Παρασκευή, 16 Μαρτίου 2018

Samsum Ant Venom Exerts Anticancer Activity Through Immunomodulation In Vitro and In Vivo

Cancer Biotherapy and Radiopharmaceuticals, Volume 33, Issue 2, Page 65-73, March 2018.


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Current and Future Approaches for Effective Cancer Imaging and Treatment

Cancer Biotherapy and Radiopharmaceuticals, Volume 33, Issue 2, Page 39-51, March 2018.


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PTPN12 Affects Nasopharyngeal Carcinoma Cell Proliferation and Migration Through Regulating EGFR

Cancer Biotherapy and Radiopharmaceuticals, Volume 33, Issue 2, Page 60-64, March 2018.


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64Cu-Labeled Phosphonate Cross-Bridged Chelator Conjugates of c(RGDyK) for PET/CT Imaging of Osteolytic Bone Metastases

Cancer Biotherapy and Radiopharmaceuticals, Volume 33, Issue 2, Page 74-83, March 2018.


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Samsum Ant Venom Exerts Anticancer Activity Through Immunomodulation In Vitro and In Vivo

Cancer Biotherapy and Radiopharmaceuticals, Volume 33, Issue 2, Page 65-73, March 2018.


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Current and Future Approaches for Effective Cancer Imaging and Treatment

Cancer Biotherapy and Radiopharmaceuticals, Volume 33, Issue 2, Page 39-51, March 2018.


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PTPN12 Affects Nasopharyngeal Carcinoma Cell Proliferation and Migration Through Regulating EGFR

Cancer Biotherapy and Radiopharmaceuticals, Volume 33, Issue 2, Page 60-64, March 2018.


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64Cu-Labeled Phosphonate Cross-Bridged Chelator Conjugates of c(RGDyK) for PET/CT Imaging of Osteolytic Bone Metastases

Cancer Biotherapy and Radiopharmaceuticals, Volume 33, Issue 2, Page 74-83, March 2018.


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Is There a Moore's Law for 3D Printing?

3D Printing and Additive Manufacturing, Volume 5, Issue 1, Page 53-62, March 2018.


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A Conversation with Marcelo Coelho, Head of Design at Formlabs

3D Printing and Additive Manufacturing, Volume 5, Issue 1, Page 1-3, March 2018.


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Production Techniques for 3D Printed Inflatable Elastomer Structures: Part I—Fabricating Air-Permeable Forms and Coating with Inflatable Silicone Membranes via Spray Deposition

3D Printing and Additive Manufacturing, Volume 5, Issue 1, Page 5-16, March 2018.


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Additive Manufacturing with Ultraviolet Curable Silicones Containing Carbon Black

3D Printing and Additive Manufacturing, Volume 5, Issue 1, Page 73-86, March 2018.


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Production Techniques for 3D Printed Inflatable Elastomer Structures: Part II—Four-Axis Direct Ink Writing on Irregular Double-Curved and Inflatable Surfaces

3D Printing and Additive Manufacturing, Volume 5, Issue 1, Page 17-28, March 2018.


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3D Printed Composites of Copper–Aluminum Oxides

3D Printing and Additive Manufacturing, Volume 5, Issue 1, Page 46-52, March 2018.


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Three-Dimensional Printing Antimicrobial and Radiopaque Constructs

3D Printing and Additive Manufacturing, Volume 5, Issue 1, Page 29-36, March 2018.


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3D-Printed Acrylonitrile Butadiene Styrene-Metal Organic Framework Composite Materials and Their Gas Storage Properties

3D Printing and Additive Manufacturing, Volume 5, Issue 1, Page 63-72, March 2018.


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The Value of 3D Printed Models in Understanding Acetabular Fractures

3D Printing and Additive Manufacturing, Volume 5, Issue 1, Page 37-46, March 2018.


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Neuroanesthesiology Update

imageWe provide a synopsis of innovative research, recurring themes, and novel experimental findings pertinent to the care of neurosurgical patients and critically ill patients with neurological diseases. We cover the following broad topics: general neurosurgery, spine surgery, stroke, traumatic brain injury, monitoring, and anesthetic neurotoxicity.

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Yet Another Absolute Indication for Rapid Sequence Intubation

No abstract available

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The ASA Committee for Neuroanesthesia and Anesthesia Quality Institute: Report for Demographic Patterns for Neurosurgical Anesthesia Practice in the United States

imageNo abstract available

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Neuroanesthesia

No abstract available

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Dexmedetomidine Reduces Perioperative Opioid Consumption and Postoperative Pain Intensity in Neurosurgery: A Meta-analysis

imageBackground: Dexmedetomidine (DEX) has been administered to patients during neurosurgery. Some studies have found that DEX could reduce perioperative opioid consumption and postoperative pain intensity. However, no firm conclusions have been reached. The purpose of this meta-analysis was to assess the efficacy of DEX for managing pain in neurosurgical patients. Materials and Methods: A comprehensive literature review was conducted to identify randomized controlled trials (RCTs) focusing on the effects of DEX on perioperative opioid consumption and postoperative pain intensity in patients undergoing neurosurgery. PubMed, the Web of science, the Cochrane Library, and Scopus were searched. The resulting data were combined to calculate the pooled mean differences (MDs), standard MDs or odds ratios (ORs), and 95% confidence intervals (CIs), as appropriate. Heterogeneity and potential publication bias were assessed. Furthermore, a trial sequential analysis was performed to improve the precision of our findings. Results: A total of 11 published RCTs involving 674 patients undergoing neurosurgery (335 patients, 339 controls) were included in this meta-analysis. There were significant differences in postanesthesia care unit (PACU) visual analog scale scores between the groups (MD=−1.54, 95% CI, −2.33 to 0.75, I2=87%, P=0.0001). In addition, there were significant differences in PACU opioid requirements between the treatment and control groups (standard MD=−0.88, 95% CI, −1.74 to 0.02, I2=91%, P=0.05). Furthermore, intraoperative opioid consumption was significantly reduced in the treatment group (MD=−127.75, 95% CI, −208.62 to 46.89, I2=98%, P=0.002). Conclusions: DEX could reduce perioperative and PACU opioid consumption as well as postoperative pain intensity.

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Patient, Surgeon, and Anesthesiologist Satisfaction: Who has the Priority?

imageNo abstract available

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Injury and Liability Associated With Spine Surgery

imageBackground: Although spine surgery is associated with significant morbidity, the anesthesia liability profile for spine surgery is not known. We examined claims for spine procedures in the Anesthesia Closed Claims Project database to evaluate patterns of injury and liability. Materials and Methods: A retrospective cohort study was performed. Inclusion criteria were anesthesia claims provided for surgical procedures in 2000 to 2014. We compared mechanisms of injury for cervical spine to thoracic or lumbar spine procedures using χ2 and the Fisher exact test. Univariate and multivariate logistic regression analyses were used to determine factors associated with permanent disabling injury in spine surgery claims. Results: The 207 spine procedure (73% thoracic/lumbar; 27% cervical) claims comprised >10% of claims. Permanent disabling injuries to nerves, the spinal cord, and the eyes or visual pathways were more common with spine procedures than in nonspine procedures. Hemorrhage and positioning injuries were more common in thoracic/lumbar spine claims, whereas difficult intubation was more common in cervical spine claims. Multiple logistic regression demonstrated prone positioning (odds ratio=3.50; 95% confidence interval, 1.30-9.43) and surgical duration of ≥4 hours increased the odds of severe permanent injury in spine claims (odds ratio=2.73; 95% confidence interval, 1.11-6.72). Conclusions: Anesthesia claims related to spine surgery were associated with severe permanent disability primarily from nerve and eye injuries. Prone positioning and surgical duration of ≥4 hours were associated with permanent disabling injuries. Attention to positioning, resuscitation during blood loss, and reducing length of surgery may reduce these complications.

