Copper phthalocyanines as a mode-locker in an Er-doped fiber laser.

We demonstrate a mode-locked erbium-doped fiber laser (EDFL) utilizing copper phthalocyanines (CuPc) as a saturable absorber (SA) for the first time, to the best of our knowledge. The investigated SA was prepared using a simple, low-cost and straightforward technique, whereby the CuPc powder was embedded into polyvinyl alcohol (PVA) to form a thin film. The thin film acted as a mode-locker when it was incorporated into the EDFL cavity to produce output pulses at a repetition rate of 1.8 MHz with a pulse duration of 1.98 ps. The frequency spectrum showed a signal-to-noise ratio as high as 55 dB, which indicates the stability of the mode-locking operation. To the best of our knowledge, this is the first work to report using CuPc as a mode-locker.

Synthesis of inventive biphenyl and azabiphenyl derivatives as potential insecticidal agents against the cotton leafworm, Spodoptera littoralis.

The emergence of pest resistance of Spodoptera littoralis (order; Lepidoptera, family; Noctuidae) towards the large scale of different classes of insecticides necessitates the development of some new poly-functionalized biphenyl and azabiphenyl with highly anticipated insecticidal bioresponse. Four new biphenyl carboxamidines 4a-d and four aza-analogue picolinamidine derivatives 8a-d were designed and prepared via the treatment of their corresponding carbonitriles with lithium-bis trimethylsilylamide [LiN(TMS)2], followed by hydrolysis with hydrogen chloride. Furthermore, these compounds were elucidated by spectral data, and their toxicity and insecticidal activity were screened against Spodoptera littoralis. Whereby, toxicological and biochemical aspects of the inventively synthesized biphenyl and azabiphenyl derivatives against the cotton leafworm, Spodoptera littoralis were inspected. As regards the indomitable LC50 and LC90 values, biphenyl and aza-analogues 8d, 8a, 4b, and 8b, revealed the furthermost forceful toxic effects with LC50 values of 113.860, 146.265, 216.624, and 289.879 ppm, respectively. Whereby, their LC90 values are 1235.108, 1679.044, 2656.296, and 3381.256 ppm, respectively, and toxicity index being 22.31%, 17.36%, 11.72%, and 8.76%, respectively, comparing with the already recommended, methomyl insecticide, lannate 90% SP (LC50, 25.396 and LC90, 57.860 and toxicity index, 100%). Additionally, electrochemical parameters via DFT studies were carried out for demonstrating and elucidation of structure-activity relationship (SAR) according to highly motived compounds, descriptors, and the in vivo insecticidal activities.

Growth performance and hematological responses of silver barb (Barbonymus gonionotus bleeker, 1850) fingerlings to dietary blanched moringa (Moringa oleifera lam.) leaf meal as a substitute of soybean meal.

The fastest-growing aquaculture industry relies heavily on animal protein, fishmeal and plant protein to maintain production levels. Therefore, present study was conducted to perceive the effectiveness of blanched moringa (Moringa oliefera) leaf meal (MLM) as a replacement of soybean meal in silver barb (Barbonymus gonionotus) fingerling diet. Four experimental feeds were prepared replacing soybean meal with MLM at 0, 10, 30, and 50%. Fish were reared for 60 days in 12 hapas installed in three similar size and shaped ponds comprising four treatments each having 3 replications. Fish were fed with the experimental diet at 5% body weight twice daily. Fish growth parameters and length-weight relationship were assessed. To determine their resistance to stressful conditions, the fish were submerged in low pH-5 solution at the conclusion of the experiment. According to the results of the fish growth metrics, the majority of the parameters were comparable and statistically insignificant between the treatments. However, when compared to the control, T1 and T2 treatments, the T3 treatment demonstrated increased survival, PER, and fish production. In addition, other parameters such as percent weight gain, SGR, FCR and FCE were higher in control but statistically similar with T3. Besides, the length-weight relationship of silver barb fingerlings fed with all the test diets showed a positive association and isometric growth pattern. With the incremental addition of MLM to the fish diet, the hematological parameters-red blood cells (RBC), white blood cells (WBC), hemoglobin (Hb), and mean corpuscular hemoglobin (MCH) gradually increased. The fish fed the T3 diet had the highest recorded stress tolerance (6.50 ± 0.50 min), whereas the fish on the control diet had the lowest (T0, 4.77 ± 0.68 min). According to the study, MLM has the potential to replace soybean meal in the diet of silver barb fingerlings to the tune of 50:50 without having an adverse impact on growth. It can enhance fish hematological performance and tolerance for unfavorable environmental conditions as well.

