bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of the Physical Performance Test to Assess Preclinical Disability in Subjects With Asymptomatic Carotid Artery Disease
Authors: Landgraff Nancy C , Whitney Susan L , Rubinstein Elaine N , Yonas Howard
Published: February 2017

Background and Purpose. The purpose of this study was to determine whether subjects with asymptomatic carotid artery stenosis and occlusion demonstrate deficits in physical performance compared with a comparison group. These deficits may indicate that a person is demonstrating preclinical disability. Subjects. Seventy-one subjects with no known disease and 39 subjects with asymptomatic carotid artery stenosis of moderate and severe degrees or with occlusion were included. Methods. Physical performance was assessed with the 9-item and 7-item versions of the Physical Performance Test (PPT). Individual tasks also were timed for the subjects with disease. Results. There were significant differences between the comparison group and the subjects with carotid artery stenosis on the 9-item PPT (P<.00) and on the 7-item PPT (P<.03). Subjects with asymptomatic carotid artery stenosis and occlusion demonstrated less than optimal performance on the PPT (9-item PPT, X̅=27 of 36; 7-item PPT, X̅=21 of 28). Subjects with moderate stenosis were the slowest in performing the task of simulated eating. Discussion and Conclusion. Subjects with asymptomatic carotid artery stenosis and occlusion exhibited changes in function, as indicated by their performance on the PPT relative to that of a comparison group. This finding may be indicative of preclinical disability, indicating that these people are symptomatic. This indication may affect the medical and surgical options that can be considered for their care. [Landgraff NC, Whitney SL, Rubinstein EN, Yonas H. Use of the Physical Performance Test to assess preclinical disability in subjects with asymptomatic carotid artery disease. Phys Ther. 2006;86:541–548.]
Early Rehabilitation Following Surgical Fixation of a Femoral Shaft Fracture
Authors: Paterno Mark V , Archdeacon Michael T , Ford Kevin R , Galvin Doug , Hewett Timothy E
Published: February 2017

Background and Purpose. The purpose of this case report is to describe the outcome of a patient following fixation of a midshaft femur fracture and an evaluation-based, immediate-weight-bearing approach to rehabilitation. Case Description. The patient was a 28-year-old male manual laborer whose left femur was fractured in a head-on motor vehicle accident. The patient was treated with internal fixation of the left femur by use of an antegrade intramedullary nail. Following surgery, impairments in range of motion, knee extensor and hip abductor strength, and gait were observed. Intervention focused on immediate weight bearing and early progression of strengthening to address the observed impairments. Outcomes. All of the patient’s impairments improved, and he was able to return to work as a manual laborer within 6 months. Discussion. Immediate weight bearing with early strengthening activities following surgical correction of a midshaft femur fracture may result in early resolution of impairments and functional limitations and decreased disability.
Timed “Up & Go” Test: Reliability in Older People Dependent in Activities of Daily Living— Focus on Cognitive State
Authors: Nordin Ellinor , Rosendahl Erik , Lundin-Olsson Lillemor
Published: February 2017

Background and Purpose. It is unknown how cognitive impairment affects the reliability of Timed “Up & Go” Test (TUG) scores. The aim of the present study was to investigate the expected variability of TUG scores in older subjects dependent in activities of daily living (ADL) and with different levels of cognitive state. The hypothesis was that cognitive impairment would increase the variability of TUG scores. Subjects. Seventy-eight subjects with multiple impairments, dependent in ADL, and living in residential care facilities were included in this study. The subjects were 84.8±5.7 (mean±SD) years of age, and their Mini-Mental State Examination score was 18.7±5.6. Methods. The TUG assessments were performed on 3 different days. Intrarater and interrater analyses were carried out. Results. Cognitive impairment was not related to the size of the variability of TUG scores. There was a significant relationship between the variability and the time taken to perform the TUG. The intraclass correlations were greater than .90 and were similar within and between raters. In repeated measurements at the individual level, an observed value of 10 seconds was expected to vary from 7 to 15 seconds and an observed value of 40 seconds was expected to vary from 26 to 61 seconds for 95% of the observations. Discussion and Conclusion. The measurement error of a TUG assessment is substantial for a frail older person dependent in ADL, regardless of the level of cognitive function, when verbal cuing is permitted during testing. The variability increases with the time to perform the TUG. Despite high intraclass correlation coefficients, the ranges of expected variability can be wide and are similar within and between raters. Physical therapists should be aware of this variability before they interpret the TUG score for a particular individual.
Neuromuscular Activation in Conventional Therapeutic Exercises and Heavy Resistance Exercises: Implications for Rehabilitation
Authors: Andersen Lars L , Magnusson S Peter , Nielsen Michael , Haleem John , Poulsen Kenn , Aagaard Per
Published: February 2017

