EMS From a Distance: Forget me not

What skills and practices should be routine for EMS providers in the field?

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The Caenorhabditis elegans Oxidative Stress Response Requires the NHR-49 Transcription Factor

The overproduction of reactive oxygen species (ROS) in cells can lead to the development of diseases associated with aging. We have previously shown that C. elegans BRAP-2 (Brca-1 associated binding protein 2) regulates phase II detoxification genes such as gst-4, by increasing SKN-1 activity. Previously, a transcription factor (TF) RNAi screen was conducted to identify potential activators that are required to induce gst-4 expression in brap-2(ok1492) mutants. The lipid metabolism regulator NHR-49/HNF4 was among 18 TFs identified. Here, we show that knockdown of nhr-49 suppresses the activation of gst-4 caused by brap-2 inactivation and that gain-of-function alleles of nhr-49 promote gst-4 expression. We also demonstrate that nhr-49 and its cofactor mdt-15 are required to express phase II detoxification enzymes upon exposure to chemicals that induce oxidative stress. Furthermore, we show that NHR-49 and MDT-15 enhance expression of skn-1a/c. These findings identify a novel role for NHR-49 in ROS detoxification by regulating expression of SKN-1C and phase II detoxification genes.

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A European Whitefish Linkage Map and Its Implications for Understanding Genome-Wide Synteny Between Salmonids Following Whole Genome Duplication

Genomic datasets continue to increase in number due to the ease of production for a wider selection of species including non-model organisms. For many of these species, especially those with large or polyploid genomes, highly contiguous and well-annotated genomes are still rare due to the complexity and cost involved in their assembly. As a result, a common starting point for genomic work in non-model species is the production of a linkage map. Dense linkage maps facilitate the analysis of genomic data in a variety of ways, from broad scale observations regarding genome structure e.g. chromosome number and type or sex-related structural differences, to fine scale patterns e.g. recombination rate variation and co-localization of differentiated regions. Here we present both sex-averaged and sex-specific linkage maps for Coregonus sp. "Albock", a member of the European whitefish lineage (C. lavaretus spp. complex), containing 5395 single nucleotide polymorphism (SNP) loci across 40 linkage groups to facilitate future investigation into the genomic basis of whitefish adaptation and speciation. The map was produced using restriction-site associated digestion (RAD) sequencing data from two wild-caught parents and 156 F1 offspring. We discuss the differences between our sex-averaged and sex-specific maps and identify genome-wide synteny between C. sp. "Albock" and Atlantic Salmon (Salmo salar), which have diverged following the salmonid-specific whole genome duplication. Our analysis confirms that many patterns of synteny observed between Atlantic Salmon and Oncorhynchus and Salvelinus species are also shared by members of the Coregoninae subfamily. We also show that regions known for their species-specific rediploidization history can pose challenges for synteny identification since these regions have diverged independently in each salmonid species following the salmonid-specific whole genome duplication. The European whitefish map provided here will enable future studies to understand the distribution of loci of interest, e.g. F_ST outliers, along the whitefish genome as well as assisting with the de novo assembly of a whitefish reference genome.

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The use of STarT back screening tool to predict functional disability outcomes in patients receiving physical therapy for low back pain

The STarT Back Screening Tool (SBST) categorizes risk of future disability in patients with low back pain (LBP). Previous studies evaluating the use of SBST in physical therapy populations do not reflect the ethnic and socioeconomic diversity occurring in clinical practice and lack statistical power to evaluate factors associated with outcomes within each SBST risk category.

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A simple mathematical model using centred loops and random perturbations accurately reconstructs search patterns observed in desert ants

Abstract

This paper describes a new mathematical model that is based on centred loops to reconstruct the "Systematic Search" behaviour of Cataglyphis desert ants. The notable advantage of this model is the combination of simplicity, efficiency and performance. All model input is kept to a minimum, using only parameters that previous research has shown to be available to the animals at all times: distance from the origin, direction of the last step and home vector. Outbound and inbound search paths are being combined into loops that return to the origin, sampling this area more intensely. A stochastic element is added by random perturbations during the next step, mimicking unsystematic errors during the process of path integration and yielding the typical search patterns observed in Cataglyphis desert ants. The model output is compared to runs observed in the field.