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Editorial

No abstract available

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Effects of Hypertonic Saline and Sodium Lactate on Cortical Cerebral Microcirculation and Brain Tissue Oxygenation

imageBackground: Hyperosmolar solutions have been used in neurosurgery to modify brain bulk. The aim of this animal study was to compare the short-term effects of equivolemic, equiosmolar solutions of hypertonic saline (HTS) and sodium lactate (HTL) on cerebral cortical microcirculation and brain tissue oxygenation in a rabbit craniotomy model. Methods: Rabbits (weight, 1.5 to 2.0 kg) were anesthetized, ventilated mechanically, and subjected to a craniotomy. The animals were allocated randomly to receive a 3.75 mL/kg intravenous infusion of either 3.2% HTS (group HTS, n=9), half-molar sodium lactate (group HTL, n=10), or normal saline (group C, n=9). Brain tissue partial pressure of oxygen (PbtO2) and microcirculation in the cerebral cortex using sidestream dark-field imaging were evaluated before, 20 and 40 minutes after 15 minutes of hyperosmolar solution infusion. Global hemodynamic data were recorded, and blood samples for laboratory analysis were obtained at the time of sidestream dark-field image recording. Results: No differences in the microcirculatory parameters were observed between the groups before and after the use of osmotherapy. Brain tissue oxygen deteriorated over time in groups C and HTL, this deterioration was not significant in the group HTS. Conclusions: Our findings suggest that equivolemic, equiosmolar HTS and HTL solutions equally preserve perfusion of cortical brain microcirculation in a rabbit craniotomy model. The use of HTS was better in preventing the worsening of brain tissue oxygen tension.

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Prone Position, Cerebral Oximetry, and Delirium

No abstract available

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Comparison of 3% Hypertonic Saline and 20% Mannitol for Reducing Intracranial Pressure in Patients Undergoing Supratentorial Brain Tumor Surgery: A Randomized, Double-blind Clinical Trial

imageBackground: In the present study, we hypothesized that 3% hypertonic saline (HS) is more effective than 20% mannitol to reduce intracranial pressure (ICP) and to modify brain bulk in patients undergoing an elective supratentorial craniotomy. Materials and Methods: After institutional review board approval, patients scheduled to undergo supratentorial craniotomy were enrolled into this prospective, randomized, double-blind study. The patients were monitored for routine hemodynamic parameters, depth of anesthesia, and ICP. They received 5 mL/kg 20% mannitol (n=20) or 3% HS (n=19) as infusion for 15 minutes. The patients' ICP values were monitored during hypertonic fluid infusion and throughout 30 minutes after infusion as a primary outcome. Secondary outcomes were hemodynamic variables, serum sodium value, blood gases, and surgeon brain relaxation assessment score (1=relaxed, 2=satisfactory, 3=firm, 4=bulging). In addition, the length of intensive care unit and hospital stay were recorded. Results: Demographic and tumor characteristics were similar between groups. The basal (before hypertonic infusion, ICPT0) and last (30 min after hypertonic infusion finished, ICPT45) ICP values were 13.7±3.0 and 9.5±1.9 mm Hg, respectively, for the M group, which were comparable with the corresponding levels of 14.2±2.8 and 8.7±1.1 mm Hg in the HS group (P>0.05). The median amount of ICP reduction between T0 and T45 timepoints were 4 (1 to 7) and 5 (1 to 9) mm Hg for group M and group HS, respectively (P=0.035). Baseline central venous pressure, pulse pressure variation, and serum sodium and lactate values were similar between groups, but the last measured pulse pressure variation and lactate value were lower, and sodium value was higher in group HS than in group M (P

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A Comparison of Regional Versus General Anesthesia for Lumbar Spine Surgery: An Untouched Aspect of the Meta-Analysis

No abstract available

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Comparison of Anesthetic Management and Outcomes in Patients Having Either Transnasal or Transoral Endoscopic Odontoid Process Surgery

imageBackground: Endoscopic neurosurgical procedures involving the upper cervical vertebrae are challenging due to a narrow operating field and close proximity to vital anatomical structures. Historically, transoropharyngeal (transoral) endoscopy has been the preferred approach. More recently, however, an endoscopic transnasal approach was developed as an alternative method in hopes to reduce postoperative dysphagia, a common complication following transoral neurosurgery. Methods: Twenty-two endoscopic neurosurgical cases involving the odontoid or C1 vertebra were reviewed between January 1, 2005 and December 31, 2015 (17 and 5 through transoral and transnasal approaches, respectively). Patient demographics, anesthetic technique, intraoperative course, and postoperative outcomes such as were recorded. Results: Patients who underwent transnasal odontoidectomy had a shorter length of stay and lower rates of tracheostomy compared with those having similar surgery via the transoral route. In those having transoral surgery, no patient presented to the operating room with a preexisting tracheostomy. In 16 of 17 patients within the transoral group, a tracheostomy was performed. In those having transnasal surgery, 2 of 5 patients had a preexisting tracheostomy. In the remaining 3 of 5 patients, orotracheal intubation was performed and patients were extubated after the procedure. Conclusions: The transnasal odontoid resection technique may become a more popular surgical approach without increasing rates of complications compared with those having transoral surgery. Ultimately, a larger, study is needed to further clarify these relationships.

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Spectrogram Analysis as a Monitor of Anesthetic Depth in a Pediatric Patient

imageNo abstract available

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Journal Club

No abstract available

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2017 SNACC Annual Meeting Report

No abstract available

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Haplotype-Based Genome-Wide Prediction Models Exploit Local Epistatic Interactions Among Markers

Genome-wide prediction approaches represent versatile tools for the analysis and prediction of complex traits. Mostly they rely on marker-based information, but scenarios have been reported in which models capitalizing on closely-linked markers that were combined into haplotypes outperformed marker-based models. Detailed comparisons were undertaken to reveal under which circumstances haplotype-based genome-wide prediction models are superior to marker-based models. Specifically, it was of interest to analyze whether and how haplotype-based models may take local epistatic effects between markers into account. Assuming that populations consisted of fully homozygous individuals, a marker-based model in which local epistatic effects inside haplotype blocks were exploited (LEGBLUP) was linearly transformable into a haplotype-based model (HGBLUP). This theoretical derivation formally revealed that haplotype-based genome-wide prediction models capitalize on local epistatic effects among markers. Simulation studies corroborated this finding. Due to its computational efficiency the HGBLUP model promises to be an interesting tool for studies in which ultra-high-density SNP data sets are studied. Applying the HGBLUP model to empirical data sets revealed higher prediction accuracies than for marker-based models for both traits studied using a mouse panel. In contrast, only a small subset of the traits analyzed in crop populations showed such a benefit. Cases in which higher prediction accuracies are observed for HGBLUP than for marker-based models are expected to be of immediate relevance for breeders, due to the tight linkage a beneficial haplotype will be preserved for many generations. In this respect the inheritance of local epistatic effects very much resembles the one of additive effects.



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Regulation of tRNA synthesis and modification in physiological conditions and disease

Publication date: Available online 16 March 2018
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): Magdalena Boguta, Joseph C. Reese




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The relationship between mismatch response and the acoustic change complex in normal hearing infants

The importance of exposure to quality spoken language during the first year of life has been highlighted in studies of normal hearing (NH) infants and toddlers (Kuhl, 1991; Strange and Jenkins, 1978; Werker and Tees, 1984) and in studies of the later implications of this exposure on word learning and syntactic abilities (Graf Estes et al., 2007; van Leeuwen et al., 2008; Mueller et al., 2012). Research in infants with hearing loss (HL) has shown improved language outcomes when infants are fit with amplification and enrolled in early intervention by six months of age (Yoshinaga-Itano et al., 1998).

