bluuebunny/crossref_metadata_2025 huggingface dataset:
Covalent Immobilization of Enoxacin onto Titanium Implant Surfaces for Inhibiting Multiple Bacterial Species Infection and
In Vivo
Methicillin-Resistant Staphylococcus aureus Infection Prophylaxis
Authors: Nie Bin'en , Long Teng , Ao Haiyong , Zhou Jianliang , Tang Tingting , Yue Bing
Published: November 2016

Infection is one of the most important causes of titanium implant failure
in vivo
. A developing prophylactic method involves the immobilization of antibiotics, especially vancomycin, onto the surface of the titanium implant. However, these methods have a limited effect in curbing multiple bacterial infections due to antibiotic specificity. In the current study, enoxacin was covalently bound to an amine-functionalized Ti surface by use of a polyethylene glycol (PEG) spacer, and the bactericidal effectiveness was investigated
in vitro
and
in vivo
. The titanium surface was amine functionalized with 3-aminopropyltriethoxysilane (APTES), through which PEG spacer molecules were covalently immobilized onto the titanium, and then the enoxacin was covalently bound to the PEG, which was confirmed by X-ray photoelectron spectrometry (XPS). A spread plate assay, confocal laser scanning microscopy (CLSM), and scanning electron microscopy (SEM) were used to characterize the antimicrobial activity. For the
in vivo
study, Ti implants were inoculated with methicillin-resistant
Staphylococcus aureus
(MRSA) and implanted into the femoral medullary cavity of rats. The degree of infection was assessed by radiography, micro-computed tomography, and determination of the counts of adherent bacteria 3 weeks after surgery. Our data demonstrate that the enoxacin-modified PEGylated Ti surface effectively prevented bacterial colonization without compromising cell viability, adhesion, or proliferation
in vitro
. Furthermore, it prevented MRSA infection of the Ti implants
in vivo
. Taken together, our results demonstrate that the use of enoxacin-modified Ti is a potential approach to the alleviation of infections of Ti implants by multiple bacterial species.
Efavirenz Is Predicted To Accumulate in Brain Tissue: an
In Silico
,
In Vitro
, and
In Vivo
Investigation
Authors: Curley Paul , Rajoli Rajith K. R. , Moss Darren M. , Liptrott Neill J. , Letendre Scott , Owen Andrew , Siccardi Marco
Published: November 2016

Adequate concentrations of efavirenz in the central nervous system (CNS) are necessary to suppress viral replication, but high concentrations may increase the likelihood of CNS adverse drug reactions. The aim of this investigation was to evaluate the efavirenz distribution in the cerebrospinal fluid (CSF) and the brain by using a physiologically based pharmacokinetic (PBPK) simulation for comparison with rodent and human data. The efavirenz CNS distribution was calculated using a permeability-limited model on a virtual cohort of 100 patients receiving efavirenz (600 mg once daily). Simulation data were then compared with human data from the literature and with rodent data. Wistar rats were administered efavirenz (10 mg kg of body weight
−1
) once daily over 5 weeks. Plasma and brain tissue were collected for analysis via liquid chromatography-tandem mass spectrometry (LC-MS/MS). The median maximum concentrations of drug (
C
max
) were predicted to be 3,184 ng ml
−1
(interquartile range [IQR], 2,219 to 4,851 ng ml
−1
), 49.9 ng ml
−1
(IQR, 36.6 to 69.7 ng ml
−1
), and 50,343 ng ml
−1
(IQR, 38,351 to 65,799 ng ml
−1
) in plasma, CSF, and brain tissue, respectively, giving a tissue-to-plasma ratio of 15.8. Following 5 weeks of oral dosing of efavirenz (10 mg kg
−1
), the median plasma and brain tissue concentrations in rats were 69.7 ng ml
−1
(IQR, 44.9 to 130.6 ng ml
−1
) and 702.9 ng ml
−1
(IQR, 475.5 to 1,018.0 ng ml
−1
), respectively, and the median tissue-to-plasma ratio was 9.5 (IQR, 7.0 to 10.9). Although it is useful, measurement of CSF concentrations may give an underestimation of the penetration of antiretrovirals into the brain. The limitations associated with obtaining tissue biopsy specimens and paired plasma and CSF samples from patients make PBPK modeling an attractive tool for probing drug distribution.
Comparative
In Vivo
Efficacies of Tedizolid in Neutropenic versus Immunocompetent Murine Streptococcus pneumoniae Lung Infection Models
Authors: Abdelraouf Kamilia , Nicolau David P.
Published: November 2016

