Giftedness and atypical sexual differentiation: enhanced perceptual functioning through estrogen deficiency instead of androgen excess.

Syndromic autism spectrum conditions (ASC), such as Klinefelter syndrome, also manifest hypogonadism. Compared to the popular Extreme Male Brain theory, the Enhanced Perceptual Functioning model explains the connection between ASC, savant traits, and giftedness more seamlessly, and their co-emergence with atypical sexual differentiation. Overexcitability of primary sensory inputs generates a relative enhancement of local to global processing of stimuli, hindering the abstraction of communication signals, in contrast to the extraordinary local information processing skills in some individuals. Weaker inhibitory function through gamma-aminobutyric acid type A (GABAA) receptors and the atypicality of synapse formation lead to this difference, and the formation of unique neural circuits that process external information. Additionally, deficiency in monitoring inner sensory information leads to alexithymia (inability to distinguish one's own emotions), which can be caused by hypoactivity of estrogen and oxytocin in the interoceptive neural circuits, comprising the anterior insular and cingulate gyri. These areas are also part of the Salience Network, which switches between the Central Executive Network for external tasks and the Default Mode Network for self-referential mind wandering. Exploring the possibility that estrogen deficiency since early development interrupts GABA shift, causing sensory processing atypicality, it helps to evaluate the co-occurrence of ASC with attention deficit hyperactivity disorder, dyslexia, and schizophrenia based on phenotypic and physiological bases. It also provides clues for understanding the common underpinnings of these neurodevelopmental disorders and gifted populations.

Intranasal trigeminal sensitivity to mechanical stimuli is associated with the perception of nasal patency.

PURPOSE: The aim of this prospective study was to examine the characteristics of a clinical test for the assessment of nasal trigeminal sensitivity to mechanical stimuli and its association with the perception of nasal patency. METHODS: Thirty-two normosmic healthy subjects participated (17 women and 15 men; age = 26 ± 3 years). Precisely defined air puffs were used with a flow rate of 2L/min for mechanical stimulation. They were presented to the nasal vestibule, nasal septum, and inferior turbinate with various stimulus durations. Thresholds were measured by single-staircase stimuli with changes in stimulus duration in steps of 10 ms. Trigeminal suprathreshold intensity was rated by subjects for stimulus durations of 200, 300, 400, and 500 ms. Test-retest reliability was examined by intraclass correlations (ICCs) and Bland-Altman plot with limits of agreement. Pearson's correlations were calculated between self-rated nasal patency and nasal trigeminal sensitivity. RESULTS: As indicated by trigeminal threshold and suprathreshold intensities, the nasal vestibule is the most sensitive area among the three locations, followed by the nasal septum and the inferior turbinate (p < 0.001). Coefficients of correlations between test and retest were 0.76 for thresholds, and 0.56 suprathreshold intensities (p < 0.001). The Bland-Altman analysis showed a good agreement between test-retest values. In addition, significant positive associations between trigeminal suprathreshold intensities and self-rated nasal obstruction were found at the inferior turbinate (r = 0.4, p < 0.05). CONCLUSION: Reliable assessment of nasal trigeminal sensitivity for air puffs appears to be possible. Nasal trigeminal suprathreshold sensitivity to mechanical stimuli is associated with the perception of nasal patency at the inferior turbinate. This opens a window into the assessment of the perception of nasal airflow in various clinical purposes, especially for patients with sinonasal diseases.

Envelhecimento, sentido de lugar e planejamento urbano: facilitadores e barreiras / Envejecimiento, sentido de lugar y planificación urbana: facilitadores y barreras / Aging, sense of place and urban planning: facilitators and barriers

