bluuebunny/crossref_metadata_2025 huggingface dataset:
Enjeux de la Tunisie orientale : un territoire développé et un environnement à protéger
Authors: Chouari Walid , Belarem Mongi
Published: March 2017

Depuis les années 1970, en Tunisie orientale, on assiste à la montée des problèmes environnementaux et des risques naturels : pollutions multiformes et risques essentiellement d’origine hydrodynamique et hydrologique, etc.Sans solution à ces problèmes, le pays pourrait entrer dans une spirale de déclin, perdant les atouts qui font sa richesse et abandonnant une partie de sa population dans l’exclusion sociale et spatiale. Ces perspectives imposent d’engager une réflexion globale sur l’espace tunisien, sur ses contraintes et ses risques, et sur les atouts et les moyens dont il dispose pour orienter les changements dans une perspective de développement durable.
Geografia e ambiente: trajetórias e tendências das pesquisas geossistêmicas no Estado de São Paulo
Authors: Neves Carlos Eduardo das , Machado Gilnei
Published: March 2017

É fato a relevância da análise geossistêmica na pesquisa geográfica, considerando a necessidade do entendimento das relações entre a sociedade e a natureza. Nesse cenário, buscou-se compreender o desenvolvimento da pesquisa geográfica relacionada ao geossistema, entre 1971 e 2011, no Estado de São Paulo. Para isso, realizou-se análise teórico-metodológica das dissertações e teses defendidas na UNESP (Rio Claro e Presidente Prudente), UNICAMP e USP, a partir da adaptação da proposta teórico-metodológica de Gamboa (1987), da criação de banco de dados digital para a análise bibliométrica, do método histórico-documental, além de cálculos estatísticos e geoprocessamento. Por meio dos resultados foi possível sistematizar contribuições científicas que se encontravam dispersas na história, bem como auxiliar no entendimento das trajetórias e tendências das pesquisas de cunho geossistêmico e sua correlação e importância para o desenvolvimento dos estudos ambientais na ciência geográfica brasileira.
Incidents of Cyberbullying Among Library and Information Science (LIS) Students at Delta State University, Abraka, Nigeria
Authors: Adomi Esharenana E. , Eriki Joy Ashy , Tiemo Pereware Aghwotu , Akpojotor Lucky O.
Published: March 2017

The purpose of this study is to explore incidents of cyberbullying among library and information science (LIS) students at Delta State University, Abraka, Nigeria. Descriptive survey research design was adopted in this study. This design was adopted because it would permit the researchers to investigate the current status of the incidents of cyberbullying among library and information science students at Delta State University, Abraka and did not involve manipulation of variables. The population and sample of this study consisted of year three undergraduate library and information science student of Delta State University, Abraka, Nigeria. This is made of 80 students in 2013/2014 academic session. The questionnaire was used as instrument of data collection. Frequency counts and percentage were used for data analysis. The study revealed that 80% of the students have knowledge of cyberbullying; 80% of them have been cyberbullied; the types of cyberbullying experienced include harassment, flaming, masquerade, denigration, exclusion, outing and trickery, and cyberstalking in that order; 40.6% of the students were cyberbullied via Facebook, 37.5% via cell phone, 31.3% chat room, 21.9% via instant messaging, 14.1% e-mail; 35.9% of them perceived perpetrators of the cyberbullying to be friends, 25 anonymous/don't know, 23.4% ex-lover, 15.6% course mate; the effects of cyberbullying on the students are anger (40.6%), low self-esteem (25%), depression (21.9%), low academic performance (20.3%), school phobia (15.6%). This study provided primary data on students and cyberbullying in a developing country. The findings would enable educational authorities to know the status of cyberbullying among university students, which would help them to educate the students on the issues involved and plan intervention actions that will assist the students to deal with experience of cyberbullying.
Glucose-Dependent Insulinotropic Polypeptide Receptor Deficiency Leads to Impaired Bone Marrow Hematopoiesis
Authors: Mantelmacher Fernanda Dana , Fishman Sigal , Cohen Keren , Pasmanik Chor Metsada , Yamada Yuichiro , Zvibel Isabel , Varol Chen
Published: March 2017

The bone marrow (BM) contains controlled specialized microenvironments, or niches, that regulate the quiescence, proliferation, and differentiation of hematopoietic stem and progenitor cells (HSPC). The glucose-dependent insulinotropic polypeptide (GIP) is a gut-derived incretin hormone that mediates postprandial insulin secretion and has anabolic effects on adipose tissue. Previous studies demonstrated altered bone microarchitecture in mice deficient for GIP receptor (Gipr−/−), as well as the expression of high-affinity GIP receptor by distinct cells constructing the BM HSPC niche. Nevertheless, the involvement of GIP in the process of BM hematopoiesis remains elusive. In this article, we show significantly reduced representation and proliferation of HSPC and myeloid progenitors in the BM of Gipr−/− mice. This was further manifested by reduced levels of BM and circulating differentiated immune cells in young and old adult mice. Moreover, GIP signaling was required for the establishment of supportive BM HSPC niches during HSPC repopulation in radioablated BM chimera mice. Finally, molecular profiling of various factors involved in retention, survival, and expansion of HSPC revealed significantly lower expression of the Notch-receptor ligands Jagged 1 and Jagged 2 in osteoblast-enriched bone extracts from Gipr−/− mice, which are important for HSPC expansion. In addition, there was increased expression of CXCL12, a factor important for HSPC retention and quiescence, in whole-BM extracts from Gipr−/− mice. Collectively, our data suggest that the metabolic hormone GIP plays an important role in BM hematopoiesis.
Binding of Platelets to Lymphocytes: A Potential Anti-Inflammatory Therapy in Rheumatoid Arthritis
Authors: Zamora Carlos , Cantó Elisabet , Nieto Juan C. , Bardina Jorge , Diaz-Torné Cesar , Moya Patricia , Magallares Berta , Ortiz M. Angels , Julià Germà , Juarez Candido , Llobet Josep M. , Vidal Silvia
Published: March 2017

