Δευτέρα, 23 Οκτωβρίου 2017

Songbird chemical signals reflect uropygial gland androgen sensitivity and predict aggression: implications for the role of the periphery in chemosignaling

Abstract

Chemical signals can provide useful information to potential mates and rivals. The production mechanisms of these signals are poorly understood in birds, despite emerging evidence that volatile compounds from preen oil may serve as chemosignals. Steroid hormones, including testosterone (T), may influence the production of these signals, yet variation in circulating T only partly accounts for this variation. We hypothesized that odor is a T-mediated signal of an individual's phenotype, regulated in part by androgen sensitivity in the uropygial gland. We quantified natural variation in chemosignals, T, uropygial gland androgen sensitivity, and aggressive behavior in dark-eyed juncos (Junco hyemalis). The interaction between circulating T and androgen receptor transcript abundance significantly correlated with volatile concentrations in male, but not female, preen oil. In both sexes, odorant variables correlated with aggressive response to an intruder. Our results suggest that preen oil volatiles could function as signals of aggressive intent, and, at least in males, may be regulated by local androgen receptor signaling in the uropygial gland. Because these behavioral and chemical traits have been linked with reproductive success, local regulation of androgen sensitivity in the periphery has the potential to be a target of selection in the evolution of avian olfactory signaling.



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World-wide distributions of lactase persistence alleles and the complex effects of recombination and selection

Abstract

The genetic trait of lactase persistence (LP) is associated with at least five independent functional single nucleotide variants in a regulatory region about 14 kb upstream of the lactase gene [−13910*T (rs4988235), −13907*G (rs41525747), −13915*G (rs41380347), −14009*G (rs869051967) and −14010*C (rs145946881)]. These alleles have been inferred to have spread recently and present-day frequencies have been attributed to positive selection for the ability of adult humans to digest lactose without risk of symptoms of lactose intolerance. One of the inferential approaches used to estimate the level of past selection has been to determine the extent of haplotype homozygosity (EHH) of the sequence surrounding the SNP of interest. We report here new data on the frequencies of the known LP alleles in the 'Old World' and their haplotype lineages. We examine and confirm EHH of each of the LP alleles in relation to their distinct lineages, but also show marked EHH for one of the older haplotypes that does not carry any of the five LP alleles. The region of EHH of this (B) haplotype exactly coincides with a region of suppressed recombination that is detectable in families as well as in population data, and the results show how such suppression may have exaggerated haplotype-based measures of past selection.



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Ivermectin and its target molecules: shared and unique modulation mechanisms of ion channels and receptors by ivermectin

Abstract

Ivermectin (IVM) is an antiparasitic drug that is used worldwide and rescues hundreds of millions of people from Onchocerciasis and lymphatic filariasis. It was discovered by Dr. Omura and Dr. Campbell, to whom the 2015 Nobel Prize in Physiology or Medicine was awarded. IVM kills parasites by activating glutamate-gated Cl channels, and it also targets several ligand-gated ion channels and receptors, including Cys-loop receptors, P2X4 receptors and fernesoid X receptors. Recently, we found that IVM also activates a novel target, the G-protein-gated inwardly rectifying K+ channel, and also identified the structural determinant for the activation. In this review, we aim to update and summarize the information from recent progress in the identification of IVM targets, as well as their modulation mechanisms, through molecular structures, chimeras and site-directed mutagenesis, and molecular docking and modelling studies.

This article is protected by copyright. All rights reserved



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Slow-metabolizing ADH1B and inactive heterozygous ALDH2 increase vulnerability to fatty liver in Japanese men with alcohol dependence

Abstract

Background

Genetic polymorphisms of alcohol dehydrogenase-1B (ADH1B; rs1229984, His48Arg) and aldehyde dehydrogenase-2 (ALDH2; rs671, Glu504Lys) affect body weight, body fat, and lipid metabolism in individuals with alcohol dependence, and the aim of this study was to identify their determinants in relation to the development of fatty liver.

Methods

We evaluated associations between the presence of fatty liver and ADH1B and ALDH2 genotypes and other factors in 1604 Japanese men who had been admitted for treatment of alcohol dependence.

Results

Fatty liver was diagnosed when ultrasonography showed both hepatorenal contrast and liver brightness. Age-adjusted usual alcohol intake did not differ according to ADH1B or ALDH2 genotypes. A multivariate analysis showed that the adjusted odds ratio (OR, 95% confidence interval) of slow-metabolizing ADH1B Arg/Arg carriers was 1.61 (1.27–2.03) for fatty liver and 1.82 (1.37–2.41) for fatty liver with deep attenuation in comparison with the ADH1B His/Arg or His/His carriers, and that the OR of inactive heterozygous ALDH2 Glu/Lys carriers was 1.43 (1.08–1.91) for fatty liver and 1.84 (1.31–2.59) for fatty liver with deep attenuation in comparison with the ALDH2 Glu/Glu carriers. Younger age, shorter interval between the last drink and the ultrasound examination, larger body mass index, and absence of cirrhosis were identified as other positive determinants for fatty liver.

Conclusions

The ADH1B Arg/Arg genotype and the ALDH2 Glu/Lys genotype were positive determinants of fatty liver in the subjects. These results suggest that slow ethanol and acetaldehyde metabolism accelerates the development of alcoholic fatty liver in heavy drinkers.



