bluuebunny/crossref_metadata_2025 huggingface dataset:
Impulse source localization in an urban environment: Time reversal versus time matching
Authors: Cheinet Sylvain , Ehrhardt Loïc , Broglin Thierry
Published: January 2016

This study investigates two approaches for localizing an impulse sound source with distributed sensors in an urban environment under controlled processing time. In both approaches, the numerical model used for calculating the sound propagation is a finite-difference time-domain (FDTD) model. The simulations are drastically accelerated by restricting to the lower frequencies of the impulse signals and are evaluated against in situ measurements. The first tested localization technique relies on the time reversal of the measurements with the model. In the second technique, the source is localized by matching the observed differences in the first times of arrival of the signals to those obtained from a pre-defined database of simulations with known source positions. The localization performance is physically investigated on the basis of the measurements, considering two source positions and all possible combinations from 5 to 15 microphones. The time matching localization attains an accuracy of 10 m, which is targeted in this study, in the vast majority of the configurations. In comparison, the time reversal localization is affected by the weakness of contributions from sensors masked and distant from the source. Practical requirements are also discussed, such as real-time constraints, hardware and description of the urban environment.
Resonance scattering by fish schools: A comparison of two models
Authors: Raveau M. , Feuillade C.
Published: January 2016

The effective medium method is used to investigate resonance scattering from schools of fish with gas-filled swim bladders, as a function of frequency and azimuth. Calculations are also performed with a coupled differential equation model, which incorporates both multiple scattering between fish and wave interference interactions of their scattered fields [Feuillade, Nero, and Love, J. Acoust. Soc. Am. 99, 196–208 (1996)]. A theoretical comparison of the models for idealized spherical schools shows good agreement over the entire resonance region in the forward direction, where interference interactions have a minimal effect. Good agreement is also seen in back scattering at low frequencies, where the wavelength λ≥4s, and s is the average nearest neighbor fish separation. If λ<4s, the models diverge in back scattering, and the effective medium method fails. This can be critically important when migrations of schools to deeper water cause the collective resonance frequency to increase. Multiple scattering interactions are negligible when |4πnfb2/k|⪅0.01, where n is the fish number density, fb is the individual fish scattering amplitude, and k=2π/λ. A comparison with forward scattering data shows very good agreement for both models, and indicates a method for estimating fish abundance. For back scattering data, the effective medium method diverges strongly when λ<4s.
Acoustic impedance of micro perforated membranes: Velocity continuity condition at the perforation boundary
Authors: Li Chenxi , Cazzolato Ben , Zander Anthony
Published: January 2016

The classic analytical model for the sound absorption of micro perforated materials is well developed and is based on a boundary condition where the velocity of the material is assumed to be zero, which is accurate when the material vibration is negligible. This paper develops an analytical model for finite-sized circular micro perforated membranes (MPMs) by applying a boundary condition such that the velocity of air particles on the hole wall boundary is equal to the membrane vibration velocity (a zero-slip condition). The acoustic impedance of the perforation, which varies with its position, is investigated. A prediction method for the overall impedance of the holes and the combined impedance of the MPM is also provided. The experimental results for four different MPM configurations are used to validate the model and good agreement between the experimental and predicted results is achieved.
Development of a standing wave apparatus for calibrating acoustic vector sensors and hydrophones
Authors: Lenhart Richard D. , Sagers Jason D. , Wilson Preston S.
Published: January 2016

An apparatus was developed to calibrate acoustic hydrophones and vector sensors between 25 and 2000 Hz. A standing wave field is established inside a vertically oriented, water-filled, elastic-walled waveguide by a piston velocity source at the bottom and a pressure-release boundary condition at the air/water interface. A computer-controlled linear positioning system allows a device under test to be precisely located in the water column while the acoustic response is measured. Some of the challenges of calibrating hydrophones and vector sensors in such an apparatus are discussed, including designing the waveguide to mitigate dispersion, understanding the impact of waveguide structural resonances on the acoustic field, and developing algorithms to post-process calibration measurement data performed in a standing wave field. Data from waveguide characterization experiments and calibration measurements are presented and calibration uncertainty is reported.
Sub-harmonic broadband humps and tip noise in low-speed ring fans
Authors: Moreau Stéphane , Sanjose Marlène
Published: January 2016

A joint experimental and numerical study has been achieved on a low-speed axial ring fan in clean inflow. Experimental evidence shows large periodic broadband humps at lower frequencies than the blade passing frequencies and harmonics even at design conditions. These sub-harmonic humps are also found to be sensitive to the fan process and consequently to its tip geometry. Softer fans yield more intense humps more shifted to lower frequencies with respect to the fan harmonics. Unsteady turbulent flow simulations of this ring fan mounted on a test plenum have been achieved by four different methods that have been validated by comparing with overall performances and detailed hot-wire velocity measurements in the wake. Noise predictions are either obtained directly or are obtained through Ffowcs Williams and Hawkings' analogy, and compared with narrowband and third-octave power spectra. All unsteady simulations correctly capture the low flow rates, the coherent vortex dynamics in the tip clearance and consequently the noise radiation dominated by the tip noise in the low- to mid-frequency range. Yet, only the scale-adaptive simulation and the lattice Boltzmann method simulations which can describe most of the turbulent structures accurately provide the proper spectral shape and levels, and consequently the overall sound power level.
A semi-numerical model for near-critical angle scattering
Authors: Fradkin Larissa Ju. , Darmon Michel , Chatillon Sylvain , Calmon Pierre
Published: January 2016

