Restricted Period Research Articles

Both Feed Restriction and Transition Period Suppressed Adipose Tissue MRNA Abundance of Genes Involved in Lipogenesis and Lipolysis in Fat-Tailed Ewes.

This study sought to investigate the consequences of the induced feed restriction during the transition period on the mRNA abundance of genes entangled in lipogenesis and lipolysis in the tail adipose of fat-tailed sheep. Twenty fat-tailed ewes were randomised into the control (Control; n = 10) and restriction (Restriction; n = 10) groups. Control animals were fed 100% of the balanced diet pre-(Week -5 to parturition) and post-partum (parturition to Week 5). Restriction ewes received equivalent 100%, 50%, 65%, 80%, and 100% of the balanced ration at Weeks -5, -4, -3, -2, and -1 relative to parturition, respectively. After parturition, the latter group received the equivalent of 100%, 50%, 65%, 80%, and 100% of the diet recommendation at weeks 1, 2, 3, 4, and 5, respectively. At the end of weeks -3 and 3, tail adipose were sampled under local anesthesia. Fatty acid synthase, acetyl-CoA carboxylase, carnitine palmitoyltransferase I and II, and acyl-CoA synthase long-chain family member-1 mRNA abundances were measured using the TaqMan quantity real-time PCR. A mixed model procedure of SAS software was used to evaluate the results. Feed restriction downregulated target genes' mRNA abundance during both pre- and post-partum. Parturition suppressed the mRNA abundance of measured genes in both groups. Established on the outcomes, lipogenesis, and lipolysis of the adipose tissue would be influenced by metabolite and hormone instability during the transition period and feed restriction. The lessening of adipose tissue lipogenesis and lipolysis might be a hemostatic response to cope with the energy insufficiency for fetal growth and the onset of lactation and also prevent the induction of inflammation, metabolic disorders, and infectious diseases during feed restriction or transition period.

A multi-perspective qualitative exploration of the reasons for changes in the physical activity among 10–11-year-old children following the easing of the COVID-19 lockdown in the UK in 2021

Abstract Background Active-6 is exploring how the COVID-19 pandemic has impacted physical activity behaviour among Year 6 children (aged 10–11 years) and their parents in Southwest England. Initial findings from the Active-6 project have shown a 7–8 min decrease in moderate-to-vigorous physical activity and an increase in sedentary behaviour among children following the easing of restrictions in the UK in latter half of 2021. This finding suggests that the pandemic has had a persistent impact on child physical activity behaviour. This paper explored the possible mechanisms behind these changes. Methods Interviews with parents (n = 21), members of school staff (n = 9) and focus groups with children aged 10–11 years (n = 47) were conducted between August and December 2021 to discuss the impact of the pandemic on child physical activity behaviour. The framework method was used for analysis. Results Five themes spanning two key stages of the pandemic were described. Three themes related to the period of lockdowns and fluctuating restrictions (March 2020 – April 2021). These included: Theme 1) Lockdown: A short-lived adventure; Theme 2) Access to facilities during restrictions; and Theme 3) The importance of the parent. A further two themes were identified related to the period following the gradual easing of restrictions in April 2021. These included: Theme 4) An overwhelming return to normal; and Theme 5) Reopening fatigue. Conclusions The analysis suggested that feelings of novelty experienced during the initial stages of lockdown waned as restrictions were prolonged, creating an increasingly challenging period for parents and their children. However, during periods of restrictions, the importance of parental encouragement and access to appropriate facilities in the local and home environment helped facilitate physical activity. Following the easing of COVID-19 restrictions, emotional overwhelm and physical fatigue among children, stemming from a sedentary and socially isolated life in lockdown and other restrictions, were key contributors to the decreased moderate to vigorous physical activity and increased sedentary behaviour that was observed in a related quantitative study.

