Present Study Research Articles

Online Learning With Uncertain Feedback Graphs.

Online learning with expert advice is widely used in various machine learning tasks. It considers the problem where a learner chooses one from a set of experts to take advice and make a decision. In many learning problems, experts may be related, henceforth the learner can observe the losses associated with a subset of experts that are related to the chosen one. In this context, the relationship among experts can be captured by a feedback graph, which can be used to assist the learner's decision-making. However, in practice, the nominal feedback graph often entails uncertainties, which renders it impossible to reveal the actual relationship among experts. To cope with this challenge, the present work studies various cases of potential uncertainties and develops novel online learning algorithms to deal with uncertainties while making use of the uncertain feedback graph. The proposed algorithms are proved to enjoy sublinear regret under mild conditions. Experiments on real datasets are presented to demonstrate the effectiveness of the novel algorithms.

Superficial temporal artery access for transfemoral or transbrachial carotid artery stenting in selected patients considered unfit for carotid surgery.

Transfemoral (TFCAS) or transbrachial carotid artery stenting (TBCAS) is an alternative to carotid endarterectomy (CEA) for treatment of high-grade internal carotid artery (ICA) stenosis. A difficult aortic arch (i.e., type III or bovine arch) and/or a tortuous/stenosed common carotid artery (CCA) are potential reasons for technical failure. This study explores the benefits of superficial temporal artery access (STAA) in aiding TFCAS or TBCAS for patients with challenging anatomical conditions. Clinical data of patients who underwent TFCAS or TBCAS using STAA between January and November 2023 were prospectively collected. Demographics, comorbidities, clinical presentation, and imaging studies were reviewed. Primary outcomes included 30-day stroke/death and technical success. Secondary outcomes and causes of failures were assessed. Ten patients (mean age: 74 [range: 66-84] years) with difficult aortic arch (N.=2), CCA tortuosity (N.=2), proximal CCA stenosis (N.=2), previous technical TFCAS failure (N.=2) and aortoiliac occlusive disease (AIOD) (N.=2) underwent TFCAS or TBCAS supported by STAA. Successful STAA was possible in eight patients (six facilitated TFCAS and two TBCAS. after TBCAS occurred TIA). In two cases STAA was not successful. There were no deaths or strokes within 30 days, transient ischemic attack (TIA) occurred in one patient. Follow-up Duplex ultrasound confirmed occlusion of the STA in all patients, without clinical consequences. This prospective study suggests that TFCAS/TBCAS supported by STAA is a viable and safe approach when traditional access methods are ineffective and transcarotid artery stenting in not available or not possible. Despite a 20% technical failure in the current series, this technique may be useful for challenging anatomy of the aortic arch, CCA stenosis and tortuosity, and AIOD. When feasible, STAA may be a promising adjunct to TFCAS/TBCAS.

Research-based Analytical Procedures to Evaluate Diabetic Biomarkers and Related Parameters: In Vitro and In Vivo Methods.

The degenerative tendency of diabetes leads to micro- and macrovascular complications due to abnormal levels of biochemicals, particularly in patients with poor diabetic control. Diabetes is supposed to be treated by reducing blood glucose levels, scavenging free radicals, and maintaining other relevant parameters close to normal ranges. In preclinical studies, numerous in vivo trials on animals as well as in vitro tests are used to assess the antidiabetic and antioxidant effects of the test substances. Since a substance that performs poorly in vitro won't perform better in vivo, the outcomes of in vitro studies can be utilized as a direct indicator of in vivo activities. The objective of the present study is to provide research scholars with a comprehensive overview of laboratory methods and procedures for a few selected diabetic biomarkers and related parameters. The search was conducted on scientific database portals such as ScienceDirect, PubMed, Google Scholar, BASE, DOAJ, etc. Conclusion: The development of new biomarkers is greatly facilitated by modern technology such as cell culture research, lipidomics study, microRNA biomarkers, machine learning techniques, and improved electron microscopies. These biomarkers do, however, have some usage restrictions. There is a critical need to find more accurate and sensitive biomarkers. With a few modifications, these biomarkers can be used with or even replace conventional markers of diabetes.