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Expression and function analysis of a rice OsHSP40 gene under salt stress

Abstract

Heat shock proteins (HSPs) play essential roles in both plant growth and abiotic stress tolerance. In rice, OsHSP40 was recently reported to regulate programmed cell death (PCD) of suspension cells under high temperature. However, the expression and functions of OsHSP40 under normal growth or other abiotic stress conditions is still unknown. We reported the expression and function of a rice OsHSP40 gene under salt stress. Homologous proteins of OsHSP40 were collected from the NCBI database and constructed the neighbor-joining (NJ) phylogenetic tree. The expression pattern of OsHSP40 was detected by qRT-PCR under NaCl (150 mM) treatment. Then, identified a rice T-DNA insertion mutant oshsp40. At last, we compared and analyzed the phenotypes of oshsp40 and wild type under salt stress. OsHSP40 was a constitutively expressed small HSP (sHSP) gene and was close related to other plant sHSPs. Moreover, the expression of OsHSP40 was regulated by salt, varying across time points and tissues. Furthermore, the growth of T-DNA insertion mutant of OsHSP40 (designated as oshsp40) was suppressed by NaCl (150 mM) compared with that of the WT at seedling stage. Detailed measurement showed root and shoot length of the oshsp40 seedlings were significantly shorter than those of the WT seedlings under NaCl stress. In addition, the pot experiment results revealed that seedlings of oshsp40 withered more seriously compared with those of WT after NaCl treatment and recovery, and that survival rate and fresh weight of oshsp40 seedlings were significantly reduced. Taken together, these data suggested that OsHSP40 had multiple functions in rice normal growth and abiotic stress tolerance.

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Functional evaluation of alternative splicing in the FAM190A gene

Abstract

The human FAM190A gene undergoes frequent alteration in human cancer, most commonly involving in-frame deletions in exon 9 or exons 9 & 10. These deletions form novel peptide sequences, serving as presumptive cancer-specific neo antigens. However, it remains elusive whether these in-frame deletions of FAM190A could induce oncogenic properties in vivo. In this study, we aimed to explore the functional significance of in-frame deletions in FAM190A genes. We generated two deletion mutant forms, FAM190A^Δexon9 and FAM190A^Δexon9&10, and examined their gain-of-function effects in vitro and in vivo. Global transcript profiling in NIH3T3 cells revealed that the transcripts displaying altered expression following introduction of FAM190A^Δexon9 and FAM190A^Δexon9&10 were significantly enriched for genes assigned to cellular movement and cell-to-cell signaling, respectively. Furthermore, ectopic expression of FAM190A^Δexon9 and FAM190A^Δexon9&10 induced in vivo tumor formation in nu/nu mice. Taken together, our results are the first to demonstrate the in vivo oncogenic properties of in-frame deletions in the FAM190A gene and indicate that these transcript variants might be clinically applicable as therapeutic targets in patients with cancer.

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Over 50 Years of Researching Force Profiles in Rowing: What Do We Know?

Abstract

There has been substantial interest in the mechanisms underpinning the skilled movements of on-water rowing for more than 150 years. Contemporary attention from biomechanical research has focused on the important relationship between kinetics (such as force application at the oar) and performance. A range of instrumentation systems have been developed and used in both academic and applied training contexts to better understand this relationship. Both qualitative and quantitative analytical approaches have been used in conjunction with these instrumentation systems for observing differences in propulsive force patterns between rowers. Despite the use of these analytical approaches, there is still limited consensus surrounding which characteristics of force profiles are associated with better rowing performance. Newell's model of constraints is provided as a framework for understanding why this lack of clarity exists surrounding force profile characteristics and performance. Further to this, direction for further research is provided by a framework that outlines two main streams: (1) exploration of constraints and how they are related to force profile characteristics; and (2) after controlling for constraints, exploration of performance and how it is related to force profile characteristics. These two steps are sequential, with an understanding of constraints influencing how we understand the interaction of force profiles and performance.

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Modeling the Benefits of Cooperative Drafting: Is There an Optimal Strategy to Facilitate a Sub-2-Hour Marathon Performance?

Abstract

Background

During a race, competing cyclists often cooperate by alternating between leading and drafting positions. This approach allows them to maximize velocity by using the energy saved while drafting, a technique to reduce the overall drag by exploiting the leader's slipstream. We have argued that a similar cooperative drafting approach could benefit elite marathon runners in their quest for the sub-2-hour marathon.

Objective

Our aim was to model the effects of various cooperative drafting scenarios on marathon performance by applying the critical velocity concept for intermittent high-intensity running.

Methods

We used the physiological characteristics of the world's most elite long-distance runners and mathematically simulated the depletion and recovery of their distance capacity when running above and below their critical velocity throughout a marathon.