Intimate Partner Violence in the Late COVID-19 Period: A Study of 10 Countries from the I-SHARE Consortium

ABSTRACT Intimate partner violence (IPV) is a serious public health issue and violation of human rights. During 2021–2022, many countries relaxed COVID-19 restrictions. This provided a unique opportunity to understand the prevalence and correlates of IPV during a period of relaxing COVID-19 restrictions. This cross-sectional study examined IPV during this period from the International Sexual HeAlth and REproductive Health (I-SHARE) study conducted from March to July 2022. Mixed-effects modeling was used to determine correlations of physical, sexual, and psychological violence as compared to before the COVID-19 restrictions. The population comprised individuals in 10 countries (Armenia, Brazil, Egypt, Denmark, Germany, Moldova, Nigeria, Portugal, Singapore and Spain). Our sample included 4,464 participants from these countries. In the previous 3 months, a total of 150 (6.1%) and 114 (4.6%) participants experienced physical violence once or multiple times, respectively. A total of 129 (5.1%) and 174 (6.9%) of participants experienced any form of sexual violence once or multiple times, respectively; and 377 (13.7%) and 574 (20.9%) of participants experienced any form of psychological violence once or multiple times, respectively. In general, identifying as a sexual minority and having children at home were associated with higher odds of experiencing IPV. Age, economic situation, cohabitation status, and a country’s GDP per capita were associated with recent IPV or a worsening of IPV compared to before the COVID-19 restrictions, although results varied depending on the types of violence. Further work is needed to strengthen IPV support for several groups, especially in emergency situations or future pandemics.

Replacing sulfate with hydroxychloride sources of trace minerals modulated the growth performance and plasma indicators of inflammation and energy metabolism in beef heifers during periods of feed restriction and adaptation to a high-starch diet.

This study evaluated the effects of different sources (sulfate vs. hydroxychloride) of Cu, Mn, and Zn during feed restriction and high-starch diet on heifer growth performance. On day 0, Nelore heifers (n = 40) were stratified by body weight (BW = 238 ± 38kg) and age (21 ± 1 mo), and individually allocated into 1 of 40 drylot pens. The study was divided into periods of pen acclimation (day 0 to 27), nutrient surplus (day 28 to 55), nutrient restriction (day 56 to 83), and step-up adaptation to a high-starch diet (day 84 to 112). Heifers had free choice access to Tifton hay (Cynodon sp.) and salt from day 0 to 27. On day 28, 20 heifers/treatment were randomly assigned to receive free choice access to Tifton hay and protein supplementation at 0.10% of BW (dry matter, DM) added with sulfate (SUL) or hydroxychloride (HYD) sources of Cu, Mn, and Zn from day 28 to 112. From day 56 to 83, heifers were offered 50% of the average hay DM intake obtained from day 50 to 55. From day 84 to 112, each respective protein supplement was mixed with a starch-based total mixed ration (TMR) and concentrate DM amount was gradually increased every 7 days (starting with 35% concentrate and 65% hay on day 84 and ending with 80% concentrate and 20% hay from day 106 to 112). Effects of treatment × day and treatment were not detected (P ≥ 0.37) for heifer BW, fecal pH, average daily gain (ADG), and DM intake, except for ADG from day 28 to 56, which was less (P = 0.05) for SUL vs. HYD heifers. Effects of treatment × day were detected (P = 0.02) for plasma concentrations of insulin-like growth factor 1 (IGF-1) and haptoglobin. Plasma concentrations of IGF-1 were greater (P ≤ 0.05) for HYD vs. SUL heifers on days 56, 70, 77, 84, and 91. Plasma concentration of haptoglobin was greater (P = 0.05) for SUL vs. HYD heifers on day 63. Effects of treatment × day of the study and treatment were not detected (P ≥ 0.35) for plasma concentrations of cortisol, ß-hydroxybutyrate (BHBA) and non-esterified fatty acids (NEFA). Thus, Nelore heifers offered hydroxychloride sources of Cu, Mn, and Zn exhibited greater plasma concentrations of IGF-1 and a temporary increase in ADG during nutrient surplus compared to those receiving sulfate sources. While hydroxychloride supplementation reduced the acute phase response early in nutrient restriction, it did not improve growth and plasma concentrations of haptoglobin, cortisol, NEFA and BHBA during nutrient restriction and adaptation to a high-starch diet.