Thalassemia: A Review of the Challenges to the Families and Caregivers.

Thalassemias are a group of congenital hemoglobin (Hb) disorders distinguished by dwindling or total curtailment of production of one or more globin chains of hemoglobin tetramers, ensuing in unrestrained destruction of red blood cells (RBC) that causes severe anemia. The severity of the disease often remains immensely variable. Children with thalassemia suffer from the disease's consequences and treatment complications. The disease also causes a negative impact on family members, who suffer mentally, socially, financially, and even physically. In this review, we highlight the challenges experienced by the family and caregivers; for instance, repeated blood transfusion as the dominant origin of tissue casualty, morbidity, and fatal clinical outcomes. Treatment modalities regarding thalassemias were not successful until the inception of bone marrow transplantation and gene therapy.

Spatiotemporal drought analysis in Bangladesh using the standardized precipitation index (SPI) and standardized precipitation evapotranspiration index (SPEI).

Countries depending on small-scale agriculture, such as Bangladesh, are susceptible to climate change and variability. Changes in the frequency and intensity of drought are a crucial aspect of this issue and the focus of this research. The goal of this work is to use SPI (standardized precipitation index) and SPEI (standardized precipitation evapotranspiration index) to investigate the differences in drought characteristics across different physiognomy types in Bangladesh and to highlight how drought characteristics change over time and spatial scales when considering different geomorphologies. This study used monthly precipitation and temperature data from 29 metrological stations for 39 years (1980-2018) for calculating SPI and SPEI values. To determine the significance of drought characteristic trends over different temporal and spatial scales, the modified Mann-Kendall trend test and multivariable linear regression (MLR) techniques were used. The results are as follows: (1) Overall, decreasing dry trend was found in Eastern hill regions, whereas an increasing drought trends were found in the in the rest of the regions in all time scaless (range is from - 0.08 decade-1 to - 0.15 decade-1 for 3-month time scale). However, except for the one-month time scale, the statistically significant trend was identified mostly in the north-central and northeast regions, indicating that drought patterns migrate from the northwest to the center region. (2) SPEI is anticipated to be better at capturing dry/wet cycles in more complex regions than SPI. (3) According to the MLR, longitude and maximum temperature can both influence precipitation. (4) Drought intensity increased gradually from the southern to the northern regions (1.26-1.56), and drought events occurred predominantly in the northwestern regions (27-30 times), indicating that drought meteorological hotspots were primarily concentrated in the Barind Tract and Tista River basin over time. Findings can be used to improve drought evaluation, hazard management, and application policymaking in Bangladesh. This has implications for agricultural catastrophe prevention and mitigation.

Yield improvement of Gracilaria tenuistipitata by optimizing different aspects in coast of cox's bazar, Bangladesh.

This research was designed to find out the effect of different factors such as influence of lunar cycle, harvesting interval, rope type and seeding gap on the production of G. tenuistipitata in coast of Cox's Bazar. Duration of these experiments were sixty days and all the parameters were recorded fortnightly. Monitoring of water quality parameters indicated that salinity, temperature, transparency, pH and DO were suitable for seaweed cultivation. In determining lunar cycle effect, results envisaged that fresh yield was 14.43% increased when seeding and harvesting time was selected considering the moon cycle. Regarding the selection of harvesting interval, it was found that T3 (30 days interval) was the best to harvest the seaweed whereas T4 (40 days interval) showed decreasing trend in production. Our study also found that semi floating single line showed better yield performance compared to semi floating double line system. In case of influence on seeding gap, it has been found that 20 cm gap between two seed showed the highest yields followed by 10 cm, 30 cm and 40 cm, respectively. Overall, it can be concluded that yield of G. tenuistipitata in coast of Cox's Bazar could be improved considering those factors.

Cobalt-ferrite/Ag-fMWCNT hybrid nanocomposite catalyst for efficient degradation of synthetic organic dyes via peroxymonosulfate activation.

