Injury and illness in short-course triathletes:A systematic review

Background:Determining the incidence and prevalence of injury and illness in short-course triathletes would improve understanding of their etiologies and therefore assist in the development and implementation of prevention strategies.This study synthesizes the existing evidence on the incidence and prevalence of injury and illness and summarizes reported injury or illness etiology and risk factors affecting short-course triathletes.Methods:This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Studies reporting health problems(injury and illness)in triathletes(all sexes,ages,and experience levels)training and/or competing in short-course distances were included.Six electronic databases(Cochrane Central Register of Controlled Trials,MEDLINE,Embase,APA PsychINFO,Web of Science Core Collection,and SPORTDiscus)were searched.Risk of bias was independently assessed by 2 reviewers using the Newcastle-Ottawa Quality Assessment Scale.Two authors independently completed data extraction.Results:The search yielded 7998 studies,with 42 studies eligible for inclusion.Twenty-three studies investigated injuries,24 studies investigated illnesses,and 5 studies investigated both injuries and illnesses.The injury incidence rate ranged 15.7-24.3 per 1000 athlete exposures,and the illness incidence rate ranged 1.8-13.1 per 1000 athlete days.Injury and illness prevalence ranged between 2%-15%and 6%-84%,respectively.Most injuries reported occurred during running(45%-92%),and the most frequently reported illnesses affected the gastrointestinal(7%-70%),cardiovascular(14%-59%),and respiratory systems(5%-60%).Conclusion:The most frequently reported health problems in short-course triathletes were:overuse and lower limb injuries associated with running;gastrointestinal illnesses and altered cardiac function,primarily attributable to environmental factors;and respiratory illness mostly caused by infection.

A Robust Method of Bipolar Mental Illness Detection from Facial Micro Expressions Using Machine Learning Methods

Bipolar disorder is a serious mental condition that may be caused by any kind of stress or emotional upset experienced by the patient.It affects a large percentage of people globally,who fluctuate between depression and mania,or vice versa.A pleasant or unpleasant mood is more than a reflection of a state of mind.Normally,it is a difficult task to analyze through physical examination due to a large patient-psychiatrist ratio,so automated procedures are the best options to diagnose and verify the severity of bipolar.In this research work,facial microexpressions have been used for bipolar detection using the proposed Convolutional Neural Network(CNN)-based model.Facial Action Coding System(FACS)is used to extract micro-expressions called Action Units(AUs)connected with sad,happy,and angry emotions.Experiments have been conducted on a dataset collected from Bahawal Victoria Hospital,Bahawalpur,Pakistan,Using the Patient Health Questionnaire-15(PHQ-15)to infer a patient’s mental state.The experimental results showed a validation accuracy of 98.99%for the proposed CNN modelwhile classification through extracted featuresUsing SupportVectorMachines(SVM),K-NearestNeighbour(KNN),and Decision Tree(DT)obtained 99.9%,98.7%,and 98.9%accuracy,respectively.Overall,the outcomes demonstrated the stated method’s superiority over the current best practices.

Study on the Accuracy of Serum Prealbumin Level in Predicting the Prognosis of Patients with Critical Respiratory Illness

Objective: To analyze the accuracy of serum prealbumin levels in predicting the prognosis of patients with critical respiratory illness. Methods: Fifty patients with critical respiratory illness admitted to our hospital from October 2022 to September 2023 were selected and divided into an observation group and a control group after condition assessment, with 25 cases in each group. The results of cholinesterase (ChE), prealbumin (PALB), albumin (ALB), aspartate aminotransferase (AST), total protein (TP), and forced expiratory volume (FEV1)/Predicted (Pred) of the two groups were measured. Results: The ChE levels of the observation group were lower than those of the control group, while the PALB and ALB levels of the observation group were higher than those of the control group (P < 0.05). The AST, TP, and FEV1 /Pred levels of the observation group were higher than those in the control group (P < 0.05). Conclusion: Serum PALB levels can be used as the main indicator for prognosis in critically ill respiratory patients.