Given that tedizolid exhibits substantial lung penetration, we hypothesize that it could achieve good efficacy against
Streptococcus pneumoniae
lung infections. We evaluated the pharmacodynamics of tedizolid for treatment of
S. pneumoniae
lung infections and compared the efficacies of tedizolid human-simulated epithelial lining fluid (ELF) exposures in immunocompetent and neutropenic murine lung infection models. ICR mice were rendered neutropenic via intraperitoneal cyclophosphamide injections and then inoculated intranasally with
S. pneumoniae
suspensions. Immunocompetent CBA/J mice were inoculated similarly. Single daily tedizolid doses were administered 4 h postinoculation (termed 0 h). Changes in log
10
CFU at 24 h compared with 0-h controls were estimated. Ratios of area under the free-drug concentration-time curve to MIC (
f
AUC
0–24
/MIC) required to achieve various efficacy endpoints against each isolate were estimated using the Hill equation. Tedizolid doses in neutropenic and immunocompetent mice that mimic the human-simulated ELF exposure were examined. Stasis, 1-log reduction, and 2-log reduction were achieved at
f
AUC
0–24
/MIC of 8.96, 24.62, and 48.34, respectively, in immunocompetent mice and 19.21, 48.29, and 103.95, respectively, in neutropenic mice. Tedizolid at 40 mg/kg of body weight/day and 55 mg/kg/day in immunocompetent and neutropenic mice, respectively, resulted in ELF AUC
0–24
comparable to that achieved in humans following a 200-mg once-daily clinical dose. These human-simulated ELF exposures were adequate to attain >2-log reduction in bacterial burden at 24 h in 3 out of 4 isolates in both models and 1.58- and 0.74-log reductions with the fourth isolate in immunocompetent and neutropenic mice, respectively. Tedizolid showed potent
in vivo
efficacy against
S. pneumoniae
in both immunocompetent and neutropenic lung infection models, which support its consideration for
S. pneumoniae
lung infections.
Efficacy of High-Dose Meropenem (Six Grams per Day) in Treatment of Experimental Murine Pneumonia Induced by Meropenem-Resistant Pseudomonas aeruginosa
Authors: Oshima Kazuhiro , Nakamura Shigeki , Iwanaga Naoki , Takemoto Koji , Miyazaki Taiga , Yanagihara Kastunori , Miyazaki Yoshitsugu , Mukae Hiroshi , Kohno Shigeru , Izumikawa Koichi
Published: November 2016

High-dose meropenem (MEPM; 6 g/day) has been approved as a treatment for purulent meningitis; however, little is known regarding its
in vivo
efficacy in refractory lower respiratory tract infections. The purpose of this study was to evaluate the efficacy of MEPM at 6 g/day in a murine model of severe pneumonia caused by MEPM-resistant
Pseudomonas aeruginosa
. Experimental pneumonia induced by MEPM-resistant
P. aeruginosa
was treated with normal-dose MEPM (150 mg/kg of body weight, simulating a 3-g/day regimen in humans) or high-dose MEPM (500 mg/kg, simulating a 6-g/day regimen in humans). Mice treated with high-dose MEPM showed significantly restored survival relative to that of untreated mice and tended to show a survival rate higher than that of mice treated with normal-dose MEPM. The viable bacterial counts (of two clinical isolates) in the lungs decreased significantly in mice treated with high-dose MEPM from those for untreated mice (
P
< 0.001) or mice treated with normal-dose MEPM (
P
, <0.01 and <0.05). The number of inflammatory cells in the bronchoalveolar lavage fluid (BALF) was also significantly lower in mice treated with high-dose MEPM than in untreated mice. The free MEPM concentration in the epithelial lining fluid (ELF) exceeded 16 μg/ml for 85 min in mice treated with high-dose MEPM, but not for mice treated with normal-dose MEPM. Our results demonstrate that high-dose MEPM (6 g/day) might provide better protection against pneumonia caused by MEPM-resistant strains of
P. aeruginosa
than the dose normally administered (less than 3 g/day).
Distinct Effects of Integrins αXβ2and αMβ2on Leukocyte Subpopulations during Inflammation and Antimicrobial Responses
Authors: Jawhara Samir , Pluskota Elzbieta , Cao Wei , Plow Edward F. , Soloviev Dmitry A.
Published: November 2016

Integrins αMβ2and αXβ2are homologous adhesive receptors that are expressed on many of the same leukocyte populations and bind many of the same ligands. Although αMβ2was extensively characterized and implicated in leukocyte inflammatory and immune functions, the roles of αXβ2remain largely obscure. Here, we tested the ability of mice deficient in integrin αMβ2or αXβ2to deal with opportunistic infections and the capacity of cells derived from these animals to execute inflammatory functions. The absence of αMβ2affected the recruitment of polymorphonuclear neutrophils (PMN) to bacterial and fungal pathogens as well as to model inflammatory stimuli, and αMβ2-deficient PMN displayed defective inflammatory functions. In contrast, deficiency of αXβ2abrogated intraperitoneal recruitment and adhesive functions of monocytes and macrophages (Mϕ) and the ability of these cells to kill/phagocytoseCandida albicansorEscherichia colicells bothex vivoandin vivo. During systemic candidiasis, the absence of αXβ2resulted in the loss of antifungal activity by tissue Mϕ and inhibited the production of tumor necrosis factor alpha (TNF-α)/interleukin-6 (IL-6) in infected kidneys. Deficiency of αMβ2suppressed Mϕ egress from the peritoneal cavity, decreased the production of anti-inflammatory IL-10, and stimulated the secretion of IL-6. The absence of αXβ2, but not of αMβ2, increased survival against a septic challenge with lipopolysaccharide (LPS) by 2-fold. Together, these results suggest that αMβ2plays a primary role in PMN inflammatory functions and regulates the anti-inflammatory functions of Mϕ, whereas αXβ2is central in the regulation of inflammatory functions of recruited and tissue-resident Mϕ.
MutS2 Promotes Homologous Recombination in Bacillus subtilis
Authors: Burby Peter E. , Simmons Lyle A.
Published: November 2016