Decreased Incidence of Pediatric Neuro-Autoimmune Disorders During COVID-19 Pandemic Restrictions.

Infections are hypothesized to trigger certain autoimmune diseases; however, there is a lack of epidemiologic data surrounding pediatric neuro-autoimmune disorders during the COVID-19 pandemic. Our retrospective study assessed the incidence of pre-defined autoimmune disorders diagnosed at the Children's Hospital of Eastern Ontario in Ottawa, Canada, between October 2017 and June 2024. Inpatient and outpatient charts were queried to identify subjects with neuro-autoimmune disorders or type 1 diabetes as a nonneurologic autoimmune comparison group. Monthly incidences were calculated and compared between 3 COVID-19 pandemic restriction periods: the prerestrictions period (October 2017-March 2020), intrarestrictions period (April 2020-June 2022), and postrestrictions period (July 2022-June 2024). Poisson regression models were fit to the incidence data. New diagnoses of neuro-autoimmune disorders and type 1 diabetes were identified in 111 and 670 subjects, respectively. Incidence of neuro-autoimmune disorders, but not type 1 diabetes, decreased during the intrarestrictions period when compared to the prerestrictions period (incidence rate ratio = 0.57, 95% confidence interval 0.33-0.95, P < .05).

Self-regulation and socially responsible business: points of contact

The business environment is changing rapidly. The practice of adhering to the principles of socially responsible business is becoming more widespread every year (the number of companies that share and implement such practices is growing rapidly). Of course, in addition to changes in the worldview of business owners and management, external factors, including certain extraordinary events, also contribute to this. Businesses demonstrate the ability to self-regulate their activities and the need for further sectoral unification. The article aims to study the relationship between self-regulation and socially responsible business. The author analyses the specifics of the activities of self-regulatory organisations, which are a classic manifestation of self-regulation. The article analyses the provisions of the Memorandum of Intent to create a favourable environment, develop fair competition in the Ukrainian petroleum products market and meet consumer needs for the period of quarantine and restrictions; the Memorandum on ensuring stable operation of the food supply chain in Ukraine under martial law; and the Memorandum on bank lending for energy infrastructure rehabilitation projects. It is substantiated that memoranda (declarations) of market participants are one of the forms of self-regulation that set out additional obligations and/or new rules of conduct. The author also considers self-regulatory local acts of business entities (declarations of integrity, rules for verification of counterparties, codes of ethics, etc.), which are also part of the concept of self-regulation. The author provides a classification of self-regulation in the context of socially responsible business. The study proves that self-regulation is one of the principles of socially responsible management. It is noted that only companies that adhere to high standards of socially responsible behaviour can demonstrate the ability of business to self-regulate. It is also noted that initiative is one of the key elements of socially responsible business behaviour.

Exploring the use of artificial intelligence in humanitarian supply chain: empirical evidence using user-generated contents

PurposeThe purpose of this study is to investigate the various challenges of humanitarian supply chains (HSC) and how these challenges can be addressed using artificial intelligence (AI).Design/methodology/approachThis study employs exploratory analysis to identify various issues in HSC and the use cases of AI to address these issues through published literature. Subsequently, we collected tweets from Twitter and posts from LinkedIn using relevant keywords over four months. The collected data were cleaned, analyzed and interpreted to gain insights into users' perspectives on the various issues and use cases of AI in HSC.FindingsThe analysis reveals that various issues of HSC such as logistical challenges, security concerns, health and safety, access constraints, information gaps, coordination and collaboration, cultural sensitivity, funding constraints, climate and environmental factors and ethical dilemmas are predominantly discussed in published literature. Meanwhile, user-generated content reveals different levels of prioritization of these issues and AI attributes and offers AI-based solutions.Research limitations/implicationsThis study is subject to certain limitations, including a restricted data collection period of only four months and the use of just two social media platforms. These limitations could be addressed by conducting a more comprehensive and extended data collection across additional platforms to produce more conclusive findings. Another limitation is the lack of contextual information, which may have provided more specific insights.Originality/valueTo the best of the authors’ knowledge, this is possibly the first paper to explore both published literature and the collective intelligence of social media users to examine AI attributes, the various challenges of HSC and how AI can address these challenges.

