bluuebunny/crossref_metadata_2025 huggingface dataset:
Update on treatment of immunoglobulin A nephropathy
Authors: Zhang Yue‐Miao , Zhang Hong
Published: October 2018

Immunoglobulin A nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide and the most common cause of end‐stage renal disease in young adults. However, there are still no specific therapies capable of targeting key pathways involved in disease pathogenesis. Recently, many large randomized controlled trials have been reported, such as Supportive Versus Immunosuppressive Therapy for the Treatment of Progressive IgA Nephropathy, Targeted‐release Budesonide Versus Placebo in Patients with IgA Nephropathy and Therapeutic Evaluation of Steroids in IgA Nephropathy Global, which are considered to update the 2012 Kidney Disease: Improving Global Outcomes Guideline. More importantly, with a deeper understanding of the roles of mucosal immunity, B‐cell activation and complement activation in IgAN, the studies of targeting pathogenic pathways are ongoing. In this review, by systemically searching the clinical trials in IgAN on ClinicalTrials.gov (https://clinicaltrials.gov/), we update the evidence for corticosteroids/immunosuppressive therapy in IgAN and explore the promising targeting pathogenic pathway therapeutic options. With better understanding of pathogenesis of IgAN, emerging therapies will soon become a reality in future.
Maternal obesity and offspring risk of chronic kidney disease
Authors: Wong Muh Geot , The Nguyen Long , Glastras Sarah
Published: October 2018

It is increasingly recognized that maternal obesity is implicated in developmental programming, contributing to the future risk of chronic disease development in offspring. The exact mechanisms of the role of maternal obesity in the development of chronic kidney disease in offspring remain unclear and animal models used are not without limitation. Human studies are limited by the effects of postnatal environmental conditions, which may have a direct impact on disease phenotype; and animal models are limited by use of species that differ significantly. This review will examine the most recent evidence from animal models on the impact of maternal factors during pregnancy/lactation on the future risk of chronic kidney disease development in offspring, emphasising the role of maternal obesity in exacerbating the deleterious effects of diet‐induced obesity and/or diabetes on renal health.
CKD prevention: Perspectives in Hong Kong
Authors: Tang Sydney CW
Published: October 2018

Hong Kong experiences a progressive rise in the prevalence of treated end‐stage renal disease (ESRD) as recorded by the Hong Kong Renal Registry managed by the Hospital Authority (HA) that takes care of 90 – 95% of the ESRD burden. The CKD burden is envisaged to be high, as reflected by 2 initiatives – SHARE which detected a high prevalence of urine or blood pressure abnormalities among 1,201 asymptomatic individuals who underwent screening, and RISKS that aimed to further characterize the spread of CKD in the asymptomatic population.

For CKD prevention, two statutory bodies – the HA and Hong Kong College of Physicians (HKCP), and two non‐governmental organizations – Hong Kong Society of Nephrology (HKSN) and Hong Kong Kidney Foundation (HKKF), all have a role to play. The Central Renal Committee (CRC) operated under HA co‐produces with HKCP and HKSN a clinical practice guideline for the provision of renal service in Hong Kong which includes CKD care and prevention. HKSN now holds annual educational symposia and a Continuous Medical Education (CME) course in partnership with the HKCP and Asian Pacific Society of Nephrology in addition to its Annual Scientific Meeting. The HKSN also provides a collective International Society of Nephrology (ISN) membership for all its full members to enhance education and other pertinent initiatives.

For public education, the HKSN and HKKF participate in the annual World Kidney Day event and organize free blood pressure and CKD surveys in public housing estates to increase public awareness of CKD. The latter is also effected via regular promotion through the mass media.
How to treat patients with chronic kidney disease: With special focus on IgA nephropathy
Authors: Tomino Yasuhiko
Published: October 2018

Chronic kidney disease has become a worldwide problem. Among chronic kidney disease patients, IgA nephropathy is common in the world. Serum levels of galactose deficient (Gd)‐IgA1 and Gd‐IgA1‐specific antibodies are elevated in most IgA nephropathy patients. Glomerular Gd‐IgA1 deposition has been observed by immunofluorescence. There are many reports that the anti‐proteinuric effect is significantly greater in groups who receive tonsillectomy with steroid pulse therapy in IgA nephropathy patients. Furthermore, patients with tonsillectomy with steroid pulse therapy have shown a strong down‐regulation of delta serum IgA/C3 per year and have conserved their renal function. New treatments, that is, Atacicept and glucocorticoid budesonide, have been developed for this disease.
Biomarkers for acute cardiorenal syndrome
Authors: Fan Pei‐Chun , Chang Chih‐Hsiang , Chen Yung‐Chang
Published: October 2018

Cardiorenal syndromes are disorders of the heart and kidneys whereby dysfunction in one organ may lead to dysfunction in the other organ. Cardiorenal syndrome type I (CRS I) is defined as acute kidney injury caused by acute cardiac dysfunction such as acute decompensated heart failure and acute coronary syndrome. Traditional markers like serum creatinine may delay the diagnosis of acute kidney injury and provide limited information regarding the underlying pathophysiology in the setting of CRS I. Herein, we briefly review some emerging biomarkers, including brain natriuretic peptide, soluble ST2, angiopoietin, soluble thrombomodulin, neutrophil gelatinase‐associated lipocalin, kidney injury molecule‐1, cystatin C, interleukin‐18 and calprotectin. These biomarkers may help early detecting, differential diagnosis, assessing disease severity and prognosis in patients with CRS I, therefore improve patient management and outcomes.
Symbiotic dinitrogen fixation is seasonal and strongly regulated in water‐limited environments
Authors: Dovrat Guy , Sheffer Efrat
Published: October 2018

Plants, especially perennials, growing in drylands and seasonally dry ecosystems are uniquely adapted to dry conditions. Legume shrubs and trees, capable of symbiotic dinitrogen (N2) fixation, often dominate in drylands. However, the strategies that allow symbiotic fixation in these ecosystems, and their influence on the nitrogen cycle, are largely unresolved. We evaluated the climatic, biogeochemical and ontogenetic factors influencing nitrogen fixation in an abundant Mediterranean legume shrub, Calicotome villosa.

