Δευτέρα 17 Ιουλίου 2017

Static cerebrovascular pressure autoregulation remains intact during deep hypothermia

Summary

Background

Clinical studies measuring cerebral blood flow in infants during deep hypothermia have demonstrated diminished cerebrovascular pressure autoregulation. The coexistence of hypotension in these cohorts confounds the conclusion that deep hypothermia impairs cerebrovascular pressure autoregulation.

Aim

We sought to compare the lower limit of autoregulation and the static rate of autoregulation between normothermic and hypothermic piglets.

Methods

Twenty anesthetized neonatal piglets (5-7 days old; 10 normothermic and 10 hypothermic to 20°C) had continuous measurements of cortical red cell flux using laser Doppler flowmetry, while hemorrhagic hypotension was induced without cardiopulmonary bypass. Lower limit of autoregulation was determined for each subject using piecewise regression and SRoR was determined above and below each lower limit of autoregulation as (%change cerebrovascular resistance/%change cerebral perfusion pressure).

Results

The estimated difference in lower limit of autoregulation was 1.4 mm Hg (lower in the hypothermic piglets; 95% C.I. −10 to 14 mm Hg; P=0.6). The median lower limit of autoregulation in the normothermic group was 39 mm Hg [IQR 38-51] vs 35 mm Hg [31-50] in the hypothermic group. Intact steady-state pressure autoregulation was defined as static rate of autoregulation >0.5 and was demonstrated in all normothermic subjects (static rate of autoregulation=0.72 [0.65-0.87]) and in 9/10 of the hypothermic subjects (static rate of autoregulation=0.65 [0.52-0.87]). This difference in static rate of autoregulation of 0.06 (95% C.I. −0.3 to 0.1) was not significant (P=0.4).

Conclusion

Intact steady-state cerebrovascular pressure autoregulation is demonstrated in a swine model of profound hypothermia. Lower limit of autoregulation and static rate of autoregulation were similar in hypothermic and normothermic subjects.



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Exercise Improves V˙O2max and Body Composition in Androgen Deprivation Therapy–treated Prostate Cancer Patients

imageIntroduction: Prostate cancer is the most common cancer in men, and patients treated with androgen deprivation therapy (ADT) experience unfavorable changes in body composition and associated metabolic complications, which can increase the risk of cardiovascular disease. We examined the effect of a 6-month program of aerobic and resistance exercise aimed at improving body composition and cardiorespiratory health in this population. Methods: Ninety-seven men (43–90 yr) with localized prostate cancer receiving ADT were randomized to either exercise (EX, n = 50) or usual care (CON, n = 47). Supervised exercise was undertaken twice weekly at moderate to high intensity. Measures of cardiorespiratory capacity (V˙O2max), resting metabolic rate, central blood pressure, hemodynamic variables, blood markers, and body composition were assessed. Results: There was a significant group–time interaction present for V˙O2max (P = 0.033) with a treatment effect for EX of 0.11 L·min−1 (95% confidence interval [CI] = 0.04–0.19) (relative to body mass = 1.3 mL·kg−1·min−1, 95% CI = 0.3–2.3) and fat oxidation (P = 0.037) of 12.0 mg·min−1 (95% CI = 2.3–21.7). Similarly, there was a significant improvement in glucose (P

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Sex-Specific Maximum Predicted Heart Rate and Its Prognosis for Mortality and Myocardial Infarction

imagePurpose: Maximum predicted heart rate (MPHR) is traditionally calculated by (220 − age). However, this formula's validity has been questioned in women. The purpose of this study was to derive sex-specific formulas for MPHR in a clinical population and compare their prognostic significance with the traditional formula. Methods: This was a retrospective cohort of adults referred for exercise treadmill testing between 1991 and 2009. Peak heart rate versus age was plotted by sex, and linear regression analysis was used to derive sex-specific MPHR formulas. Cox models were used to calculate risk of death and myocardial infarction (MI) based on attainment of 85% MPHR using both formulas. Results: Of 31,090 patients (mean ± SD, age = 55 ± 10 yr), there were 2824 deaths over 11 ± 5 yr. MPHR was best estimated by 197 − 0.8 × age for women and 204 − 0.9 × age for men (P interaction

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Continuous Cardiac Autonomic and Hemodynamic Responses to Isometric Exercise

imagePurpose: Elevated arterial blood pressure (BP) is associated with autonomic dysfunction and impaired hemodynamic control mechanisms. Isometric exercise (IE) training has been demonstrated effective at reducing BP; however, the continuous cardiovascular responses during IE are underinvestigated. We hypothesized that reflex autonomic cardiovascular control is an important mediator in reducing BP. To test our hypothesis, we investigated continuous cardiac autonomic modulation and baroreceptor reflex sensitivity (BRS) in response to IE. Methods: Twenty-five prehypertensive participants performed a single IE wall squat training session. Total power spectral density (PSD) of HR variability (HRV) and associated low-frequency (LF) and high-frequency (HF) power spectral components were recorded in absolute (ms2) and normalized units (nu) before, during, and after an IE session. HR was recorded via electrocardiography and BRS via the sequence method. Continuous BP was recorded via the vascular unloading technique and stroke volume via impedance cardiography. Total peripheral resistance was calculated according to Ohm's law. Results: During IE, there were significant reductions in HRV (P

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Effect of Knee Joint Angle and Contraction Intensity on Hamstrings Coactivation

imagePurpose: This study investigated the effect of knee joint angle and contraction intensity on the coactivation of the hamstring muscles (when acting as antagonists to the quadriceps) in young and older individuals of both sexes. Methods: A total of 25 young (24 ± 2.6 yr) and 26 older (70 ± 2.5 yr) healthy men and women participated. Maximal voluntary isometric contraction of the knee extensors and flexors was assessed at two knee joint angles (90° and 60°, 0° = full extension). At each angle, participants performed submaximal contractions of the knee extensors (20%, 50%, and 80% maximal voluntary isometric contraction), whereas surface EMG was simultaneously acquired from the vastus lateralis and biceps femoris muscles to assess the level (EMG root-mean-square) of agonist activation and antagonist coactivation. Subcutaneous adipose tissue in the areas corresponding to surface EMG electrode placements was measured via ultrasonography. Results: The contractions performed at 90° knee flexion demonstrated higher levels of antagonist coactivation (all P

