Type 2 diabetes can result in debilitating vascular complications, and resistance training (RT) is an effective therapy for improving cardiovascular outcomes. However, only 10-30% of adults meet the public health guidance for RT. While current RT guidelines focus on targeting major muscle groups, guidance specific to simplified movement categorization may augment understanding of RT programming and improve uptake and outcomes. Current movement pattern definitions and descriptions lack clarity, accuracy, and consistency. This paper proposes movement definitions and descriptions to be used for RT intervention design and prescription, and includes the following categories: hip, knee, ankle, vertebral column, vertical push, horizontal push, vertical pull, and horizontal pull. These categories are intended to aid clinicians, researchers, and trainers in RT surveillance and RT intervention design for improving vascular complications in type 2 diabetes. Simplified RT program design using these categories may also facilitate greater RT program understanding and adherence for patients.

Lymphedema evaluation entails multifaceted considerations for which options continue to evolve and emerge. This paper provides a critical review of the current status of diagnostic and quantitative measures for lymphedema, from traditional and novel bedside assessment tools for volumetric and fluid assessment, to advanced imaging modalities. Modalities are contrasted with regard to empirical support and feasibility of clinical implementation. The manuscript proposes a grid framework for comparing the ability of each modality to quantify specific lymphedema characteristics, including distribution, dysmorphism, tissue composition and fluid content, lymphatic anatomy and function, metaplasia, clinical symptoms, and quality of life and function. This review additionally applies a similar framework approach to consider how well assessment tools support important clinical needs, including: (1) screening, (2) diagnosis and differential diagnosis, (3) individualization of treatment, and (4) monitoring treatment response. The framework highlights which clinical needs are served by an abundance of assessment tools and identifies others that have problematically few. The framework clarifies which tools have greater or lesser empirical support. The framework is designed to assist stakeholders in selecting appropriate diagnostic and surveillance modalities, gauging levels of confidence when applying tools to specific clinical needs, elucidating overarching patterns of diagnostic and quantitative strengths and weaknesses, and informing future investigation.

It has been hypothesized that key lifestyle behaviors of physical activity and sleep worsened in response to the Coronavirus disease (COVID-19) pandemic. However, there have been inconsistencies in findings of changes in these key lifestyle behaviors across populations likely due to the wide variety of assessment methods. The purpose of the study was to compare physical activity and sleep before and after the COVID-19 pandemic using accelerometers and self-reported behaviors. A longitudinal follow-up was conducted on students, faculty, and staff at a university campus in the United States. In the periods before March 2020 (covering the academic years of 2018-2019 or 2019-2020) and again in April-June 2021, participants completed surveys to evaluate their physical activity and sleep behaviors and wore an accelerometer. A total of 44 participants completed the survey at both timepoints and 32 completed accelerometer assessment at both timepoints. Fifty-seven percent of participants reported a perceived decline in physical activity, while 30% reported a worsening in sleep. From self-reported data, overall physical activity did not change, but there was a decrease in active transport (p ​< ​0.001) and increase in domestic physical activity (p ​= ​0.012). Sleep quality decreased as evidenced by an increase in Pittsburgh Sleep Quality Index scores (p ​= ​0.045). There were no changes in accelerometer measured physical activity or sleep. There were no changes in physical or mental health. While perceptions of physical activity declined from prior to the COVID-19 pandemic, there were no changes in device-measured physical activity, and changes in self-reported physical activity differed by domain.

