Linking 24-h Movement Behavior Guidelines to Cognitive Difficulties,Internalizing and Externalizing Problems in Preterm Youth

Background:Given the heightened risk of developmental challenges associated with preterm birth,it is crucial to explore interventions that may ameliorate potential adverse outcomes.This study aimed to examine whether meeting the 24-h movement behavior(24-HMB)guidelines,which include recommendations on physical activity(PA),screen time(ST),and sleep(SL),is related to indicators of cognitive difficulties,internalizing problems(e.g.,depression and anxiety),and externalizing problems(e.g.,difficulties in making friends and arguing)in a sample of preterm youth(children and adolescents born preterm).Methods:In this cross-sectional study,data from 3410 preterm youth(aged 6 to 17 years)were included for data analyses.Multivariable logistic regression was used to investigate associations between meeting the 24-HMB guidelines and the above-mentioned health outcomes,while controlling for sociodemographic and health-related factors.Results:The prevalence of meeting 24-HMB guidelines varied across independent and integrated components of the 24-HMB guidelines.Meeting the ST guideline alone(p<0.05)and integrated guidelines(i.e.,ST+SL and ST+SL+PA)were associated with fewer cognitive difficulties and reduced internalizing and externalizing problems(p<0.05).Specifically,meeting the SL guideline alone and integrated guidelines(i.e.,SL+ST)were associated with lower odds of depression and anxiety(p<0.01).Additionally,meeting independent,and integrated(PA and/or ST)guidelines were associated with less pronounced difficulties in making friends and arguing(p<0.05).Meeting 24-HMB guidelines in an isolated and integrated manner are linked to better cognitive performance and fewer internalizing and externalizing problems in preterm youth.Conclusion:Results suggest that advocating for the implementation of the 24-HMB guidelines may reduce cognitive challenges and behavioral issues,which is of high relevance for improving public health.Future longitudinal studies in preterm youth should investigate how modifying specific 24-HMB behaviors,especially ST,influence cognitive difficulties,internalizing and externalizing problems in this vulnerable population.

Evidence for the Reliability and Validity of the Arabic Version of the Student Risk Screening Scale for Internalizing and Externalizing Behaviors (SRSS-IE)

School-based universal screening for behavioral/emotional risk is a necessary first step to providing services in an educational setting for students with emotional and behavioral disorders (EBDs). Psychometric properties are critical to making decisions about choosing a screening instrument. The purpose of the present study was to examine the psychometric properties of the student risk screening scale for internalizing and externalizing behaviors (SRSS-IE). Participants included 3145 students and their teachers. Item-level analyses of the current sample supported the retention of all items. The internal consistency of the SRSS items ranged from 0.83 to 0.85. Convergent validity between the SRSS-IE and a well-established screening tool, the strength and difficulties questionnaire (SDQ), was found for the total score (r = 0.70). Additionally, the results of this study demonstrate strong social validity, suggesting the SRSS-IE to be a useful and functional screening tool. We conclude that the SRSS-IE is a valid and reliable instrument for assessing the level of emotional and behavioral difficulties among elementary students.

Effect of external and internal cues on core muscle activation during the Sahrmann five-level core stability test

BACKGROUND Pain in the back or pelvis or fear of back pain may affect the timing or cocontraction of the core muscles.In both static and dynamic movements,the Sahrmann core stability test provides an assessment of core muscle activation and a person's ability to stabilize the lumbopelvic complex.Preparatory cues and images can be used to increase the activation of these muscles.To attain optimal movement patterns,it will be necessary to determine what cueing will give the most effective results for core stability.AIM To investigate the effects of external and internal cues on core muscle activation during the Sahrmann five-level core stability test.METHODS Total 68 participants(21.83±3.47 years)were randomly allocated to an external(n=35)or internal cue group(n=33).Participants performed the Sahrmann fivelevel core stability test without a cue as baseline and the five-level stability exercises with an internal or external cue.External cue group received a pressure biofeedback unit(PBU),and the internal cue group received an audio cue.A Delsys Trigno^(TM)surface electromyography unit was used for muscle activation from the rectus abdominis,external oblique,and transverse abdominis/internal oblique muscles.RESULTS Linear mixed effects model analysis showed that cueing had a significant effect on core muscle activation(P=0.001);however,there was no significant difference between cue types(internal or external)(P=0.130).CONCLUSION Both external and internal cueing have significant effects on core muscle activation during the Sahrmann five-level core stability test and the PBU does not create higher muscle activation than internal cueing.