We measured nodulation, fixation rate, nitrogen allocation and soil biogeochemistry in three field sites over a full year. A controlled experiment evaluated differences in plant regulation of fixation as a function of soil nutrient availability and seedling and adult developmental stages.

We found a strong seasonal pattern, shifting between high fixation rates during the rainy season at flowering and seed‐set times to almost none in the rainless season. Under controlled conditions, plants downregulated fixation in response to soil nitrogen availability, but this response was stronger in seedlings than in adult shrubs. Finally, we did not find elevated soil nitrogen under N2‐fixing shrubs.

We conclude that seasonal nitrogen fixation, regulation of fixation, and nitrogen conservation are key adaptations influencing the dominance of dryland legumes in the community, with broader consequences on the ecosystem nitrogen cycle.
Progressive sensitivity of trophic levels to warming underlies an elevational gradient in ant–aphid mutualism strength
Authors: Nelson Annika S. , Pratt Riley T. , Pratt Jessica D. , Smith Richard Alexander , Symanski Cole T. , Prenot Cathrine , Mooney Kailen A.
Published: October 2018

Although species interactions are often proposed to be stronger at lower latitudes and elevations, few studies have evaluated the mechanisms driving such patterns. In this study, we assessed whether, and by which mechanisms, abiotic changes associated with elevation altered the outcome of an ant–aphid protection mutualism. To do so, we characterized the multi‐trophic interactions among the ant Formica podzolica, the aphid Aphis varians, and aphid natural enemies occurring on the plant Chamerion angustifolium within replicate high and low elevation valleys. Low (versus high) elevation sites had longer summers (snowmelt 13 days earlier) and were on average 1.1°C warmer and 41% drier throughout the year. At low elevations, individual ant colonies consumed approximately double the volume of carbohydrate baits, likely due to a higher foraging tempo, and possibly due to a greater demand for sugar‐ versus protein‐rich resources (as indicated by stable isotope analysis). Wild aphid colonies at low elevations were visited by 1.4‐fold more natural enemies (controlling for variation in aphid abundance), while experimental aphid colonies on potted plants were tended 52% more frequently by ants. As a result, ants increased aphid colony survival by 66% at low elevations but had no detectable effect at high elevations; at low (versus high) elevations aphid colonies without ants had lower survival, demonstrating stronger predator effects, while aphid colonies with ants had higher survival, demonstrating even stronger ant benefits. Analyses for the effects of mean summer temperature yielded qualitatively identical results to those based on elevation. Collectively, these findings support predictions for a greater sensitivity of higher trophic levels to warming and demonstrate how species interactions can vary across environmental gradients due to simultaneous changes in species traits and abundances across multiple trophic levels.
Epstein‐Barr virus associated smooth muscle tumors in solid organ transplant recipients: Incidence over 31 years at a single institution and review of the literature
Authors: Stubbins Ryan J. , Alami Laroussi Nassiba , Peters Anthea C. , Urschel Simon , Dicke Frank , Lai Raymond L. , Zhu James , Mabilangan Curtis , Preiksaitis Jutta K.
Published: October 2018

Introduction

Epstein‐Barr virus (EBV) associated smooth muscle tumors (EBV‐SMT) are a rare complication of solid organ transplantation (SOT). Incidence data related to this EBV‐SMT are limited. EBV DNA is universally present in these tumors. How these cells get infected with EBV, whether this is a result of primary EBV infection vs reactivation, and how persistent active EBV infection post‐transplant influences EBV‐SMT pathogenesis remains unknown.

Methods

Among 5006 SOT recipients (474 pediatric, 4532 adult) receiving SOT at our center between Jan 1984 and Dec 2015, three cases of post‐transplant EBV‐SMT were identified.

Results

All cases were pediatric heart transplants who were EBV seronegative prior to transplant, and experienced primary EBV infection with persistently elevated EBV viral loads, despite antiviral therapy. Two are deceased at 3.2 and 0.9 years post‐diagnosis, while one remains alive 6.2 years post diagnosis. The overall local incidence of post‐transplant EBV‐SMT at our institution was 0.7 (95% CI, 0.2‐1.7) per 1000 patient years, and 2.6 (95% CI, 0.6‐6.7) per 1000 patient years in pediatric heart transplants. A literature review identified 36 pediatric and 51 adult cases of post‐transplant EBV‐SMT.

