Cardiovascular reactivity to acute psychological stress is associated with generalized self-efficacy and self-efficacy outcomes during adventure challenges.

Outdoor adventure challenges are commonly used to enhance self-efficacy, but the physiological mechanisms involved remain unexplored. Additionally, while studies have documented the influence of self-efficacy on stress management, general self-efficacy has yet to be fully understood in the context of cardiovascular stress reactivity (CVR). This study investigated the influence of self-efficacy beliefs on CVR during acute psychological stress tasks. Additionally, it explored whether CVR serves as a novel mechanism underlying the outcomes of outdoor adventure challenges. As part of a wider randomized controlled trial, participants (n = 55) were invited to complete a laboratory session to assess CVR to an active (paced auditory serial addition test (PASAT)) and a passive (cold pressor test (CPT)) stress task. Randomized participants (n = 33) to the experimental condition also engaged in a high ropes challenge course after the laboratory session. It was found that greater self-reported self-efficacy was associated with larger CVR during the CPT and positively associated with perceived engagement and performance during the PASAT. Secondly, participants reporting positive change in self-efficacy post-intervention were associated with greater CVR and greater CVR was associated with higher ratings of intervention engagement and perceived challenge. This study provides preliminary evidence suggesting that greater efficacy beliefs may heighten CVR to passive acute psychological stressors. Habitual stress reactivity may represent a novel mechanism involved in outdoor and adventure-based interventions. Future research should continue to explore the impact of psychological variables on stress physiology and examine CVR as a potential mechanism in adventure experiences.

From Scan to Simulation-A Novel Workflow for Developing Bioinspired Heart Valves.

Current heart valve replacements lack durability and prolonged performance, especially in pediatric patients. In part, these problems may be attributed to the materials chosen for these constructs, but another important contributing factor is the design of the valve, as this dictates hemodynamic performance and impacts leaflet stresses which may accelerate structural valve deterioration. Most current era bioprosthetic valves adhere to a fundamental design where flat leaflets are supported by commissural posts, secured to a sewing ring. This overall design strategy is effective, but functionality and durability can be improved by incorporating features of the native valve geometry. This paper presents a novel workflow for developing and analyzing bio-inspired valve designs computationally. The leaflet curvature was defined using a mathematical equation whose parameters were derived from the three-dimensional model of a native sheep pulmonary valve obtained via microcomputed tomography. Finite element analysis was used to screen the various valve designs proposed in this study by assessing the effect of leaflet thickness, Young's modulus, and height/curvature on snap-through (where leaflets bend against their original curvature), geometric orifice area (GOA) and the stress in the leaflets. This workflow demonstrated benefits for valve designs with leaflet thicknesses between 0.1 and 0.3 mm, Young's moduli less than 50 MPa, and elongated leaflets with higher curvatures. The proposed workflow brings substantial efficiency gains at the design stage, minimizing manufacturing and animal testing during iterative improvements, and offers a bridge between in vitro and more complex in silico studies in the future.

Nasal Irrigation Delivery in Three Post-FESS Models From a Squeeze-bottle Using CFD.

PURPOSE: Nasal saline irrigation is highly recommended in patients following functional endoscopic sinus surgery (FESS) to aid the postoperative recovery. Post-FESS patients have significantly altered anatomy leading to markedly different flow dynamics from those found in pre-op or non-diseased airways, resulting in unknown flow dynamics. METHODS: This work investigated how the liquid stream disperses through altered nasal cavities following surgery using Computational Fluid Dynamics (CFD). A realistic squeeze profile was determined from physical experiments with a 27-year-old male using a squeeze bottle with load sensors. The administration technique involved a head tilt of 45-degrees forward to represent a head position over a sink. After the irrigation event that lasted 4.5 s, the simulation continued for an additional 1.5 s, with the head orientation returning to an upright position. RESULTS: The results demonstrated that a large maxillary sinus ostium on the right side allows saline penetration into this sinus. The increased volume of saline entering the maxillary sinus limits the saline volume available to the rest of the sinonasal cavity and reduces the surface coverage of the other paranasal sinuses. The average wall shear stress was higher on the right side than on the other side for two patients. The results also revealed that head position alters the sinuses' saline residual, especially the frontal sinuses. CONCLUSION: While greater access to sinuses is achieved through FESS surgery, patients without a nasal septum limits posterior sinus penetration due to the liquid crossing over to the contralateral cavity and exiting the nasal cavity early.