Prevalence of COVID-19 Among 8000 Patients at a Hospitalized and Mortality in Old Age.

COVID-19 created a general challenge to healthcare systems throughout the world and was an important cause of mortality. The aim of the present study was to report the general evolution of patients with COVID-19 at a teaching hospital and analyze differences by age group and sex considering mortality rates in the years 2020 and 2021 among patients older than 60 years of age. A cross-sectional study was conducted with patients hospitalized with a diagnosis of COVID-19 confirmed by RT-PCR at the São Jose do Rio Preto university hospital between March 2020 and March 2022. The patients were male and female patients, of varying ages belonging to the region of Sao Jose do Rio Preto, were accommodated in the wards or intensive care units (ICUs). Overall mortality was analyzed for the hospital as well as in the ICUs and wards. This analysis was performed separately in two years considering age group, sex, and main comorbidities in patients older than 60 years of age. A total of 8032 patients with COVID-19 were hospitalized between March 2020 and March 2022: 2866 patients with 658 deaths (22.92%) in 2020; 4324 patients with 1168 deaths (27.01%) in 2021; and 842 patients with 205 deaths (24.35 %) in 2022 up to the month of March. More than half (53.60%) of the patients were hospitalized in the ICUs and 46.39% were hospitalized in the wards. Differences in the mortality rate were found for the different age groups in the comparison of the years, with more deaths occurring among individuals up to 90 years of age in the second year (p <0.05). Men were affected more and had a higher mortality rate (p <0.0001). The main comorbidities were cardiovascular disease (70.93%), diabetes (37.76%), and obesity (23.68%). The mortality rate of older people hospitalized with COVID-19 was higher than the average, it was higher in 2021 compared to 2020 and increased with age. Cardiovascular disease, diabetes, and obesity were the main comorbidities.

Pre-clinical Evidence-based Neuroprotective Potential of Naringin against Alzheimer's Disease-like Pathology: A Comprehensive Review.

Neurodegenerative disorders (NDs) are a group of progressive, chronic, and disabling disorders that are highly prevalent and the incidence is on a constant rise globally. Alzheimer's disease (AD), one of the most common neurodegenerative disorders is hallmarked by cognitive impairment, amyloid-β (Aβ) deposition, hyperphosphorylation of tau protein, cholinergic dysfunction, mitochondrial toxicity, and neurodegeneration. Available therapeutic agents only provide symptomatic relief and their use are limited due to serious side effects. Recent research has recognized flavonoids as potential multi-target biomolecules that can reduce the pathogenesis of AD. Naringin, a natural citrus flavonoid has been traditionally used to treat various NDs including AD, and has gained special attention because exhibits a neuroprotective effect by affecting numerous signaling pathways with minimum adverse effects. Naringin reduces deposition of Aβ, hyperphosphorylation of tau protein, cholinergic dysfunction, oxidative stress burden, mitochondrial toxicity, the activity of glutamate receptors, and apoptosis of the neuronal cells. Additionally, it reduces the expression of phosphorylated-P38/P38 and the NF-κB signaling pathway, showing that a wide range of molecular targets is involved in naringin's neuroprotective action. The present study describes the possible pharmacological targets, signaling pathways, and molecular mechanisms of naringin involved in neuroprotection against AD-like pathology. Based on the above pre-clinical reports it can be concluded that naringin could be an alternative therapeutic agent for the management of AD-like manifestation. Thus, there is a strong recommendation to perform more preclinical and clinical studies to develop naringin as a novel molecule that could be a multi-target drug to counteract AD.