RESUMO O planejamento urbano é um processo que compreende sucessivas melhorias voltadas para a qualidade de vida das populações e o envelhecimento populacional pressiona para que instâncias sociais assumam novas posturas sobre os modos de se planejar a cidade. Para compreender a ligação do idoso com o ambiente, é necessário entender os recursos disponíveis no local e as experiências vividas naquele contexto. A partir do sentido de lugar, as pessoas transformam os espaços e são por eles transformados. Assim, esse estudo questionou como moradores idosos de três localidades da cidade de Brasília constroem seu sentido de lugar, a partir da identificação de facilitadores e barreiras enfrentadas diariamente e das demandas para a construção de um ambiente amigável ao envelhecimento. Os dados qualitativos apresentados decorrem do uso de três técnicas de pesquisa: entrevistas face a face, entrevistas caminhadas e diários fotográficos. Fizeram parte do estudo 63 participantes com idade entre 60 e 90 anos. A análise realizada por meio do software Iramuteq permitiu a elaboração de quatro classes relacionadas aos vínculos sociais e comunitários, às atividades das rotinas diárias, aos aspectos simbólicos que refletem o sentido de lugar e a relação com elementos rurais e urbanos percebidos em cada cenário. Estar atento às mudanças resultantes dessa inversão da pirâmide demográfica incide sobre algumas das questões identificadas nesse estudo, mas também confirma o quanto ainda se faz necessário avançar para incluir de modo mais realista a dinâmica relação idoso-ambiente em estudos que abordam o processo de envelhecimento.

RESUMEN El urbanismo es un proceso que comprende sucesivas mejoras encaminadas a la calidad de vida de las poblaciones y el envejecimiento de la población presiona a las instancias sociales para que asuman nuevas posturas sobre las formas de planificar este entorno. Para comprender la percepción del ambiente por parte de los adultos mayores, es necesario comprender los recursos disponibles en el lugar y también las experiencias vividas en ese contexto. Desde el sentido del lugar, las personas transforman espacios y son transformados por ellos. Por lo tanto, este estudio cuestionó cómo los residentes mayores de tres localidades de la ciudad de Brasilia construyen su sentido de lugar, en función de sus identificaciones de los facilitadores y las barreras que se enfrentan a diario y las demandas para construir un ambiente amigable con el envejecimiento. Los datos cualitativos presentados derivan del uso de tres técnicas de investigación: entrevistas personales, entrevistas complementarias y diarios fotográficos. 63 personas mayores entre 60 y 90 años participaron en el estudio. El análisis realizado con el software Iramuteq permitió el desarrollo de cuatro clases relacionadas con los vínculos sociales y comunitarios, actividades de la rutina diaria, aspectos simbólicos que reflejan el sentido del lugar y la relación con los elementos rurales y urbanos percibidos en cada escenario. Conocer los cambios resultantes de esta inversión de la pirámide demográfica se centra en algunos de los problemas identificados en este estudio, pero también confirma cuánto progreso aún se necesita para incluir de manera más dinámica la relación entre el anciano y el ambiente en los estudios que abordan el envejecimiento.

ABSTRACT. The urban planning is a process that comprises successive improvements aimed at the quality of life of populations and the aging of the population puts pressure on social instances to assume new postures about the ways of planning this environment. To understand the elderly's attachment with the environment, it is necessary to understand the resources available in the place and the experiences lived in that context. From the sense of place, people transform spaces and are transformed by them. Thus, this study questioned how elderly residents of three locations in the city of Brasília build their sense of place, based on their identification of facilitators and barriers faced daily and the demands for building an aging-friendly environment. The qualitative data presented derives from the use of three research techniques: face-to-face interviews, go-along interviews, and photographic diaries. Sixty-three elderly persons between 60 and 90 years participated in the study. The analysis carried out using the Iramuteq software allowed the development of four classes related to social and community bonds, activities of daily routines, symbolic aspects that reflect the sense of place and the relationship with rural and urban elements perceived in each scenario. Being aware of the changes resulting from the demographic pyramid's inversion incur on some of the issues identified in this study. However, the results confirm how much further progress is still needed to include more dynamically the elderly-environment relationship in studies that address the aging process.