Numerous phenomena in the fields of physics and mathematics as seemingly different as seismology, ultrasonics, crystallography, photonics, relativistic quantum mechanics, and analytical number theory are described by integrals with oscillating integrands that contain three coalescing criticalities, a branch point, stationary phase point, and pole as well as accumulation points at which the speed of integrand oscillation is infinite. Evaluating such integrals is a challenge addressed in this paper. A fast and efficient numerical scheme based on the regularized composite Simpson's rule is proposed, and its efficacy is demonstrated by revisiting the scattering of an elastic plane wave by a stress-free half-plane crack embedded in an isotropic and homogeneous solid. In this canonical problem, the head wave, edge diffracted wave, and reflected (or compensating) wave each can be viewed as a respective contribution of a branch point, stationary phase point, and pole. The proposed scheme allows for a description of the non-classical diffraction effects near the “critical” rays (rays that separate regions irradiated by the head waves from their respective shadow zones). The effects include the spikes present in diffraction coefficients at the critical angles in the far field as well as related interference ripples in the near field.
Effect of Two- Versus Three-Way Split Resistance Training Routines on Body Composition and Muscular Strength in Bodybuilders: A Pilot Study
Authors: Ribeiro Alex S. , Schoenfeld Brad J. , Silva Danilo R.P. , Pina Fábio L.C. , Guariglia Débora A. , Porto Marcelo , Maestá Nailza , Burini Roberto C. , Cyrino Edilson S.
Published: January 2016

The purpose of this study was to compare different split resistance training routines on body composition and muscular strength in elite bodybuilders. Ten male bodybuilders (26.7 ± 2.7 years, 85.3 ± 10.4 kg) were randomly assigned into one of two resistance training groups: 4 and 6 times per week (G4× and G6×, respectively), in which the individuals trained for 4 weeks, 4 sets for each exercise performing 6–12 repetitions maximum (RM) in a pyramid fashion. Body composition was assessed by dual energy X-ray absorptiometry, muscle strength was evaluated by 1RM bench-press testing. The food intake was planned by nutritionists and offered individually throughout the duration of the experiment. Significant increases (p < .05) in fat-free mass (G4× = +4.2%, G6× = +3.5%) and muscular strength (G4× = +8.4%, G6× = +11.4%) with no group by time interaction were observed. We conclude that 4 and 6 weekly sessions frequencies of resistance training promote similar increases in fat-free mass and muscular strength in elite bodybuilders.
Robust bidirectional links for photonic quantum networks
Authors: Xu Jin-Shi , Yung Man-Hong , Xu Xiao-Ye , Tang Jian-Shun , Li Chuan-Feng , Guo Guang-Can
Published: January 2016

Researchers experimentally realize a promising method for creating robust bidirectional quantum communication links.
Monitoring transient changes within overpressured regions of subduction zones using ambient seismic noise
Authors: Chaves Esteban J. , Schwartz Susan Y.
Published: January 2016

This paper uses temporal variations in seismic velocity to identify pressurized pore fluids in forearc crust.
Targeting NF-κB in glioblastoma: A therapeutic approach
Authors: Friedmann-Morvinski Dinorah , Narasimamurthy Rajesh , Xia Yifeng , Myskiw Chad , Soda Yasushi , Verma Inder M.
Published: January 2016

Inhibition of the transcription factor NF-κB or its target genes should be considered for the treatment of patients with glioblastoma multiforme.
Shape memory polymer network with thermally distinct elasticity and plasticity
Authors: Zhao Qian , Zou Weike , Luo Yingwu , Xie Tao
Published: January 2016

Shape memory polymer with thermally distinct elasticity and plasticity enables highly complex shape manipulations.
Long-Term Colonization by
bla
CTX-M
-Harboring Escherichia coli in Healthy Japanese People Engaged in Food Handling
Authors: Nakane Kunihiko , Kawamura Kumiko , Goto Kensuke , Arakawa Yoshichika
Published: January 2016

The actual state of intestinal long-term colonization by extended-spectrum β-lactamase (ESBL)-producing
Escherichia coli
in healthy Japanese people remains unclear. Therefore, a total of 4,314 fecal samples were collected from 2,563 food handlers from January 2010 to December 2011. Approximately 0.1 g of each fecal sample was inoculated onto a MacConkey agar plate containing cefotaxime (1 μg/ml). The bacterial colonies that grew on each plate were checked for ESBL production by the double-disk synergy test, as recommended by the Clinical and Laboratory Standards Institute. The bacterial serotype, antimicrobial susceptibility, pulsotype, sequence type (ST), and ESBL genotype were checked, and the replicon types of plasmids harboring the ESBL gene were also determined after conjugation experiments. ESBL producers were recovered from 70 (3.1%) of 2,230 participants who were checked only once. On the other hand, ESBL producers were isolated at least once from 52 (15.6%) of 333 participants who were checked more than twice, and 13 of the 52 participants carried ESBL producers for from more than 3 months to up to 2 years. Fluoroquinolone (FQ)-resistant
E. coli
strains harboring
bla
CTX-M
were repeatedly recovered from 11 of the 13 carriers of
bla
CTX-M
-harboring
E. coli
. A genetically related FQ-resistant
E. coli
O25b:H4-ST131 isolate harboring
bla
CTX-M-27
was recovered from 4 of the 13 carriers for more than 6 months. Three FQ-resistant
E. coli
O1:H6-ST648 isolates that harbored
bla
CTX-M-15
or
bla
CTX-M-14
were recovered from 3 carriers. Moreover, multiple CTX-M-14- or CTX-M-15-producing
E. coli
isolates with different serotypes were recovered from 2 respective carriers. These findings predict a provable further spread of ESBL producers in both community and clinical settings.
Evaluation of Ultrasound-Induced Damage to Escherichia coli and Staphylococcus aureus by Flow Cytometry and Transmission Electron Microscopy
Authors: Li Jiao , Ahn Juhee , Liu Donghong , Chen Shiguo , Ye Xingqian , Ding Tian
Published: January 2016