Bacterial MutS proteins are subdivided into two families, MutS1 and MutS2. MutS1 family members recognize DNA replication errors during their participation in the well-characterized mismatch repair (MMR) pathway. In contrast to the well-described function of MutS1, the function of MutS2 in bacteria has remained less clear. In
Helicobacter pylori
and
Thermus thermophilus
, MutS2 has been shown to suppress homologous recombination. The role of MutS2 is unknown in the Gram-positive bacterium
Bacillus subtilis
. In this work, we investigated the contribution of MutS2 to maintaining genome integrity in
B. subtilis
. We found that deletion of
mutS2
renders
B. subtilis
sensitive to the natural antibiotic mitomycin C (MMC), which requires homologous recombination for repair. We demonstrate that the C-terminal
s
mall
M
utS-
r
elated (Smr) domain is necessary but not sufficient for tolerance to MMC. Further, we developed a CRISPR/Cas9 genome editing system to test if the inducible prophage PBSX was the underlying cause of the observed MMC sensitivity. Genetic analysis revealed that MMC sensitivity was dependent on recombination and not on nucleotide excision repair or a symptom of prophage PBSX replication and cell lysis. We found that deletion of
mutS2
resulted in decreased transformation efficiency using both plasmid and chromosomal DNA. Further, deletion of
mutS2
in a strain lacking the Holliday junction endonuclease gene
recU
resulted in increased MMC sensitivity and decreased transformation efficiency, suggesting that MutS2 could function redundantly with RecU. Together, our results support a model where
B. subtilis
MutS2 helps to promote homologous recombination, demonstrating a new function for bacterial MutS2.

IMPORTANCE
Cells contain pathways that promote or inhibit recombination. MutS2 homologs are Smr-endonuclease domain-containing proteins that have been shown to function in antirecombination in some bacteria. We present evidence that
B. subtilis
MutS2 promotes recombination, providing a new function for MutS2. We found that cells lacking
mutS2
are sensitive to DNA damage that requires homologous recombination for repair and have reduced transformation efficiency. Further analysis indicates that the C-terminal Smr domain requires the N-terminal portion of MutS2 for function
in vivo
. Moreover, we show that a
mutS2
deletion is additive with a
recU
deletion, suggesting that these proteins have a redundant function in homologous recombination. Together, our study shows that MutS2 proteins have adapted different functions that impact recombination.
Distinguishing between Microbial Habitats Unravels Ecological Complexity in Coral Microbiomes
Authors: Apprill Amy , Weber Laura G. , Santoro Alyson E.
Published: November 2016

This study demonstrates that coral tissue or mucus habitats structure the microbiome of corals and that separation of these habitats facilitates identification of consistent microbial associates. Using this approach, we demonstrated that sequences related to “
Candidatus
Amoebophilus,” recognized intracellular symbionts of amoebae, were highly associated with the tissues of Caribbean corals and possibly endosymbionts of a protistan host within corals, adding a further degree of intricacy to coral holobiont symbioses. Examining specific habitats within complex hosts such as corals is useful for targeting important microbial associations that may otherwise be masked by the sheer microbial diversity associated with all host habitats.
Endovascular recanalization of the common carotid artery in a patient with radio induced chronic occlusion
Authors: Nico Lorena , Cester Giacomo , Viaro Federica , Baracchini Claudio , Causin Francesco
Published: November 2016

Recanalization of chronic occlusion of the common carotid artery (CCA) in patients with a history of neck irradiation is challenging, both for vascular surgeons and interventional neuroradiologists. We describe a case of successful stenting of radio induced chronic occlusion of the right CCA in a 41-year-old patient with neurological deterioration and minor stroke due to cerebral hypoperfusion caused by concomitant bilateral arterial occlusions. Direct surgery and surgical bypass were considered contraindicated. The endovascular approach was successful and required multiple precautions during the procedure. We describe particular solutions, not used in day to day practice, that allowed us to carry out the endovascular treatment in this unusual situation.
Leydig cell tumour and mature ovarian teratoma: rare androgen-secreting ovarian tumours in postmenopausal women
Authors: Palha Ana , Cortez Luísa , Tavares Ana Paula , Agapito Ana
Published: November 2016

Androgen-secreting ovarian tumours are extremely rare accounting for <5% of all ovarian neoplasms. They are more frequent in postmenopausal women and should be suspected in the case of a rapid onset of androgenic symptoms. We report 4 cases of postmenopausal women who presented with signs of virilisation. All patients revealed increased serum levels of testosterone, normal dehydroepiandrosterone-sulfate and negative pelvic ultrasound for adnexal masses. An androgen-secreting ovarian tumour was suspected and all of them were submitted to bilateral oophorectomy. Histology confirmed the diagnosis of Leydig cell tumours in 3 patients and mature teratoma in 1. A successful response to surgery, which includes a decline in serum androgen levels and signs of hyperandrogenism, was observed in our patients. This case series demonstrates that androgen-secreting ovarian neoplasms may not be detectable by imaging studies, but should be considered in the differential diagnosis of all postmenopausal women with signs of hyperandrogenism.
Rare cause of acute hepatitis: a common energy drink
Authors: Harb Jennifer Nicole , Taylor Zachary A , Khullar Vikas , Sattari Maryam
Published: November 2016

A previously healthy man aged 50 years presented with malaise, anorexia, abdominal pain, nausea, vomiting, generalised jaundice, scleral icterus and dark urine. He was not on any prescription or over-the-counter medications, but reported drinking 4–5 energy drinks daily for 3 weeks prior to presentation. Physical examination revealed jaundice and right upper quadrant abdominal tenderness. Laboratory studies were remarkable for transaminitis and evidence of chronic hepatitis C infection. Ultrasound scan demonstrated an echogenic liver and diffuse gallbladder wall thickening. Liver biopsy showed severe acute hepatitis with bridging necrosis and marked cholestasis. The patient was treated supportively with complete resolution of his symptoms and marked improvement in his laboratory abnormalities. The development of acute hepatitis in this patient was likely secondary to excessive energy drink consumption. Energy drinks as well as other herbal/over-the-counter supplements should be considered by clinicians in the workup of patients with acute hepatitis, particularly once other aetiologies have been excluded.
Infected pseudoaneurysm of the left anterior descending artery
Authors: Madkaiker Ashish , Krishna Neethu , Kumaraswamy Natarajan , Varma Praveen
Published: November 2016

