Small Increase Research Articles

Thermal analysis and structure optimization of wavy microchannel with combining ribs of porous layer and solid wall in multi objective genetic algorithm

The combining rib of porous layer and solid wall is set in wavy microchannel heat sink to enlarge heat transfer area and convection with smaller increase in flow resistance, in which the consumption of pump power relates to the ratios of wave amplitude to length or to width and the thickness of porous layer due to vortices generation while coolant passing through channel. The local thermal equilibrium occurs in porous layer, and the Forchheimer-Brinkman-Darcy relations were used to describe the flow inside porous ribs. The effects of channel-to-pitch width ratio, width ratio of porous layer to pitch and microchannel height on its cooling performance are investigated, and the parameter of figure of merit (FOM) is defined to evaluate thermo-hydraulic performance in wavy microchannel. Besides, the multi objective genetic algorithm method is employed to optimize structure parameters in wavy microchannel to obtain better performances, in which the increase in thermal resistance from 0.062 K/W to 0.166 K/W together with consumption of pump power decreasing from 0.00416 W to 0.00185 W can be obtained in the Pareto front set, and it relates to the heat dissipation in convection between coolant and bottom surface or vertical side ribs. Compared to wavy microchannel with solid rib, the 37.61% and 16.67% decreases respectively in thermal resistance and consumption of pump power occur in the case with optimal combining rib of porous layer and solid wall.

Stiffening of double-shelled fullerene molecules under uniaxial strains

Onion-like fullerenes (OLFs) have spherical and tunable shell structures that make them perfect solid lubricants, but their molecular mechanical properties are largely unknown as they are extremely difficult to measure. In this computational study, double-shelled OLFs C60@C180, C80@C180, C60@C240 and C80@C240 are subject to uniaxial elastic strains to obtain their mechanical response. Compressive and tensile elastic moduli are calculated using density functional theory with van der Waals correction. We found that the tensile elastic moduli of the single- and double-shelled fullerenes are always larger than the compressive ones by about 50% to 100%. Inserting C80 into C180 causes an increase in compressive elastic modulus from 96.8 GPa to 178.6 GPa, while inserting C60 into C240 cause much smaller increases. The key factor that determines the stiffening effects is the relative sizes of the inner and outer shells.

Effects of Repeated High-Intensity Effort Training or Repeated Sprint Training on Repeated High-Intensity Effort Ability and In-Game Performance in Professional Rugby Union Players.

Glaise, P, Rogowski, I, and Martin, C. Effects of repeated high-intensity effort training or repeated sprint training on repeated high-intensity effort ability and in-game performance in professional rugby union players. J Strength Cond Res 38(5): 932-940, 2024-This study investigated the effects of repeated high-intensity efforts (RHIE) training compared with repeated sprint exercise (RSE) training on RHIE ability (RHIEa) and in-game performance in professional rugby union players. Thirty-nine, male, professional, rugby union players were randomly assigned to 3 training groups (RHIE training, RSE training, and control). Repeated high-intensity effort ability and high-intensity effort characteristics (including sprints, acceleration, and contact efforts) during official games were measured before and after a 10-week specific (RHIE, RSE, or control) training period. The results of this study showed that concerning RHIEa, both the RHIE and RSE training significantly increased the players' average sprint velocity ( p < 0.001, d = -0.39 and p < 0.001, d = -0.53 respectively), average sled push velocity (ASPV; p < 0.001, d = -0.81 and p = 0.017, d = -0.48 respectively), and RHIE score ( p < 0.001, d = -0.72 and p < 0.001, d = -0.60 respectively). Repeated high-intensity effort training trended in a smaller increase in average sprint velocity than RSE training, a larger increase in ASPV, and a similar increase in RHIE score. Concerning in-game high-intensity efforts, both the RHIE and RSE training produced significant improvements in the number of sprints ( p = 0.047, d = -0.28 and p < 0.001, d = -0.47 respectively), total distance ( p < 0.001, d = -0.50 and p = 0.002, d = -0.38 respectively), the number of accelerations ( p < 0.001, d = -0.37 and p = 0.003, d = -0.32 respectively), and contact rate ( p < 0.001, d = -0.97 and p = 0.020, d = -0.28 respectively). Conversely, the magnitude of the increase in contact rate was almost twice as high in RHIE compared with RSE training. To conclude, the findings of this study were that both RSE and RHIE training are effective methods for developing RHIEa and in-game high-intensity efforts in professional rugby union. In practical applications, as the gains in certain abilities and game performance data differed depending on the training method chosen, we suggest that coaches choose the most appropriate method according to the profile of the players, their position, and the style of play they want to develop.