As a nonthermal sterilization technique, ultrasound has attracted great interest in the field of food preservation. In this study, flow cytometry and transmission electron microscopy were employed to investigate ultrasound-induced damage to
Escherichia coli
and
Staphylococcus aureus
. For flow cytometry studies, single staining with propidium iodide (PI) or carboxyfluorescein diacetate (cFDA) revealed that ultrasound treatment caused cell death by compromising membrane integrity, inactivating intracellular esterases, and inhibiting metabolic performance. The results showed that ultrasound damage was independent of initial bacterial concentrations, while the mechanism of cellular damage differed according to the bacterial species. For the Gram-negative bacterium
E. coli
, ultrasound worked first on the outer membrane rather than the cytoplasmic membrane. Based on the double-staining results, we inferred that ultrasound treatment might be an all-or-nothing process: cells ruptured and disintegrated by ultrasound cannot be revived, which can be considered an advantage of ultrasound over other nonthermal techniques. Transmission electron microscopy studies revealed that the mechanism of ultrasound-induced damage was multitarget inactivation, involving the cell wall, cytoplasmic membrane, and inner structure. Understanding of the irreversible antibacterial action of ultrasound has great significance for its further utilization in the food industry.
Strong Seasonality of Marine Microbial Eukaryotes in a High-Arctic Fjord (Isfjorden, in West Spitsbergen, Norway)
Authors: Marquardt Miriam , Vader Anna , Stübner Eike I. , Reigstad Marit , Gabrielsen Tove M.
Published: January 2016

The Adventfjorden time series station (IsA) in Isfjorden, West Spitsbergen, Norway, was sampled frequently from December 2011 to December 2012. The community composition of microbial eukaryotes (size, 0.45 to 10 μm) from a depth of 25 m was determined using 454 sequencing of the 18S V4 region amplified from both DNA and RNA. The compositional changes throughout the year were assessed in relation to
in situ
fjord environmental conditions. Size fractionation analyses of chlorophyll
a
showed that the photosynthetic biomass was dominated by small cells (<10 μm) most of the year but that larger cells dominated during the spring and summer. The winter and early-spring communities were more diverse than the spring and summer/autumn communities. Dinophyceae were predominant throughout the year. The Arctic
Micromonas
ecotype was abundant mostly in the early-bloom and fall periods, whereas heterotrophs, such as marine stramenopiles (MASTs), Picozoa, and the parasitoid marine alveolates (MALVs), displayed higher relative abundance in the winter than in other seasons. Our results emphasize the extreme seasonality of Arctic microbial eukaryotic communities driven by the light regime and nutrient availability but point to the necessity of a thorough knowledge of hydrography for full understanding of their succession and variability.
Prokaryotic Community Structure Driven by Salinity and Ionic Concentrations in Plateau Lakes of the Tibetan Plateau
Authors: Zhong Zhi-Ping , Liu Ying , Miao Li-Li , Wang Fang , Chu Li-Min , Wang Jia-Li , Liu Zhi-Pei
Published: January 2016

The prokaryotic community composition and diversity and the distribution patterns at various taxonomic levels across gradients of salinity and physiochemical properties in the surface waters of seven plateau lakes in the Qaidam Basin, Tibetan Plateau, were evaluated using Illumina MiSeq sequencing. These lakes included Lakes Keluke (salinity, <1 g/liter), Qing (salinity, 5.5 to 6.6 g/liter), Tuosu (salinity, 24 to 35 g/liter), Dasugan (salinity, 30 to 33 g/liter), Gahai (salinity, 92 to 96 g/liter), Xiaochaidan (salinity, 94 to 99 g/liter), and Gasikule (salinity, 317 to 344 g/liter). The communities were dominated by
Bacteria
in lakes with salinities of <100 g/liter and by
Archaea
in Lake Gasikule. The clades At12OctB3 and
Salinibacter
, previously reported only in hypersaline environments, were found in a hyposaline lake (salinity, 5.5 to 6.6 g/liter) at an abundance of ∼1.0%, indicating their ecological plasticity. Salinity and the concentrations of the chemical ions whose concentrations covary with salinity (Mg
2+
, K
+
, Cl
−
, Na
+
, SO
4
2−
, and Ca
2+
) were found to be the primary environmental factors that directly or indirectly determined the composition and diversity at the level of individual clades as well as entire prokaryotic communities. The distribution patterns of two phyla, five classes, five orders, five families, and three genera were well predicted by salinity. The variation of the prokaryotic community structure also significantly correlated with the dissolved oxygen concentration, pH, the total nitrogen concentration, and the PO
4
3−
concentration. Such correlations varied depending on the taxonomic level, demonstrating the importance of comprehensive correlation analyses at various taxonomic levels in evaluating the effects of environmental variable factors on prokaryotic community structures. Our findings clarify the distribution patterns of the prokaryotic community composition in plateau lakes at the levels of individual clades as well as whole communities along gradients of salinity and ionic concentrations.
The Bacteriome of Bat Flies (Nycteribiidae) from the Malagasy Region: a Community Shaped by Host Ecology, Bacterial Transmission Mode, and Host-Vector Specificity
Authors: Wilkinson David A. , Duron Olivier , Cordonin Colette , Gomard Yann , Ramasindrazana Beza , Mavingui Patrick , Goodman Steven M. , Tortosa Pablo
Published: January 2016

