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Introduction: Emerging literature links fatherhood to men's health but lacks comprehensive assessment of health outcomes, especially among multiethnic populations. This study's objective was to evaluate the associations of fatherhood (age at onset and status) with cardiovascular health scores, incident cardiovascular disease, cardiovascular disease death, and all-cause mortality, examining differences by race/ethnicity. Methods: The study sample included men from Multi-Ethnic Study of Atherosclerosis, prospective cohort study that enrolled adults aged 45–84 years without known cardiovascular disease at baseline. Cardiovascular health was defined using the American Heart Association's Life's Essential 8 scores (0–100), excluding sleep (cardiovascular health score). Results: In this sample of 2,814 men, mean age at cardiovascular health assessment was 62.2 years, 82% were fathers, 24% self-identified as Black, 13% self-identified Chinese, 22% self-identified Hispanic, and 41% self-identified White. Fathers who were aged 35 years (adjusted mean score of 61.1 vs 64.7 [p=0.01] and 61.0 vs 64.7 [p

Objective: The choice to operate on moderate tricuspid regurgitation (TR) during mitral surgery is challenging owing to limited mid-term data. We assess whether concomitant tricuspid operations improve mid-term quality of life, morbidity, or mortality. Methods: An institutional database identified mitral surgery recipients with moderate TR at the time of surgery from 2010 to 2019. Patients were stratified by the presence of a concomitant tricuspid operation. Quality of life at the last follow-up was assessed with the Kansas City Cardiomyopathy Questionnaire (KCCQ-12). Morbidity was compared using the χ2 test, Mann-Whitney U test, and Student t test. Survival was analyzed with Kaplan-Meier estimation. Results: Of 210 mitral surgery recipients, 67 (31.9%) underwent concomitant tricuspid surgery. The concomitant tricuspid surgery cohort had greater preoperative dialysis use (10.5% vs 3.5%; P = .043) but similar age, New York Heart Association class, and cardiac surgery history relative to the nonconcomitant cohort (P > .05 for all). The concomitant tricuspid surgery cohort had a longer cardiopulmonary bypass time (144 minutes vs 122 minutes; P = .005) but a similar rate of mitral repair (P = .220). Postoperative KCCQ-12 scores reflected high quality of life in both cohorts (95.1 vs 89.1; P = .167). The concomitant tricuspid surgery cohort trended toward a higher perioperative pacemaker placement rate (22.8% vs 12.7%; P = .088) but were less likely to develop severe TR (0.0% vs 13.0%; P = .004). Overall survival was comparable between the 2 cohorts at 1 year (84.9% vs 81.6%; P = .628) and 5 years (73.5% vs 57.9%; P = .078). Five-year survival free from severe TR was higher in the concomitant cohort (73.5% vs 54.3%; P = .032). Conclusions: Concomitant tricuspid surgery for moderate TR is associated with increased 5-year survival free from severe TR but not with increased quality of life.

Background: Lifetime risk of fragility fractures is 50% in post-menopausal women and 20% in men aged >50 years. Identifying people at high risk facilitates early intervention and reduction of biopsychosocial morbidity associated with these fractures. Aim: To explore if bone health assessment (BHA) rates differ between women and men aged ≥50 years with fragility fracture risk factors. Design & setting: A primary care-based cohort study in North Staffordshire, UK. Method: Patients were identified from the Consultations in Primary Care Archive (CiPCA) database between 2002 and 2014 with one or more fragility fracture risk factors (previous fractures, falls, and prolonged steroid use). Evaluation of BHA within 12 months of presentation of the first risk factor was carried out by searching for codes for fracture risk assessment tools (FRAX and QFracture), bone density measurement, specialist service referral, or if bone-protection medication was started. Results: A total of 15 581 patients with risk factors were identified; men represented 40.4% of the cohort. The study found 1172 (7.5%) had BHA performed within 1 year of presentation, and 8.9% of women and 5.5% of men had BHAs, which was found with strong statistical evidence (χ2 = 59.88, P = 1 × 10–14). This relationship prevailed after adjusting for other covariates, such as comorbidity and number of consultations, with an odds ratio of 1.25 (95% confidence interval [CI] = 1.08 to 1.43). Conclusion: This study has shown that rates of BHA were generally low and even lower in men compared with women. Primary care clinicians should be alert to fragility fracture risk factors in both men and women to enable early assessment and intervention.