Results

Our simulations showed that with four of the most elite runners in the world, a 2:00:48 (h:min:s) marathon is possible, a whopping 2 min faster than the current world record. We also explored the possibility of a sub-2-hour marathon using multiple runners with the physiological characteristics of Eliud Kipchoge, arguably the best marathon runner of our time. We found that a team of eight Kipchoge-like runners could break the sub-2-hour marathon barrier.

Conclusion

In the context of cooperative drafting, we show that the best team strategy for improving marathon performance time can be optimized using a mathematical model that is based on the physiological characteristics of each athlete.

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Ankle Bracing is Effective for Primary and Secondary Prevention of Acute Ankle Injuries in Athletes: A Systematic Review and Meta-Analyses

Abstract

Background

Ankle bracing has been verified as being effective for secondary prevention of ankle injuries. However, new studies have recently been published that are not included in previous meta-analyses. Furthermore, the effects of bracing for primary prevention of ankle injuries are still unclear.

Objective

The objective of this article was to systematically review the literature about the effectiveness of ankle bracing on primary and secondary prevention of acute ankle injuries in athletes.

Methods

We searched PubMed, EMBASE, SPORTDiscus, CINAHL, and PEDro databases for eligible articles until July 2018. Randomized controlled trials that studied ankle bracing vs. no intervention for athletes were included. Risk of bias was assessed with the Cochrane Risk of Bias tool. Meta-analyses were conducted to study the effect of ankle bracing for primary and secondary prevention of ankle injuries. The Grading of Recommendation Assessment, Development, and Evaluation method was used to determine the quality of evidence.

Results

We included six randomized controlled trials. Significant risk ratios of 0.53 (95% confidence interval 0.32–0.88) and 0.37 (95% confidence interval 0.24–0.58) were found in favor of ankle bracing vs. no ankle bracing for primary (low quality of evidence, I² = 77%) and secondary prevention (moderate quality of evidence, I² = 0%) of acute ankle injuries. Numbers needed to treat were 26 and 12 for the primary and secondary prevention of acute ankle injuries.

Conclusions

Ankle bracing is effective for primary and secondary prevention of acute ankle injuries among athletes. However, conclusions in regard to primary prevention should be drawn cautiously because of the low quality of evidence and significant heterogeneity.

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An Updated Systematic Review of Childhood Physical Activity Questionnaires

Abstract

Background and Objective

This review is an update of a previous review published in 2010, and aims to summarize the available studies on the measurement properties of physical activity questionnaires for young people under the age of 18 years.

Methods

Systematic literature searches were carried out using the online PubMed, EMBASE, and SPORTDiscus databases up to 2018. Articles had to evaluate at least one of the measurement properties of a questionnaire measuring at least the duration or frequency of children's physical activity, and be published in the English language. The standardized COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used for the quality assessment of the studies.

Results

This review yielded 87 articles on 89 different questionnaires. Within the 87 articles, 162 studies were conducted: 103 studies assessed construct validity, 50 assessed test–retest reliability, and nine assessed measurement error. Of these studies, 38% were of poor methodological quality and 49% of fair methodological quality. A questionnaire with acceptable validity was found only for adolescents, i.e., the Greek version of the 3-Day Physical Activity Record. Questionnaires with acceptable test–retest reliability were found in all age categories, i.e., preschoolers, children, and adolescents.

Conclusion

Unfortunately, no questionnaires were identified with conclusive evidence for both acceptable validity and reliability, partly due to the low methodological quality of the studies. This evidence is urgently needed, as current research and practice are using physical activity questionnaires of unknown validity and reliability. Therefore, recommendations for high-quality studies on measurement properties of physical activity questionnaires were formulated in the discussion.

PROSPERO Registration Number

CRD42016038695.

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The Influence of Caffeine Supplementation on Resistance Exercise: A Review