The Nycteribiidae are obligate blood-sucking Diptera (Hippoboscoidea) flies that parasitize bats. Depending on species, these wingless flies exhibit either high specialism or generalism toward their hosts, which may in turn have important consequences in terms of their associated microbial community structure. Bats have been hypothesized to be reservoirs of numerous infectious agents, some of which have recently emerged in human populations. Thus, bat flies may be important in the epidemiology and transmission of some of these bat-borne infectious diseases, acting either directly as arthropod vectors or indirectly by shaping pathogen communities among bat populations. In addition, bat flies commonly have associations with heritable bacterial endosymbionts that inhabit insect cells and depend on maternal transmission through egg cytoplasm to ensure their transmission. Some of these heritable bacteria are likely obligate mutualists required to support bat fly development, but others are facultative symbionts with unknown effects. Here, we present bacterial community profiles that were obtained from seven bat fly species, representing five genera, parasitizing bats from the Malagasy region. The observed bacterial diversity includes
Rickettsia
,
Wolbachia
, and several
Arsenophonus
-like organisms, as well as other members of the
Enterobacteriales
and a widespread association of
Bartonella
bacteria from bat flies of all five genera. Using the well-described host specificity of these flies and data on community structure from selected bacterial taxa with either vertical or horizontal transmission, we show that host/vector specificity and transmission mode are important drivers of bacterial community structure.
A 1,3-1,4-β-Glucan Utilization Regulon in Paenibacillus sp. Strain JDR-2
Authors: Chow Virginia , Kim Young Sik , Rhee Mun Su , Sawhney Neha , St. John Franz J. , Nong Guang , Rice John D. , Preston James F.
Published: January 2016

Paenibacillus
sp. strain JDR-2 (
Paenibacillus
JDR-2) secretes a multimodular cell-associated glycoside hydrolase family 10 (GH10) endoxylanase (XynA10A
1
) that catalyzes the depolymerization of methylglucuronoxylan (MeGX
n
) and rapidly assimilates the products of depolymerization. Efficient utilization of MeGX
n
has been postulated to result from the coupling of the processes of exocellular depolymerization and assimilation of oligosaccharide products, followed by intracellular metabolism. Growth and substrate utilization patterns with barley glucan and laminarin similar to those observed with MeGX
n
as a substrate suggest similar processes for 1,3-1,4-β-glucan and 1,3-β-glucan depolymerization and product assimilation. The
Paenibacillus
JDR-2 genome includes a cluster of genes encoding a secreted multimodular GH16 β-glucanase (Bgl16A
1
) containing surface layer homology (SLH) domains, a secreted GH16 β-glucanase with only a catalytic domain (Bgl16A
2
), transporter proteins, and transcriptional regulators. Recombinant Bgl16A
1
and Bgl16A
2
catalyze the formation of trisaccharides, tetrasaccharides, and larger oligosaccharides from barley glucan and of mono-, di-, tri-, and tetrasaccharides and larger oligosaccharides from laminarin. The lack of accumulation of depolymerization products during growth and a marked preference for polymeric glucan over depolymerization products support a process coupling extracellular depolymerization, assimilation, and intracellular metabolism for β-glucans similar to that ascribed to the GH10/GH67 xylan utilization system in
Paenibacillus
JDR-2. Coordinate expression of genes encoding GH16 β-glucanases, transporters, and transcriptional regulators supports their role as a regulon for the utilization of soluble β-glucans. As in the case of the xylan utilization regulons, this soluble β-glucan regulon provides advantages in the growth rate and yields on polymeric substrates and may be exploited for the efficient conversion of plant-derived polysaccharides to targeted products.
Loop-Mediated Isothermal Amplification (LAMP) for Rapid Detection and Quantification of Dehalococcoides Biomarker Genes in Commercial Reductive Dechlorinating Cultures KB-1 and SDC-9
Authors: Kanitkar Yogendra H. , Stedtfeld Robert D. , Steffan Robert J. , Hashsham Syed A. , Cupples Alison M.
Published: January 2016