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Proving cortical death after vascular coma: Evoked potentials, EEG and neuroimaging

Prognostication of coma outcome is a key factor for the management of critically ill patients. The self-fulfilling prophecy related to treatment limitation is likely to appear after neurological insults with tragic consequences in case of erroneous prognostication, especially if a bad outcome is expected (Murray et al., 1993). With this caveat in mind, it is important to consider that clinical judgment appears frequently more severe than the objective assessment 6 months after traumatic brain injury (Bonds et al., 2015) and could conduce to inappropriate early care withdrawal in anoxic coma (Elmer et al., 2016; Gobert et al., 2016).

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Frailty and the gut

Frailty, which is a syndrome that encompasses losses in physical, psychological and social domains, is responsible for enhanced vulnerability to endogenous and/or exogenous stressors. Frailty is a public health problem for an ageing society; however, it is poorly understood and often under-recognised in clinical settings. In particular, the impact of frailty on either intestinal functions, i.e. immune response, permeability, and absorption, or gut microbiota composition is as yet mostly unexplored.

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Tenofovir disoproxil fumarate-induced severe liver injury in a patient with chronic hepatitis B virus infection



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Frailty and the gut

Frailty, which is a syndrome that encompasses losses in physical, psychological and social domains, is responsible for enhanced vulnerability to endogenous and/or exogenous stressors. Frailty is a public health problem for an ageing society; however, it is poorly understood and often under-recognised in clinical settings. In particular, the impact of frailty on either intestinal functions, i.e. immune response, permeability, and absorption, or gut microbiota composition is as yet mostly unexplored.

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Tenofovir disoproxil fumarate-induced severe liver injury in a patient with chronic hepatitis B virus infection



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Tip60: updates

Abstract

The maintenance of genome integrity is essential for organism survival. Therefore, eukaryotic cells possess many DNA repair mechanisms in response to DNA damage. Acetyltransferase, Tip60, plays a central role in ATM and p53 activation which are involved in DNA repair. Recent works uncovered the roles of Tip60 in ATM and p53 activation and how Tip60 is recruited to double-strand break sites. Moreover, recent works have demonstrated the role of Tip60 in cancer progression. Here, we review the current understanding of how Tip60 activates both ATM and p53 in response to DNA damage and his new roles in tumorigenesis.



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How EMS agencies can prepare their communities to 'Stop the Bleed'

Prehospital care experts stress the importance of the Stop the Bleed initiative, preparing bystanders to control severe hemorrhage and securing funding for a statewide program

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Steps per Day and Its Relationship to Energy Expenditures

No abstract available

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Metabolic and Performance Effects of Yerba Mate on Well-trained Cyclists

imageIntroduction Yerba Mate (YM) is a South American plant, rich in polyphenols, saponins, and xanthines, of growing scientific interest because of its metabolic effects. YM has been shown to increase fat utilization during exercise in untrained humans, but its effects on well-trained individuals during exercise are unknown. Methods We characterized metabolic and physical performance effects of YM in 11 well-trained male cyclists. In a double-blind crossover design, participants ingested 5 g of YM or placebo (PL; maltodextrin) daily for 5 d and 1 h before experimental trials. Results Ergometer-based tests included a submaximal step test (SST) at 30%–80% of V˙O2max (6 × 5-min stages), followed by a cycloergometer-based time trial (TT) test to complete mechanical work (~30 min; n = 9). Before and during tests, blood and respiratory gas samples were collected. YM increased resting plasma adrenaline concentration (P = 0.002), and fat utilization by 23% at 30%–50% V˙O2max versus PL (Glass effect sizes (ES) ± 95% confidence interval (CI), 0.8 ± 0.55) correlating strongly with post-SST plasma (glycerol; r = 0.758). Treatment effects on rates of perceived exertion, heart rate, and gross efficiency were unclear during SST. Respiratory exchange ratio during TT indicated carbohydrate dependence and did not differ between treatments (PL, 0.95 ± 0.03 (SD); YM, 0.95 ± 0.02). TT performance showed a small (ES = 0.38 ± 0.33) but significant (P = 0.0278) improvement with YM (PL, 30.1 ± 1.8 min (SD); YM, 29.4 ± 1.4 min; 2.2% ± 2% (95% CI)), with an average increase of 7-W power output (ES = 0.2 ± 0.19; P = 0.0418; 2.3% ± 2% (95% CI)) and 2.8% V˙O2 (P = 0.019). Pacing displayed lower power output after 30% of total TT workload in PL vs YM. Conclusions YM increased fat utilization during submaximal exercise and improved TT performance, but performance-enhancement effect was unrelated to measures of substrate metabolism during maximal exercise.

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Acute Inflammatory Responses to Exercise in Patients with Abdominal Aortic Aneurysm

imagePurpose Inflammation and extracellular matrix degeneration contribute to abdominal aortic aneurysm (AAA) development. We aimed to assess the effect of exercise intensity on circulating biomarkers of inflammation and extracellular matrix degeneration in patients with AAA and healthy older adults. Methods Twenty patients with AAA (74 ± 6 yr) and 20 healthy males (72 ± 5 yr) completed moderate-intensity cycling at 40% peak power output, higher-intensity intervals at 70% peak power output, and control (rest) on separate days. Circulating matrix metalloproteinase-9 (MMP-9), transforming growth factor beta 1, interleukin-6 (IL-6), IL-10, and tumor necrosis factor alpha (TNF-α) were analyzed at rest and 0 to 90 min postexercise. Results Biomarkers at baseline were similar between groups. IL-6 responses to exercise were similar between groups, with a greater increase in ΔIL-6 after moderate-intensity compared with higher-intensity exercise (P

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Acute Impact of Different Exercise Modalities on Arterial and Platelet Function

imagePurpose Acute coronary syndromes and ischemic stroke are associated with arterial events involving platelets, the endothelium, and atherosclerosis. Although regular physical activity is associated with lower risk of cardiovascular events and mortality, risk is transiently increased during and immediately after participation in an acute bout of exercise. No previous study has investigated the acute impact of exercise on platelet activation and arterial function in the same participants; it is also unknown if responses are dependent on exercise modality. We hypothesized that commonly adopted, yet physiologically distinct, modalities of exercise ("aerobic" vs "resistance") have differing effects on in vivo platelet activation and conduit artery diameter. Methods Eight apparently healthy middle-age (53.5 ± 1.6 yr) male subjects took part in four 30-min experimental interventions (aerobic exercise, resistance exercise, combined aerobic/resistance exercise, or no-exercise), in random order. Blood samples were collected, and the measurement of brachial artery diameter by ultrasound was performed before, immediately after, and 1 h after each intervention. Platelet activation was determined by the positive binding of antibodies to surface receptors exposed on activated platelets (anti-CD62P and PAC-1). Results Brachial artery diameter increased immediately after all three exercise modalities (P

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The Role of Airway Inflammation and Bronchial Hyperresponsiveness in Athlete’s Asthma

imagePurpose Asthma is frequently reported in endurance athletes. The aim of the present study was to assess the long-term airway inflammatory response to endurance exercise in high-level athletes with and without asthma. Methods In a cross-sectional design, 20 asthmatic athletes (10 swimmers and 10 cross-country skiers), 19 athletes without asthma (10 swimmers and 9 cross-country skiers), and 24 healthy nonathletes completed methacholine bronchial challenge, lung function tests, and sputum induction on two separate days. All athletes competed on a national or international level and exercised ≥10 h·wk−1. The nonathletes exercised ≤5 h·wk−1 and reported no previous lung disease. Bronchial hyperresponsiveness (BHR) was defined as a methacholine provocation dose causing 20% decrease in the forced expiratory volume in 1 s of ≤8 μmol. Results BHR was present in 13 asthmatic athletes (62%), 11 healthy athletes (58%), and 8 healthy nonathletes (32%), and the prevalence differed among groups (P = 0.005). Sputum inflammatory and epithelial cell counts did not differ between groups and were within the normal range. Median (25th to 75th percentiles) sputum interleukin-8 was elevated in both asthmatic (378.4 [167.0–1123.4]) and healthy (340.2 [175.5–892.4]) athletes as compared with healthy nonathletes (216.6 [129.5–314.0], P = 0.02). No correlations were found between provocation dose causing 20% decrease and sputum cell counts. Conclusion Independent of asthma diagnosis, a high occurrence of BHR and an increased sputum interleukin-8 were found in athletes as compared with nonathletes. Airway inflammation or epithelial damage was not related to BHR.