BACKGROUND: This study aims to investigate the measurement of breastfeeding prevalence indicators using Demographic and Health Surveys (DHS) data, focusing on early initiation, exclusive breastfeeding, and continued breastfeeding indicators as reported by the World Health Organization (WHO) and the United Nations Children\'s Fund (UNICEF) and on the discrepancies arising from small changes in their definition.
METHODS: Two hundred sixty DHS samples from 78 countries were analyzed to re-calculate usual indicators reported by WHO and UNICEF: early initiation of breastfeeding (EIB), exclusive breastfeeding under 6 months (EBF), and continued breastfeeding between 1 and 2 years (CBF12 and CBF24). Additionally, alternative estimates of the same indicators, slightly changing their definition, were calculated to test their robustness.
RESULTS: The WHO and UNICEF indicators for early initiation (EIB) primarily capture cases where breastfeeding is initiated \"immediately\" after birth, omitting those initiated within 0 or 1 hour. This discrepancy leads to substantial underestimation of levels in some regions, particularly South Asia, and in trends. Furthermore, sizable discrepancies between exclusive breastfeeding (EBF) indicators arise from the inclusion or exclusion of plain water in the definition, with significant variations across regions, especially in West and Middle Africa. However, continued breastfeeding indicators showed consistency across definitions, proving them robust for international comparisons and time trend estimations.
CONCLUSIONS: This study highlights the importance of understanding how breastfeeding indicators are defined and calculated using DHS data. Researchers should be cautious when using WHO and UNICEF indicators for early initiation and exclusive breastfeeding, as they may underestimate prevalence due to their narrow definition. Continued breastfeeding indicators, on the other hand, are less affected by small changes in definitions and provide reliable measures for cross-country comparisons and trend analyses. These findings underscore the need for standardized robust definitions and transparent reporting of breastfeeding indicators in global health assessments.

Carnosine is an endogenous dipeptide that buffers intracellular pH and quenches toxic products of lipid peroxidation. Used as a dietary supplement, it also supports exercise endurance. However, the accumulation and distribution of carnosine after supplementation has not been rigorously evaluated. To do this, we randomized a cohort to receive daily supplements of either placebo or carnosine (2 g/day). Blood and urine samples were collected twice over the subsequent 12 week supplementation period and we measured levels of red blood cell (RBC) carnosine, urinary carnosine, and urinary carnosine-propanol and carnosine-propanal conjugates by LC/MS-MS. We found that, when compared with placebo, supplementation with carnosine for 6 or 12 weeks led to an approximate twofold increase in RBC carnosine, while levels of urinary carnosine increased nearly sevenfold. Although there were no changes in the urinary levels of carnosine propanol, carnosine propanal increased nearly twofold. RBC carnosine levels were positively associated with urinary carnosine and carnosine propanal levels. No adverse reactions were reported by those in the carnosine or placebo arms, nor did carnosine supplementation have any effect on kidney, liver, and cardiac function or blood electrolytes. In conclusion, irrespective of age, sex, or BMI, oral carnosine supplementation in humans leads to its increase in RBC and urine, as well as an increase in urinary carnosine-propanal. RBC carnosine may be a readily accessible pool to estimate carnosine levels. Clinical trial registration: This study is registered with ClinicalTrials.gov (Nucleophilic Defense Against PM Toxicity (NEAT Trial)-Full Text View-ClinicalTrials.gov), under the registration: NCT03314987.

Sensors have recently become valuable tools in engineering, providing real-time data for monitoring structures and the environment. They are also emerging as new tools in education and training, offering learners real-time information to reinforce their understanding of engineering concepts. However, sensing technology\'s complexity, costs, fabrication and implementation challenges often hinder engineers\' exploration. Simplifying these aspects could make sensors more accessible to engineering students. In this study, the researcher developed, fabricated, and tested an efficient low-cost wireless intelligent sensor aimed at education and research, named LEWIS1. This paper describes the hardware and software architecture of the first prototype and their use, as well as the proposed new versions, LEWIS1-β and LEWIS1-γ, which simplify both hardware and software. The capabilities of the proposed sensor are compared with those of an accurate commercial PCB sensor. This paper also demonstrates examples of outreach efforts and suggests the adoption of the newer versions of LEWIS1 as tools for education and research. The authors also investigated the number of activities and sensor-building workshops that have been conducted since 2015 using the LEWIS sensor, showing an increasing trend in the excitement of people from various professions to participate and learn sensor fabrication.