Conclusions

We hypothesize that pre‐transplant EBV seronegativity, followed by primary EBV infection and persistently high EBV viral loads, represents a unique risk factor for post‐transplant EBV‐SMT. Pediatric heart transplant recipients were found to be disproportionately affected by post‐transplant EBV‐SMT at our institution.
Longer storage of red blood cells does not affect mortality in transfused liver transplant recipients
Authors: Kwon Ji Hye , Han Sangbin , Cho Duck , Spahn Donat R. , Ko Justin S. , Kim Do Yeon , Jun Joo Hyun , Gwak Mi Sook , Kim Gaab Soo
Published: October 2018

BACKGROUND

The characteristics of red blood cell (RBC) products change after 2 weeks of cold storage. It is unclear whether older RBCs affect mortality after liver transplantation. This retrospective cohort study aimed to evaluate the association between the age of transfused RBCs and death after living donor liver transplantation (LDLT).

STUDY DESIGN AND METHODS

Of 200 recipients who underwent LDLT, 118 who received RBCs with a mean storage duration of less than 10 days (shorter storage group) were compared with 82 with an RBC mean storage duration of more than 14 days (longer storage group). Key exclusion criteria were transfusion of very fresh RBCs stored for less than 4 days and transfusion of old RBCs in recipients of the shorter storage group. The primary outcome was posttransplant overall death. Survival analysis was performed using the Cox model.

RESULTS

Mean RBC storage duration was 7 days in the shorter storage group and 17 days in the longer storage group. Death probability at 1, 2, and 5 years posttransplant was 5.1%, 7.6%, and 13.6% in the shorter storage group, respectively, and 6.1%, 8.5%, and 13.5% in the longer storage group. Death risk was comparable between the two groups in univariable (hazard ratio [HR] 1.00, 95% confidence interval [CI], 0.47‐2.16, p = 0.991) and multivariable (HR 1.07, 95% CI, 0.46‐2.50, p = 0.882) analyses. Graft failure risk was also comparable (HR 1.04, 95% CI, 0.50‐2.18, p = 0.916). Hepatocellular carcinoma recurrence probability at 1, 2, and 5 years was 10.8%, 15.4%, and 23.1%, respectively, in the shorter storage group and 11.4%, 15.9%, and 20.7% in the longer storage group (HR 0.84, 95% CI, 0.37‐1.89, p = 0.670). No significant differences were observed regarding graft regeneration/function, vascular/biliary complications, acute kidney injury, surgical site infection, or rejection (p > 0.05).

CONCLUSIONS

No evidence was found that transfusion of old RBCs contributes to death after LDLT.
Ex vivo evaluation of the efficacy of canine fresh‐frozen plasma thawed using a microwave plasma defroster
Authors: Turner Matthew Alfred , Rahilly Louisa Jane , Katheryn O'Marra Shana
Published: October 2018

Background

Commercial microwave plasma defrosters (MPDs) are used globally in human medicine to safely thaw fresh‐frozen plasma (FFP), but this technology has never been tested in a veterinary setting. This study was undertaken to assess the efficacy of a commercial MPD for the rapid thawing of canine FFP.

Study Design

Twenty‐three units (twelve 120 mL and eleven 240 mL) of canine FFP were thawed using an MPD. Time‐to‐thaw and pre‐ and postthawing temperatures of the units were measured. Clotting factor activities (factors II, V, VII, VIII, IX, X, and von Willebrand factor), fibrinogen concentrations, prothrombin times, and activated partial thromboplastin times were measured.

Key Findings

The evaluated MPD effectively thaws plasma quickly for both 120 mL units (2.7 ± 0.08 min) and 240 mL units (3.9 ± 0.15 min) while maintaining clinically relevant activities of clotting factors and fibrinogen concentration. While some measurements of factor VIII activity fell below the reference interval, none fell below 40%. One 240 mL unit had von Willebrand factor activity <70%. There was no evidence of excessively heated plasma to indicate a safety concern.

Significance

The MPD evaluated in this study provides a useful means to rapidly thaw canine FFP for correction of factor‐deficient coagulopathy.
Nonsurgical management of traumatic pneumoperitoneum in a cat
Authors: Philp Helen S. , Hammond Gawain J. C.
Published: October 2018

Objective

To describe the nonsurgical management of a cat with traumatic pneumoperitoneum.

Case Series Summary

A 4‐year‐old cat was presented following vehicular polytrauma. Thoracic radiographs revealed 4 rib fractures, a scapular fracture, and pneumothorax. Abdominal ultrasound revealed a small volume of free abdominal fluid. Computed tomography showed a mild pneumoretroperitoneum and a pneumoperitoneum in the region of the porta hepatis. The cat was managed conservatively with close monitoring. Exploratory laparotomy was not pursued given patient stability and static serial imaging studies revealing no indications for surgical intervention. After 6 days, the pneumoperitoneum was no longer detectable.

New or Unique Information Provided

To the authors’ knowledge, this is the first report of successful nonsurgical management of traumatic pneumoperitoneum in a cat.
In vitro hemolysis of stored units of canine packed red blood cells
Authors: Ferreira Rui R. F. , Graça Rita M. C. , Cardoso Inês M. , Gopegui Rafael R. , de Matos Augusto J. F.
Published: October 2018

Background

Hemolysis is an important quality parameter of packed red blood cells (pRBCs) that is used to assess the cellular integrity of stored blood units. According to human standards, hemolysis at the end of storage must not exceed 1%, as otherwise it may be responsible for decreased transfusion effectiveness and acute life‐threatening reactions.