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A Construct Validation Study of PLAYfun

imageIntroduction Physical Literacy Assessment for Youth (PLAYfun) is a measure of motor competence, comprehension, and confidence which is part of a suite of scales used to assess physical literacy in children and youth; however, its measurement properties have not been reported in the published literature. The purpose of this study is to examine the factor structure of PLAYfun, in addition to variations in PLAYfun subscale results by age and sex. Method In this study, we use a sample of children and youth 7 to 14 yr of age (n = 215) to test a proposed factor structure for the motor competence component of PLAYfun and to examine age and sex differences in subscale and total scores. The initial (n = 128) and secondary (n = 98) samples were drawn from a stratified (by geographic region), random sample of 27 after-school programs from a larger pool of 400 programs across the province of Ontario. Seven research assistants were initially trained on the administration of PLAYfun and rated a small pilot sample of 10 children. These trained assessors then assessed the full sample. Results Interrater agreement was very good (intraclass correlation, 0.87). The hypothesized five-factor structure of the scale was found to have an acceptable fit to the data (root mean square error of approximation, 0.055; 90% confidence interval, 0.03–0.075; comparative fit index, 0.95; Tucker–Lewis Index, 0.94). In general, PLAYfun scores increased with age as developmentally expected. There were few sex differences across skills, but girls did not perform as well as boys on upper and lower body object control skills. Conclusions The factor structure and patterns of results by age and sex support PLAYfun as a measure of motor competence. Continued evaluation of the tool and other subscales of PLAY is required.

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Association between Physical Activity and Adiposity in Adolescents with Down Syndrome

imagePurpose Obesity is highly prevalent among adolescents with Down syndrome (DS); however, reported associations between body composition and moderate-to-vigorous physical activity (MVPA) have been small and nonsignificant. The purpose of this study was to compare group differences between adolescents with and without DS, including dual-energy x-ray absorptiometry (DXA) measured body composition and accelerometer-measured physical activity, and then examine associations within adolescents with DS. Methods Thirty-nine adolescents (22 with DS and 17 typically developing controls) 12–18 yr of age participated in the study. Groups had similar distributions of age, sex, and Tanner pubertal stage. Body composition was assessed by DXA, body mass index (BMI), and BMI percentile. MVPA was measured with ActiGraph GT3X+ accelerometers. Results Adolescents with DS had significantly higher BMI, BMI percentile, and DXA-derived percent body fat (%BF) as well as lower MVPA compared with controls (P 0.05). Conclusions Our findings suggest that MVPA is associated with adiposity when measured with DXA among adolescents with DS.

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Short-Term Exercise Training Alters Leukocyte Chemokine Receptors in Obese Adults—Corrigendum

No abstract available

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Maximal Exercise Alters the Inflammatory Phenotype and Response of Mononuclear Cells

imagePurpose Monocytes express the CD14 receptor that facilitates lipopolysaccharide (LPS) ligation to toll-like receptor 4 (TLR4) to elicit production of interleukin (IL)-6, IL-10, and tumor necrosis factor alpha (TNF-α). However, proinflammatory conditions, such as strenuous exercise, increase the percentage of monocytes expressing CD16, a receptor that enhances LPS stimulated TNF-α production. Therefore, we examined whether maximal treadmill exercise would alter the inflammatory phenotype of classical (CD14+/CD16−) and proinflammatory monocytes (intermediate [CD14++/CD16+] and nonclassical [CD14+/CD16++]), evidenced by changes in TLR4, CD14, and CD16 receptor expression, and their inflammatory response to ex vivo LPS stimulation. Methods Human mononuclear cells from 25 male participants (age, 24.2 ± 4.0 yr) were isolated before and after exercise to assess TLR4, CD14, and CD16 expression by flow cytometry and ex vivo production of LPS-stimulated inflammatory cytokines (IL-6, IL-10, and TNF-α). Results Exercise reduced the percentage of classical monocytes and increased the percentage of intermediate and nonclassical monocytes. In addition, TLR4 expression decreased on classical and intermediate monocytes, but not the nonclassical monocyte subset. Furthermore, although CD14 expression decreased on all monocyte subsets, CD16 expression increased on intermediate monocytes only. In parallel with these phenotypic changes, the inflammatory milieu shifted toward a proinflammatory response after LPS stimulation (decreased IL-6 and IL-10 and increased IL-6 to IL-10 ratio and TNF-α production). Conclusions These findings demonstrate that acute maximal exercise elicits a proinflammatory phenotype of isolated monocytes exposed to LPS and highlight potential mechanisms that will help elucidate the role of acute and chronic exercise on the innate immune response of circulating monocytes.

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Workplace Strategies to Prevent Sitting-induced Endothelial Dysfunction

imageProlonged sitting induces endothelial dysfunction in healthy young adults, which has been demonstrated to be offset by intermittent fidgeting and standing. No information exists on the effect of sitting and endothelial dysfunction in sedentary middle-age adults, and whether common workplace counterinterventions (i.e., desk standing/desk pedaling) mitigate sitting-induced endothelial dysfunction. Purpose The objective of this study was to examine whether breaking up prolonged sitting with intermittent standing or underdesk pedaling prevents sitting-induced popliteal artery endothelial dysfunction in middle-age sedentary, overweight/obese office workers. Hypothesis We tested the hypothesis that sitting-induced leg endothelial dysfunction would be prevented by intermittent standing or desk pedaling. Methods Thirteen middle-age, sedentary overweight/obese subjects (10 men, 3 women; age, 38 ± 3 yr; body mass index, 29.7 ± 2 kg·m−2) participated in three separate testing sessions in a randomized order: 1) 4 h of uninterrupted sitting, 2) 4 h of sitting interrupted with four 10-min bouts of standing, and 3) 4 h of sitting interrupted with four 10-min bouts of light-intensity desk pedaling. Doppler ultrasound–measured popliteal artery flow-mediated dilation and associated measures (e.g., shear rate, blood velocity) were measured immediately before and immediately after each intervention (sit, stand, and desk pedaling). Results Four hours of uninterrupted sitting induced a significant impairment in popliteal artery flow-mediated dilation (baseline: 3.1% ± 0.3%, post: 1.6% ± 0.5%; P

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Associations between BMI Change and Cardiometabolic Risk in Retired Football Players

imagePurpose Elevated rates of cardiometabolic diseases have been observed in former American football players. The current study sought to determine whether change in body mass index (ΔBMI) after retirement influences the prevalence of CHD, diabetes, or high blood pressure (HBP) in former professional football players. Methods Retired professional football players (n = 3729) were sent a survey with questions regarding health status, playing history, and demographic information. Self-reported BMI at the time of retirement was subtracted from current self-reported BMI to calculate ΔBMI. Prevalence of CHD, diabetes, and HBP were determined by asking participants if they had ever been diagnosed by a health care professional. Binomial regression with a Poisson residual and robust variance estimation was used to compute crude prevalence ratios (PR) and 95% confidence intervals (CI) for each outcome. Adjusted PR values were calculated by adjusting for BMI at the time of retirement, age, years of football experience, race, exercise habits, alcohol use, steroid history, smoking history, and playing position. Results Complete data were available for 2062 respondents. Prevalence of CHD increased 25%–31% for each five-point increase in ΔBMI after retirement (crude PR = 1.25, 95% CI = 1.03–1.52, P = 0.026; adjusted PR = 1.31, 95% CI = 1.11–1.55, P = 0.001). Diabetes prevalence increased 69%–88% for each five-point ΔBMI increase (crude = 1.88, 95% CI = 1.45–2.44, P