Olympic coaching excellence: A quantitative study of Olympic swimmers' perceptions of their coaches.

Although coaching is a co-created process, researchers investigating the psychological aspects of Olympic coaching have tended to overlook the perceptions of athletes and whether these distinguish between performance-related outcomes. The objective of this research was to examine whether athletes' perceptions of their coaches discriminate between world-leading (i.e., Olympic gold medal winning) and world-class (i.e., Olympic non-gold medal winning) coaches. Observer-reported psychometric questionnaires were completed by 38 Olympic swimmers who had collectively won 59 Olympic medals, of which 31 were gold. The questionnaires assessed perceptions of 12 variables within the Big Five personality traits, the dark triad, and emotional intelligence, and the data was analyzed using three one-way multivariate analysis of variance and follow-up univariate F-tests. The results showed that world-leading coaches were perceived to be significantly higher on conscientiousness, openness to experience, perception of emotion, and management of others emotion, and lower on narcissism, than world-class coaches. This suggests that athletes' perceptions of their coaches may discriminate between world-leading and world-class coaches. The implications for coaches' psychological development are discussed and compared with previously reported Olympic coaches' perceptions of themselves.

Recent Advances in Video Analytics for Rail Network Surveillance for Security, Trespass and Suicide Prevention-A Survey.

Railway networks systems are by design open and accessible to people, but this presents challenges in the prevention of events such as terrorism, trespass, and suicide fatalities. With the rapid advancement of machine learning, numerous computer vision methods have been developed in closed-circuit television (CCTV) surveillance systems for the purposes of managing public spaces. These methods are built based on multiple types of sensors and are designed to automatically detect static objects and unexpected events, monitor people, and prevent potential dangers. This survey focuses on recently developed CCTV surveillance methods for rail networks, discusses the challenges they face, their advantages and disadvantages and a vision for future railway surveillance systems. State-of-the-art methods for object detection and behaviour recognition applied to rail network surveillance systems are introduced, and the ethics of handling personal data and the use of automated systems are also considered.

Assessing lifetime stressor exposure in sport performers: Associations with trait stress appraisals, health, well-being, and performance.

Research has found that greater lifetime stressor exposure increases the risk for mental and physical health problems. Despite this, few studies have examined how stressors occurring over the entire lifespan affect sport performers' health, well-being, and performance, partly due to the difficulty of assessing lifetime stressor exposure. To address this issue, we developed a sport-specific stress assessment module (Sport SAM) for the Stress and Adversity Inventory (STRAIN) and then analyzed the instrument's usability, acceptability, validity, and test-retest reliability. Furthermore, we examined whether trait-like tendencies to appraise stressful situations as a challenge or threat mediated the association between lifetime stressor exposure and health, well-being, and performance. Participants were 395 sport performers (Mage = 22.50 years, SD = 5.33) who completed an online survey. Results revealed that the Sport SAM demonstrated good usability and acceptability, good concurrent validity in relation to the Adult STRAIN (rs = 0.23 to 0.29), and very good test-retest reliability (r icc = 0.87 to 0.89). Furthermore, the Sport SAM was significantly associated with symptoms of depression (ß = 0.21 to 0.24, ps ≤ .001) and anxiety (ß = 0.13 to 0.19, ps ≤ .012), and general physical (ß = 0.24 to 0.27, ps = ≤ 0.001) and mental (ß = 0.23 to 0.32, p ≤ .001) health complaints. Finally, we found that associations between total lifetime non-sport and sport-specific stressor severity and health were mediated by trait stress appraisals. Consequently, these findings may help practitioners better identify sport performers who are at risk of developing stress-related health problems.

Lifetime Stressor Exposure and Psychophysiological Reactivity and Habituation to Repeated Acute Social Stressors.