Background and Purpose. Central activation failure and muscular atrophy are common after knee joint injury. Thus, exercises that aim to stimulate muscular hypertrophy and increase neural drive to the muscle fibers should be used during rehabilitation. This study examined the level of knee joint neuromuscular activation during 4 conventional therapeutic exercises (quadriceps femoris muscle setting, manual lateralization of the patella, rhythmic stabilization, and the pelvic bridging exercise) and 4 heavy resistance exercises (free-weight squat with a barbell, horizontal seated leg press, isolated knee extension with a cam mechanism, and isolated hamstring muscle curl) in young, untrained men who were healthy. Subjects. Thirteen male subjects (mean age=25.3 years, SD=3.0) with no previous history of knee injury participated in the study. Methods. Neuromuscular activation during the exercises was defined as the root-mean-square (RMS) electromyographic (EMG) signal normalized to the peak RMS EMG signal of a maximal isometric muscle contraction. Results. Low levels of neuromuscular activation were found during all conventional exercises (<35%). A limitation may be that only a few of many different conventional exercises were investigated. The highest level of neuromuscular activation (67%–79%) was observed during the open kinetic chain resistance exercises (isolated knee extension and hamstring muscle curl). None of the conventional exercises or heavy resistance exercises were found to preferentially activate the vastus medialis muscle over the vastus lateralis muscle. Discussion and Conclusion. The results indicate that heavy resistance exercises should be included in rehabilitation programs to induce sufficient levels of neuromuscular activation to stimulate muscle growth and strength.
Interferential Therapy Produces Antinociception During Application in Various Models of Inflammatory Pain
Authors: Jorge Sérgio , Parada Carlos A , Ferreira Sérgio H , Tambeli Cláudia H
Published: February 2017

Background and Purpose. Although interferential therapy (IFT) is used widely in the management of many painful conditions, the effectiveness and the mechanism of action of IFT in animal models of inflammatory pain have not been evaluated. The aim of this study was to evaluate the effectiveness of IFT in reducing inflammatory pain and edema in rats. Subjects. Sixty-nine male Wistar rats were used in the study. Methods. The effect of IFT application (4,000-Hz carrier frequency, 140-Hz amplitude-modulated beat frequency, pulse duration=125 milliseconds, current intensity=5 mA) for 1 hour on the formalin-induced nociceptive response and edema and on carrageenan-induced mechanical hyperalgesia and edema was evaluated. Results. Interferential therapy significantly reduced the formalin-evoked nociceptive response when applied to the paw immediately after but not before the formalin injection. Interferential therapy application at 2 hours after the carrageenan injection significantly prevented a further increase in carrageenan-induced mechanical hyperalgesia only immediately after discontinuation of the electrical current application. The antinociception induced by IFT was not attributable to a reduction in inflammation because IFT did not significantly reduce the edema induced by either formalin or carrageenan. Discussion and Conclusion. The results suggest that, despite its short-duration effect, IFT is effective in reducing inflammatory pain and should be considered primarily for use in the control of acute inflammatory pain. [Jorge S, Parada CA, Ferreira SH, Tambeli CH. Interferential therapy produces antinociception during application in various models of inflammatory pain. Phys Ther. 2006;86:800–808.]
Determining Meaningful Changes in Gait Speed After Hip Fracture
Authors: Palombaro Kerstin M , Craik Rebecca L , Mangione Kathleen K , Tomlinson James D
Published: February 2017

Background and Purpose. Older subjects after hip fracture walk more slowly than age-matched peers. The extent to which they walk more slowly is difficult to define because the standard error of the measure (SEM), sensitivity to change, and clinically important change have not been reported for gait speed. The purposes of this study were to quantify the SEM for habitual and fast gait speeds among older subjects after hip fracture, to define the minimal detectable change (MDC), and to estimate the minimal clinically important difference (MCID) for habitual gait speed. Subjects. A sample of 92 subjects after hip fracture was drawn from 3 studies that collected gait speed data. Methods. An estimate of the MDC was determined by use of the SEM. The MCID was determined from expert opinion and from a receiver operating characteristic (ROC) curve. Results. The SEM and the MDC were 0.08 m/s and 0.10 m/s for habitual speed and fast speed, respectively. Both methods of MCID estimation identified 0.10 m/s as a meaningful change in habitual gait speed. Discussion and Conclusion. The estimated MCID for gait speed of 0.10 m/s was supported by clinical expert opinion and the cutoff point of the ROC curve. [Palombaro KM, Craik RL, Mangione KK, Tomlinson JD. Determining meaningful changes in gait speed after hip fracture.Phys Ther. 2006; 86:809–816.]
Descriptive Characteristics as Potential Predictors of Outcomes Following Constraint-Induced Movement Therapy for People After Stroke
Authors: Fritz Stacy L , Light Kathye E , Clifford Shannon N , Patterson Tara S , Behrman Andrea L , Davis Sandra B
Published: February 2017