A population-based time-series analysis of opioid agonist treatment dispensed during pregnancy.

Identifying effective opioid treatment options during pregnancy is a high priority due to the growing prevalence of opioid use disorder across North America. We assessed the temporal impact of three population-level interventions on the use of opioid agonist treatment (OAT) during pregnancy in Ontario, Canada. This was a population-based time-series analysis to identify trends in the monthly prevalence of pregnant people dispensed methadone and buprenorphine. The impact of adding buprenorphine/naloxone to the public drug formulary, the release of pregnancy-specific guidance and the start of the COVID-19 pandemic were assessed. The study was conducted in Ontario, Canada between 1 July 2013 and 31 March 2022, comprising people who delivered a live or stillbirth in any Ontario hospital during the study period. We identified any prescription for methadone or buprenorphine dispensed between the estimated conception date and delivery date and calculated the monthly prevalence of OAT-exposed pregnancies among all pregnant people in Ontario. Overall, rates of OAT during pregnancy have declined since mid-2018. Methadone-exposed pregnancies decreased from 0.46% of all pregnancies in Ontario in 2015 to a low of 0.16% in 2022. In the primary analysis, none of the interventions had a statistically significant impact on overall OAT rates; however, in the stratified analyses, there was a small increase in buprenorphine after the formulary change [0.006%, 95% confidence interval (CI) = 0.0032-0.0081, P < 0.0001] and a decrease in buprenorphine after the release of the 2017 guidelines (-0.005%, 95% CI = -0.0080 to -0.0020, P = 0.001) and the start of the COVID-19 pandemic (-0.003%, 95% CI = -0.0054 to -0.0006, P = 0.015). Despite changes in guidance and funding, opioid agonist treatment during pregnancy has been declining in Ontario, Canada since 2018.

Prior implantation of hydrogen as a mechanism to delay helium bubbles, blistering, and exfoliation in titanium

This study explores the delaying of the formation of helium bubbles and blisters in pure titanium by hydrogen pre-implantation. Titanium, implanted with helium (40 KeV, 5 × 1017 ions/cm²), exhibited large bubbles that cause exfoliation after heat treatment, whereas hydrogen pre-implantation inhibited bubble growth at room temperature and reduced the exfoliation after heat treatment.In the samples pre-implanted with hydrogen, we found evidence of helium diffusion delay by: (a) a fourfold reduction in bubble pressure (b) faceted cavities in the samples (c) a smaller increase in titanium lattice parameters (d) a 16-fold reduction in average bubble size and a sixfold reduction in bubble area fraction (e) a more than twofold decrease in exfoliation (f) a tendency toward the formation of larger bubbles as a result of heat treatment. We believe that it is reasonable to assume that the inhibition of helium diffusion between tetrahedral interstitial lattice sites takes place because of the occupation of the intermediate octahedral sites by hydrogen atoms.Evidence for the opposite effect, that is inhibition of the diffusion of hydrogen in the presence of helium, is found in the retention of hydrogen in the specimens at elevated temperatures. This retention allowed the existence of titanium hydride after heat treatment at 680 °C. The present study sheds light on the intricate interplay between hydrogen and helium in titanium, providing insights into mechanisms that can potentially mitigate helium-induced damage in materials.

Fat supplement for dairy cows during early lactation – potentials, challenges, and risks – a meta-analysis

ABSTRACT The most critical challenge in early lactation is to meet the increasing energy demand for milk production, which results in a negative energy balance (EB). The objective of this study was to evaluate the productive performance and plasma metabolite responses of early lactating dairy cows fed diets supplemented with increasing levels of different fat sources. Diets were categorized as diets supplemented with saturated fatty acid rich fat sources (SFAR), with Ca-soaps of fatty acids (CaFA), and with polyunsaturated fatty acid rich fat sources (PUFAR). There was an interaction between crude fat level and source for dry matter intake (DMI); each percentage-unit increase reduced DMI by 0.38 and 0.77 kg/d in CaFA and PUFAR, respectively, and increased DMI by 0.55 kg/d in SFAR. Corrected milk yield increased by 0.44 kg/d for each percentage-unit increase in crude fat level. Plasma non-esterified fatty acid (NEFA) concentration increased with 0.04 mmol/L per percentage-unit increase. In conclusion, the increased crude fat level increased corrected milk yield. Fat supplementation in early lactation does not seem to cause negative effects on productive performance or metabolism, and despite a small increase, both plasma NEFA and β-hydroxybutyrate (BHB) concentrations stayed below the threshold for incidence of subclinical ketosis.