Primary percutaneous transluminal coronary angioplasty (PTCA) with the insertion of a stent is a well-established procedure for management of coronary artery disease. Infected pseudoaneurysms following PTCA and stenting are very rare and have poor outcomes if not managed properly. We are presenting a case of a man aged 50 years with infected pseudoaneurysm of the left anterior descending artery following multiple percutaneous interventions for coronary artery disease. In this paper, we have described the presentation, diagnosis and management of this patient and have discussed the aetiology and management options of infected pseudoaneurysm affecting coronary arteries.
When plenty is too much: water intoxication in a patient with a simple urinary tract infection
Authors: Lee Laura Christine , Noronha Maryann
Published: November 2016

Healthcare professionals frequently advise patients with simple infective illness to drink more fluids. Here, a 59-year-old woman with a urinary tract infection followed such advice resulting in hospital admission with symptomatic acute hyponatraemia. Water intoxication is well recognised as a cause of symptomatic hyponatraemia in endurance sports, MDMA use and psychogenic polydipsia. It has rarely been described outside of these circumstances. With normal renal function, it is difficult to overwhelm the excretory capacity for water. However, in infective illness, increased levels of antidiuretic hormones (which may be secreted both appropriately to correct volume status and inappropriately as a feature of disease) reduce renal excretion of water. In this scenario, could increased administration of oral hypotonic fluids lead to hyponatraemia, with associated morbidity and mortality, than has previously been recognised? There is a need for more research to qualify our oft-given advise to drink more fluids.
PROSPECTIVE RANDOMIZED CLINICAL STUDY FOR THE TREATMENT OF LATERAL EPICONDYLITIS; COMPARISON AMONG PRP (PLATELET-RICH PLASM), PROLOTHERAPY, PHYSIOTHERAPY AND ESWT
Authors: Lhee SH , Kim JW , Jeon JB , Lee DY
Published: November 2016

As recent knowledge proved that pathology of lateral epicondylitis is no more an inflammatory condition, but angiofibroblastic degeneration, steroid injection is no more recommended for lateral epicondylitis. It seems to be inappropriate that most of the comparative study used steroid injection as control group, as steroid injection is no more accepted as a treatment option. As control group should be treated with widely accepted proven method, the authors concluded that physiotherapy is the optimal control group treatment in designing prospective randomized control study. Ideal treatment option for lateral epicondylitis should have potential to promote healing of collagen fibres as basic pathology of lateral epicondylitis is the presence of degenerative changes including disorganized collagen fibres. Among recently highlighted treatments which have healing potential theoretically. The authors chose PRP (Platelet-Rich Plasma), prolotherapy and ESWT (Extracorpeal Shockwave Therapy) considering accessibility and national regulations. Consecutive patients who had refractory elbow pain more than 6 months were recruited into the study and randomized into 4 groups. Group A: Physiotherapy, B: ESWT, C: Prolotherapy, D: PRP. A power analysis performed before data collection indicated that a sample size of 200 patients (50 patients per group) will have 80% power which is able to detect 30% difference in DASH scoring system at a significance level of .05 (effect size=0.64). Mean and standard deviation for power analysis was determined according to preliminary study. Mean age was 52 years and mean Follow-up was 29 months (24–39). All 4 groups showed a decrease of DASH score after treatments (A: from 41.2 to 33.2, B: from 41.3 to 28.0, C: from 37.1to 16.3, D: from 41.2 to 10.6). Difference among DASH scores were not significant at initial point, 3 months and 6 months after the treatments (p>0.01). Post hoc comparisons at 18 and 24 months after treatment indicated that DASH score was better in the PRP group (p<0.01) than in the ESWT or the physiotherapy group and in the prolotherapy group (p<0.01) than in the physiotherapy group. In summary, prolotherapy and PRP showed better clinical outcome compared to ESWT and physiotherapy group and PRP showed most superior results.
KNEE LAXITY MEASUREMENT IN ACUTE KNEE TRAUMA AND ACL EVALUATION WITH THE ROLIMETER
Authors: Ericsson D , Östenberg A Hafsteinsson , Alricsson M
Published: November 2016

The Rolimeter is an instrument that quantifies anterior knee laxity and has in previous studies showed satisfactory results regarding intra- and inter test reliability in subjects without injuries or with chronic ACL deficiency. The aim of the present study was to test reliability of the Rolimeter in the acute phase following a substantial knee trauma. The repeatability of the test procedure was also investigated. Totally 15 subjects (aged 22.7±6.9) with acute knee trauma were examined by one single observer at three different times with the Rolimeter (arthrometer model, Aircast, Europa) using maximum force. Both injured and non-injured knees were examined and anterior posterior displacement was recorded. Endpoint examination was used as “golden standard” in data analysis. The results showed strong significant correlations for the Rolimeter scores of knee laxity between baseline and endpoint for both injured and non-injured knees (r=0.928, p<0.01 and r=0.987, p<0.01 respectively). Mean differences in anterior laxity were small with no significant differences between readings. High repeatability was found in repeated measurements with no significant change over time for the non-injured knees. The study implicates that the Rolimeter produces reliable quantification of anterior knee laxity in repeated measurements even in the acute phase following knee trauma. In combination with manual tests the Rolimeter seems to be a valuable instrument in diagnosing ACL injuries.
SEDENTARY BEHAVIOUR – ARE WE SITTING TOO MUCH?
Authors: Ikogho O
Published: November 2016