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Squatting Biomechanics in Individuals with Symptomatic Femoroacetabular Impingement

imagePurpose: Identification of the biomechanical alterations in individuals with symptomatic femoroacetabular impingement (FAI) is critical to understand the pathology and inform treatments. Yet hip function in this condition is poorly defined. Squatting requires large hip flexion range and involves motion toward the position of hip impingement; thus, it is likely to expose modified biomechanics in these individuals. This study aimed to determine whether hip and pelvis biomechanics differ between individuals with and without symptomatic FAI during an unconstrained deep squat and a constrained squat designed to limit compensation by the pelvis and trunk. Methods: Fifteen participants with symptomatic cam-type or combined (cam plus pincer) FAI who were scheduled for arthroscopic surgery and 14 age- and sex-matched controls without FAI underwent three-dimensional motion analysis during the two squatting tasks. Trunk, pelvis, and hip kinematics and hip kinetics were compared between groups. Results: There were no between-group differences in normalized squat depth for either task. Descent speed was slower for the FAI group during the unconstrained squat (P

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Multiple-Transportable Carbohydrate Effect on Long-Distance Triathlon Performance

imageThe ingestion of multiple (2:1 glucose–fructose) transportable carbohydrate in beverages at high rates (>78 g·h−1) during endurance exercise enhances exogenous carbohydrate oxidation, fluid absorption, gut comfort, and performance relative to glucose alone. However, during long-distance endurance competition, athletes prefer a solid–gel–drink format, and the effect size of multiple-transportable carbohydrate is unknown. Purpose: This study aimed to determine the effect of multiple-transportable carbohydrate on triathlon competition performance when ingested within bars, gels, and drinks. Methods: A double-blind randomized controlled trial was conducted within two national-body sanctioned half-ironman triathlon races held 3 wk apart in 74 well-trained male triathletes (18–60 yr; >2 yr competition experience). Carbohydrate comprising glucose/maltodextrin–fructose (2:1 ratio) or standard isocaloric carbohydrate (glucose/maltodextrin only) was ingested before (94 g) and during the cycle (2.5 g·km−1) and run (7.8 g·km−1) sections, averaging 78.6 ± 6.6 g·h−1, partitioned to bars (25%), gels (35%), and drink (40%). Postrace, 0- to 10-unit Likert-type scales were completed to assess gut comfort and energy. Results: The trial returned low dropout rate (9%), high compliance, and sensitivity (typical error 2.2%). The effect of multiple-transportable carbohydrate on performance time was −0.53% (95% confidence interval = −1.30% to 0.24%; small benefit threshold = −0.54%), with likelihood-based risk analysis supporting adoption (benefit–harm ratio = 48.9%:0.3%; odds ratio = 285:1). Covariate adjustments for preexercise body weight and heat stress had negligible impact performance. Multiple-transportable carbohydrate possibly lowered nausea during the swim and bike; otherwise, effects on gut comfort and perceived energy were negligible. Conclusions: Multiple-transportable (2:1 maltodextrin/glucose–fructose) compared with single-transportable carbohydrate ingested in differing format provided a small benefit to long-distance triathlon performance, inferred as adoption worthy. Large sample in-competition randomized trials offer ecological validity, high participant throughput, compliance, and sensitivity for evaluation of health and performance interventions in athletes.

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Central Contribution to Electrically Induced Fatigue depends on Stimulation Frequency

imagePurpose: This study analyzed the impact of several protocols of neuromuscular electrical stimulation (NMES), matched with a similar total torque-time integral, on muscle activation pathways and neuromuscular fatigue. Methods: Ten young healthy participants (age, 24.6 ± 4.2 yr) performed three randomized NMES sessions on the triceps surae muscles with 20-, 60-, or 100-Hz stimulation frequencies (pulse duration, 1 ms), with pulse amplitude (IES) set at 20% of isometric maximal voluntary contraction (MVC). Muscle activity during NMES was assessed by means of the twitch, the soleus H-reflex and M wave responses evoked by single muscle stimulation at IES. Neuromuscular fatigue was assessed as the changes in evoked and MVC torques and the underlying mechanisms by analyzing variations in superimposed maximal M-waves (Msup), normalized H-reflexes (Hsup/Msup) and V-waves (V/Msup) of the triceps surae muscles. Results: Electromyographic responses at IES suggested that the relative contribution of the indirect muscle activation increases as the stimulation frequency was high and the pulse amplitude was low (P = 0.03). The decrease in MVC torque after NMES was significantly (P = 0.003) greater after 100-Hz protocol (20 Hz, −9.6% ± 3.3%; 60 Hz, −10.7% ± 3.2%; 100 Hz, −16.3% ± 2.7%). Hsup/Msup decreased significantly (P

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Movement Strategies among Groups of Chronic Ankle Instability, Coper, and Control

imageIntroduction: Comprehensive evaluation of movement strategies during functional movement is a difficult undertaking. Because of this challenge, studied movements have been oversimplified. Furthermore, evaluating movement strategies at only a discrete time point(s) provide limited insight into how movement strategies may change or adapt in chronic ankle instability (CAI) patients. This study aimed to identify abnormal movement strategies in individuals with a history of ankle sprain injury during a sports maneuver compared with healthy controls. Methods: Sixty-six participants, consisting of 22 CAI patients, 22 ankle sprain copers, and 22 healthy controls, participated in this study. Functional profiles of lower extremity kinematics, kinetics, and EMG activation from initial contact (0% of stance) to toe-off (100% of stance) were collected and analyzed during a jump landing/cutting task using a functional data analysis approach. Results: Compared with copers, CAI patients displayed landing positions of less plantarflexion, less inversion, more knee flexion, more hip flexion, and less hip abduction during the first 25% of stance. However, restricted dorsiflexion angle was observed in both CAI patients and copers relative to controls during the midlanding to mid–side-cutting phase when the ankle and knee reached its peak range of motion (e.g., dorsiflexion and knee flexion). Reduced EMG activation of tibialis anterior, peroneus longus, medial gastrocnemius, and gluteus medius may be due to altered kinematics that reduce muscular demands on the involved muscles. Conclusions: CAI patients displayed altered movement strategies, perhaps in an attempt to avoid perceived positions of risk. Although sagittal joint positions seemed to increase the external torque on the knee and hip extensors, frontal joint positions appeared to reduce the muscular demands on evertor and hip abductor muscles.