Soluble factors released from platelets can modulate the immune response of leukocytes. We and others have recently found that T lymphocytes with bound platelets have reduced proliferation and IFN-γ and IL-17 production. Thus, we speculate that if we induce the binding of platelets to lymphocytes, we will be able to regulate the inflammatory response. When we cocultured platelets with lymphocytes at different ratios, we were able to increase the percentage of lymphocytes with bound platelets. The coculture of platelets with lymphocytes in the presence of stimulation decreased the production of IFN-γ and TNF-α, T cell proliferation, and the expression of CD25, PD-L1, and SLAM. However, this coculture increased CD39 expression. All of these effects were dependent on the dose of platelets and operated indistinctly with platelets from different healthy donors. When platelets were cocultured in the same compartment with lymphocytes, we observed less IFN-γ and TNF-α production and T lymphocyte proliferation than in cultures with platelets separated from lymphocytes by a 0.4-μm pore size filter. The binding of platelets to lymphocytes was blocked with anti–P-selectin Abs, and when this occurred we observed higher IFN-γ and TNF-α production than in nonblocked conditions. The cocultures of platelets with synovial fluid cells from rheumatoid arthritis patients reduced inflammatory cytokine production and increased IL-10 production. These results suggest that platelet binding to lymphocytes effectively regulates T lymphocyte function. This mechanism could be easily applied to reduce inflammatory responses.
Maturational Changes in Ear Advantage for Monaural Word Recognition in Noise among Listeners with Central Auditory Processing Disorders
Authors: Shaikh Mohsin Ahmed , Fox-Thomas Lisa , Tucker Denise
Published: March 2017

This study aimed to investigate differences between ears in performance on a monaural word recognition in noise test among individuals across a broad range of ages assessed for (C)APD. Word recognition scores in quiet and in speech noise were collected retrospectively from the medical files of 107 individuals between the ages of 7 and 30 years who were diagnosed with (C)APD. No ear advantage was found on the word recognition in noise task in groups less than ten years. Performance in both ears was equally poor. Right ear performance improved across age groups, with scores of individuals above age 10 years falling within the normal range. In contrast, left ear performance remained essentially stable and in the impaired range across all age groups. Findings indicate poor left hemispheric dominance for speech perception in noise in children below the age of 10 years with (C)APD. However, a right ear advantage on this monaural speech in noise task was observed for individuals 10 years and older.
Hemophagocytic Lymphohistiocytosis, an Unclear Nosologic Entity: Case Report of an Adult Man with Rising of Amylase and Lipase and Spinal Cord Infiltration
Authors: Sangineto Moris , Perrone Antonio , Agosti Pasquale , Boccuti Viera , Campobasso Anna , Sabbà Carlo
Published: March 2017

Here we present the case of a 57-years old patient affected by hemophagocytic lymphohistiocytosis (HLH), a rare disease characterized by an uncontrolled immune activation, resulting in clinical and biochemical manifestations of extreme inflammation. In a previous hospitalization, the patient showed fever, hepato-splenomegaly, pancytopenia, hyperferrtitinemia, lymphadenopathy and cholestasis. No diagnosis was done, however, he totally recovered after splenectomy. Eight months later, he relapsed, showing also hypofibrinogenemia, hypertriglyceridemia, hemophagocytic signs in bone marrow, cholestatic jaundice, high LDH and high PT-INR. Interestingly, he presented increased levels of amylase and lipase in absence of radiologic signs of pancreatitis. He was treated with Dexamethasone and Cyclosporine according to HLH-2004 guidelines. The clinical and biochemical manifestations disappeared in a few weeks, but he was newly hospitalized for lower limbs hypotonia caused by a hemophagocytic lesion of the cauda equina and lumbar cord. The death occurred in a few days, despite the immunosuppressive treatment.
Hemoglobin Willamette (b51 Pro → Arg): Case Report and Literature Review
Authors: Barbosa Orivaldo Alves , de Sousa Dias Matheus Martins , Távora Saymon Medeiros , de Galiza Neto Gentil Claudino , de Souza Jacqueline Holanda , da Silva Herivaldo Ferreira
Published: March 2017