Sedentary behavior is defined as “Engaging in behaviors during the waking day that are done while sitting or reclining and result in little energy expenditure.” (Koster et al Diabetes Care, 2011;34(2):497–503) Research shows that there are health risks are associated with spending more than 6–7 sedentary hours per day, independent of exercise time. (Patel et al, Am J Epidemiol, 2010;172(4):419–29) The aim was to identify which patients could benefit from reducing their sedentary time. 101 patients at Cleadon Park Medical Centre, South Shields were questioned. Sedentary hours were self-reported, physical activity was measured using The General Practice Physical Activity Questionnaire (GPPAQ). Four categories emerged: Less than active and excessively sedentary n= 45 (45%); Less than active and not excessively sedentary n= 37 (37%); Active and excessively sedentary n=9 (9%); Active and not excessively sedentary n=10 (10%). This shows patients are not exercising enough, sitting too much or, as with 45%, both. Reducing sedentary time as well as increasing physical activity should be encouraged. Many patients, including those who are already adequately active, would benefit.
A STUDY OF THE PHYSICAL ACTIVITY OF SUPPORTERS OF PROFESSIONAL SPORTS
Authors: Dhand R , Rae G , Richardson A
Published: November 2016

Physical inactivity has been identified as the 4th leading cause of global mortality (http://www.who.int/topics/physical_activity/en). UK physical activity (PA) guidelines advise adults should achieve a weekly minimum of 150 minutes moderate activity, 75 minutes vigorous activity or a combination of the two. Adults should also partake in at least 2 days of muscle strengthening (MS) exercise per week (https://www.gov.uk/government/ publications/uk-physical-activity-guidelines). The project aimed to assess sports fans' knowledge of PA guidelines, to evaluate the amount of PA undertaken, and assess whether PA knowledge and participation is influenced by sport preference. A 2-part questionnaire (Part 1 knowledge of PA guidelines; Part 2 amount of PA) was completed by supporters aged over 18 attending a fixture at Durham CCC, Sunderland AFC, Newcastle Falcons RFC and Newcastle Racecourse. Supporters with health problems limiting moderate exercise were excluded from Part 2. 277 supporters were analysed. Relevant data for incomplete questionnaires was excluded and valid percentages were used. 72% of participants said they were aware of PA guidelines existing but only 6.2% correctly answered 150 minutes for the amount of PA advised per week. 25.6% correctly documented 2 MS days per week. 21.1% of participants failed to reach 150 minutes PA per week, with 59.6% undertaking MS exercise on less than 2 days per week. There was a significant difference between sports for number of days per week of MS exercise (mean (SD): Football 2.32 (2.01); Rugby 1.48 (1.63); Cricket 0.77 (1.37); Horse Racing 0.72 (1.29) [p<0.001]). There was a significant difference between sports for participant perspective of how active they are [p=0.004]. Analysis shows that most sports fans do meet PA guidelines for moderate/vigorous activity. This is not the case for MS exercise, which may be influenced by preferred sport. Knowledge of recommended PA and MS exercise suggests further education is required.
INFLUENCE OF RUN AND CUT MANOEUVRES ON PATELLOFEMORAL KINETICS AND KINEMATICS
Authors: Sinclair J , Dillon S
Published: November 2016

Patellofemoral pain syndrome is the most common knee pathology. Those with patellofemoral pain are much more likely to be physically active than age-matched controls. The prevalence of patellofemoral pain in athletic populations is considered to be between 8–40 %. It has been suggested that patellofemoral pain may serve as a precursor to the progression of osteoarthritic symptoms in later life. The effects of different sports tasks on patellofemoral kinetics and kinematics has received a paucity of research attention. The aim of the current investigation was to explore differences in patellofemoral kinetics and kinematics during the run and cut manoeuvres. Ten male participants took part in this investigation. They performed run and 45˚ cut movements using an approach velocity of 4.0 m.s−1. Three-dimensional kinematics of the thigh, shank and patella segments were quantified using retro reflective markers via an eight camera motion capture system which operated at 250 Hz. In addition to this patellofemoral kinetics were quantified using a musculoskeletal modelling approach. Differences between manoeuvres were explored statistically using paired samples t-tests. The results showed that patellofemoral force (Cut=4.65 & Run=4.11 Bodyweights) and pressure (Cut=12.32 & Run=10.93 MPa) were larger in the cut movement compared to the run. In addition patella angular range of motion was larger in the sagittal (Cut=11.66 & Run=7.89°) and transverse (Cut=13.55 & Run=7.57°) planes when performing the cut movement in comparison to the run. In conclusion given the association between patellofemoral loading/ patella mal-alignment and the aetiology of patellofemoral pain syndrome, the current study indicates that the cut manoeuvre may place athletes at increased risk from injury.
EFFECT OF 4 WEEKS HIGH-INTENSITY INTERMITTENT TAEKWONDO TRAINING ON BODY COMPOSITION AND PHYSICAL FITNESS IN ZULU DESCENT, SOUTH AFRICAN TAEKWONDO ATHLETES
Authors: Mathunjwa ML , Mugandani SC , Kappo AP , Ivanov S , Djarova-Daniels T
Published: November 2016