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A Primer on the Use of Equivalence Testing for Evaluating Measurement Agreement

imagePurpose Statistical equivalence testing is more appropriate than conventional tests of difference to assess the validity of physical activity (PA) measures. This article presents the underlying principles of equivalence testing and gives three examples from PA and fitness assessment research. Methods The three examples illustrate different uses of equivalence tests. Example 1 uses PA data to evaluate an activity monitor's equivalence to a known criterion. Example 2 illustrates the equivalence of two field-based measures of physical fitness with no known reference method. Example 3 uses regression to evaluate an activity monitor's equivalence across a suite of 23 activities. Results The examples illustrate the appropriate reporting and interpretation of results from equivalence tests. In the first example, the mean criterion measure is significantly within ±15% of the mean PA monitor. The mean difference is 0.18 METs and the 90% confidence interval of −0.15 to 0.52 is inside the equivalence region of −0.65 to 0.65. In the second example, we chose to define equivalence for these two measures as a ratio of mean values between 0.98 and 1.02. The estimated ratio of mean V˙O2 values is 0.99, which is significantly (P = 0.007) inside the equivalence region. In the third example, the PA monitor is not equivalent to the criterion across the suite of activities. The estimated regression intercept and slope are −1.23 and 1.06. Neither confidence interval is within the suggested regression equivalence regions. Conclusions When the study goal is to show similarity between methods, equivalence testing is more appropriate than traditional statistical tests of differences (e.g., ANOVA and t-tests).

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The Interplay between Genes and Psychosocial Home Environment on Physical Activity

imageIntroduction Genetic factors contribute to individual differences in physical activity, but it remains uncertain whether the magnitude of the genetic effects is modified by variations in home environments. We aimed to examine to what extent the psychosocial home environment in childhood and adolescence modifies the genetic influences on leisure time physical activity in young adulthood. Methods Participants were Finnish twins (N = 3305) who reported their leisure time physical activity at age 24 yr. The psychosocial home environment was assessed by twins at ages 12, 14, and 17 yr, as well as by their parents when the twins were age 12 yr. Gene–environment interaction modeling was performed with OpenMx software. Results Parental ratings of positive home atmosphere as well as the twins' ratings of both positive home atmosphere at age 14 yr and lower relational tensions at ages 12 and 14 yr predicted higher leisure time physical activity levels in young adulthood (regression coefficients = 0.33–0.64). Parental perceptions as well as the twins' perceptions of positive home atmosphere at ages 14 and 17 yr increased the additive genetic variation (moderation effects: 0.55, 95% confidence interval [CI] = 0.29–0.80; 0.60, 95% CI = 0.26–1.05; and 0.52, 95% CI = 0.19–0.87, respectively). The twins' ratings of positive home atmosphere at age 12 yr and lower relational tensions at ages 12 and 14 yr increased the unique environmental variation of their subsequent physical activity (moderation effects: 0.46, 95% CI = 0.19–0.60; 0.48, 95% CI = 0.29–0.64; and 0.85, 95% CI = 0.12–0.95, respectively). Conclusions A psychosocial home environment that is warm and supportive in childhood and adolescence not only increases the mean level of subsequent leisure time physical activity in young adulthood but also modifies the genetic and environmental variances in leisure time physical activity.

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Dietary Nitrate and Muscle Function in Humans: Acute versus Chronic Mechanisms

No abstract available

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Dopaminergic Genetic Variants and Voluntary Externally Paced Exercise Behavior

imagePurpose Most candidate gene studies on the neurobiology of voluntary exercise behavior have focused on the dopaminergic signaling pathway and its role in the mesolimbic reward system. We hypothesized that dopaminergic candidate genes may influence exercise behavior through additional effects on executive functioning and that these effects are only detected when the types of exercise activity are taken into account. Methods Data on voluntary exercise behavior and at least one single-nucleotide polymorphism/variable number of tandem repeat (VNTR) were available for 12,929 participants of the Netherlands Twin Registry. Exercise activity was classified as externally paced if a high level of executive function skill was required. The total volume of voluntary exercise (minutes per week) as well as the volume specifically spent on externally paced activities were tested for association with nine functional dopaminergic polymorphisms (DRD1: rs265981, DRD2/ANKK1: rs1800497, DRD3: rs6280, DRD4: VNTR 48 bp, DRD5: VNTR 130–166 bp, DBH: rs2519152, DAT1: VNTR 40 bp, COMT: rs4680, MAOA: VNTR 30 bp), a polygenic score (PGS) based on nine alleles leading to lower dopamine responsiveness, and a PGS based on three alleles associated with both higher reward sensitivity and better executive functioning (DRD2/ANKK1: "G" allele, COMT: Met allele, DAT1: 440-bp allele). Results No association with total exercise volume or externally paced exercise volume was found for individual alleles or the nine-allele PGS. The volume of externally paced exercise behavior was significantly associated with the reward and executive function congruent PGS. This association was driven by the DAT1 440-bp and COMT Met allele, which acted as increaser alleles for externally paced exercise behavior. Conclusions Taking into account the types of exercise activity may increase the success of identifying genetic variants and unraveling the neurobiology of voluntary exercise behavior.

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Clinical Orthopedic Rehabilitation: A Team Approach, 4th Edition

No abstract available

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Link between Physical Activity Type in Adolescence and Body Composition in Adulthood

imagePurpose We investigated whether type of physical activity (PA) (sports, running, and fitness/dance) engaged in during adolescence is associated with body composition in late adolescence or early adulthood. Methods Data were drawn from 631 participants in the Nicotine Dependence in Teens study, a prospective investigation of students ages 12–13 yr at inception. Self-report PA data were collected at baseline, in grade 7, and every 3–4 months thereafter during the 5 yr of high school (1999–2005). Anthropometric indicators (height, weight, waist circumference, triceps, and subscapular skinfold thickness) were measured at ages 12, 16, and 24 yr. On the basis of prior exploratory factor analysis, PA was categorized into one of three types (sports, running, and fitness/dance). Regression models estimated the association between number of years participating in each PA type (0–5 yr) during high school and body composition measures in later adolescence or early adulthood. Results In multivariable models accounting for age, sex, and parent education, more number of years participating in running during adolescence was associated with lower body mass index, waist circumference, and skinfold thickness in later adolescence and early adulthood (all P

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Cold Water Ingestion Improves Exercise Tolerance of Heat-Sensitive People with MS

imagePurpose Heat intolerance commonly affects the exercise capacity of people with multiple sclerosis (MS) during bouts of hot weather. Cold water ingestion is a simple cooling strategy, but its efficacy for prolonging exercise capacity with MS remains undetermined. We sought to identify whether cold water ingestion blunts exercise-induced rises in body temperature and improves exercise tolerance in heat-sensitive individuals with MS. Methods On two separate occasions, 20 participants (10 relapsing–remitting MS (expanded disability status scale, 2–4.5); 10 age-matched healthy controls) cycled at ∼40% V˙O2max at 30°C and 30% relative humidity until volitional exhaustion (or a maximum of 60 min). Every 15 min, participants ingested 3.2 mL·kg−1 of either 1.5°C (CLD) or 37°C (NEU) water. Rectal (Tre) temperature, mean skin (Tsk) temperature, and heart rate (HR) were measured throughout. Results All 10 controls but only 3 of 10 MS participants completed 60 min of exercise in NEU trial. The remaining 7 MS participants all cycled longer (P = 0.006) in CLD (46.4 ± 14.2 min) compared with NEU (32.7 ± 11.5 min), despite a similar absolute Tre (NEU: 37.32°C ± 0.34°C; CLD: 37.28°C ± 0.26°C; P = 0.44), change in Tre (NEU: 0.38°C ± 0.21°C; CLD: 0.34°C ± 0.24°C), absolute Tsk (NEU: 34.48°C ± 0.47°C; CLD: 34.44°C ± 0.54°C; P = 0.82), and HR (NEU: 114 ± 20 bpm; CLD: 113 ± 18 bpm; P = 0.38) for the same exercise volume. Conclusions Cold water ingestion enhanced exercise tolerance of MS participants in the heat by ∼30% despite no differences in Tre, Tsk or HR. These findings support the use of a simple cooling strategy for mitigating heat intolerance with MS and lend insight into the potential role of cold-afferent thermoreceptors that reside in the abdomen and oral cavity in the modulation of exercise tolerance with MS in the heat.