Background and Purpose. Limited evidence exists regarding the characteristics of people who benefit most from constraint-induced movement therapy (CIMT). This study’s purpose was to investigate 6 potential descriptors in predicting CIMT outcomes. Subjects. The participants were a convenience sample (N=55) of people who were more than 6 months poststroke. Methods. The Wolf Motor Function Test (WMFT) and the Motor Activity Log amount scale (MALa) were used to assess outcomes for CIMT. The potential predictors (side of stroke, time since stroke, hand dominance, age, sex, and ambulatory status) were entered into a linear regression model using stepwise entry, with simultaneous entry of the dependent variables’ pretest scores as the covariate. Results. Age was the only significant predictor of the 6 potential predictors in the model and was predictive only of MALa scores. None of the independent variables showed a predictive relationship with the WMFT. Discussion and Conclusion. Although age was the only significant predictor, an equally strong finding in this study was that side of stroke, chronicity, hand dominance, sex, and ambulatory status were not found to be predictors at the follow-up session. This finding emphasizes the importance of not excluding people from CIMT based on these predictors. [Fritz SL, Light KE, Clifford SN, et al. Descriptive characteristics as potential predictors of outcomes following constraint-induced movement therapy for people after stroke.Phys Ther. 2006;86:825– 832.]
Physical Therapist Examination, Evaluation, and Intervention Following the Surgical Reconstruction of a Grade III Acromioclavicular Joint Separation
Authors: Culp Lisa B , Romani William A
Published: February 2017

Background and Purpose. This case report describes the examination, intervention, and outcome of a patient following the surgical reconstruction of a grade III acromioclavicular (AC) joint separation. Detailed postoperative interventions have not previously been described in the literature. Case Description. The patient was a 34-year-old male college professor with a left grade III AC joint separation and no prior restrictions of upper-extremity function. After 12 weeks of presurgical treatment, the patient’s complaints included crepitus and the inability to push open heavy doors. Intervention. Surgical reconstruction of the AC joint and a 4-month graded exercise program were used. Outcome. The patient returned to preinjury levels of function 5 months after surgery with scores of 3.33/100 and 0/100 on the Disabilities of the Arm, Shoulder and Hand questionnaire and optional Sport/Music or Work Module, respectively. Discussion. An intervention focusing on restoring shoulder strength, range of motion, flexibility, and neuromuscular control of the shoulder following a surgical reconstruction of the AC joint can lead to a successful functional outcome. [Culp LB, Romani WA. Physical therapist examination, evaluation, and intervention following the surgical reconstruction of a grade III acromioclavicular joint separation.Phys Ther.2006;86:857 – 869.]
Are Models of Disability Useful in Real Cases? Pediatric Case Examples Realized in Research, Clinical Practice, and Education
Authors: Campbell Suzann K
Published: February 2017

Conceptual models are useful devices for organizing complex material and examining interrelationships among variables. For example, speakers at the 1990 II STEP Conference presented a systems model of motor control, the dynamical systems model as used in studying infant motor development, and the World Health Organization model as a systematic approach to the description of impairments, functional limitations, and disability. The purpose of this perspective is to provide examples of the usefulness of models of disability in organizing research, educational materials, and measurement in clinical practice. The disability model of the National Center for Medical Rehabilitation Research was used: (1) to design a measurement strategy for assessing effects of spasticity reduction in a child with cerebral palsy, (2) to develop a new assessment of functional motor performance in infants, and (3) as the conceptual framework for a comprehensive reference book for the practice of pediatric physical therapy (the current edition has been reformatted to conform to the International Classification of Function, Disability and Health). Similar models of the dimensions of disability have guided extensive development of tests designed by physical therapists for assessing function and quality of life in children with neurologic conditions. [Campbell SK. Are models of disability useful in real cases? Pediatric case examples realized in research, clinical practice, and education.Phys Ther. 2006;86:881 – 887.]
Effects of Two 4-Week Proprioceptive Neuromuscular Facilitation Programs on Muscle Endurance, Flexibility, and Functional Performance in Women With Chronic Low Back Pain
Authors: Kofotolis Nick , Kellis Eleftherios
Published: February 2017

Background and Purpose. Improving functional performance in patients with chronic low back pain is of primary importance. The purpose of this study was to examine the effects of 2 proprioceptive neuromuscular facilitation (PNF) programs on trunk muscle endurance, flexibility, and functional performance in subjects with chronic low back pain (CLBP). Subjects. Eighty-six women (40.2±11.9 [X̅±SD] years of age) who had complaints of CLBP were randomly assigned to 3 groups: rhythmic stabilization training, combination of isotonic exercises, and control. Methods. Subjects trained with each program for 4 weeks with the aim of improving trunk stability and strength. Static and dynamic trunk muscle endurance and lumbar mobility were measured before, at the end of, and 4 and 8 weeks after training. Disability and back pain intensity also were measured with the Oswestry Index. Results. Multivariate analysis of variance indicated that both training groups demonstrated significant improvements in lumbar mobility (8.6%–24.1%), static and dynamic muscle endurance (23.6%–81%), and Oswestry Index (29.3%–31.8%) measurements. Discussion and Conclusion. Static and dynamic PNF programs may be appropriate for improving short-term trunk muscle endurance and trunk mobility in people with CLBP. [Kofotolis N, Kellis E. Effects of two 4-week proprioceptive neuromuscular facilitation programs on muscle endurance, flexibility, and functional performance in women with chronic low back pain. Phys Ther. 2006;86:1001–1012.]
Prognosis in Soft Tissue Disorders of the Shoulder: Predicting Both Change in Disability and Level of Disability After Treatment
Authors: Kennedy Carol A , Manno Michael , Hogg-Johnson Sheilah , Haines Ted , Hurley Laurie , McKenzie Deirdre , Beaton Dorcas E
Published: February 2017