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Increased Fatigue Response to Augmented Deceptive Feedback during Cycling Time Trial

imagePurpose: This study aimed to investigate the effect of different magnitudes of deception on performance and exercise-induced fatigue during cycling time trial. Methods: After three familiarization visits, three women and eight men performed three 5-km cycling time trials while following a simulated dynamic avatar reproducing either 100% (5K100%), 102% (5K102%), or 105% (5K105%) of the subject's previous fastest trial. Quadriceps muscle activation was quantified with surface electromyography. Fatigue was quantified by preexercise to postexercise (10 s through 15 min recovery) changes in quadriceps maximal voluntary contraction (MVC) force, potentiated twitch force evoked by electrical femoral nerve stimulation (QTSingle) and voluntary activation (VA, twitch interpolation technique). Results: Greater quadriceps muscle activation in 5K102% versus 5K100% (12% ± 11%) was found in parallel with a 5% ± 2% and 2% ± 1% improvement in power output and completion time, respectively (P

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Endocannabinoid and Mood Responses to Exercise in Adults with Varying Activity Levels

imageAcute aerobic exercise improves mood and activates the endocannabinoid (eCB) system in physically active individuals; however, both mood and eCB responses to exercise may vary based on habitual levels of physical activity. Purpose: This study aimed to examine eCB and mood responses to prescribed and preferred exercises among individuals with low, moderate, and high levels of physical activity. Methods: Thirty-six healthy adults (21 ± 4 yr) were recruited from low (≤60 min moderate–vigorous physical activity [MVPA] per week), moderate (150–299 min MVPA per week), and high (≥300 MVPA per week) physical activity groups. Participants performed both prescribed (approximately 70%–75% max) and preferred (i.e., self-selected) aerobic exercise on separate days. Mood states and eCB concentrations were assessed before and after exercise conditions. Results: Both preferred and prescribed exercise resulted in significant increases (P

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Lack of Activation of Mitophagy during Endurance Exercise in Human

imagePurpose: This study aimed to determine whether fission and mitophagy are activated by acute endurance exercise in human skeletal muscle and to investigate if this activation is dependent upon the nutritional state. Methods: Trained athletes (n = 7) cycled for 2 h at 70% V˙O2peak in a fed or fasted state. Vastus lateralis muscle biopsies were obtained at baseline, before, immediately after, and 1 h after exercise. Protein and mRNA markers for mitophagy, mitochondrial biogenesis, fission, and fusion were analyzed using quantitative real-time polymerase chain reaction and Western blot. Results: Fission, assessed by phospho-DRP1Ser616 in the mitochondrial fraction, increased postexercise and 1 h postexercise only in the fed state. LC3bII and p62/SQSTM1 in the mitochondrial fraction were unchanged, whereas the LC3bII/LC3bI ratio was decreased only postexercise in the fasted state (P = 0.019), indicating a reduced mitophagy. Genes implicated in fission and mitophagy, such as Drp1, Bnip3, and Bnip3L, and proteins involved in fission (Fis1) or mitophagy (BNIP3) were all more expressed after exercise in the fed state (P

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Comparable Neutrophil Responses for Arm and Intensity-matched Leg Exercise

imageIntroduction: Arm exercise is performed at lower absolute intensities than lower body exercise. This may impact on intensity-dependent neutrophil responses, and it is unknown whether individuals restricted to arm exercise experience the same changes in the neutrophil response as found for lower body exercise. Therefore, we aimed to investigate the importance of exercise modality and relative exercise intensity on the neutrophil response. Methods: Twelve moderately trained men performed three 45-min constant load exercise trials after determination of peak oxygen uptake for arm exercise (V˙O2peak arms) and cycling (V˙O2peak legs): 1) arm cranking exercise at 60% V˙O2peak arms, 2) moderate cycling at 60% V˙O2peak legs, and 3) easy cycling at 60% V˙O2peak arms. Results: Neutrophil numbers in the circulation increased for all exercise trials, but were significantly lower for easy cycling when compared with arm exercise (P = 0.009), mirroring the blunted increase in HR and epinephrine during easy cycling. For all trials, exercising HR explained some of the variation of the neutrophil number 2 h postexercise (R = 0.51–0.69), epinephrine explaining less of this variation (R = 0.21–0.34). The number of neutrophils expressing CXCR2 decreased in the recovery from exercise in all trials (P

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Effect of Resistance Exercise on Muscle Metabolism and Autophagy in sIBM

imagePurpose: Sporadic inclusion body myositis (sIBM), a muscular degenerative disease in the elderly, is an inflammatory myopathy characterized by muscle weakness in the wrist flexor, quadriceps, and tibialis anterior muscles. We aimed to identify the therapeutic effect of resistance exercise (RE) in improving sIBM symptoms in an sIBM animal model. Methods: Six-week-old male Wistar rats were divided into a sham group (sham, n = 12), chloroquine—control group (CQ-con, n = 12), and chloroquine—RE group (CQ-RE, n = 12). The rats were subjected to 1 wk of exercise adaptation and 8 wk of exercise (three sessions per week). Protein expression was measured by Western blotting. Rimmed vacuoles (RV) were identified by hematoxylin and eosin staining and modified Gömöri trichrome staining, and amyloid deposition was examined by Congo red staining. Results: The effects of CQ and RE differed depending on myofiber characteristics. Soleus muscles showed abnormal autophagy in response to CQ, which increased RV generation and amyloid-β accumulation, resulting in atrophy. RE generated RV and decreased amyloid deposition in soleus muscles and also improved autophagy without generating hypertrophy. This reduced the atrophy signal transduction, resulting in decreased atrophy compared with the CQ-con group. Despite no direct effect of CQ, flexor hallucis longus muscles showed loss of mass because of reduced activity or increased inflammatory response; however, RE increased the hypertrophy signal, resulting in reduced autophagy and atrophy. Conclusions: These results demonstrate that RE had a preventive effect on sIBM induced by CQ treatment in an animal model. However, because the results were from an animal experiment, a more detailed study should be conducted over a longer period, and the effectiveness of different RE programs should also be investigated.

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Musculoskeletal Physical Examination: An Evidence-Based Approach, 2nd Edition

No abstract available

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Targeting Reductions in Sitting Time to Increase Physical Activity and Improve Health

image New evidence suggests that reductions in sedentary behavior may increase physical activity and improve health. These findings point to new behavioral targets for intervention and new ways to think about intervening to increase overall physical activity in the population. This report provides a knowledge update reflecting the rapid accumulation of new evidence related to sedentary behavior and health among adults. Recent observational studies suggest that leveraging the time-inverse relationship between sedentary and active behaviors by replacing sitting with standing, light- or moderate-intensity activity can have important health benefits, particularly among less active adults. Clinical studies are providing evidence of the probable physiologic mechanisms underlying these associations, as well as insights into the cardiometabolic impact of breaking up and reducing sedentary behavior. In contrast to the well-established behavioral theories that guide the development and dissemination of evidence-based interventions to increase moderate- to vigorous-intensity physical activity, much less is known about how to reduce sedentary time to increase daily activities. It has become clear that the environmental, social, and individual level determinants for sedentary time are distinct from those linked to the adoption and maintenance of moderate- to vigorous-intensity physical activity. As a result, novel intervention strategies that focus on sitting and lower-intensity activities by leveraging the surrounding environment (e.g., workplace, school, and home) as well as individual-level cues and habits of sedentary behavior are being tested to increase the potency of interventions designed to increase overall physical activity. Herein we summarize the solutions-oriented research across the behavioral research framework, with a focus on highlighting areas of synergy across disciplines and identifying gaps for future research.