We report a case of hemoglobin (Hb) Willamette (β51 Pro → Arg) in the Hematology Department of a tertiary hospital in Fortaleza, Northeast of Brazil. A literature review of the cases described in health sciences databases using as a descriptor Hb Willamette was performed, revealing 12 reported cases, of which only one presented with anemia. Herein, we describe a case of a female 29 years old, with hemoglobinopathy Willamette presenting clinically with anemia, having the lowest hemoglobin rate of the published cases. The relatives of the patient were evaluated andthe patient’s mother corresponded to the first description of the association between Hb Willamette and HbC. Among the hemoglobinopathies, hemoglobin Willamette is an extremely rare disease; therefore it is important to analyze its clinical and laboratory manifestations for accurate diagnosis and assessment of potential interactions with other genetic variants.
Bridging between litterbags and whole-ecosystem experiments: a new approach for studying lake sediments
Authors: Tanentzap Andrew J. , Szkokan-Emilson Erik J. , Desjardins Cyndy M. , Orland Chloe , Yakimovich Kurt , Dirszowsky Randy , Mykytczuk Nadia , Basiliko Nathan , Gunn John
Published: March 2017

Nearshore sediments have a major influence over the functioning of aquatic ecosystems, but predicting their response to future environmental change has proven difficult. Previous manipulative experiments have faced challenges controlling environmental conditions, replicating sediment mixing dynamics, and extrapolating across spatial scales. Here we describe a new approach to manipulate lake sediments that overcomes previous concerns about reproducibility and environment controls, whilst also bridging the gap between smaller microcosm or litterbag experiments and whole-ecosystem manipulations. Our approach involves submerging moderate-sized (~15 L) artificial substrates that have been standardised to mimic natural sediments within the littoral zones of lakes.  We show that this approach can accurately mirror the absolute dissolved organic carbon concentrations and pH of pore water, and to a lesser degree inorganic carbon concentrations, from natural lake sediments with similar organic matter profiles. On a relative basis, all measured variables had similar temporal dynamics between artificial and adjacent natural sediments. Late-summer zooplankton biomass also did not differ between natural and artificial sediments.  By offering a more realistic way to manipulate freshwater sediments than previously possible, our approach can improve predictions of lake ecosystems in a changing world.

 
This work is licensed under a Creative Commons Attribution 4.0 International.
Il dibattito in Biogiuridica - Si può considerare la nascita un danno risarcibile? / The dabate in Biolaw – Is it possible to consider birth as a compensable damage?
Authors: Casini Marina
Published: March 2017

Non disponibile / Not available
A Preliminary Multifactorial Approach Describing the Relationships Among Lower Extremity Alignment, Hip Muscle Activation, and Lower Extremity Joint Excursion
Authors: Nguyen Anh-Dung , Shultz Sandra J. , Schmitz Randy J. , Luecht Richard M. , Perrin David H.
Published: March 2017

Context: Multiple factors have been suggested to increase the risk of faulty dynamic alignments that predict noncontact anterior cruciate ligament injury. Few researchers have examined this relationship using an integrated, multifactorial approach.

Objective: To describe the relationship among static lower extremity alignment (LEA), hip muscle activation, and hip and knee motion during a single-leg squat.

Design: Descriptive laboratory study.

Setting: Research laboratory.

Patients or Other Participants: Thirty men (age = 23.9 ± 3.6 years, height = 178.5 ± 9.9 cm, mass = 82.0 ± 14.1 kg) and 30 women (age = 22.2 ± 2.6 years, height = 162.4 ± 6.3 cm, mass = 60.3 ± 8.1 kg).

Main Outcome Measure(s): Pelvic angle, femoral anteversion, quadriceps angle, tibiofemoral angle, and genu recurvatum were measured to the nearest degree; navicular drop was measured to the nearest millimeter. The average root mean square amplitude of the gluteus medius and maximus muscles was assessed during the single-leg squat and normalized to the peak root mean square value during maximal contractions for each muscle. Kinematic data of hip and knee were also assessed during the single-leg squat. Structural equation modeling was used to describe the relationships among static LEA, hip muscle activation, and joint kinematics, while also accounting for an individual's sex and hip strength.

Results: Smaller pelvic angle and greater femoral anteversion, tibiofemoral angle, and navicular drop predicted greater hip internal-rotation excursion and knee external-rotation excursion. Decreased gluteus maximus activation predicted greater hip internal-rotation excursion but decreased knee valgus excursion. No LEA characteristic predicted gluteus medius or gluteus maximus muscle activation during the single-leg squat.

Conclusions: Static LEA, characterized by a more internally rotated hip and valgus knee alignment and less gluteus maximus activation, was related to commonly observed components of functional valgus collapse during the single-leg squat. This exploratory analysis suggests that LEA does not influence hip muscle activation in controlling joint motion during a single-leg squat.
Microdialysis and Delivery of Iontophoresis-Driven Lidocaine Into the Human Gastrocnemius Muscle
Authors: Coglianese Mark , Draper David O. , Shurtz Joseph , Mark Gary
Published: March 2017

Context: Iontophoresis is used frequently in physical medicine and rehabilitation, but many research techniques do not adequately measure it for depth of medicine delivery.

Objective: To determine if iontophoresis delivers lidocaine 5 mm under the surface of human skin.

Design: Descriptive laboratory study.

Setting: Therapeutic modalities research laboratory.