Background and Purpose. Clinicians often are faced with questions about prognosis and outcome of shoulder disorders. The purpose of this study was to identify predictors of both change in disability and level of disability following physical therapy treatment. Subjects. The subjects were consecutive patients (n=361) who were receiving physical therapy for soft tissue shoulder disorders. Methods. Clinical response to physical therapy, which was measured using the Disabilities of the Arm, Shoulder, and Hand (DASH) measure, was assessed over 12 weeks. The 28 independent baseline predictors included demographics, disorder-related and disability measures, medication use, clinical findings, and expectations for recovery. Multiple linear regression techniques were used. Results. Predictors of greater disability at discharge were: higher initial disability, therapist prediction of restricted activities at discharge, workers’ compensation claim, older age, and being female. Predictors of greater improvement in disability were: shoulder surgery, higher pain intensity, shorter duration of symptoms, younger age, and poorer general physical health (measured using the 36-Item Short-Form Health Survey [SF-36]). Discussion and Conclusions. Prognostic factors differ depending on the format of the outcome. Only age was significant in both models. [Kennedy CA, Manno M, Hogg-Johnson S, et al. Prognosis in soft tissue disorders of the shoulder: predicting both change in disability and level of disability after treatment. Phys Ther. 2006;86:1013–1032.]
A Simplified Stroke Rehabilitation Assessment of Movement Instrument
Authors: Hsueh I-Ping , Wang Wen-Chung , Wang Chun-Hou , Sheu Ching-Fan , Lo Sing-Kai , Lin Jau-Hong , Hsieh Ching-Lin
Published: February 2017

Background and Purpose. An efficient, reliable, and valid instrument for assessing motor function in patients with stroke is needed by both clinicians and researchers. To improve administration efficiency, we applied the multidimensional Rasch model to the 30-item, 3-subscale Stroke Rehabilitation Assessment of Movement (STREAM) instrument to produce a concise, reliable, and valid instrument (simplified STREAM [S-STREAM]) for measuring motor function in patients with stroke. Subjects and Methods. The STREAM (consisting of 3 subscales: upper-limb movements, lower-limb movements, and mobility) was administered to 351 subjects with first stroke occurrence and a median time after stroke of 12.5 months. The unidimensionality of each subscale of the STREAM first was verified with unidimensional Rasch analysis. Each subscale of the STREAM then was simplified by deleting redundant items on the basis of expert opinion and the results of the Rasch analysis. The Rasch reliability of the S-STREAM and the concurrent validity of the S-STREAM with the STREAM were examined with multidimensional Rasch analysis and the intraclass correlation coefficient (ICC), respectively. Results. After deleting the items that did not fit the Rasch model, we found that the 8-item upper-limb movement subscale, the 9-item lower-limb movement subscale, and the 10-item mobility subscale assessed single, unidimensional upper-limb movements, lower-limb movements, and mobility, respectively. We selected 5 items from each subscale to construct the S-STREAM and found that the reliability of each subscale of the resulting simplified instrument was high (Rasch reliability coefficients of ≥.91). The agreement between the subscale scores (Rasch estimates) of the S-STREAM and those of the STREAM was excellent (ICC of ≥.99, with a lower limit for the 95% confidence interval of ≥.985), indicating good concurrent validity of the S-STREAM with the STREAM. Discussion and Conclusion. The S-STREAM demonstrates high Rasch reliability, unidimensionality, and concurrent validity with the STREAM in patients with stroke. Furthermore, the S-STREAM is efficient to administer, as it consists of only half the number of items in the original STREAM. Additional studies to examine other psychometric properties (eg, predictive validity and responsiveness) of the S-STREAM or its psychometric properties in various recovery stages after stroke are needed to further establish its utility in both clinical and research settings.
A Systematic Review of the Effectiveness of Exercise, Manual Therapy, Electrotherapy, Relaxation Training, and Biofeedback in the Management of Temporomandibular Disorder
Authors: Medlicott Marega S , Harris Susan R
Published: February 2017

Background and Purpose. This systematic review analyzed studies examining the effectiveness of various physical therapy interventions for temporomandibular disorder. Methods. Studies met 4 criteria: (1) subjects were from 1 of 3 groups identified in the first axis of the Research Diagnostic Criteria for Temporomandibular Disorders, (2) the intervention was within the realm of physical therapist practice, (3) an experimental design was used, and (4) outcome measures assessed one or more primary presenting symptoms. Thirty studies were evaluated using Sackett’s rules of evidence and 10 scientific rigor criteria. Four randomly selected articles were classified independently by 2 raters (interrater agreement of 100% for levels of evidence and 73.5% for methodological rigor). Results. The following recommendations arose from the 30 studies: (1) active exercises and manual mobilizations may be effective; (2) postural training may be used in combination with other interventions, as independent effects of postural training are unknown; (3) mid-laser therapy may be more effective than other electrotherapy modalities; (4) programs involving relaxation techniques and biofeedback, electromyography training, and proprioceptive re-education may be more effective than placebo treatment or occlusal splints; and (5) combinations of active exercises, manual therapy, postural correction, and relaxation techniques may be effective. Discussion and Conclusion. These recommendations should be viewed cautiously. Consensus on defining temporomandibular joint disorder, inclusion and exclusion criteria, and use of reliable and valid outcome measures would yield more rigorous research. [Medlicott MS, Harris SR. A systematic review of the effectiveness of exercise, manual therapy, electrotherapy, relaxation training, and biofeedback in the management of temporomandibular disorder. Phys Ther. 2006;86:955–973.]
Effect of Pelvic-Floor Muscle Exercise Position on Continence and Quality-of-Life Outcomes in Women With Stress Urinary Incontinence
Authors: Borello-France Diane F , Zyczynski Halina M , Downey Patricia A , Rause Christine R , Wister Joseph A
Published: February 2017