Impact of the COVID-19 pandemic on cancer diagnoses, oncological care and cancer patients in Germany: a report from the “COVID & Cancer” workshop 2023 of the German Society for Epidemiology (DGEpi)

PurposeThe COVID-19 pandemic was associated with severe disruptions in healthcare worldwide. Cancer patients are at particular risk of adverse consequences from delays in diagnosis and treatment. To evaluate the available data on the impact of the pandemic on cancer diagnoses, oncological care and patient well-being in Germany, the German Society for Epidemiology (DGEpi) in collaboration with the Epidemiological Cancer Registry of Lower Saxony invited to a workshop on “COVID & Cancer” (held on 26–27 October 2023 in Hanover, Germany). This report provides a summary of the scientific presentations, highlights methodological challenges, and recognises essential evidence gaps.MethodsTwelve studies addressing various aspects in relation to cancer diagnoses, oncological care and patient well-being during the COVID-19 pandemic in Germany and two talks sharing experiences from the UK and the Netherlands were presented at the workshop.Results and conclusionsResults from German cancer registries consistently showed lower number of incident cancer diagnoses among adults during the first months of the pandemic compared to the respective months of the years before the pandemic. Data from the cancer registries of Baden-Württemberg and Lower Saxony found especially for breast cancer a notable drop (by approximately one third) in the numbers of diagnoses during the first restriction period (April-May 2020), during which the nationwide mammography screening programme in Germany was temporarily suspended. Overall, the extent and ways, in which the pandemic had adversely affected cancer diagnoses, oncological care and created service backlogs, is still not adequately understood. The long-term consequences are yet to be determined.

Lower levels of household transmission of SARS-CoV-2 VOC Omicron compared to Wild-type: an interplay between transmissibility and immune status.

Knowledge of SARS-CoV-2 household transmission dynamics guides infection control and vaccination measures. This household cohort study prospectively assessed the impact of both the Omicron BA.2 variant and immunity on household transmission using dense saliva sampling and sequence analysis. Households consisting of a PCR-confirmed index and at least two household members were enrolled in March and April 2022 during the Omicron BA.2 wave in the Netherlands. SARS-CoV-2 PCR was performed on ten consecutive saliva samples. Serum-antibodies were measured at baseline and day 42. Household and per-person Secondary Attack Rate (SAR) were calculated to measure transmission. Whole genome sequencing was performed for phylogenetic analysis, followed by sensitivity analysis, to correct for multiple household introductions and index definition. Results were compared with the identical, early-pandemic, pre-immunisation predecessor study. Sixty-seven households were included, consisting of 241 individuals (median age 33.0 years (IQR 12.0-46.0)). Maximum household SAR was 59.7%, per-person SAR 41.5%. Paediatric index cases were more likely to transmit. Transmission was negatively affected by household members' immunity. Phylogenetic analysis showed multiple introductions in four households. Sensitivity analysis resulted in a minimal household SAR of 51.0% and per-person SAR of 28.5%. The Omicron BA.2 variant is highly transmissible within households. However, the transmission rate is lower compared to previous studies with other SARS-CoV-2 variants, highlighting the effect of immunity. Regardless of immune status, children have a crucial role in Omicron household transmission. Intensive sampling and phylogenetic analysis are beneficial for correctly calculating transmission rates, especially during periods of minimal behavioural restrictions.