Effects of enriched task-specific training on sit-to-stand tasks in individuals with chronic stroke.

Approximately 80% of stroke survivors experience motor impairment of the contralateral limb that severely affects their activities of daily living (ADL). To evaluate whether an enriched task-specific training (ETT) program affected the performance and kinetics of sit-to-stand (STS) tasks. The study was part of an exploratory study with a within-subject, repeated-measure-design, with assessments before and after a three-week-long baseline period, and six months after the intervention. Forty-one participants underwent assessments of strength and endurance measured by the 30-second-chair-stand test (30sCST). The STS-kinetics, including the vertical ground reaction force (GRF) during STS, were analysed in an in-depth-subgroup of three participants, using a single-subject-experimental-design (SSED). For kinetic data, statistical significance was determined with the two-standard deviation band method (TSDB). After the baseline period, a small increase was seen in the 30sCST (from 5.6±4.5 to 6.1±4.9, p = 0.042). A noticeable significant change in the 30sCST was shown after the intervention (from 6.1±4.9 to 8.2±5.4, p < 0.001), maintained at six months. The in-depth kinetic analyses showed that one of three subjects had a significant increase in loading of the affected limb post-intervention. ETT can produce long-term gains in STS performance. Weight-bearing strategies could be one of several factors that contribute to improvements in STS performance in the chronic phase after stroke.

Characterization of the Pb Coordination Environment and Its Connectivity in Lead Silicate Glasses: Results from 2D 207Pb NMR Spectroscopy.

The Pb-O coordination environment in binary (PbO)x(SiO2)100-x glasses with 30 ≤ x ≤ 70 is probed by using two-dimensional 207Pb nuclear magnetic resonance (NMR) isotropic-anisotropic correlation spectroscopy. The isotropic 207Pb NMR spectra show little composition-dependent evolution of the Pb-O nearest-neighbor coordination environment. The systematic variation of the chemical shift tensor parameters offers a unique insight into their local site symmetry and suggests the presence of pyramidal PbO3 and PbO4 sites with sterically active electron lone pairs and with Pb-O bond lengths ranging between 0.23 and 0.25 nm. The PbO3/PbO4 ratio shows a small but monotonic increase from ∼70:30 to 80:20 as the PbO content increases from 30 to 70 mol %. When taken together, the isotropic and anisotropic 207Pb NMR spectra suggest that the majority of the PbOn (3 ≤ n ≤ 4) pyramids in these glasses are connected to the SiO4 tetrahedra via Pb-O-Si linkages. A significant fraction of Pb-O-Pb linkages, where the oxygen is linked only to Pb atoms, appears only in glasses with PbO ≥ 60 mol %. These oxygen atoms appear to be corner-shared between the PbOn pyramids in the structure, and no evidence for edge-sharing between these pyramids is observed in this composition range. We hypothesize that a substantial fraction of the constituent PbOn pyramids start to participate in edge-sharing only at higher PbO contents (>70 mol %), which diminishes the glass-forming ability of the network. This work illustrates the potential of isotropic-anisotropic correlation NMR spectroscopy in structural studies involving nuclides with large chemical shift ranges and anisotropy.

Sharp increase in gonorrhoea notifications among young people, EU/EEA, July 2022 to June 2023.

Gonorrhoea cases increased steeply in women aged 20 to 24 years across 15 EU/EEA countries in July to December 2022 and January to June 2023 with, respectively, 73% and 89% more cases reported than expected, based on historical data from 2015 to 2019. Smaller increases among men due to heterosexual transmission were observed in nine EU/EEA countries. Interventions to raise awareness among young people about sexually transmitted infection risks are needed, emphasising the benefit of safe sexual practices and testing.

Natural history and biomarkers of KCNV2-associated retinopathy.

