Miracle-dz/UniFAR-FTUs huggingface dataset:
Effect of Docosahexaenoic Acid on a Biomarker of Head Trauma in American Football.

PURPOSE American football athletes are exposed to subconcussive impacts over the course of the season resulting in elevations in serum neurofilament light (NFL), a biomarker of axonal injury. Docosahexaenoic acid (DHA) has been reported to reduce axonal trauma associated with traumatic brain injury in rodent models. However, the optimal dose in American football athletes is unknown. This study examined the effect of differing doses of DHA on serum NFL over the course of a season of American football. METHODS In a randomized, double-blind, placebo-controlled, parallel design, 81 National Collegiate Athletic Association Division I American football athletes were assigned to ingest either 2, 4, 6 g·d of DHA or placebo. Blood was sampled at specific times over the course of 189 d, coincident with changes in intensity, hours of contact, and likely changes in head impacts. Standardized magnitude-based inference was used to define outcomes. RESULTS DHA supplementation increased plasma DHA in a dose-dependent manner (2 g·d: mean difference from baseline; ±90% CL; 2 g·d: 1.3; ±0.6; 4 g·d: 1.6; ±0.7%; 6 g·d: 2.8; ±1.2%). Serum NFL increased to a greater extent in starters (area under the curve, 1995 ± 1383 pg·mL) versus nonstarters (1398 ± 581 pg·mL; P = 0.024). Irrespective of dose, supplemental DHA likely attenuated serum NFL coincident with increases in serum NFL by likely small and moderate magnitude (effect size = 0.4-0.7). CONCLUSIONS Findings from this study, the first large-scale study examining potential prophylactic use of DHA in American football athletes, include identification of optimal dose of DHA, suggesting a neuroprotective effect of DHA supplementation.
Influence of Step Rate on Shin Injury and Anterior Knee Pain in High School Runners.

PURPOSE High school cross-country runners have a high incidence of injury, particularly at the shin and knee. An increased step rate during running has been shown to reduce impact forces and loading of the lower extremity joints. The purpose of this prospective study was to examine step rate as a risk factor for injury occurrence. MATERIALS AND METHODS Running step rates of 68 healthy high school cross-country runners (47 females; 21 males; mean age 16.2 ± 1.3 yr) were assessed at a fixed speed (3.3 ± 0.0 m·s) and self-selected speed (mean, 3.8 ± 0.5 m·s). Runners were prospectively followed during the interscholastic season to determine athletic exposures, occurrences of shin injury and anterior knee pain (AKP), and days lost to injury. RESULTS During the season, 19.1% of runners experienced a shin injury and 4.4% experienced AKP. Most injuries (63.6%) were classified as minor (1-7 d lost). At the fixed speed, runners in the lowest tertile of step rate (≤164 steps per minute) were more likely (odds ratio, 6.67; 95% confidence interval, 1.2-36.7; P = 0.03) to experience a shin injury compared with runners in the highest tertile (≥174 steps per minute). Similarly, for self-selected speed, runners in the lowest tertile (≤166 steps per minute) (odds ratio, 5.85; 95% confidence interval, 1.1-32.1; P < 0.04) were more likely to experience a shin injury than runners in the highest tertile (≥178 steps per minute). AKP incidence was not significantly influenced by step rate. CONCLUSION A lower running step rate was associated with a greater likelihood of shin injury at both self-selected and fixed running speeds. Future studies evaluating whether increasing running step rate reduces shin injury risk and time lost during a high school cross-country season should be considered.
Effect of Carotid Angioplasty and Stenting on Duplex Velocity Measurements in a Porcine Model

