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The effect of parity status on the prevalence and impact of musculoskeletal injury (MSKi) among female Canadian Armed Forces (CAF) members is unknown. This study aims to identify whether a history of childbirth and pregnancy-related complications are associated with MSKi occurrence among female members of the CAF. From September 2020 to February 2021, data were collected via an online questionnaire that assessed MSKi, reproductive health, and barriers to recruitment and retention in the CAF. Actively serving, female members were included in this analysis stratified by parous (n = 313) or nulliparous (n = 435) status. Descriptive analysis and binary logistic regressions were used to identify prevalence and adjusted odds ratios (aOR) of repetitive strain injuries (RSI), acute injuries, and body regions affected. Covariates included in aOR: age, body mass index, and rank. A p value of <0.05 was considered significant and 95% confidence intervals (CI) were reported. Female members with a history of childbirth were more likely to report an RSI (80.9% vs. 69.9%, OR = 1.57, CI: 1.03 to 2.40), and when stratified by body region, were more likely to have an RSI of the wrist (30.0% vs. 20.5%, aOR = 1.62, CI: 1.09 to 2.40), and foot (39.3% vs. 24.1%, aOR = 1.79, CI: 1.24 to 2.59). When compared to the nulliparous group, parity did not influence prevalence of acute injuries. MSKi and mental health perceptions were different for females who experienced postpartum depression, miscarriage, or preterm birth. Childbirth and pregnancy-related complications impact prevalence of some RSI among female CAF members. Thus, specific health and fitness support may be needed for parous female CAF members. [ABSTRACT FROM AUTHOR]

The effect of parity status on the prevalence and impact of musculoskeletal injury (MSKi) among female Canadian Armed Forces (CAF) members is unknown. This study aims to identify whether a history of childbirth and pregnancy-related complications are associated with MSKi occurrence among female members of the CAF. From September 2020 to February 2021, data were collected via an online questionnaire that assessed MSKi, reproductive health, and barriers to recruitment and retention in the CAF. Actively serving, female members were included in this analysis stratified by parous (n = 313) or nulliparous (n = 435) status. Descriptive analysis and binary logistic regressions were used to identify prevalence and adjusted odds ratios (aOR) of repetitive strain injuries (RSI), acute injuries, and body regions affected. Covariates included in aOR: age, body mass index, and rank. A p value of <0.05 was considered significant and 95% confidence intervals (CI) were reported. Female members with a history of childbirth were more likely to report an RSI (80.9% vs. 69.9%, OR = 1.57, CI: 1.03 to 2.40), and when stratified by body region, were more likely to have an RSI of the wrist (30.0% vs. 20.5%, aOR = 1.62, CI: 1.09 to 2.40), and foot (39.3% vs. 24.1%, aOR = 1.79, CI: 1.24 to 2.59). When compared to the nulliparous group, parity did not influence prevalence of acute injuries. MSKi and mental health perceptions were different for females who experienced postpartum depression, miscarriage, or preterm birth. Childbirth and pregnancy-related complications impact prevalence of some RSI among female CAF members. Thus, specific health and fitness support may be needed for parous female CAF members. [ABSTRACT FROM AUTHOR]

Recent comprehensive systematic reviews indicate that females are at greater risk of musculoskeletal injuries (MSKi) than males in military populations. Considering the Canadian Armed Forces (CAF) goal of increasing female representation in the next few years, exploring these trends is essential. We aimed to determine the association between biological sex and MSKi in the CAF. An online survey was conducted with active-duty and former CAF members aged 18–65 years. Sex disparities in MSKi (acute or repetitive strain [RSI]) were analyzed using bivariate associations and binary logistic regressions with significance level at p < 0.05. Analyses were stratified by military environment (i.e., Army, Navy, and Air Force). From the 1947 respondents whose biological sex was reported, 855 were females and 1092 were males. Rates of RSI sustained by females and males while serving were 76.2% and 70.5% (p = 0.011), respectively, whereas 61.4% of females reported acute injuries compared to 63.7% of males (p = 0.346). Females were more likely to report overall RSI (adjusted odds ratio [aOR]: 1.397; 95% confidence intervals [CI]: 1.068–1.829), RSI having a greater impact on daily activities (aOR [95%CI]: 2.979 [2.093–4.239]) and greater impact on career progress/length (aOR [95%CI]: 1.448 [1.066–1.968]). Acute injuries, also more prevalent in females, were reported to have a greater impact on daily activities (aOR [95%CI]: 1.688 [1.198–2.379]). This study highlights sex disparities in MSKi prevalence and outcomes. Females within the CAF sample presented greater likelihood of reporting RSI, perceived impact of RSI on daily activities and career progress/length, and perceived impact of acute injuries on daily activities. [ABSTRACT FROM AUTHOR]