Mental health status among COVID-19 patients survivors of critical illness in Saudi Arabia:A 6-month follow-up questionnaire study

BACKGROUND Psychological assessment after intensive care unit(ICU)discharge is increasingly used to assess patients'cognitive and psychological well-being.However,few studies have examined those who recovered from coronavirus disease 2019(COVID-19).There is a paucity of data from the Middle East assessing the post-ICU discharge mental health status of patients who had COVID-19.AIM To evaluate anxiety and depression among patients who had severe COVID-19.METHODS This is a prospective single-center follow-up questionnaire-based study of adults who were admitted to the ICU or under ICU consultation for>24 h for COVID-19.Eligible patients were contacted via telephone.The patient’s anxiety and depression six months after ICU discharge were assessed using the Hospital Anxiety and Depression Scale(HADS).The primary outcome was the mean HADS score.The secondary outcomes were risk factors of anxiety and/or depression.RESULTS Patients who were admitted to the ICU because of COVID-19 were screened(n=518).Of these,48 completed the questionnaires.The mean age was 56.3±17.2 years.Thirty patients(62.5%)were male.The main comorbidities were endocrine(n=24,50%)and cardiovascular(n=21,43.8%)diseases.The mean overall HADS score for anxiety and depression at 6 months post-ICU discharge was 11.4(SD±8.5).A HADS score of>7 for anxiety and depression was detected in 15 patients(30%)and 18 patients(36%),respectively.Results from the multivariable ordered logistic regression demonstrated that vasopressor use was associated with the development of anxiety and depression[odds ratio(OR)39.06,95% confidence interval:1.309-1165.8;P<0.05].CONCLUSION Six months after ICU discharge,30% of patients who had COVID-19 demonstrated a HADS score that confirmed anxiety and depression.To compare the psychological status of patients following an ICU admission(with vs without COVID-19),further studies are warranted.

Sleep during and following critical illness:A narrative review

Sleep is a complex process influenced by biological and environmental factors.Disturbances of sleep quantity and quality occur frequently in the critically ill and remain prevalent in survivors for at least 12 mo.Sleep disturbances are associated with adverse outcomes across multiple organ systems but are most strongly linked to delirium and cognitive impairment.This review will outline the predisposing and precipitating factors for sleep disturbance,categorised into patient,environmental and treatment-related factors.The objective and subjective methodologies used to quantify sleep during critical illness will be reviewed.While polysomnography remains the gold-standard,its use in the critical care setting still presents many barriers.Other methodologies are needed to better understand the pathophysiology,epidemiology and treatment of sleep disturbance in this population.Subjective outcome measures,including the Richards-Campbell Sleep Questionnaire,are still required for trials involving a greater number of patients and provide valuable insight into patients’experiences of disturbed sleep.Finally,sleep optimisation strategies are reviewed,including intervention bundles,ambient noise and light reduction,quiet time,and the use of ear plugs and eye masks.While drugs to improve sleep are frequently prescribed to patients in the ICU,evidence supporting their effectiveness is lacking.

Examination of the Illness Representations among Children with T1DM in Relation to Mental Health Factors

The most common comorbid psychiatric disorders in children with type 1 diabetes mellitus(T1DM)are depression,anxiety and behavioral disorders.Patients with comorbid psychopathology are less capable of psychically adjusting to the new life situation resulting from T1DM,which may negatively affect glycemic control and adherence related to the treatment.We aimed to investigate the association between mental health and type 1 diabetes including illness representation.115 children and adolescents with T1DM were recruited through the outpatient clinic in Debrecen,Hungary.Measures:PRISM-D,Child Depression Inventory(CDI),Cantril Ladder and Self-Rated Health,Glycosylaeted haemoglobin(HbA1C)were measured.Children having depressive symptoms drew fewer circles with less area.Children not drawing any important relationships possessed more depressive symptoms.Those diagnosed at a younger age displayed smaller distance between the Self-and Illness-circles.The PRISM-D test can be a promising tool to analyse emotional and cognitive representations and the psychological burden of T1DM.