Objectives

This prospective study was designed to evaluate the hemolysis of canine pRBCs stored in an additive solution containing adenine, dextrose, mannitol, and sodium chloride, and to assess its associations with storage time, duration of the collection process, collection disturbances, and with the final volume and PCV of the pRBCs units.

Methods

One hundred eighty pRBCs units were collected from canine donors. Hemolysis of the pRBCs units was determined immediately after processing (t = 0). The units were then stored and retested (t = 1) either before administration (during weeks 2, 3, 4, 5, or 6 of storage) or at the end of the storage period (42 d) if not used.

Results

Mean hemolysis at t = 0 was 0.09% (SD 0.06) and increased during storage, at a more pronounced rate from the 5th (mean values of 0.52%, SD 0.29) to the 6th week (1.2%, SD 0.72). Almost 51% of the units with 36–42 days of shelf‐life showed more than 1% hemolysis. Disturbances in the collection process, the volume of the whole blood units, and the volume of stored pRBCs units or their PCV were not related to pRBCs hemolysis.

Conclusions

According to human blood bank recommendations regarding acceptable hemolysis, canine pRBCs stored for more than 35 days should be tested to ensure <1% hemolysis prior to administration.
Determining prognosis in canine sepsis by bedside measurement of cell‐free DNA and nucleosomes
Authors: Letendre Jo‐Annie , Goggs Robert
Published: October 2018

Objective

To investigate the use of plasma cell‐free DNA (cfDNA) and nucleosome concentrations as prognostic biomarkers in canine sepsis.

Design

Prospective, observational cohort study conducted from June 2015 to February 2016.

Setting

University teaching hospital.

Animals

Forty‐five dogs with sepsis, 10 dogs with nonseptic systemic inflammatory response syndrome (nSIRS), and 15 healthy controls were consecutively enrolled and followed to hospital discharge. Patients were eligible for enrollment if they met ≥2 SIRS criteria and had a documented or highly suspected bacterial infection. Dogs <3 kg or with a known coagulopathy were excluded.

Interventions

None.

Measurements and Main Results

Acute Patient Physiology and Laboratory Evaluation scores (APPLE) were calculated and outcomes recorded. Plasma cfDNA was measured using a benchtop fluorimeter. Plasma nucleosome concentrations were determined by ELISA. Plasma nucleosome and cfDNA concentrations in dogs with sepsis or nSIRS were compared to those of healthy controls and cfDNA concentrations in septic dogs with and without bacteremia were compared. Associations between cfDNA concentrations and nucleosomes, leukocyte count, neutrophil count, and APPLE scores were evaluated. For septic dogs, cfDNA concentrations relative to neutrophil count and nucleosome concentrations in survivors and nonsurvivors were compared. Alpha was set at 0.05. cfDNA concentrations were significantly higher in dogs with sepsis or nSIRS compared to healthy controls (P < 0.0001 andP = 0.0034, respectively). Nucleosome concentrations were significantly higher in dogs with sepsis compared to healthy controls (P = 0.007). There was limited association between cfDNA and nucleosome concentrations (rs = 0.266), and no association between cfDNA concentration and leukocyte count, neutrophil count, and APPLEfullscores. Concentrations of cfDNA were positively correlated with APPLEfastscore (rs = 0.335,P = 0.025); however, cfDNA concentrations were significantly higher in dogs with bacteremia (P = 0.0299). In dogs with sepsis, cfDNA concentrations relative to neutrophil count were significantly higher in nonsurvivors than in survivors (P = 0.008).

Conclusions

In dogs with sepsis, high cfDNA concentrations relative to neutrophil count are associated with nonsurvival. Point‐of‐care cfDNA measurement may aid identification of bacteremia.
Issues of intelligibility in world Englishes and EIL contexts
Authors: Bayyurt Yasemin
Published: October 2018

This article examines Larry Smith's work on intelligibility issues in English as an International Language (EIL) contexts. In his seminal articles and books, Smith describes how intelligibility can be problematized in both intra‐/inter‐national contexts in relation to cross‐/inter‐/intra‐cultural communication purposes. As one of the guiding/founding scholars of the world Englishes paradigm, he is one of the first to describe the functions of English as an International Language in inter‐/intra‐/cross‐cultural communication in world Englishes. His views on intelligibility influenced various fields of study – including the English as a Lingua Franca (ELF) paradigm – ranging from its connection to comprehensibility to interpretability in national and international contexts in intercultural communication studies to its implications for an EIL‐aware pedagogical practice.
Larry Smith and world Englishes
Authors: Bolton Kingsley , Davis Daniel R.
Published: October 2018

This article discusses the contribution of Professor Larry E. Smith to the field of world Englishes (WE), a linguistic and educational enterprise in which Professor Smith was a founding figure. The article traces the development of Smith's thinking on world Englishes from early attempts to theorize English as an ‘international auxiliary language’ (EIAL), to a full theorization of world Englishes as a dynamic new field of study in the 1980s and 1990s. This discussion of Larry Smith's work also acknowledges his contribution to such other related areas of study as intercultural communication, and intelligibility studies, as well as his enduring contribution to the World Englishes journal, and the International Association for World Englishes (IAWE).
Language and communication
Authors: Dissanayake Wimal
Published: October 2018