This study addressed whether lifetime stressor exposure was associated with psychophysiological reactivity and habituation to a novel laboratory-based stressor. Eighty-six participants (Mage = 23.31 years, SD = 4.94) reported their exposure to lifetime non-sport and sport-specific stressors before completing two consecutive trials of the Trier Social Stress Test, while cardiovascular (i.e., heart rate) and endocrine (i.e., salivary cortisol) data were recorded. Exposure to a moderate number of lifetime non-sport and sport-specific stressors was associated with adaptive cardiovascular reactivity, whereas very low or very high stressor exposure was related to maladaptive reactivity. Moreover, experiencing a very low number of lifetime non-sport (but not sport-specific) stressors was associated with poorer habituation. In contrast, lifetime stressor severity was unrelated to cardiovascular reactivity. Finally, greater lifetime non-sport and sport-specific stressor counts were associated with blunted cortisol reactivity and poorer habituation. These results suggest that lifetime stressor exposure may influence sport performers' acute stress responses.

Reducing Read Time of Point-of-Care Test Does Not Affect Detection of Hepatitis C Virus and Reduces Need for Reflex RNA.

BACKGROUND & AIMS: Global elimination of hepatitis C virus (HCV) will require increases in diagnosis. Point of care (POC) tests that detect antibodies against HCV can be useful for testing large and difficult to reach populations. The most accurate POC test requires a 20 min read time to identify antibody-positive samples. We investigated whether viremic patients could be identified using a shorter read time, to increase efficiency and reduce the need for reflex tests (a follow-up test for HCV RNA on the same specimen to confirm viremia). METHODS: Patients with past or current HCV infections provided samples at 2 clinics in Canada for evaluation by the OraQuick HCV Rapid antibody POC test. A community HCV-screening program in Madrid, Spain (real-world cohort) invited people to be tested for HCV with the same OraQuick test. Patients provided samples of whole blood, via finger prick. Fingerprick samples were tested immediately after collection. In the clinic cohort, photographs of the developing test were taken at 15 second intervals, and blinded readers recorded the time to positivity. In the real-world cohort, readers recorded the OraQuick result at 5 minutes, and each minute after, up to 10 minutes, and then again at 20 minutes; viremia was then evaluated using a POC HCV RNA test (GeneXpert HCV Viral Load Assay). Sera from viremic and non-viremic clinic patients were used to quantify antibody titers to investigate the relationship between the time of band appearance and antibody concentration. Fisher's exact test and exact logistic regression were used to determine factors associated with a positive result at 5 minutes. RESULTS: Blood from all viremic patients produced a positive result in the antibody POC test by 5 min. Median time to a positive result for 171 viremic patients was 2.6 min (range, 1.8-4.6 min), vs 4.1 min (range, 2.3-14.4 min) for 108 patients with resolved infection (P < .001). The 5-min threshold identified all viremic cases among 176 HCV antibody-positive patients in the real-world cohort, confirmed by testing for HCV RNA. In the pooled cohorts, antibody positivity at 5 min identified viremic patients with 100% sensitivity (95% CI, 98.4%-100%); the negative predictive value was 100% (95% CI, 94.9%-100%). The positive predictive value at 5 min was 62.0% (95% CI, 56.7%-67.0%) and therefore insufficient alone to detect viremia; an HCV RNA test would still be necessary to confirm active infection. CONCLUSIONS: The wait time for the OraQuick HCV Rapid antibody POC blood test can be reduced from 20 min to 5 min and continue to reliably identify patients with HCV infection. Shortening the test time could increase high-throughput screening, reduce loss to follow up, and reduce the need for reflex HCV RNA testing.

On the Use of Computational Fluid Dynamics (CFD) Modelling to Design Improved Dry Powder Inhalers.

PURPOSE: Computational Fluid Dynamics (CFD) simulations are performed to investigate the impact of adding a grid to a two-inlet dry powder inhaler (DPI). The purpose of the paper is to show the importance of the correct choice of closure model and modeling approach, as well as to perform validation against particle dispersion data obtained from in-vitro studies and flow velocity data obtained from particle image velocimetry (PIV) experiments. METHODS: CFD simulations are performed using the Ansys Fluent 2020R1 software package. Two RANS turbulence models (realisable k - ε and k - ω SST) and the Stress Blended Eddy Simulation (SBES) models are considered. Lagrangian particle tracking for both carrier and fine particles is also performed. RESULTS: Excellent comparison with the PIV data is found for the SBES approach and the particle tracking data are consistent with the dispersion results, given the simplicity of the assumptions made. CONCLUSIONS: This work shows the importance of selecting the correct turbulence modelling approach and boundary conditions to obtain good agreement with PIV data for the flow-field exiting the device. With this validated, the model can be used with much higher confidence to explore the fluid and particle dynamics within the device.