Reducing psychiatric illness in the perinatal period:A review and commentary

This brief overview highlights the global crisis of perinatal psychiatric illness(PPI).PPI is a major contributor to many adverse pregnancy,childbirth,and childhood development outcomes.It contributes to billions of dollars in spending worldwide each year and has a significant impact on the individual,their family,and their community.It is also highly preventable.Current recommendations for intervention and management of PPI are limited and vary considerably from country to country.Furthermore,there are several significant challenges associated with implementation of these recommendations.These challenges are magnified in number and consequence among women of color and/or minority populations,who experience persistent and negative health disparities during pregnancy and the postpartum period.This paper aims to provide a broad overview of the current state of recommendations and implementation challenges for PPI and layout a framework for overcoming these challenges.An equityinformed model of care that provides universal intervention for pregnant women may be one solution to address the preventable consequences of PPI on child and maternal health.Uniquely,this model emphasizes the importance of managing and eliminating known barriers to traditional health care models.Culturally and contextually specific challenges must be overcome to fully realize the impact of improved management of PPI.

Stories of Coping with Sickness:Illness Narratives in Early Medieval Chinese Anecdotal Literature

As basic facts of life,illness and healing occur frequently and in a variety of patterns in Chinese non-medical literature,starting from the earliest sources inscribed on oracle bones and continuing throughout literary history up to the present day.This article looks at illness narratives in early medieval anecdotal literature(3rd to 6th century CE)to understand how the experience of being sick or of attending to the sick was reflected in these socio-literary environments and what rhetorical and ideological roles these narratives played in their larger narrative contexts.By focusing on the experiences of the sick and those around them,this article aims at“Honoring the Stories of Illness,”in Rita Charon’s words,that are hiding in plain sight in much of Chinese non-medical literature.

Analysis of the effectiveness of cognitive rehabilitation for patients with chronic mental illness:A meta-analysis

BACKGROUND People suffering from chronic mental illness are sensitive to stressful stimuli,lack coping skills,and have low self-esteem due to problems such as social situations.They also experience depression,isolation,fear,and frustration.Due to cognitive dysfunction,people suffering from chronic mental illness have inadequate cognitive processes that lead to distorted thinking.AIM To confirm the effectiveness of cognitive rehabilitation therapy in improving cognitive function and alleviating behavioral and psychological symptoms in patients with chronic mental illness,and to identify the cognitive function that had the main effect.METHODS The quality of the studies was evaluated using the Assessment of Multiple Systematic Reviews criteria,and data published from 2011 to December 2022 were searched using PubMed,Cochrane,RISS,KISS,and DBpia.The keywords used in the search were“mental illness,”“cognitive rehabilitation,”“cognition,”and“mental.”A meta-analysis was conducted on the 12 selected papers.RESULTS The level of evidence for the 12 documents was that of a randomized experimental study.Intervention types in cognitive rehabilitation can be divided into cognitive behavior,cognitive training,cognitive rehabilitation,and computerized cognitive programs.Most of the studies were on schizophrenia,and the measurement areas were cognitive functions(e.g.,concentration,memory,and executive function)as well as depression,sociability,and quality of life.As a result of the meta-analysis of each variable,the effect size for cognitive rehabilitation treatment was in the following order:Sociability,memory,concentration,executive function,quality of life,and depression.Particularly,sociability and memory exhibited significant effects.CONCLUSION Cognitive rehabilitation aids cognitive function and sociability in patients with chronic mental illness and can be used as evidence for cognitive rehabilitation in mental health and occupational therapy.

Predictive value of controlling nutritional status score for progression to chronic critical illness in elderly patients with sepsis