Internal fixator vs external fixator in the management of unstable pelvic ring injuries:A prospective comparative cohort study

BACKGROUND Reconstruction of the pelvic ring anatomy in unstable anterior pelvic ring injuries is a significant step to reduce the mortality rate associated with these injuries efficiently.There is a debate on using either an anterior subcutaneous pelvis internal fixator(INFIX)or an anterior supra-acetabular external fixator(EXFIX)to manage an unstable anterior pelvic ring fracture.AIM To compare the functional and radiological outcomes and complications of INFIX vs EXFIX in managing unstable pelvic ring injuries.METHODS A prospective cohort study included 54 patients with unstable pelvic ring fractures.The patients were divided into two groups;the INFIX group,in which 30 cases were fixed by INFIX,and the EXFIX group,in which 24 patients were treated by EXFIX.The average age in the EXFIX group was 31.17 years(16-57 years),while in the INFIX group,it was 34.5 years(17-53 years).The study included 20(66.7%)males and 10(33.3%)females in the INFIX group and 10(41.7%)males and 14(58.3%)females in the EXFIX group.The radiological outcomes were evaluated using Matta and Tornetta's score,and the functional outcomes using the Majeed score.RESULTS The results revealed a statistically significant difference between both groups(P=0.013)regarding radiological outcomes,according to Matta and Tornetta's score in favor of the INFIX group.Sitting,standing,and walking abilities were measured at a 3-mo follow-up visit using Majeed score modules.It was significantly better among the INFIX group than the EXFIX group in all three modules.At the final follow-up,both groups had no statistically significant difference according to the Majeed score;92.35 in the INFIX group and 90.99 in the EXFIX group(P=0.513).A lower surgical site infection rate was noticed in the INFIX group(P=0.007).CONCLUSION Anterior subcutaneous pelvis INFIX is associated with better radiological outcomes and a lower infection rate than anterior supra-acetabular EXFIX in managing patients with unstable anterior pelvic ring fractures.

Meta-analysis of the efficacy of volar plate internal fixation versus closed reduction and external fixation in the treatment of adult distal radius fractures

Objective:To compare the efficacy of open reduction and volar locking plate internal fixation with closed reduction and external fixation in the treatment of distal radius fractures by using meta analysis.Methods:The databases of CNKI,Wanfang,Weipu,Chinese biomedical literature,Pubmed,Embase,and Cochrane Library were retrieved,and the randomized controlled studies that directly compared the efficacy of plate internal fixation and closed reduction external fixation in the treatment of distal radius fractures published publicly from the establishment of the database to April 2023 were collected.The two researchers independently screened the retrieved literature according to the inclusion and exclusion criteria,extracted data,used Cochrane risk bias assessment tool for quality assessment,and used RevMan 5.4 software for meta analysis.Results:A total of 10 randomized controlled trials were included,all of which were in English.There were 1042 patients in total,and 9 of them were rated as low risk.Meta analysis results showed that one year after the treatment of distal radius fracture with volar locking plate internal fixation,DASH score[MD=-5.64,95%CI(-7.21,-4.06),P<0.00001];One year later,PRWE score[MD=-5.90,95%CI(-8.88,-2.92),P=0.001];Palm flexion[MD=5.92,95%CI(1.29,10.55),P=0.01];Pronation[MD=2.48,95%CI(0.59,4.36),P=0.01];Postrotation[MD=4.73,95%CI(2.15,7.31),P=0.0003];Grip strength[MD=0.61,95%CI(0.12,1.10),P=0.02];palmar tilt angle[MD=9.84,95%CI(5.66,14.02),P<0.00001];Radial inclination[MD=4.33,95%CI(2.97,5.69),P<0.00001]was superior to closed reduction plaster or splint external fixation.One year later,the European Five dimensional Health Scale(EQ-5D-5L)score[MD=0.02,95%CI(-0.01,0.05),P=0.27];Back extension[MD=2.22,95%CI(-4.15,8.59),P=0.49];Ulnar deviation[MD=3.49,95%CI(-0.80,7.78),P=0.11];Radial deviation[MD=2.05,95%CI(-2.39,6.50),P=0.37];Ulnar variance[MD=-1.14,95%CI(-3.16,0.88),P=0.27];There was no significant difference in complications[MD=0.77,95%CI(0.54,1.10),P=0.16](P>0.05).Conclusion:Based on the current clinical data,internal fixation with volar locking plate is more conducive to mid-term DASH score and grip strength recovery than closed reduction plaster or splint external fixation,but there is no significant difference in the quality of life and complications of patients.For adult distal radius fractures,surgical indications should be carefully grasped,and non operative treatment should be given priority.