COVID-19 public health restrictions and opioid overdoes: a summative content analysis of emergency medical services records in three Texas counties

BackgroundWith the broad recognition of increased U.S. opioid overdose (OOD) rates between 2020 and 2021, media, public health, and healthcare organizations have raised significant concerns over the emergence of a simultaneous COVID-19-opioid “twindemic.” Research in this area has explored the possible relationships between negative externalities associated with the pandemic and/or COVID-19 public health interventions and increased risks for opioid use and overdose alongside diminished outcomes following OOD events.MethodsThe study offers a summative content analysis of Emergency Medical Service (EMS) responses to opioid overdose (OOD) events before and after the institution of COVID-19 restrictions. Specifically, the study investigates three Texas counties to evaluate changing OOD rates, patient demographics, and OOD event features. The analysis uses a previously validated machine learning tool to identify OOD events and conducted a summative content analysis of identified events.ResultsA total of 1170 OOD responses events were identified in the three-county dataset. This includes 874 in Travis County, 242 in El Paso County, and 54 in Williamson County. Each county experienced modest changes in EMS calls for OOD events between the pre-restriction and public health restriction time periods. Travis County’s OOD event rate declined from 454 to 420. El Paso’s increased from 103 to 139, and Williamson County’s increased from 23 to 31. These changes were not significant as percentage of possible OOD events or based on by-month comparison. The notable differences between pre-restriction and public health restriction periods were significant decreases in documentation of patient race/ethnicity in Travis and Williamson Counties, significant decreases in housing insecurity and use alone in Travis County, and an increase in transport refusal after treatment in the field in Travis County.ConclusionsUltimately the results presented here problematize prevailing analyses about the so-called opioid-COVID-19 “twindemic.” The data further support emerging trends about substantial geographic variation and show some ways that COVID-19 mitigation measures may have improved conditions for some populations, particularly in terms of housing security. Additionally, the results presented here indicate that further attention should be paid to the effects of first responder stress on documentation quality.

Characteristics of medical student education during the COVID-19 pandemic

Introduction. After the last pandemic, the university community faced a number of issues related to the management and conduct of training, so improving the quality of education and training of medical students is relevant. The transition to distance learning on various platforms with all kinds of media support, on the one hand, made it possible not to interrupt the educational process during a difficult period of social restrictions, and on the other hand, created a load and stressed both students and teachers of educational institutions. Purpose. To assess the impact of changes on the educational process of medical students during the COVID-19 pandemic, including the implementation of distance learning technologies and the use of online platforms, and to identify the need for social support measures to reduce academic burnout and improve students’ psychological resilience. Materials and methods. A comparative observational study was conducted at the Urology Clinic of the Russian University of Medicine, which used an anonymous Internet survey. Two hundred forty eight 4th year medical students were interviewed from 2020 to 2021 and 501 respondents from 2021 to 2022. Results. Two groups of students were compared, distributed according to a time criterion. The most frequent area of application of social networks in the educational process was consultation with teachers and search for information for educational activities. In relation to distance learning, positive responses were received from 170 respondents (68.55%) in group 1 and 342 (68.26%) in group 2, and negative responses from 68 (27.42%) and 127 (25.35%) respondents, respectively. Research limitations. A narrow focus on the sample of medical students, which does not reflect the diversity of opinions and experiences in the wider population, as well as conducting research during the COVID-19 pandemic. Conclusions. Given the changes in educational activities against the background of the coronavirus pandemic, as well as the lack of regulated norms, rules, and support for students and teachers during this period, comprehensive coverage and development of distance learning methods are necessary.

Production and metabolic responses of Montbéliarde and Holstein cows during periparturient period and a sequential feed restriction challenge