Objective:To investigate the predictive value of controlling nutritional status(CONUT)score for progression to chronic critical illness sepsis in elderly patients,and to construct a predictive model based on CONUT score histogram.Methods:739 elderly patients with sepsis admitted from January 2020 to December 2022 were selected as the study objects,and were divided into chronic critical illness group(n=188)and non-chronic critical illness group(n=551)according to whether chronic critical illness disease occurred.Clinical data of the patients were collected and compared.The predictive value of CONUT score,PNI and NLR in the progression of senile sepsis to chronic severe disease was compared,and the optimal threshold value was determined,which was used to convert the numerical variables into binary variables.Through univariate analysis and multivariate Logistic regression analysis,the risk factors affecting the progression of elderly sepsis patients to chronic critical illness disease were screened out,and the prediction model was built based on the nomogram.The efficacy and clinical utility of the prediction model were evaluated by the area under the ROC curve(AUC),calibration curve and decision curve analysis(DCA).Results:The best cut-off value for CONUT score in predicting elderly sepsis progressing to chronic critical illness was 4 points.The predictive performance of CONUT score(AUC=0.739)was better than that of PNI(AUC=0.609)and NLR(AUC=0.582)in elderly sepsis progressing to chronic critical illness(CONUT score vs PNI:Z=5.960,P<0.001;CONUT score vs NLR:Z=6.119,P<0.001).Univariate analysis showed that age,CCI score,SOFA score,sepsis shock,serum Lac,CONUT score,mechanical ventilation(MV),and continuous renal replacement therapy(CRRT)treatment were related to elderly sepsis progressing to chronic critical illness(P<0.05).Multivariate logistic regression analysis showed that CONUT score≥4 points,age≥75 years,CCI score≥3 points,SOFA score>5 points,sepsis shock,and serum Lac≥4 mmol/L were independent risk factors for elderly sepsis progressing to chronic critical illness(P<0.05).The nomogram showed that CONUT score had the greatest contribution value in predicting elderly sepsis progressing to chronic critical illness.Based on this,the nomogram prediction model had an AUC of 0.846[95%CI(0.812~0.879)],with a sensitivity of 75.5%and specificity of 81.3%,indicating good predictive performance.The calibration curve was close to the ideal curve,and the DCA threshold had clinical utility advantages when ranging from 0.1 to 0.9.Conclusion:The nomographic prediction model based on CONUT score can effectively predict the risk probability of senile sepsis progressing to chronic critical illness,helpful for clinicians to identify the high risk group of chronic and severe senile sepsis,which is helpful for clinicians to identify high-risk populations of elderly sepsis with chronic critical illness.

Malaria Illness and Accessing Healthcare in an African Indigenous Population: A Qualitative Study of the Lived Experiences of Uganda’s Batwa in Kanungu District

Purpose: Malaria continues to be a public health threat, especially in sub-Saharan Africa, including Uganda. While Batwa Indigenous People (IPs) face a higher burden of malaria, there is limited understanding of their malaria-lived experiences. We assessed and characterized malaria illness and accessing healthcare lived experiences of the Batwa in Kanungu district to inform contextually and culturally appropriate public health interventions. Methods: An exploratory qualitative study was conducted in 5 Batwa settlements where 5 Focus Group Discussions (n = 36) and 13 Key Informant Interviews (n = 13) were held. Data were collected using printed guides and voice recorders in April 2018. Transcripts from the data that captured the lived experiences of the symptoms, prevention, treatment and barriers to accessing formal healthcare services were applied to Atlas.ti a qualitative data analysis software and condensed into codes, categories, and themes. Results: Many Batwa have experienced malaria in their households, and they know its causes and risk factors, like not sleeping under insecticide-treated mosquito nets (ITNs), living near water bodies, prevention measures like the use of ITNs, and vector management. The lived experiences demonstrate malaria management by an Indigenous population in a rural setting and comprised detecting malaria symptoms, use of herbs as first line of treatment, buying medicines from drug shops, and village health teams (VHTs) treatment. For many Batwa accessing formal healthcare is normally a second option. Barriers for malaria treatment included: long distances to health facilities, geographically difficult terrain, economic constraints, irregular health outreaches, and stockouts of malaria medicines at health facilities. Conclusion: This study characterized Batwa’s malaria illness lived experiences and access to healthcare in rural remote settings. These experiences are essential in appreciating the ways in which Indigenous populations understand and manage common illnesses and how appropriate policies and interventions can be developed.

Illness Narratives in Edgar Allan Poe’s Short Stories

Edgar Allan Poe occupies a unique position in the history of American literature.His gothic horror novels prove astounding on account of extraordinary rendering the atmosphere and in-depth psychological description.In his gothic novels,pestilence,tuberculosis and madness are common and the protagonists always suffer from foregoing diseases.Based on the investigation of the relation between Poe’s life and illness and the social and cultural background of Poe’s time,the thesis aims to discuss the emergence and embodiment of illness narratives in Poe’s tales in order to explore the aesthetic values and cultural connotations.