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The Preferred Movement Path Paradigm: Influence of Running Shoes on Joint Movement

imagePurpose: (A) To quantify differences in lower extremity joint kinematics for groups of runners subjected to different running footwear conditions, and (B) to quantify differences in lower extremity joint kinematics on an individual basis for runners subjected to different running footwear conditions. Methods: Three-dimensional ankle and knee joint kinematics were collected for 35 heel–toe runners when wearing three different running shoes and when running barefoot. Absolute mean differences in ankle and knee joint kinematics were computed between running shoe conditions. The percentage of individual runners who displayed differences below a 2°, 3°, and 5° threshold were also calculated. Results: The results indicate that the mean kinematics of the ankle and knee joints were similar between running shoe conditions. Aside from ankle dorsiflexion and knee flexion, the percentage of runners maintaining their movement path between running shoes (i.e., less than 3°) was in the order of magnitude of about 80% to 100%. Many runners showed ankle and knee joint kinematics that differed between a conventional running shoe and barefoot by more than 3°, especially for ankle dorsiflexion and knee flexion. Conclusions: Many runners stay in the same movement path (the preferred movement path) when running in various different footwear conditions. The percentage of runners maintaining their preferred movement path depends on the magnitude of the change introduced by the footwear condition.

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Sedentary Behavior, Physical Activity, and Fitness—The Maastricht Study

imagePurpose: This cross-sectional study examined the mutual independent associations of sedentary behavior, lower intensity physical activity (LPA) and higher intensity physical activity (HPA) (an approximation of moderate to vigorous physical activity with cardiorespiratory fitness (CRF). Methods: Two thousand twenty-four participants were included from The Maastricht Study (mean ± SD age, 59.7 ± 8.1 yr; 49.6% men). With the activPAL3 activity monitor, we assessed sedentary time (ST), sedentary pattern variables (number of sedentary breaks, average sedentary bout duration, and number of prolonged sedentary bouts [≥30 min]), LPA, and HPA. CRF was calculated as maximum power output per kilogram body mass (Wmax·kg−1) estimated from a submaximal cycle ergometer test. Linear regression analyses and isotemporal substitution analyses were used to examine associations of ST, sedentary pattern variables, and HPA with CRF. Analyses were stratified by sex. Results: One hour of ST per day was associated with a lower Wmax·kg−1: Bmen = −0.03 (95% confidence interval [CI], −0.05 to −0.01) and Bwomen = −0.02 (95% CI, −0.04 to 0.00), independent of HPA. No statistically significant associations between sedentary patterns variables and CRF were observed. LPA was associated with a higher Wmax·kg−1: Bmen = 0.12 (95% CI, 0.07–0.17) and Bwomen = 0.12 (95% CI, 0.07–0.18). HPA was associated with a higher Wmax·kg−1: Bmen = 0.48 (95% CI, 0.38–0.58) and Bwomen = 0.27 (95% CI, 0.18–0.36). Replacing ST with LPA (Bmen, 0.08; 95% CI, 0.03–0.14; Bwomen, 0.10; 95% CI, 0.05–0.16) or with HPA (Bmen, 0.49; 95% CI, 0.39–0.59; Bwomen = 0.28; 95% CI, 0.19–0.36), but not with standing was associated with higher CRF. Conclusions: Modest associations between sedentary behavior and CRF were observed. Replacing ST with LPA was associated with higher CRF, which could be of particular importance for individuals who cannot engage in HPA. Nonetheless, replacing ST with HPA was associated with greatest estimated change in CRF.

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Contributions to Leg Stiffness in High- Compared with Low-Arched Athletes

imagePurpose: High-arched (HA) athletes exhibit greater lower extremity stiffness during functional tasks than low-arched (LA) athletes. The contributions of skeletal and muscular structures to stiffness may underlie the distinct injury patterns observed in these athletes. The purpose of this study was to compare skeletal and muscular contributions to leg stiffness in HA and LA athletes during running and landing tasks. Methods: Ten HA and 10 LA female athletes performed five overground running trials at a self-selected pace and five step off bilateral landing trials from a height of 30 cm. Three-dimensional kinematics and kinetics were collected using a motion capture system and a force platform. Leg stiffness and its skeletal and muscular contributions were calculated. Independent t-tests were used to compare variable means between arch type groups and Cohen's d were computed to assess effect sizes of mean differences. Results: In running, HA athletes had greater leg stiffness (P = 0.010, d = 1.03) and skeletal stiffness (P = 0.016, d = 0.81), although there are no differences in muscular stiffness (P = 0.134). During landing, HA had greater leg stiffness (P = 0.015, d = 1.06) and skeletal stiffness (P

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Using Activity Monitors to Measure Sit-to-Stand Transitions in Overweight/Obese Youth

imageIntroduction: Reducing sedentary behavior has emerged as an important health intervention strategy. Although hip-worn, and more recently wrist-worn, accelerometers are commonly used for measuring physical activity and sedentary behavior, they may not provide accurate measures of postural changes. The current study examined the validity of commonly used hip- and wrist-worn accelerometer cut points and the thigh-worn activPAL activity monitor for measuring sit-to-stand transitions as compared with direct observation in youth with overweight and obesity. Methods: Nine children wore three activity monitors while being directly observed. The monitors included a hip- and wrist-worn ActiGraph and thigh-worn activPAL. The hip-worn ActiGraph was processed with the normal- and low-frequency filters and the inclinometer function. Cut points of ≤25 counts per 15-s epoch for the hip and ≤105 counts per 15-s epoch for the wrist were applied to the vertical axis to identify sit-to-stand transitions. Epoch-level absolute agreement, Bland–Altman plots, mixed-effects linear regression, and intraclass correlation coefficients (ICC) were investigated. Results: The hip and wrist accelerometer cut points and the hip inclinometer function overestimated the number of hourly sit-to-stand transitions by approximately triple as compared with direct observation. ICC values between the ActiGraph methods and the direct observation were all

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Effects of Mental Fatigue on Endurance Performance in the Heat

imagePurpose: Mental fatigue is a psychobiological state caused by prolonged periods of demanding cognitive activity and has been observed to decrease time trial (TT) endurance performance by ∼3.5% in normal ambient temperatures. Recently, it has been suggested that heat may augment the negative effect of mental fatigue on cognitive performance, raising the question whether it may also amplify the effect of mental fatigue on TT performance. Methods: In 30°C and 30% relative humidity, 10 endurance-trained male athletes (mean ± SD; age = 22 ± 3 yr, Wmax = 332 ± 41 W) completed two experimental conditions: intervention (I; 45-min Stroop task) and control (C; 45-min documentary). Pre- and postintervention/control, cognitive performance was followed up with a 5-min Flanker task. Thereafter, subjects cycled for 45 min at a fixed pace equal to 60% Wmax, immediately followed by a self-paced TT in which they had to produce a fixed amount of work (equal to cycling 15 min at 80% Wmax) as fast as possible. Results: Self-reported mental fatigue was significantly higher after I compared with C (P