Analysis of the Internal and External Factors Involved in Second Language Acquisition

Materialist dialectics holds that internal causes are the basis of change and the external causes are the condition of change, and that external causes become operative through internal causes. This law can be applied into SLA. The internal causes and external causes influence SLA greatly. This paper mainly discusses the factors involved in SLA process.

Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection for circumferential mixed hemorrhoids

AIM:To identify a more effective treatment protocol for circumferential mixed hemorrhoids.METHODS:A total of 192 patients with circumferential mixed hemorrhoids were randomized into the treatment group,where they underwent Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection,or the control group,where traditional external dissection and internal ligation were performed.Postoperative recovery and complications were monitored.RESULTS:The time to wound healing was 12.96 ± 2.25 d in the treatment group shorter than 19.58 ± 2.71 d in the control group.Slight pain rate was 58.3% in the treatment group higher than 22.9% in the control group;moderate pain rate was 33.3% in the treatment group lower than 56.3% in the control group severe pain rate was 8.4% in the treatment group lower than 20.8% in the control group.No edema rate was 70.8% in the treatment group higher than 43.8% in the control group;mild local edema rate was 26% in the treatment group lower than 39.6% in the control group obvious local edema was 3.03% in the treatment group lower than 16.7% in the control group.No stenosis rate was 85.4% in the treatment group higher than 63.5% in the control group;moderate stenosis rate was 14.6% in the treatment group Lower than 27.1% in the control group severe anal stenosis rate was 0% in the treatment group lower than 9.4% in the control group.CONCLUSION:Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection is the optimal treatment for circumferential mixed hemorrhoids and can be widely applied in clinical settings.

Current status of laparoscopic and robotic ventral mesh rectopexy for external and internal rectal prolapse

External and internal rectal prolapse with their affiliated rectocele and enterocele, are associated with debilitating symptoms such as obstructed defecation, pelvic pain and faecal incontinence. Since perineal procedures are associated with a higher recurrence rate, an abdominal approach is commonly preferred. Despite the description of greater than three hundred different procedures, thus far no clear superiority of one surgical technique has been demonstrated. Ventral mesh rectopexy(VMR) is a relatively new and promising technique to correct rectal prolapse. In contrast to the abdominal procedures of past decades, VMR avoids posterolateral rectal mobilisation and thereby minimizes the risk of postoperative constipation. Because of a perceived acceptable recurrence rate, good functional results and low mesh-related morbidity in the short to medium term, VMR has been popularized in the past decade. Laparoscopic or robotic-assisted VMR is now being progressively performed internationally and several articles and guidelines propose the procedure as the treatment of choice for rectal prolapse. In this article, an outline of the current status of laparoscopic and robotic ventral mesh rectopexy for the treatment of internal and external rectal prolapse is presented.