Background and Purpose. Pelvic-floor muscle (PFM) exercises are effective in reducing stress urinary incontinence (SUI), but few studies have investigated the effect of specific exercise variables on treatment outcomes. This study explored the effect of exercise position on treatment outcomes in women with SUI. Subjects and Methods. Forty-four women were randomly assigned to exercise in the supine position only or in both supine and upright positions. Bladder diary, pad test, urodynamic test, quality-of-life (Incontinence Impact Questionnaire [IIQ]), and PFM strength outcomes were obtained at baseline and after treatment. Results. Exercise position did not affect outcomes. After data from both groups were collapsed, statistically significant improvements with treatment were observed in bladder diary, IIQ, PFM strength, and urodynamic test results. Discussion and Conclusion. Exercise position did not differentially affect treatment outcomes. However, women in this study achieved a mean 67.9% reduction in the frequency of SUI episodes and improvements in other study outcomes. [Borello-France DF, Zyczynski HM, Downey PA, et al. Effect of pelvic-floor muscle exercise position on continence and quality-of-life outcomes in women with stress urinary incontinence. Phys Ther. 2006;86:974–986.]
Synergies in Health and Disease: Relations to Adaptive Changes in Motor Coordination
Authors: Latash Mark L , Anson J Greg
Published: February 2017

This article describes an approach to motor synergies that allows them to be quantified in people with atypical movement patterns during exercise or practice. Within this approach, motor variability may be classified with respect to a task-specific performance variable as “good” (not affecting the variable) or “bad” (changing the variable). The authors review studies of motor synergies in people with typical movement patterns, in people with Down syndrome, in patients after stroke, and in elderly people. Two stages of practice effects on motor synergies are described as being characterized by different changes in the synergy index: an increase followed by a drop in the index. Synergy changes with practice may be accompanied by plastic changes in both descending projections from the primary cortex and interhemispheric projections. The authors emphasize the importance—for practitioners in the area of motor disorders and rehabilitation—of being aware of the latest progress in motor control and coordination.
Reprint—Comprehensive Foot Examination and Risk Assessment: A Report of the Task Force of the Foot Care Interest Group of the American Diabetes Association, With Endorsement by the American Association of Clinical Endocrinologists
Authors: Boulton Andrew JM , Armstrong David G , Albert Stephen F , Frykberg Robert G , Hellman Richard , Kirkman M Sue , Lavery Lawrence A , LeMaster Joseph W , Mills Joseph L , Mueller Michael J , Sheehan Peter , Wukich Dane K
Published: February 2017

The following article1 is the report of an American Diabetes Association task force that summarizes the recent literature on tests and measures to identify people at risk for foot ulceration and to recommend what should be included in the comprehensive foot exam for adult patients with diabetes. Although this information would be timely and pertinent for physical therapists at any time, its content is particularly complementary to the content of PTJ's Special Issue on Diabetes.

This article has been reprinted with permission of the American Diabetes Association from Boulton AJM, Armstrong DG, Albert SF, et al. Comprehensive foot examination and risk assessment: a report of the Task Force of the Foot Care Interest Group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists. Diabetes Care. 2008;31:1679-1685. DOI: 10.2337/dc08-9021. Available online at: http://care.diabetesjournals.org.

Copyright ©2008 American Diabetes Association. From Diabetes Care®, Vol 31, 2008; 1679-1685. Reprinted with permission from The American Diabetes Association.

Reference

1 Boulton AJM , ArmstrongDG, AlbertSF, . Comprehensive foot examination and risk assessment: a report of the Task Force of the Foot Care Interest Group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists. Diabetes Care. 2008;31:1679–1685.
Ethnic Differences in Self-Reported Sleep Problems in Older Adults
Authors: Jean-Louis G , Magai C M , Cohen C I , Zizi F , von Gizycki H , DiPalma J , Casimir G J
Published: February 2017

Study Objectives:

To date, conflicting observations have been made regarding ethnic differences in sleep patterns. Plausibly, differing sampling strategies and disparity in the cohorts investigated might help explain discrepant findings. To our knowledge population-based studies investigating ethnic differences in sleep complaints have not addressed within-group ethnic heterogeneity, although within-group health disparities have been documented.

Design

Volunteers (n =1118) in this study were community-residing older European Americans and African Americans residing in Brooklyn, New York, which were recruited by a stratified, cluster sampling technique. Trained interviewers of the same race as the respondents gathered data during face-to-face interviews conducted either in the respondent's home or another location of their choice. Data included demographic and health risk factors, physical health, social support, and emotional experience. Relationships of demographic and health risk factors to sleep disturbances were examined in multiple linear regression analyses. Withingroup differences in sleep complaints were also explored.