Mycobacterium tuberculosis-Induced Bronchoalveolar Lavage Gene Expression Signature in Latent Tuberculosis Infection Is Dominated by Pleiotropic Effects of CD4+ T Cell-Dependent IFN-γ Production despite the Presence of Polyfunctional T Cells within the Airways.

Tuberculosis (TB) remains a worldwide public health threat. Development of a more effective vaccination strategy to prevent pulmonary TB, the most common and contagious form of the disease, is a research priority for international TB control. A key to reaching this goal is improved understanding of the mechanisms of local immunity to Mycobacterium tuberculosis, the causative organism of TB. In this study, we evaluated global M. tuberculosis-induced gene expression in airway immune cells obtained by bronchoalveolar lavage (BAL) of individuals with latent TB infection (LTBI) and M. tuberculosis-naive controls. In prior studies, we demonstrated that BAL cells from LTBI individuals display substantial enrichment for M. tuberculosis-responsive CD4+ T cells compared with matched peripheral blood samples. We therefore specifically assessed the impact of the depletion of CD4+ and CD8+ T cells on M. tuberculosis-induced BAL cell gene expression in LTBI. Our studies identified 12 canonical pathways and a 47-gene signature that was both sensitive and specific for the contribution of CD4+ T cells to local recall responses to M. tuberculosis In contrast, depletion of CD8+ cells did not identify any genes that fit our strict criteria for inclusion in this signature. Although BAL CD4+ T cells in LTBI displayed polyfunctionality, the observed gene signature predominantly reflected the impact of IFN-γ production on a wide range of host immune responses. These findings provide a standard for comparison of the efficacy of standard bacillus Calmette-Guérin vaccination as well as novel TB vaccines now in development at impacting the initial response to re-exposure to M. tuberculosis in the human lung.

Typologies of dual career in sport: A cluster analysis of identity and self-efficacy.

Research has previously identified different approaches to a dual career (i.e., the simultaneous development of a vocational career alongside the athletic career): (a) educational/vocational pathway (i.e., a prioritisation of the vocational career), (b) a parallel dual career pathway (i.e., an equal focus on athletic and vocational career), and (c) a sporting pathway (i.e., a prioritisation of the athletic career). Yet, the identity and self-efficacy characteristics of these profiles require further investigation. To address this, the current study collected survey responses from 111 dual career athletes. The survey measured aspects of career identity, athletic identity and self-efficacy and results were analysed via a cluster analysis. The results showed three athlete profiles: (a) student-athletes showing an education or vocation prioritisation; (b) dual career athletes showing an equal balance between vocational career and sporting career; and (c) athlete students indicating a sport prioritisation. The results extend the current literature that understands dual career athletes as a heterogeneous group and establishes identity and self-efficacy as important factors in dual career pathways. This understanding also enables practitioners to take an individualistic approach to supporting dual career athletes.

Cumulative lifetime stress exposure, depression, anxiety, and well-being in elite athletes: A mixed-method study.

Research suggests that elite athletes are at increased risk of poor mental health, partly due to the intense demands associated with top-level sport. Despite growing interest in the topic, the factors that influence the mental health and well-being of elite athletes remain unclear. From a theoretical perspective, the accumulation of stress and adversity experienced over the life course may be an important factor. To investigate this possibility, we employed a mixed-method design to: (a) examine whether cumulative lifetime stress predicted depression, anxiety, and well-being in elite athletes; and (b) help explain why cumulative lifetime stress exposure might have resulted in poor mental health and well-being. Ninety-five elite athletes (M age = 29.81, SD = 10.88) completed the Stress and Adversity Inventory, Patient Health Questionnaire, Generalized Anxiety Disorder 7-item scale, and the Scales of General Well-Being. Hierarchical regression analyses revealed that total count and severity of lifetime stressor exposure significantly predicted greater depression (ß = .42, p < .001; ß = .46, p < .001) and anxiety symptoms (ß = .34, p = .003; ß = .28, p = .018), and worse well-being (ß = -.42, p < .001; ß = -.30, p = .015). Semi-structured interviews were then conducted with six athletes. Thematic analysis revealed that cumulative lifetime stress exposure fostered poor mental health and well-being by promoting maladaptive long-term coping strategies, increasing susceptibility to future stress, and limiting interpersonal relationships. We believe these findings can help practitioners identify, and intervene accordingly with, elite athletes at risk of experiencing stress-related mental health problems.

