bluuebunny/crossref_metadata_2025 huggingface dataset:
Video Analysis of Reported Concussion Events in the National Football League During the 2015-2016 and 2016-2017 Seasons
Authors: Lessley David J. , Kent Richard W. , Funk James R. , Sherwood Christopher P. , Cormier Joseph M. , Crandall Jeff R. , Arbogast Kristy B. , Myers Barry S.
Published: November 2018

Background:

Concussions in American football remain a high priority of sports injury prevention programs. Detailed video review provides important information on causation, the outcomes of rule changes, and guidance on future injury prevention strategies.

Purpose:

Documentation of concussions sustained in National Football League games played during the 2015-2016 and 2016-2017 seasons, including consideration of video views unavailable to the public.

Study Design:

Descriptive epidemiology study.

Methods:

All reported concussions were reviewed with all available video footage. Standardized terminology and associated definitions were developed to describe and categorize the details of each concussion.

Results:

Cornerbacks sustained the most concussions, followed by wide receivers, then linebackers and offensive linemen. Half (50%) of concussions occurred during a passing play, 28% during a rushing play, and 21% on a punt or kickoff. Tackling was found to be the most common activity of concussed players, with the side of the helmet the most common helmet impact location. The distribution of helmet impact source—the object that contacted the concussed player’s helmet—differed from studies of earlier seasons, with a higher proportion of helmet-to-body impacts (particularly shoulder) and helmet-to-ground impacts and with a lower proportion of helmet-to-helmet impacts. Helmet-to-ground concussive impacts were notable for the high prevalence of impacts to the back of the helmet and their frequency during passing plays.

Conclusion:

Concussion causation scenarios in the National Football League have changed over time.

Clinical Relevance:

The results of this study suggest the need for expanded evaluation of concussion countermeasures beyond solely helmet-to-helmet test systems, including consideration of impacts with the ground and with the body of the opposing player. It also suggests the possibility of position-specific countermeasures as part of an ongoing effort to improve safety.
Nonoperative Management of Femoroacetabular Impingement: A Prospective Study
Authors: Pennock Andrew T. , Bomar James D. , Johnson Kristina P. , Randich Kelly , Upasani Vidyadhar V.
Published: November 2018

Background:

The literature has given little attention to the nonoperative management of femoroacetabular impingement (FAI) syndrome despite a rapidly expanding body of research on the topic.

Purpose:

To perform a prospective study utilizing a nonoperative protocol on a consecutive series of patients presenting to our clinic with FAI syndrome.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Between 2013 and 2016, patients meeting the following criteria were prospectively recruited in a nonoperative FAI study: no prior hip surgery, groin-based pain, a positive impingement test, and radiographic FAI syndrome. The protocol consisted of an initial trial of rest, physical therapy, and activity modification. Patients who remained symptomatic were then offered an image-guided intra-articular steroid injection. Patients with recurrent symptoms were then offered arthroscopic treatment. Outcome scores were collected at 12 and 24 months. Statistical analysis was performed to identify risk factors for the need for operative treatment and to determine patient outcomes based on FAI type and treatment.

Results:

Ninety-three hips (n = 76 patients: mean age, 15.3 years; range, 10.4-21.4 years) were included in this study and followed for a mean ± SD 26.8 ± 8.3 months. Sixty-five hips (70%) were managed with physical therapy, rest, and activity modification alone. Eleven hips (12%) required a steroid injection but did not progress to surgery. Seventeen hips (18%) required arthroscopic management. All 3 groups saw similar improvements in modified Harris Hip Score ( P = .961) and nonarthritic hip score ( P = .975) with mean improvements of 20.3 ± 16.8 and 13.2 ± 15.5, respectively. Hips with cam impingement and combined cam-pincer impingement were 4.0 times more likely to meet the minimal clinically important difference in modified Harris Hip Score ( P = .004) and 4.4 times more likely to receive surgical intervention ( P = .05) than patients with pincer deformities alone. Participants in team sports were 3.0 times more likely than individual sport athletes to return to competitive activities ( P = .045).

Conclusion:

A majority (82%) of adolescent patients presenting with FAI syndrome can be managed nonoperatively, with significant improvements in outcome scores at a mean follow-up of 2 years.