The objective was to compare the production and metabolic responses of 22 Montbéliarde (MONT) and 18 Holstein (HOLS) multiparous cows during the periparturient period, and during a sequential nutritional challenge (SNC), consisting of 4 successive induced short feed restrictions each separated by a refeeding period, to explore breed differences in robustness (ability to maintain lactation function during successive challenges) and resilience (ability to recover after each challenge). Cows were studied from 4 wk before expected calving until 158 ± 9 DIM (mean ± SD). Milk and ECM yields were greater in HOLS than in MONT during both the early (i.e., from calving to wk 10) and mid-lactation (i.e., from wk 18 to 22) periods, whereas BCS was greater in MONT than HOLS. During early lactation, energy balance was lower (5 vs. 16 MJ/d), plasma NEFA (270 vs 163 µM) were greater, for HOLS than MONT, respectively. Cows in third-and-greater lactation secreted more ECM, and had delayed resumption of luteal activity compared with second lactation cows. The SNC started at 87 ± 9 DIM and consisted of a sequence of 4 4-d periods of feed restriction (FR), during which feed allowance was calculated to meet 50% of individual energy requirements (FR1, FR2, FR3, FR4), each of them being followed by an ad libitum intake period. Cows were allowed 10 d of ad libitum intake between FR1 and FR2 to study the recovery and compare it with the recovery following FR4, and 3 d of ad libitum intake between FR2, FR3 and FR4 to study responses to repeated FR. Feed allowance met 59 to 67% of energy requirements during FR1 through FR4, as milk secretion decreased with successive FR. Breed differences in milk secretion persisted throughout the nutritional challenges, but were more pronounced during the first 2 FR: Uncorrected MY was greater for HOLS throughout the entire SNC, whereas ECM and plasma NEFA concentrations and milk fat yield were greater for HOLS than MONT during FR1 and FR2, but not FR3 and FR4, suggesting a reduced ability of HOLS to mobilize and transfer fatty acids into milk with successive FRs, and indicating altered robustness of HOLS to maintain high milk yield. Resilience for ECM yield did not differ between breeds. Cows were able to respond to and recover from the SNC, by decreasing milk secretion during FR, undergoing acute metabolic adaptations to support lactation, and recovering DMI during each refeeding period. Cow rankings for ECM yield were maintained consistently from early lactation throughout the SNC periods (rs = 0.59 to 0.90), suggesting that dairy potential was a major driver of responses during the SNC for both HOLS and MONT.

Incidence of ventricular arrhythmias after implantable cardioverter-defibrillator implantation or replacement, and driving restriction consequences

BackgroundFollowing implantation/replacement of an implantable cardioverter-defibrillator, patients are legally subjected to variable lengths of driving restrictions based on the indication (1 and 3 months after primary and secondary prevention, respectively; 1 week after device replacement). AimTo assess the incidence of ventricular arrhythmia during the theoretical driving restriction period in a large cohort of patients. MethodsPatients who underwent implantable cardioverter-defibrillator implantation for primary or secondary prevention or device replacement between 2015 and 2021 were included retrospectively. The primary endpoint was the occurrence of ventricular arrhythmia during the theoretical driving restriction period, as defined by guidelines. ResultsA total of 914 patients were analysed, including 654 first implantations (438 and 216 for primary and secondary prevention, respectively) and 260 device replacements. The primary outcome occurred in 2/438 patients (0.004%) during the 1-month period following device implantation for primary prevention and in 25/216 patients (11.5%) during the 3-month period following device implantation for secondary prevention; it did not occur in the 1-week period following device replacement. The monthly calculated risk of harm remained below the accepted threshold of 0.005% for each group. ConclusionsPrimary prevention patients, such as those who have undergone device replacement, have a low risk of ventricular arrhythmia, which could lead to a reduction in their driving restriction period. Secondary prevention patients experienced a higher risk of recurrent ventricular arrhythmia, supporting the 3-month driving restriction period.

A comparative analysis of predisposing factors for delirium in hospitalized patients during and after COVID-19 restriction periods

A comparative analysis of predisposing factors for delirium in hospitalized patients during and after COVID-19 restriction periods

A window into Their World: How Video Visits Facilitate Father–Child Relationships

Maintaining the parent–child relationship while a parent is incarcerated is critical to the well-being of both parent and child. There is some evidence that video visits can be beneficial when they are used to supplement rather than replace in-person visits. This study explores how video visits support the father–child relationship during parental incarceration. Research was conducted with two public prisons in New South Wales, Australia, during the period of COVID-19 restrictions. Interviews with children’s carers (n = 17) and fathers (n = 27) were analysed to identify the ways fathers engaged with their children and the benefits of the relationship. Three themes were identified: show and tell, which explored how the visual element of video visits contributed to parent–child interactions; part of their world, which identified how video visits became integrated into children’s everyday lives; and along for the ride, which focused on child-initiated interactions. Challenges of using video visits were also explored in two themes: difficulty engaging, which showed how fathers and children can struggle to communicate and interact, and timing and transitions, which highlighted how video visits could be difficult or disruptive to children’s mood and routines. Overall, video visits were perceived as enabling interactions that strengthened the engagement and relationship between the father and child.