Correctional workers form a high-priority group for tuberculosis control measures because of their high exposure and risk. This cross-sectional study conducted in April and May 2022 included 71 criminal police officers from the State Penitentiary of Francisco Beltrão-PR, Brazil. Their sociodemographic and laboratory data were collected. Latent tuberculosis infection (LTBI) was assessed using a QuantiFERON-TB Gold Plus in-tube test kit. Binary logistic regression was applied to calculate the odds ratios (ORs) and 95% confidence intervals (CI) of the LTBI predictors. The prevalence of LTBI was 22.6% (95% CI, 12.8–32.2%). Factors associated with LTBI were age > 43 years (OR, 0.18; 95% CI, 0.04–0.70; p < 0.014) and the use of medications (OR, 5.13; 95% CI, 1.40–18.87; p < 0.014). The prevalence was close to that estimated worldwide for LTBI in correctional workers, reinforcing the need for occupational health control measures consisting of regular screening and treatment of positive cases of latent infection among correctional workers to reduce the risk of illness and spread of infection in the penitentiary system and community. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal injuries (MSKi) play a role in member retention in the military. In general, female military members have higher rates of MSKi than males and female reproductive health characteristics may be contributing to these disparities. This study seeks to characterize reproductive health factors in female Canadian Armed Forces (CAF) members and their relationship with MSKi. Materials and Methods: An electronic survey (SurveyMonkey®) was made available to present and former CAF members 18–65 years of age. Responses were collected between September 2020 and February 2021. Seven female reproductive characteristics were assessed: age of menarche, menstrual cycle regularity, birth control use, having given birth while serving, endometriosis, early menopause, and secondary oligomenorrhea/amenorrhea. Binary logistic regressions were used to analyze associations between reproductive characteristics with repetitive strain (RSI) and acute injuries. Results: A total of 2,001 participants consented to the survey with 855 respondents being female. Females reporting menstrual cycles as never regular, irregular for a few months, who never had a period, and whose periods stopped while serving presented a greater likelihood of reporting RSI compared to their peers who reported regular menstrual cycles (adjusted odds ratio [aOR]: 1.898, confidence interval [CI]: 1.138–3.166). Participants who have experienced endometriosis presented a higher likelihood of reporting acute injuries than those who did not (aOR: 2.426, CI: 1.030–5.709). Conclusion: This examination of females within the CAF suggests that irregular menstrual cycles or absent periods increase the likelihood of experiencing MSKi, namely those categorized as RSI injuries and reporting endometriosis were associated with greater rates of acute injuries. [ABSTRACT FROM AUTHOR]

The purpose of the study was to clarify the independent association between sedentary behavior and physical activity with multiple chronic diseases and medicine intake in older individuals. Sedentary behavior and physical activity were measured by questionnaires. Diseases and medication use were self-reported. Poisson's regression was adopted for main analysis, through crude and adjusted prevalence ratio and confidence interval of 95%. For men, sedentary time >4 hr/day presented a 76% higher prevalence of ≥2 chronic diseases, while physical inactivity increases the likelihood of using ≥2 medicines in 95%. For women, sedentary behavior >4 hr/day presented an 82% and 43% greater prevalence for ≥2 chronic diseases and the intake of ≥2 medicines, respectively. Sedentary behavior represents an independent associated factor of multiple chronic diseases in older men and women. In addition, inactivity for men and sedentarism for women are associated with the amount of medicine intake. [ABSTRACT FROM AUTHOR]