Abstract

This paper aims to critically evaluate and thoroughly discuss the evidence on the topic of caffeine supplementation when performing resistance exercise, as well as provide practical guidelines for the ingestion of caffeine prior to resistance exercise. Based on the current evidence, it seems that caffeine increases both maximal strength and muscular endurance. Furthermore, power appears to be enhanced with caffeine supplementation, although this effect might, to a certain extent, be caffeine dose- and external load-dependent. A reduction in rating of perceived exertion (RPE) might contribute to the performance-enhancing effects of caffeine supplementation as some studies have observed decreases in RPE coupled with increases in performance following caffeine ingestion. However, the same does not seem to be the case for pain perception as there is evidence showing acute increases in resistance exercise performance without any significant effects of caffeine ingestion on pain perception. Some studies have reported that caffeine ingestion did not affect exercise-induced muscle damage, but that it might reduce perceived resistance exercise-induced delayed-onset muscle soreness; however, this needs to be explored further. There is some evidence that caffeine ingestion, compared with a placebo, may lead to greater increases in the production of testosterone and cortisol following resistance exercise. However, given that the acute changes in hormone levels seem to be weakly correlated with hallmark adaptations to resistance exercise, such as hypertrophy and increased muscular strength, these findings are likely of questionable practical significance. Although not without contrasting findings, the available evidence suggests that caffeine ingestion can lead to acute increases in blood pressure (primarily systolic), and thus caution is needed regarding caffeine supplementation among individuals with high blood pressure. In the vast majority of studies, caffeine was administered in capsule or powder forms, and therefore the effects of alternative forms of caffeine, such as chewing gums or mouth rinses, on resistance exercise performance remain unclear. The emerging evidence suggests that coffee might be at least equally ergogenic as caffeine alone when the caffeine dose is matched. Doses in the range of 3–9 mg·kg⁻¹ seem to be adequate for eliciting an ergogenic effect when administered 60 min pre-exercise. In general, caffeine seems to be safe when taken in the recommended doses. However, at doses as high as 9 mg·kg⁻¹ or higher, side effects such as insomnia might be more pronounced. It remains unclear whether habituation reduces the ergogenic benefits of caffeine on resistance exercise as no evidence exists for this type of exercise. Caution is needed when extrapolating these conclusions to females as the vast majority of studies involved only male participants.

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Short and long-term effectiveness and safety of vedolizumab in inflammatory bowel disease: Results from the ENEIDA registry

Alimentary Pharmacology and Therapeutics

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Index C-reactive protein predicts increased severity in acute sigmoid diverticulitis

Therapeutics and Clinical Risk Management

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Predictive factors of the treatment outcome in patients with advanced biliary tract cancer receiving gemcitabine plus cisplatin as first-line chemotherapy

Abstract

Background

Few studies have clearly identified the prognostic factors in patients with advanced biliary tract cancer (BTC) receiving gemcitabine plus cisplatin (GC) which is acknowledged as standard chemotherapy regimen.

Objectives

The aim of this study was to identify predictive factors of the overall survival (OS) in advanced BTC patients receiving GC therapy.

Methods

Data of 307 patients with advanced BTC who received GC therapy as the first-line chemotherapy at our institution from January 2007 to June 2017 were reviewed retrospectively. The patients were randomly assigned to the investigation or the validation dataset at the ratio of 2:1. Multivariate analysis was conducted to identify the prognostic factors, a prognostic index is proposed from the investigation dataset, and the usefulness of this index was confirmed in the validation dataset.

Results

Multivariate analysis identified poor performance status, elevated serum lactate dehydrogenase, and elevated neutrophil-to-lymphocyte ratio as independent unfavorable predictors. The patients could be classified into three groups according to these factors, and it was found that the outcomes differed significantly among the three groups (P = 0.0002, good- vs. intermediate-prognosis groups; P = 0.005, intermediate- vs. poor-prognosis groups). When this index was applied to the validation dataset, the OS was confirmed to differ significantly among the three groups (P = 0.04, good- vs. intermediate-prognosis groups, P < 0.0001, intermediate- vs. poor-prognosis groups).

Conclusions

We identified three predictors of the OS in patients with advanced BTC receiving GC therapy in this study, based on which we could classify the patients into three risk groups.

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Iridescent colouration of male Anna’s hummingbird ( Calypte anna ) caused by multilayered barbules

Abstract

The male Anna's hummingbird features a brightly reddish-pink reflecting gorget, due to large stacks of melanosomes in the feather barbules, arranged in layers separated by keratin. Direct observations together with detailed scatterometry demonstrated that the barbules reflect incident light in an approximately specular manner. The structural colouration is iridescent, i.e. varies with a changing angle of light incidence. Spectrophotometrical measurements of the barbule reflectance and absorbance can be well interpreted with calculated spectra obtained with a transfer matrix method for optical multilayers, using anatomical data and measured refractive index spectra. The organization of the reflectors as a Venetian blind presumably functions to create a high spectral contrast of the male's plumage during courtship.

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A 46,XX Testicular Disorder of Sex Development Caused by a Wilms’ Tumour Factor‐1 (WT1) Pathogenic Variant

Clinical Genetics, Volume 0, Issue ja, -Not available-.


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Spatiotemporal parameters in sprinters with unilateral and bilateral transfemoral amputations and functional impairments

Abstract

Purpose

Although sprinters with unilateral (UTF) and bilateral transfemoral (BTF) amputations and functional impairments (FIs) without amputation were allocated into different classifications because of the recent revision of the International Paralympic Committee Athletics Rules and Regulations, it is unclear whether running mechanics differ among the three groups. The aim of this study was to investigate the differences in the spatiotemporal parameters of the three groups during 100-m sprint in official competitions.