KCNV2-associated retinopathy is an autosomal recessive inherited retinal disease classically named cone dystrophy with supernormal rod response (CDSRR). This study aims to identify the best biomarker for evaluating the condition. A retrospective review of eight patients from seven families with genetically confirmed KCNV2-associated retinopathy was performed. The best corrected visual acuity (BCVA), full-field electroretinogram (ffERG), pattern ERG (pERG), fundus imaging: retinal photograph and fundus autofluorescence (FAF), and optical coherence tomography (OCT) were analysed. There was a disproportionate increase in b-wave amplitude with a relatively small light intensity increase, especially between the two dimmest stimuli of DA 0.002 and 0.01 (-2.7 and -2.0 log cd.s/m2 ). The a-wave amplitude was normal. The a-wave peak time was delayed in all stimuli. The b-wave peak time was delayed compared to normal, but the gap tightened as intensity increased. The b:a wave ratio was above or at the upper limit for the reference values. FAF bull's eye maculopathy pattern was prominent and variable foveal disruption on OCT was apparent in all patients. Legal blindness was reached before the age of 25. We identified three potential electrophysiology biomarkers to assist in evaluating future therapies: the disproportionate b-wave amplitude jump, delayed a-wave and b-wave peak time, and the higher than normal b:a wave ratio. Any of these biomarkers found with photoreceptor ellipsoid zone foveal-perifoveal disruption should prompt consideration for KCNV2 retinopathy. The BCVA natural history data suggests the probable optimum therapeutic window in the first three decades of life.

Lateralizing calcaneal osteotomy performed with a percutaneous burr results in a significantly lower increase in tarsal tunnel pressure.

Tarsal tunnel syndrome is well documented following lateralizing calcaneal osteotomy to manage varus hindfoot deformity. Traditionally, calcaneal osteotomy is performed with an oscillating saw. No studies have investigated the effect of alternative surgical techniques on postoperative tarsal tunnel pressure. The purpose of this study was to investigate the difference in tarsal tunnel pressures following lateralizing calcaneal osteotomy performed using a high-torque, low-speed "minimally invasive surgery" (MIS) Shannon burr versus an oscillating saw. Lateralizing calcaneal osteotomy was performed on 10 below-knee cadaveric specimens. This was conducted on 5 specimens each using an oscillating saw (Saw group) or MIS burr (Burr group). The calcaneal tuberosity was translated 1cm laterally and transfixed using 2 Kirschner wires. Tarsal tunnel pressure was measured before and after osteotomy via ultrasound-guided percutaneous needle barometer. Mean pre/post-osteotomy pressures were compared between groups. Differences were analyzed using Student's t test. The mean pre-procedure tarsal tunnel pressure was 25.8 ± 5.1mm Hg in the Saw group and 26.4 ± 4.3mm Hg in the Burr group (p = 0.85). The mean post-procedure pressure was 63.4 ± 5.1 in the Saw group and 47.8 ± 4.3 in the Burr group (p = 0.01). Change in tarsal tunnel pressure was significantly lower in the Burr group (21.4 ± 4.5) compared to the Saw group (37.6 ± 12.5) (p = 0.03). The increase in tarsal tunnel pressure was 43% lower in the Burr group. In this cadaveric study, tarsal tunnel pressure increase after lateralizing calcaneal osteotomy was significantly lower when using a burr versus a saw. This is likely because the increased width ("kerf") of the 3mm MIS burr, compared to the submillimeter saw blade width, causes calcaneal shortening. Given the smaller increase in tarsal tunnel pressure, using the MIS burr for lateralizing calcaneal osteotomy may decrease the risk of postoperative tarsal tunnel syndrome. Future research in vivo should explore this.

Effect of TiO2 addition on microstructure and mechanical properties of Al2O3 ceramic joints brazed with Ag‐CuO fillers

AbstractIn our work, 0.5 mol.% TiO2 was added to Ag‐xCuO (x = 2, 4, 8 mol.%) fillers whose compositions at 1050°C were in the L2 single liquid phase region, the boundary of the miscible phase region, and the L1+L2 miscible phase region, respectively. The role of TiO2 was derived by comparing the quenching microstructure of the fillers on the Al2O3 ceramics and the effect on the interfacial microstructure and shear strength of the joints before and after the addition of TiO2. The results showed that the TiO2 would dissolve into the CuO‐rich L1 liquid phase of the filler, leading it to spread outside the molten droplet. When brazing with Ag‐4CuO‐0.5TiO2 filler, the CuO at the joint interface almost completely disappeared, and the shear strength of the joint was significantly reduced. In contrast, the joint strength showed a small increase when using Ag‐8CuO‐0.5TiO2 filler, as the excess CuO at the interface of the brazed joint was reduced. When the filler composition was in the L2 single liquid phase region, CuO was diffusely distributed throughout the molten droplet. TiO2 was hardly contacted with CuO and its addition had no significant effect on the interfacial microstructure and the shear strength of the joints.