RELATIONSHIP BETWEEN INTERNAL ANAL SPHINCTER FUNCTION AND LENGTH OF REMAINING RECTUM AFTER RESECTING RECTAL CARCINOMA

Objective: To study the relationship between internal anal sphincter function and length of remaining rectum after resecting rectal carcinoma. Methods: Preoperatively, 21 patients were evaluated via patients' clinical date, including anal resting pressure (resting pressure) assay. Six months postoperatively, repeated manometric studies and clinical evaluations were performed to assess the level of continence . The formula use for calculating post operative resting pressure is as follows: postoperative resting pressure=0.42×preoperative resting pressure+1.56×length of remaining recturm+12.37(R 2=0.58; P <0.01).Degree of continence was graded based on severity of the dysfunction and grade of the continence score. Results: It was demonstrated the patients with low postoperative resting pressures (<4.0 Kpa) had incontinence, and those with high postoperative resting pressures (>4.7 Kpa) were continent. There were significant correlations between length of the remaining rectum and ratio of the decrease in maximum resting pressure (postoperative/preoperative maximum resting pressure;r=0.62; P <0.01). Conclusion: Continence of rectum is influenced by maximum resting pressure of function of the internal anal sphincter, length of remaining rectum is shorter, the more damage to the internal anal sphincter. It is able to foretell stool incontinence by using the postoperative resting pressure formula, and to determine the length of the remaining rectum.

Role of intracellular calcium in contraction of internal anal sphincter

ＩＮＴＲＯＤＵＣＴＩＯＮＩｎｔｅｒｎａｌａｎａｌｓｐｈｉｎｃｔｅｒ（ＩＡＳ）ｉｓａｃｏｎｔｉｎｕａｔｉｏｎｏｆｔｈｅｓｍｏｏｔｈｃｉｒｃｕｌａｒｍｕｓｃｌｅｌａｙｅｒｔｈｉｃｋｅｎｅｄａｔｔｈｅｒｅｃｔｕｍ，ｉｎｎｅｒｖａｔｅｄｂｙｖｅｇｅｔａｔｉｖ...

Nonlinear Dynamic Analysis of Coupled Gear-Rotor-Bearing System with the Effect of Internal and External Excitations

Extensive studies on nonlinear dynamics of gear systems with internal excitation or external excitation respectively have been carried out. However, the nonlinear characteristics of gear systems under combined internal and external excitations are scarcely investigated. An eight-degree-of-freedom（8-DOF） nonlinear spur gear-rotor-bearing model, which contains backlash, transmission error, eccentricity, gravity and input/output torque, is established, and the coupled lateral-torsional vibration characteristics are studied. Based on the equations of motion, the coupled spur gear-rotor-bearing system（SGRBS） is investigated using the Runge-Kutta numerical method, and the effects of rotational speed, error fluctuation and load fluctuation on the dynamic responses are explored. The results show that a diverse range of nonlinear dynamic characteristics such as periodic motion, quasi-periodic motion, chaotic behaviors and impacts exhibited in the system are strongly attributed to the interaction between internal and external excitations. Significantly, the changing rotational speed could effectively control the vibration of the system. Vibration level increases with the increasing error fluctuation. Whereas the load fluctuation has an influence on the nonlinear dynamic characteristics and the increasing excitation force amplitude makes the vibration amplitude increase, the chaotic motion may be restricted. The proposed model and numerical results can be used for diagnosis of faults and vibration control of practical SGRBS.

A STUDY ON THE CHARACTERISTICS OF INTERNAL ANDEXTERNAL WALL SURFACE TEMPERATUREIN THE URBAN AREA

Internal and external wall surface temperatures (Tws) in April, August and December in Kunming, a city in low latitude plateau, were investigated. Results showed that the Tws in April were of the highest among the three, followed by August and December. The Tws differences among walls with different orientation were higher in April and December when the weather tends to be sunny, and lower in August with more cloudy days in the time. In April and August, Tws of E-wall was the highest, followed by S- and N-wall. But in December Tws of S-wall might be sometimes higher than E one. Diurnal range of internal Tws was usually smaller than that of the external, with also a time lag for the occurrence of its maximum and minimum. The results can serve as a basis for further research on building microclimate and urban architecture designs. It also gives suggestions for similar studies in other areas.