Purpose: To evaluate if there are any differences in duplex ultrasound velocity measurements between native and stented carotid arteries using duplex ultrasound in an animal model. Methods: The common carotid artery of 5 pigs was exposed bilaterally (10 arteries). Diameters and velocities were measured by ultrasound in the proximal, mid, and distal native artery at the intended site of stent implantation. Measurements were repeated after bilateral stent placement (Wallstent versus Precise) under angiographic control. Outcomes of native versus stented arteries and Wallstent versus Precise were statistically compared. Results: Angiographic measurements matched well with duplex-measured diameters. The mean proximal stent diameter (3.5±0.5 mm) was significantly smaller than the native proximal artery diameter (4.2±0.4 mm, p=0.004), mostly due to narrowing of the Wallstent diameter to 3.2±0.5 mm (p=0.009). Proximal, mid, and distal segments of the Wallstents were narrower than those of the Precise stent, and associated peak systolic velocities (PSV) were higher at the 3 locations versus the Precise stent, although the differences were not statistically significant. Wallstent PSVs were higher than in the native artery at the proximal, mid, and distal segments, respectively; again, the differences were not statistically significant. Conclusion: Stent placement caused anatomical and hemodynamic alterations. Narrowings and associated increased velocities were noted. Such alterations, however, were stent-type dependent and did not justify a general approach to new velocity criteria indiscriminately applied to all stents.
A perspective of massive open online courses (MOOCs) and public health

Massive open online courses (MOOCs) have emerged as an innovative educational technology relevant to and affecting higher education, professional development, and lifelong learning. This paper introduces the principles of MOOCs and reviews the development of these platforms over time. We reflect upon the considerable investment by institutions to develop, deliver and promote such courses, particularly in public health. While open to interpretation, the inherent power, influence, and effectiveness of MOOCs is unquestionable. The potential contribution of MOOCs to public health education is immense, with almost universal reach and access. However, apart from research into participant engagement and knowledge, MOOC-related research and evaluation continue to lag with the rapid proliferation of these courses in response to emerging challenges, as seen with the Coronavirus Disease 19 (COVID-19) pandemic. This makes analyzing the contribution of MOOCs to public health education, health promotion and community programs challenging. This perspective article provides a robust rationale for the necessity of MOOCs and their utility in upskilling health professionals and the general public. It builds on current knowledge to comprehensively explore the factors influencing the development, and application of MOOCs.
An Assessment of Intra Partum Care Provided to Women in Labor at Omdurman Maternity Hospital in Sudan and Their Level of Satisfaction with It

Background: Quality assessment means “the process of measuring quality of care, including development of quality measures, implementation of quality measurement activities and monitoring of quality information over time to detect trends or to identify high-performance or low-performance". Objective: Specific issues explored were assessment of inrapartum care quality among labouring women in delivery suite and to evaluate women satisfaction of inrapartum care services. Methodology: This was a cross sectional and hospital based study conducted at Omdurman Maternity Hospital during one year (July 2011 – July 2012). A total of 284 laboring women selected through systematic random sampling. The inquiries were recorded by pre designed questionnaire. Results: The mean age of women was 26.03 ± 4.55 years. Only (47.5%) of patients were satisfied or very satisfied, (37%) were either dissatisfied or very dissatisfied, and (15.5%) were not particularly pleased or frustrated by intra partum care services. The communication in this study was found to be defective as about one third of the women felt that they were not welcomed. Conclusion: Quality of intrapartum care was moderate and about one half of patients were satisfied by intra partum care services. Despite having good assessment, the communication is low.
Optimizing QT Interval Measurement for the Preparticipation Screening of Young Athletes.

PURPOSE Sudden cardiac death is the leading cause of death in athletes. Long QT syndrome (LQTS) is one of the most common cardiogenetic diseases that can lead to sudden cardiac death and is identified by QT interval prolongation on an ECG. Recommendations for QT monitoring in athletes are adopted from nonathlete populations. To improve screening, ECG data of athletes are assessed to determine a more appropriate method for QT interval estimation. METHODS ECG (CardeaScreen) data were collected from June 2010 to March 2015. ECG data with HR greater than 100 bpm were excluded. Fiducial points of outliers were manually corrected if the QRS onset or the T wave offset was misidentified. A model of best fit was determined and compared across four QT correction factors. Classification analysis was used to compare the Bazett's corrected QT interval to the 99th percentile of uncorrected QT interval. RESULTS High school (n = 597), college (n = 1207), and professional athletes (n = 273) (N = 2077) were analyzed. Mean age was 19 ± 3.5 yr. QT interval varied by cohort (HS = 388 ± 30, Col = 410 ± 33, Pro = 407 ± 27, p < 0.0001). A nonlinear power function with a cubic exponent of -0.349 fit the data the best (R = 0.64). Of the four common correction factors, Fridericia had the lowest residual dependence to HR (m = -0.10). With standard screening, 75% of athletes within the top 1% for QT interval were not identified for further investigation for LQTS. CONCLUSION Up to 75% of athletes possessing an uncorrected QT interval greater than 99% of the population are not identified for investigation for LQTS using the recommended criteria. We propose a new method of risk stratification that replaces QT interval correction. Further study is needed to establish QT interval distributions and risk thresholds in athletes.
Attacking and fixing PKCS#11 security tokens