The activation of peroxymonosulfate (PMS) by nanocatalysts has shown promise as an effective wastewater treatment protocol. Magnetic CoFe2O4/Ag-nanoparticles (NPs) anchored on functionalized multiwalled carbon nanotubes (fMWCNTs), a support material, were synthesized using a one-pot solvothermal method. The surface morphologies and physicochemical properties of the CoFe2O4/Ag-fMWCNT hybrid nanocomposite catalyst were investigated by powder X-ray diffraction analysis, field-emission scanning electron microscopy, energy-dispersive X-ray spectroscopy, high-resolution transmission electron microscopy, Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, and nitrogen adsorption-desorption isotherms. The activity of the nanocomposite combined with PMS (serving as an activator) toward the degradation of rhodamine B, methylene blue, methyl orange, and methyl red was investigated. The obtained optimal 0.02 g CoFe2O4/Ag-fMWCNTs exhibited the highest PMS activation performance, with a removal percentage of 100% for 20 ppm dye concentration at pH 6.5 within 14 min. In addition, the rhodamine B degradation product was investigated by analyzing the intermediate products by liquid chromatography/mass spectrometry (LC-MS). The homogeneous distribution of CoFe2O4/Ag NPs on fMWCNTs accelerated PMS activation and enhanced the catalytic degradation of dyes. The effects of the reaction parameters on the dye degradation efficiency were investigated by using different nanocatalysts (fMWCNTs, CoFe2O4/fMWCNTs, and CoFe2O4/Ag-fMWCNTs) as well as by varying the pH (3-11), dye concentration (10-50 mg/l), catalyst dose (0.002-0.3 g), and PMS dose (0.02-0.1 g). Quenching experiments revealed that sulfate radicals are primarily responsible for rhodamine B degradation. A plausible mechanism for catalytic PMS activation was also proposed. Complete decolorization occurred within the first few minutes of the reaction. Furthermore, the catalytic activity of the CoFe2O4/Ag-fMWCNT/PMS hybrid nanocomposite remained stable after five successive cycles. This study verifies the applicability of CoFe2O4/Ag-fMWCNTs as an ultrafast catalyst for the complete removal of persistent organic pollutants via PMS activation, revealing their promising application in wastewater treatment.

Knowledge, Attitude, and Practice Among Parents of Strabismic Children in Saudi Arabia: A Cross-Sectional Study.

Background Strabismus is a reversible condition that must be identified and treated during the critical period of childhood. Thus, this study aims to evaluate the degree of knowledge, attitude, and practice among parents of strabismic children in Riyadh, Saudi Arabia. Method To this end, a cross-sectional study was conducted from August 2021 to November 2021 with a sample size of 424 parents of children with strabismus seeking ophthalmologic consultants in private and governmental ophthalmology clinics in Riyadh, Saudi Arabia. A self-administered questionnaire was used to collect the data. The questionnaire contains knowledge-related questions about strabismus, beliefs-related questions, questions addressing the barriers parents face regarding strabismus in a child, and sources of information about cross-eye and its management. Data were analysed using the SPSS database version 21 (IBM Corp., Armonk, NY, USA). P-values <0.5 was used for clinical significance. Result We found that most parents know there is a relationship between strabismus and refractive errors (69%) and cross eye can be corrected (55%). Moreover, strabismus causes psychosocial difficulties (55%), low self-esteem, and low school performance. Parents of strabismic children believed that their love for their children is not affected due to crossed eyes (53%) and that strabismic children should not be taken to traditional healers (59%). Barriers faced during the management of strabismus are parents' negligence (76%), fear of surgery (34%), and high cost (29%). Doctors are the most used and preferred source of information among parents of strabismic children. Conclusion This study identifies gaps in knowledge, wrong beliefs in society, and the barriers faced by parents of strabismic children. Thus, raising awareness of the importance of detecting and treating strabismus early, avoiding psychosocial complications, and improving children's quality of life.

Paths and timings of the peopling of Polynesia inferred from genomic networks.

Polynesia was settled in a series of extraordinary voyages across an ocean spanning one third of the Earth1, but the sequences of islands settled remain unknown and their timings disputed. Currently, several centuries separate the dates suggested by different archaeological surveys2-4. Here, using genome-wide data from merely 430 modern individuals from 21 key Pacific island populations and novel ancestry-specific computational analyses, we unravel the detailed genetic history of this vast, dispersed island network. Our reconstruction of the branching Polynesian migration sequence reveals a serial founder expansion, characterized by directional loss of variants, that originated in Samoa and spread first through the Cook Islands (Rarotonga), then to the Society (Totaiete ma) Islands (11th century), the western Austral (Tuha'a Pae) Islands and Tuamotu Archipelago (12th century), and finally to the widely separated, but genetically connected, megalithic statue-building cultures of the Marquesas (Te Henua 'Enana) Islands in the north, Raivavae in the south, and Easter Island (Rapa Nui), the easternmost of the Polynesian islands, settled in approximately AD 1200 via Mangareva.