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Impact of Moderate-Intensity and Vigorous-Intensity Physical Activity on Mortality

imagePurpose Physical activity guidelines recommend at least 150 min of moderate-intensity physical activity (MPA), 75 min of vigorous-intensity physical activity (VPA), or combination of MPA and VPA. However, few epidemiological studies have examined whether the general population can derive equal health benefits from MPA or VPA. This study examined the associations of different activity intensities with mortality. Methods In this prospective cohort study, a total of 83,454 community-dwelling Japanese who answered a questionnaire in 2000–2003 were followed for all-cause mortality through 2012. Subjects were classified into four groups by physical activity guidelines and also by the proportion of VPA to total MVPA, that is, physically inactive, physically active without any VPA (0% VPA), and active with some VPA (30% or less) or with more VPA (more than 30%). Hazard ratios of all-cause mortality were calculated with adjustment for potential confounders including physical activity volume. Results During 894,718 person-years of follow-up, 8891 deaths were identified. Compared with physically inactive subjects, the adjusted hazard ratios for all-cause mortality were 0.75 (95% confidence interval, 0.68–0.83), 0.73 (0.65–0.82), and 0.74 (0.62–0.89) among men, and 0.71 (0.62–0.81), 0.75 (0.64–0.88), and 0.74 (0.58–0.94) among women. For "0% VPA," "30% or less" and "more than 30%," respectively. Conclusions Meeting the guidelines in either pattern of physical activity is important for lowering mortality risk. It may be suggested that people can receive comparable health benefit by MPA or VPA as long as they meet the guideline.

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Isotemporal Substitution of Sedentary Behavior and Physical Activity on Function

imageThe amount of time spent in sedentary behaviors (SB) progressively increases with age, while reducing time spent in light-intensity physical activity (LPA) and moderate- to vigorous-intensity physical activity (MVPA). These trajectories in PA and SB are linked to accelerated reductions in physical functioning. Purpose This study aimed to examine the association of substituting SB time with LPA and MVPA on physical function in older adults. Methods Ninety-one older adults (mean age, 70.7 ± 10.2 yr) wore a hip-mounted accelerometer to measure SB, LPA, and MVPA time. Measures of physical function included a 400-m walk test (400W), the usual gait speed (UGS), the five times sit-to-stand (5xSTS) test, and the short physical performance battery (SPPB). Isotemporal substitution regression modeling was performed to assess the relationship of replacing the amount of time spent in one activity for another. Results Replacing 30 min·d−1 of SB with LPA was associated with a significant improvement in 400W (P = 0.0497), whereas MVPA resulted in a significant improvement (P

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An Acute Bout of Aquatic Treadmill Exercise Induces Greater Improvements in Endothelial Function and Post-Exercise Hypotension than Land Treadmill Exercise: A Crossover Study

Objective The purpose of the study was to compare acute bouts of aquatic treadmill (ATM) and land treadmill (LTM) exercise on flow-mediated dilation (FMD), post-exercise blood pressure (BP), plasma nitrate/nitrite (PN), and atrial natriuretic peptide (ANP) in untrained, pre-hypertensive men. Design In a counterbalanced, crossover design, 19 untrained, pre-hypertensive men completed bouts of ATM and LTM on separate days. FMD was measured pre-exercise and 1-hour post-exercise. Blood samples were obtained pre-exercise and immediately post-exercise and analyzed for PN and ANP. A magnitude-based inference approach to inference was used for statistical analysis. Results A possible clinically beneficial increase in FMD (1.2%; 90% confidence interval (CI), -0.07% to 2.5%) was observed 1-hour post ATM. In contrast, a possible clinically harmful decrease in FMD (-1.3%; 90% CI, -2.7% to 0.2%) was observed 1-hour post LTM. The magnitude of the post-exercise systolic BP reduction was greater following ATM (-4.9, SD 2.9 mmHg) than LTM (-2.6, SD 2.5 mmHg). ANP increased 34.3 (SD 47.0) % following ATM and decreased -9.0 (SD 40.0) % following LTM. Conclusion An acute bout of ATM induced a more favorable endothelial response and greater post-exercise hypotensive response than LTM. These changes were associated with increased ANP levels following ATM. Address for correspondence: Dustin P. Joubert, Ph.D., Department of Kinesiology and Health Science, Stephen F. Austin State University, P.O. Box 13015, SFA Station, Nacogdoches, TX 75962-3015; ; E-mail: joubertd@sfasu.edu Disclosures: The authors declare no conflict of interest. This study was partially funded by the Sydney and J.L. Huffines Institute for Sports Medicine and Human Performance and the Texas – American College of Sports Medicine. Partial findings from the present study were previously presented at the 2016 and 2017 American College of Sports Medicine Annual Meeting. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Facilitating weight shifting during treadmill training improves walking function in humans with SCI: a randomized controlled pilot study

Objective To determine whether the integration of dynamic weight shifting into treadmill training would improve the efficacy of treadmill training in humans with spinal cord injury (SCI). Design Sixteen humans with SCI were randomly assigned to receive robotic or treadmill only training, and underwent 6 weeks of training. A force was applied to the pelvis for facilitating weight shifting and to the legs for assisting with leg swing for participants in the robotic group. No assistance force was applied for participants in the treadmill only group. Outcome measures consisted of overground walking speed, 6-minute walking distance, and other clinical measures, and were assessed pre, post 6 weeks of training, and 8 weeks after the end of training. Results A greater improvement in 6-minute walking distance was observed after robotic training than that after treadmill only training (p = 0.03), but there was not a significant difference between the two groups in improvements in walking speed. However, a greater improvement was observed for the participants who underwent robotic training than those who underwent treadmill only training (i.e., 15% vs. 2%). Conclusion Applying a pelvis assistance force for facilitating weight shifting during treadmill training may improve locomotor function in humans with SCI. Correspondence to: Ming Wu Ph.D., Legs and walking lab, Shirley Ryan Abilitylab, 355 East Erie Street, 23 floor, Chicago, IL, USA, 60611, E_mail: w-ming@Northwestern.edu Acknowledgement: This work is supported by the Davee Foundation, in partial by NIH (NIH/NICHD R01HD082216). We thank Dr. Sheng-Che Yen, Mrs. Jillian MacDonald, and Ms. Pooja Arora for their assistance during data collection. We thank Ms. Jill Landry for her suggestions and comments. Suppliers: GaitRite, CIR Systems Inc. 12 Cork Hill Road, Bldg #2, Franklin, NJ, 07416 Woodway, WOODWAY USA, Inc. W229 N591 Foster Ct., Waukesha, WI, 53186 Highlights: Humans with SCI underwent 6 weeks (3/week) of robotic or treadmill only training. Pelvis assistance was applied for facilitating weight shifting for robotic group. A greater improvement in endurance was obtained through robotic training. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Trajectories of quality of life and associated risk factors in patients with knee osteoarthritis: findings from the Osteoarthritis Initiative