Bulk wave acoustic time-of-flight (ToF) measurements in pipes and closed containers can be hindered by guided waves with similar arrival times propagating in the container wall, especially when a low excitation frequency is used to mitigate sound attenuation from the material. Convolutional neural networks (CNNs) have emerged as a new paradigm for obtaining accurate ToF in non-destructive evaluation (NDE) and have been demonstrated for such complicated conditions. However, the generalizability of ToF-CNNs has not been investigated. In this work, we analyze the generalizability of the ToF-CNN for broader applications, given limited training data. We first investigate the CNN performance with respect to training dataset size and different training data and test data parameters (container dimensions and material properties). Furthermore, we perform a series of tests to understand the distribution of data parameters that need to be incorporated in training for enhanced model generalizability. This is investigated by training the model on a set of small- and large-container datasets regardless of the test data. We observe that the quantity of data partitioned for training must be of a good representation of the entire sets and sufficient to span through the input space. The result of the network also shows that the learning model with the training data on small containers delivers a sufficiently stable result on different feature interactions compared to the learning model with the training data on large containers. To check the robustness of the model, we tested the trained model to predict the ToF of different sound speed mediums, which shows excellent accuracy. Furthermore, to mimic real experimental scenarios, data are augmented by adding noise. We envision that the proposed approach will extend the applications of CNNs for ToF prediction in a broader range.

Streptococcus pneumoniae (pneumococcus) belongs to the Gram-positive cocci. This bacterium typically colonizes the nasopharyngeal region of healthy individuals. It has a distinct polysaccharide capsule – a virulence factor allowing the bacteria to elude the immune defense mechanisms. Consequently, it might trigger aggressive conditions like septicemia and meningitis in immunocompromised or older individuals. Moreover, children below five years of age are at risk of morbidity and mortality. Studies have found 101 S. pneumoniae capsular serotypes, of which several correlate with clinical and carriage isolates with distinct disease aggressiveness. Introducing pneumococcal conjugate vaccines (PCV) targets the most common disease-associated serotypes.

Background: This study, therefore, sought to find out factors influencing the utilization of oral HIV Pre-Exposure prophylaxis among Female Sex Workers in Koome Islands. Methodology: Results were obtained using a convenience sampling technique. A target population of 124 respondents was included in the study. A researcher-based questionnaire was designed with relevant questions in line with the study objectives. Data were collected, entered, and analyzed critically using SPSS software. Results: PrEP use among FSWs was at 61.3%, and the level of self-perception as being at risk of contracting HIV infection among FSWs was at 96%. The majority of the FSWs were aware of HIV prevention with oral HIV PrEP. Conclusions: The study shows high self-perception as being at risk of contracting HIV infection among FSWs causing a high need for utilization of PrEP medicines. There is low utilization of PrEP among FSWs with lower levels of education despite their awareness of PrEP medicines. The findings from the study also show that a high proportion of FSWs would not afford PrEP medicines if they were not freely provided by the government and support organizations. The study findings show that the majority of FSWs did not access PrEP medicines because they were out of stock. Recommendations: The government should not only maintain the free provision of oral HIV PrEP medicines but also increase the amount of the medicines supplied to Koome Health Centre III to ensure easy access to and reduce shortages of PrEP medicines. The government should as well ensure a timely supply of PrEP medicines to Koome Health Center III. Healthcare providers should increase the counseling of FSWs before and after initiating them on PrEP medicines.

Introducción. Los pacientes con Covid-19 tienen el riesgo de presentar síndrome de dificultad respiratoria aguda, por lo que pueden requerir ventilación mecánica y traqueostomía. De este modo, la decanulación es un proceso importante que está a cargo del equipo rehabilitador. Objetivos. Describir y caracterizar el proceso de decanulación en pacientes traqueostomizados con COVID-19 para identificar posibles factores que influyen en su realización exitosa. Métodos. Estudio descriptivo transversal realizado en los pacientes que fueron sometidos a traqueostomía entre junio de 2020 y julio del 2021 en la Clínica de Alta Complejidad Santa Bárbara de Palmira, Colombia. Las variables categóricas se presentaron con porcentajes y para las cuantitativas se contrastó la hipótesis de normalidad a través de la prueba de Kolmogorov-Smirnov. Resultados. Los pacientes, al momento de ingreso, tenían características de severidad, con un promedio de PaO2/FiO2 de 99,7 mmhg y bloqueo neuromuscular hasta por 20 días; el tiempo promedio de ventilación mecánica fue 17,3 días. A todos los pacientes el equipo de rehabilitación les realizó intervención; de los 15 pacientes incluidos, tres no fueron decanulados. Se realizó un análisis descriptivo de los objetivos y de la interven- ción realizada por cada disciplina; para los tres pacientes no decanulados se analizaron las principales barreras y los predictores del fracaso de una decanulación. Conclusión. Gracias a la instauración de un plan constante y activo de rehabilitación multidisciplinario en el que los pacientes reciben intervención desde su ingreso hasta su egreso se logró decanular de manera exitosa al 80% de los pacientes traqueostomizados.