Idiopathic linear IgA bullous dermatosis treated with prednisone.

We present a case of a 43-year-old man with a medical history of paroxysmal atrial fibrillation that presented with acute onset generalised vesiculobullous rash of 1-week duration. The rash was initially noticed on his groin and then spread to his hands, feet and mucosal surfaces. Laboratory tests were unremarkable, including an extensive infection aetiology work-up. Punch biopsies were obtained of a fresh lesion and were stained with H&E and sent for direct immunofluorescence. Light microscopy and immunofluorescence study demonstrated a subepidermal blister with predominant neutrophilic infiltrates and a linear band of IgA at the dermoepidermal junction, respectively. The patient was diagnosed with linear IgA bullous dermatosis and was subsequently treated with 0.5 mg/kg of prednisone daily following previous case reports. At 1-week follow-up as an outpatient, the bullae became crusted, and the rash was nearly completely regressed.

Ultrafast soliton mode-locked fiber laser at 1560 nm based on Znq2 as a saturable absorber.

A mode-locked fiber laser was developed by using bis(8-hydroxyquinoline) zinc (Znq2) as a saturable absorber (SA). Znq2 is an organic metal chelate with several advantages such as good saturable absorption, relatively high damage threshold, and an easy, low-cost, and simple fabrication process. The developed SA based on Znq2 has a linear absorption (at 1560 nm), modulation depth, and saturation intensity of 1.2 dB, 16.6 %, and 95MW/cm2, respectively. The laser cavity produced a very stable soliton mode-locking operation at 1560.6 nm with pulse duration, repetition rate, and SNR of 1.46 ps, 3.5 MHz, and 60.6 dB, respectively. This work is the first, to the best of our knowledge, to report Znq2 as a mode locker.

Validity and reliability of the Arabic version of the Identification of Functional Ankle Instability questionnaire (IdFAI-Ar) in college-aged population.

OBJECTIVES: The aims of this work are to culturally adapt the Identification of Functional Ankle Instability questionnaire (IdFAI) into Arabic language and to examine its psychometrics. DESIGN: Cross-sectional study. SETTING: This research took place at Cairo University in Egypt. PARTICIPANTS: Twenty eight college-aged students participated in the translation and cultural adaptation, while another 86 college-aged students participated in the measurements (validity and reliability). MAIN OUTCOME MEASURES: The original IdFAI was translated into Arabic language using standard guidelines. The Arabic version of the IdFAI (IdFAI-Ar) and the Arabic version of the Lower Extremity Functional Scale (LEFS-Ar) were applied to 86 college-aged students with and without functional ankle instability. The IdFAI-Ar was tested on two occasions with an interval of one week to investigate its psychometrics. RESULTS: The IdFAI-Ar had a moderate correlation with LEFS-Ar and a strong correlation with ankle status classification. The reliability and internal consistency were excellent. The accuracy, sensitivity, and specificity were 0.91, 0.80, and 0.99 respectively. CONCLUSION: The IdFAI-Ar has high validity and reliability. It can be used in clinical and research practices as a region-specific tool to discriminate between participants with and without functional ankle instability in the Arabic-speaking countries.

Sexually dimorphic response of mice to the Western-style diet caused by deficiency of fatty acid binding protein 6 (Fabp6).