Time perception and suicidal ideation during COVID-19 pandemic: A longitudinal study

BackgroundThere are several reports of disruptions in time perception during lockdown periods throughout the COVID-19 pandemic. Our aim was to study the role of subjective flow of time (SFT) in the triggering of suicidal ideation in patients with a history of suicide attempt (SA), as compared with affective controls without such history (AC). MethodsThis study involved 296 psychiatric patients that were assessed five times between 2020 and 2021. We analyzed the SFT using a mixed logistic model and characterized SFT during significant periods of governmental restrictions. Multivariate logistic regressions were used to identify independent SFT characteristics. We evaluated the association between SFT and suicidal ideation, considering interactions with depression, insomnia, loneliness, and social support. ResultsThe findings revealed a significant alteration in SFT, closely linked to the implementation and easing of governmental restrictions. During the initial lockdown, SA exhibited lower SFT levels compared to AC. Furthermore, the relationship between SFT and suicidal ideation was influenced by depression. In the interim period between lockdowns, SFT's impact on suicidal ideation was mediated by insomnia. DiscussionDisturbances in SFT could be related to adaptability to lockdown conditions or may be a coping mechanism with depression, insomnia, suicidal ideation and overall psychological distress. Understanding the interplay of SFT with these factors provides crucial insights into the complex psychological mechanisms involved.

Move, connect and go outside! A randomized controlled trial of two online interventions and analysis of helpful coping strategies in COVID-19 "homestayers".

The COVID-19 pandemic has led to a global health crisis and a significant increase in psychological distress and psychopathological symptoms. We conducted a randomized controlled trial with two online interventions derived from positive psychology (PP) and acceptance and commitment therapy (ACT) in N = 138 "homestayers" during the first lock-down period in Germany. PP exercises had a positive impact on anxiety scores, which decreased significantly during the intervention, particularly in participants without access to a garden. Direct or indirect social contact, movement/exercise, and exposure to nature were the most frequently reported helpful coping strategies. We conclude that low-threshold online interventions with a focus on positive aspects of people's lives may be helpful to support mental health during pandemic crises. From a mental health perspective, the results also reinforce the approach of countries that allow their citizens to, for example, still go for walks during periods of contact restrictions, compared to full lock-down conditions.

Developmental profile of Filipino children born during the SARS-COV-2 pandemic: pilot study.

The Philippines experienced one of the longest restriction periods during the COVID-19 pandemic. This study aimed to provide a developmental profile of 18-25 month-old children and identify factors associated with their development during their early years being born and raised during the pandemic. The study population was recruited through convenience sampling among families living in proximity to the daycare centers in Cainta, Rizal, Philippines. 116 children qualified to participate and underwent developmental screening using the Early Childhood Care and Development (ECCD) Checklist and their parents were interviewed related to demographic and social factors. The mean score of the children's Overall Development is 106.47 (SD = 13.43) indicating that children's skills were within the expected range of 80-119. Girls had significantly higher mean scores compared to boys [M Girl = 111.23, SD Girl = 9.95 vs. M Boy = 101.18, SD Boy = 14.83 t(114) = -4.32 p < 0.001]. Mean scores were highest among children whose mothers completed a high school education (M High School = 107.76, SD HighSchool = 12.47) compared to those who have some or have completed an elementary education (M SomeElem = 72.50, SD SomeElem = 6.36 and M Elem = 103.58, SD Elem = 13.86 respectively) [F(2, 113) = 8.18, p < 0.001]. Unadjusted linear regression shows a modest increase in mean scores as the number of household members increased [ꞵ = 0.86, (CI: 0.02, 1.70), t-score (1, 113) = 2.03, p = 0.045]. The developmental skills of 18-25 month-old children born and raised during the COVID-19 pandemic in an urban municipality in the Philippines are within average scores. Both hindering and protective demographic factors were identified as associated with the children's developmental evaluation scores. It is important to acknowledge these factors and continue monitoring the children's development and address needs among children who may need further support.