Real-time quantitative PCR (qPCR) protocols specific to the reductive dehalogenase (RDase) genes
vcrA
,
bvcA
, and
tceA
are commonly used to quantify
Dehalococcoides
spp. in groundwater from chlorinated solvent-contaminated sites. In this study, loop-mediated isothermal amplification (LAMP) was developed as an alternative approach for the quantification of these genes. LAMP does not require a real-time thermal cycler (i.e., amplification is isothermal), allowing the method to be performed using less-expensive and potentially field-deployable detection devices. Six LAMP primers were designed for each of three RDase genes (
vcrA
,
bvcA
, and
tceA
) using Primer Explorer V4. The LAMP assays were compared to conventional qPCR approaches using plasmid standards, two commercially available bioaugmentation cultures, KB-1 and SDC-9 (both contain
Dehalococcoides
species). DNA was extracted over a growth cycle from KB-1 and SDC-9 cultures amended with trichloroethene and vinyl chloride, respectively. All three genes were quantified for KB-1, whereas only
vcrA
was quantified for SDC-9. A comparison of LAMP and qPCR using standard plasmids indicated that quantification results were similar over a large range of gene concentrations. In addition, the quantitative increase in gene concentrations over one growth cycle of KB-1 and SDC-9 using LAMP was comparable to that of qPCR. The developed LAMP assays for
vcrA
and
tceA
genes were validated by comparing quantification on the Gene-Z handheld platform and a real-time thermal cycler using DNA isolated from eight groundwater samples obtained from an SDC-9-bioaugmented site (Tulsa, OK). These assays will be particularly useful at sites subject to bioaugmentation with these two commonly used
Dehalococcoides
species-containing cultures.
Microbial Diversity in the Early
In Vivo
-Formed Dental Biofilm
Authors: Heller D. , Helmerhorst E. J. , Gower A. C. , Siqueira W. L. , Paster B. J. , Oppenheim F. G.
Published: January 2016

Although the mature dental biofilm composition is well studied, there is very little information on the earliest phase of
in vivo
tooth colonization. Progress in dental biofilm collection methodologies and techniques of large-scale microbial identification have made new studies in this field of oral biology feasible. The aim of this study was to characterize the temporal changes and diversity of the cultivable and noncultivable microbes in the early dental biofilm. Samples of early dental biofilm were collected from 11 healthy subjects at 0, 2, 4, and 6 h after removal of plaque and pellicle from tooth surfaces. With the semiquantitative Human Oral Microbiome Identification Microarray (HOMIM) technique, which is based on 16S rRNA sequence hybridizations, plaque samples were analyzed with the currently available 407 HOMIM microbial probes. This led to the identification of at least 92 species, with streptococci being the most abundant bacteria across all time points in all subjects. High-frequency detection was also made with
Haemophilus parainfluenzae
,
Gemella haemolysans
,
Slackia exigua
, and
Rothia
species. Abundance changes over time were noted for
Streptococcus anginosus
and
Streptococcus intermedius
(
P
= 0.02),
Streptococcus mitis
bv. 2 (
P
= 0.0002),
Streptococcus oralis
(
P
= 0.0002),
Streptococcus
cluster I (
P
= 0.003),
G. haemolysans
(
P
= 0.0005), and
Stenotrophomonas maltophilia
(
P
= 0.02). Among the currently uncultivable microbiota, eight phylotypes were detected in the early stages of biofilm formation, one belonging to the candidate bacterial division TM7, which has attracted attention due to its potential association with periodontal disease.
Trigger Point Dry Needling versus Strain–counterstrain Technique for Upper Trapezius Myofascial Trigger Points: A Randomised Controlled Trial
Authors: Segura-Ortí E , Prades-Vergara S , Manzaneda-Piña L , Valero-Martínez R , Polo-Traverso JA
Published: January 2016

Background

Treatment of active myofascial trigger points includes both invasive and non-invasive techniques.

Objectives

To compare the effects of upper trapezius trigger point dry needling (DN) and strain–counterstrain (SCS) techniques versus sham SCS.

Study Design

Randomised controlled trial.

Method

34 study subjects with active trigger points were randomly assigned to one of three treatment groups, and received either three sessions of DN (n=12), six sessions of SCS (n=10), or sham SCS (n=12) over a 3-week period. Subjective pain response and subjects’ own ratings of perceived disability were measured.

Results

The analysis of variance mixed model showed a significant time effect for pain (p<0.001), elicited pain (p<0.001), pain pressure threshold (p<0.01), and neck disability index (p=0.016). Pain at rest decreased in all groups, as follows: DN 18.5 mm (95% CI 4.3 to 32.7 mm); SCS 28.3 mm (95% CI 12.4 to 44.1 mm); sham SCS 21.9 mm (95% CI 3.5 to 40.1 mm). Reductions in disability score (points) were significant in the SCS group (5.5, 95% CI 1.6 to 9.4) but not in the DN (1.4, 95% CI −4.9 to 2.1) or sham SCS (1.8, 95% CI −6.4 to 2.7) groups. There was no significant group×time interaction effect for any variables studied.

Conclusions

There were no differences between the sham SCS, SCS, and DN groups in any of the outcome measures. DN relieved pain after fewer sessions than SCS and sham SCS, and thus may be a more efficient technique. Future studies should include a larger sample size.

Trial Registration Number

NCT01290653.
Contributions of Adp and Atp to the Increase in Skeletal Muscle Blood Flow after Manual Acupuncture Stimulation in Rats
Authors: Nagaoka S , Shinbara H , Okubo M , Kawakita T , Hino K , Sumiya E
Published: January 2016

Objective

To investigate the contributions of adenosine triphosphate (ATP) and adenosine diphosphate (ADP) to the increase in skeletal muscle blood flow (MBF) observed following manual acupuncture (MA) stimulation in rats.