Composição nutricional e atividades antioxidante e quimiopreventiva de câncer de frutos de Psidium myrtoides (O. Berg)

ABSTRACT: Psidiummyrtoides fruits food industries produce by-products such as liqueurs, ice cream, jellies, and juices. However, there needs to be more information about the nutritional composition of fruits, as well as the biological potential, mainly of seed flour.Therefore, the present study aimed to evaluate the nutritional composition and antioxidant and cancer chemopreventive activities of pulp and seed of fruits of Psidiummyrtoides. Moisture content, total minerals and mineral profile, total lipids and fatty acids profile, total proteins, dietary fiber (soluble and insoluble) and total carbohydrates were analyzed. Vitamins C and complex B, organic acids and the profile of phenolic compounds were also determined. DPPH and ABTS methods evaluated the antioxidant activity, and cancer chemopreventive activity was evaluated by quinone reductase induction and NF-κB inhibitory activity. The fruits are a good source of thiamine, iron, phosphorus, potassium, fiber, and protein. Linoleic acid was the major fatty acid in both pulp and seed. Quercetin (1600 µg/100g) and pyrogallol(819 µg/100g) were the major phenolic compounds pulp and seed, respectively. The fruits showed strong antioxidant capacity, mainly the seeds, and the ability to induce quinone reductase activity, highlighting a cancer chemopreventive activity. Seed flour has a high potential to enrich food, in addition to valuing agro-industrial by-products, where we can highlight 25%, 13% and 37% of the recommended daily intake for iron (1.6 mg/100g), phosphorus (58 mg/100g) and vitamin B1 (450 µg/100g), respectively, in addition to antioxidant and cancer chemopreventive activities.

Biological Importance of Phellodendrine in Traditional and Modern Medicines: An Update on Therapeutic Potential in Medicine.

Herbal medicines have been used for the preparation of numerous pharmaceutical products for the treatment of human disorders. Plant-derived products have been used in medicine, nutraceuticals, perfumery, beverages, and cosmetics industries for different purposes. Herbal medicines are mainly derived from different parts of plant materials. Phellodendron bark has been widely known as one of the fundamental herbs of traditional Chinese medicine. Phellodendron bark contains phellodendrine as a main active phytochemical. Phellodendrine ((7S,13aS)-3,10-dimethoxy-7-methyl-6,8,13,13atetrahydro-5H-isoquinolino[2,1-b]isoquinolin-7- ium-2,11-diol), is a quaternary ammonium alkaloid. This present study aimed to investigate the biological potential and therapeutic effectiveness of phellodendrine in medicine through scientific data analysis of different research works on phellodendrine. The therapeutic value of phellodendrine was analyzed in the present work through scientific data available in Google, Google Scholar, ScienceDirect, and PubMed. All the scientific data on phellodendrine were collected from these databases using the terms herbal drugs and phellodendrine. Pharmacological and analytical data of phellodendrine were analyzed in the present work in order to know the medicinal importance of phellodendrine. Scientific data analysis of phellodendrine in the present work signified the biological importance of phellodendrine in medicine. Phellodendrine has numerous beneficial aspects in medicine due to its potential benefits in ulcerative colitis, inflammation, pancreatic cancer, nephritis, immune response, acetylcholinesterase activity, psoriasis, arthritis, atopic dermatitis, and oxidative stress. However, it also has significant effects on eicosanoid generation, neuraminidase-1, inflammasome generation, cytochrome p450, taste receptors, and hepatic gluconeogenesis. Furthermore, scientific data has indicated the presence of phellodendrine in different natural sources, including Phellodendri cortex. Analytical data on phellodendrines has signified their importance in the isolation and separation of pure phytochemicals in medicine. Pharmacokinetic parameters have highlighted the tissue distribution of phellodendrine in different tissue of human beings and higher animals. In the present work, scientific data analysis has indicated the biological importance, pharmacological activities, and analytical aspects of phellodendrine in medicine.

Differences in Lower-Extremity Joint Coordination During Two Landing Phases of a Drop Jump Task.