Evaluating the implementation of the Primary Health Integrated Care Project for Chronic Conditions: a cohort study from Kenya

IntroductionIn Kenya, non-communicable diseases (NCDs) are estimated to account for almost one-third of all deaths and this is likely to rise by over 50% in the next 10 years. The...

Effects of cryogenic pre-deformation on the microstructure and mechanical properties of Ti–Mo alloys

In the present study, pre-deformation at liquid nitrogen temperature (77 K) was applied to introduce twins into Ti–Mo alloys with different contents of molybdenum. The microstructural evolution and mechanical properties with different cryogenic pre-deformation amounts (from 0 to 9 %) were characterized and analyzed. The results show that the twinning activities and the evolution of twinning systems are mainly influenced by β phase stability and cryogenic pre-deformation amount. After cryogenic pre-deformation, the primary and secondary twinning of {332}<113>twins are observed in Ti–12Mo and Ti–15Mo alloys but absent in Ti–20Mo alloy. With the cryogenic pre-deformation amounts increasing, the width and quantity of twins increase constantly. Moreover, {112}<111>twinning is activated in Ti–15Mo alloy pre-deformed by 6 % and 9 %. Twins and high-density dislocations induced by cryogenic pre-deformation cause a significant enhancement in strength of all these three alloys. However, the effect of cryogenic pre-deformation on the elongation of alloys is complicated. For Ti–12Mo alloys, the yield strength increases monotonically (from 527 to 778 MPa) with the increase of cryogenic pre-deformation reduction, while the elongation is completely opposite (from 47 to 20 %). For Ti–15Mo alloys, the optimal matching of strength and ductility is achieved when the amount of cryogenic pre-deformation is 6 %, with a tensile strength of 815 MPa and an elongation of 24 %. Compared with the other two alloys, Ti–20Mo alloy gets a smaller increase in strength and a slight decrease in elongation with the amount of cryogenic pre-deformation increasing.

Lactato de sodio 0,5 molar vs. suero salino hipertónico al 3% en el traumatismo de cráneo grave con hipertensión intracraneana: estudio clínico piloto

ObjectiveTo evaluate the effectiveness of hypertonic sodium lactate (HSL) 0.5 molar in the treatment of intracranial hypertension (ICH) compared to 3% hypertonic saline (HS) in critically ill patients with severe traumatic brain injury (TBI). MethodsProspective, experimental, randomised study conducted in an Intensive Care Unit (ICU) of a university hospital in critically ill patients with TBI and ICH. Those with ICH were randomised into two groups to receive LSH 0.5M or SSH 3% 500 cc with crossover of intervention according to pH or chloremia. Intracranial pressure (ICP) and internal milieu variables were determined. Results11 patients were enrolled (54.5% to LSH; 45.5% to SSH). Sixty-four infusions were performed, 45 LSH, 19 SSH. Non-crossover was 90.9% vs. 75%, respectively (p = 0.098). ICP decreased 11.66±6.49mmHg (p < 0.0001) with LSH vs. 10.1±9.19mmHg with SSH (p< 0.0001), without significant difference between both groups. Natraemia increased 3.11±1.87 mEq/L with LSH (p < 0.0001) and 5.43±4.41 mEq/L with SSH (p < 0.0001), in favour of SSH (p = 0.004). The chloremia decreased 1.95±2.60 mEq/L with LSH (p < 0.0001) and increased 5.78±3.7 mEq/L with SSH (p < 0.0001), significant difference of p < 0.0001. ConclusionsLSH 0.5M is as effective as SSH 3% in the control of ICH in patients with TBI, causing a smaller increase in plasma sodium and chloride levels, preventing the development of hyperchloremic acidosis.