Communication is the lifeblood of society. An understanding of communication is vital to an understanding of society. Larry Smith and I, in our explorations into language, have been guided by this conviction. Two questions inform our project. First, why is communication important? Second, what are the conditions of its possibility? The phenomenon of miscommunication, which is not often given adequate attention in communication research, is central to our endeavor, and it is explored in terms of three intersecting circles that are designated by the terms subjectivity, sociality and metaphysics. We have sought to highlight the phenomenon of miscommunication against the backdrop of dominant models of communication that have made a deep impression on communication studies.
Bi‐/multilingual creativity in Indian English
Authors: Gargesh Ravinder
Published: October 2018

The article highlights the contribution of Larry E. Smith in the contexts of English as an International Language and world Englishes. It views Larry's framework of intelligibility, comprehensibility and interpretability that led to an egalitarian view about the different varieties of Englishes.
Intelligibility after 1979
Authors: Nelson Cecil L.
Published: October 2018

This article discusses Larry Smith's theoretical and applied approach to the investigation of intelligibility in the teaching of English as a Second Language and in other areas of world Englishes. In particular, Smith's investigation of this topic, which distinguishes between intelligibility, comprehensibility, and interpretability, has provided a framework the analysis of this topic from a range of diverse perspectives in applied linguistics and sociolinguistics. For Larry, the issue of intelligibility also illuminated many other areas of investigation, including cross‐cultural discourse and intercultural communication.
Digital religion and Hinduism in the United States
Authors: Pandharipande Rajeshwari V.
Published: October 2018

As religions migrate from their native contexts, they adopt new languages for their communication. Additionally, in the 21st century, digital media is being used for religious practices such as ritual worship, sermons and discourses. This article focuses on the case of Hinduism in the US diaspora where the Hindu community (unlike its native counterpart in India) uses the English language and the digital media for the Hindu religious practices. In particular, this article discusses the ways in which the use of the English language and digital media is more conventionalized in the context of discussion about religion (in the discourses of satsang), as opposed to the experience of religion (for example, in puja ‘worship ritual’).
Total Energy Expenditure, Physical Activity Level, and Water Turnover of Collegiate Dinghy Sailors in a Training Camp
Authors: Sagayama Hiroyuki , Toguchi Makiko , Yasukata Jun , Yonaha Kazunari , Higaki Yasuki , Tanaka Hiroaki
Published: October 2018

Prior studies have examined offshore sailing and energy strategies using accurate total energy expenditure (TEE) measurement in free-living conditions. However, no research has studied energy and water requirements during dinghy class sailing such as an Olympic event with concentrated training. This study aimed to investigate the TEE, physical activity level (PAL), and water turnover (rH2O) of collegiate dinghy sailors in a training camp using the doubly labeled water method. Eleven dinghy sailing collegiate athletes (nine males and two females) participated. The doubly labeled water method was used to determine the participants’ TEE and PAL over 8 days (six training and two nontraining days). Participants trained approximately 7 hr/day on water. Body fat was measured using a stable isotope dilution method. The rH2O was estimated using deuterium turnover. The mean TEE, PAL, and rH2O were 17.30 ± 4.22 MJ/day (4,133 ± 1,009 kcal/day), 2.8 ± 0.3 (range: 2.1–4.1), and 3.3 ± 0.7 L/day (range: 2.6–4.5 L/day), respectively. To our knowledge, this was the first study to use the doubly labeled water method to determine TEE, PAL, and rH2O as references for competitive dinghy sailors in a spring training camp. Our results may serve as a reference to assist competitive dinghy sailors in determining their required nutritional support.
Stress Relaxation and Targeted Nutrition to Treat Patellar Tendinopathy
Authors: Baar Keith
Published: October 2018

Patellar tendinopathy is one of the most common afflictions in jumping sports. This case study outlines the rehabilitation of a professional basketball player diagnosed by magnetic resonance imaging (MRI) with a central core patellar tendinopathy within the proximal enthesis. The player undertook a nutrition and strength-based rehabilitation program combining gelatin ingestion and heavy isometric loading of the patellar tendon designed to produce significant stress relaxation as part of their competition schedule and a whole-body training plan. On follow-up one and a half years into the program an independent orthopedic surgeon declared the tendon normal on MRI. Importantly, the improved MRI results were associated with a decrease in pain and improved performance. This case study provides evidence that a nutritional intervention combined with a rehabilitation program that uses stress relaxation can improve clinical outcomes in elite athletes.
Effects of Carbohydrate, Caffeine, and Guarana on Cognitive Performance, Perceived Exertion, and Shooting Performance in High-Level Athletes
Authors: Pomportes Laura , Brisswalter Jeanick , Hays Arnaud , Davranche Karen
Published: October 2018

Purpose:To investigate the effect of ingesting carbohydrate (CHO), caffeine  (CAF), and a guarana complex (GUAc) during a running exercise on cognitive performance, rating of perceived exertion (RPE), and shooting performance in high-level modern pentathlon athletes.Methods:A total of 10 athletes completed 4 counterbalanced sessions within a 2-wk period, corresponding to ingestions of CHO (30 g), GUAc (300 mg), CAF (200 mg), or placebo. The exercise involved a 40-min run on a treadmill at a steady speed, previously determined as a “somewhat hard” exercise (RPE 13). Shooting and cognitive performance (Simon task) were assessed in 3 phases: before exercise and ingestion, before exercise and after half ingestion, and after exercise and full ingestion. Drinks were consumed 40 min (250 mL) and 5 min (125 mL) prior to exercise and after 20 min of running (125 mL). RPE was assessed at 10-min intervals during exercise.Results:There was an interaction between drink and exercise on mean reaction time (P = .01,) and a drink effect on RPE (P = .01,). CHO, CAF, and GUAc enhanced the speed of information processing after exercise (P = .003,P = .004, andP = .04, respectively), but only CAF and GUAc decreased RPE (P = .002 andP = .02, respectively).Conclusion:The results highlight a beneficial effect of nutritional supplements on information processing and RPE. This finding is particularly interesting as decision-making processes are crucial in the performance of many sports.
Training to Compete at Altitude:Natural Altitude or Simulated Live High:Train Low?
Authors: Carr Amelia J. , Garvican-Lewis Laura A. , Vallance Brent S. , Drake Andrew P. , Saunders Philo U. , Humberstone Clare E. , Gore Christopher J.
Published: October 2018