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Prospective evaluation of poly-4-hydroxybutyrate mesh in CDC class I/high-risk ventral and incisional hernia repair: 18-month follow-up

Abstract

Background

Long-term resorbable mesh represents a promising technology for complex ventral and incisional hernia repair (VIHR). Preclinical studies indicate that poly-4-hydroxybutyrate (P4HB) resorbable mesh supports strength restoration of the abdominal wall. This study evaluated outcomes of high-risk subjects undergoing VIHR with P4HB mesh.

Methods

This was a prospective, multi-institutional study of subjects undergoing retrorectus or onlay VIHR. Inclusion criteria were CDC Class I, defect 10–350 cm2, ≤ 3 prior repairs, and ≥ 1 high-risk criteria (obesity (BMI: 30–40 kg/m2), active smoker, COPD, diabetes, immunosuppression, coronary artery disease, chronic corticosteroid use, hypoalbuminemia, advanced age, and renal insufficiency). Physical exam and/or quality of life surveys were performed at regular intervals through 18 months (to date) with longer-term, 36-month follow-up ongoing.

Results

One hundred and twenty-one subjects (46M, 75F) with an age of 54.7 ± 12.0 years and BMI of 32.2 ± 4.5 kg/m2 (mean ± SD), underwent VIHR. Comorbidities included the following: obesity (n = 95, 78.5%), hypertension (n = 72, 59.5%), cardiovascular disease (n = 42, 34.7%), diabetes (n = 40, 33.1%), COPD (n = 34, 28.1%), malignancy (n = 30, 24.8%), active smoker (n = 28, 23.1%), immunosuppression (n = 10, 8.3%), chronic corticosteroid use (n = 6, 5.0%), advanced age (n = 6, 5.0%), hypoalbuminemia (n = 3, 2.5%), and renal insufficiency (n = 1, 0.8%). Hernia types included the following: primary ventral (n = 17, 14%), primary incisional (n = 54, 45%), recurrent ventral (n = 15, 12%), and recurrent incisional hernia (n = 35, 29%). Defect and mesh size were 115.7 ± 80.6 and 580.9 ± 216.1 cm2 (mean ± SD), respectively. Repair types included the following: retrorectus (n = 43, 36%), retrorectus with additional myofascial release (n = 45, 37%), onlay (n = 24, 20%), and onlay with additional myofascial release (n = 8, 7%). 95 (79%) subjects completed 18-month follow-up to date. Postoperative wound infection, seroma requiring intervention, and hernia recurrence occurred in 11 (9%), 7 (6%), and 11 (9%) subjects, respectively.

Conclusions

High-risk VIHR with P4HB mesh demonstrated positive outcomes and low incidence of hernia recurrence at 18 months. Longer-term 36-month follow-up is ongoing.



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What happens to biliary colic patients in New York State? 10-year follow-up from emergency department visits

Abstract

Introduction

Biliary colic is a common diagnosis for patients presenting to the emergency department (ED). The purpose of this study is to examine the outcomes of patients coming to the ED with biliary colic.

Methods

The NYS longitudinal SPARCS database was used to identify patients presenting to the ED with biliary colic from 2005 to 2014. Through the use of a unique identifier, patients were followed in NYS across multiple institutions. Patients who were lost to follow-up, with duplicated records, and those that underwent percutaneous cholecystectomy tubes were excluded from the analysis.

Results

Between 2005 and 2014, there were 72,376 patients who presented to an ED with biliary colic. The admission rate was 20.7–26.02%. Overall, most patients who presented to the ED did not undergo surgery (39,567, 54.7%), of which 35,204 (89%) had only one ED visit, while 4,363(11%) returned to the ED (≥ 2 visits). Only 3.23–5.51% of patients underwent cholecystectomy at the time of initial presentation. Most subsequent cholecystectomies were performed electively (27.38–52.51%) (See Table 1 in this article). Average time to surgery among patients with elective cholecystectomy was 178.4 days. From the patients who underwent cholecystectomy, 10.35% had cholecystectomy at their first ED visit, 77.7% had cholecystectomy following the first ED visit, and 12% had multiple ED visits prior to surgery. Among patients who were discharged from the ED, 32% had their surgery at a different hospital than index presentation.

Conclusion

A significant portion of patients (48.6%) who present to the ED with biliary colic will not return or have surgery within 5 years. A third of patients who eventually undergo cholecystectomy will go to another hospital for their surgery.



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Acute Effects of Dynamic Stretching on Muscle Flexibility and Performance: An Analysis of the Current Literature

Abstract

Stretching has long been used in many physical activities to increase range of motion (ROM) around a joint. Stretching also has other acute effects on the neuromuscular system. For instance, significant reductions in maximal voluntary strength, muscle power or evoked contractile properties have been recorded immediately after a single bout of static stretching, raising interest in other stretching modalities. Thus, the effects of dynamic stretching on subsequent muscular performance have been questioned. This review aimed to investigate performance and physiological alterations following dynamic stretching. There is a substantial amount of evidence pointing out the positive effects on ROM and subsequent performance (force, power, sprint and jump). The larger ROM would be mainly attributable to reduced stiffness of the muscle–tendon unit, while the improved muscular performance to temperature and potentiation-related mechanisms caused by the voluntary contraction associated with dynamic stretching. Therefore, if the goal of a warm-up is to increase joint ROM and to enhance muscle force and/or power, dynamic stretching seems to be a suitable alternative to static stretching. Nevertheless, numerous studies reporting no alteration or even performance impairment have highlighted possible mitigating factors (such as stretch duration, amplitude or velocity). Accordingly, ballistic stretching, a form of dynamic stretching with greater velocities, would be less beneficial than controlled dynamic stretching. Notwithstanding, the literature shows that inconsistent description of stretch procedures has been an important deterrent to reaching a clear consensus. In this review, we highlight the need for future studies reporting homogeneous, clearly described stretching protocols, and propose a clarified stretching terminology and methodology.