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Gene expression profiles of fin regeneration in loach (Paramisgurnus dabryanu)

Publication date: Available online 18 July 2017
Source:Gene Expression Patterns
Author(s): Li Li, Jingya He, Linlin Wang, Weihua Chen, Zhongjie Chang
Teleost fins can regenerate accurate position-matched structure and function after amputation. However, we still lack systematic transcriptional profiling and methodologies to understand the molecular basis of fin regeneration. After histological analysis, we established a suppression subtraction hybridization library containing 418 distinct sequences expressed differentially during the process of blastema formation and differentiation in caudal fin regeneration. Genome ontology and comparative analysis of differential distribution of our data and the reference zebrafish genome showed notable subcategories, including multi-organism processes, response to stimuli, extracellular matrix, antioxidant activity, and cell junction function. KEGG pathway analysis allowed the effective identification of relevant genes in those pathways involved in tissue morphogenesis and regeneration, including tight junction, cell adhesion molecules, mTOR and Jak-STAT signaling pathway. From relevant function subcategories and signaling pathways, 78 clones were examined for further Southern-blot hybridization. Then, 17 genes were chosen and characterized using semi-quantitative PCR. Then 4 candidate genes were identified, including F11r, Mmp9, Agr2 and one without a match to any database. After real-time quantitative PCR, the results showed obvious expression changes in different periods of caudal fin regeneration. We can assume that the 4 candidates, likely valuable genes associated with fin regeneration, deserve additional attention. Thus, our study demonstrated how to investigate the transcript profiles with an emphasis on bioinformatics intervention and how to identify potential genes related to fin regeneration processes. The results also provide a foundation or knowledge for further research into genes and molecular mechanisms of fin regeneration.

Graphical abstract

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Impact of Caffeine Boluses and Caffeine Discontinuation on Apnea and Hypoxemia in Preterm Infants

Journal of Caffeine Research , Vol. 0, No. 0.


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Impact of Caffeine Boluses and Caffeine Discontinuation on Apnea and Hypoxemia in Preterm Infants

Journal of Caffeine Research , Vol. 0, No. 0.


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Erratum to: The German Lipoprotein Apheresis Registry (GLAR) – almost 5 years on



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RNA-Seq of Rice Yellow Stem Borer, Scirpophaga incertulas Reveals Molecular Insights During Four Larval Developmental Stages

The yellow stem borer (YSB), Scirpophaga incertulas is a prominent pest in the rice cultivation causing serious yield losses. The larval stage is an important stage in YSB, responsible for maximum infestation. However, limited knowledge exists on biology and mechanisms underlying growth and differentiation of YSB. To understand and identify the genes involved in YSB development and infestation, so as to design pest control strategies, we performed de novo transcriptome at 1st, 3rd, 5th and 7th larval developmental stages employing Illumina Hi-seq. High quality reads of ~229 Mb were assembled into 24,775 transcripts with an average size of 1485bp. Genes associated with various metabolic processes i.e. detoxification mechanism (CYP450, GSTs and CarEs), RNAi machinery (Dcr-1, Dcr-2, Ago-1, Ago-2, Sid-1, Sid-2, Sid-3 and sid-1 related gene), chemoreception (CSPs, GRs, OBPs and ORs) and regulators (TFs and hormones) were differentially regulated during the developmental stages. Identification of stage specific transcripts made possible to determine the essential processes of larval development. Comparative transcriptome analysis revealed that YSB has not much evolved in detoxification mechanism but showed presence of distinct RNAi machinery. Presence of strong specific visual recognition coupled with chemosensory mechanisms supports the monophagous nature of YSB. Designed EST-SSRs will facilitate accurate estimation of genetic diversity of YSB. This is the first report on characterization of YSB transcriptome and identification of genes involved in key processes which will help researchers and industry to devise novel pest control strategies. This study opens a new avenue to develop next generation resistant rice using RNAi or genome editing approaches.



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Annotated Draft Genome Assemblies for the Northern Bobwhite (Colinus virginianus) and the Scaled Quail (Callipepla squamata) Reveal Disparate Estimates of Modern Genome Diversity and Historic Effective Population Size

Northern bobwhite (Colinus virginianus; hereafter bobwhite) and scaled quail (Callipepla squamata) populations have suffered precipitous declines across most of their U.S. ranges. Illumina-based first- (v1.0) and second-generation (v2.0) draft genome assemblies for the scaled quail and the bobwhite produced N50 scaffold sizes of 1.035 Mb and 2.042 Mb, thereby producing a 45-fold improvement in contiguity over the existing bobwhite assembly, and ≥ 90% of the assembled genomes were captured within 1,313 and 8,990 scaffolds, respectively. The scaled quail assembly (v1.0 = 1.045 Gb) was approximately 20% smaller than the bobwhite (v2.0 = 1.254 Gb), which was supported by kmer-based estimates of genome size. Nevertheless, estimates of GC content (41.72%; 42.66%), genome-wide repetitive content (10.40%; 10.43%), and MAKER-predicted protein coding genes (17,131; 17,165) were similar for the scaled quail (v1.0) and bobwhite (v2.0) assemblies, respectively. BUSCO analyses utilizing 3,023 single-copy orthologs revealed a high level of assembly completeness for the scaled quail (v1.0; 84.8%) and the bobwhite (v2.0; 82.5%), as verified by comparison with well-established avian genomes. We also detected 273 putative segmental duplications in the scaled quail genome (v1.0), and 711 in the bobwhite genome (v2.0), including some that were shared among both species. Autosomal variant prediction revealed approximately 2.48 and 4.17 heterozygous variants per Kb within the scaled quail (v1.0) and bobwhite (v2.0) genomes, respectively, and estimates of historic effective population size were uniformly higher for the bobwhite across all time points in a coalescent model. However, large-scale declines were predicted for both species beginning approximately 15-20 kya.



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Regulation of Small Mitochondrial DNA Replicative Advantage by Ribonucleotide Reductase in Saccharomyces cerevisiae

Small mitochondrial genomes can behave as selfish elements by displacing wild-type genomes regardless of their detriment to the host organism. In the budding yeast Saccharomyces cerevisiae, small hypersuppressive mtDNA transiently co-exist with wild-type in a state of heteroplasmy, wherein the replicative advantage of the small mtDNA outcompetes wild-type and produces offspring without respiratory capacity in >95% of colonies. The cytosolic enzyme ribonucleotide reductase (RNR) catalyzes the rate-limiting step in dNTP synthesis and its inhibition has been correlated with increased petite colony formation, reflecting loss of respiratory function. Here, we used heteroplasmic diploids containing wild-type (rho+) and suppressive (rho-) or hypersuppressive (HS rho-) mitochondrial genomes to explore the effects of RNR activity on mtDNA heteroplasmy in offspring. We found that the proportion of rho+ offspring was significantly increased by RNR overexpression or deletion of its inhibitor, SML1, while reducing RNR activity via SML1 overexpression produced the opposite effects. In addition, using Ex Taq and KOD Dash polymerases, we observed a replicative advantage for small over large template DNA in vitro, but only at low dNTP concentrations. These results suggest that dNTP insufficiency contributes to the replicative advantage of small mtDNA over wild-type and cytosolic dNTP synthesis by RNR is an important regulator of heteroplasmy involving small mtDNA molecules in yeast.