Bile acids are natural detergents that aid in the absorption of dietary lipids. Fatty acid binding protein 6 (Fabp6) is a component of the bile acid recovery system that operates in the small intestine. The aim of this study was to determine if Fabp6 deficiency causes dietary fat malabsorption. Wild-type and Fabp6-deficient mice were fed a Western-style diet (WSD) or a reference low-fat diet (LFD) for 10 weeks. The body weight gain, bile acid excretion, fat excretion, energy metabolism, and major gut microbial phyla of the mice were assessed at the end of the controlled diet period. Fabp6-/- mice exhibited enhanced excretion of both bile acids and fat on the WSD but not on the LFD diet. Paradoxically, male Fabp6-/- mice, but not female Fabp6-/- mice, had greater adiposity despite increased fat excretion. Analysis of energy intake and of expenditure by indirect calorimetry revealed sex differences in physical activity level and respiratory quotient, but these did not account for the enhanced adiposity displayed by male Fabp6-/- mice. Analysis of stool DNA showed sex-specific changes in the abundance of major phyla of bacteria in response to Fabp6 deficiency and WSD feeding. The results obtained indicate that the malabsorption of bile acids that occurs in Fabp6-/- mice is associated with dietary fat malabsorption on the high-fat diet but not on the low-fat diet. The WSD induced a sexually dimorphic increase in adiposity displayed by Fabp6-/- mice and sexually distinct pattern of change in gut microbiota composition.

Genetic characterization of N-acetyltransferase 2 variants in acquired multidrug-resistant tuberculosis in Indonesia.

Background: Owing to the high resistance rate of tuberculosis (TB) to isoniazid, which is metabolized by N-acetyltransferase 2 (NAT2), we investigated the associations between NAT2 variants and multidrug-resistant (MDR)-TB. Materials & methods: The acetylator status based on NAT2 haplotypes of 128 patients with MDR-TB in Indonesia were compared with our published data from patients with anti-TB drug-induced liver injury (AT-DILI), TB and the general population. Results:NAT2*4 was more frequent in the MDR-TB group than in the AT-DILI group, TB controls and general controls. NAT2*4/*4 was significantly more frequent in patients with MDR-TB than in those with AT-DILI. NAT2*5B/7B, *6A/6A and *7B/*7B were detected at lower frequencies in patients with AT-DILI. Rapid acetylators were significantly more frequent in patients with MDR-TB than in those with AT-DILI. Conclusion: These results provide an initial data for optimizing TB treatment in the Indonesian population, and suggest that NAT2 genotyping may help to select appropriate treatment by predicting TB-treatment effect.

Synthesis, Characterization, and Biochemical Impacts of Some New Bioactive Sulfonamide Thiazole Derivatives as Potential Insecticidal Agents against the Cotton Leafworm, Spodoptera littoralis.

A novel series of anticipated biologically active heterocyclic compounds, such as pyrazole, thiazole, pyridine, acrylamide, thiophene, triazolo[1,5-a]pyrimidine, imidazolidine, aminopyrazole, pyrazolo[5,1-c][1,2,4]triazine, triazolo[4,3-a]pyrimidine, benzo[4,5]imidazo[1,2-a]pyrimidine, pyrido[2',3':3,4]pyrazolo[5,1-c][1,2,4]triazine, isoxazole, benzo[4,5]imidazo[2,1-c][1,2,4]triazine, pyrimidine, pyrido[2',3':3,4]pyrazolo[1,5-a]pyrimidine, pyrano[2,3-d]pyrimidine, and chromene derivatives, incorporating a sulfonamide-bearing thiazole moiety suitable to utilize as insecticidal agents were synthesized via a versatile, readily accessible cyanoacetanilide, 2-cyano-N-(4-(N-(thiazol-2-yl)sulfamoyl)phenyl)acetamide (1).The structures of the newly synthesized compounds were elucidated by IR, MS, 1H NMR, 13C NMR, distortionless enhancement by polarization transfer (DEPT), 1H-1H correlation spectroscopy (COSY), heteronuclear multiple bond correlation (HMBC), and heteronuclear single quantum coherence (HSQC) spectral analysis. Toxicological and biochemical parameters and biological aspects of the demonstrated compounds of the synthesized products against the cotton leafworm, Spodoptera littoralis, under laboratory conditions were also investigated. Regarding the determined LC50 and LC90 values, sulfonamides bearing a thiazole moiety, 16a, 8, 28, and 31b, showed the most potent toxic effects with LC50 values of 49.04, 62.66, 78.62, and 94.90 ppm, respectively, and toxicity index of 100%, 78.26%, 62.38%, and 51.68%, respectively.

The socioeconomic cost of chronic rhinosinusitis study.