Objective Knee osteoarthritis (OA) has a significant impact on quality of life (QOL). Although QOL is generally thought to diminish over time, it is unknown if different patient groups demonstrate unique patterns of change in QOL. We sought to identify and characterize QOL trajectories in knee OA. Design This prospective cohort study included 1013 individuals with symptomatic knee OA from the Osteoarthritis Initiative. We used group-based trajectory modeling to identify distinct temporal patterns of change in the Knee Injury and Osteoarthritis Outcome Score (KOOS) QOL subscale over 8 years. Baseline covariates included age, gender, ethnicity, education, comorbidities, body mass index (BMI), substance use, depression, knee pain, and functional tests. Results Group-based trajectory modeling revealed three distinct QOL trajectories: a high QOL trajectory (32% of the cohort) experiencing improvement over 8 years, and moderate (49%) and low QOL (20%) trajectories maintaining similar levels over time. Low QOL trajectory membership was significantly associated with younger age (p

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Long-term Retention of Musculoskeletal Ultrasound Training During Residency

The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Physical Medicine and Rehabilitation (ABPMR) developed milestones for evaluation of resident physicians that include proper musculoskeletal ultrasound (MSUS) examination of major joints. To date, there have been no published data demonstrating acquisition and retention of these skills and correlation with the milestone evaluation. The investigators developed and implemented a curriculum in musculoskeletal ultrasound examination for Physical Medicine and Rehabilitation (PM&R) residents at a large academic medical center. The investigators chose six joints for training and evaluation: ankle, elbow, hip, knee, shoulder and wrist/hand. The program included: 1) didactic lectures on anatomy and ultrasound technique; 2) peer-led demonstrations of the procedure on a standardized patient (SP); 3) individual practice on SPs; 4) faculty observation and feedback; 5) review sessions and additional practice; and, 6) assessment of skills in an objective structured clinical examination (OSCE). From 2013-2017, 30 PM&R residents were trained and evaluated. The results, based on OSCE scores, showed that the majority of residents achieved the appropriate level of competency for their year. A blended, standardized curriculum in MSUS instruction with assessment by an OSCE, can be used to evaluate MSUS skills, and can help align this education with residency milestones. Correspondence should be addressed to Dr. Irwin, Professor and Interim Chairman, Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine; PO Box 016960 (C206), Miami, FL 33101; Email: RIrwin@med.miami.edu. Disclosures: Ultrasound machines were supplied by FUJIFILM SonoSite, Inc., Bothell, WA Funding: No funding was received for this project Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Paramedic - Texas and Louisiana - Acadian Ambulance

Acadian provides emergency and non-emergency transports to 72 parishes/counties in Louisiana, Texas, and Mississippi, and is the largest privately-owned EMS service in the country. In addition, Acadian is employee-owned and nationally accredited in every market we serve. Our 4,000+ employees are committed to quality patient care and customer service. In business for 40+ years and only growing stronger ...

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Carrying capacity, carnivoran richness and hominin survival in Europe

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Publication date: May 2018
Source:Journal of Human Evolution, Volume 118
Author(s): Jesús Rodríguez, Ana Mateos
Carrying capacity, the maximum biomass that an ecosystem can sustain over the long term, strongly influences several ecological processes and it is also one of the main determinants of biodiversity. Here, we estimate the carrying capacity (CC) of the late Early and early Middle Pleistocene ecosystems of Europe, using equations describing the relationship between CC and climatic variables observed in the present, as well as maps of inferred paleotemperature and paleoprecipitation. Maps of paleoclimate values were interpolated from the composite benthic stable oxygen isotope ratios and a transfer function was used to estimate ungulate carrying capacity (CCU) from the interpolated mean annual temperature and annual precipitation values. Carnivoran carrying capacity was subsequently estimated from ungulate carrying capacity and the effect of CC on the carnivoran faunas was analyzed in 12 paleocommunities from Southern Europe. Our results show that carnivoran species richness is strongly related to ungulate carrying capacity in recent ecosystems, but the late Early Pleistocene paleocommunities from Southern Europe included much richer carnivore guilds than would be expected for a recent community with a similar ungulate carrying capacity. Thus, those late Early Pleistocene ecosystems supported a high number of carnivoran species, but the carnivoran biomass they could support was relatively low. Consequently, carnivorans occurred at low densities in Southern Europe compared to the recent African savanna ecosystems, but likely also compared to coeval East African ecosystems. Consequently, the first Homo populations that arrived in Europe at the end of the late Early Pleistocene found mammal communities consisting of a low number of prey species, which accounted for a moderate herbivore biomass, as well as a diverse but not very abundant carnivore guild. This relatively low carnivoran density implies that the hominin-carnivore encounter rate was lower in the European ecosystems than in the coeval East African environments, suggesting that an opportunistic omnivorous hominin would have benefited from a reduced interference from the carnivore guild.



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EMS agency debuts St. Patrick's Day-themed ambulance

The Chatham Emergency Services ambulance is decked out in shamrocks and will make its first public debut in the St. Patrick's Day parade

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Periodization Theory: Confronting an Inconvenient Truth

Abstract

Periodization theory has, over the past seven decades, emerged as the preeminent training planning paradigm. The philosophical underpinnings of periodization theory can be traced back to the integration of diverse shaping influences, whereby coaching beliefs and traditions were blended with historically available scientific insights and contextualized against pervading social planning models. Since then, many dimensions of elite preparation have evolved significantly, as driven by a combination of coaching innovations and science-led advances in training theory, techniques, and technologies. These advances have been incorporated into the fabric of the pre-existing periodization planning framework, yet the philosophical assumptions underpinning periodization remain largely unchallenged and unchanged. One particularly influential academic sphere of study, the science of stress, particularly the work of Hans Selye, is repeatedly cited by theorists as a central pillar upon which periodization theory is founded. A fundamental assumption emanating from the early stress research is that physical stress is primarily a biologically mediated phenomenon: a presumption translated to athletic performance contexts as evidence that mechanical training stress directly regulates the magnitude of subsequent 'fitness' adaptations. Interestingly, however, since periodization theory first emerged, the science of stress has evolved extensively from its historical roots. This raises a fundamental question: if the original scientific platform upon which periodization theory was founded has disintegrated, should we critically re-evaluate conventional perspectives through an updated conceptual lens? Realigning periodization philosophy with contemporary stress theory thus presents us with an opportunity to recalibrate training planning models with both contemporary scientific insight and progressive coaching practice.



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Correction to: Tanner–Whitehouse Skeletal Ages in Male Youth Soccer Players: TW2 or TW3?

An Online First version of this article was made available online at https://link.springer.com/article/10.1007%2Fs40279-017-0799-7 on 29 October 2017. Errors were subsequently identified in the article, and the following corrections should be noted:



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A Comparison of the Energetic Cost of Running in Marathon Racing Shoes

Abstract

Background

Reducing the energetic cost of running seems the most feasible path to a sub-2-hour marathon. Footwear mass, cushioning, and bending stiffness each affect the energetic cost of running. Recently, prototype running shoes were developed that combine a new highly compliant and resilient midsole material with a stiff embedded plate.

Objective

The aim of this study was to determine if, and to what extent, these newly developed running shoes reduce the energetic cost of running compared with established marathon racing shoes.

Methods

18 high-caliber athletes ran six 5-min trials (three shoes × two replicates) in prototype shoes (NP), and two established marathon shoes (NS and AB) during three separate sessions: 14, 16, and 18 km/h. We measured submaximal oxygen uptake and carbon dioxide production during minutes 3–5 and averaged energetic cost (W/kg) for the two trials in each shoe model.