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Tho’ Much is Taken, Much Abides: Asylum Seekers’ Subjective Wellbeing

Abstract

The influence of psychosocial factors on the subjective wellbeing of asylum-seekers residing in host Western countries has scarcely been explored qualitatively. Qualitative data derived from a mixed methods prospective study investigated the subjective wellbeing of 56 community-dwelling asylum-seekers and refugees at baseline and an average of 15.7 months later. Positive and negative experiences over time were explored in relation to self-perceived emotional health. Nineteen positive and 15 negative categories of experience emerged. Distinct psychosocial and protective factors were salient regarding the valence of experiences over time, with positive experiences comprising employment, improved financial circumstances, and social support or connectivity. Negative experiences included news of adversity from one's homeland, un(der)employment, poor health, and factors relating to the refugee determination process. Positive and negative experiences were contemporaneous, indicating that employment and social support may ameliorate the detrimental impact of traversing the protracted process of refugee status determination for asylum-seekers in particular.



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Adiponectin is required for maintaining normal body temperature in a cold environment

Thermogenic impairment promotes obesity and insulin resistance. Adiponectin is an important regulator of energy homeostasis. While many beneficial metabolic effects of adiponectin resemble that of activated th...

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Tribute to Professor Dr. Abdel Moniem Tewfik Hussein

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Publication date: September 2017
Source:Arab Journal of Gastroenterology, Volume 18, Issue 3
Author(s): Sherif Mohamed Abdel Fattah




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Editorial Board

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Publication date: September 2017
Source:Arab Journal of Gastroenterology, Volume 18, Issue 3





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Nitrite administration improves sepsis-induced myocardial and mitochondrial dysfunction by modulating stress signal responses

Abstract

Purpose

A specific therapeutic strategy in sepsis-induced myocardial dysfunction remains to be determined. Nitrite may have cardioprotective effects against sepsis-induced myocardial dysfunction. This study investigated the cardioprotective effects of nitrite on myocardial function, mitochondrial bioenergetics, and its underlying molecular mechanisms in severe septic rats.

Methods

Sepsis was induced in male Wistar rats by cecal ligation and puncture (CLP). After CLP, we administered normal saline (NS group) or nitrite (nitrite group) subcutaneously. We administered nitrite at different doses (0.1–10 mg/kg) to ascertain the most effective dose and examined cardiac function in an isolated heart experiment 8 h after CLP. We investigated mitochondrial bioenergetics and molecular mechanisms underlying the administration of nitrite in vitro.

Results

In isolated heart experiments, the left ventricular developed pressure (96 ± 5 mmHg) at a moderate nitrite dose (1.0 mg/kg) was significantly higher than that in the NS group (75 ± 4 mmHg, P < 0.05). Mitochondrial oxidative phosphorylation in the nitrite group was significantly higher than that in the NS group (P < 0.01). Immunoblotting revealed that nitrite significantly increased the phosphorylation of Akt (P < 0.05) and reduced the nuclear translocation of NF-κB (P < 0.05) compared with the NS group. Nitrite was also shown to improve the rate of survival in severe septic rats (P < 0.001).

Conclusions

Our results showed that a moderate nitrite dose improved septic myocardial dysfunction at organ, cellular, and molecular levels via modulation of stress signal responses, which resulted in an improvement in survival.



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Transmissible Plasmids and Integrons Shift Escherichia coli Population Toward Larger Multiple Drug Resistance Numbers

Microbial Drug Resistance , Vol. 0, No. 0.


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Emergence of Daptomycin-Nonsusceptible Methicillin-Resistant Staphylococcus aureus Clinical Isolates Among Daptomycin-Naive Patients in Korea

Microbial Drug Resistance , Vol. 0, No. 0.


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Vancomycin-Resistant Enterococci: A Review of Antimicrobial Resistance Mechanisms and Perspectives of Human and Animal Health

Microbial Drug Resistance , Vol. 0, No. 0.


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Prevalence and Molecular Characterization of New Delhi Metallo-Beta-Lactamases in Multidrug-Resistant Pseudomonas aeruginosa and Acinetobacter baumannii from India

Microbial Drug Resistance , Vol. 0, No. 0.


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Mycobacterium tuberculosis of the Beijing Genotype in Iran and the WHO Eastern Mediterranean Region: A Meta-Analysis

Microbial Drug Resistance , Vol. 0, No. 0.


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Transient Hypokalemic Quadriplegia Following a Lumbar Transforaminal Epidural Dexamethasone Injection: A Case Report

A 30-year-old male with no significant past medical history presented with hypokalemic quadriplegia four hours after he received a lumbar transforaminal epidural steroid injection (TFESI) containing dexamethasone and lidocaine. A comprehensive work up ruled out acquired and hereditary causes of hypokalemic paralysis. Symptoms gradually resolved within hours after potassium restoration with no residual neurologic deficits. Paralysis after TFESI is uncommon, but has been associated with particulate steroids that can coalesce into aggregates and occlude vessels.