A percepção da pessoa idosa sobre a sexualidade e a saúde sexual no envelhecimento / La percepción de los mayores sobre la sexualidad y la salud sexual en el envejecimiento / The elderly person's perception about sexuality and sexual health in aging

O processo de envelhecimento, geralmente, desencadeia mudanças físicas e psicológicas na população idosa, porém, isto não deve ser considerado um fator limitador da sua sexualidade. O objetivo desta pesquisa é conhecer a percepção dos idosos sobre sexualidade e saúde sexual no processo de envelhecimento. Trata-se de uma pesquisa exploratória, descritiva, explicativa, de campo, com caráter qualitativo, realizada com idosos residentes em um condomínio social no município de Francisco Beltrão, Paraná. Os dados foram coletados por meio de entrevistas parcialmente estruturada, onde as perguntas e as respostas foram gravadas com o uso de dispositivo eletrônico e transcritas posteriormente. Os resultados demonstraram prevalência de idosos do sexo feminino (80%), com faixa etária entre 64 e 85 anos (70%), brancos (70%), casados (50%), com ensino fundamental incompleto (40%) aposentados e com renda de 1 salário mínimo (90%). Observou-se baixa escolaridade na maioria dos idosos e desconhecimento quanto a distinção entre sexualidade e o ato sexual, além do risco de contaminação por infecções sexualmente transmissíveis, pela não utilização de preservativo nas relações sexuais. O estudo revelou que ainda há carência de conhecimentos quanto a sexualidade da pessoa idosa, com uma visão estereotipada da sexualidade na velhice, como não sendo importante, tornando-se primordial o desenvolvimento de medidas políticas que possam conscientizar esse público.

The aging process usually triggers physical and psychological changes in the elderly population; however, this should not be considered a limiting factor for their sexuality. The objective of this research is to know the perception of the elderly about sexuality and sexual health in the aging process. This is an exploratory, descriptive, explanatory, field research, with qualitative character, carried out with elderly residents in a social condominium in the municipality of Francisco Beltrão, Paraná. Data were collected through partially structured interviews, where questions and answers were recorded using an electronic device and later transcribed. The results showed a prevalence of elderly females (80%), aged between 64 and 85 years (70%), white (70%), married (50%), with incomplete elementary school education (40%) retired and with an income of 1 minimum wage (90%). It was observed low schooling in most of the elderly and lack of knowledge about the distinction between sexuality and sexual intercourse, besides the risk of contamination by sexually transmitted infections, by not using condoms during sexual intercourse. The study revealed that there is still a lack of knowledge regarding the sexuality of the elderly, with a stereotypical view of sexuality in old age, as not being important, making it paramount the development of policy measures that can raise awareness of this public.

El proceso de envejecimiento suele desencadenar cambios físicos y psicológicos en la población de edad avanzada, sin embargo, esto no debe considerarse un factor limitante de su sexualidad. El objetivo de esta investigación es conocer la percepción de los mayores sobre la sexualidad y la salud sexual en el proceso de envejecimiento. Se trata de una investigación exploratoria, descriptiva, explicativa, de campo, con carácter cualitativo, realizada con ancianos residentes en un condominio social en el municipio de Francisco Beltrão, Paraná. Los datos se recopilaron mediante entrevistas parcialmente estructuradas, en las que las preguntas y las respuestas se grabaron con el uso de un dispositivo electrónico y se transcribieron posteriormente. Los resultados muestran una prevalencia de individuos de sexo femenino (80%), con una edad de entre 64 y 85 años (70%), con un nivel de vida bajo (70%), casados (50%), con una educación básica incompleta (40%) y con un salario mínimo (90%). Se observó una baja educación en la mayoría de los ancianos y falta de conocimiento sobre la distinción entre sexualidad y acto sexual, además del riesgo de contaminación por infecciones de transmisión sexual, al no utilizar preservativos en las relaciones sexuales. El estudio reveló que aún existe un desconocimiento sobre la sexualidad de las personas mayores, con una visión estereotipada de la sexualidad en la vejez, como si no fuera importante, por lo que es primordial el desarrollo de medidas políticas que puedan sensibilizar a este público.

[Correlation between nasal mucosal temperature change and nasal airflow perception].

The mechanism of nasal airflow perception remains little known. It is currently believed that the main mechanism for perceiving nasal patency is to activate transient receptor potential melastatin subtype 8. Computer fluent dynamics show that increased airflow and heat flux are associated with higher subjective scores. Similarly, physical measurements of the nasal cavity using a temperature probe show a correlation between the lower nasal mucosa temperature and better results. Trigeminal function detection also indirectly confirms this. This literature review aimed to explore the role of nasal mucosal temperature change in the subjective perception of nasal patency and the secondary aim was to appraise the relevant evidence about the mechanism.