The aim of the present study was to compare the differences in joint coordination patterns and variability in the lower extremity between the first and second landing phases of the drop jump. Eighteen resistance-trained men (age: 22.8 ± 1.8years) performed drop jumps from a height of 0.40m. An eight-camera motion capture system was utilized to record kinematic trajectories. Modified vector coding technique and circular statistics were used to determine the coordination pattern and variability of the following joint couples during the first and second landings: hip frontal-knee frontal (HfKf), hip sagittal-knee frontal (HsKf), hip sagittal-knee sagittal (HsKs), knee frontal-ankle frontal (KfAf), knee sagittal-ankle frontal (KsAf), and knee sagittal-ankle sagittal (KsAs). Statistical differences in the distribution frequencies of coupling angles and variability between the dominant and nondominant limbs across the two landing phases were compared using two-way repeated analysis of variance and Wilcoxon rank-sum tests. During the second landing phase, the proportion of HsKs, KfAf, and KsAs showing in-phase coordination was reduced but the proportion of KfAf and KsAs showing proximal joint (knee) coordination was increased (p < .05). Significant differences in bilateral asymmetry were observed only for the HfKf and KfAf patients (p < .05). HsKs, KfAf, and KsAf varied considerably during the second landing phase (p < .05). Joint coordination patterns during the second landing phase of the drop jump differed considerably from those during the first landing phase, thereby increasing the risk of knee and ankle injuries.

CTXP, The Major Cobra Toxin Peptide from Naja Naja Oxiana Venom; A Promising Target for Antivenom Agent Development.

Snakebite envenoming is a serious public health issue causing more than 135,000 annual deaths worldwide. Naja Naja Oxiana is one of the most clinically important venomous snakes in Iran and Central Asia. Conventional animal-derived polyclonal antibodies are the major treatment of snakebite envenoming. Characterization of venom components helps to pinpoint the toxic protein responsible for clinical manifestations in victims, which aids us in developing efficient antivenoms with minimal side effects. Therefore, the present study aimed to identify the major lethal protein of Naja Naja Oxiana by top-down proteomics. Venom proteomic profiling was performed using gel filtration (GF), reversed-phase (RP) chromatography, and intact mass spectrometry. The toxicity of GF-, and RP-eluted fractions was analyzed in BALB/c mice. The rabbit polyclonal antisera were produced against crude venom, GF fraction V (FV), and RP peak 1 (CTXP) and applied in neutralization assays. Toxicity studies in BALB/c identified FV as the major toxic fraction of venom. Subsequently, RP separation of FV resulted in eight peaks, of which peak 1, referred to as "CTXP" (cobra toxin peptide), was identified as the major lethal protein. In vivo neutralization assays using rabbit antisera showed that polyclonal antibodies raised against FV and CTXP are capable of neutralizing at least 2-LD50s of crude venom, FV, and CTXP in all tested mice. Surprisingly, the Anti-CTXP antibody could neutralize 8-LD50 of the CTXP peptide. These results identified CTXP (a 7 kDa peptide) as a potential target for the development of novel efficient antivenom agents.

Formulation, Optimization and Evaluation of Dabigartan Etexilate Encapsulated Solid Supersaturated Self-Nanoemulsifying Drug Delivery System

Objective: The present study proposed Dabigatran Etexilate loaded solid supersaturat-ed self-nanoemulsifying drug delivery system (solid S-SNEDDS) for enhancement of payload, drug solubility, dissolution rate as well as minimization of drug precipitation. Methods: The study involved formulation optimization using the Box-Behnken design. The op-timal SNEDDS consisting of Caprylic acid (32.9% w/w), Cremophor EL (50.2% w/w) and Transcutol HP (18.8% w/w) as Oil, Surfactant and Co-surfactant, respectively were formulated and evaluated for particle size, PDI, Zeta potential and saturation solubility. The SNEDDS was further incorporated with PPIs for the preparation of supersaturated SNEDDS (S-SNEDDS) to in-crease the drug payload in the formulation. S-SNEDDS was converted to solid S-SNEDDS by ad-sorption onto the porous carrier i.e., Aerosil®200. The in-vitro drug release study was also con-ducted for solid S-SNEDDS. Results: SNEDDS had size, PDI, and Zeta potential of 82 nm, 0.347, -10.50 mV, respectively. SNEDDS enhanced the saturation solubility of the drug by 93.65-fold. Among PPIs, HPMC K4M showed the most effective response for the formulation of S-SNEDDS. The S-SNEDDS had a more substantial drug payload, which further increased the solubility by 150 times of pure drugs and 16 times of SNEDDS. Solid S-SNEDDS exhibited free-flowing properties. Reconstituted sol-id S-SNEDDS had acceptable size, PDI, and Zeta potential of 131.3 nm, 0.457, and -11.3 mV, respectively. In-vitro drug release study revealed higher drug dissolution and minimized drug pre-cipitation by SNEDDS compared to marketed products and pure drugs. Conclusion: Proposed nano-formulation was found to efficiently improve the aqueous solubility of the drug and avoid the drug precipitation, thereby avoiding drug loss and improving drug bioa-vailability.