Setting

N/A

Participants

N/A

Interventions

N/A

Measurements and Results

Of the factors showing significant associations with sleep disturbance, European American ethnicity was the most significant predictor (r2 = 0.20). Worse sleep and greater reliance on sleep medicine were observed among European Americans. Caribbean Americans reported less sleep complaints than did U.S.-born African Americans, and immigrant European Americans reported greater complaints than did US-born European Americans.

Conclusions

As expected several health risk factors were predictive of sleep disturbance among urban community-dwelling older adults, but ethnicity was the most significant predictor. The present data suggest both between-group and within-group ethnic differences in sleep complaints. Understanding of demographic and cultural differences between African Americans and European Americans may be critical in interpreting subjective health-related data.
Genioglossal Muscle Response to CO2 Stimulation During NREM Sleep
Authors: Lo Yu-Lun , Jordan Amy S. , Malhotra Atul , Wellman Andrew , Heinzer Raphael C. , Schory Karen , Dover Louise , Fogel Robert B. , White David P.
Published: February 2017

Study Objectives:

The objective was to evaluate the responsiveness of upper airway muscles to hypercapnia with and without intrapharyngeal negative pressure during non-rapid eye movement (NREM) sleep and wakefulness.

Design:

We assessed the genioglossal muscle response to CO2 off and on continuous positive airway pressure (CPAP) (to attenuate negative pressure) during stable NREM sleep and wakefulness in the supine position.

Setting:

Laboratory of the Sleep Medicine Division, Brigham and Women's Hospital.

Patients or Participants:

Eleven normal healthy subjects.

Interventions:

During wakefulness and NREM sleep, we measured genioglossal electromyography (EMG) on and off CPAP at the normal eupneic level and at levels 5 and 10 mm Hg above the awake eupneic level.

Measurements and Results:

We observed that CO2 could increase upper-airway muscle activity during NREM sleep and wakefulness in the supine position with and without intrapharyngeal negative pressure. The application of nasal CPAP significantly decreased genioglossal EMG at all 3 levels of PETCO2 during NREM sleep (13.0 ± 4.9% vs. 4.6 ± 1.6% of maximal EMG, 14.6 ± 5.6% vs. 7.1 ± 2.3% of maximal EMG, and 17.3 ± 6.3% vs. 10.2 ± 3.1% of maximal EMG, respectively). However, the absence of negative pressure in the upper airway did not significantly affect the slope of the pharyngeal airway dilator muscle response to hypercapnia during NREM sleep (0.72 ± 0.30% vs. 0.79 ± 0.27% of maximal EMG per mm Hg PCO2 , respectively, off and on CPAP).

Conclusions:

We conclude that both chemoreceptive and negative pressure reflex inputs to this upper airway dilator muscle are still active during stable NREM sleep.

Citation:

Lo YL; Jordan AS; Malhotra A et al. Genioglossal muscle responseto CO2 stimulation during NREM sleep.
Effects of Sleep Fragmentation on the Arousability to Resistive Loading in NREM and REM Sleep in Normal Men
Authors: Zavodny Jeannette , Roth Corinne , Bassetti Claudio L. , Mathis Johannes , Douglas Neil J. , Gugger Matthias
Published: February 2017

Study Objectives:

In healthy subjects, arousability to inspiratory resistive loading is greater during rapid eye movement (REM) sleep compared with non-REM (NREM) sleep but is poorest in REM sleep in patients with sleep apnea. We therefore examined the hypothesis that sleep fragmentation impairs arousability, especially from REM sleep.

Design:

Two blocks of 3 polysomnographies (separated by at least 1 week) were performed randomly. An inspiratory-loaded night followed either 2 undisturbed control nights (LNC) or 2 acoustically fragmented nights (LNF).

Setting:

Sleep laboratory.

Participants:

Sixteen healthy men aged 20 to 29 years.

Intervention:

In both loaded nights, an inspiratory resistive load was added via a valved facemask every 2 minutes during sleep and turned off either when arousal occurred or after 2 minutes.

Measurements and Results:

During LNF, arousability remained significantly greater in REM sleep (71% aroused within 2 minutes) compared with stage 2 (29%) or stage 3/4 (16%) sleep. After sleep fragmentation, arousability was decreased in stage 2 sleep (LNF: 29%; LNC: 38%; p <.05) and low in early REM sleep, increasing across the night (p < .01). In stage 3/4 sleep, neither an attenuation nor a change across the night was seen after sleep fragmentation.

Conclusions:

Mild sleep fragmentation is already sufficient to attenuate arousability in stage 2 sleep and to decrease arousability in early, compared with late, REM sleep. This means that sleep fragmentation affects the arousal response to increasing resistance and that the effects are different in stage 2 and REM sleep. The biologic reason for this increase in the arousal response in REM sleep across the night is not clear.