Characterization of cortical hemodynamic changes following sensory, visual, and speech activation by intraoperative optical imaging utilizing phase-based evaluation methods.

Alterations within cerebral hemodynamics are the intrinsic signal source for a wide variety of neuroimaging techniques. Stimulation of specific functions leads due to neurovascular coupling, to changes in regional cerebral blood flow, oxygenation and volume. In this study, we investigated the temporal characteristics of cortical hemodynamic responses following electrical, tactile, visual, and speech activation for different stimulation paradigms using Intraoperative Optical Imaging (IOI). Image datasets from a total of 22 patients that underwent surgical resection of brain tumors were evaluated. The measured reflectance changes at different light wavelength bands, representing alterations in regional cortical blood volume (CBV), and deoxyhemoglobin (HbR) concentration, were assessed by using Fourier-based evaluation methods. We found a decrease of CBV connected to an increase of HbR within the contralateral primary sensory cortex (SI) in patients that were prolonged (30 s/15 s) electrically stimulated. Additionally, we found differences in amplitude as well as localization of activated areas for different stimulation patterns. Contrary to electrical stimulation, prolonged tactile as well as prolonged visual stimulation are provoking increases in CBV within the corresponding activated areas (SI, visual cortex). The processing of the acquired data from awake patients performing speech tasks reveals areas with increased, as well as areas with decreased CBV. The results lead us to the conclusion, that the CBV decreases in connection with HbR increases in SI are associated to processing of nociceptive stimuli and that stimulation type, as well as paradigm have a nonnegligible impact on the temporal characteristics of the following hemodynamic response.

Influence of conceptus presence and preovulatory estradiol exposure on uterine gene transcripts and proteins around maternal recognition of pregnancy in beef cattle.

The uterine environment must provide sufficient endocrine conditions and nutrients for pregnancy maintenance and conceptus survival. The objective of this study was to determine the effects of preovulatory estradiol and conceptus presence on uterine transcripts and uterine luminal fluid (ULF) proteins. Beef cows/heifers were synchronized and artificially inseminated (d 0). Uteri were flushed (d 16); conceptuses and endometrial biopsies were collected. Total cellular RNA was extracted from endometrium for RNA sequencing and RT-PCR validation. There were two independent ULF pools made for each of the following groups: highE2/conceptus, highE2/noconceptus, lowE2/conceptus, and lowE2/noconceptus that were analyzed using the 2D LC-MS/MS based iTRAQ method. There were 64 differentially expressed genes (DEGs) and 77 differentially expressed proteins (DEPs) in common among the highE2/conceptus vs highE2/noconceptus and lowE2/conceptus vs lowE2/noconceptus groups. In summary, the interaction between preovulatory estradiol and the conceptus induces the expression of genes, proteins, and pathways necessary for pregnancy.

Effects of Including Sprints in LIT Sessions during a 14-d Camp on Muscle Biology and Performance Measures in Elite Cyclists.

PURPOSE: This study investigated the effects of including sprints within low-intensity training (LIT) sessions during a 14-d training camp focusing on LIT, followed by 10-d recovery (Rec), on performance and performance-related measures in elite cyclists. METHODS: During the camp, a sprint training group (SPR; n = 9) included 12 × 30-s maximal sprints during five LIT sessions, whereas a control group (CON; n = 9) performed distance-matched LIT only. Training load was equally increased in both groups by 48% ± 27% during the training camp and subsequently decreased by -56% ± 23% during the recovery period compared with habitual training. Performance tests were conducted before the training camp (Pre) and after Rec. Muscle biopsies, hematological measures, and stress/recovery questionnaires were collected Pre and after the camp (Post). RESULTS: Thirty-second sprint (SPR vs CON: 4% ± 4%, P < 0.01) and 5-min mean power (SPR vs CON: 4% ± 8%, P = 0.04) changed differently between groups. In muscle, Na+-K+ ß1 protein content changed differently between groups, decreasing in CON compared with SPR (-8% ± 14%, P = 0.04), whereas other proteins showed similar changes. SPR and CON displayed similar increases in red blood cell volume (SPR: 2.6% ± 4.7%, P = 0.07; CON: 3.9% ± 4.5%, P = 0.02) and V˙O2 at 4 mmol·L-1 [BLa-] (SPR: 2.5% ± 3.3%, P = 0.03; CON: 2.2% ± 3.0%, P = 0.04). No changes were seen for V˙O2max, Wmax, hematological measures, muscle enzyme activity, and stress/recovery measures. CONCLUSIONS: Inclusion of 30-s sprints within LIT sessions during a high-volume training camp affected competition-relevant performance measures and Na+-K+ ß1 protein content differently from LIT only, without affecting sport-specific stress/recovery or any other physiological measure in elite cyclists.