The association between acculturative stress and rule-breaking behaviors among Latinx adolescents in rural areas: A moderated mediation analysis.

The present study examined the association between acculturative stress and rule-breaking behaviors, with depressive symptoms as the mediator, and emotion regulation and parental behavioral involvement (i.e., time spent in shared activities between parents and adolescents) as the moderators among Latinx adolescents in rural areas. Using a sample of Latinx adolescents (N = 193; Mage = 15.90; 54.4% female) recruited from rural areas, a moderated mediation model was tested. Findings showed that the mediational pathways connecting acculturative stress, depressive symptoms, and rule-breaking behaviors were moderated by emotion regulation and parental behavioral involvement. Specifically, higher levels of acculturative stress were associated with higher levels of rule-breaking behaviors through elevated depressive symptoms only among adolescents who reported low levels of both emotion regulation and parental behavioral involvement. These findings underscore the importance of considering multiple contextual factors in understanding the development of internalizing and externalizing behaviors among Latinx adolescents in rural areas. The findings suggest intervention programs may target parental behavioral involvement and emotion regulation to help adolescents cope with acculturative stress and perhaps other minority stressors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Retrospective study on the distribution of hemoglobinopathies in Karnataka-A laboratory experience.

The importance of screening for hemoglobinopathies is well-documented in India. However, information on the distribution of hemoglobinopathies in Karnataka is lacking. The present study focuses on determining the spectrum of hemoglobinopathies for various districts of Karnataka. A retrospective analysis of samples registered for hemoglobinopathies for a period of 5 years (2017-2021) was carried out. A total of 17066 records registered only from the Karnataka region, were anonymized and retrieved. The data included gender, age, district, and results of the tests. The results were based on complete blood count, peripheral smear, and capillary electrophoresis (CE) pattern. The data were revalidated by pathologists, and the unambiguous data were analyzed for the study. One-fourth of the records (25%) showed abnormal hematological parameters. The number of female records (66%) was twice that of males and both genders showed higher distribution of thalassemia, followed by variants and double heterozygotes (DH). Several cases of thalassemia major were identified below the age of 17 years. The majority of thalassemia cases were β thal and 93% of them were β thal trait. Among the variants, HbS was more prevalent than HbE. Among the districts, Hassan had a 35.2% thal, Mysuru had a 7.2% variant, and Chitradurga had a 5.5% DH. Thalassemia, variants, and DH were distributed across several districts of Karnataka to various levels. The comprehensive retrospective analysis of the spectrum of hemoglobinopathies in various districts of Karnataka serves as evidence to carry out a prospective study on population screening where the incidence of thalassemia and structural variants is high.

Kadına Yönelik Şiddet: Kalıcı ve Yükselen Bir Sorun

Violence against women is a widespread global public health problem. It is also a serious violation of women's human rights. Violence has traumatic effects on the health and well-being of women and the children who witness it. Violence against women is associated with physical, mental, emotional, sexual health, reproductive health problems and death. Violence and gender norms, which are one of the risk factors causing the continuation of violence; also have significant effects on families and societies, and these negative effects cross social and economic boundaries. However, it is also clear that current prevention initiatives and policy responses are insufficient. Mental health professionals have an important role to play in identifying, preventing and responding appropriately to violence against women and may take primary, secondary and tertiary measures to reduce the risk of violence against women. While providing mental health services, İt is very important to be aware of interpersonal violence and to provide gender-sensitive services. When providing these services, the impact of violence against women on mental health and knowledge of potential treatments are considered as a prerequisite. Along with the knowledge about the dynamics of violence, it is considered extremely important to take measures against the risks that weaken women who are disadvantaged due to problems such as gender inequality. For this reason, in this review, the concept of violence against women and the types of violence are explained and in this context, the initiatives that can be made in the field of mental health are included. It is thought that this review will contribute to the awareness of professionals working in the field about the seriousness of the problem and how violence affects women's mental health. It is also hoped that the present study will provide insight into the complex relationship between violence and health outcomes to help improve health policies and prevention responses in the relevant field.