We show how to extract sensitive cryptographic keys from a variety of commercially available tamper resistant cryptographic security tokens, exploiting vulnerabilities in their RSA PKCS#11 based APIs. The attacks are performed by Tookan, an automated tool we have developed, which reverse-engineers the particular token in use to deduce its functionality, constructs a model of its API for a model checker, and then executes any attack trace found by the model checker directly on the token. We describe the operation of Tookan and give results of testing the tool on 17 commercially available tokens: 9 were vulnerable to attack, while the other 8 had severely restricted functionality. One of the attacks found by the model checker has not previously appeared in the literature. We show how Tookan may be used to verify patches to insecure devices, and give a secure configuration that we have implemented in a patch to a software token simulator. This is the first such configuration to appear in the literature that does not require any new cryptographic mechanisms to be added to the standard. We comment on lessons for future key management APIs.
Raw Accelerometer Data Analysis with GGIR R-package: Does Accelerometer Brand Matter?

PURPOSE This study aimed to determine the agreement between outputs from contemporaneous measures of acceleration from wrist-worn GENEActiv and ActiGraph accelerometers when processed using the GGIR open source package. METHODS Thirty-four participants wore a GENEActiv and an ActiGraph GT3X+ on their nondominant wrist continuously for 2 d to ensure the capture of one 24-h day and one nocturnal sleep. GENEActiv.bin files and ActiGraph . csv files were analyzed with R-package GGIR version 1.2-0. Key outcome variables were as follows: wear time, average magnitude of dynamic wrist acceleration (Euclidean norm minus one [ENMO]), percentile distribution of accelerations, time spent across acceleration levels in a 40-mg resolution, time in moderate-to-vigorous physical activity (MVPA: total, 10-min bouts), and duration of nocturnal sleep. RESULTS There was a high agreement between accelerometer brands for all derived outcomes (wear time, MVPA, and sleep; intraclass correlation coefficient [ICC] > 0.96), ENMO (ICC = 0.99), time spent across acceleration levels (ICC > 0.93), and accelerations ≥50th percentile of the distribution (ICC > 0.82). ENMO (mean ± SD, GENEActiv = 29.9 ± 20.7 mg, ActiGraph = 27.8 ± 21.4 mg) and accelerations between the 5th and the 75th percentile of the distribution measured by the GENEActiv were significantly higher than those measured by the ActiGraph. Correspondingly, the number of minutes recorded between 0 and 40 mg was significantly greater for the ActiGraph (745 min cf. 734 min), and the number of minutes recorded between 40 and 80 mg was significantly greater for the GENEActiv (110 min cf. 105 min). CONCLUSION Derived outcomes (wear time, MVPA, and sleep) were similar between brands. Brands compared well for acceleration magnitudes >50-80 mg but not lower magnitudes indicative of sedentary time. Caution is advised when comparing the magnitude of ENMO between brands, but there was a high consistency between brands for the ranking of individuals for activity and sleep outcomes.
Influence of Obesity on In-Hospital and Midterm Outcomes after Endovascular Repair of Abdominal Aortic Aneurysm