Estimating overdispersion in sparse multinomial data.

Multinomial data arise in many areas of the life sciences, such as mark-recapture studies and phylogenetics, and will often by overdispersed, with the variance being higher than predicted by a multinomial model. The quasi-likelihood approach to modeling this overdispersion involves the assumption that the variance is proportional to that specified by the multinomial model. As this approach does not require specification of the full distribution of the response variable, it can be more robust than fitting a Dirichlet-multinomial model or adding a random effect to the linear predictor. Estimation of the amount of overdispersion is often based on Pearson's statistic X2 or the deviance D. For many types of study, such as mark-recapture, the data will be sparse. The estimator based on X2 can then be highly variable, and that based on D can have a large negative bias. We derive a new estimator, which has a smaller asymptotic variance than that based on X2 , the difference being most marked for sparse data. We illustrate the numerical difference between the three estimators using a mark-recapture study of swifts and compare their performance via a simulation study. The new estimator has the lowest root mean squared error across a range of scenarios, especially when the data are very sparse.

Characterizing the endometrial fluid cytokine profile in women with endometriosis.

PURPOSE: To compare growth factor and cytokine profiles in the endometrial secretions of patients with and without endometriosis to determine whether a particular protein profile is predictive of the disease. METHODS: Patients undergoing laparoscopic gynecologic surgery for benign indications were recruited for this prospective cohort study. Prior to surgery, endometrial fluid was aspirated and multiplex immunoassay was used to quantify 7 cytokines and growth factors. During surgery, each patient was staged according to the ASRM staging system for endometriosis. Cytokines and growth factors were evaluated using the Mann-Whitney and Kruskal-Wallis tests. Combinations of cytokines were evaluated using logistic regression analysis, and ROC curves were generated to evaluate the predictive capacity of the assay. RESULTS: Endometrial secretions were analyzed from 60 patients. Nineteen had stage 3-4 endometriosis, 19 had stage 1-2 disease, and 22 had no endometriosis. There were no significant differences between controls and stage 1-2 endometriosis; however, levels of IL-1α and IL-6 were significantly increased in women with moderate-to-severe disease. A combination of IL-1α, IL-1ß, and IL-6 in endometrial secretions predicts stage 3-4 endometriosis with an AUC of 0.78. A threshold value of 118 pg/mL yields a sensitivity of 75% and specificity of 70%. CONCLUSION: Aspiration of endometrial fluid is a safe and effective approach for evaluating the endometrial profile of women with endometriosis. Women with moderate-to-severe endometriosis demonstrate a distinct cytokine profile compared to controls. A combination of IL-1α, IL-1ß, and IL-6 in the endometrial secretions is predictive of stage 3-4 endometriosis, but is not predictive of minimal-to-mild disease.

An experience sampling study of organizational stress processes and future playing time in professional sport.

This study examined the relationships between daily cognitive appraisals of organizational events, affective responses, and coping. In addition, a 5-year longitudinal relationship between coping and performance outcomes at the senior professional level was assessed. Using an experience sampling method, professional academy rugby union players (N = 39, Mage = 17.23 years, SD = 0.87) completed daily diary measures of appraisals, affective responses, and coping over 5 weeks of training. Hierarchical linear modeling revealed that daily cognitive appraisals were related to daily affective responses and coping functions enacted by behaviours, after accounting for a series of within (e.g., time, day, week) and between-person (e.g., personality, key decision-makers) differences. Zero-inflated negative binomial regression revealed that coping related to eliciting support was associated with minutes played at the senior professional level five years later. This study extends theoretical knowledge of the within- and between-person relationships that explain organizational stress experiences. The findings suggest that some coping functions enacted by behaviours may be early indicators of future performance outcomes in professional sport.

Validation of Newly Developed Surveys to Evaluate Patients' and Providers' Satisfaction with Telehealth Obstetric Services.