Community-based supervised group exercise may be an effective option to increase activity levels throughout pregnancy. Previous studies that have explored predictors of low adherence to exercise during pregnancy have not examined group-based settings. We analysed an international cohort of 347 pregnant women who participated in group-based prenatal exercise interventions (from <20 weeks to 34–36 weeks pregnant). Probable adherence predictors informed by previous literature that were assessed included: pre-pregnancy physical activity level and body mass index (BMI) classification, age, number of previous pregnancies, and education level. Adherence was measured by attendance. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated to explore the relationship between the selected predictors and high adherence (≥70%). Post-secondary education level versus only secondary (aOR 5.28; CI 1.67; 16.72) or primary level (aOR 13.82; CI 4.30; 44.45) presented greater likelihood to have high adherence to the exercise intervention than low adherence. Future research and public health initiatives should consider implementing strategies to overcome education-related barriers to improve accessibility to prenatal exercise. [ABSTRACT FROM AUTHOR]

Quarantine periods change routines and behaviors with potential impact on different health outcomes. To determine the association between changes in physical activity and sedentary behaviors with changes in back pain during the COVID-19 pandemic quarantine among Brazilian adults. This was a nationwide survey through online questionnaires using data from 43,062 adults (≥ 18 years of age). Information on back pain was assessed using questions about episodes of back pain and worsening symptoms during the quarantine. The pattern of movement behaviors adopted before and during the pandemic were considered for physical inactivity (< 150 min/week of activity), high TV-viewing (≥ 4 h/d), and high computer/tablet use (≥ 4 h/d). Covariates included sex, age group, academic achievement, skin color, working status during the quarantine, and adherence to the quarantine. Logistic regression models were used for statistical analyses (weighted for national representativity). Becoming inactive (OR=1.76, 95% CI: 1.32, 2.37), with high TV-viewing (OR=1.35, 95% CI: 1.14, 1.61) and high computer/tablet use (OR=1.39, 95% CI: 1.11, 1.73) during the pandemic were associated with a higher incidence of back pain. The incidence of physical inactivity was also associated with increased back pain (OR=2.71, 95%CI: 1.64, 4.48). We conclude that increased physical inactivity and sedentary behaviors due to the COVID-19 pandemic quarantine are associated with the incidence and worsening symptoms of back pain among Brazilian adults. [ABSTRACT FROM AUTHOR]

Is patient education effective as a standalone intervention or combined with other interventions for people with knee osteoarthritis? Systematic review of randomised controlled trials. MEDLINE, EMBASE, SPORTDiscus, CINAHL and Web of Science were searched from inception to April 2020. The Cochrane Risk of Bias tool was used for included studies, and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to interpret certainty of results. People with knee osteoarthritis. Any patient education intervention compared with any non-pharmacological comparator. Primary outcomes were self-reported pain and function. Twenty-nine trials involving 4,107 participants were included, informing low to very-low certainty evidence. Nineteen of 28 (68%) pooled comparisons were not statistically significant. Patient education was superior to usual care for pain (SMD −0.35, 95% CI −0.56 to −0.14) and function in the short term (−0.31, 95% CI −0.62 to 0.00), but inferior to exercise therapy for pain in the short term (0.77, 95% CI 0.07 to 1.47). Combining patient education with exercise therapy produced superior outcomes compared with patient education alone for pain in the short term (0.44, 95% CI 0.19 to 0.69) and function in the short (0.81, 95% CI 0.54 to 1.08) and medium term (0.39, 95% CI 0.15 to 0.62). When using the Western Ontario and McMaster Universities Osteoarthritis Index for these comparisons, clinically important differences indicated that patient education was inferior to exercise therapy for pain in the short term (MD 1.56, 95% CI 0.14 to 2.98) and the combination of patient education and exercise therapy for function in the short term (8.94, 95% CI 6.05 to 11.82). Although patient education produced statistically superior short-term pain and function outcomes compared with usual care, differences were small and may not be clinically important. Patient education should not be provided as a standalone treatment and should be combined with exercise therapy to provide statistically superior and clinically important short-term improvements in function compared with education alone. PROSPERO CRD42019122004. [ABSTRACT FROM AUTHOR]