Influence of external circulation on sludge characteristics during start-up of internal circulation reactor

The start-up of external circulationadded internal circulation(IC) reactor was finished in 26 d, 32 d fewer than that of IC reactor. To evaluate the influence of the added external circulation on the development of granular sludge, the characteristics of the granular sludge taken from the two tested laboratory-scale reactors during start-up were studied. The results show that the added external circulation can enhance biomass granulation, accelerate granule development and improve sludge characteristics. At the end of start-up, the granular size of sludge in external circulation-added IC reactor greatly increases with a size distribution much better than that of sludge in IC reactor. The granular sludge originated from external circulationadded IC reactor contains more extracellular polymers and has a greater settling velocity than that from IC reactor. Methanogenic activity of the granular sludge from the external circulationadded IC reactor started 26 d ago reaches 358.23mL·g -1 ·d -1 , 1.66 and 1.20 times as great as that of the sludge from the IC reactor started 26 d and 58 d ago respectively.

EXTERNALIZATION AND INTERNALIZATION OF CARDIAC ENDOTHELIN RECEPTORS DURING DIFFERENT PHASES OF SEPSIS IN RAT

To study the redistribution of endothelin- 1 (ET- 1) receptors in two subcellular organelles , the sarcolemmal membrane and the light vesicle, of rat heart during the progression of sepsis. Methods. Sepsis was induced by cecal ligation and puncture (CLP). ET1 receptor was assayed by using [125I]- ET1 binding. Marker enzyme activities, protein yield, and dry- to- wet weight ratio of cardiac membranes were measured. Results. Septic rat heart exhibited two distinct phases: an initial hyperdynamic phase( 9h after CLP; early stage of sepsis) followed by a hypodynamic (18h after CLP, late stage of sepsis) phase. [125I]- ET1 binding study showed that during early stage of sepsis, the Bmax of ET1 receptors was increased by 30％ in sarcolemma but decreased by 19％ in light vesicles, while during late stage of sepsis, the Bmax was decreased by 24％ in sarcolemma but increased by 38％ in light vesicles.The total binding of sarcolemma and light vesicles was increased by 25％ during early stage of sepsis but decreased by 17％ during late stage of sepsis. Conclusions. These data indicated that ET1 receptors in the rat heart were externalized from light vesicles to sarcolemmal membranes during early hyperdynamic phase while internalized from surface membranes to intracellular compartment during late hypodynamic phase of sepsis.

Triple Arthrodesis with Internal and External Fixation: Technique Paper

Background: The triple arthrodesis was described early by Myerson in 1923 and has been the gold standard surgical procedure for various conditions with the goal to reduce pain, improve deformity and facilitate function. Methods: The procedure consists of fusion of the subtalar joint, talonavicular joint and calcaneocuboid joint [1]. The procedure is traditionally done with internal fixation, however, Marinet al. has shown it to be performed with external fixation [2]. Dr. Marin and the associates have developed an alternative technique to perform a triple arthrodesis using internal and external fixation. This paper describes a step-by-step technique to perform a triple arthrodesis with both internal and external fixation. It will demonstrate the use of the prefabricated arches on the footplate for more precise and accurate placement of transosseous wires using arch-wire technique [3]. Results/Conclusion: We believe this technique will not only help increase the ability to achieve fusion with a less chance of non-union, but may also decrease healing time, which may allow patients to be mobile from the first week post-operatively and may diminish the risks associated with being non-weightbearing.