Purpose: To compare the effects of natural altitude training (NAT) and simulated (SIM) live high:train low altitude training on road-race walking performance (min), as well as treadmill threshold walking speed (km·h−1) at 4 mmol·L−1 and maximal oxygen consumption, at 1380 m. Methods: Twenty-two elite-level male (n = 15) and female (n = 7) race walkers completed 14 d of NAT at 1380 m (n = 7), SIM live high:train low at 3000:600 m (n = 7), or control conditions (600-m altitude; CON, n = 8). All preintervention and postintervention testing procedures were conducted at 1380 m and consisted of an incremental treadmill test, completed prior to a 5 × 2-km road-race walking performance test. Differences between groups were analyzed via mixed-model analysis of variance and magnitude-based inferences, with a substantial change detected with >75% likelihood of exceeding the smallest worthwhile change. Results: The improvement in total performance time for the 5 × 2-km test in NAT was not substantially different from SIM but was substantially greater (85% likely) than CON. The improvement in percentage decrement in the 5 × 2-km performance test in NAT was greater than in both SIM (93% likely) and CON (93% likely). The increase in maximal oxygen consumption was substantially greater (91% likely) in NAT than in SIM. Improvement in threshold walking speed was substantially greater than CON for both SIM (91% likely) and NAT (90% likely). Conclusions: Both NAT and SIM may allow athletes to achieve reasonable acclimation prior to competition at low altitude.
Anaerobic Speed Reserve: A Key Component of Elite Male 800-m Running
Authors: Sandford Gareth N. , Allen Sian V. , Kilding Andrew E. , Ross Angus , Laursen Paul B.
Published: October 2018

Purpose: In recent years (2011–2016), men’s 800-m championship running performances have required greater speed than previous eras (2000–2009). The “anaerobic speed reserve” (ASR) may be a key differentiator of this performance, but profiles of elite 800-m runners and their relationship to performance time have yet to be determined. Methods: The ASR—determined as the difference between maximal sprint speed (MSS) and predicted maximal aerobic speed (MAS)—of 19 elite 800- and 1500-m runners was assessed using 50-m sprint and 1500-m race performance times. Profiles of 3 athlete subgroups were examined using cluster analysis and the speed reserve ratio (SRR), defined as MSS/MAS. Results: For the same MAS, MSS and ASR showed very large negative (both r = −.74 ± .30, ±90% confidence limits; very likely) relationships with 800-m performance time. In contrast, for the same MSS, ASR and MAS had small negative relationships (both r = −.16 ± .54; possibly) with 800-m performance. ASR, 800-m personal best, and SRR best defined the 3 subgroups along a continuum of 800-m runners, with SRR values as follows: 400–800 m ≥ 1.58, 800 m ≤ 1.57 to ≥ 1.48, and 800–1500 m ≤ 1.47 to ≥ 1.36. Conclusion: MSS had the strongest relationship with 800-m performance, whereby for the same MSS, MAS and ASR showed only small relationships to differences in 800-m time. Furthermore, the findings support the coaching observation of three 800-m subgroups, with the SRR potentially representing a useful and practical tool for identifying an athlete’s 800-m profile. Future investigations should consider the SRR framework and its application for individualized training approaches in this event.
Factors Affecting Cyclists’ Chances of Success in Match-Sprint Tournaments
Authors: Phillips Kathryn E. , Hopkins Will G.
Published: October 2018

Purpose: To further the understanding of elite athlete performance in complex race environments by examining the changes in cyclists’ performance between solo time trials and head-to-head racing in match-sprint tournaments. Methods: Analyses were derived from official results of cyclists in 61 elite international sprint tournaments (2000–2016), incorporating the results of 2060 male and 1969 female head-to-head match races. Linear mixed modeling of log-transformed qualification and finish ranks was used to determine estimates of performance predictability as intraclass correlation coefficients. Correlations between qualifying performance and final tournament rank were also calculated. Chances of winning head-to-head races were estimated adjusting for the difference in the cyclists’ qualifying times. All effects were evaluated using magnitude-based inference. Results: Minor differences in predictability between qualification time trial and final tournament rank were suggestive of more competitiveness among men in the overall tournament. Performance in the qualification time trial was strongly correlated with, but not fully indicative of, performance in the overall tournament. Correspondingly, being the faster qualifier had a large positive effect on the chances of winning a head-to-head race, but small substantial differences between riders remained after adjustment for time-trial differentials. Conclusions: The present study provides further insight into how real-world competition data can be used to investigate elite athlete performance in sports where athletes must directly interact with their opponents. For elite match-sprint cyclists, qualifying time-trial performance largely determines success in the overall tournament, but there is evidence of a consistent match-race ability that modifies the chances of winning head-to-head races.
Reliability and Validity of a Novel Trunk-Strength Assessment for High-Performance Sprint Flat-Water Kayakers
Authors: Steeves Darren , Thornley Leo J. , Goreham Joshua A. , Jordan Matthew J. , Landry Scott C. , Fowles Jonathon R.
Published: October 2018