Risk perception of the pre-distribution of stable iodine to guardians of children living around the Genkai Nuclear Power Plant, Saga Prefecture, Japan.

Iodine thyroid blocking (ITB) is effective for preventing childhood thyroid cancer when radioactive iodine is released into the environment during a nuclear power plant accident. Japan employs the pre-distribution of stable iodine (PDSI) to residents living near nuclear power plants; however, the number of residents who have actually received stable iodine to date remains limited. The aim of this study was to evaluate the profile of guardians of children living around the Genkai Nuclear Power Plant (GNPP) in Japan. We distributed self-administered questionnaires regarding perception of risks associated with administration of stable iodide to approximated 400 guardians of children aged 0-6 in 10 kindergartens located in four municipalities. We obtained responses from 286 guardians, and after excluding invalid responses, 247 were included in the analysis. Logistic regression analysis revealed that living within 5 km of the GNPP (odds ratio [OR] = 4.48, 95% confidence interval [CI]: 2.43-8.24), awareness of preferential implementation of ITB to children (OR = 3.33, 95%CI: 1.78-6.22), and awareness of the prophylaxis booklet published by the local government (OR = 2.53, 95%CI: 1.37-4.68) were independently associated with PDSI for children. The main reasons for not receiving PDSI were "anxiety about the side effects of stable iodine" (40.2%), "distrust of the effectiveness of SI" (23.5%), "complicated procedures for receiving stable iodine" (15.7%) and "missed the date for receiving stable iodine" (8.8%). In the case of ITB implementation during a nuclear emergency, it is necessary to clarify the risk perceptions of guardians and adapt risk communication accordingly.

Tumor patients' fears and worries and perceived changes of specific attitudes, perceptions and behaviors due to the COVID-19 pandemic are still relevant.

OBJECTIVE: During the COVID-19 pandemic, tumor patients not only perceived fears and worries but were experiencing also positive changes as the perception of nature and silence, moments of wondering awe, and more intense relationships. We intended to analyze whether these perceptions may differ between patients from waves 1 and 2 of the pandemic. METHODS: Cross-sectional study at two time periods (May to June, sample 1) and September to November 2020 (sample 2) with standardized questionnaires (i.e. WHO-5, MLQ, PCQ-12). RESULTS: Patients from sample 1 (n = 292) and sample 2 (n = 221) did not differ with respect to gender, age, partner or tumor status. Most are still "irritated by statements about danger and course of the infection" (58%) and are "worrying to be infected and to have complicated course of disease" (55%). Neither their well-being nor meaning in life nor fears and worries were significantly different. In sample 2 patients, Worrying reflections and loneliness scored significantly lower, while their Perception of nature and silence was lower in trend only; more intense relationships are still relevant. Moments of wondering awe and religious trust were perceived less often during wave 2. Particularly religious patients scored stronger for Perception of nature and silence and Worrying reflections and loneliness. CONCLUSION: Oncologists/psychologist have to know that patients' situation has not changed within the time of pandemic and that they still require information, close support and encouragement to rely on their resources to cope. Perceived changes are reflecting coping strategies that could be trained to increase patients' resilience during further pandemic waves.

Effects of post-exercise sodium bicarbonate ingestion on acid-base balance recovery and time-to-exhaustion running performance: a randomised crossover trial in recreational athletes.

