance with source documented status. Self-report may be a reasonable source of COVID-19 vaccination information for timely VE assessment for public health action

Voice of the Clinician: the case of an Australian health system.

Purpose The Voice of the Clinician project commenced during an era when practitioner burnout, dissatisfaction, and turnover became an increasingly global health workforce concern. One key problem is clinical staff not being empowered to voice their concerns to decision-makers, as was found in this case study of an Australian public health organization. The following research question informed the present study: What is a better committee system for clinician engagement in decision-making processes? The paper aims to discuss this issue. Design/methodology/approach The Mid North Coast Local Health District in New South Wales aspired to improve engagement between frontline clinicians and decision-makers. Social network analysis methods and mathematical modeling were used in the discovery of how committees are connected to each other and subsequently to other committee members. Findings This effort uncovered a hidden organizational architecture of 323 committees of 926 members which overall cost 84,729 person hours and AUD$2.923 million per annum. Furthermore, frontline clinicians were located far from centers of influence, just 37 percent of committees had terms of reference, and clinicians reported that meeting agendas were not being met. Practical implications In response to the findings, a technological platform was created so that the board of directors could visually see all the committees and the connections between them, thus creating ways to further improve communication, transparency of process, and - ultimately - clinician engagement. Originality/value The breakthrough idea is that all organizational meetings can be seen as a system of engagement and should be analyzed to determine and describe the points and pathways where clinician voice is blocked

Latent tuberculosis infection screening and treatment in HIV: insights from evaluation of UK practice

Latent TB infection (LTBI) screening and treatment in HIV-positive individuals in the UK is advocated by the British HIV Association (BHIVA) and National Institute for Health and Care Excellence (NICE), although each recommends differing strategies. We undertook an evaluation of UK practice, relating the responses to the local HIV/TB disease burden. 162 of 188 (86%) UK geographical areas responded; only 93/162 (57.4%) offer LTBI testing with considerable heterogeneity in practice, and no difference in HIV/TB burden between areas offering testing and those who do not. Only 33/93 (35.5%) and 6/93 (6.5%) reported full compliance with BHIVA and NICE guidance respectively. A uniform national guideline is required

1-Benzoyl-3-(pyridin-2-yl)-1H-pyrazole

In the title compound, C15H11N3O, the dihedral angle betwen the heterocyclic rings is 9.23 (5)° and the dihedral angle between the benzoyl and pyrazole rings is 58.64 (5)°. In the crystal, inversion dimers linked by pairs of C—H⋯O hydrogen bonds generate R 2 2(10) loops. The dimers stack into a column running parallel to the b-axis direction

Racial and Ethnic Diversity in Grounded Theory Research

National initiatives in the United States call for health research that addresses racial/ethnic disparities. Although grounded theory (GT) research has the potential to contribute much to the understanding of the health experiences of people of color, the extent to which it has contributed to health disparities research is unclear. In this article we describe a project in which we reviewed 44 GT studies published in Qualitative Health Research within the last five years. Using a framework proposed by Green, Creswell, Shope, and Clark (2007), we categorized the studies at one of four levels based on the status and significance afforded racial/ethnic diversity. Our results indicate that racial/ethnic diversity played a primary role in five studies, a complementary role in one study, a peripheral role in five studies, and an absent role in 33 studies. We suggest that GT research could contribute more to health disparities research if techniques were developed to better analyze the influence of race/ethnicity on health-related phenomena

Preoperative localisation for parathyroid surgery in primary hyperparathyroidism: a study to evaluate the clinical utility of different imaging modalities

Primary hyperparathyroidism (PHPT) is caused by a solitary benign adenoma in 80‐85% of cases, but may also be due to multi‐gland or ectopic disease, hyperplasia, and rarely parathyroid carcinoma. Preoperative localisation studies are important to identify patients suitable for minimally invasive parathyroid surgery. The aim of this study was to evaluate the accuracy of ultrasound (US), parathyroid scintigraphy (MIBI) and computed tomography (CT) utilised in the preoperative setting in a district general hospital, with limited access to single photon‐emission computed tomography (SPECT)

Pennsylvanian-Early Triassic stratigraphy in the Alborz Mountains (Iran)