Purpose: To determine the reliability and validity of a novel trunk maximal isometric force assessment involving 7 different tasks with 200-m times for elite sprint flat-water kayakers. Methods: Ten elite sprint flat-water kayakers performed a series of maximal isometric voluntary contractions (MVCs) on 2 separate days to assess reliability. MVC force was assessed as the participants sat on a modified kayak ergometer and applied their maximal isometric force to a uniaxial load cell during 7 different tasks. The 7 tasks of interest were a seated trunk-forward flexion, bilateral (left and right) rotational pulls, bilateral rotational pushes, and a sport-specific bilateral kayak-stroke simulation. Twenty elite flat-water kayak athletes (10 male and 10 female) participated in the validity portion by completing the series of tasks in conjunction with a 200-m race. Results: MVC force values ranged from 84 to 800 N across all participants and all tasks. The average coefficient of variation of the 7 tasks ranged from 2.4% to 7.7%. Regression analysis showed Pearson correlations ranging from −.84 to −.22 for both absolute and relative values with 200-m performance times. Conclusions: MVC force measured in each task was considered reliable as a small degree of variance between trials was found. The summation of the 7 trunk scores showed very strong correlations with on-water performance, indicating that this assessment is valid for elite sprint kayakers.
Brief Report: Training Load, Salivary Immunoglobulin A, and Illness Incidence in Elite Paratriathletes
Authors: Stephenson Ben T. , Hynes Eleanor , Leicht Christof A. , Tolfrey Keith , Goosey-Tolfrey Victoria L.
Published: October 2018

Purpose: To gain an exploratory insight into the relation between training load (TL), salivary secretory immunoglobulin A (sIgA), and upper respiratory tract illness (URI) in elite paratriathletes. Methods: Seven paratriathletes were recruited. Athletes provided weekly saliva samples for the measurement of sIgA over 23 consecutive weeks (February to July) and a further 11 consecutive weeks (November to January). sIgA was compared to individuals’ weekly training duration, external TL, and internal TL, using time spent in predetermined heart-rate zones. Correlations were assessed via regression analyses. URI was quantified via weekly self-report symptom questionnaire. Results: There was a significant negative relation between athletes’ individual weekly training duration and sIgA secretion rate (P = .028), with changes in training duration accounting for 12.7% of the variance (quartiles: 0.2%, 19.2%). There was, however, no significant relation between external or internal TL and sIgA parameters (P ≥ .104). There was no significant difference in sIgA when URI was present or not (101% vs 118% healthy median concentration; P ≥ .225); likewise, there was no difference in sIgA when URI occurred within 2 wk of sampling or not (83% vs 125% healthy median concentration; P ≥ .120). Conclusions: Paratriathletes’ weekly training duration significantly affects sIgA secretion rate, yet the authors did not find a relation between external or internal TL and sIgA parameters. Furthermore, it was not possible to detect any link between sIgA and URI occurrence, which throws into question the potential of using sIgA as a monitoring tool for early detection of illness.
Clinical Breathing Mechanics Differ Based on Test and Position
Authors: Horris Hannah , Anderson Barton E. , Bay R. Curtis , Huxel Bliven Kellie C.
Published: October 2018

Context:Altered diaphragm function is linked to decreased core stabilization, postural changes, and decreased function. Two clinical tests used to assess breathing are the Hi-lo and lateral rib expansion (LRE) tests. It is currently unknown how breathing classification based on these tests differ and how their results are affected by varying test positions.Objective:To compare the results of breathing tests when conducted in varying test positions.Design:Prospective cross-sectional study.Setting:University laboratory.Participants:A total of 50 healthy adults (females 31 and males 29; age 29.3 [4.1] y; height 170.0 [10.4] cm; weight70.7 [15.1] kg).Intervention(s):Hi-lo and LRE tests in supine, seated, standing, and half-kneeling body positions. All tests were recorded and later scored by a single examiner. A generalized estimating equations approach with breathing test and body position as factors was used for analysis. Pairwise comparison with Bonferroni correction was used to adjust for multiple tests. Statistical significance was set atP = .05, 2 tailed.Main Outcome Measures:Hi-lo and LRE tests were scored based on the presence or absence of abdominal excursion, LRE, and superior rib cage migration. Following scoring, results were classified as functional or dysfunctional based on observation of these criteria.Results:A significant breathing test × test position interaction (P < .01) was noted, as well as main effects for test (P < .01) and test position (P < .01). All Hi-lo test positions identified significantly more dysfunctional breathers in positions of increased stability demand (P < .01), except between standing and half-kneeling positions (P = .52). In the LRE test, all positions were similar (P > .99) except for half-kneeling, which was significantly different from all other positions (P < .01).Conclusions:The Hi-lo test and LRE tests assess different breathing mechanics. Clinicians should use these tests in combination to gain a comprehensive understanding of a person’s breathing pattern. The Hi-lo test should be administered in multiple testing positions.
Females Decrease Vertical Ground Reaction Forces Following 4-Week Jump-Landing Feedback Intervention Without Negative Affect on Vertical Jump Performance
Authors: Ericksen Hayley M. , Lefevre Caitlin , Luc-Harkey Brittney A. , Thomas Abbey C. , Gribble Phillip A. , Pietrosimone Brian
Published: October 2018