Purpose: To evaluate the influence of obesity on outcomes after endovascular aneurysm repair (EVAR). Methods: A retrospective analysis was conducted of 80 patients (77 men; mean age 75.0±7.6 years) undergoing elective EVAR for abdominal aortic aneurysm (AAA) between 2001 and 2008. Patients were stratified on presence of obesity [body mass index (BMI) ≥30 kg/m2). Outcomes in-hospital and during follow-up were compared between obese and non-obese patients. Results: In this cohort, 26 (33%) patients had a BMI ≥30 kg/m2. Mean BMI in the non-obese group was 25.6 kg/m2 versus 34.1 kg/m2 in the obese group (p≥0.001). In obese patients, EVAR operating time was longer compared to non-obese patients: 217 versus 177 minutes (p=0.006). One obese patient died after EVAR (p=0.325); the combined operative mortality and major complication rate was 8% (n=2) in the obese group versus 7% (n=4) in the non-obese group (p=NS). Endoleak occurred in 25% (n=6) of the obese group versus 14% (n=7) of the non-obese group (p=0.261). Postoperative intensive care for >24 hours (65% versus 70%, p=0.796) and overall length of stay (3.9 versus 3.8 days, p=0.845) did not differ significantly; neither did all-cause mortality during 2 years of follow-up (p=0.688). Conclusion: Obesity is associated with extended operation times during EVAR, but increasing BMI appears to have little influence on outcomes after EVAR. A preferential approach to offering EVAR for obese patients may be reasonable.
Nitinol Stent Implantation in Long Superficial Femoral Artery Lesions: 12-Month Results of the DURABILITY I Study

Purpose: To evaluate the long-term efficacy and integrity of the PROTÉGÉ EverFlex stent in superficial femoral artery (SFA) lesions in symptomatic patients with peripheral artery disease (PAD). Methods: A prospective, multicenter, nonrandomized study enrolled 151 subjects (111 men; mean age 67.8 years, range 42–93) undergoing percutaneous treatment of de novo, restenotic, or reoccluded SFA lesions between August 11, 2006, and June 26, 2007. Subjects were scheduled to receive a single stent and be evaluated through 12 months following the implant procedure. Occlusions were present in 40% of the patients. Mean lesion length was 96.4 mm (range 10–150). Results: A total of 161 stents (158 EverFlex) were implanted in the 151 patients: single stents in 93.4% (141/151) and a second stent in 6.6% (10/151). One-year follow-up information was available for 88.7% (134/151) of the study participants; of the remaining 17 subjects, 6 subjects withdrew from the study, 2 were lost to follow-up, and 9 died. Freedom from restenosis data were available for 99.3% (133/134) of the subjects who completed a 12-month follow-up visit. The mean Rutherford classification fell from 2.8±0.8 (range 1–5) at baseline to 0.6±1.1 (range 0–5) at 12 months. The mean ankle-brachial index rose from 0.6±0.2 (range 0–1.4) at baseline to 0.9±0.2 (range 0–1.2) at 12 months. The rates for freedom from >50% restenosis at 6 and 12 months were 91.3% (95% CI 84.9% to 95.2%) and 72.2% (95% CI 63.8% to 79.6%), respectively. The freedom from target lesion revascularization rate at 12 months was 79.1% (95% CI 71.2% to 85.6%). The 1-year stent fracture rate was 8.1% (95% CI 4.0% to 14.4%). Conclusion: The high freedom from >50% restenosis and low fracture rate at 12 months suggests that the PROTÉGÉ EverFlex stent offers a safe and acceptably efficacious means of treating SFA lesions in symptomatic subjects with PAD.
Return-oriented programming without returns

We show that on both the x86 and ARM architectures it is possible to mount return-oriented programming attacks without using return instructions. Our attacks instead make use of certain instruction sequences that behave like a return, which occur with sufficient frequency in large libraries on (x86) Linux and (ARM) Android to allow creation of Turing-complete gadget sets. Because they do not make use of return instructions, our new attacks have negative implications for several recently proposed classes of defense against return-oriented programming: those that detect the too-frequent use of returns in the instruction stream; those that detect violations of the last-in, first-out invariant normally maintained for the return-address stack; and those that modify compilers to produce code that avoids the return instruction.
Arterial Stiffness Is Reduced Regardless of Resistance Training Load in Young Men