Patients or Other Participants: Eight men and 5 women volunteers (age range = 21 ± 2.3 years) who had less than 5 mm of adipose tissue in the area we measured participated in the study.

Intervention(s): We inserted a microdialysis probe 5 mm under the skin of both legs and into the triceps surae muscle groups of 10 participants. Microdialysis was performed for 60 minutes to allow a recovery period for local skin blood flow to return to baseline. We then delivered 2 mL of 1% lidocaine to the treatment leg via iontophoresis at 40 mA/min. Next, microdialysis was performed continuously in both legs during the treatment and for 30 minutes posttreatment to collect the lidocaine samples. After we had gathered the samples, several saline solutions with various amounts of lidocaine (0.005%, 0.025%, 0.05%, and 0.1%) were prepared in vitro and analyzed. Although we did not intend to do so as a part of the original study, we also performed an identical follow-up study at 3 mm in 3 participants.

Main Outcome Measure(s): Both in vitro and in vivo samples were analyzed via reverse-phase high-performance liquid chromatography (RP-HPLC). A protocol for detection and quantification of lidocaine using RP-HPLC was followed.

Results: We did not detect any measurable levels or concentrations of lidocaine in the 10 control samples. According to the RP-HPLC analysis, the 10 treatment samples also were negative for the presence of lidocaine. However, when we performed the study at 3 mm, microdialysis detected lidocaine in the 3 participants at this depth in the treatment leg only.

Conclusions: Measurable levels of lidocaine were not detected at 5 mm but were found at 3 mm. More studies are needed to determine the efficacy of microdialysis in measuring iontophoresis-delivered compounds.
Performance After Rotator Cuff Tear and Operative Treatment: A Case-Control Study of Major League Baseball Pitchers
Authors: Namdari Surena , Baldwin Keith , Ahn Albert , Huffman G. Russell , Sennett Brian J.
Published: March 2017

Context: Little is known about pitching performance or lack of it among Major League Baseball (MLB) pitchers who undergo operative treatment of rotator cuff tears.

Objective: To assess pitching performance outcomes in MLB players who needed operative treatment of rotator cuff tears and to compare performance in these athletes with that in a control group of MLB players.

Design: Case-control study.

Setting: Publicly available player profiles, press releases, and team injury reports.

Patients or Other Participants: Thirty-three MLB pitchers with documented surgery to treat rotator cuff tears and 117 control pitchers who did not have documented rotator cuff tears were identified.

Main Outcome Measure(s): Major League Baseball pitching attrition and performance variables.

Results: Players who underwent rotator cuff surgery were no more likely not to play than control players. Performance variables of players who underwent surgery improved after surgery but never returned to baseline preoperative status. Players who needed rotator cuff surgery typically were more experienced and had better earned run averages than control players.

Conclusions: Pitchers who had symptomatic rotator cuff tears that necessitated operative treatment tended to decline gradually in performance leading up to their operations and to improve gradually over the next 3 seasons. In contrast to what we expected, they did not have a greater attrition rate than their control counterparts; however, their performances did not return to preoperative levels over the course of the study.
Perceptions of Clinical Athletic Trainers on the Spiritual Care of Injured Athletes
Authors: McKnight Cynthia M. , Juillerat Stephanie
Published: March 2017

Context: Treating both the body and the mind of an injured or ill patient is accepted as necessary for full healing to occur. However, treating the spiritual needs of the patient has less consensus.

Objective: To determine the perceptions and practices of certified athletic trainers (ATs) working in the college/university setting pertaining to spiritual care of the injured athlete.

Design: Cross-sectional study.

Setting: A survey instrument was e-mailed to a stratified random sample of 2000 ATs at 4-year colleges and universities.

Patients or Other Participants: Five hundred sixty-four participants (296 men, 234 women; 34 did not specify sex).

Main Outcome Measure(s): We measured the ATs' perceptions and practices related to spiritual care for athletes.

Results: We found that 82.4% of respondents agreed that addressing spiritual concerns could result in more positive therapeutic outcomes for athletes; however, 64.3% disagreed that ATs are responsible for providing the spiritual care. Positive correlations were found between personal spirituality and items favoring implementing spiritual care.

Conclusions: Athletic trainers have a conceptual appreciation of the importance of spiritual care for athletes, but the practicalities of how to define, acquire skills in, and practice spiritual care are unresolved.
National Collegiate Athletic Association Division and Primary Job Title of Athletic Trainers and Their Job Satisfaction or Intention to Leave Athletic Training
Authors: Terranova Aaron B. , Henning Jolene M.
Published: March 2017

Context: Membership in the National Athletic Trainers' Association (NATA) has declined in recent years, generating much debate about professional commitment.

Objective: To compare the contributing factors of job satisfaction and intention to leave athletic training of certified athletic trainers (ATs) employed in National Collegiate Athletic Association (NCAA) institutions.

Design: Cross-sectional study.

Setting: A link to a Web-based questionnaire containing the Spector Job Satisfaction Survey (JSS) and an original Intention to Leave Survey (ITLS) was distributed by e-mail to 1003 certified members of the National Athletic Trainers' Association.