The Effect Of Grain Prices On Food Inflation: A Forward-Looking Evaluation Among The Russia-Ukraine Conflict

The present study investigates how grain prices have been affecting food inflation in the wake of the recent pandemic and the ongoing Russia-Ukraine conflict. This study examines the effects on inflation of the limitations on exports of wheat, barley and corn products by Russia and Ukraine on the food inflation in Asia and North Africa by using cointegration test. Drawing upon monthly data from the 2000:01–2020:08 period, the study reveals that the food price index and grain prices in both Asia and North Africa are cointegrated in the long term, and that in both country groups wheat price increases in particular are triggering an increase in food prices.

Radiofrequency Catheter Ablation for Atrial Fibrillation Patients on Hemodialysis (From the Kansai Plus Atrial Fibrillation Registry) - Clinical Impact of Early Recurrence.

Catheter ablation (CA) for atrial fibrillation (AF) in patients on hemodialysis (HD) is reported to have a high risk of late recurrence (LR). However, the relationship between early recurrence (ER) within a 90-day blanking period after CA in AF patients and LR in HD patients remains unclear.Methods and Results: Of the 5,010 patients in the Kansai Plus Atrial Fibrillation Registry, 5,009 were included in the present study. Of these patients, 4,942 were not on HD (non-HD group) and 67 were on HD (HD group). HD was an independent risk factor for LR after the initial CA (adjusted hazard ratio 1.6; 95% confidence interval 1.1-2.2; P=0.01). In patients with ER, the rate of sinus rhythm maintenance at 3 years after the initial CA was significantly lower in the HD than non-HD group (11.4% vs. 35.4%, respectively; log-rank P=0.004). However, in patients without ER, there was no significant difference in the rate of sinus rhythm maintenance at 3 years between the HD and non-HD groups (67.7% vs. 74.5%, respectively; log-rank P=0.62). ER in HD patients was a strong risk factor for LR. However, even HD patients could expect a good outcome without ER after the initial CA.

A Contrastive Study of Theme Types in Academic IELTS Essays Written by English-Majored Students and IELTS Candidates

The present study was conducted to investigate theme types in academic IELTS essays written by successful test-takers and English-majored students at Quang Nam university, applying Halliday (2014)’s functional model of Theme-Rheme in English, and then making a comparison between two different levels of performance: one with 7-7.5 band scores and the other written by English-majored students to identify similarities and differences between two essay groups. In this study, the data were 60 IELTS essays collected from two domains: 30 IELTS essays written by English majored students at Quang Nam university, and 30 sample essays scored from 7.0 to 7.5. The findings of this study are expected to enable IELTS test-takers in general and English-majored students at Quang Nam university in particular to take into account the prominent theme types of academic IELTS sample essays in order to make good use of thematic strategies to produce an effective and coherent piece of writing.

Performance of sugarcane molasses in concrete under hot weather

AbstractThe present research studies the effect of adding sugar factory waste sugarcane molasses as an alternative to chemical inhibitory additives manufactured on concrete cast during hot weather in the summer of Iraq. The current study includes a study of the setting time for cement paste and workability for fresh concrete and some mechanical properties of hardened concrete with sugarcane molasses using percentage 0–0.3% of cement weight. The study also included studying the value of pH of concrete to investigate the effect of sugarcane molasses on reinforced concrete. The results showed that the sugarcane molasses can be used by about 0.1% of cement weight for medium projects and between 0.1 and 0.2% for large projects. It was also found that the compression strength increased by about 11.5% and the indirect tensile strength increased by about 7.5 and 7.4% for splitting and flexural test, respectively for concrete mixtures containing 0.2% of sugarcane molasses.