Critical illness polyneuropathy and myopathy:a systematic review

Critical illness polyneuropathy and critical illness myopathy are frequent complications of severe illness that involve sensorimotor axons and skeletal muscles, respectively. Clinically, they manifest as limb and respiratory muscle weakness. Critical illness polyneuropathy/myopathy in isolation or combination increases intensive care unit morbidity via the inability or difficulty in weaning these patients off mechanical ventilation. Many patients continue to suffer from decreased exercise capacity and compromised quality of life for months to years after the acute event. Substantial progress has been made lately in the understanding of the pathophysiology of critical illness polyneuropathy and myopathy. Clinical and ancillary test results should be carefully interpreted to differentiate critical illness polyneuropathy/myopathy from similar weaknesses in this patient population. The present review is aimed at providing the latest knowledge concerning the pathophysiology of critical illness polyneuropathy/myopathy along with relevant clinical, diagnostic, differentiating, and treatment information for this debilitat- ing neurological disease.

Progression of intervention-focused research for Gulf War illness

The Persian Gulf War of 1990 to 1991 involved the deployment of nearly 700,000 American troops to the Middle East.Deployment-related exposures to toxic substances such as pesticides,nerve agents,pyridostigmine bromide(PB),smoke from burning oil wells,and petrochemicals may have contributed to medical illness in as many as 250,000 of those American troops.The cluster of chronic symptoms,now referred to as Gulf War Illness(GWI),has been studied by many researchers over the past two decades.Although over$500 million has been spent on GWI research,to date,no cures or condition-specific treatments have been discovered,and the exact pathophysiology remains elusive.Using the 2007 National Institute of Health(NIH)Roadmap for Medical Research model as a reference framework,we reviewed studies of interventions involving GWI patients to assess the progress of treatment-related GWI research.All GWI clinical trial studies reviewed involved investigations of existing interventions that have shown efficacy in other diseases with analogous symptoms.After reviewing the published and ongoing registered clinical trials for cognitivebehavioral therapy,exercise therapy,acupuncture,coenzyme Q10(CoQ10),mifepristone,and carnosine in GWI patients,we identified only four treatments(cognitive-behavioral therapy,exercise therapy,CoQ10,and mifepristone)that have progressed beyond a phase II trial.We conclude that progress in the scientific study of therapies for GWI has not followed the NIH Roadmap for Medical Research model.Establishment of a standard case definition,prioritized GWI research funding for the characterization of the pathophysiology of the condition,and rapid replication and adaptation of early phase,single site clinical trials could substantially advance research progress and treatment discovery for this condition.

Health care experiences in infancy and subsequent frequent illness in 1-year-old children

Background: Parents of infants suffering from frequent episodes of illness demand more acknowledgement from general practice with regard to their observations of these illnesses, which is evident from their tendency to book multiple consultations. Aim: To identify factors relating to illness and health-care experiences in infancy that predict frequent episodes of illness in toddlers. Design of study: A retrospective questionnaire and a prospective diary study including 183 infants born in February 2001 in a district of the capital region of Denmark. Setting: Denmark, primary care. Methods: Infants were recruited from a birth cohort and experiences of illness from birth until the age of 11 months were collected using a questionnaire. Thereafter the infants were followed prospectively from the age of 11 to 14 months using diary cards. The diary data consisted of 1) selected symptoms, 2) doctor-contacts and 3) parent-rated illness severity, information used to form three aspects of a frequently ill child. The analyses explore associations from the infant data with the three indicators of frequent illness. Results: Experiences of restless sleep, earache, otitis media, penicillin usage and use of medicine associated with illness in infancy were highly associated with factors of excess illness during the follow up period. Disturbed sleep in infancy was the factor with the highest probability of frequent illness as a toddler—an unexpected finding. Experiences of acute otitis media (earache, frequent visits to the doctor and antibiotic treatment) were strongly related to frequent illnesses. Asthma or giving the child medicine correlated with a higher parent-rated frequency of illness later on. Conclusions: Sleep problems in infancy can predict frequent illness episodes later on. In clinical practice the GP may benefit from talking about sleep in the consultations in order to learn something more. The three different indicators of frequent illness applied to different aspects of being a frequently ill child.