Patients or Other Participants: A total of 191 certified members of the NATA employed in a college or university setting in a primarily clinical capacity; representing all NCAA divisions; and having the job title of head athletic trainer, associate/assistant athletic trainer, or graduate assistant/intern athletic trainer.

Main Outcome Measure(s): We used separate 3 × 3 factorial analyses of variance to compare the mean scores of each JSS subscale and of the ITLS with NCAA division and job title. A stepwise multiple regression was used to determine the strength of the relationships between the JSS subscales and the ITLS.

Results: We found differences for job title in the subscales of Fringe Benefits (F2,182 = 7.82, P = .001) and Operating Conditions (F2,182 = 12.01, P < .001). The JSS subscale Nature of Work was the greatest indicator of intention to leave (β = −0.45).

Conclusions: We found a strong negative correlation between various facets of job satisfaction and intention to leave athletic training. The NCAA division seemed to have no effect on an individual's job satisfaction or intention to leave the profession. In addition, only Fringe Benefits and Operating Conditions seemed to be affected by job title. The ATs had similar levels of job satisfaction regardless of NCAA division, and their job titles were not a major factor in job satisfaction.
Transient Global Amnesia in a Collegiate Baseball Player with Type I Diabetes Mellitus: A Case Report
Authors: Gravlee Jocelyn R. , Barrett John J.
Published: March 2017

Objective: To present the case of a collegiate pitcher with type I diabetes mellitus who developed transient global amnesia and to characterize the acute onset of symptoms and clinical diagnosis of this rarely reported neurologic condition in the student-athlete population.

Background: A 21-year-old collegiate pitcher with type I diabetes mellitus was found by his roommate to have acute-onset memory loss. The athletic trainer identified normal blood glucose levels and normal vital signs but profound amnesia. The patient was evaluated by his team physician and referred to the local emergency department for acute-onset memory disturbance.

Differential Diagnosis: Hypoglycemia, ketoacidosis, adverse drug reaction, infectious disease, transient epileptic amnesia, transient ischemic attack, acute confusional state, complex partial seizure, psychogenic amnesia, migraine, intracerebral hemorrhage, traumatic brain injury, tumor, and transient global amnesia.

Treatment: Diagnostic studies included computed tomography of the head, urine and serum toxicology, urinalysis, blood glucose level, electrolytes, blood urea nitrogen level, creatinine level, complete blood count, and electroencephalography. The patient was admitted overnight to the neurology service. The next morning, electroencephalography was repeated, and magnetic resonance imaging of the head with contrast was performed. The patient was discharged with the diagnosis of transient global amnesia.

Uniqueness: Transient global amnesia is considered a benign condition characterized by an acute episode of memory disturbance involving the inability to form new memories and recall recent events. It is rare in young people, with only 3 case reports involving young athletes published in the literature.

Conclusions: Transient global amnesia is a rarely diagnosed neurologic disturbance that may present acutely in student–athletes, although most reported cases affect older adults. Un-familiarity with the symptoms may cause anxiety for the athlete and bystanders. Transient global amnesia does not result in long-term neurologic deficit, and neurologic function will return to baseline.
Between-Seasons Test-Retest Reliability of Clinically Measured Reaction Time in National Collegiate Athletic Association Division I Athletes
Authors: Eckner James T. , Kutcher Jeffrey S. , Richardson James K.
Published: March 2017

Context: Reaction time is typically impaired after concussion. A clinical test of reaction time (RTclin) that does not require a computer to administer may be a valuable tool to assist in concussion diagnosis and management.

Objective: To determine the test-retest reliability of RTclin measured over successive seasons in competitive collegiate athletes and to compare these results with a computerized measure of reaction time (RTcomp).

Design: Case series with repeated measures.

Setting: Preparticipation physical examinations for the football, women's soccer, and wrestling teams at a single university.

Patients or Other Participants: 102 National Collegiate Athletic Association Division I athletes.

Intervention(s): The RTclin was measured using a measuring stick embedded in a weighted rubber disk that was released and caught as quickly as possible. The RTcomp was measured using the simple reaction time component of CogState Sport.

Main Outcome Measure(s): Data were collected at 2 time points, 1 season apart, during preparticipation physical examinations. Outcomes were mean simple RTclin and RTcomp.

Results: The intraclass correlation coefficient estimates from season 1 to season 2 were 0.645 for RTclin (n = 102, entire sample) and 0.512 for RTcomp (n = 62 athletes who had 2 consecutive valid baseline CogState Sport test sessions).

Conclusions: The test-retest reliability of RTclin over consecutive seasons compared favorably with that of a concurrently tested computerized measure of reaction time and with literature-based estimates of computerized reaction time measures. This finding supports the potential use of RTclin as part of a multifaceted concussion assessment battery. Further prospective study is warranted.
Evidence-Based Medicine and the Recognition and Treatment of Exertional Heat Stroke, Part II: A Perspective From the Clinical Athletic Trainer
Authors: Mazerolle Stephanie M. , Pinkus Danielle E. , Casa Douglas J. , McDermott Brendon P. , Pagnotta Kelly D. , Ruiz Roberto C. , Armstrong Lawrence E. , Maresh Carl M.
Published: March 2017

Context: Exertional heat stroke (EHS) is one of the leading causes of death in athletes. Certified athletic trainers (ATs) demonstrate strong knowledge of recommended practices with EHS but are apprehensive in implementing 2 basic procedures: rectal temperature assessment and cold water immersion. This apprehension might lead to deaths from EHS that could have been prevented.