Citation:

Zavodny J; Roth C; Bassetti CL et al. Effects of sleep fragmentation on the arousability to resistive loading in NREM and REM sleep in normal men.
Nutrition Outweighs Defense:Myzus Persicae(Green Peach Aphid) Prefers and Performs Better on Young Leaves of Cabbage
Authors: Cao He-He , Zhanga Zhan-Feng , Wang Xiao-Feng , Liu Tong-Xian
Published: February 2017

Plant leaves of different ages differ in nutrition and toxic metabolites and thus exhibit various resistance levels against insect herbivores. However, little is known about the relationship between leaf ontogeny and plant resistance against phloem-feeding insects. In this study, we found that the green peach aphid,Myzus persicaeSulzer, preferred to settle on young cabbage leaves (Brassica oleraceaL. var.capitata) rather than mature or old leaves, although young leaves contained the highest concentration of glucosinolates. Furthermore, aphids feeding on young leaves had higher levels of glucosinolates in their bodies, but aphids performed better on young leaves in terms of body weight and population growth. The concentration of glutamine in young leaves was the highest, which stimulated aphids feeding when added to the sucrose solution. Phloem sap of young leaves had higher amino acid:sucrose molar ratio than mature leaves, and aphids feeding on young leaves showed two times longer phloem feeding time and five times more dry honeydew excretion than on other leaves. These results indicate that aphids acquired the highest amount of nutrition and defensive metabolites when feeding on young cabbage leaves that are strong natural plant sinks. The higher phloem sap availability of young leaves likely contributes to the attractiveness and suitability for aphids and may compensate the negative effects of glucosinolates on aphids. According to these findings, we propose that phloem sap availability influenced by leaf ontogeny and source-sink status play a significant role in plant-aphid interaction, which desires more attention in future research.
A performance assessment of relatedness inference methods using genome-wide data from thousands of relatives
Authors: Ramstetter Monica D. , Dyer Thomas D. , Lehman Donna M. , Curran Joanne E. , Duggirala Ravindranath , Blangero John , Mezey Jason G. , Williams Amy L.
Published: February 2017

Inferring relatedness from genomic data is an essential component of genetic association studies, population genetics, forensics, and genealogy. While numerous methods exist for inferring relatedness, thorough evaluation of these approaches in real data has been lacking. Here, we report an assessment of 12 state-of-the-art pairwise relatedness inference methods using a dataset with 2,485 individuals contained in several large pedigrees that span up to six generations. We find that all methods have high accuracy (~92% – 99%) when detecting first and second degree relationships, but their accuracy dwindles to less than 43% for seventh degree relationships. However, most IBD segment-based methods inferred seventh degree relatives correct to within one relatedness degree for more than 76% of relative pairs. Overall, the most accurate methods are ERSA and approaches that compute total IBD sharing using the output from GERMLINE and Refined IBD to infer relatedness. Combining information from the most accurate methods provides little accuracy improvement, indicating that novel approaches—such as new methods that leverage relatedness signals from multiple samples—are needed to achieve a sizeable jump in performance.
Genome-Wide Association Analysis Identifies Genetic Correlates of Immune Infiltrates in Solid Tumors
Authors: Siemers Nathan O. , Holloway James L , Chang Han , Chasalow Scott D. , Ross-MacDonald Petra B. , Voliva Charles F. , Szustakowski Joseph D.
Published: February 2017

Therapeutic options for the treatment of an increasing variety of cancers have been expanded by the introduction of a new class of drugs, commonly referred to as checkpoint blocking agents, that target the host immune system to positively modulate anti-tumor immune response. Although efficacy of these agents has been linked to a pre-existing level of tumor immune infiltrate, it remains unclear why some patients exhibit deep and durable responses to these agents therapy while others do not benefit. To examine the influence of tumor genetics on tumor immune state, we interrogated the relationship between somatic mutation and copy number alteration with infiltration levels of 7 immune cell types across 40 tumor cohorts in The Cancer Genome Atlas. Levels of cytotoxic T, regulatory T, total T, natural killer, and B cells, as well as monocytes and M2 macrophages, were estimated using a novel set of transcriptional signatures that were designed to resist interference from the cellular heterogeneity of tumors. Tumor mutational load and estimates of tumor purity were included in our association models to adjust for biases in multi-modal genomic data. Copy number alterations, mutations summarized at the gene level, and position-specific mutations were evaluated for association with tumor immune infiltration. We observed a strong relationship between copy number loss of a large region of chromosome 9p and decreased lymphocyte estimates in melanoma, pancreatic, and head/neck cancers. Mutations in the oncogenes PIK3CA, FGFR3, and RAS/RAF family members, as well as the tumor supressor TP53, were linked to changes in immune infiltration, usually in restricted tumor types. Associations of specific WNT/beta-catenin pathway genetic changes with immune state were limited, but we noted a link between 9p loss and the expression of the WNT receptor FZD3, suggesting that there are interactions between 9p alteration and WNT pathways. Finally, two different cell death regulators, CASP8 and DIDO1, were often mutated in head/neck tumors that had higher lymphocyte infiltrates. In summary, our study supports the relevance of tumor genetics to questions of efficacy and resistance in checkpoint blockade therapies. It also highlights the need to assess genome-wide influences during exploration of any specific tumor pathway hypothesized to be relevant to therapeutic response. Some of the observed genetic links to immune state, like 9p loss, may influence response to cancer immune therapies. Others, like mutations in cell death pathways, may help guide combination therapeutic approaches.
Circular Economy Rebound
Authors: Zink Trevor , Geyer Roland
Published: February 2017