爱丁堡大学“Living with chronic illness”课程对我国护理教育的启示

从教学概述、教学目标、教学内容、教学方法、课程考核5个方面对爱丁堡大学Living with chronic illness课程进行介绍。结合我国护理教学现状,建议我国护理教育增加慢性病病人人文关怀相关课程,鼓励护生从病人角度学习慢性病病人护理,增强教学内容的时效性,推广适合我国护理教育的多样化教学方式,重视护生科研能力、评判性思维、团队协作能力和解决实际问题能力的培养。

Annual cost of illness of stomach and esophageal cancer patientsin urban and rural areas in China： A multi-center study

Objective： Stomach and esophageal cancer are imposing huge threats to the health of Chinese people whereasthere were few studies on the financial burden of the two cancers.Methods： Costs per hospitalization of all patients with stomach or esophageal cancer discharged betweenSeptember 2015 and August 2016 in seven cities/counties in China were collected, together with their demographicinformation and clinical details. Former patients in the same hospitals were sampled to collect information onannual direct non-medical cost, indirect costs and annual number of hospitalization. Annual direct medical cost wasobtained by multiplying cost per hospitalization by annual number of hospitalization. Annual cost of illness （ACI）was obtained by adding the average value of annual direct medical cost, direct non-medical cost and indirect cost,stratified by sex, age, clinical stage, therapy and pathologic type in urban and rural areas. Costs per hospitalizationwere itemized into eight parts to calculate the proportion of each part. All costs were converted to 2016 US dollars（1 USD：6.6423 RMB）.Results： Totally 19,986 cases were included, predominately male. Mean ages of stomach cancer and urbanpatients were lower than that of esophageal cancer and rural patients. ACI of stomach and esophageal cancerpatients were $10,449 and $13,029 in urban areas, and $2,927 and $3,504 in rural areas, respectively. Greater ACIwas associated with male, non-elderly patients as well as those who were in stage I and underwent surgeries.Western medicine fee took the largest proportion of cost per hospitalization.Conclusions： The ACI of stomach and esophageal cancer was tremendous and varied substantially among thepopulation in China. Preferential policies of medical insurance should be designed to tackle with this burden andfurther reduce the health care inequalities.

Changes in thyroid function in patients with liver failure and their clinical significance:A clinical study of non-thyroidal illness syndrome in patients with liver failure

Background:Non-thyroidal illness syndrome(NTIS)develops in a large proportion of critically ill patients and is associated with high risk for death.We aimed to investigate the correlation between NTIS and liver failure,and the short-term mortality of patients with these conditions.Methods:The clinical data of 87 patients with liver failure were collected retrospectively,73 of them were randomly selected for an observational study and to establish prognostic models,and 14 for model validation.Another 73 sex-and age-matched patients with mild chronic hepatitis were randomly selected as a control group.Serum free triiodothyronine(FT3),free thyroxine(FT4),and thyroid-stimulating hormone(TSH)were measured.The clinical characteristics of patients with liver failure and NTIS were analyzed.The follow-up of patients lasted for 3 months.Additionally,the values for predicting short-term mortality of model for end-stage liver disease(MELD),Child-Turcotte-Pugh(CTP),chronic liver failure-sequential organ failure assessment(CLIF-SOFA)scores,FT3-MELD model,and FT3 were evaluated.Results:The observation group had significantly lower FT3(2.79±0.71 vs.4.43±0.75 pmol/L,P<0.001)and TSH[0.618(0.186-1.185)vs.1.800(1.570-2.590)mIU/L,P<0.001],and higher FT4(19.51±6.26 vs.14.47±2.19 pmol/L,P<0.001)than the control group.NTIS was diagnosed in 49 of the patients with liver failure(67.12%).In the observation group,patients with NTIS had a higher mortality rate than those without(63.27%vs.25.00%,P=0.002).Across the whole cohort,the 3-month mortality was 50.68%.The international normalized ratios(INR)were 2.40±1.41 in survivors and 3.53±1.81 in deaths(P=0.004),the creatinine(Cr)concentrations were 73.27±36.94μmol/L and 117.08±87.98μmol/L(P=0.008),the FT3 concentrations were 3.13±0.59 pmol/L and 2.47±0.68 pmol/L(P<0.001),the MELD scores were 22.19±6.64 and 29.57±7.99(P<0.001),the CTP scores were 10.67±1.53 and 11.78±1.25(P=0.001),and the CLIF-SOFA scores were 8.42±1.68 and 10.16±2.03(P<0.001),respectively.FT3 was negatively correlated with MELD score(r=−0.430,P<0.001).An FT3-MELD model was established by subjecting FT3 concentration and MELD score to logistic regression analysis using the following formula:Logit(P)=−1.337×FT3+0.114×MELD+0.880.The area under the receiver operating characteristic(ROC)curve was 0.827 and the optimal cut-off value was 0.4523.The corresponding sensitivity and specificity were 67.6%and 91.7%.The areas under the ROC curve for FT3 concentration,MELD score,CTP score,and CLIF-SOFA score were 0.809,0.779,0.699,and 0.737,respectively.Conclusions:Patients with liver failure often develop NTIS.FT3-MELD score perform better than CTP and CLIF-SOFA scores in predicting mortality in patients with liver failure.Thus,the FT3-MELD model could be of great value for the evaluation of the short-term mortality of such patients.