Objective: To investigate why collegiate and high school ATs do not implement best practices for the recognition and treatment of EHS.

Design: Qualitative study.

Setting: In-person focus groups consisting of 3 to 6 collegiate or high school ATs.

Patients or Other Participants: A total of 19 ATs (9 men, 10 women; age = 36 ± 10 years, length of certification = 12 ± 9 years) employed at either the collegiate (n = 10) or high school (n = 9) level participated in the study.

Data Collection and Analysis: Interviews were transcribed verbatim, and data were analyzed using deductive data analysis. Peer review and multiple-analyst data triangulation were conducted to establish trustworthiness of the data.

Results: Five emergent themes explained the lack of evidence-based practice (EBP) regarding recognition and treatment of EHS. Three themes (lack of knowledge, comfort level, lack of initiative) were common in both the collegiate and high school settings, and 2 separate themes (liability concerns, lack of resources) were present in the high school setting.

Conclusions: Our findings are consistent with those in the literature on EBP and EHS. Regardless of clinical setting, ATs have basic information on recognition and treatment of EHS, but 5 themes act as barriers to implementing proper management in the clinical setting. Workshops or hands-on training sessions need to be made available to improve students' comfort levels so ATs will implement EBP into everyday settings.
Half-Marathon and Full-Marathon Runners' Hydration Practices and Perceptions
Authors: O'Neal Eric K. , Wingo Jonathan E. , Richardson Mark T. , Leeper James D. , Neggers Yasmine H. , Bishop Phil A.
Published: March 2017

Context: The behaviors and beliefs of recreational runners with regard to hydration maintenance are not well elucidated.

Objective: To examine which beverages runners choose to drink and why, negative performance and health experiences related to dehydration, and methods used to assess hydration status.

Design: Cross-sectional study.

Setting: Marathon registration site.

Patients or Other Participants: Men (n = 146) and women (n = 130) (age = 38.3 ± 11.3 years) registered for the 2010 Little Rock Half-Marathon or Full Marathon.

Intervention(s): A 23-item questionnaire was administered to runners when they picked up their race timing chips.

Main Outcome Measure(s): Runners were separated into tertiles (Low, Mod, High) based on z scores derived from training volume, expected performance, and running experience. We used a 100-mm visual analog scale with anchors of 0 (never) and 100 (always). Total sample responses and comparisons between tertile groups for questionnaire items are presented.

Results: The High group (58±31) reported greater consumption of sport beverages in exercise environments than the Low (42 ± 35 mm) and Mod (39 ± 32 mm) groups (P < .05) and perceived sport beverages to be superior to water in meeting hydration needs (P < .05) and improving performance during runs greater than 1 hour (P < .05). Seventy percent of runners experienced 1 or more incidents in which they believed dehydration resulted in a major performance decrement, and 45% perceived dehydration to have resulted in adverse health effects. Twenty percent of runners reported monitoring their hydration status. Urine color was the method most often reported (7%), whereas only 2% reported measuring changes in body weight.

Conclusions: Greater attention should be paid to informing runners of valid techniques to monitor hydration status and developing an appropriate individualized hydration strategy.
Evaluation of Persistent Antimicrobial Effects of an Antimicrobial Formulation
Authors: Ferrara Michael S. , Courson Ron , Paulson Daryl S.
Published: March 2017

Context: Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) is becoming more prevalent in healthy athletic populations. Various preventive measures have been proposed, but few researchers have evaluated the protective effects of a prophylactic application of a commercially available product.

Objective: To compare the persistent antimicrobial properties of a commercially available antimicrobial product containing 4% chlorhexidine gluconate (Hibiclens) with those of a mild, nonmedicated soap (Dr. Bronner's Magic Soap).

Design: Cross-sectional study.

Setting: Microbiology laboratory, contract research organization.

Patients or Other Participants: Twenty healthy human volunteers.

Intervention(s): The test and control products were randomly assigned and applied to both forearms of each participant. Each forearm was washed for 2 minutes with the test or control product, rinsed, and dried. At, 1, 2, and 4 hours after application, each forearm was exposed to MRSA for approximately 30 minutes.

Main Outcome Measure(s): Differences in numbers of MRSA recovered from each forearm, test and control, at each postapplication time point were compared.

Results: Fewer MRSA (P < .0001) were recovered from the forearms treated with the test product (4% chlorhexidine gluconate) than from the forearms treated with the control product (nonmedicated soap).

Conclusions: The 4% chlorhexidine gluconate product demonstrated persistent bactericidal activity versus MRSA for up to 4 hours after application.
Personal Food Systems of Male Collegiate Football Players: A Grounded Theory Investigation
Authors: Long Doug , Perry Christina , Unruh Scott A. , Lewis Nancy , Stanek-Krogstrand Kaye
Published: March 2017

Context: Factors that affect food choices include the physical and social environments, quality, quantity, perceived healthfulness, and convenience. The personal food choice process was defined as the procedures used by athletes for making food choices, including the weighing and balancing of activities of daily life, physical well-being, convenience, monetary resources, and social relationships.