Background: Patient and/or provider satisfaction and experience are among the most important indicators for quality assurance of health care services, including telehealth. Validated surveys should be used for this purpose to provide reliable information for a program evaluation. Objective: To validate the newly developed satisfaction surveys, report patient, and provider satisfaction with Antenatal and Neonatal Guidelines, Education and Learning Systems (ANGELS) telehealth services. Methods: Two self-administered paper surveys were developed by a multidisciplinary team. The surveys were validated among obstetric patients who received telehealth services in 2016 and providers in Arkansas from July to August 2017. Psychometric testing was performed to establish reliability and validity of both the surveys. Descriptive statistics was performed to describe patient and provider satisfaction. Results: A total of 89 patient- and 66 provider surveys were analyzed. Construct validity and internal consistency reliability (Cronbach's α >0.7) were confirmed on both the surveys. The majority of patients were highly satisfied with telehealth services and reported positive perceptions toward future use of services. In the past 12 months, telehealth (78.6%) was the most used ANGELS service by providers. Finally, >90% of the providers reported high satisfaction and rated telehealth services as "excellent." Conclusions: The newly developed patient and provider telehealth surveys were reliable and valid. The surveys also demonstrated that the telehealth services were well-accepted and highly valued in a sample of obstetric patients and providers. As both surveys are short, they can be used in routine evaluation of patient and provider satisfaction with similar telehealth programs in the country.

Balancing Demands and Resources in Sport: Adaptation and Validation of the Demand-Induced Strain Compensation Questionnaire for Use in Sport.

Too high demands, combined with a lack of resources, are often detrimental to athletic health and well-being. However, a valid and reliable instrument to investigate different dimensions of demands and resources in sport is currently unavailable. Therefore, the present study examines the psychometric properties of an existing and well-validated survey instrument on demands and resources at task-level that was adapted to sport. This instrument, the Demand-Induced Strain Compensation Questionnaire for Sport (DISQ-SPORT), was empirically tested among 1,101 athletes (416 females and 685 males) from a variety of sports and in different languages. Results supported the proposed six-factor structure of the instrument, consisting of physical, cognitive, and emotional demands and resources. Internal consistencies of all subscales were satisfactory and the instrument was invariant across type of sport, competitive level and language. Continued evaluation of the psychometric properties of the DISQ-SPORT, especially in terms of content validity and test-retest stability, is nevertheless warranted. Theoretical and practical implications as well as areas for future research are discussed.

Organisational stressors, coping, and outcomes in competitive sport.

Organisational stressors are associated with positive and negative outcomes in extant literature; however, little is known about which demands predict which outcomes. Extant theory and literature also suggests that coping style may influence an individual's resilience or vulnerability to stressors and, subsequently, their psychological responses and outcomes. The purpose of this study was, therefore, to examine the main effects of organisational stressors and coping styles on various outcomes (e.g., positive and negative affect, performance satisfaction). Sport performers (n = 414) completed measures of organisational stressors, coping styles, positive and negative affect, and performance satisfaction. Multiple regression analyses revealed positive relationships of both goals and development stressors (duration and intensity) and team and culture stressors (frequency and intensity) on negative affect. Furthermore, problem-focused coping was positively related to positive affect, and emotion-focused coping was positively related to negative affect. This study furthers theoretical knowledge regarding the associations that both organisational stressors (and their dimensions) and coping styles can have with various outcomes, and practical understanding regarding the optimal design of stress management interventions.

Thriving on Pressure: A Factor Mixture Analysis of Sport Performers' Responses to Competitive Encounters.

Although considerable research exists on performers' responses to sporting encounters, little is known about thriving in sport contexts. The current study examined if distinct response patterns existed between sport performers who thrived in competitive encounters compared with those who did not. Participants were 535 sport performers (134 women; Mage = 23.60 years, SDage = 8.08; Mcompeting = 11.84 years, SDcompeting = 7.11). Results of factor mixture analysis supported a four-profile solution comprising a thriving group (n = 146), a low-functioning group (n = 38), and two groups characterized by scores marginally above (n = 131) and below (n = 209) the sample mean. Profile membership was found to be predicted by personal enablers (viz., personal resilient qualities, psychological skills use) and process variables (viz., basic psychological need satisfaction and frustration, challenge appraisal). This examination of thriving in sport performers offers significant implications for research and practice.