Medical services for sports injuries and illnesses in the Beijing 2022 Olympic Winter Games

BACKGROUND:Beijing 2022 Olympic Winter Games was the second Games held amid the COVID-19 pandemic.To a certain extent,it has altered the way sporting activities operate.There is a lack of knowledge on injury risk and illness occurrence in elite winter sport athletes amid the COVID-19 pandemic.This study aimed to describe the incidence of injuries and illnesses sustained during the XXIV Olympic Winter Games in Beijing from February 4 to 20,2022.METHODS:We recorded the daily number of injuries and illnesses among athletes reported by Beijing 2022 medical staff in the polyclinic,medical venues,and ambulance.We calculated injury and illness incidence as the number of injuries or illnesses occurring during competition or training,respectively,with incidence presented as injuries/illnesses per 100 athlete-days.RESULTS:In total,2,897 athletes from 91 nations experienced injury or illness.Beijing 2022 medical staff reported 326 injuries and 80 illnesses,equaling 11.3 injuries and 2.8 illnesses per 100 athletes over the 17-day period.Altogether,11%of the athletes incurred at least one injury and nearly 3%incurred at least one illness.The number of injured athletes was highest in the skating sports(n=104),followed by alpine skiing(n=53),ice track(n=37),freestyle skiing(n=36),and ice hockey(n=35),and was the lowest in the Nordic skiing disciplines(n=20).Of the 326 injuries,14(4.3%)led to an estimated absence from training or competition of more than 1 week.A total of 52 injured athletes were transferred to hospitals for further care.The number of athletes with illness(n=80)was the highest for skating(n=33)and Nordic skiing(n=22).A total of 50 illnesses(62.5%)were admitted to the department of dentistry/ophthalmology/otolaryngology,and the most common cause of illness was other causes,including preexisting illness and medicine(n=52,65%).CONCLUSION:Overall,11%of athletes incurred at least one injury during the Games,which is similar to the findings during the Olympic Winter Games in 2014 and 2018.Regarding illness,2%of athletes were affected,which is approximately one-third of the number affected in the 2018 Olympic Winter Games.

Effectiveness of an intervention for reducing social stigma towards mental illness in adolescents

AIM: To evaluate the effectiveness of an intervention for reducing social stigma towards mental illness in adolescents. The effect of gender and knowledge of someone with mental illness was measured. METHODS: Two hundred and eighty secondary school students were evaluated using the Community Attitudes towards Mental Illness(CAMI) questionnaire. The schools were randomized and some received the intervention and others acted as the control group. The programme consisted of providing information via a documentary film and of contact with healthcare staff in order to reduce the social stigma within the school environment. RESULTS: The intervention was effective in reducing the CAMI authoritarianism and social restrictiveness subscales. The intervention showed significant changes in girls in terms of authoritarianism and social restrictiveness, while boys only showed significant changes in authoritarianism. Following the intervention, a significant reduction was found in authoritarianism and social restrictiveness in those who knew someone with mental illness, and only in authoritarianism in those who did not know anyone with mental illness. CONCLUSION: The intervention was effective to reduce social stigma towards people with mental illness, especially in the area of authoritarianism. Some differences were found depending on gender and whether or not the subjects knew someone with mental illness.