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An Unusual Cause of Myelopathy: Ochronotic Spondyloarthropathy With Positive HLA B27

imageAbstract: Ochronosis is a late developing complication of alkaptonuria, a black brownish pigment in the fibrous and cartilaginous tissues. Although most previous studies reported alkaptonuria and back pain due to ochronosis, thoracic myelopathy is an extremely rare complication. In this report, a paraparetic patient who has ochronotic spondiloarthropathy with the presence of HLA B27 antigen is described. He had low back and leg pain and morning stiffness for 5 yrs. Last year, these were followed by tingling, numbness, and weakness the in lower extremities and he was operated on with preliminary diagnosis of prolapsed disc herniation and cord compression. Surgery is suggested for disc herniations related to ochronotic spondyloarthropathy if it is necessary or neurologic symptoms are present. However, his pain and weakness have partially recovered after the operation. After medical and physical treatment, he showed clinically significant improvements. This case report demonstrates that the management of ochronosis needs a multidisciplinary approach with physiologic, neurologic, and psychologic effects and proper treatment may significantly improve functional outcomes in these patients.

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Effect of Land-Based Generic Physical Activity Interventions on Pain, Physical Function, and Physical Performance in Hip and Knee Osteoarthritis: A Systematic Review and Meta-Analysis

imageObjective: The aim of this study was to evaluate the effects of land-based generic physical activity interventions on pain, physical function, and physical performance in individuals with hip/knee osteoarthritis, when compared with a control group that received no intervention, minimal intervention, or usual care. Methods: A systematic search for randomized controlled trials on 11 electronic databases (from their inception up until April 30, 2016) identified 27 relevant articles. According to the compendium of physical activities, interventions were categorized into: recreational activities (tai chi/Baduajin—6 articles), walking (9 articles), and conditioning exercise (12 articles). Results: Meta-analysis for recreational activity (n = 3) demonstrated significant mean difference (MD) of −9.56 (95% confidence interval [CI], −13.95 to −5.17) for physical function (Western Ontario and McMaster Universities Arthritis Index) at 3 mos from randomization. Pooled estimate for walking intervention was not significant for pain intensity and physical performance but was significant for physical function (n = 2) with a MD of −10.38 (95% CI, −12.27 to −8.48) at 6 mos. Meta-analysis for conditioning exercise was significant for physical function (n = 3) with a MD of −3.74 (95% CI, −5.70 to −1.78) and physical performance (6-minute walk test) with a MD of 42.72 m (95% CI, 27.78, 57.66) at 6 mos. The timed stair-climbing test (n = 2) demonstrated a significant effect at 18 mos with a MD of −0.49 secs (95% CI, −0.75 to −0.23). Conclusion: Very limited evidence to support recreational activity and walking intervention was found for knee osteoarthritis, in the short-term on pain and physical function, respectively.

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Precise Target Site of Ultrasound-Guided C5 Cervical Root Block

imageNo abstract available

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Efficacy of Platelet-Rich Plasma in Pain and Self-Report Function in Knee Osteoarthritis: A Best-Evidence Synthesis

imageObjective: The aim of this study was to assess the efficacy of platelet-rich plasma (PRP) in pain and self-report function of patients with knee osteoarthritis on the basis of comparisons with hyaluronic acid or placebo. Design: Best-evidence synthesis of randomized controlled trials (RCTs) was conducted. Literature retrieval was limited to RCTs assessing the efficacy of PRP in knee osteoarthritis. Methodology evaluation and data extraction were based on Cochrane Collaboration guidelines. Meta-analyses were performed using mean difference or standardized mean difference as effect size. Results: Ten RCTs were included and analyzed. Meta-analysis showed significant superiority of PRP in outcome scores when compared with hyaluronic acid (standardized mean difference = −0.85, P = 0.004, I2 = 93%), but no statistical difference was found in well-designed double-blind trials (standardized mean difference = −0.09, P = 0.38, I2 = 0%). Pooled standardized mean difference of trials comparing PRP with placebo directly was −2.13 (95% confidence interval = −3.29 to −0.98), and that of indirect comparison was −0.22 (95% confidence interval = −0.45 to −0.01). Conclusions: In relieving pain and improving self-report function, PRP showed no superiority over hyaluronic acid in well-designed double-blind trials, and beneficial effects of PRP in most trials probably resulted from insufficient blinding methods. However, PRP is still considered more effective than placebo on the basis of present evidence.

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Effects of the Integration of Dynamic Weight Shifting Training Into Treadmill Training on Walking Function of Children with Cerebral Palsy: A Randomized Controlled Study

imageObjective: The aim of the study was to determine whether applying an assistance force to the pelvis and legs during treadmill training can improve walking function in children with cerebral palsy. Design: Twenty-three children with cerebral palsy were randomly assigned to the robotic or treadmill only group. For participants who were assigned to the robotic group, a controlled force was applied to the pelvis and legs during treadmill walking. For participants who were assigned to the treadmill only group, manual assistance was provided as needed. Each participant trained 3 times/wk for 6 wks. Outcome measures included walking speed, 6-min walking distance, and clinical assessment of motor function, which were evaluated before, after training, and 8 wks after the end of training, and were compared between two groups. Results: Significant increases in walking speed and 6-min walking distance were observed after robotic training (P = 0.03), but no significant change was observed after treadmill training only. A greater increase in 6-min walking distance was observed after robotic training than that after treadmill only training (P = 0.01). Conclusions: Applying a controlled force to the pelvis and legs, for facilitating weight-shift and leg swing, respectively, during treadmill training may improve walking speed and endurance in children with cerebral palsy. To Claim CME Credits: Complete the self-assessment activity and evaluation online at http://ift.tt/1l80W45 CME Objectives: Upon completion of this article, the reader should be able to: (1) discuss the importance of physical activity at the participation level (sports programs) for children with cerebral palsy; (2) contrast the changes in walking ability and endurance for children in GMFCS level I, II and III following sports programs; and (3) identify the impact of higher frequency of sports program attendance over time on walking ability. Level: Advanced Accreditation: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