Context: High vertical ground reaction force (vGRF) when initiating ground contact during jump landing is one biomechanical factor that may increase risk of anterior cruciate ligament injury. Intervention programs have been developed to decrease vGRF to reduce injury risk, yet generating high forces is still critical for performing dynamic activities such as a vertical jump task. Objective: To evaluate if a jump-landing feedback intervention, cueing a decrease in vGRF, would impair vertical jump performance in a separate task (Vertmax). Design: Randomized controlled trial. Patients (or Other Participants): Forty-eight recreationally active females (feedback: n = 31; 19.63 [1.54] y, 1.6 [0.08] cm, 58.13 [7.84] kg and control: n = 15; 19.6 [1.68] y, 1.64 [0.05] cm, 60.11 [8.36] kg) participated in this study. Intervention: Peak vGRF during a jump landing and Vertmax were recorded at baseline and 4 weeks post. The feedback group participated in 12 sessions over the 4-week period consisting of feedback provided for 6 sets of 6 jumps off a 30-cm box. The control group was instructed to return to the lab 28 days following the baseline measurements. Main Outcome Measures: Change scores (postbaseline) were calculated for peak vGRF and Vertmax. Group differences were evaluated for peak vGRF and Vertmax using a Mann–Whitney U test (P < .05). Results: There were no significant differences between groups at baseline (P > .05). The feedback group (−0.5 [0.3] N/kg) demonstrated a greater decrease in vGRF compared with the control group (0.01 [0.3] N/kg) (t(46) = −5.52, P < .001). There were no significant differences in change in Vertmax between groups (feedback = 0.9 [2.2] cm, control = 0.06 [2.1] cm; t(46) = 0.46, P = .64). Conclusions: While the feedback intervention was effective in decreasing vGRF when landing from a jump, these participants did not demonstrate changes in vertical jump performance when assessed during a different task. Practitioners should consider implementing feedback intervention programs to reduce peak vGRF, without worry of diminished vertical jump performance.
The Efficacy of Lower-Limb Screening Tests in Predicting PlayerLoad Within a Professional Soccer Academy
Authors: Bowen Charlie , Weaver Kristian , Relph Nicola , Greig Matt
Published: October 2018

Context: Training exposure has been associated with injury epidemiology in elite youth soccer, where lower-limb musculoskeletal screening is commonly used to highlight injury risk. However, there has been little consideration of the relationship between lower-limb screening and the loading response to soccer activities. Objective: To quantify the efficacy of using screening tests to predict the loading elicited in soccer-specific activities and to develop a hierarchical ordering of musculoskeletal screening tests to identify test redundancy and inform practice. Design: Correlational. Setting: Professional soccer club academy. Participants: A total of 21 elite male soccer players aged 15.7 (0.9) years. Intervention: Players completed a battery of 5 screening tests (knee to wall, hip internal rotation, adductor squeeze, single-leg hop, and anterior reach) and a 25-minute standardized soccer session with a Global Positioning System unit placed at C7 to collect multiplanar PlayerLoad data. Main Outcome Measures: Baseline data on each screening test, along with uniaxial PlayerLoad in the mediolateral, anteroposterior, and vertical planes. Results: Stepwise hierarchical modeling of the screening tests revealed that dominant leg knee-to-wall distance was the most prevalent and powerful predictor of multiplanar PlayerLoad, accounting for up to 42% of variation in uniaxial loading. The adductor squeeze test was the least powerful predictor of PlayerLoad. Of note, one player who incurred a knee injury within 3 weeks of testing had shown a 20% reduction in knee-to-wall distance compared with peers, and elicited 23% greater PlayerLoad, supporting the hierarchical model. Conclusions: There was some evidence of redundancy in the screening battery, with implications for clinical choice. Hierarchical ordering and a concurrent case study highlight dominant leg knee-to-wall distance as the primary predictor of multiaxial loading in soccer. This has implications for the design and interpretation of screening data in elite youth soccer.
The protein kinase p38α destabilizes p63 to limit epidermal stem cell frequency and tumorigenic potential
Authors: Choo Min-Kyung , Kraft Stefan , Missero Caterina , Park Jin Mo
Published: October 2018

The kinase p38α restrains skin stem cell–associated tumorigenesis by inhibiting p63.
Effect of composition and method of preparation of liposomes on their stability and interaction with murine monocytes infected with Brucella abortus
Authors: Vitas A I , Díaz R , Gamazo C
Published: October 2018

The success of the use of liposomes as drug carriers depends on both their formulation and the method of preparation. We have carried out a series of in vitro studies using different formulations and preparation methods, with the aim of obtaining a type of liposome which is efficient in the treatment of brucellosis. On the basis of results obtained in studies of stability at 37 degrees C in the presence of serum lipoproteins and of the activation of phagocytic cells and antibiotic transport to the interior of monocytes infected with Brucella abortus, we conclude that the most suitable vesicles are positively charged, stable plurilamellar vesicles (phosphatidylcholine, 30% cholesterol, and 10% stearylamine). Gentamicin incorporated into these cationic liposomes completely eliminated all of the intracellular Brucella organisms (4.6 logs), while free gentamicin was capable of reducing the number of intracellular bacteria by only 0.3 log.