Methods

Male Sprague-Dawley rats were used as experimental animals (300–370 g, n=40). MA was applied to the right tibialis anterior muscle (TA) for 1 min using a stainless steel acupuncture needle. In eight rats, high-performance liquid chromatography with the microdialysis technique was used to measure local extracellular concentrations of ATP, ADP, adenosine monophosphate (AMP), and adenosine in the TA. In the remaining 32 rats, fluorescent microspheres (15 µm in diameter) were used to measure MBF in the TA following pre-treatment with either the P2 receptor antagonist suramin (100 mg/kg intra-arterially) or saline (control) (n=16 each). Rats receiving MA (Suramin+MA and Saline+MA groups, n=8 each) were compared with untreated rats (Suramin and Saline groups, n=8).

Results

MA significantly increased the local extracellular concentration of ATP, ADP, and adenosine (p<0.05, before MA vs 30 min after MA). In addition, MA significantly increased MBF in rats pre-treated with saline or suramin (p<0.01, Saline vs Saline+MA; p<0.05, Suramin vs Suramin+MA, respectively). However, suramin significantly suppressed this MA-induced increase in MBF (p<0.05, Saline+MA vs Suramin+MA).

Conclusions

These results suggest that both ATP and ADP partially contribute to the MA-induced increase in MBF via P2 receptors. However, further studies are needed to clarify the contributions of other vasodilators.
Physical performance tests predict injury in National Collegiate Athletic Association athletes: a three-season prospective cohort study
Authors: Hegedus Eric J , McDonough Suzanne , Bleakley Chris , Baxter G David , DePew J Tyler , Bradbury Ian , Cook Chad
Published: January 2016

Background

The ability to predict injury is difficult. Prior injury is the only risk factor that has been reported consistently in multiple research studies. Convenient and easy to perform, physical performance tests (PPTs) have great allure as prognostic factors.

Methods

11 PPTs were issued to 359 participants over the course of three seasons of National Collegiate Athletic Association Division I athletic competition. Injuries were monitored and reported in a centralised university tracking system. Exploratory factor analysis was performed in order to group the PPTs into constructs. The relationship between injury and these PPT-based constructs and other known predictors of injury was explored using univariate and multivariate regression.

Results

PPTs clustered into five constructs: (1) active motion, (2) power, (3) hip stability, (4) flexibility and (5) motor control. When these five were placed into a multiple regression equation along with known risk factors (age, body mass index (BMI), gender, excessive flexibility and past injury), hip stability and active motion were predicted injury. In addition, motor control predicted non-traumatic injury. Past injury did not predict injury in the multivariate model.

In college athletes, hip stability, active motion and motor control as assessed through PPTs can be useful as part of preseason screening. These PPT-related constructs seem to have a mediating effect on the relationship between past injury and future injury. This study provides the rationale to test targeted interventions to address these limitations.

Clinical trial registration number

NCT01804894.
Hamstring injuries have increased by 4% annually in men's professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study
Authors: Ekstrand Jan , Waldén Markus , Hägglund Martin
Published: January 2016

Background

There are limited data on hamstring injury rates over time in football.

Aim

To analyse time trends in hamstring injury rates in male professional footballers over 13 consecutive seasons and to distinguish the relative contribution of training and match injuries.

Methods

36 clubs from 12 European countries were followed between 2001 and 2014. Team medical staff recorded individual player exposure and time-loss injuries. Injuries per 1000 h were compared as a rate ratio (RR) with 95% CI. Injury burden was the number of lay off days per 1000 h. Seasonal trend for injury was analysed using linear regression.

Results

A total of 1614 hamstring injuries were recorded; 22% of players sustained at least one hamstring injury during a season. The overall hamstring injury rate over the 13-year period was 1.20 injuries per 1000 h; the match injury rate (4.77) being 9 times higher than the training injury rate (0.51; RR 9.4; 95% CI 8.5 to 10.4). The time-trend analysis showed an annual average 2.3% year on year increase in the total hamstring injury rate over the 13-year period (R2=0.431, b=0.023, 95% CI 0.006 to 0.041, p=0.015). This increase over time was most pronounced for training injuries—these increased by 4.0% per year (R2=0.450, b=0.040, 95% CI 0.011 to 0.070, p=0.012). The average hamstring injury burden was 19.7 days per 1000 h (annual average increase 4.1%) (R2=0.437, b=0.041, 95% CI 0.010 to 0.072, p=0.014).

Conclusions

Training-related hamstring injury rates have increased substantially since 2001 but match-related injury rates have remained stable. The challenge is for clubs to reduce training-related hamstring injury rates without impairing match performance.
Four biomechanical and anthropometric measures predict tibial stress fracture: a prospective study of 1065 Royal Marines
Authors: Nunns Michael , House Carol , Rice Hannah , Mostazir Mohammod , Davey Trish , Stiles Victoria , Fallowfield Joanne , Allsopp Adrian , Dixon Sharon
Published: January 2016

Background

Tibial stress fractures (TSFs) cause a significant burden to Royal Marines recruits. No prospective running gait analyses have previously been performed in military settings.