Methods

Using publicly available Internet broadcasts, we analyzed 11 elite-level sprinters with UTF amputation, 4 sprinters with BTF amputation, and 5 sprinters with FI without amputation. The best personal times for nearly all individuals were included. For each sprinter's race, the average speed, step frequency, and step length were calculated using the number of steps in conjunction with the official race time.

Results

Although there were no significant differences in the average speed among the UTF, BTF, and FI groups (7.95 ± 0.22, 7.90 ± 0.42, and 7.93 ± 0.14 m/s, respectively, p = 0.87), those with BTF amputation showed significantly lower step frequency (UTF: 4.20 ± 0.20 Hz, BTF: 3.71 ± 0.32 Hz, FI: 4.20 ± 0.10 Hz, p < 0.05) and longer step length (UTF: 1.90 ± 0.08 m, BTF: 2.14 ± 0.02 m, FI: 1.89 ± 0.06 m, p < 0.05) than the other two groups.

Conclusion

These results suggest that the step characteristics during sprinting are not the same among sprinters with UTF amputation, BTF amputations, or FI without amputations.

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Supplemental Oxygen Does Not Influence Self-selected Work Rate at Moderate Altitude

Introduction It is well known that supplemental oxygen can increase aerobic power output during high-intensity and/or maximal efforts at moderate altitude, yet the effects on self-selected work rate during lower-intensity, submaximal exercise are unknown. We reasoned that if the degree of arterial oxygen saturation (SaO2) influences teleoanticipatory regulation of power output, supplemental oxygen given at moderate altitude would increase average power output during exercise performed at self-selected work rates corresponding to RPE 9 (very light) and 13 (somewhat hard). Methods Twenty-three subjects (17 males, 6 females) completed one familiarization [fraction of inspired O2 (FIO2)=0.209] and two blinded, experimental trials (FIO2=0.209 and FIO2=0.267). In each trial, subjects self-regulated their work rate on a cycle ergometer to maintain RPE 9 for 5 min and RPE 13 for 10 min, before performing an incremental step test to exhaustion (25 W/min). Oxygen consumption (VO2) and SaO2 via pulse oximetry (SpO2) were continuously monitored. Subjects were asked to guess the experimental condition after each stage of the protocol. Results Supplemental oxygen increased SpO2 throughout exercise (~4%; P0.14). Conclusions Small increases in inspired oxygen concentration at moderate altitude are imperceptible and do not appear to influence selection of submaximal work rates at RPE ≤ 13. Corresponding Address: Andrew W. Subudhi, Department of Biology, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918, Phone: 719-255-3938, Email: asubudhi@uccs.edu This project was internally funded by the UCCS Department of Biology. The data presented represent clear, honest, original work without fabrication, falsification, or manipulation. The results of the study and viewpoints presented do not constitute endorsement by the American College of Sports Medicine. CONFLICTS OF INSTEREST: The authors report no conflicts of interest between this work and others. Accepted for Publication: 3 October 2018 © 2018 American College of Sports Medicine

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Sucrose but Not Nitrate Ingestion Reduces Strenuous Cycling–induced Intestinal Injury

Purpose Strenuous exercise induces intestinal injury, which is likely related to splanchnic hypoperfusion and may be associated with gastrointestinal complaints commonly reported during certain exercise modalities. Increasing circulating nitric oxide (NO) levels or inducing postprandial hyperemia may improve splanchnic perfusion, thereby attenuating intestinal injury during exercise. Therefore, we investigated the effects of both dietary nitrate ingestion and sucrose ingestion on splanchnic perfusion and intestinal injury induced by prolonged strenuous cycling. Methods In a randomized cross-over manner, 16 well-trained male athletes (age: 28±7 y; Wmax: 5.0±0.3 W·kg-1) cycled 60 min at 70% Wmax following acute ingestion of: sodium nitrate (NIT; 800 mg NO3), sucrose (SUC; 40 g) or a water placebo (PLA). Splanchnic perfusion was assessed by determining the gap between gastric and arterial pCO2 (gapg-apCO2) using gastric air tonometry. Plasma intestinal fatty-acid binding protein (I-FABP) concentrations, reflecting enterocyte damage, were assessed every 20 min during and up to 60 min of post-exercise recovery. Results The exercise protocol resulted in splanchnic hypoperfusion, as gapg-apCO2 levels increased during exercise (P

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