Seismic fragility analysis of high‐strength concrete frame structures reinforced with high‐strength steel bars

SummaryTo investigate the influence of using high‐strength steel bars in columns on the seismic resistance capacity and seismic resilience of frame structures, seismic fragility evaluation of three 8‐story reinforced concrete (RC) frame structures was conducted based on the incremental dynamic analysis (IDA) using 11 ground motion records. The main parameter is the longitudinal reinforcement configuration in the frame columns, where the first structure is reinforced with HRB 600 grade steel bars in the columns, the second structure is replaced with equal area ultra‐high‐strength (UHS) steel bars (i.e., with a yield strength of approximately 1425 MPa), and the third structure is replaced with equal strength UHS steel bars. A numerical model of the RC frame structure was developed and then validated using previous experimental results. The exceeding probabilities at various performance limit states were calculated based on two typical engineering demand parameters (EDPs) of maximum interstory drift and residual interstory drift. The results showed that using UHS longitudinal steel bars instead of HRB 600 grade steel bars in frame columns could reduce the energy dissipation capacity of the structure, inevitably leading to an increase in the maximum interstory response of the frame. However, much lower exceedance probability was observed in the UHS‐enhanced frame under the repair available limit state based on the residual interstory drift, indicating that the UHS‐enhanced RC frame had higher seismic resilience. In addition, compared to equal area substitution, equal strength substitution is a more ideal design method that can use fewer UHS steel bars to achieve comparable reparability and a smaller increase in maximum interstory drift.

Abstract A021: Pilot study of daily exemestane in patients with Endometrial Intraepithelial Neoplasia (EIN) or grade 1 endometrial cancer

Abstract Introduction: The purpose of this study is to evaluate exemestane, an aromatase inhibitor, as a potential agent for the chemoprevention of endometrial cancer. Experimental procedures: This is a multi-center, phase IIA, single arm ‘window of opportunity’ pilot study of 25 mg per day of exemestane for 21-42 days in postmenopausal patients undergoing hysterectomy for endometrial intraepithelial neoplasia (EIN) or low-grade endometrial cancer. The primary objective is to determine if there is a decrease in proliferation index, measured by percent Ki-67 expression in endometrial tissue, from pre-treatment to post-exposure. Results of Ki-67 are compared with a historic control cohort of tumors from patients matched by preoperative histologic diagnosis, age, BMI category. Specimens from the historic control cohort included a preoperative endometrial biopsy as well as a surgical specimen, separated in time by less than 42 days. Secondary outcomes include comparison of Ki67 to historic controls, circulating serum estradiol and progesterone levels, pathologic response, tissue biomarkers, safety and adverse effects. Summary of Data: Forty patients accrued to the study between January of 2018 and March of 2021. The mean age was 63 (range 52-75). Thirty-nine patients (97.5%) self identifiedself-identified as white; 1 patient (2.5%) identified as Asian. The mean BMI was 40.3 (SD 9.75, range 22.8-60.5). Preoperative diagnoses included EIN, grade 1 endometrial adenocarcinoma, and grade 2 endometrial adenocarcinoma in 11 (27.5%), 26 (65%), and 3 (7.5%) patients respectively. Thirty-nine patients (97.5%) were compliant with exemestane dosing. All patients completed the study and no patients discontinued or interrupted therapy due to treatment related adverse events. Thirty-eight patients had evaluable specimens for both pre and post-treatment Ki-67 analysis. Median Ki-67 score decreased from 40.7% [IQR (33.9%, 50.3] at baseline to 18.1% [IQR (8.8%, 31.8%)]. This represents a median absolute change from baseline of -20.4% [IQR (-29.9, -6.7), p&amp;lt;0.001]. In total, percentage of Ki-67 in tumor cells declined in 31 patients and increased in 7 patients. In the historic control cohort, patients also had a decrease in Ki-67 score with a median absolute change from baseline of -6.7% [IQR (-12.7%, -1.3%), p&amp;lt;0.001]. However, the decrease in Ki-67 was greater in the study patients than the matched historic controls, with a median difference between the groups of -13.4% [IQR= (-23.3%, 6.9%), p=0.0095]. Serum estradiol levels did not change significantly between baseline and post-treatment (p=0.16). There was a small but significant increase from baseline to post-treatment in serum progesterone (0.14 ng/mL vs 0.37 ng/mL, p&amp;lt;0.001). Conclusion: In this pilot window of opportunity study, exemestane demonstrates anti-proliferative effects in endometrial intraepithelial neoplasia and low-grade endometrial cancer. This agent warrants further evaluation for the chemoprevention of endometrial cancer. Citation Format: Britt K. Erickson, Lisa Barrioullet, Rebecca C. Arend, Dina El-Rayes, Mahmoud Khalifa, Amy Skubitz, Kristin Boylan, Andrew Nelson, Bharat Thyagarajan, Thomas Havighurst, Richard Chappell, Eileen Dimond, Katina Deshong, Goli Samimi, Eva Szabo, Howard Bailey. Pilot study of daily exemestane in patients with Endometrial Intraepithelial Neoplasia (EIN) or grade 1 endometrial cancer [abstract]. In: Proceedings of the AACR Special Conference on Endometrial Cancer: Transforming Care through Science; 2023 Nov 16-18; Boston, Massachusetts. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(5_Suppl):Abstract nr A021.