This study investigated the effect of post-exercise sodium bicarbonate (NaHCO3) ingestion on acid-base balance recovery and time-to-exhaustion (TTE) running performance. Eleven male runners (stature, 1.80 ± 0.05 m; body mass, 74.4 ± 6.5 kg; maximal oxygen consumption, 51.7 ± 5.4 mL·kg-1·min-1) participated in this randomised, single-blind, counterbalanced and crossover design study. Maximal running velocity (v-V̇O2max) was identified from a graded exercise test. During experimental trials, participants repeated 100% v-V̇O2max TTE protocols (TTE1, TTE2) separated by 40 min following the ingestion of either 0.3 g·kg-1 body mass NaHCO3 (SB) or 0.03 g·kg-1 body mass sodium chloride (PLA) at the start of TTE1 recovery. Acid-base balance (blood pH and bicarbonate, HCO3-) data were studied at baseline, post-TTE1, after 35 min recovery and post-TTE2. Blood pH and HCO3- concentration were unchanged at 35 min recovery (p > 0.05), but HCO3- concentration was elevated post-TTE2 for SB vs. PLA (+2.6 mmol·L-1; p = 0.005; g = 0.99). No significant differences were observed for TTE2 performance (p > 0.05), although a moderate effect size was present for SB vs. PLA (+14.3 s; g = 0.56). Post-exercise NaHCO3 ingestion is not an effective strategy for accelerating the restoration of acid-base balance or improving subsequent TTE performance when limited recovery is available. Novelty: Post-exercise sodium bicarbonate ingestion did not accelerate the restoration of blood pH or bicarbonate after 35 min. Performance enhancing effects of sodium bicarbonate ingestion may display a high degree of inter-individual variation. Small-to-moderate changes in performance were likely due to greater up-regulation of glycolytic activation during exercise.

Vibrotactile sensitivity testing for occupational and disease-induce peripheral neuropathies.

The International Standard Organization (ISO) standard 13091-1 describes methods and procedures for performing the vibrotactile perception threshold (VPT) testing to diagnose changes in tactile sensory function associated with occupational exposures. However, the VPT test also has been used in the diagnosis of peripheral neuropathies associated with a number of disorders. This review examines the VPT test, variations in procedures that have been used, as well as disorders and diseases in which this test has been reliable for the detection of sensory changes. Mechanisms potentially underlying the changes in VPTs are also discussed along with procedural and subject/patient factors that may affect the interpretation of test results. Based upon the review of the literature, there are also suggestions for where additional research might improve the administration of this test, depending upon the subject/patient population and interpretation of data.

Blueberry supplementation reduces the blood lactate response to running in normobaric hypoxia but has no effect on performance in recreational runners.

BACKGROUND: Blueberries are concentrated with anthocyanins possessing antioxidant properties. As these properties counter fatigue, blueberry supplementation may improve performance and recovery, particularly in hypoxia, where oxidative stress is elevated. METHODS: This study examined the effects of blueberry supplementation on running performance, physiological responses, and recovery in normobaric hypoxia. Eleven experienced runners completed a 30-minute time-trial (TT) in normobaric hypoxia (%O2 = 15.5 %) on separate days after supplementation with four days of blueberries (BLU) or four days of placebo (PLA). Heart rate (HR), oxygen saturation (SaO2) and ratings of perceived exertion (RPE) were monitored during the TT. Blood lactate and fraction of exhaled nitric oxide (FENO) were assessed pre-TT, post-TT, and during recovery. RESULTS: No significant differences were observed in the distance run during the TT, HR, SaO2, and RPE. The post-TT increase in blood lactate was significantly lower in BLU than PLA (p = 0.036). Pre-TT and post-TT FENO did not differ between conditions. Blood lactate recovery following the TT was similar between conditions. CONCLUSIONS: Four days of blueberry supplementation did not alter running performance or cardiovascular and perceptual responses in normobaric hypoxia. Supplementation lowered the blood lactate response to running, however, the significance of this finding is uncertain given the absence of an ergogenic effect.

Modelling the determinants of health and cancers as perceived by children: using imagery as a mediator of expression and narration.