Background This study examined the joint associations of leisure time physical activity and television (TV) viewing time with the prevalence of chronic diseases among Brazilian adults. Methods Data from the Brazilian Health Survey, a nationally representative survey conducted in 2013 (n  = 60 202; ≥18 years), were used. Time spent in TV viewing and leisure physical activity, physician diagnoses of diabetes, hypertension and heart disease and information on co-variables (chronological age, education, ethnicity, candies/sweets consumption, sodium intake and tobacco smoking) were collected via interview. Descriptive statistics (mean and 95% confidence interval) and logistic regression models were used for etiological analyses. Results Physical activity attenuated but did not eliminate the risk associated with high TV viewing for at least one chronic disease in the general population [odds ratio [OR]: 1.29 (1.11–1.50)] and among women [OR: 1.31 (1.09–1.60)], adults [OR: 1.24 (1.05–1.46)] and older adults [OR: 1.63 (1.05–2.53)]. On the other hand, physical activity eliminated the risk associated with high TV viewing for at least one chronic disease among men [OR: 1.24 (0.98–1.58)]. Conclusions We conclude that physical activity can attenuate but not eliminate the negative effects of high TV viewing on chronic disease among subgroups of Brazilian adults. [ABSTRACT FROM AUTHOR]

Objectives: The present study analyzed the association between (i) eating habits during pregnancy, (ii) advice from family or friends about gestational weight gain (GWG), and iii) personal effort to stay within weight gain limits, and meeting GWG recommendations. Methods: Participants included pregnant and postpartum women who completed the validated electronic maternal health survey (EMat). Sociodemographic, lifestyle variables, and body mass index were covariates used in the analyses. Results: Among all eligible women (1171), and a subset of women receiving a specific GWG target from HCP (365, 31.2%), participants who considered that their eating habits became less healthy, or could not evaluate if habits changed, had a higher likelihood of gaining above (adjusted odds ratio, aOR = 2.62; 95% CI 1.84; 3.73 for the total sample (TS); aOR = 4.79; CI 2.32;9.88 for the subset) GWG guidelines after adjusting for the covariates. Women who received advice from family or friends about how much weight they should gain while pregnant were more likely to experience GWG below (TS: aOR = 1.49; CI 1.02;2.17; subset: aOR = 1.95; CI 1.03;3.68) and above (TS: aOR = 1.42; CI 1.01;1.99; subset: aOR = 1.92; CI 1.06;3.48) guidelines, when compared to women who did not receive family/friends advice. Moreover, lower personal effort to stay within weight gain limits was associated with gaining below (TS: aOR = 1.77; CI 1.07;2.92; subset: aOR = 2.71; CI 1.30; 5.65) GWG guidelines. Conclusions for Practice: Women self-reporting less healthy eating habits than before pregnancy, receiving advice from family/friends about GWG, and lower personal effort to stay within guidelines, had an increased odds of weight gain discordant with recommendations. [ABSTRACT FROM AUTHOR]

Background: Characteristics of the neighborhood built environment are associated with physical activity (PA). However, few studies with representative samples have examined environmental correlates of domain-specific PA in Latin America. We examined the associations of the perceived neighborhood built environment with domain-specific PA in a large sample of adults from eight Latin American countries. Methods: This study examined data from 8185 adults (aged 18–65 years) from eight Latin American countries. The Neighbourhood Environment Walkability Survey - Abbreviated (NEWS-A) scale was used to assess perceptions of land use mix–diversity, land use mix-access, street connectivity, walking/cycling facilities, aesthetics, safety from traffic, and safety from crime. Perceived proximity from home to public open spaces (metropolitan parks, playgrounds, public squares) and to shopping centers was also measured. Transport-related and leisure-time PA were assessed using the long form of the International Physical Activity Questionnaire. Both logistic and linear regression models were estimated on pooled data. Results: Perceptions of higher land use mix-access (OR: 1.40; 95% CI: 1.22,1.61), the existence of many alternative routes in the neighbourhood (1.12; 1.04,1.20), slow speed of traffic (1.19; 1.03,1.35) and few drivers exceeding the speed limits (1.09; 1.03,1.15) were associated with greater odds of reporting at least 10 min/week of transport-related PA. Perceptions of higher levels of land use mix-diversity, better aesthetics and greater safety from crime, the presence of crosswalks and pedestrian signals, and greater proximity of shopping centers were associated with more min/week of transport-related PA. Perceptions of higher land use mix-diversity (1.12; 1.05,1.20), higher land use mix-access (1.27; 1.13,1.43), more walking/cycling facilities (1.18; 1.09,1.28), and better aesthetics (1.10; 1.02,1.18) were associated with greater odds of engaging in at least 10 min/week of leisure-time PA versus none. Perceptions of higher land use mix-diversity were associated with more min/week of leisure PA. Conclusions: Different perceived neighborhood built environment characteristics were associated with domain-specific PA among adults from Latin America countries. Interventions designed to modify perceptions of the neighbourhood built environment might influence initiation or maintenance of domain-specific PA. Trial registration: ClinicalTrials. Gov NCT02226627. Retrospectively registered on August 27, 2014. [ABSTRACT FROM AUTHOR]