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Treadmill Walking Combined With Anodal Transcranial Direct Current Stimulation in Parkinson Disease: A Pilot Study of Kinematic and Neurophysiological Effects

imageObjective: We tested the hypothesis that combining treadmill walking with transcranial direct current stimulation (tDCS) enhances the gait improvements associated with treadmill walking in Parkinson disease. We explored the effects of these combined methodologies on corticospinal parameters. Design: Eighteen participants with Parkinson disease were evaluated under the following three conditions: treadmill walking alone (treadmill), treadmill walking combined with anodal tDCS (AtDCS+treadmill) delivered over the motor cortex, and treadmill walking combined with sham stimulation (StDCS+treadmill). Overground walking performance, soleus H-reflex, reciprocal Ia inhibition from the tibialis anterior to the soleus muscle, intracortical facilitation, and short intracortical inhibition of the tibialis anterior muscle, were measured before and after each treadmill condition. The soleus H-reflex and walking performance on the treadmill were also evaluated. Results: All treadmill conditions improved walking performance and modulated spinal and corticospinal parameters in a similar way. However, AtDCS+treadmill lead to a different modulation of reciprocal Ia inhibition in comparison with the other treadmill conditions. Conclusions: A single session combining treadmill walking and anodal tDCS delivered over the motor cortex resulted in a specific modulation of the reciprocal Ia inhibition from the tibialis anterior to the soleus muscle. However, this acute effect did not result in improvements of gait parameters associated with treadmill walking in Parkinson disease.

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Gastrointestinal Hemorrhage Related to Fluoxetine in a Patient With Stroke

Abstract: We report on a patient who developed massive gastrointestinal hemorrhage related to the use of fluoxetine in combination with aspirin and clopidogrel. A 58-year-old man was admitted with a posterior circulation infarct with significant weakness in all four limbs and dysarthria. Aspirin and clopidogrel were started. Fluoxetine was started for pharmacological neurostimulation to promote motor recovery and for low mood. He developed gastrointestinal hemorrhage a week after fluoxetine was started. Fluoxetine was suspended and investigations failed to reveal the source of the bleeding. He was then restarted on fluoxetine along with dual antiplatelets, and gastrointestinal hemorrhage recurred after 1 week. He was extensively investigated for a source of gastrointestinal hemorrhage, and again no source could be identified. Eventually, fluoxetine was switched to mirtazapine with no further gastrointestinal hemorrhage. He remained on dual antiplatelets. A number of case–control and cohort studies had identified the association of gastrointestinal hemorrhage with the use of selective serotonin reuptake inhibitor (SSRI). We hope to raise awareness of this association in physical medicine and rehabilitation physicians as the use of SSRI is expected to rise.

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Effects of Antigravity Treadmill Training on Gait, Balance, and Fall Risk in Children With Diplegic Cerebral Palsy

imageObjective: The aim of this study was to investigate the effects of antigravity treadmill training on gait, balance, and fall risk in children with diplegic cerebral palsy. Design: Thirty children with diplegic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received antigravity treadmill training (20 mins/d, 3 d/wk) together with traditional physical therapy for 3 successive mos and (2) a control group that received only traditional physical therapy program for the same period. Outcomes included selected gait parameters, postural stability, and fall risk. Outcomes were measured at baseline and after 3 mos of intervention. Results: Children in both groups showed significant improvements in the mean values of all measured variables (P

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Atypical Fatty Infiltration in a Below-Knee Amputation

imageNo abstract available

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A Systematic Review of Comorbidity Measurement Methods for Patients With Nontraumatic Brain Injury in Inpatient Rehabilitation Settings

imageAbstract: This review summarizes comorbidity measurements used on patients with nontraumatic brain injury in inpatient rehabilitation and describes findings on measurement validation and comorbidity profiles. MEDLINE and MEDLINE In-Process, EMBASE, PsycINFO, the Cochrane Database of Systematic Reviews, Health, and Psychosocial Measurement Instruments were searched. Two reviewers screened results according to predefined inclusion and exclusion criteria. Population, statistical methods, comorbidity measurement, justification of its use, and results involving comorbidity were extracted using a standard table. Of 9476 articles retrieved, 16 were included. Comorbidity has been measured using various methods including the following: number and type within various classification systems, such as the International Disease Classification system, the Charlson comorbidity index, Centers for Medicare and Medicaid Services comorbidity tiers and patient comorbidity and complexity level values and subsets of diagnoses within nonadministrative data studies. No studies have assessed the predictive ability of the comorbidity measurements for inpatient rehabilitation outcomes in this population. Because comorbidities are common among the nontraumatic brain injury population, the predictive validity of comorbidity measurements should be assessed to determine the most appropriate measure to predict or risk adjust rehabilitation outcomes, which has implications for the development of clinical guidelines, and to inform health service research, planning, and delivery.