Community resilience results from complex interactions between people, places, and environments. Measuring community resilience aligns with policy objectives to enhance resilience to adverse events and address spatial disparities. The Baseline Resilience Indicators for Communities (BRIC) is a composite index used to measure resilience. This study adapts the BRIC approach to develop a Community Resilience Index (CRI) for England. A systematic review informed indicator selection, and principal components analysis was used to define sub-indices and allocate weightings. The resulting CRI comprised 44 indicators across five domains, quantifying the resilience of English local authorities. Geographical comparisons were made using t-tests and ANOVA, and the CRI was validated against the Index of Multiple Deprivation (IMD). The mean CRI score for local authorities in England was 83.1, ranging from 53.3 to 108.9. Resilience scores showed spatial patterning, with London and the South East scoring highest. The North had lower CRI scores than the Midlands and South (p = 0.022). Coastal and rural areas also showed lower resilience (p < 0.001). CRI and IMD were inversely correlated (r = -0.564, p < 0.0001). This study contributes to the literature by providing the first detailed assessment of community resilience in England using an adapted BRIC framework. The CRI provides a framework for measuring community resilience in England and could be used to explore associations with health outcomes and guide funding allocation.

BACKGROUND: The purpose of this study was to compare geographic atrophy (GA) area semi-automatic measurement using fundus autofluorescence (FAF) versus optical coherence tomography (OCT) annotation with the cRORA (complete retinal pigment epithelium and outer retinal atrophy) criteria.
METHODS: GA findings on FAF and OCT were semi-automatically annotated at a single time point in 36 pairs of FAF and OCT scans obtained from 36 eyes in 24 patients with dry age-related macular degeneration (AMD). The GA area, focality, perimeter, circularity, minimum and maximum Feret diameter, and minimum distance from the center were compared between FAF and OCT annotations.
RESULTS: The total GA area measured on OCT was 4.74 ± 3.80 mm2. In contrast, the total GA measured on FAF was 13.47 ± 8.64 mm2 (p < 0.0001), with a mean difference of 8.72 ± 6.35 mm2. Multivariate regression analysis revealed a significant correlation between the difference in area between OCT and FAF and the total baseline lesion perimeter and maximal lesion diameter measured on OCT (adjusted r2: 0.52; p < 0.0001) and the total baseline lesion area measured on FAF (adjusted r2: 0.83; p < 0.0001).
CONCLUSIONS: We report that the GA area measured on FAF differs significantly from the GA area measured on OCT. Further research is warranted in order to determine the clinical relevance of these findings.

Problematic internet use (PIU) has drawn attention due to its potentially negative consequences on individuals\' social and personal lives. At present, a consensus on diagnostic criteria for problematic internet use remains elusive, leaving uncertainty regarding its classification as a distinct mental disorder. Extensive research efforts are underway to investigate its underlying causes, risk factors, and correlated adverse consequences. Nonetheless, research on problematic internet use (PIU) frequently faces challenges due to the absence of consistent and dependable evaluation methods, with many existing assessment tools lacking a solid theoretical basis. This study introduces a novel instrument that incorporates positive emotional regulation along with negative emotional regulation, compulsive use, and cognitive preoccupation, all crucial aspects of PIU. The study involved 3054 adolescents from Madrid, Spain, and employed exploratory and confirmatory factor analyses to validate the instrument\'s structure. The resulting four-factor model includes Positive Emotional Regulation, Negative Emotional Regulation, Compulsive Use, and Cognitive Preoccupation. The instrument demonstrates good internal consistency and an association with risk factors, as evidenced by correlations with time spent on various internet-related activities. This comprehensive tool enhances our understanding of PIU and its underlying cognitive and emotional processes and provides a valuable resource for assessing and addressing problematic internet use in adolescents.

This paper illustrates a rigorous approach to the initial phases of scale development when evaluating an existing construct, dyadic efficacy, in a new population. Cancer-related dyadic efficacy represents a couples\' confidence in their conjoint abilities to manage the effects of cancer. Two samples of individuals diagnosed with cancer and their partners, along with a professional panel, contributed lay and content expertise, respectively. Thematic analysis was used to describe cancer-related dyadic efficacy and identify content domains. Cancer-related dyadic efficacy was conceptualized as multidimensional, consistent with relational functioning, and distinct from self-efficacy. A pool of 50 items was developed to assess eight content domains grouped into three main themes: dyadic efficacy for managing (a) illness intrusions, (b) emotional responses and (c) communication and care for children. This paper responds to calls for more rigorous reporting of the qualitative procedures required to establish a conceptual grounding for a new scale.