OBJECTIVES: To model and analyse conceptions of determinants of health and cancer that are expressed and perceived by school children aged 6-11 based on a multiphase qualitative protocol. METHODOLOGY: This is a multicentric, qualitative study of human and social sciences conducted among school children aged 6-11 years old. Two different tools were used, e.Photoexpression and Photonarration, in four French schools. This innovative and exploratory method addresses global health during the first phase (e.Photoexpression) and the theme of cancer during the second phase (Photonarration). The children express themselves through photography and narration. RESULTS: 1498 qualitative productions were made by 381 children aged 6-11 years old. The analysis of these productions of expression and narration through images allowed modelling of determinants of health and cancer as perceived by children through 7 fields and 28 categories. The conceptions of determinants of health and child cancer refer to rationalities that are centred on individual determinants (76%), minimise environmental determinants (20%) and conceal the parameters of access to healthcare and social services (3%). DISCUSSION: These findings provide new data to the international literature on children's perceptions of determinants of health and cancer. These research findings, which can be applied to interventions and current practices, will enable prevention workers to act more effectively, closer to children's perceptions and needs.

Parental Perception of Weight Status for Adenotonsillectomy Patients.

OBJECTIVE: Weight status can affect outcomes in pediatric adenotonsillectomy performed for obstructive sleep disordered breathing. Parents frequently underestimate their child's weight and are unaware weight status may affect adenotonsillectomy success. Accurate understanding of a child's weight status is important for shared decision making with the family and perioperative care. The purpose of this study is to analyze the accuracy of the parent's perception of their child's weight status. METHODS: A retrospective analysis was performed of prospective data collected from families of children undergoing adenotonsillectomy from June 2018 through June 2019. RESULTS: A total of 522 children met the inclusion criteria. Two hundred and thirty-two children were either overweight (n = 46, 9%) or obese (n = 186, 36%). Among parents of this cohort whose children were overweight or obese, 74 (32%) erroneously reported that their child was normal weight. For the 290 nonoverweight children, 99% of parents accurately reported weight status. After adjusting for ethnicity, race, BMI%, and sex, for every 1-year increase in age of the child, the odds of the parent correctly identifying their child as overweight increased by a factor of 1.18 (95% CI: 1.09, 1.27). CONCLUSION: One-third of families with children who were overweight or obese undergoing adenotonsillectomy for obstructive sleep disordered breathing underestimated their child's weight. This study highlights the need to facilitate family understanding of weight status' potential impact on both obstructive sleep disordered breathing severity and adenotonsillectomy success, especially for younger children. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:2121-2125, 2021.

The effects of local versus systemic passive heating on the acute inflammatory, vascular and glycaemic response.

The aim of this study was to compare the acute cardiometabolic and perceptual responses between local and whole-body passive heating. Using a water-perfused suit, 10 recreationally active males underwent three 90 min conditions: heating of the legs with upper-body cooling (LBH), whole-body heating (WBH) and exposure to a thermoneutral temperature (CON). Blood samples were collected before and up to 3 h post-session to assess inflammatory markers, while a 2 h oral glucose tolerance test was initiated 1 h post-session. Femoral artery blood flow and perceptual responses were recorded at regular intervals. The interleukin (IL)-6 incremental area under the curve (iAUC) was higher for LBH (1096 ± 851 pg/mL × 270 min) and WBH (833 ± 476 pg/mL × 270 min) compared with CON (565 ± 325 pg/mL × 270 min; p < 0.047). Glucose concentrations were higher after WBH compared with LBH and CON (p < 0.046). Femoral artery blood flow was higher at the end of WBH (1713 ± 409 mL/min) compared with LBH (943 ± 349 mL/min; p < 0.001), and higher in LBH than CON (661 ± 222 mL/min; p = 0.002). Affect and thermal comfort were more negative during WBH compared with LBH and CON (p < 0.010). In conclusion, local passive heating elevated blood flow and the IL-6 iAUC. However, while resulting in more positive perceptual responses, the majority of the included cardiometabolic markers were attenuated compared with WBH. Novelty: The increase in the IL-6 iAUC in response to passive heating is not reduced by upper-body cooling. Upper-body cooling attenuates the plasma nitrite, IL-1ra and femoral artery blood flow response to passive heating. Upper-body cooling leads to more positive perceptual responses to passive heating.

To treat or not to treat: perceptions of the initial American Society for Reproductive Medicine COVID-19 recommendations among women's health providers.