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Transcutaneous Electrical Nerve Stimulation for Spasticity

No abstract available

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Muscle Strength, But Not Muscle Oxidative Capacity, Varies Between the Morning and the Afternoon in Patients with Multiple Sclerosis: A Pilot Study

imageAbstract: Despite frequent muscle strength or muscle oxidative capacity (based on exercise-onset oxygen uptake [VO2] kinetics) assessments in patients with multiple sclerosis, the impact of time of day on these parameters is often not taken into account. Based on observations in healthy subjects, it remains to be studied whether muscle strength, and/or exercise-onset VO2 kinetics, varies between the morning and the afternoon in patients with multiple sclerosis. In this prospective observational pilot study, walking capacity, exercise-onset VO2 kinetics, isometric knee extension/flexion strength (dynamometry), and self-reported fatigue were measured in 11 patients with multiple sclerosis (age, 51.8 ± 9.3 yrs; body mass index, 24.7 ± 5.1 kg/m2; Expanded Disability Status Scale, 3.5 ± 1.4; 3 men) in the morning and 5 hrs later (afternoon). In the afternoon, self-reported fatigue (1.9 ± 0.9 cm) and muscle strength (knee extension peak torque at 45 degrees, 84 ± 26 Nm) were significantly different (P 0.05). Consistent with observations in healthy subjects, muscle strength varies between the morning and the afternoon in patients with multiple sclerosis, under the conditions of the present study. These findings suggest that muscle strength assessments should be conducted at similar or nearly similar times of the day to minimize diurnal variation in these measures and hence insure correct interpretation.

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Ultrasound-Guided Injection to the Fifth Cervical Spinal Nerve Root Level

No abstract available

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Effects of Exercise on the Immune Function of Pediatric Patients With Solid Tumors: Insights From the PAPEC Randomized Trial

imageAbstract: The purpose of this study was to assess the effects of an in-hospital exercise intervention during neoadjuvant chemotherapy on the inflammatory profile and immune cell subpopulation in 20 children with solid tumors (control [n = 11] and exercise group [n = 9]). Although no significant interaction (group × time) effect was found with an analysis of variance test, we found a trend toward an interaction effect for natural killer cells expressing the immunoglobulin-like receptor KIR2DS4, with their numbers remaining stable in the exercise group but increasing in controls. Our data support that exercise interventions are safe in pediatric cancer patients with solid tumors during chemotherapy treatment despite its aggressive, immunosuppressive nature.

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A Rare Complete Metacarpal Pseudoepiphysis in a Teenager With a Scaphoid Fracture

imageAbstract: A 13-yr-old adolescent boy presented with wrist pain after falling off a scooter onto his outstretched hand. Radiographs revealed a nondisplaced hairline fracture of the scaphoid bone and an irregular radiolucent line in the proximal metaphysis of the second metacarpal bone, consistent with an anomalous growth plate, or complete pseudoepiphysis. Complete pseudoepiphysis is a rare finding, with only a few cases reported. Learning about the common locations of growth plates and the radiographic differences between normal, injured, and anomalous growth plates can help decrease physician error and improve patient outcomes.

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Feasibility and Neurobehavioral Changes of 10-Day Simulated Microgravity in Acute Ischemic Stroke Patients

imageObjective: The aim of the study was to investigate feasibility and functional changes of simulated microgravity with 6-degree head-down-tilt (HDT) bed rest in acute ischemic stroke. Design: Patients without lesions in the cingulate cortex and/or cerebellum were enrolled. They underwent HDT for 30 minutes twice per day for 10 weekdays. Systolic blood pressure, diastolic blood pressure, and heart rate were measured before the HDT, immediately after, and also 30 minutes after the stop. Mini-Mental State Examination, Geriatric Depression Scale, Neurobehavioral Tests (i.e., span test, finger-tapping test, continuous performance test, and trail-making test) were conducted before and after the 10-day HDT. Results: One male and four female patients (median age = 64.6 yrs [SD = 10.5 yrs]) were recruited. Changes in the finger-tapping test (57.80 [SD = 40.96 ] vs. 85.80 [SD = 0.46], P = 0.08) and in the digit span backward test (3.60 [SD = 1.14] vs. 1.42 [SD = 1.75], P = 0.07) were noticed. Few changes were found in other scales. No significant changes in systolic blood pressure, diastolic blood pressure, or heart rate were observed, and no adverse effects occurred. Conclusions: The 6-degree HDT revealed no adverse effects on the cardiovascular system, showing nonsignificant increment in the finger-tapping test (representative of motor speed and performance) and nonsignificant reduction in the digit backward span test (representative of spatial memory).

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Sacral Insufficiency Fracture in an Elderly Woman With Hip Pain

imageNo abstract available

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Stories of an Emigrant Physician: What It Has Been Like to Practice in Canada Compared With the United States

imageNo abstract available

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Bilateral Patellar Tendon Tears After a Fall From Standing Position

imageNo abstract available

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Vertebral body spread in thoracolumbar burst fractures can predict posterior construct failure

The Load Sharing Classification (LSC) laid foundations for a scoring system able to indicate which thoracolumbar fractures, after short-segment posterior-only fixations, would need for longer instrumentations or additional anterior supports.