INTRODUCTION: Chronic rhinosinusitis (CRS) is highly prevalent, affecting 11% of the population. Studies evaluating the socio-economic impact of CRS are mostly limited to the US population. Currently there is no study that has evaluated the socio-economic costs of CRS in the UK. METHODS: A case-control study of patients with CRS and healthy controls was conducted to investigate the wider socio-economic impact of the disease. Data on demographic and socioeconomic characteristics, out-of-pocket expenditure (OOPE), health resource utilisation, productivity losses and health-related quality of life (HRQoL) via the EQ-5D and SNOT-22 instruments, were collected from questionnaires. RESULTS: A total of 139 CRS participants and 67 control participants completed the questionnaires. The average total OOPE per patient extrapolated to a 12-month period was £304.84. Other important findings include significantly higher reported primary care interactions (4.14 vs. 1.16) as well as secondary care interactions (2.61 vs 0.4) in CRS group as compared to controls over three-months. The average total missed workdays was estimated to be 18.7 per patient per year. The estimated incremental healthcare cost of CRS per year is £16.8 billion or £2.8 billion per million inhabitants. Factors predictive of a higher OOPE include higher household occupancy and income and these accounted for only 9.7% of the total variance in total OOPEs. Other socioeconomic, demographic and HRQoL variables were not found to be predictive factors of OOPE. CONCLUSIONS: This study showed that CRS has a significant wider economic burden beyond the immediate direct healthcare costs. CRS participants had a high level of healthcare service use, OOPE and productivity loss. Results from this study will add to the existing limited data both for the UK and abroad and emphasises the need for effective treatments for these patients to reduce the disease impact.

Acceleration of ammonium phosphate hydrolysis using TiO2 microspheres as a catalyst for hydrogen production.

Titania microspheres are considered an adequate material with low cost and easily attainable pathways, and can be utilized in photocatalytic H2 production to solve the energy crisis. Spherical porous titanium dioxide materials, with nanostructure composition, were chemically synthesized from titanate nanotubes via a simple hydrothermal technique, then added as a catalyst to accelerate the route of ammonium phosphate hydrolysis for hydrogen production. The mechanism of sphere formation from titanate nanotubes is elucidated in detail through the current study. The prepared materials were applied as a photocatalyst to facilitate the separation and transfer of photoinduced electrons, while preventing the recombination of electron-hole pairs. Experimental results show that the obtained microspheres possess significantly enhanced photocatalytic hydrogen (H2) production performance. The amount of photocatalytic hydrogen product using the microspheres is found to be ∼2.5 fold greater than that of titanate nanotubes. Analytical techniques such as field-emission scanning electron microscopy (FESEM), high-resolution transmission electron microscopy (HR-TEM), simulated visible solar light and X-ray diffraction (XRD) were used for the evaluation and characterization of the developed products, as well as the elucidation of the route of hydrolysis in the hydrogen production process.

The Impact of Tennis and Golfer's Elbow on Shoulder External Rotators and Abductors' Peak Torque.

CONTEXT: Upper limb activities require a repetitive movement of the shoulder external rotator and abductor muscles. The malfunction of the proximal part of the upper limb kinetic chain tends to change the mechanics of the distal part and increase the risk of injuries. OBJECTIVES: To compare the normalized eccentric peak torque (NEPT) of the shoulder external rotator and abductor muscles among healthy athletes and those with tennis elbow and golfer's elbow. DESIGN: An experimental cross-sectional study. SETTING: Isokinetic laboratory, Faculty of Physical Therapy, Cairo University. PARTICIPANTS: A total of 30 male athletes participated voluntarily in this study. INTERVENTION: Participants were distributed into 3 groups: healthy group, tennis elbow group, and golfer's elbow group. MAIN OUTCOME MEASURES: NEPT of shoulder abductors and external rotators. The Biodex Isokinetic Dynamometer was used to measure the variables of interest. RESULTS: There was a significant increase in the NEPT of shoulder abductors and external rotators in healthy control group compared with both tennis elbow and golfer's elbow groups at an angular velocity of 60°/s (P < .05). Moreover, there was a significant increase in the NEPT of shoulder external rotators and abductors at an angular velocity of 120°/s in healthy control group compared with tennis elbow group and in golfer's elbow group compared with tennis elbow group (P < .05). CONCLUSION: Tennis elbow and golfer's elbow are associated with decreased NEPT of shoulder external rotators and abductors compared with those of healthy athletes. This tends to decrease the external stability of the shoulder joint and put high stress on the distal joints of the upper kinetic chain.