PURPOSE: The objective of this study was to evaluate the perception of the initial ASRM COVID-19 recommendations for infertility treatment held by women's health providers within varying subspecialties, as well as their attitudes toward pregnancy and fertility during this time. METHODS: An electronic survey was sent to all women's healthcare providers, including physicians, mid-level providers and nurses, in all subspecialties of obstetrics and gynaecology (Ob/Gyn) at a large tertiary care university-affiliated hospital. RESULTS: Of the 278 eligible providers, the survey response rate was 45% (n = 127). Participants represented 8 Ob/Gyn subspecialties and all professional levels. Participants age 18-30 years were significantly more likely to feel that women should have access to infertility treatment despite the burden level of COVID-19 in respective community/states (p = 0.0058). Participants within the subspecialties of general Ob/Gyn, maternal foetal medicine and gynecologic oncology were significantly more likely to disagree that all women should refrain from planned conception during the COVID-19 pandemic, in comparison to those in urogynecology and reproductive endocrinology and infertility (p = 0.0003). CONCLUSIONS: Considering the immediate and unknown long-term impact of the COVID-19 pandemic on fertility care delivery, a better understanding of perceptions regarding infertility management during this time is important. Our study shows overall support for the initial ASRM recommendations, representing a wide spectrum of women's health providers.

Physiological and Metabolic Responses to Exercise on Treadmill, Elliptical Trainer, and Stepper: Practical Implications for Training.

Elliptical trainers and steppers are proposed as useful exercise modalities in the rehabilitation of injured runners due to the reduced stress on muscles and joints when compared to running. This study compared the physiological responses to submaximal running (treadmill) with exercise on the elliptical trainer and stepper devices at three submaximal but identical workloads. Authors had 18 trained runners (male/female: N = 9/9, age: mean ± SD = 23 ± 3 years) complete randomized maximal oxygen consumption tests on all three modalities. Submaximal tests of 3 min were performed at 60%, 70%, and 80% of peak workload individually established for each modality. Breath-by-breath oxygen consumption, heart rate, fuel utilization, and energy expenditure were determined. The value of maximal oxygen consumption was not different between treadmill, elliptical, and stepper (49.3 ± 5.3, 48.0 ± 6.6, and 46.7 ± 6.2 ml·min-1·kg-1, respectively). Both physiological measures (oxygen consumption and heart rate) as well as carbohydrate and fat oxidation differed significantly between the different exercise intensities (60%, 70%, and 80%) but did not differ between the treadmill, elliptical trainer, and stepper. Therefore, the elliptical trainer and stepper are suitable substitutes for running during periods when a reduced running load is required, such as during rehabilitation from running-induced injury.

Long-term Patient Perception Following Surgery for Adolescent Idiopathic Scoliosis if Dissatisfied at 2-year Follow-up.

STUDY DESIGN: Longitudinal. OBJECTIVES: To evaluate whether the rate of patients who report low health-related quality of life (HRQOL) scores at 2 years following surgical correction of adolescent idiopathic scoliosis (AIS) improves by 5 years postoperatively. SUMMARY OF BACKGROUND DATA: HRQOL scores are dependent upon a number of factors and even in instances of good surgical correction of a spinal deformity, are not guaranteed to be high postoperatively. Understanding how a low HRQOL score varies over the postoperative period can help surgeons more effectively counsel patients and temper expectations. METHODS: A multicenter database was reviewed for patients with both 2 and 5-year follow-up after spinal fusion and instrumentation for AIS. From a cohort of 916 patients, 52 patients with low HRQOL scores at their 2-year follow-up were identified and reevaluated at 5-year follow-up. A low HRQOL outcome was defined as having SRS-22 domain or total scores less than 2 standard deviations below the mean score. Reoperations were also evaluated to determine if they were associated with HRQOL scores. RESULTS: Of those patients with low SRS-22 HRQOL scores at 2 years postoperatively, improvements were seen in all SRS-22 domains and total scores at the 5-year time point. The greatest change was seen in the satisfaction category where 41 patients showed improvement. The rate of reoperations during this period did not significantly impact patient-reported outcomes. CONCLUSIONS: Having a low HRQOL score 2 years after surgery for AIS does not guarantee a low score 5 years after surgery. Promisingly, most patients demonstrate some improvement in all domains for patient-reported SRS-22 scores at 5-year compared to 2-year follow-up. Understanding the longer term postoperative evolution in patient-reported outcomes may help surgeons to effectively manage and counsel patients who are dissatisfied in the short term.Level of Evidence: 3.