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Neuroprotective assessment of prolonged local hypothermia post-contusive spinal cord injury in rodent model

While general hypothermia is recognised as a clinically applicable neuroprotective intervention, acute moderate local hypothermia post-contusive Spinal Cord Injury (SCI) is being considered a more effective approach. Previously, we have investigated the feasibility and safety of inducing prolonged local hypothermia in the Central Nervous System of rodent model.

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Comparison of three-dimensional helical axes of the cervical spine between in vitro and in vivo testing

The range of motion is a well-accepted parameter for the assessment and evaluation of cervical motion. However, more qualitative data of the kinematics of the cervical spine is needed for the development and success of cervical disc arthroplasty [1].

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Augmented Reality for Evaluation of Spinal Deformity and Spinal Pathologies

BACKGROUND CONTEXT: Management of complex deformities is one of the most challenging clinical scenarios in spinal surgery. Designing a robust, patient-centered surgical plan requires detailed understanding of the anatomy in each case. As such, radiographic imaging is essential in appropriate surgical planning. Despite the advent of cross-sectional imaging platforms clinicians are forced to extrapolate the three-dimensional geometry of the human spine from two-dimensional axial, coronal and sagittal images, limiting the ability for the surgeon to understand the visuospatial nuances of the pathology in three dimensions.

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Prediction of sub-surface 37Ar concentrations at locations in the Northwestern United States

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Publication date: January 2018
Source:Journal of Environmental Radioactivity, Volume 181
Author(s): Bradley G. Fritz, Craig E. Aalseth, Henning O. Back, James C. Hayes, Paul H. Humble, Pavlo Ivanusa, Emily K. Mace
The Comprehensive Nuclear-Test-Ban Treaty, which is intended to prevent nuclear weapon test explosions and any other nuclear explosions, includes a verification regime, which provides monitoring to identify potential nuclear explosions. The presence of elevated 37Ar is one way to identify subsurface nuclear explosive testing. However, the naturally occurring formation of 37Ar in the subsurface adds a complicating factor. Prediction of the naturally occurring concentration of 37Ar can help to determine if a measured 37Ar concentration is elevated relative to background. The naturally occurring 37Ar background concentration has been shown to vary between less than 1 mBq/m3 to greater than 100 mBq/m3 (Riedmann and Purtschert, 2011). The purpose of this work was to enhance the understanding of the naturally occurring background concentrations of 37Ar, allowing for better interpretation of results. To that end, we present and evaluate a computationally efficient model for predicting the average concentration of 37Ar at any depth under transient barometric pressures. Further, measurements of 37Ar concentrations in samples collected at multiple locations are provided as validation of the concentration prediction model. The model is shown to compare favorably with concentrations of 37Ar measured at multiple locations in the Northwestern United States.



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Private vs. public ambulance services: What's the difference?

In the fire service, the career versus volunteer battle is a never-ending debate. And, in a similar vein, the discussion of private versus public ambulance services is often met with animosity. In Costa Mesa, Calif., city officials voted against a public-private model, stating that they wanted to maintain the city's current ambulance transportation service. The plan would have assigned ambulance ...

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Autoimmune Hepatitis and AIH Overlap with Sclerosing Cholangitis: Immunophenotype Markers in Children and Adolescents.

Objective: The pathophysiology of autoimmune hepatitis (AIH) may involve the activation of immune cells and changes in the expression of cellular markers. The aim of this study was to characterize the immunophenotype markers of lymphocytes and monocytes in the peripheral blood of children and adolescents with type 1 AIH and AIH overlap with sclerosing cholangitis (overlap syndrome, OS). Methods: This is a cross-sectional study of 20 children and adolescents diagnosed with type 1 AIH and 19 with OS. Fifteen healthy subjects were included as controls. Flow cytometric analysis was used to identify markers of inflammation and autoimmunity. Results: The total number of CD4+T cells was higher in the AIH patients compared with the controls. The number of CD4+T cells expressing CCR3 and CD28 was higher in the AIH group than in the control group. CD45RO was more highly expressed in the AIH group, while CD45RA was more highly expressed in the OS group. In regard to CD8+T lymphocytes, the CCR3 expression was higher in both groups of patients. Patients with OS had the highest expression of CD45RA and CD25. In monocytes, HLA-DR was less expressed in both groups of patients. Conclusion: Complex phenotype features may be involved in the pathophysiology of autoimmune hepatitis, accounting for changes in immune system regulation mechanisms. In conclusion, even after good response to treatment, patients still have immune activity signals at the cellular level. (C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Neuromuscular Electrical Stimulation Superimposed on Movement Early after ACL Surgery.