Objective: To develop a theoretical model explaining the personal food choice processes of collegiate football players.

Design: Qualitative study.

Setting: National Collegiate Athletic Association Division II football program.

Patients or Other Participants: Fifteen football players were purposefully sampled to represent various positions, years of athletic eligibility, and ethnic backgrounds.

Data Collection and Analysis: For text data collection, we used predetermined, open-ended questions. Data were analyzed using the constant comparison method. The athletes' words were used to label and describe their interactions and experiences with the food choice process. Member checks and an external audit were conducted by a qualitative methodologist and a nutrition specialist, and the findings were triangulated with the current literature to ensure trustworthiness of the text data.

Results: Time was the core category and yielded a cyclic graphic of a theoretical model for the food choice system. Planning hydration, macronutrient strategies, snacks, and healthful food choices emerged as themes.

Conclusions: The athletes planned meals and snacks around their academic and athletic schedules while attempting to consume foods identified as healthful. Healthful foods were generally lower in fat but high in preferred macronutrients. High-protein foods were the players' primary goal; carbohydrate consumption was secondary. The athletes had established plans to maintain hydration. Professionals may use these findings to implement educational programs on food choices for football players.
Lumbopelvic Joint Manipulation and Quadriceps Activation of People With Patellofemoral Pain Syndrome
Authors: Grindstaff Terry L. , Hertel Jay , Beazell James R. , Magrum Eric M. , Kerrigan D. Casey , Fan Xitao , Ingersoll Christopher D.
Published: March 2017

Context:

Quadriceps weakness and inhibition are impairments associated with patellofemoral pain syndrome (PFPS). Lumbopelvic joint manipulation has been shown to improve quadriceps force output and inhibition, but the duration of the effect is unknown.

Objective:

To determine whether quadriceps strength and activation are increased and maintained for 1 hour after high-grade or low-grade joint mobilization or manipulation applied at the lumbopelvic region in people with PFPS.

Design:

Randomized controlled clinical trial.

Setting:

University laboratory.

Patients or Other Participants:

Forty-eight people with PFPS (age = 24.6±8.9 years, height = 174.3 ± 11.2 cm, mass = 78.4 ± 16.8 kg) participated.

Intervention(s):

Participants were randomized to 1 of 3 groups: lumbopelvic joint manipulation (grade V), side-lying lumbar midrange flexion and extension passive range of motion (grade II) for 1 minute, or prone extension on the elbows for 3 minutes.

Main Outcome Measure(s):

Quadriceps force and activation were measured using the burst superimposition technique during a seated isometric knee extension task. A 2-way repeated-measures analysis of variance was performed to compare changes in quadriceps force and activation among groups over time (before intervention and at 0, 20, 40, and 60 minutes after intervention).

Results:

We found no differences in quadriceps force output (F5,33,101,18 = 0.65, P = .67) or central activation ratio (F4.84,92.03 = 0.38, P= .86) values among groups after intervention. When groups were pooled, we found differences across time for quadriceps force (F2.66,101.18 = 5.03, P = .004) and activation (F2.42,92.03 = 3.85, P = .02). Quadriceps force was not different at 0 minutes after intervention (t40 = 1.68, P = .10), but it decreased at 20 (t40 = 2.16, P = .04), 40 (t40 = 2.87, P = .01) and 60 (t40 = 3.04, P = .004) minutes after intervention. All groups demonstrated decreased quadriceps activation at 0 minutes after intervention (t40 = 4.17, P <.001), but subsequent measures were not different from preintervention levels (t40 range, 1.53–1.83, P >.09).

Conclusions:

Interventions directed at the lumbopelvic region did not have immediate effects on quadriceps force output or activation. Muscle fatigue might have contributed to decreased force output and activation over 1 hour of testing.
Two Different Fatigue Protocols and Lower Extremity Motion Patterns During a Stop-Jump Task
Authors: Quammen David , Cortes Nelson , Van Lunen Bonnie L. , Lucci Shawn , Ringleb Stacie I. , Onate James
Published: March 2017

Context:

Altered neuromuscular control strategies during fatigue probably contribute to the increased incidence of non-contact anterior cruciate ligament injuries in female athletes.

Objective:

To determine biomechanical differences between 2 fatigue protocols (slow linear oxidative fatigue protocol [SLO-FP] and functional agility short-term fatigue protocol [FAST-FP]) when performing a running-stop-jump task.

Design:

Controlled laboratory study.

Setting:

Laboratory.

Patients or Other Participants:

A convenience sample of 15 female soccer players (age = 19.2 ±0.8 years, height = 1.67±0.05m, mass = 61.7 + 8.1 kg) without injury participated.

Intervention(s):

Five successful trials of a running–stop-jump task were obtained prefatigue and postfatigue during the 2 protocols. For the SLO-FP, a peak oxygen consumption (V˙o2peak) test was conducted before the fatigue protocol. Five minutes after the conclusion of the V˙o2peak test, participants started the fatigue protocol by performing a 30-minute interval run. The FAST-FP consisted of 4 sets of a functional circuit. Repeated 2 (fatigue protocol) × 2 (time) analyses of variance were conducted to assess differences between the 2 protocols and time (prefatigue, postfatigue).