New fieldwork was carried out in the central and eastern Alborz, addressing the sedimentary succession from the Pennsylvanian to the Early Triassic. A regional synthesis is proposed, based on sedimentary analysis and a wide collection of new palaeontological data. The Moscovian Qezelqaleh Formation, deposited in a mixed coastal marine and alluvial setting, is present in a restricted area of the eastern Alborz, transgressing on the Lower Carboniferous Mobarak and Dozdehband formations. The late Gzhelian–early Sakmarian Dorud Group is instead distributed over most of the studied area, being absent only in a narrow belt to the SE. The Dorud Group is typically tripartite, with a terrigenous unit in the lower part (Toyeh Formation), a carbonate intermediate part (Emarat and Ghosnavi formations, the former particularly rich in fusulinids), and a terrigenous upper unit (Shah Zeid Formation), which however seems to be confined to the central Alborz. A major gap in sedimentation occurred before the deposition of the overlying Ruteh Limestone, a thick package of packstone–wackestone interpreted as a carbonate ramp of Middle Permian age (Wordian–Capitanian). The Ruteh Limestone is absent in the eastern part of the range, and everywhere ends with an emersion surface, that may be karstified or covered by a lateritic soil. The Late Permian transgression was directed southwards in the central Alborz, where marine facies (Nesen Formation) are more common. Time-equivalent alluvial fans with marsh intercalations and lateritic soils (Qeshlaq Formation) are present in the east. Towards the end of the Permian most of the Alborz emerged, the marine facies being restricted to a small area on the Caspian side of the central Alborz. There, the Permo-Triassic boundary interval is somewhat similar to the Abadeh–Shahreza belt in central Iran, and contains oolites, flat microbialites and domal stromatolites, forming the base of the Elikah Formation. The P–T boundary is established on the basis of conodonts, small foraminifera and stable isotope data. The development of the lower and middle part of the Elikah Formation, still Early Triassic in age, contains vermicular bioturbated mudstone/wackestone, and anachronostic-facies-like gastropod oolites and flat pebble conglomerates. Three major factors control the sedimentary evolution. The succession is in phase with global sea-level curve in the Moscovian and from the Middle Permian upwards. It is out of phase around the Carboniferous–Permian boundary, when the Dorud Group was deposited during a global lowstand of sealevel. When the global deglaciation started in the Sakmarian, sedimentation stopped in the Alborz and the area emerged. Therefore, there is a consistent geodynamic control. From the Middle Permian upwards, passive margin conditions control the sedimentary evolution of the basin, which had its depocentre(s) to the north. Climate also had a significant role, as the Alborz drifted quickly northwards with other central Iran blocks towards the Turan active margin. It passed from a southern latitude through the aridity belt in the Middle Permian, across the equatorial humid belt in the Late Permian and reached the northern arid tropical belt in the Triassic

Forensic Investigation of Cyberstalking Cases using Behavioural Evidence Analysis

Behavioural Evidence Analysis (BEA) is, in theory, useful in developing an understanding of the offender, the victim, the crime scene, and the dynamics of the crime. It can add meaning to the evidence obtained through digital forensic techniques and assist investigators with reconstruction of a crime. There is, however, little empirical research examining the application of BEA to actual criminal cases, particularly cyberstalking cases. This study addresses this gap by examining the utility of BEA for such cases in terms of understanding the behavioural and motivational dimensions of offending, and the way in which digital evidence can be interpreted. It reports on the forensic analysis of 20 cyberstalking cases investigated by Dubai Police in the last five years. Results showed that BEA helps to focus an investigation, enables better understanding and interpretation of victim and offender behaviour, and assists in inferring traits of the offender from available digital evidence. These benefits can help investigators to build a stronger case, reduce time wasted to mistakes, and to exclude suspects wrongly accused in cyberstalking cases

Stepwise assembly of an adamantoid Ru4Ag6 cage by control of metal coordination geometry at specific sites

The geometrically pure ‘complex ligand’ fac-[Ru(Lph)3]2+, in which three pendant bidentate binding sites are located on one face of the complex, reacts with Ag(I) ions to form the adamantoid decanuclear cage [{Ru(Lph)3}4Ag6](PF6)14 which contains a 6-coordinate Ru(II) ion at each vertex of a large tetrahedron and a 4-coordinate Ag(I) ion along each edge