Aim

We aimed to identify biomechanical gait factors and anthropometric variables associated with increased risk of TSF.

Methods

1065 Royal Marines recruits were assessed in week 2 of training. Bilateral plantar pressure and three-dimensional lower limb kinematics were obtained for barefoot running at 3.6 m/s, providing dynamic arch index, peak heel pressure and lower limb joint angles. Age, bimalleolar breadth, calf girth, passive hip internal/external range of motion and body mass index (BMI) were also recorded. 10 recruits who sustained a TSF during training were compared with 120 recruits who completed training injury-free using a binary logistic regression model to identify injury risk factors.

Results

4 variables significantly (p<0.05) predicted increased risk of TSF (ORs and 95% CI): smaller bimalleolar width (0.73, 0.58 to 0.93), lower BMI (0.56, 0.33 to 0.95), greater peak heel pressure (1.25, 1.07 to 1.46) and lower range of tibial rotation (0.78, 0.63 to 0.96).

Reduced impact attenuation and ability to withstand load were implicated in tibial stress fracture risk.
Step training improves reaction time, gait and balance and reduces falls in older people: a systematic review and meta-analysis
Authors: Okubo Yoshiro , Schoene Daniel , Lord Stephen R
Published: January 2016

Objective

To examine the effects of stepping interventions on fall risk factors and fall incidence in older people.

Data source

Electronic databases (PubMed, EMBASE, CINAHL, Cochrane, CENTRAL) and reference lists of included articles from inception to March 2015.

Study selection

Randomised (RCT) or clinical controlled trials (CCT) of volitional and reactive stepping interventions that included older (minimum age 60) people providing data on falls or fall risk factors.

Results

Meta-analyses of seven RCTs (n=660) showed that the stepping interventions significantly reduced the rate of falls (rate ratio=0.48, 95% CI 0.36 to 0.65, p<0.0001, I2=0%) and the proportion of fallers (risk ratio=0.51, 95% CI 0.38 to 0.68, p<0.0001, I2=0%). Subgroup analyses stratified by reactive and volitional stepping interventions revealed a similar efficacy for rate of falls and proportion of fallers. A meta-analysis of two RCTs (n=62) showed that stepping interventions significantly reduced laboratory-induced falls, and meta-analysis findings of up to five RCTs and CCTs (n=36–416) revealed that stepping interventions significantly improved simple and choice stepping reaction time, single leg stance, timed up and go performance (p<0.05), but not measures of strength.

Conclusions

The findings indicate that both reactive and volitional stepping interventions reduce falls among older adults by approximately 50%. This clinically significant reduction may be due to improvements in reaction time, gait, balance and balance recovery but not in strength. Further high-quality studies aimed at maximising the effectiveness and feasibility of stepping interventions are required.

Systematic reviews registration number

CRD42015017357.
Factors associated with declining under-five mortality rates from 2000 to 2013: an ecological analysis of 46 African countries
Authors: Kipp Aaron M , Blevins Meridith , Haley Connie A , Mwinga Kasonde , Habimana Phanuel , Shepherd Bryan E , Aliyu Muktar H , Ketsela Tigest , Vermund Sten H
Published: January 2016

Objective

Inadequate overall progress has been made towards the 4th Millennium Development Goal of reducing under-five mortality rates by two-thirds between 1990 and 2015. Progress has been variable across African countries. We examined health, economic and social factors potentially associated with reductions in under-five mortality (U5M) from 2000 to 2013.

Setting

Ecological analysis using publicly available data from the 46 nations within the WHO African Region.

Outcome measures

We assessed the annual rate of change (ARC) of 70 different factors and their association with the annual rate of reduction (ARR) of U5M rates using robust linear regression models.

Results

Most factors improved over the study period for most countries, with the largest increases seen for economic or technological development and external financing factors. The median (IQR) U5M ARR was 3.6% (2.8 to 5.1%). Only 4 of 70 factors demonstrated a strong and significant association with U5M ARRs, adjusting for potential confounders. Higher ARRs were associated with more rapidly increasing coverage of seeking treatment for acute respiratory infection (β=0.22 (ie, a 1% increase in the ARC was associated with a 0.22% increase in ARR); 90% CI 0.09 to 0.35; p=0.01), increasing health expenditure relative to gross domestic product (β=0.26; 95% CI 0.11 to 0.41; p=0.02), increasing fertility rate (β=0.54; 95% CI 0.07 to 1.02; p=0.07) and decreasing maternal mortality ratio (β=−0.47; 95% CI −0.69 to −0.24; p<0.01). The majority of factors showed no association or raised validity concerns due to missing data from a large number of countries.

Conclusions

Improvements in sociodemographic, maternal health and governance and financing factors were more likely associated with U5M ARR. These underscore the essential role of contextual factors facilitating child health interventions and services. Surveillance of these factors could help monitor which countries need additional support in reducing U5M.
Patient-centredness as a quality domain in Swedish healthcare: results from the first national surveys in different Swedish healthcare settings
Authors: Kandelaki Ketevan , Marrone Gaetano , Lundborg Cecilia Stålsby , Schmidt Ingrid , Björkman Ingeborg
Published: January 2016

Objectives

Patients’ perception of the quality and patient-centredness of healthcare has gained increasing interest in the last decade in Sweden, as in other countries. The purpose of the study was to evaluate to what extent patients perceived Swedish healthcare as patient-centred and to explore the satisfaction levels related to gender, education level and to having or not having Swedish as one's mother tongue.