The aim of the present study was to determine the effect of 4 weeks high intensity intermittent Taekwondo (TKD) training program on body composition, physical fitness and performance of South African TKD athletes of Zulu ancestry. Thirty four (n=34) active TKD athletes aged 20–26 years volunteered for this study. The athletes were divided into control and experimental groups. The control participants (10 males and 7 females) were holders of green and lower belts with provincial exposure. The experimental group (10 males and 7 females) had blue or senior belts who qualified to represent the provincial club and to compete in International championships. Both groups were subjected to a 4 week of TKD and strength training. The experimental group performing high intensity intermittent (85–95%VO2max) training and control group performing interval TKD training of lower intensity (70–75% VO2max). All subject were pre and post-tested on body composition [body mass, BMI, body fat percentage (%BF), sum of 6 skinfolds (SS)], flexibility (sit & reach), leg power (standing broad jump), muscle strength and endurance (sit-ups and push-ups), and agility (T-test) and VO2max(20 m bleep test). Resting heart rate (RHR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured. Data was analyzed using pairedt-test for independent samples and Z-score individual radar plots statistics. After 4 weeks of training, athletes in the experimental group showed a reduction in body weight (p<0.05), BMI (p<0.001), SBP (p<0.05), RHR (p<0.05), SS (p<0.05), and fat % (p<0.001) and improvement (p<0.001) in flexibility, muscle strength, power, agility and VO2max. In male controls, fat % was decreased (p<0.05), flexibility and VO2maxwere increased (p<0.05). In female controls, only flexibility was improved (p<0.05). The findings of this study support the effectiveness of 4 weeks high intensity intermittent training in Taekwondo athletes of Zulu ancestry improves body composition, cardiorespiratory response and physical performance that could contribute to health and enhanced combat skills.
CUSTOMISED SPORT INJURY REHABILITATION WITH YOGA AND PHYSIOTHERAPY FOR ACL - 12 WEEK REHABILITATION PROGRESS OF AN INJURED YOUNG ALPINE SKIER
Authors: Ravi S
Published: November 2016

Perception of the usefulness /value of yoga as an adjunct intervention is a significant factor for the injured athlete's adherence to the customised sport injury rehabilitation program. The findings from 12 week rehabilitation progress assessment post Anterior Cruciate Ligament (ACL) reconstruction of an injured skier, highlight improvement in the injury rehabilitation goals which influence the performance goals of the injured athlete. A customised program was designed for the injured athlete with a 30 minute yoga protocol as an adjunct intervention, thrice a week along with 90 minute physical therapy session. IKDC score improved from 49.4 to 63.2. Range of Motion (ROM) of the injured right knee improved from −3 to normal, knee flexion increased by 20 deg, external rotation flexion enhanced (active 20 deg and passive 10 deg), passive hip flexion increased by 15 deg. Muscle test for hip extension increased from 4 to 5, flexion (from 3+ to 5), knee flexion (from 3 to 4), knee extension (3+ to 5). The perceived value of the injured athlete to practice yoga as part of rehabilitation is 5.8 whereas the perceived choice is 3.9 on a 7 point scale of Perception of Activity. While yoga and physical therapy improve flexibility, muscle strength, stability and balance of the injured athlete, perception about usefulness of the customised yoga and physical therapy influences adherence to rehabilitation and effective participation in the rehabilitation program. Biopsychosocial model (Brewer et al 2002) helps to understand rehabilitation of sport injury rehabilitation. Yoga and physiotherapy as a combined intervention, could enhance the biological and psychological factors that have a significant effect on the intermediate biopsychological outcomes. In this research, knowledge about usefulness of yoga in sport injury treatment could benefit the sport medicine and physiotherapy fraternity to include yoga as an adjunct intervention. Collaboration of physiotherapists, yoga professionals, doctors and coaches with an athlete-centric approach might help injured athletes to enhance adherence to sport injury rehabilitation programs. Further studies are warranted to measure long term effect of yoga on sport injury rehabilitation and prevention of non-contact injuries of athletes.
INTER-INDIVIDUAL DIFFERENCES IN THE RESPONSES OF VO2MAX TO PHYSICAL ACTIVITY COUNSELLING
Authors: Williamson P , Atkinson G , Batterham A
Published: November 2016

Low cardiorespiratory fitness (VO2max) is an important risk factor for diabetes, cardiovascular disease and some cancers, making lifestyle interventions especially relevant. There is purported to be substantial inter-individual differences in how VO2maxresponds to lifestyle/exercise interventions. Recently, we described the appropriate approach for quantifying these inter-individual differences. Therefore, we aimed to apply this approach to quantify inter-individual differences in the responses of VO2max. We re-analysed data from the influential ‘Activity Counselling Trial’ (ACT), which was designed to determine the effects of general lifestyle assistance as well as formal counselling on physical activity and VO2maxin 479 men and 395 women. Importantly, an appropriate comparator group was also present in order to quantify ‘true’ inter-individual differences in VO2maxresponse. For women, the ‘true’ inter-individual responses in VO2max(expressed as a SD) were found to be±129 (95% Confidence interval: −40 to 187) ml/min in the general lifestyle assistance group and±93 (−91 to 160) ml/min in the formal lifestyle counselling group. For men, true individual differences in response were±116 (95%CI: −130 to 210) ml/min and±148 (−105 to 234) ml/min in the assistance and counselling groups, respectively.