*OBJECTIVE: To determine whether neuromuscular deficits in trunk and hip-related function are risk factors for athletic knee injuries. 9 DESIGN: Etiology systematic review with meta-analysis. *LITERATURE SEARCH: Six online databases (MEDLINE, Web of Science, Embase, CINAHL, Scopus, and SPORTDiscus) were searched up to April 2019. *STUDY SELECTION CRITERIA: Studies assessing trunk and hip neuromuscular function as risk factors for knee injuries in healthy athletic populations were included. *DATA SYNTHESIS: Outcomes were synthesized quantitatively using meta-analysis of odds ratios, and qualitatively using best-evidence synthesis. * RESULTS: Twenty-one studies met the Inclusion criteria. There was very low-certainty evidence hat greater hip external rotation strength protected against knee injuries (odds ratio = 0.78; 95% confidence interval: 0.70,0.87; P<.05). There was limited evidence that deficits in trunk proprioception and neuromuscular control, and the combination of excessive knee valgus and ipsilateral trunk angle when landing unilaterally from a jump, may be risk factors for knee injuries. * CONCLUSION: Most variables of trunk and hip function were not risk factors for injuries. Further research is required to confirm whether hip external rotation strength, trunk proprioception and neuromuscular control, and the combination of knee valgus angle and ipsilateral trunk control are risk factors for future knee injuries. [ABSTRACT FROM AUTHOR]

• Crepitus is not associated with higher odds of having total knee replacement. • Crepitus is associated with decreased quadriceps strength in patients with KOA. • Crepitus does not affect physical function and quality of life of patients with KOA. To investigate whether the presence of knee crepitus is associated with the occurrence of total knee replacement (TKR), quality of life and deficits in physical function at long-term. Setting – This observational study uses longitudinal data (up to 4-year follow-up) from the Osteoarthritis Initiative (OAI). Participants – 4566 participants. Main Outcome Measure(s) – Logistic regression models were used to test if baseline knee crepitus is associated with the occurrence of TKR. Linear mixed models with adjustment for confounding variables (age, gender, BMI and Kellgren–Lawrence grade) were used to test the association between baseline knee crepitus and longitudinal changes in the pain, self-reported physical function, quality of life and performance-based function. The presence of knee crepitus at baseline does not predict the occurrence of TKR at 36 months (p = 0.58 and 0.67 for right and left knees, respectively). The crepitus group presented a slightly knee extension strength decline from baseline to 48 months (p = 0.03 for the right and 0.01 for the left knee; between group difference = 2% for both right [95%CI = −0.12; −0.01] and left knees [95%CI = −0.13; −0.02]). The presence of knee crepitus is not associated with the occurrence of TKR in the following three years. Knee crepitus is associated with slightly declines in knee extension strength, but this does not seem to affect physical function and quality of life at long-term. [ABSTRACT FROM AUTHOR]

Aim Examine the association between child and adolescent physical activity maintenance categories and metabolic profile in adolescence. Methods This cross-sectional study was conducted with 1152 adolescents (57.4% female) aged 10–16 years from Londrina, Brazil. Physical activity was self-reported in childhood (7–10 years old, retrospective data) and adolescence through questionnaires. Cardiorespiratory fitness (20 m shuttle-run test), body fat (skinfolds), waist circumference, blood pressure (automatic instrument) and blood variables (fasting glucose, HDL-cholesterol and triglycerides) were measured at adolescence. Results Frequency of physical activity in childhood and adolescence was 50.3 and 17.2%, respectively, and only 25.7% of boys and 10.9% of girls were active at both ages. Adolescents who were physically active in childhood alone were less likely [OR = 0.71 (95% CI: 0.52–0.97)] to present low cardiorespiratory fitness in adolescence compared to those who were non-active in childhood. Regardless of controlled, actives in childhood and adolescence were less likely to present low cardiorespiratory fitness [OR = 0.50 (95% CI: 0.34–0.73)], high blood pressure [OR = 0.52 (95% CI: 0.32–0.85)] and high metabolic risk score [OR = 0.44 (95% CI: 0.22–0.90)] compared to the non-actives at both ages. Conclusions Actives through childhood to adolescence are less likely to present low cardiorespiratory fitness, high blood pressure and high metabolic risk. [ABSTRACT FROM AUTHOR]