Purpose Discrepancies regarding the effect of resistance exercise training (RET) on arterial stiffness have led to uncertainty regarding the effect of RET on cardiovascular health. Confounding our understanding in this area are the roles of the following: load (heavier vs lighter), participant cardiovascular health, and arterial stiffness assessment method. We aimed to investigate the effects of a heavier versus a lighter load resistance training protocol on both central and local arterial stiffness in previously trained young men. Methods Participants were randomly assigned to a 12-wk supervised whole-body RET program consisting of three sets of 8–12 repetitions (heavier-load, lower-repetition [LR]; n = 16) or three sets of 20–25 repetitions (lighter-load, higher-repetition [HR]; n = 16) to volitional failure, or a control group who maintained their regular activity habits (n = 14). Central arterial stiffness (carotid-femoral pulse wave velocity), local arterial stiffness (common carotid arterial distensibility), and left ventricular mass were measured before and after 12 wk of RET. Results There was a reduction in carotid-femoral pulse wave velocity in both LR (6.24 ± 0.56 vs 5.77 ± 0.76 m·s−1; P < 0.05) and HR (6.42 ± 0.70 vs 5.72 ± 0.60 m·s−1; P < 0.05) with no changes in carotid distensibility (P = 0.52) or left ventricular mass allometrically scaled to fat-free mass (P = 0.60). There were no changes in any variable in the control group. Conclusions Using current criterion-standard assessment methods, central arterial stiffness was reduced after resistance training, regardless of the load lifted during RET, with no effect on local carotid artery distensibility or left ventricular mass. Our results support a role of RET in the promotion of positive adaptations in vascular function.
Does the choice of spinal level treated during posteroanterior (PA) mobilisation affect treatment outcome?

The purpose of this study was to establish whether posteroanterior (PA) mobilisation is more effective in relieving low back pain (LBP) when the treatment is delivered to the level identified by the therapist as responsible for the LBP, than when delivered to a randomly selected level. One physiotherapist and 120 subjects suffering LBP participated. Prior to treatment allocation, baseline measurements were taken. The therapist then assessed subjects and nominated the preferred treatment grade and spinal level to be treated. The subjects were then randomly allocated to one of two groups; Group 1 received the treatment at the level identified by the therapist as responsible for the symptoms, whereas Group 2 received treatment at a random lumbar level. In both groups the originally nominated treatment grade was used and all subjects received one treatment session with follow-up measures taken immediately after intervention. Two-way analysis of variance (ANOVA) was used to analyse the data; the first factor was treatment group and the second factor was the direction of the patient's worst movement. There was greater reduction in pain intensity when the mobilisation was applied to the symptomatic level rather than to a randomly assigned level (F 1,114 = 4.504, p = 0.036). There was also an interaction effect on pain reduction between the two factors (F 2,114 = 3.301, p = 0.04). The results of this study confirm that the level treated is a determinant of the immediate analgesic effect of PA mobilisation treatment for LBP. Other parameters of treatment dose such as the direction, peak force, and frequency of PA mobilisation await formal investigation.
The role of microbial ecology in improving the performance of anaerobic digestion of sewage sludge

The use of next-generation diagnostic tools to optimise the anaerobic digestion of municipal sewage sludge has the potential to increase renewable natural gas recovery, improve the reuse of biosolid fertilisers and help operators expand circular economies globally. This review aims to provide perspectives on the role of microbial ecology in improving digester performance in wastewater treatment plants, highlighting that a systems biology approach is fundamental for monitoring mesophilic anaerobic sewage sludge in continuously stirred reactor tanks. We further highlight the potential applications arising from investigations into sludge ecology. The principal limitation for improvements in methane recoveries or in process stability of anaerobic digestion, especially after pre-treatment or during co-digestion, are ecological knowledge gaps related to the front-end metabolism (hydrolysis and fermentation). Operational problems such as stable biological foaming are a key problem, for which ecological markers are a suitable approach. However, no biomarkers exist yet to assist in monitoring and management of clade-specific foaming potentials along with other risks, such as pollutants and pathogens. Fundamental ecological principles apply to anaerobic digestion, which presents opportunities to predict and manipulate reactor functions. The path ahead for mapping ecological markers on process endpoints and risk factors of anaerobic digestion will involve numerical ecology, an expanding field that employs metrics derived from alpha, beta, phylogenetic, taxonomic, and functional diversity, as well as from phenotypes or life strategies derived from genetic potentials. In contrast to addressing operational issues (as noted above), which are effectively addressed by whole population or individual biomarkers, broad improvement and optimisation of function will require enhancement of hydrolysis and acidogenic processes. This will require a discovery-based approach, which will involve integrative research involving the proteome and metabolome. This will utilise, but overcome current limitations of DNA-centric approaches, and likely have broad application outside the specific field of anaerobic digestion.