Although the mean increase in VO2maxwas greater in women, this increase corresponded to a trivial effect size. This application of the appropriate analyses to the ACT dataset indicate that, on average, the effects of activity counselling on VO2maxwere small, although there were moderate ‘true’ inter-individual differences in the VO2maxresponse in women (0.34 SD) and small ‘true’ inter-individual differences in men (0.27 SD). Further genotype investigation may therefore be warranted in order to determine the mediators of this observed heterogeneity in response.
INTER-INDIVIDUAL RESPONSES OF MAXIMAL OXYGEN UPTAKE TO EXERCISE TRAINING: A CRITICAL REVIEW
Authors: Williamson P , Atkinson G , Batterham A
Published: November 2016

We recently reported how to quantify the inter-individual differences in response to an intervention. We now aim to scrutinise the research on the individual responses to training of maximal oxygen uptake (VO2max). The key trigger for further investigation into individual responses is when the standard deviation of change (SDchange) in the intervention sample is substantially larger than the same standard deviation derived from a suitable comparator sample. ‘True’ inter-individual response can then be inferred. Six relevant studies from the influential HERITAGE family study were published in the 1980s. Unfortunately, only one of these studies included a comparator arm (1) Re-analysis of data from this study, accounting for random within-subjects variation, revealed an absence of clinically important individual difference in VO2max response. The SDchangewas, in fact, larger (±5.6 ml/kg/min) for the comparator than the intervention group (±3.7 ml/kg/min). Over 180 publications have now resulted from The HERITAGE study, but the crucial comparator arm is absent in all of these studies. Some authors rationalized this absence by claiming that only inter-individual differences in exercise response were of interest. This absence of a comparator sample is also the case in some present on-going studies. Again, re-analysis of data from the most recent studies does not suggest clinically relevant inter-individual differences in response. We also have concerns about the intraclass correlation coefficient approach to data analysis in twin studies. These are often heterogeneous for the obviously influential factors of sex, age and fitness, thereby inflating an unadjusted coefficient. We conclude that most studies on individual differences in VO2max response have no comparator sample. Therefore, ‘true’ individual response differences cannot be quantified. For those studies with a comparator sample, the difference between individual differences in response and random within-subjects variation is not clinically relevant.
FOAM ROLLING INCREASES SKELETAL MUSCULAR EFFICIENCY WITHOUT AFFECTING RANGE OF MOTION
Authors: Macgregor LJ , Hunter AM
Published: November 2016

Foam rolling (FR) has been shown to alleviate some symptoms of exercise-induced muscle damage, and has been suggested to increase range of movement (ROM) without negatively impacting strength. However, the exact mechanisms of action are unclear. The aim of this study was to investigate mechanisms associated with a single acute bout of FR, as well as repeated bouts of FR, on healthy rested muscle. Muscle stiffness of vastus lateralis and rectus femoris of 16 healthy active male volunteers were measured using tensiomyography (TMG). Knee extension maximal voluntary contraction (MVC) and knee flexion ROM were also assessed, and surface electromyography (sEMG) was recorded during a submaximal isometric contraction (50% of MVC). Measures were performed before and after (0, 15 and 30 minutes) either a 2 minute rest period (control) or a 2 minute bout of FR, performed on quadriceps; each condition was repeated for 3 consecutive days, with 7 days between conditions. MVC was reduced in control compared to with FR (p<0.001), ROM was not altered (p=0.125). Dm of the VL (p=0.001) was elevated on the third day of FR. sEMG was reduced (p<0.01) 0, 15 and 30 minutes after FR compared to control. Following FR, MVC was elevated compared to control and sEMG was transiently reduced during a submaximal task. This suggests that the activation efficiency of the involved muscles has been increased by FR, which has spared the decline in MVC, observed in control, due to fatigue from repeated efforts.
EFFECT OF CARBOHYDRATE-ELECTROLYTE-PROTEIN SOLUTION INGESTION ON 21 KM RUNNING PERFORMANCE IN FEMALE MARATHON RUNNERS
Authors: SUN F , GUI Z
Published: November 2016

The purpose of the present study was to compare the effects of carbohydrate-electrolyte-protein solutions (CEPS), carbohydrate-electrolyte solutions (CES), and placebo (PLA) consumption on 21 km running performance in female runners. Nine healthy recreational female marathon runners (Age 36±7 y, BMI 21.0±2.3 kg/m2,VO2max48.4±6.8 ml/kg/min) completed 3 experimental trials in a randomized crossover study design, separated by at least 30 days. All the main trials were required to be finished in their follicular phase. In each main trial, participants were required to complete one 21 km performance running. For the first 5 km, the participants ran at a fixed speed of their individual 70%VO2max.Thereafter, the participants ran at whatever speed they wished for the remaining 16 km of the performance run. Every 2.5 km throughout the run, 150 ml of solutions was provided to the participants. The three solutions were CES (6%CHO), CEPS (4%CHO+2%PRO), and a non-caloric, artificially sweetened PLA. Three solutions contained the same electrolyte profile. Total energy was matched between CES and CEPS. No differences was found in remaining 16 km running performance among the three trials, with mean times of 103.3±3.1, 98.7±1.9, and 103.1±2.9 min for CEPS, CES and PLA trials, respectively. Blood glucose concentration was lower in PLA trial (4.5±0.1 mmol/L) than CES trial (5.6±0.2 mmol/L) (P=0.004). Blood lactate was higher in CES trial (2.5±0.3 mmol/L) than CEPS trial (1.8±0.2 mmol/L) (P=0.043). It seems that neither CES nor CEPS consumption during a 21 km run can improve exercise performance in recreational female marathon runners.