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Background: Physical inactivity and sedentary behavior are major concerns for public health. Although global initiatives have been successful in monitoring physical activity (PA) worldwide, there is no systematic action for the monitoring of correlates of these behaviors, especially in low- and middle-income countries. Here we describe the prevalence and distribution of PA domains and sitting time in population sub-groups of six south American countries. Methods: Data from the South American Physical Activity and Sedentary Behavior Network (SAPASEN) were used, which includes representative data from Argentina (n = 26,932), Brazil (n = 52,490), Chile (n = 3719), Ecuador (n = 19,851), Peru (n = 8820), and Suriname (n = 5170). Self-reported leisure time (≥150 min/week), (≥150 min/week), transport (≥10 min/week), and occupational PA total (≥10 min/week), as well as sitting time (≥4 h/day) were captured in each national survey. Sex, age, income, and educational status were exposures. Descriptive statistics and harmonized random effect meta-analyses were conducted. Results: The prevalence of PA during leisure (Argentina: 29.2% to Peru: 8.6%), transport (Peru: 69.7% to Ecuador: 8.8%), and occupation (Chile: 60.4 to Brazil 18.3%), and ≥4 h/day of sitting time (Peru: 78.8% to Brazil: 14.8%) differed widely between countries. Moreover, total PA ranged between 60.4% (Brazil) and 82.9% (Chile) among men, and between 49.4% (Ecuador) and 74.9% (Chile) among women. Women (low leisure and occupational PA) and those with a higher educational level (low transportation and occupational PA as well as high sitting time) were less active. Concerning total PA, men, young and middle-aged adults of high educational status (college or more) were, respectively, 47% [OR = 0.53 (95% CI = 0.36–0.78), I2 = 76.6%], 25% [OR = 0.75 (95% CI = 0.61-0.93), I2 = 30.4%] and 32% [OR = 0.68 (95% CI = 0.47-1.00), I2 = 80.3%] less likely to be active. Conclusions: PA and sitting time present great ranges and tend to vary across sex and educational status in South American countries. Country-specific exploration of trends and population-specific interventions may be warranted. [ABSTRACT FROM AUTHOR]

To examine the relationship between physical activity, sedentary behaviors, and social isolation in a representative sample of Brazilian adolescents. Cross sectional analyses using data from the Brazilian Scholar Health Survey conducted in 2015. The sample included 100,839 adolescents (mean age: 14.3 y, 51.4% Female) from 3040 schools. Information about social isolation (number of close friends and perceived loneliness), physical activity (International Physical Activity Questionnaire) and sedentary behaviors (total sitting time and TV viewing) were self-reported. Chronological age, race and type of city (state capital or other) were co-variables. Logistic regression models were used to analyze the data (results are presented as odds ratios (OR) with 95% confidence intervals). Physical activity was associated with lower odds of both social isolation indicators in boys, and with lower likelihood of having few friends in girls. Greater sitting time was associated with higher likelihood of social isolation, as was low (<1 h/d) [boys: OR: 1.54 (95% CI: 1.33 to 1.77); girls: OR: 1.31 (95% CI: 1.17 to 1.48] and high TV viewing (≥8 h/d) [boys: OR: 1.75 (95% CI: 1.47 to 2.09)]; girls: OR: 1.58 (95% CI: 1.37 to 1.82)]. More than 300 min/week of physical activity was sufficient to eliminate the association of high TV viewing and high sitting time with markers of social isolation in boys. Physical activity is associated with a lower prevalence of social isolation, especially among boys. Both high and low amounts of TV viewing increase the likelihood of social isolation. Physical activity reduced the association between TV viewing and sitting with social isolation among boys. [ABSTRACT FROM AUTHOR]