Results

Compared with the established racing shoes, the new shoes reduced the energetic cost of running in all 18 subjects tested. Averaged across all three velocities, the energetic cost for running in the NP shoes (16.45 ± 0.89 W/kg; mean ± SD) was 4.16 and 4.01% lower than in the NS and AB shoes, when shoe mass was matched (17.16 ± 0.92 and 17.14 ± 0.97 W/kg, respectively, both p < 0.001). The observed percent changes were independent of running velocity (14–18 km/h).

Conclusion

The prototype shoes lowered the energetic cost of running by 4% on average. We predict that with these shoes, top athletes could run substantially faster and achieve the first sub-2-hour marathon.



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EMS Strong honors first responders with ‘Stronger Together’ campaign

By EMS1 Staff WASHINGTON — A campaign to honor EMS providers was recently announced by the American College of Emergency Physicians and the National Association of Emergency Medical Technicians in an effort to raise National EMS Week awareness. According to a press release, this year's EMS Strong campaign will be "Stronger Together" and will bring together organizations and other ...

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How one product can disinfect your ambulance without damaging equipment

Prevent the spread of disease and promote provider health and safety with frequent and effective ambulance decontamination

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Quick Take: Examining pediatric intubation

One medical director is challenging the current pediatric intubation paradigm, exploring direct and video laryngoscopy

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Evaluation of EMG pattern recognition for upper limb prosthesis control: a case study in comparison with direct myoelectric control

Although electromyogram (EMG) pattern recognition (PR) for multifunctional upper limb prosthesis control has been reported for decades, the clinical benefits have rarely been examined. The study purposes were ...

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Editorial Board

Publication date: January–March 2018
Source:Mutation Research/Reviews in Mutation Research, Volume 775





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Prenatal Oral Health Counseling by Primary Care Physicians: Results of a National Survey

Abstract

Objectives Limited information exists on the extent oral health is addressed in the context of prenatal care. This study sought to investigate characteristics of primary care physicians (PCP) who provide oral health counseling to pregnant women. Methods The study relied upon data from the 2013 Survey of PCP on Oral Health. Provision of oral health counseling to pregnant women (sometimes vs. rarely/never) was the primary outcome. Covariates included respondents' demographic and practice characteristics, oral health-related training, knowledge, attitudes, preparedness and clinical behaviors. The analytical strategy included bivariate tests and multivariable Poisson regression modeling, accounting for the survey design; inference was based upon marginal effects estimation. Results Two-thirds of PCP (233 out of 366 respondents) reported providing oral health counseling to pregnant women. In bivariate comparisons, female PCP, PCP with oral health-specific instruction during medical training, favorable oral health-related attitudes, behaviors, preparedness, and knowledge were more likely to provide counseling (p < 0.05). Multivariable analyses confirmed the independent associations of female gender [marginal effect = + 9.7 percentage points (p.p.); 95% confidence interval (CI) = 0.0–19.0], years in practice (− 0.4 p.p. for each added year; 95% CI = − 0.09 to 0.0), oral health continuing education (+ 13.2 p.p.; 95% CI = 2.6–23.8), preparedness (+ 23.0 p.p.; 95% CI = 16.9–29.0) and oral health counseling of adult patients with other conditions (+ 8.8 p.p.; 95% CI = 4.6–13.3) with prenatal oral health counseling. Conclusions for Practice A considerable proportion of PCP nationwide counsel pregnant patients on oral health. Provider attributes including education and preparedness appear as promising targets for interventions aimed to enhance pregnant women's oral health and care.



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Colitis with wall thickening and edematous changes during oral administration of the powdered form of Qing-dai in patients with ulcerative colitis: a report of two cases

Abstract

Orally administered Qing-dai, called indigo naturalis in Latin, is reportedly useful for the treatment of ulcerative colitis. We herein describe two patients with ulcerative colitis who developed colitis with wall thickening and edematous changes during oral administration of the powdered form of Qing-dai. In Case 1, a 35-year-old man developed colitis similar to ischemic colitis with bloody stool that recurred each time he ingested Qing-dai. He had no signs of recurrence upon withdrawal of Qing-dai. In Case 2, a 43-year-old woman underwent ileocecal resection for treatment of an intussusception 2 months after beginning oral administration of Qing-dai. Edema and congestion but no ulceration were present in the mucosa of the resected specimen. Both patients exhibited abdominal pain with bloody diarrhea, and abdominal computed tomography showed marked wall edema affecting an extensive portion of the large bowel.



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Learning what matters: A neural explanation for the sparsity bias

Publication date: Available online 15 March 2018
Source:International Journal of Psychophysiology
Author(s): Cameron D. Hassall, Patrick C. Connor, Thomas P. Trappenberg, John J. McDonald, Olave E. Krigolson
The visual environment is filled with complex, multi-dimensional objects that vary in their value to an observer's current goals. When faced with multi-dimensional stimuli, humans may rely on biases to learn to select those objects that are most valuable to the task at hand. Here, we show that decision making in a complex task is guided by the sparsity bias: the focusing of attention on a subset of available features. Participants completed a gambling task in which they selected complex stimuli that varied randomly along three dimensions: shape, color, and texture. Each dimension comprised three features (e.g., color: red, green, yellow). Only one dimension was relevant in each block (e.g., color), and a randomly-chosen value ranking determined outcome probabilities (e.g., green > yellow > red). Participants were faster to respond to infrequent probe stimuli that appeared unexpectedly within stimuli that possessed a more valuable feature than to probes appearing within stimuli possessing a less valuable feature. Event-related brain potentials recorded during the task provided a neurophysiological explanation for sparsity as a learning-dependent increase in optimal attentional performance (as measured by the N2pc component of the human event-related potential) and a concomitant learning-dependent decrease in prediction errors (as measured by the feedback-elicited reward positivity). Together, our results suggest that the sparsity bias guides human reinforcement learning in complex environments.



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Correction to: Craniosynostosis as a clinical and diagnostic problem: molecular pathology and genetic counseling

Abstract

In the original article, figures 1 and 2 were inadvertently interchanged initially. The correct figures are as shown below. The original article has been corrected.



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Progression of corticospinal tract dysfunction in pre-ataxic spinocerebellar ataxia type 2: A two-years follow-up TMS study

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Publication date: May 2018
Source:Clinical Neurophysiology, Volume 129, Issue 5
Author(s): Luis Velázquez-Pérez, Roberto Rodríguez-Labrada, Reidenis Torres-Vega, Ricardo Ortega-Sánchez, Jacqueline Medrano-Montero, Rigoberto González-Piña, Yaimeé Vázquez-Mojena, Georg Auburger, Ulf Ziemann
ObjectiveCorticospinal tract (CST) dysfunction is common in the pre-ataxic stage of spinocerebellar ataxia type 2 (SCA2) but quantitative assessment of its progression over time has not been explored. The aim of this study was to quantify the progression of CST dysfunction in pre-ataxic SCA2 using transcranial magnetic stimulation (TMS).MethodsThirty-three pre-ataxic SCA2 mutation carriers and a 33 age- and gender-matched healthy controls were tested at baseline and 2-years follow-up by standardized clinical exams, validated clinical scales, and TMS.ResultsPre-ataxic SCA2 mutation carriers showed a significant increase of resting motor thresholds (RMT) to abductor pollicis brevis (APB) and tibialis anterior (TA) muscles, and of central motor conduction time (CMCT) to TA at 2-years follow-up, over and above changes in healthy controls. The changes in the pre-ataxic SCA2 mutation carriers were independent of the presence of clinical signs of CST dysfunction at baseline, and independent of conversion to clinically definite SCA2 at 2-years follow-up.ConclusionsTMS markers of CST dysfunction progress significantly during the pre-ataxic stage of SCA2.SignificanceTMS measures of CST dysfunction may provide biomarkers of disease progression prior to clinical disease expression that have potential utility for monitoring neuroprotective therapies in future clinical trials.



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