Novel TUBA4A variant causes congenital myopathy with focal myofibrillar disorganisation

BackgroundCongenital myopathies are a clinical, histopathological and genetic heterogeneous group of inherited muscle disorders that are defined on peculiar architectural abnormalities in the muscle fibres. Although there have been at...

Epidemiology of back pain visits and medication usage among United States emergency departments from 2016 to 2023

IntroductionLow back pain is a common reason for presentation to the Emergency Department (ED). However, there are limited large-scale, recent data on the epidemiology, disposition, and medication administration for this condition. The objective of this was to assess the incidence, admission rates, medication administrations, and discharge prescriptions among ED visits for low back pain in the United States. MethodsThis was a cross-sectional study of ED presentations for low back pain from 1/1/2016 to 12/31/2023 using the Epic Cosmos database. All ED visits for adults with low back pain identified by ICD-10 codes were included. Outcomes included admission rates, distribution of opioid, benzodiazepine, (non-benzodiazepine) muscle relaxant, acetaminophen, NSAID, and corticosteroid medications administered in the ED, and distribution of opioid, benzodiazepine, muscle relaxant, and corticosteroid medications given upon discharge. Subgroup analyses were performed by specific medication. ResultsOf 207,154,419 ED encounters, 12,241,240 (5.9%) were due to back pain with 1,957,299 of these (16.0%) admitted. The admission rate increased over time from 12.8% to 17.1%. The most common medication given in the ED was opioids (40.7%), followed by acetaminophen (37.8%), NSAIDs (22.6%), muscle relaxants (18.4%) benzodiazepines (12.8%), and corticosteroids (5.5%). The most common medications prescribed upon discharge were muscle relaxants (32.1%), followed by opioids (23.2%), corticosteroids (12.2%), and benzodiazepines (3.0%). ConclusionLow back pain represents a common reason for presentation to the ED, and admissions have been increasing over time. Opioids remain the most common ED medication, whereas muscle relaxants have arisen as the most common discharge prescription. These findings can help inform health policy decisions, resource allocation, and evidence-based interventions for medication administration.

NCAA coaches’ perceptions of the inclusion of transgender athletes: a qualitative analysis

ABSTRACT The National Collegiate Athletic Association (NCAA) established policies for the inclusion of transgender athletes to compete in collegiate sport that align with their gender identity. Despite this access, the extent to which collegiate sport environments are welcoming, inclusive and supportive of transgender athletes is unclear. Understanding coaches’ perceptions and attitudes is particularly salient given the critical, and often personal, nature of coach–athlete relationships and the impact coaches have on sport environments [Kuhlin, F., Barker-Ruchti, N., & Stewart, C. (2020). Long-term impact of the coach–athlete relationship on development, health and wellbeing: stories from a figure skater. Sports Coaching Review, 9(2), 208–230; Stirling, A. E., & Kerr, G. A. (2013). The perceived effects of elite athletes’ experiences of emotional abuse in the coach–athlete relationship. International Journal of Sport and Exercise Psychology, 11(1), 87–100]. NCAA coaches’ perceptions of, and attitudes towards the inclusion of transgender athletes is unknown, and thus the degree to which coaches are creating safe, or harmful, environments for transgender athletes is unknown. The present study aims investigate coaches’ perceptions to be able to inform policy and education for promoting inclusive, safe environments for transgender athletes. We asked NCAA coaches (N = 1358) to describe the reasoning for their beliefs regarding the inclusion of transgender athletes in collegiate sports. Through reflexive thematic analysis, we determined coaches’ reasoning for their perceptions, within the context of five higher-order themes: (a) It’s not right: Transgender identities as invalid, (b) A need to protect (cis) women’s sports, (c) Transgender rights are human rights, (d) Sport’s role in society and coaches’ role in sport and (e) I am not sure what I believe. Analyses illuminate avenues for transgender athlete inclusion training for coaches.