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Impacts of Sensation, Perception and Motor Abilities of the Ipsilesional Upper Limb on Hand Functions in Unilateral Stroke: Quantifications from Biomechanical and Functional Perspectives

The presence of subtle losses in hand dexterity after stroke impacts the regaining of independence with regard to activities of daily living. Therefore, awareness of ipsilesional upper extremity (UE) function may be of importance when drafting a comprehensive rehabilitation program. However, current hand function tests seem to be unable to identify asymptomatic UE impairments.

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Correlation of Joint Volume and Passive Range of Motion with Capsulo-synovial Thickness Measured by Contrast-enhanced MRI in Adhesive Capsulitis

No study has investigated the relationship between the findings of contrast-enhanced magnetic resonance imaging (CE-MRI) and joint volume of shoulder, which has been considered the standard reference for diagnosis of adhesive capsulitis (AC).

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Ultrasonographic Assessment of Femoral Cartilage Thickness in Patients with Cerebral Palsy

Cerebral palsy (CP) is one of the most disabling syndromes of children. To our knowledge, there has not yet been any reported evaluation of the effect of CP on distal femoral cartilage by ultrasonography. The value of understanding this effect on cartilage is that sonographic evaluation of cartilage thickness may help physician to predict the joint health of these children.

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EMS in 2030: What technologies will be widely available?

EMS1 contributors and editorial advisory board members predict the future technologies that will transform patient assessment, care and transport

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OK Google, deliver a shock: 5 opportunities for voice-activated devices in EMS

Here's how the technology in Siri, Amazon Echo and Google Home can transform EMS patient assessment, care and documentation

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Why electronic health records will replace EMS patient care reports

Access to patient records through prehospital and hospital EHR integration will help paramedics improve patient outcomes

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Body-worn cameras: 5 key considerations for EMS leaders

Body-worn cameras can provide important support for EMS providers, but it's important to understand the key issues before implementing a BWC program

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Why point-of-care ultrasound should be a mainstay in EMS

A former firefighter/EMT turned medical student describes the functional components, diagnostic uses and roadblocks of using this imaging technology

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Virtual EMS education: Growing pains and lessons learned

By Kelly Grayson I've been an EMS educator for 24 years, and in those 24 years, I've developed a pretty effective schtick. I'm good at breaking down complex concepts into easily understood terms. I can switch gears from inspirational to educational to entertaining and back again, all within the same lecture. I can read an audience with the best of them, and adapt my teaching methods ...

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Female-Headed Households Associated with Lower Childhood Stunting Across Culturally Diverse Regions of Pakistan: Results from a Cross-Sectional Household Survey

Abstract

Objectives Early childhood stunting adversely influences long-term cognitive and health outcomes. There is limited evidence on whether female empowerment within households could reduce its prevalence. We investigated this relationship in Punjab, Pakistan, which has high stunting rates and a sizeable proportion of female-headed households, and whether this relationship differed across three provincial regions with diverse cultural attitudes towards the role of women in society. Methods Using cross-sectional data from the 2011 Multiple Indicator Cluster Survey, we identified 13,412 children aged 1–4 from 8985 two-parent households in three culturally distinct regions in Punjab, Pakistan. Logistic regression models assessed whether the likelihood of stunting was associated with female-headed households, a proxy for female empowerment, and whether this relationship differed by region. Regressions controlled for child- and household-level covariates. Results Children had 26% lower odds of stunting among female-headed households (OR 0.74, CI 0.60, 0.90). The interaction term for female-headed households and child stunting by provincial region was not statistically significant, suggesting that the relationship holds across the three culturally distinct regions. Conclusions for Practice Female empowerment was associated with lower rates of stunting among young children, and the results did not vary by provincial region. This suggests that women can play important roles as agents of change, even in areas where females have limited freedoms. Greater investments in public education and awareness campaigns to improve health literacy might have important spillover effects for child health and improve the success of existing public health interventions targeting childhood stunting.



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Firefighter / Firefighter (Trainee) - Metropolitan Washington Airports Authority

The Metropolitan Washington Airports Authority Commitment…Service…Diversity… Join Our Team! Firefighter Firefighter (Trainee) Starting Salary: $53,525; excellent benefits The Metropolitan Washington Airports Authority is seeking to fill multiple Firefighter positions at Ronald Reagan Washington National and Washington Dulles International Airports. The Firefighter performs full-performance ...

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Evolutionary biology through the lens of budding yeast comparative genomics

Nature Reviews Genetics. doi:10.1038/nrg.2017.49

Authors: Souhir Marsit, Jean-Baptiste Leducq, Éléonore Durand, Axelle Marchant, Marie Filteau & Christian R. Landry



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The impact of replication stress on replication dynamics and DNA damage in vertebrate cells

Nature Reviews Genetics. doi:10.1038/nrg.2017.46

Authors: Hervé Técher, Stéphane Koundrioukoff, Alain Nicolas & Michelle Debatisse



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Comparison of two stroke volume variation-based goal-directed fluid therapies for supratentorial brain tumour resection: a randomized controlled trial

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Abstract
Background: The optimal volume status for neurosurgery has yet to be determined. We compared two fluid protocols based on different stroke volume variation (SVV) cut-offs for goal-directed fluid therapy (GDFT) during supratentorial brain tumour resection.Methods: A randomized, single-blind, open-label trial was conducted. Eighty adult patients undergoing elective supratentorial brain tumour resection were randomly divided into a low SVV and a high SVV group. The SVV cut-offs were used to determine when to initiate colloid infusion. Clinical outcomes and perioperative changes in serum neuronal biomarkers, including S100β, neurone-specific enolase (NSE) and glial fibrillary acidic protein (GFAP), were compared.Results: Patients in the low SVV group received a higher volume of colloid [869 (SD 404) vs 569 (453) ml; P=0.0025], had a higher urine output [3.4 (2.4) vs 2.5 (1.7) ml kg–1 h–1; P=0.0416] and a higher average cardiac index [3.2 (0.7) vs 2.8 (0.6) litres min–1 m–2; P=0.0204]. Patients in the low SVV group also had a shorter intensive care unit stay [1.4 (0.7) vs 2.6 (3.3) days, P=0.0326], fewer postoperative neurological events (17.5 vs 40%, P=0.0469), attenuated changes in the NSE and GFAP levels, lower intraoperative serum lactate and a higher Barthel index at discharge (all P<0.05).Conclusions: During GDFT for supratentorial brain tumour resection, fluid boluses targeting a lower SVV are more beneficial than a restrictive protocol.Clinical trial registration. NCT02113358.