Good while it lasted? Estimating the long-term and withdrawal effects of results-based financing in Malawi on maternal care utilisation using routine data

ObjectivesThis study aimed to evaluate the effect of introduction and subsequent withdrawal of the Results-based Financing for Maternal and Newborn Health Initiative (RBF4MNH) in Malawi on utilisation of facility-based childbirths,...

Quantifying Offense and Defense Workloads in Professional Rugby Union.

Rugby union is a contact team sport demanding high levels of physical capacity, and understanding the match workloads can be useful to inform training. In this study, the factors influencing locomotion and contact workloads for offensive and defensive ball-in-play periods are quantified. Locomotion and contact metrics were collected from global positioning system units and videos for 31 professional players of a Super Rugby team across 14 games in the 2021 season. Data were analyzed with a generalized mixed-model procedure that included effects for type of play, playing position, match outcome, and ball-in-play time. Magnitudes were assessed with standardization, and evidence for substantial magnitudes was derived from sampling uncertainty. When offense was compared to defense, most metrics showed decisively substantial increases (smalltomoderate) for forwards and backs. There was decisive evidence that locomotion metrics were substantially lower (large differences) and contact metrics were higher (very large differences) when comparing forwards to backs on offense and defense. When winning was compared to losing, there was good evidence that forwards experienced small increases in overall workload on defense, and backs experienced a small increase in high-speed running and a moderate decrease in contacts on offense. Match-to-match changes associated with ball-in-play time, attributed to fatigue, were decisive (moderatetovery large) across most metrics for forwards and backs in offense and defense. The increased locomotion and contact workloads in offensive periods and the differing physical requirements between positions and match outcomes for both types of play are novel findings that should aid practitioners in designing effective training.

Self-Massage Acute Effects on Pressure Pain Threshold, Muscular Electrical Activity, and Muscle Force Production: A Systematic Review and Meta-Analysis.

Furlan, MR, Machado, E, Petter, GdN, Barbosa, IM, Geremia, JM, and Glänzel, MH. Self-massage acute effects on pressure pain threshold, muscular electrical activity, and muscle force production: a systematic review and meta-analysis. J Strength Cond Res 38(3): 620-635, 2024-Self-massage (SM) is often used in physiotherapy and sports training programs. However, the SM acute effects on pressure pain threshold (PPT), muscle electrical activity (MEA), and muscle force production remain unclear. A meta-analytical review was performed to verify the SM acute effects on neuromuscular responses in healthy adults or athletes. The review (CRD42021254656) was performed in the PubMed, Web of Science, and Embase databases. A synthesis of the included studies was performed, and both the risk of bias and the evidence certainty level were assessed through the PEDro scale and Grading of Recommendations Assessment, Development, and Evaluation approach, respectively. Nineteen studies were included, 5 evaluated the PPT, 7 the thigh muscles' MEA, and 15 the lower-limb strength. The SM application induces moderate increases in quadriceps' PPT (5 studies; standardized mean difference [SMD]: 0.487; 95% CI 0.251-0.723; p < 0.001; I2 = 0%). We found no SM effects on the hamstrings and plantar flexors' MEA. Also, we observed small increases in knee extensors' concentric torque (2 studies; SMD: 0.288; 95% CI 0.088-0.489; p = 0.005; I2 = 0%), without effects in isometric muscle strength, eccentric torque, and rate of force development. Grading of recommendations assessment, development, and evaluation analysis showed high and low certainty levels for the SM effects on quadriceps' PPT and muscle strength, respectively. Self-massage pressure-volume application seems to be a determining factor in inducing changes in these parameters, and it may vary among the treated muscles, where a higher pressure-volume application is required for increasing knee flexors and plantar flexors' PPT and strength. Thus, new studies with better methodological quality should be performed to strengthen this evidence.