The present study was supported by Dean's Research Fund (FLASS/DRF/ECR-2), Faculty of Liberal Arts and Social Sciences, The Education University of Hong Kong.
MOVEMENT COMPETENCY AND ASSOCIATION WITH GAME PERFORMANCE IN SECONDARY SCHOOL NETBALL PLAYERS
Authors: Spencer K , Whatman C , Reid D
Published: November 2016

Game performance (GP) is characterised by a high frequency of jumping & catching to maintain possession & create scoring opportunities. Coaches use Movement Competency (MC) to predict player GP. A cross-sectional observational study collected MC & GP data from 37 players (age 16±1 y, height 180±6 cm, mass 69.6±8.6 kg) to determine if associations existed between MC & GP. Jumping & catching were coded as frequency of successful actions. Landings were coded as symmetrical (SL) or asymmetrical (AL) and stable or unstable. Good performance in sports is thought to be reflected through good MC as the body segments are well aligned which promotes a fluid action & an expected positive association between MC & GP. The mechanism of ‘drop jumps’ (MC score) would be expected to have a relationship with landing & balance strategies (GP measure). Players in end (GA,GS,GD,GK) positions (Mean±SD 178±4 cm) were taller than players in link (WA,WD,C) positions (171±4 cm; t(22)=4.03, p=.001, two-tailed). The magnitude of the differences in the means (MD=7.5, 95% CI: 4 to 11) was very large (eta squared=.42). Players rated with a MC score of 21 across all scores are considered as moderately competent, 58% of the players failed to reach this score. The total MC score (maximum 32) ranged from 15 to 27. Link players jumped more frequently than end players (86% jumped over 5 times compared to 30% respectively; χ2 (1,n=37)=8.5,p=.001, phi=0.54), yet there was no association with jump frequency & the MC measures of jump height, jump power & position. Drop jump right (DJR) had a medium negative correlation with total catches (r=−.36,n=35,p=.04) with a low angle of DJR associated with lower frequency of total catches & it had a medium negative correlation with AL (r=−.36,n=35,p=.05) with a low angle of DJR associated with lower frequency of AL. There was a strong negative correlation with frequency of ankle balance strategy (r=−.51,n=35,p=.002) & a low angle of DJR associated with lower frequency of stability. Poor MC remains an issue in secondary school netball & strategies to improve movement & landing competency should remain a focus of coach & player development. Yet the poor association of MC to GP suggests this is an injury prevention measure, rather than as informative data underpinning talent identification.
How prevention of violence in childhood builds healthier economies and smarter children in the Asia and Pacific region
Authors: Fry Deborah , Blight Stephen
Published: November 2016

Investments in preventing violence against children in the Asia and Pacific region will bring important social and economic returns that contribute to building the region's ‘cognitive capital’. An analysis of burden of violence research in the region is presented to identify the impacts of violence and to demonstrate these returns. Violence is an everyday experience in the lives of many children in the Asia–Pacific, and the toxic stress associated with such routine forms of violence may permanently impact the architecture and chemistry of the developing brain. This can undermine learning and affect behavioural, social and emotional functioning as children grow into adulthood. Given the hundreds of millions of children affected by violence in the region each year, its cumulative impact translates into the annual loss of hundreds of billions of dollars—or about 2% of gross domestic product of the Asia and Pacific region. Violence prevention can affect positively on health and productivity, reduce expenditure on crisis response, improve children's developmental and educational outcomes, and prevent crime. The sustainable development goals and the emerging global consensus on effective prevention strategies constitute a powerful new agenda to end violence against children, and there are critical steps that governments can take to accelerate action.
Accelerating progress towards universal health coverage in Asia and Pacific: improving the future for women and children
Authors: Beattie Allison , Yates Robert , Noble Douglas J
Published: November 2016

Universal health coverage generates significant health and economic benefits and enables governments to reduce inequity. Where universal health coverage has been implemented well, it can contribute to nation-building. This analysis reviews evidence from Asia and Pacific drawing out determinants of successful systems and barriers to progress with a focus on women and children. Access to healthcare is important for women and children and contributes to early childhood development. Universal health coverage is a political process from the start, and public financing is critical and directly related to more equitable health systems. Closing primary healthcare gaps should be the foundation of universal health coverage reforms. Recommendations for policy for national governments to improve universal health coverage are identified, including countries spending < 3% of gross domestic product in public expenditure on health committing to increasing funding by at least 0.3%/year to reach a minimum expenditure threshold of 3%.
Total and cause-specific mortality of Finnish military personnel following service in international peacekeeping operations 1990–2010: a comprehensive register-based cohort study
Authors: Laukkala T , Parkkola K , Henriksson M , Pirkola S , Kaikkonen N , Pukkala E , Jousilahti P
Published: November 2016

Objectives

To estimate total and cause-specific mortality after international peacekeeping deployments among the Finnish military peacekeeping personnel in comparison to the general population of similar age and sex.

Design

A register-based study of a cohort of military peacekeeping personnel in 1990–2010 followed for mortality until the end of 2013. Causes of death were obtained from the national Causes of Death Register. The standardised mortality ratio (SMR) for total and cause-specific mortality was calculated as the ratio of observed and expected number of deaths.

Setting

Finland (peacekeeping operations in different countries in Africa, Asia and in an area of former Yugoslavia in Europe).

Participants

14 584 men and 418 women who had participated in international military peacekeeping operations ending between 1990 and 2010.

Interventions

Participation in military peacekeeping operations.

Main outcome

Total and cause-specific mortality.

Results

209 men and 3 women died after their peacekeeping service. The SMR for all-cause mortality was 0.55 (95% CI 0.48 to 0.62). For the male peacekeeping personnel, the SMR for all diseases was 0.44 (95% CI 0.35 to 0.53) and for accidental and violent deaths 0.69 (95% CI 0.57 to 0.82). The SMR for suicides was 0.71 (95% CI 0.53 to 0.92).

Conclusions

Even though military peacekeeping personnel are working in unique and often stressful conditions, their mortality after their service is lower compared with the general population. Military peacekeeping personnel appear to be a selected population group with low general mortality and no excess risk of any cause of death after peacekeeping service.