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What do recent human studies tell us about the association between anaesthesia in young children and neurodevelopmental outcomes?

Abstract
Anaesthetic and sedative drugs transiently disrupt normal neural activity to facilitate healthcare procedures in children, but they can also cause long-term brain injury in experimental animal models. The US Food and Drug Administration (FDA) has recently advised that repeated or lengthy exposures to anaesthetic and sedative drugs prior to 3 yr of age have the potential to harm the development of children's brains and added warnings to these drug labels. Paediatric anaesthesia toxicity could represent a significant public health issue, and concern about this potential injury in children has become an important issue for families, paediatric clinicians and healthcare regulators. Since late 2015, important new data from five major clinical studies have been published. This narrative review aims to provide a brief overview of the preclinical and clinical literature, including a comprehensive review of these recent additions to the human literature. We integrate these new data with prior studies to provide further insights into how these clinical findings can be applied to children.

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Duration of general anaesthetic exposure in early childhood and long-term language and cognitive ability

Abstract
Background. The anaesthetic dose causing neurotoxicity in animals has been evaluated, but the relationship between duration of volatile anaesthetic (VA) exposure and neurodevelopment in children remains unclear.Methods. Data were obtained from the Western Australian Pregnancy Cohort (Raine) Study, with language (Clinical Evaluation of Language Fundamentals: Receptive [CELF-R] and Expressive [CELF-E] and Total [CELF-T]) and cognition (Coloured Progressive Matrices [CPM]) assessed at age 10 yr. Medical records were reviewed, and children divided into quartiles based on total VA exposure duration before age three yr. The association between test score and exposure duration quartile was evaluated using linear regression, adjusting for patient characteristics and comorbidity.Results. Of 1622 children with available test scores, 148 had documented VA exposure and were split into the following quartiles: ≤25, >25 to ≤35, >35 to ≤60 and >60 min. Compared with unexposed children, CELF-T scores for children in the first and second quartiles did not differ, but those in the third and fourth quartiles had significantly lower scores ([3rd quartile – Unexposed] -5.3; 95% confidence interval [CI], (-10.2 – -0.4), [4th quartile – Unexposed] -6.2; 95% CI, (-11.6 – -0.9). CELF-E showed similar findings, but significant differences were not found in CELF-R or CPM for any quartile.Conclusions. Children with VA exposures ≤35 min did not differ from unexposed children, but those with exposures >35 min had lower total and expressive language scores. It remains unclear if this is a dose-response relationship, or if children requiring longer exposures for longer surgeries have other clinical reasons for lower scores.

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How big data shape paediatric anaesthesia

Paediatric anaesthesia practise is changing. This change is primarily the result of new evidence emerging from analyses of large datasets and represents a shift in focus from prevention of perioperative mortality towards a reduction of perioperative morbidity. Children do offer the unique opportunity to study the lifelong consequences of any early intervention. The effects of early-life surgical and anaesthetic exposure may resonate through adolescence and into adulthood. Therefore, it appears necessary to perform long-term follow-up over several years until higher cognitive and other physiological functions have been fully matured and developed.

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Dexmedetomidine pharmacokinetic–pharmacodynamic modelling in healthy volunteers: 1. Influence of arousal on bispectral index and sedation

Abstract
Background. Dexmedetomidine, a selective α2-adrenoreceptor agonist, has unique characteristics, such as maintained respiratory drive and production of arousable sedation. We describe development of a pharmacokinetic–pharmacodynamic model of the sedative properties of dexmedetomidine, taking into account the effect of stimulation on its sedative properties.Methods. In a two-period, randomized study in 18 healthy volunteers, dexmedetomidine was delivered in a step-up fashion by means of target-controlled infusion using the Dyck model. Volunteers were randomized to a session without background noise and a session with pre-recorded looped operating room background noise. Exploratory pharmacokinetic–pharmacodynamic modelling and covariate analysis were conducted in NONMEM using bispectral index (BIS) monitoring of processed EEG.Results. We found that both stimulation at the time of Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scale scoring and the presence or absence of ambient noise had an effect on the sedative properties of dexmedetomidine. The stimuli associated with MOAA/S scoring increased the BIS of sedated volunteers because of a transient 170% increase in the effect-site concentration necessary to reach half of the maximal effect. In contrast, volunteers deprived of ambient noise were more resistant to dexmedetomidine and required, on average, 32% higher effect-site concentrations for the same effect as subjects who were exposed to background operating room noise.Conclusions. The new pharmacokinetic–pharmacodynamic models might be used for effect-site rather than plasma concentration target-controlled infusion for dexmedetomidine in clinical practice, thereby allowing tighter control over the desired level of sedation.Clinical trial registration. NCT01879865.

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Ultrasound-guided percutaneous cryoneurolysis for treatment of acute pain: could cryoanalgesia replace continuous peripheral nerve blocks?

Local anaesthetics, delivered percutaneously through a needle, have been used for over a century to provide perioperative anaesthesia and analgesia. However, the duration of a single-injection peripheral nerve block is usually limited to less than 24 hr, leaving untreated surgical pain that may last for weeks—or in some cases months. While prolonged analgesia may be provided using a perineural catheter and repeated/continuous administration of local anaesthetic, the duration of this modality is still usually limited to less than one week because of the risk of infection, rapid consumption of the local anaesthetic, and the burden of carrying an infusion pump and anaesthetic reservoir.1 An analgesic modality with a prolonged duration of action could be advantageous for various surgical procedures that are associated with a typically prolonged postoperative period of pain.

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Inhibition of p75 neurotrophin receptor does not rescue cognitive impairment in adulthood after isoflurane exposure in neonatal mice

Abstract
Background: Isoflurane is widely used for anaesthesia in humans. Isoflurane exposure of rodents prior to post-natal day 7 (PND7) leads to widespread neurodegeneration in laboratory animals. Previous data from our laboratory suggest an attenuation of apoptosis with the p75 neurotrophin receptor (p75NTR) inhibitor TAT-Pep5. We hypothesized that isoflurane toxicity leads to behavioural and cognitive abnormalities and can be rescued with pre-anaesthesia administration of TAT-Pep5.Methods: Neonatal mouse pups were pretreated with either TAT-Pep5 (25 μl, 10 μM i.p.) or a scrambled control peptide (TAT-ctrl; 25 μl, 10 μM i.p.) prior to isoflurane exposure (1.4%; 4 h) or control (n = 15–26/group). Three to 5 months after exposure, behavioural testing and endpoint assays [brain volume (stereology) and immunoblotting] were performed.Results: No significant difference was observed in open field, T-maze, balance beam or wire-hanging testing. The Barnes maze revealed a significant effect of isoflurane (P = 0.019) in errors to find the escape tunnel during the day 5 probe trial, a finding indicative of impaired short-term spatial memory. No difference was found for brain volumes or protein expression. TAT-Pep5 treatment did not reverse the effects of isoflurane on neurocognitive behaviour.Conclusion: A single isoflurane exposure to early post-natal mice caused a hippocampal-dependent memory deficit that was not prevented by pre-administration of TAT-Pep5, although TAT-Pep5, an inhibitor of p75NTR, has been shown to reduce isoflurane-induced apoptosis. These findings suggest that neuronal apoptosis is not requisite for the development of cognitive deficits in the adults attendant with neonatal anaesthetic exposure.