Design and settings

This study has a cross-sectional design. Analyses were based on the first national patient surveys in Sweden, conducted between 2009 and 2010. The surveys included responses from 232 518 patients who had been in contact with primary, outpatient, inpatient, or emergency care units. Survey questions related to indicators of patient-centred care and sociodemographic variables were selected for the analysis. The patients’ level of satisfaction in the selected indicators was analysed and compared by sociodemographic and background factors. Multivariable logistic regression models were used for analysis.

Results

The patients expressed high levels of satisfaction in questions related to the ‘Respect’ indicator (81–96% satisfied) but lower levels in most of the other indicators of patient-centred care. Only 25–30% of the patients reported they had been told about possible warning signs of their condition or treatment and 58–66% said they had received enough information about their condition. Group differences were detected. The most satisfied patient groups were men, individuals with low levels of education and those with Swedish as their mother tongue.

Conclusions

According to these first national patient surveys, achieving patient-centred healthcare for all citizens is a challenge for Swedish healthcare authorities. Future analyses of national patient surveys should show whether national efforts to encourage acceptance of patient-centred approaches and strategies for equal care will give intended results.
Are there long-term benefits of experiential, interprofessional education for non-specialists on clinical behaviours and outcomes in diabetes care? A cohort study
Authors: Ching Daniel , Forte Denise , Aitchison Elizabeth , Earle Kenneth
Published: January 2016

Objectives

Our aim was to assess the impact of an educational initiative for non-specialist, healthcare professionals in the community on the process and quality measures of diabetes care delivered, and changes in their learning experiences and clinical management behaviour in the short and long term.

Setting

Single locality of 26 primary care practices associated with one secondary centre.

Participants

General practitioners and practice nurses managing 4167 patients with diabetes.

Intervention

A rolling 10-week, experiential, interprofessional education programme delivered to 57 practitioners and observations in practice.

Primary and secondary outcome measures

Primary outcomes were changes in the proportion of patients receiving foot care, urine albumin:creatinine ratio assessments and achieving National Quality Outcome Framework targets for blood pressure (<145/80 mm Hg), glycated haemoglobin (HbA1c; >86 mmol/mol (10%) and <57.4 mmol/mol (7.4%)) and total cholesterol (<5 mmol/L) thresholds. Secondary outcomes were evidence of sustained learning and changes in the number of patients referred to secondary care.

Results

Evaluation of care processes and quality outcomes took place 15 months after the programme was initiated. The proportion of patients with a HbA1c of <57.4 mmol/mol (7.4%) and >85 mmol/mol (10%) was significantly higher (44% vs 53% p=0.0001) and lower (12.5% vs 10%; p=0.002) respectively. There was an increase in the proportion (95% CI) of patients receiving foot care reviews (+26.0% (24.0% to 28.1%)), microalbuminuria screening (+29.8% (27.7% to 31.9%)) and who achieved targets for blood pressure (+9.6% (7.5% to 11.6%)) and total cholesterol (+14.4% (12.3% to 16.5%); p<0.001). 241 fewer patients were referred to secondary care. Increases in the healthcare professional's confidence and collaborative clinical behaviour were evident 3 years after completing the programme.

Conclusions

An experiential, interprofessional intervention can result in significant improvements in quality outcomes in association with a sustained impact on behaviours and practices.
Associations of vitamin D status, bone health and anthropometry, with gross motor development and performance of school-aged Indian children who were born at term with low birth weight
Authors: Filteau Suzanne , Rehman Andrea M , Yousafzai Aisha , Chugh Reema , Kaur Manpreet , Sachdev H P S , Trilok-Kumar Geeta
Published: January 2016

Objectives

There is little information regarding motor development of children born at term with low birth weight (LBW), a group that constitutes a large proportion of children in South Asia. We used data from infancy and at school age from a LBW cohort to investigate children's motor performance using causal inference.

Design

Cross-sectional follow-up study.

Setting

Delhi, India.

Participants

We recruited 912 children aged 5 years who had participated in a trial of vitamin D for term LBW infants in the first 6 months of life.

Outcome measures

We focused on gross motor development, using the Ages and Stages Questionnaire (ASQ) gross motor scale and several measures of motor performance. We examined the effects on these of current anthropometry, vitamin D status and bone health, controlling for age, sex, season of interview, socioeconomic variables, early growth, recent morbidity, sun exposure and animal food intake.

Results

In adjusted analyses, stunted children (height-for-age Z (HAZ) <−2) took longer to run 20 m (0.52 s, 95% CI 0.35 to 0.70; p<0.001) and had greater odds of a failing score on the ASQ (OR 3.00, 95% CI 1.41 to 6.38, p=0.004). Greater arm muscle area was associated with faster run time, and the ability to perform more stands and squats in 15 s. Poorer vitamin D status was associated with the ability to perform more stands and squats. Lower tibia ultrasound Z score was associated with greater hand grip strength. Early growth and current body mass index had no associations with motor outcomes.

Conclusions

Current HAZ and arm muscle area showed the strongest associations with gross motor outcomes, likely due to a combination of simple physics and factors associated with stunting. The counterintuitive inverse associations of tibia health and vitamin D status with outcomes may require further research.