Objective To determine if plantarflexor (PF) spasticity or ankle strength best predicts variance in walking capacity or self-perceived limitations in walking in persons with multiple sclerosis (pwMS), and if pwMS with PF spasticity are weaker and have greater walking dysfunction than pwMS without PF spasticity. Design Cross-sectional study. Setting University research laboratory. Participants Forty-two pwMS (age: 42.9 ± 10.1 years; Expanded Disability Status Scale (EDSS): median = 3.0, range = 0–6) and 14 adults without disability (WD) (age: 41.9 ± 10.1 years). Intervention Not applicable. Main Outcome Measures PF spasticity and dorsiflexion (DF) and PF maximum voluntary isometric torque (MVIT) were assessed using the Modified Ashworth Scale (MAS) and a computerized dynamometer, respectively. The Timed 25-Foot Walk Test (T25FWT) was the primary outcome measure of walking capacity. Secondary measures included the Six Minute Walk Test (6MWT) and 12-item Multiple Sclerosis Walking Scale (MSWS-12). Results PF strength was the most consistent predictor of the variance in walking capacity (T25FWT: R2 change = 0.23 to 0.29, p ≤ 0.001; 6MWT: R2 change = 0.12 to 0.29, p ≤ 0.012), and self-perceived limitations of walking (MSWS-12: R2 change = 0.04 to 0.14, p < 0.18). There were no significant differences (p > 0.05) between the pwMS with PF spasticity and pwMS without PF spasticity for any of the outcome measures. Conclusions Our study suggests a unique contribution of PF weakness to walking dysfunction in pwMS, and highlights the importance of evaluating PF strength in this clinical population.

Objectives: Gaining medical residency interviews has become more competitive and costly for medical students. Although limited evidence from residency programme directors indicates predictors for successfully matching into a programme, past research has not sufficiently explored the application components necessary to receive an interview offer. The present study will identify which application components are most helpful in obtaining interview offers for different medical specialties. Methods: Data were sourced from the Texas Seeking Transparency in Application to Residency (STAR), a survey of recently matched fourth-year American medical students who self-reported information on their residency application components and interview offers. Multi-level logistic regression analyses were employed to predict the odds of interview offer according to applicants' academic, research and extracurricular characteristics. Sub-analyses were conducted for each medical specialty. Results: Nearly 10 000 students reported information on over 419 010 applications submitted, which resulted in 164 696 interview offers. Across the sample, applicants had greater odds of receiving an interview offer if they had a geographic connection to the programme (odds ratio [OR] = 4.10, 95% confidence interval [CI] 4.00-4.20), had completed an away rotation at the programme (OR = 16.00, 95% CI 14.92-17.15), were Alpha Omega Alpha Honor Medical Society members (OR = 1.49, 95% CI 1.36-1.64), or had been inducted into the Gold Humanism Honor Society (OR = 1.50, 95% CI 1.39-1.62). Applicants had reduced odds of getting an interview if they had been required to remediate a course in medical school (OR = 0.73, 95% CI 0.64-0.83) or had failed the US Medical Licensing Examination Step 1 or Step 2 examination on their first attempt (OR = 0.40, 95% CI 0.33-0.47). Predictors of obtaining an interview varied by specialty. Conclusions: The present findings can assist senior medical students as they prepare residency applications and identify programmes to which they will apply. Knowledge of the significant factors can help applicants more efficiently use resources to maximise their number of interview offers. Completing away rotations and selecting programmes with which applicants have geographic connections may increase their odds of receiving interview offers. | 199 KREMER Et al. Research year, n (%) 35 866 (8.56%) Honoured clerkships, mean ± SD 3.21 ± 2.43 3 Research experiences mean ± SD 3.86 ± 2.58 3 Abstracts for presentations mean ± SD 4.30 ± 3.53 3 Peer-reviewed publications mean ± SD 2.11 ± 2.70 1 Leadership positions mean ± SD 3.90 ± 2.62 3 Volunteer experiences mean ± SD 6.62 ± 3.01 6 Academic quartile, n (%) Bottom 25% (0-25%) 37 690 (9.00%) Middle (26-49%) 63 390 (15.13%) Middle (50-74%) 86 202 (20.57%) Top 25% (75-100%) 117 770 (28.11%) No quartile at school 113 958 (27.20%) Gold Humanism, n (%) 69 454 (16.58%) Remediated course, n (%) 25 361 (6.05%) Failed Step 1 or Step 2, n (%) 12 167 (2.90%) Region of programme, n (%) South 185 088 (44.17%...

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Breastfeeding duration is significantly associated with decreased childhood neglect and sexual abuse. Breastfeeding practices should be explored as a consideration among clinicians when assessing maltreatment risk. Further research should examine whether a causal relationship exists between breastfeeding and decreased maltreatment.

A large proportion of Americans have the opinion that immigrants increase crime. Although past research has not found immigrant status to be associated with criminal behavior, American immigration policy has historically discriminated against certain groups based on their region of birth due to safety concerns. The purpose of the present study was to examine differences in externalizing behavior by immigrant's region of birth. Data was used from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K), a nationally representative and longitudinal study of 21,260 kindergarteners. A series of Poisson regression models were used to predict externalizing behavior of fifth grade students from immigrant status and parent's region of birth. Analyses controlled for demographic characteristics of the child and family and were adjusted by probability weights and primary sampling unit provided by the ECLS-K. After controlling for family income and parents' educational status, immigrant youth had 0.04 lower externalizing behavior scores compared to native-born American youth (B = - 0.04, 95% CI - 0.06 to - 0.01). When considering differences by region of origin, youth from Asia (B = - 0.12, 95% CI - 0.17 to - 0.07) and Central America (B = - 0.10, 95% CI - 0.14 to - 0.05) had significantly lower externalizing behavior compared to native-born American youth, after controlling for covariates. In fifth grade, immigrant youth have significantly lower rates of externalizing behavior than native-born Americans. In particular, immigrant youth from Asia and Central America engaged in significantly less externalizing behavior than native-born Americans. No region of origin engaged in significantly more externalizing behavior than native-born youth.