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Variations in assessment and certification in postgraduate anaesthesia training: a European survey

Abstract
Background: Postgraduate specialty training has traditionally been based on a time- and rotation-based model, but competency-based models are emerging. Because anaesthesia training evolves differently across Europe, variations in assessment and certification processes are expected, but the extent of similarities and differences is unknown. The aim of this study was to compare anaesthesia training programmes in Europe, focusing on assessment and certification processes.Methods: We performed an online survey among national representatives of the Union of European Medical Specialists/European Board of Anaesthesiology. Results: All 36 countries participated. Duration of training had a median of 5 yr (range 2.75–7). Mean number of different assessment tools was 7.45 (range 4–13), with more tools being used in competency-based programmes [mean 9.1 (sd 2.97) vs 7.0 (sd 1.97); P=0.03]. Most countries had a nationally uniform certification process. Based on a qualitative analysis of the survey findings, a categorization of countries emerged, reflecting the approach to assessment and certification. We observed two main streams of countries with an underlying knowledge or procedural focus within a time- and rotation-based apprenticeship model. These main streams are evolving, to different extents, towards a third orientation, competency-based training.Conclusions: Assessment and certification processes in European anaesthesia training are diverse. In many countries, a time-based apprenticeship model is evolving towards a competency-based certification process. This diversity precludes comparison of competence of graduating anaesthetists across Europe.

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Evolutionary biology through the lens of budding yeast comparative genomics

Saccharomyces cerevisiae has become an important model organism in the field of evolutionary genomics. Comparative genomic analysis of laboratory, wild and domesticated yeast populations is generating insights into how new species form and how populations adapt to their environments.

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The impact of replication stress on replication dynamics and DNA damage in vertebrate cells

Recent studies have provided insights into the sources of endogenous replication stress, which can result in DNA damage, checkpoint activation and genome-wide replication fork slowing. The authors review established mechanisms involved in the replication stress response, and propose a new model that reconciles data gained from different cellular models.

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Mother and Adolescent Eating in the Context of Food Insecurity: Findings from Urban Public Housing

Abstract

Introduction Anecdotal evidence suggests that parents protect their children from food insecurity and its effects, but few studies have concurrently assessed food insecurity among youth and parents. The purpose of this study was to examine food insecurity and eating behaviors among an urban sample of mother–adolescent dyads. Methods Mother–adolescent dyads (n = 55) were from six public housing sites in Phoenix, Arizona who completed surveys during 2014. Multivariate mixed linear and logistic regression models assessed the relationship between mother and adolescent eating behaviors in the context of food insecurity. Results Food insecurity was prevalent with 65.4% of parents and 43.6% of adolescents reporting food insecurity; 34.5% of parents and 14.5% of adolescents reported very low food security. After adjusting for food insecurity status, parents' and adolescents' fruit, vegetable, and sugar-sweetened beverage consumption was not associated. However, significant associations were observed between mothers' and adolescents' fast food intake (β = 0.52; p < 0.001), family meal intake (β = 0.52; p = 0.001), mindful eating (β = 0.51; p = 0.032), and binge eating (OR 8.05; p = 0.011). Discussion Parents may protect their adolescent children against food insecurity given the lower prevalence of food insecurity observed among adolescents. Interventions addressing food insecurity among mothers and adolescents may want to capitalize on shared eating patterns and address issues related to binge eating and leverage site-based strengths of public housing.



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Lifestyle predictors for non-participation and outcome in the second round of faecal immunochemical test in colorectal cancer screening

British Journal of Cancer

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Fewer US hospitals can care for children

Reuters Health News

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Incidence and predictors of adenoma after surgery for colorectal cancer

European Journal of Gastroenterology & Hepatology

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Vapors from hand sanitizers can expose preemies to ethanol

Reuters Health News

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A comprehensive pain assessment tool (COMPAT) for chronic pancreatitis: Development, face validation and pilot evaluation

Pancreatology

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Telemedicine for management of inflammatory bowel disease (myIBDcoach): A pragmatic, multicentre, randomised controlled trial

The Lancet

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On the potential of a short-term intensive intervention to interrupt HCV transmission in HIV-positive men who have sex with men: A mathematical modelling study

Journal of Viral Hepatitis

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Colorectal cancer screening at US community health centers: Examination of sociodemographic disparities and association with patient-provider communication

Cancer

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Can Quantitative Hepatitis B surface antigen levels predict the severity of liver disease in genotype E Patients?

Journal of Viral Hepatitis

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Long-term impact of the low-FODMAP diet on gastrointestinal symptoms, dietary intake, patient acceptability, and healthcare utilization in irritable bowel syndrome

Neurogastroenterology & Motility

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Proposal of selection criteria for operative resection of hepatocellular carcinoma with inferior vena cava tumor thrombus incorporating hepatic arterial infusion chemotherapy

Surgery

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Successful treatment of chronic hepatitis C infection with directly acting antivirals in renal transplant recipients

Nephrology

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Mother’s soda intake during pregnancy tied to child’s obesity risk

Reuters Health News

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Randomized comparison of 3 high-level disinfection and sterilization procedures for duodenoscopes

Gastroenterology

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Systematic review with meta-analysis: The efficacy of faecal microbiota transplantation for the treatment of recurrent and refractory Clostridium difficile infection

Alimentary Pharmacology and Therapeutics

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Hamburg-Glasgow classification: Preoperative staging by combination of disseminated tumour load and systemic inflammation in oesophageal carcinoma

British Journal of Cancer

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The frequency and risk factors of colorectal adenoma in patients with early gastric cancer

Internal Medicine Journal

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Incidence of and risk factors for pancreatic cancer in chronic pancreatitis: A cohort of 1,656 patients

Digestive and Liver Diseases

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Evidence of an abnormal epithelial barrier in active, untreated and corticosteroid-treated eosinophilic esophagitis

Allergy

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A systematic review of the effects of polyols on gastrointestinal health and irritable bowel syndrome

Advances in Nutrition: An International Review Journal

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