Including video and novel parameter-height of penetration of external anal sphincter-in magnetic resonance imaging reporting of anal fistula

The main purpose of a radiologist’s expertise in evaluation of anal fistula magnetic resonance imaging(MRI)is to benefit patients by decreasing the incontinence rate and increasing the healing rate.Any loss of vital information during the transfer of this data from the radiologist to the operating surgeon is unwarranted and is best prevented.In this regard,two methods are suggested.First,a short video to be attached with the standardized written report highlighting the vital parameters of the fistula.This would ensure minimum loss of information when it is conveyed from the radiologist to the operating surgeon.Second,inclusion of a new parameter,the amount of external sphincter involvement by the anal fistula.This parameter is usually not included in the MRI report.This can be evaluated as the height of penetration of the external anal sphincter(HOPE)by the fistula.The external anal sphincter plays a pivotal role in maintaining continence.This parameter(HOPE)is distinct from the‘height of internal opening’and assumes immense importance as its knowledge is paramount to prevent damage to the external anal sphincter by the surgeon during surgery.

The Internal and External Factors That Help to Push English into a Popular World Language

It is well known that English is the world language nowadays, and it is an official language in most countries. It is also currently the language most often taught as a foreign language. The reasons of the popularity lie in both internal factors and external factors. In this paper, the author will analyze the factors that help to push English into a popular world language.

A Research for Regional Contribution Rate of Internal Source and External Source of PM_(2.5) Based on Set Pair Analysis Method

A problem of the air pollution control in China is getting to know a regional contribution rate of internal and external source of PM2.5. In this paper,Set Pair Analysis（ SPA） method is proposed to calculate the contribution rate of PM2.5in Dongguan City. Due to geographic,meteorological factors and the low concentration of air pollutants in Qingxi area,the PM2.5in this place is mainly contributed by the regional transport of air pollutants from other inside areas of Dongguan,and less affected by the outside of Dongguan. So the concentration of PM2.5in Qingxi area can reflect the Dongguan＇s basic background concentration of PM2.5. On the basis of the basic background concentration,firstly the concentration of each pollutant components is divided into the internal part and the mixed part. Secondly using the source apportionment samples of five monitoring sites in Dongguan we can respectively construct a sample set A and an evaluation set B. Thirdly the SPA is operated onto the mixed part in terms of set B.At last the connection degree between the concentration of each pollutant components and external source and internal source will be calculated,that is the contribution rate. The research reveals that the contribution rate of internal source and external source of PM2.5in Dongguan City is 83%and 17% respectively,which roughly met expectations. This method is simple and effective and it can provide a reference for the government taking reduction measures to control PM2.5pollutants emission.

Exploring the Internal and External Factors that Influence Chinese EFL Students' Speaking Performance: A Case Study

This case study on one Chinese EFL learner examined both the internal and external factors that affect Chinese EFL learner's speaking performance. Three interviews and three tests have been conducted in the whole process, and the findings revealed:(1) interference from first language is the most influential factor that hinders speaking performance;(2) learner attitude significantly affects speaking performance;(3) learning strategies and practicing help improving performance.

Lack of nitrate tolerance in isosorbid dinitrate- and sodium nitroprusside-induced relaxation of rabbit internal anal sphincter

AIM: To investigate the tolerance development against the relaxant effect of nitric oxide donating drug isosorbide dinitrate (ISDN) and sodium nitropruside (SNP) in internal anal sphincter (IAS) smooth muscle. METHODS: Relaxation responses of ISDN, and electrical fi eld stimulation (EFS) were obtained before and after tolerance induction by ISDN incubation. RESULTS: ISDN (10-7-10-4 mol/L) and SNP (10-8-10-4 mol/L) caused a concentration-dependent relaxation on the basal tonus of the isolated rabbit IAS strips. After a period of 2 h incubation of the 6 x 10-4 mol/L ISDN the relaxation effects of ISDN and SNP did not change compared to control strips. EFS evoked frequency-dependent relaxation in internal anal sphincter smooth muscle and Emax obtained from control strips were not changed in ISDN tolerance-inducing condition. In this study nitrate tolerance was not observed in rabbit IAS smooth muscle. CONCLUSION: This result shows that nitric oxide donating drugs relaxes the internal anal sphincter of the rabbits without the development of tolerance.