Purpose: Quadriceps weakness and asymmetrical loading of lower limbs are two major issues following anterior cruciate ligament reconstruction (ACLR). The aim of this study was to evaluate the effectiveness of a 6-week training protocol involving neuromuscular electrical stimulations (NMES) of the quadriceps muscle superimposed on repeated sit-to-stand-to-sit exercises (STSTS), as an additional treatment to standard rehabilitation, from the 15th to the 60th day following ACLR. Methods: Sixty-three ACLR patients were randomly allocated to one of the three treatment groups: NMES superimposed on STSTS (NMES+STSTS), STSTS only, or no additional treatment (NAT) to standard rehabilitation. Maximal isometric strength of knee extensor and flexor muscles was measured 60 and 180 days after surgery. Asymmetry in lower extremity loading was measured during a sit-to-stand movement at 15, 30, 60 and 180 days after surgery and during a countermovement jump 180 days after surgery by means of two adjacent force platforms placed under each foot. Results: The NMES+STSTS participants showed higher muscle strength of the knee extensors, which was accompanied by lower perception of pain, and higher symmetry in lower extremity loading compared to STSTS-only and NAT participants after both 60 and 180 days from surgery. Participants in the STSTS-only treatment group showed higher symmetry in lower extremity loading compared to those in the NAT group 60 days post-surgery. Conclusion: These results suggest that an early intervention based on NMES superimposed to repeated STSTS exercises is effective for recovering quadriceps strength and symmetry in lower extremity loading by the time of return to sport. (C) 2017 American College of Sports Medicine

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Sensor-enabled Activity Class Recognition in Preschoolers: Hip versus Wrist Data.

Purpose: Pattern recognition approaches to accelerometer data processing have emerged as viable alternatives to cut-point methods. However, few studies have explored the validity of pattern recognition approaches in pre-schoolers; and none have compared supervised learning algorithms trained on hip and wrist data. To develop, test, and compare activity class recognition algorithms trained on hip, wrist, and combined hip and wrist accelerometer data in pre-schoolers. Methods: 11 children aged 3 - 6 y (mean age 4.8 +/- 0.9 y) completed 12 developmentally appropriate PA trials while wearing an ActiGraph GT3X+ accelerometer on the right hip and non-dominant wrist. PA trials were categorised as sedentary (SED), light activity games (LG), moderate-to-vigorous games (MVG), walking (WA), and running (RU). Random forest (RF) and support vector machine (SVM) classifiers were trained using time and frequency domain features from the vector magnitude of the raw signal. Features were extracted from 15 s non-overlapping windows. Classifier performance was evaluated using leave-one-out-cross-validation. Results: Cross-validation accuracy for the hip, wrist, and combine hip and wrist RF models was 0.80 (95% CI:0.79 - 0.82), 0.78 (95% CI:0.77-0.80), 0.82 (95% CI:0.80 - 0.83), respectively. Accuracy for Hact, Wact, and HWact SVM models was 0.81 (95% CI:0.80 - 0.83), 0.80 (95% CI:0.79-0.80), 0.85 (95% CI:0.84 - 0.86), respectively. Recognition accuracy was consistently excellent for SED (> 90%), moderate for LG, MVG, and RU (69-79%), and modest for WA (61-71%). Conclusions: Machine learning algorithms such as RF and SVM are useful for predicting PA class from accelerometer data collected in preschool children. While classifiers trained on hip or wrist data provided acceptable recognition accuracy, the combination of hip and wrist accelerometer delivered better performance. (C) 2017 American College of Sports Medicine

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Active shooter response: Equip your team to save more lives

Download this free e-book to learn what training and supplies you need to prepare for a successful response to a mass casualty incident

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Efficacy of Armeo(R) Robotic Therapy versus Conventional Therapy on Upper Extremity Function in Children with Hemiplegic Cerebral Palsy.

Objective: The aim of this study was to examine the efficacy of Armeo(R) robotic therapy, compared to conventional therapy, on upper extremity function in children with hemiplegic cerebral palsy. Design: Thirty children with hemiplegic cerebral palsy, with ages ranging from 6 to 8 years, were selected for this randomized controlled study and randomly assigned to two groups. The study group (n=15) received 12 weeks of Armeo robotic therapy (45 min/session, 3 days/week) and the control group (n=15) received conventional therapy for the same time period. The measured outcomes were the Modified Ashworth Scale (MAS) and the Quality of Upper Extremity Skills Test (QUEST), measured at baseline and after 12 weeks of intervention. Results: Children in the study group showed significant improvement in the mean values of all the measured variables, compared to those in the control group (P

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EMS Field Coordinator - Idaho Department of Health and Welfare

Join a team that keeps Idahoans safe! The Idaho Department of Health and Welfare's Bureau of Emergency Medical Services (EMS) and Preparedness is accepting applications for EMS Field Coordinator and EMS Field Consultant openings. These full-time positions are located in Boise, Idaho. As an EMS Field Consultant or Coordinator, you'll provide leadership, training, and technical assistance ...

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Skeletal muscle mechanics, energetics and plasticity

The following papers by Richard Lieber (Skeletal Muscle as an Actuator), Thomas Roberts (Elastic Mechanisms and Muscle Function), Silvia Blemker (Skeletal Muscle has a Mind of its Own: a Computational Framewor...

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Androgen receptors and muscle: a key mechanism underlying life history trade-offs

Abstract

Sexual dimorphism in skeletal muscle is prominent in mammals, with males typically having larger and stronger muscles than females. Furthermore, neuromuscular systems with sexual functions are remarkably sexually dimorphic in a wide variety of vertebrates. Endocrine mechanisms are of central importance for sexual differentiation of these traits, and anabolic actions of gonadal testosterone have been intensively studied. Here we review the relationship between androgen receptor (AR) and sexual differentiation of neuromuscular systems. We focus our review on the hypotheses that sexual dimorphism and androgen responsiveness of neuromuscular systems is a function of the amount of AR expressed by muscle and that AR in muscle is a key mechanism on which evolution acts to shape individual and species differences in reproductive behavior.



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