Main Outcome Measure(s):

Kinematic and kinetic measures of the hip and knee were obtained at different times while participants performed both protocols during prefatigue and postfatigue.

Results:

Internal adduction moment at initial contact (IC) was greater during FAST-FP (0.064 ±0.09 Nm/kgm) than SLO-FP (0.024±0.06 Nm/kgm) (F1,14 = 5.610, P=.03). At IC, participants had less hip flexion postfatigue (44.7°±8.1°) than prefatigue (50.1°±9.5°) (F1,14 = 16.229, P=.001). At peak vertical ground reaction force, participants had less hip flexion postfatigue (44.7°±8.4°) than prefatigue (50.4°±10.3°) (F1,14 = 17.026, P=.001). At peak vertical ground reaction force, participants had less knee flexion postfatigue (−35.9°±6.5°) than prefatigue (−38.8°±5.03°) (F1,14 = 11.537, P=.001).

Conclusions:

Our results demonstrated a more erect landing posture due to a decrease in hip and knee flexion angles in the postfatigue condition. The changes were similar between protocols; however, the FAST-FP was a clinically applicable 5-minute protocol, whereas the SLO-FP lasted approximately 45 minutes.
Whey Protein Addition to a Carbohydrate-Electrolyte Rehydration Solution Ingested After Exercise in the Heat
Authors: James Lewis J. , Gingell Rebecca , Evans Gethin H.
Published: March 2017

Context:

Many active people finish exercise hypohydrated, so effective rehydration after exercise is an important consideration.

Objective:

To determine the effects of a rehydration solution containing whey protein isolate on fluid balance after exercise-induced dehydration.

Design:

Randomized controlled clinical trial.

Setting:

University research laboratory.

Patients or Other Participants:

Twelve healthy men (age = 21 ± 1 years, height = 1.82 ± 0.08m, mass = 82.71 ± 10.31 kg) participated.

Intervention(s):

Participants reduced body mass by 1.86% ± 0.07% after intermittent exercise in the heat and re-hydrated with a volume of drink in liters equivalent to 1.5 times their body mass loss in kilograms of a solution of either 65 g/L carbohydrate (trial C) or 50 g/L carbohydrate and 15 g/L whey protein isolate (trial CP). Solutions were matched for energy density and electrolyte content. Urine samples were collected before and after exercise and for 4 hours after rehydration.

Main Outcome Measure(s):

We measured urine volume, drink retention, net fluid balance, urine osmolality, and subjective responses. Drink retention was calculated as the difference between the volume of drink ingested and urine produced. Net fluid balance was calculated from fluid gained through drink ingestion and fluid lost through sweat and urine production.

Results:

Total cumulative urine output after rehydration was not different between trial C (1173 ± 481 mL) and trial CP (1180 ± 330 mL) (F1 = 0.002, P = .96), and drink retention during the study also was not different between trial C (50% ± 18%) and trial CP (49% ± 13%) (t11 = −0.159, P = .88). At the end of the study, net fluid balance was negative compared with base-line for trial C (−432 ± 436 mL) (t11 = 3.433, P = .03) and trial CP (−432 ± 302 mL) (t11 = 4.958, P = .003).

Conclusions:

When matched for energy density and electrolyte content, a solution of carbohydrate and whey protein isolate neither increased nor decreased rehydration compared with a solution of carbohydrate.
Menstrual Irregularity and Musculoskeletal Injury in Female High School Athletes
Authors: Thein-Nissenbaum Jill M. , Rauh Mitchell J. , Carr Kathleen E. , Loud Keith J. , McGuine Timothy A.
Published: March 2017

Context:

The female athlete triad describes the interrelatedness of energy availability, menstrual function, and bone density. Although associations between triad components and musculoskeletal injury (INJ) have been reported in collegiate athletes, limited information exists about menstrual irregularity (MI) and INJ in the high school population.

Objective:

To determine the prevalence of and relationship between MI and INJ in high school athletes.

Design:

Cross-sectional study.

Setting:

High schools.

Patients or Other Participants:

The sample consisted of 249 female athletes from 3 high schools who competed in 33 interscholastic, school-sponsored sport teams, dance teams, and cheerleading or pom-pon squad during the 2006–2007 school year. Each athlete remained on the roster throughout the season.

Main Outcome Measure(s):

Participants completed a survey regarding injury type, number of days of sport participation missed, and menstrual history in the past year.

Results:

The prevalences of MI and INJ were 19.7% and 63.1%, respectively. Athletes who reported MI sustained a higher percentage of severe injuries (missing ≥22 days of practice or competition) than did athletes who reported normal menses. Although the trend was not significant, athletes with MI were almost 3 times more likely to sustain an injury resulting in 7 or more days of time lost from sport (odds ratio = 2.7, 95% confidence interval = 0.8, 8.8) than those who sustained an injury resulting in 7 or fewer days of time lost.

Conclusions:

The incidences of MI and INJ in this high school population during the study period were high. Athletes who reported MI sustained a higher percentage of severe injuries than did athletes who reported normal menses. Education programs to increase knowledge and improve management of MI and its potential effects on injury in female high school athletes are warranted.