The so‐called circular economy—the concept of closing material loops to preserve products, parts, and materials in the industrial system and extract their maximum utility—has recently started gaining momentum. The idea of substituting lower‐impact secondary production for environmentally intensive primary production gives the circular economy a strong intuitive environmental appeal. However, proponents of the circular economy have tended to look at the world purely as an engineering system and have overlooked the economic part of the circular economy. Recent research has started to question the core of the circular economy—namely, whether closing material and product loops does, in fact, prevent primary production. In this article, we argue that circular economy activities can increase overall production, which can partially or fully offset their benefits. Because there is a strong parallel in this respect to energy efficiency rebound, we have termed this effect “circular economy rebound.” Circular economy rebound occurs when circular economy activities, which have lower per‐unit‐production impacts, also cause increased levels of production, reducing their benefit. We describe the mechanisms that cause circular economy rebound, which include the limited ability of secondary products to substitute for primary products, and price effects. We then offer some potential strategies for avoiding circular economy rebound. However, these strategies are unlikely to be attractive to for‐profit firms, so we caution that simply encouraging private firms to find profitable opportunities in the circular economy is likely to cause rebound and lower or eliminate the potential environmental benefits.
OSA and cardiometabolic risk: What's the bottom line?
Authors: Hoyos Camilla M. , Drager Luciano F. , Patel Sanjay R.
Published: February 2017

ABSTRACT

Obstructive sleep apnoea (OSA) is a common condition characterized by repetitive upper airway obstruction during sleep. OSA promotes wide intrathoracic pressure swings, intermittent hypoxia and sleep fragmentation. Growing evidence derived from animal models mimicking the oxygen profile observed in patients with OSA as well as clinical studies support that this important sleep‐disordered breathing is associated with increased cardiovascular risk. Although the precise mechanisms are not fully established, it is conceivable that the metabolic deregulation promoted by the components of OSA may have an important causal role in the poor cardiovascular prognosis. In this review, we summarize the potential role of OSA and its components on cardiometabolic disease. We also summarize evidence evaluating the impact of OSA treatment (notably continuous positive airway pressure) on reversing the metabolic deregulation promoted by OSA. Finally, we discuss the research agenda and perspectives for this important research area.
Identification and characterization of a stable intermediate in photosystem I assembly in tobacco
Authors: Wittenberg Gal , Järvi Sari , Hojka Marta , Tóth Szilvia Z. , Meyer Etienne H. , Aro Eva‐Mari , Schöttler Mark A. , Bock Ralph
Published: February 2017

Photosystem I (PSI) is the most efficient bioenergetic nanomachine in nature and one of the largest membrane protein complexes known. It is composed of 18 protein subunits that bind more than 200 co‐factors and prosthetic groups. While the structure and function of PSI have been studied in great detail, very little is known about the PSI assembly process. In this work, we have characterized a PSI assembly intermediate in tobacco plants, which we named PSI*. We found PSI* to contain only a specific subset of the core subunits of PSI. PSI* is particularly abundant in young leaves where active thylakoid biogenesis takes place. Moreover, PSI* was found to overaccumulate in PsaF‐deficient mutant plants, and we show that re‐initiation of PsaF synthesis promotes the maturation of PSI* into PSI. The attachment of antenna proteins to PSI also requires the transition from PSI* to mature PSI. Our data could provide a biochemical entry point into the challenging investigation of PSI biogenesis and allow us to improve the model for the assembly pathway of PSI in thylakoid membranes of vascular plants.
Psychosis in a 15-Year-Old Female with Herpes Simplex Encephalitis in a Background of Mannose-Binding Lecithin Deficiency
Authors: Asogwa Kenneth , Buabeng Kwame , Kaur Amarjit
Published: February 2017

Historically, psychotic disorder has been associated with viral infection. Herpes simplex infections and Epstein-Barr virus (EBV) among other viral infections have been implicated in psychotic disorder. Of note in this case report is psychotic disorder that occurred following reactivation of herpes simplex infection in a background of mannose-binding lecithin (MBL) deficiency, childhood EBV infection, and severe psychosocial stress. Herpes simplex encephalitis (HSE) remains a significant cause of morbidity and mortality despite advancement in its treatment with intravenous acyclovir. Many studies have reported psychiatric and neurological manifestation of herpes simplex infection following primary or reactivated infection, while others suggest milder clinical course of herpes simplex encephalitis in a background of immunosuppression. Another contributory factor to psychotic disorder in this case is childhood EBV exposure which has been reported to increase the risk of psychosis in adolescence and adulthood. This case report describes a 15-year-old female with MBL deficiency who presented with psychosis caused by reactivated herpes simplex infection and had good clinical recovery. Based on childhood Epstein-Barr virus exposure and psychosis in adolescence (current case), she is at increased risk of psychotic disorder in adulthood, which underscores the importance of long-term monitoring.