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INTRODUCTION Tinea pedis is a widely spread infection among military personnel. The aim of the research was to determine the prevalence of tinea pedis and its associated risk factors in Georgian Defense Forces. METHODS A cross-sectional study including interviews and clinical and laboratory examination was performed among randomly selected Georgian soldiers and civilians, after getting the signed consent form from them. In the selected population with clinical evidence of tinea pedis, scrapings were taken for direct microscopic examination. Statistical Package for Social Sciences V.22.0 was used for ststistical analysis. RESULTS Out of 729 soldiers, tinea pedis was clinically observed in 46.64% (n=340) and laboratory-confirmed in 25.24% (n=184) of cases, while out of 279 civilians, tinea pedis was found in 21.86% (n=61) and approved in 13.98%(n=39). Multivariate analysis demonstrated that tinea pedis is correlated with the age and military ranks but is not associated with the length of military service. Using a communal shower (OR=1.04, 95% CI 1.01 to 1.07) and having tinea pedis before military service (OR=3.27, 95% CI 1.79 to 5.96) increase the chances of tinea pedis development, though using two or more pairs of the military boots interchangeably decreases the spread of disease (OR=0.21, 95% CI 0.15 to 0.29). CONCLUSIONS According to our research analysis, the prevalence of tinea pedis among Georgian militaries is significantly higher than that in the civilians. It is necessary to develop a large-scale strategy and to implement appropriate preventive measures to minimise the discomfort caused by this disease. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.INTRODUCTION Exposure to enviromental flight conditions may impair performance and physical integrity, thus training in simulated environments it is a key factor. This research aimed to study the psychophysiological response, cortical arousal and autonomic modulation of pilots and medical aircrew personnel during disorientation exposure, considering gender, experience, flying hours and body mass index (BMI) as influencial variables. METHODS A total of 47 soldiers (37 men and 10 women, 22 medical aircrew personnel and 25 fighter pilots) of Spanish Air Forces faced 25 min of vestibular, proprioceptive and visual disorientation. RESULTS Disorientation exposure elicited an increased psychophysiological response, significant increases in isometric hand strength, cortical arousal, autonomic modulation, perceived stress and effort in both groups while a significant decrease in respiratory muscle capacity and blood oxygen saturation in the medical aircrew group were found. selleck compound Cross-sectional analysis showed gender differences, males presented greater parasympathetic activity and strength. Larger BMI was associated with greater levels and perception of stress as well as lower cardiovascular performance and sympathetic modulation. Furthermore, experience, previous training and larger flying hours correlated with greater parasympathetic modulation. CONCLUSION Disorientation exposure produces an increase in cortical arousal and decrease in the parasympathetic nervous system either in pilots and medical aircrew personnel. In addition, medical aircrew personnel are less adapted to disorientation stimulus presenting significantly higher psychophysiological stress response, thus complementary physical training should be mandatory. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.INTRODUCTION Inhibitors of sodium-glucose linked transporter-2 (SGLT2i) are enhancing glucose excretion in the proximal renal tubules, and thus are increasingly used to lower blood glucose levels in patients with type 2 diabetes mellitus (T2DM). The glucose analog 2-deoxy-2-(18F) fluoro-D-glucose (FDG) can be used to quantify renal function in vivo, and due to an affinity for SGLT2 could also provide information about SGLT2 transporter function. Our objectives in this study were, therefore, to assess the impact of SGLT2i on renal function parameters in patients with T2DM and identify predictive parameters of long-term response to SGLT2i using dynamic FDG positron emission tomography (PET)/MRI. METHODS PET FDG renal function measures such as mean transit time (MTT) and general renal performance (GRP) together with glomerular filtration rate (GFR) were determined in 20 patients with T2DM before (T2DMbaseline) and 2 weeks after initiation of therapy with SGLT2i (T2DMSGLT2i). Additionally, dynamic FDG PET data ofd under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.OBJECTIVE Whether participation in structured diabetes self-management education programs (DSME) for participants with diabetes mellitus is associated with a healthy lifestyle in routine care apart from randomized-controlled studies remains unclear and is this studies' research question. RESEARCH DESIGN AND METHODS We identified 1300 persons with diabetes mellitus drawn from the cross-sectional population-based analysis German Health Update 2014/2015 (GEDA 2014/2015), which integrated the modules of the European Health Interview Survey (EHIS) wave 2. Of those, 816 were ever-DSME participants and 484 never-participants. We conducted multivariable weighted logistic regression analyses for lifestyle differences comparing ever-DSME and never-DSME participants. Lifestyle was defined by physical activity (PA), current smoking, fruit/vegetable consumption and body mass index (BMI). Age, sex, socioeconomic status, living together, limitation due to health problems for at least for 6 months, self-efficacy and attentio their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.OBJECTIVE Glomerular filtration rate (GFR) decreases without or prior to the development of albuminuria in many patients with diabetes. Therefore, albuminuria and/or a low GFR in patients with diabetes is referred to as diabetic kidney disease (DKD). A certain proportion of patients with diabetes show a rapid progressive decline in renal function in a unidirectional manner and are termed early decliners. This study aimed to elucidate the prevalence of DKD and early decliners and clarify their risk factors. RESEARCH DESIGN AND METHODS This combination cross-sectional and cohort study included 2385 patients with diabetes from 15 hospitals. We defined DKD as a urinary albumin to creatinine ratio (ACR) ≥30 mg/gCr and/or estimated glomerular filtration rate (eGFR) less then 60 mL/min/1.73 m². We classified patients into four groups based on the presence or absence of albuminuria and a decrease in eGFR to reveal the risk factors for DKD. We also performed a trajectory analysis and specified the prevalence and risk factors of early decliners with sequential eGFR data of 1955 patients in five facilities.