Avascular Necrosis of the Talus: Diagnosis, Treatment, and Modern Reconstructive Options.

Talar avascular necrosis (AVN) is a devastating condition that frequently follows type III and IV talar neck fractures. As 60% of the talus is covered by hyaline cartilage, its vascular supply is limited and prone to trauma, which may eventually lead to AVN development. Early detection of AVN (Hawkins sign, MRI) is crucial, as it may prevent the development of the irreversible stages III and IV of AVN. Alertness is advised regarding non-obvious conditions that may cause this complication (sub chondroplasty, systemic lupus erythematosus, diabetes mellitus). Although, in stages I-II, AVN may be treated with non-surgical procedures (ESWT therapy, non-weight bearing) or joint-sparing techniques (core drilling, bone marrow aspirate injections), stages III-IV require more advanced procedures, such as joint-sacrificing procedures (hindfoot arthrodesis/ankle arthrodesis), or replacement surgery, including total talar replacement (TTR) or combined total ankle replacement (TAR). The advancement of 3D-printing technology and increased access to implant manufacturing are contributing to a rise in the production rates of third-generation total talar prostheses. As a result, there is a growing frequency of alloplasty procedures and combined total ankle replacement (TAR) surgeries. By performing TTR as opposed to deses, the operator avoids (i) delayed union, (ii) a shortening of the limb, (iii) a lack of mobility, and (iv) the stiffening of adjacent joints, which are the main disadvantages of joint-sacrificing procedures. Simultaneously, TTR and combined TAR offer (i) a brief period of weight-bearing restriction, (ii) quick pain relief, and (iii) preservation of the length of the limb. Here, we summarize the most up-to-date knowledge regarding AVN diagnosis and treatment, with a special focus on the role of TTR.

Adapted Low-FODMAP Diet in IBS Patients with and without Fibromyalgia: Long-Term Adherence and Outcomes.

A low-FODMAPs Diet (LFD) is considered a "second line" dietary strategy for irritable bowel syndrome (IBS) but, after a period of strict restriction of all FODMAP foods, it has to be adapted and tailored to each patient (AdLFD). Fibromyalgia often coexists with IBS in up to 65% of cases. Our aims were to evaluate if comorbid fibromyalgia influenced the long-term clinical outcomes and adherence to an AdLFD in IBS patients. IBS patients with or without fibromyalgia who had started an AdLFD were enrolled. Patients had been evaluated before starting the LFD (T0). After a mean follow-up of 62.5 ± 22.7 months (T1), they were re-evaluated using questionnaires on disease severity, bowel habits, psychological status, and adherence to AdLFD. In total, 51 IBS patients entered the study. Nineteen of them had comorbid fibromyalgia. Thirty patients reported a reduction in symptom severity at T1 in comparison with T0. Despite some slight differences in single IBS Symptom Severity Score items, comorbid fibromyalgia did not influence the IBS-SSS total score at T1. Patients with comorbid fibromyalgia showed a higher Hospital Anxiety and Depression Scale (HADS) score at baseline. A total of 44 patients showed good long-term adherence to the AdLFD. All patients improved their HADS score and had long-term adherence to the AdLFD. Comorbid fibromyalgia showed only a slight influence on long-term outcomes of an AdLFD on IBS symptoms, without affecting the relief of global symptoms. No influence on long-term adherence to AdLFD was detected. Hence, this approach can be taken into account in fibromyalgia patients for a nonpharmacological management of IBS symptoms. However, multicentric studies on larger samples would be welcome in the future.