From semi-starvation to the stage: a case report on indicators of low energy availability in a drug-free bodybuilder during contest preparation and peak week.

Natural bodybuilding competitions involve periods of low energy availability (EA) combined with resistance training and high-protein diets to achieve extreme leanness. This study tracked a drug-free bodybuilder adopting evidence-based nutrition practices during 18 weeks of contest preparation. We measured endocrine function, resting energy expenditure, respiratory exchange ratio, body composition, resting heart rate, oral temperature, mood, and strength performance.

The 2024 American Orthopaedic Association-Japanese Orthopaedic Association Traveling Fellowship.

In 1992, the American Orthopaedic Association-Japanese Orthopaedic Association (AOA-JOA) Traveling Fellowship was created to develop and enhance collaboration between the Japanese and American orthopaedic communities. The fellowship is geared to early-career surgeons and fosters clinical and cultural exchange between members of the 2 countries. In 2024, the fellows hailed from around the United States: Kelly K.

CDC's Core Elements to promote diagnostic excellence.

Nearly a decade after the National Academy of Medicine released the "Improving Diagnosis in Health Care" report, diagnostic errors remain common, often leading to physical, psychological, emotional, and financial harm. Despite a robust body of research on potential solutions and next steps, the translation of these efforts to patient care has been limited. Improvement initiatives are still narrowly focused on selective themes such as diagnostic stewardship, preventing overdiagnosis, and enhancing clinical reasoning without comprehensively addressing vulnerable systems and processes surrounding diagnosis.

Use of Multiplex Molecular Panels to Diagnose Urinary Tract Infection in Older Adults.

Importance: Multiplex molecular syndromic panels for diagnosis of urinary tract infection (UTI) lack clinical data supporting their use in routine clinical care. They also have the potential to exacerbate inappropriate antibiotic prescribing.

Objective: To describe the frequency of unspecified multiplex testing in administrative claims with a primary diagnosis of UTI in the Medicare population over time, to assess costs, and to characterize the health care professionals (eg, clinicians, laboratories, physician assistants, and nurse practitioners) and patient populations using these tests.

Evaluating the impact of the self-BAT screening tool on patient outcomes: Results of the let's talk period project.

Introduction: One of the many challenges in diagnosing bleeding disorders is distinguishing between normal and abnormal bleeding symptoms. Letstalkperiod.ca is an educational website that includes an online self-administered bleeding assessment tool (Self-BAT) which is a validated screening tool that enables patients to independently determine their bleeding scores (BS).

Complications associated with prone positioning in mechanically ventilated COVID-19 patients: A multicentre, retrospective observational study.

Background And Aims: Prone positioning is commonly applied to improve gas exchange in mechanically ventilated patients with coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome (ARDS). Whilst prone positioning is effective, specific complications may arise. We aimed to assess the prevalence of specific complications related to prone positioning in patients mechanically ventilated for COVID-19-related ARDS.

Towards a unified carbon accounting landscape.

The overarching purpose of carbon accounting is to reduce carbon emissions to meet net-zero targets and minimize the impact of climate change. However, the plethora of methods and approaches used means that products and systems sometimes cannot easily be compared. The mix of regional and life cycle-based systems can mean that we lack global oversight of our emissions and impact.

Trainee district nurses' understanding and perceptions of the palliative care key worker role: a qualitative study.

Background: The district nurse is identified as a keyworker in community based palliative care. However, a dearth of research exists on trainees' views and understanding of adopting the role upon qualification.

Aims: The aim of this study was to explore the understanding and perceptions of district nurse trainees in relation to the palliative care key worker role.

Public health case for microbiome-sparing antibiotics and new opportunities for drug development.

Although antibiotics remain a cornerstone of modern medicine, the issues of widespread antibiotic resistance and collateral damage to the microbiome from antibiotic use are driving a need for drug developers to consider more tailored, patient-directed products to avoid antibiotic-induced perturbations of the structure and function of the indigenous microbiota. This perspective summarizes a cascade of microbiome health effects that is initiated by antibiotic-mediated microbiome disruption at an individual level and ultimately leads to infection and transmission of multidrug-resistant pathogens across patient populations. The scientific evidence behind each of the key steps of this cascade is presented.

Building and Maintaining a Whole Community Initiative: Health Communication in Practice with Be Well Communities™.

The most effective health communication builds from evidence-based best practices and theory. In practice, health campaigns rely on considerations often under-discussed in health communication, such as consistent agency-style client service, image management, and community coalition-building. Health outcome progress often requires change at multiple levels, from individual cognition and behavior to policy creation.

Adherence of polystyrene microspheres on cave sediment: implications for organic contaminants and microplastics in karst systems.

Interactions of karst aquifer sediments with organic contaminants or microplastics (MPs) have received relatively little attention even though the susceptibility of karst aquifers to contamination and their ability to store and transport sediment is well documented. Studies using polystyrene microspheres as surrogate tracers for bacteria transport in karst systems have generally observed low recovery of microspheres and attributed this to microsphere adsorption onto aquifer sediments. In addition to being used as surrogate tracer for bacteria, microspheres have the potential to be used as surrogate material for organic contaminants and MPs.

Decolonization and Pathogen Reduction Approaches to Prevent Antimicrobial Resistance and Healthcare-Associated Infections.

Antimicrobial resistance in healthcare-associated bacterial pathogens and the infections they cause are major public health threats affecting nearly all healthcare facilities. Antimicrobial-resistant bacterial infections can occur when colonizing pathogenic bacteria that normally make up a small fraction of the human microbiota increase in number in response to clinical perturbations. Such infections are especially likely when pathogens are resistant to the collateral effects of antimicrobial agents that disrupt the human microbiome, resulting in loss of colonization resistance, a key host defense.

Test Purchasing of Same-Day and Rapid Online Alcohol Home Delivery in Two Australian Jurisdictions.

Objective: With same-day online alcohol sales increasing, there is a need to study their regulation. Test purchasing of alcohol home delivery was conducted to measure compliance with regulations for identification checks and unattended deliveries in two Australian jurisdictions (Perth, Western Australia, and Geelong, Victoria), which have differing regulations.

Method: Alcohol orders for same-day or rapid (<2 hours) delivery on Friday and Saturday nights were made by research assistants ages 18-24 years in Perth ( = 34) and Geelong ( = 29).

Anisocoria in patients with hyperhidrosis: A case series for the primary care physician.

The differential diagnosis for anisocoria is broad and ranges from benign to life-threatening causes. Often, patients with new onset anisocoria present to their primary care physician, an urgent care center, or an emergency room. As such, it is important for non-ophthalmologist physicians to be familiar with its common causes.

Editorial Commentary: Diminished Hip Hypoplastic Labrum Predicts Poor Patient Outcomes After Non-augmented Primary Repair.

Diminished hip labral size and tissue quality may be a predictor of poor patient outcomes when a non-augmented primary labral repair is performed. Labral augmentation is an option for patients with hypoplastic or degenerative labral tissue. The optimal graft for augmentation has yet to be identified, and biomechanical research shows no difference in force to suction-seal disruption between dermal allograft and iliotibial band allograft when used to augment the labrum.

Oxygen Isotope and Fluorine Impurity Signatures during the Conversion of Uranium Ore Concentrates to Nuclear Fuel.

Within the front end of the nuclear fuel cycle, many processes impart forensic signatures. Oxygen-stable isotopes (δO values) of uranium-bearing materials have been theorized to provide the processing and geolocational signatures of interdicted materials. However, this signature has been minimally utilized due to a limited understanding of how oxygen isotopes are influenced during uranium processing.