Clinical Relevance:

A nonoperative approach should be the first-line treatment for young active patients with symptomatic FAI syndrome.
Design and modeling of a novel robotic arm with multiple-segment joints
Authors: Zhou Hangfei , Fu Zhuang , Fei Jian , Yang Zhen
Published: November 2018

This paper presents a novel miniature robotic arm with four degrees of freedom and one end-effector. The two joints of the robotic arm are multiple-segment, which consist of several serial plates with tiny cavities. Kinematic modeling of the robotic arm has been completed for subsequent implementation. With multiple-segment joints, the robotic arm gets smooth, linear, and flexible property. Simulations and experiments show that the robot can be used in abdominal single-port minimally invasive surgery for its unique operation capability.
Drawing as a Window Onto Expertise
Authors: Chamberlain Rebecca
Published: November 2018

The ability to draw is a uniquely human activity, ubiquitous in childhood but seldom performed at expert levels in adulthood. Relative to other domains of expertise (chess, music, sport), drawing is understudied, and yet because it is a universal developmental ability mastered by so few, it provides an ideal test bed for competing theories of expertise. In this review, three strands of active research and debate in the field of expertise will be considered in relation to representational drawing ability: (a) the characterization of expertise in relation to altered visual attention and memory, (b) the relative roles of personality traits and cognitive abilities, and (c) the interaction between genes and environment in the development of expertise. The study of representational drawing sheds new light on these three strands and provides rich avenues for further research in this domain.
Keeping the neighbourhood safe: How does social media moderation control what we see (and think)?
Authors: de Zwart Melissa
Published: November 2018

This article will address the issue of the growing reach, influence and potential accountability of Facebook and other social media platforms as a source of news and current affairs and shaper of social views, political opinions and norms. It will consider the recent release by Facebook of its guidelines on content moderation and its own assessment of how it is performing against its targets with respect to detection, classification and treatment of content. It will review a recent decision regarding President Trump’s Twitter feed and conclude that greater transparency regarding moderation practices is required.
Nutritional Goals for Health in Latin America
Authors: Bengoa José María , Torún Benjamín , Behar Moisés , Scrimshaw Nevin S.
Published: November 2018

This is a translation from the Spanish of the first part of the report “Guías de alimentación: Bases para su desarrollo en America Latina” by the same authors, based on a workshop on that topic held in Caracas, Venezuela, 22–28 November 1987, sponsored jointly by the United Nations University and the Fundación Cavendes [1].

This first part of the report is concerned with quantitative nutritional goals that should be useful for nutritionists and health professionals in all countries. The second part, not presented here, gives suggestions for expressing these goals in terms of dietary guidelines adapted to the food availability and preferences of individual countries and populations in Latin America. The entire report, with sixteen background papers covering every major area of the nutritional goals and their rationale, is being published in Spanish as a special issue of Archivos Latinoamericanos de la Nutrición.
Food Fortification in the English-Speaking Caribbean
Authors: Simmons William K.
Published: November 2018

This study was designed to collect and analyse information on food fortification in the Caribbean and its possible modification to improve the health of West Indians. Foods already fortified and imported into the Caribbean are not included except for pre-ground flour. The data were obtained by visiting flour mills and supermarkets and by discussing fortification programmes with health and agriculture officials All 17 member countries of tile Caribbean Food and Nutrition Institute and the Pan American Health Organization (CFNI/PAHO) were included in the study.
Health and Nutrition Effects of Sugar Cane Production in South-Western Kenya
Authors: Kennedy Eileen , Oniang'o Ruth
Published: November 2018

In 1984, a two-part study was initiated to evaluate the income and nutritional effects of shifting from maize to sugar cane production in south Nyanza, Kenya. During the first phase, baseline data was collected on the socioeconomic, food-consumption, and health and nutritional status of a cohort of households prior to their entry into the small-holder sugar cane out-growers scheme. The combination of the two studies provided one of the few opportunities to have baseline economic and health information on the households prior to their entry into cash cropping. In the first phase, the per capita income of the two groups was the same. In the follow-up of the cohort sample, the per capita income of the new entrant group was higher than that of the non-sugar group. This increase in income did not appear to influence pre-schoolers’ morbidity or growth. Data from both phases of the study indicate that the health and sanitation environment had the most impact on pre-schoolers’ growth, suggesting that growth will not be substantially improved in the short term by income alone.
Development of a Simple Field Kit for Monitoring Iron in Fortified Salt
Authors: Ranganathan S. , Narasinga Rao B. S.
Published: November 2018

One practical way to control iron-deficiency anaemia is to fortify edible salt with iron. Effective implementation of a programme for producing and distributing iron-fortified salt requires regular monitoring of edible salt for iron, particularly at the retail sales and household levels. A simple, inexpensive (10 rupees) field kit was developed for this purpose. No glassware has to be carried, and reagents are supplied in the form of tablets. It is possible to detect iron fevers as low as 50 parts per million (ppm) and as high as 1,000 ppm. One kit can be used to test 200 salt samples.
Shortcuts in Cassava Processing and Risk of Dietary Cyanide Exposure in Zaire
Authors: Banea Mayambu , Poulter Nigel H. , Rosling Hans
Published: November 2018

Konzo is a paralytic disease that has been attributed to shortcuts in cassava processing resulting in dietary cyanide exposure. Through a combination of anthropological and chemical methods, this study in Zaire provides support for such an aetiology. Observations as well as focus group and individual interviews revealed that women in the konzo-affected Bandundu region, when in a hurry to sell cassava, shorten soaking to only one night, whereas a period of four nights was strictly adhered to in an unaffected neighbouring region. A village-based processing experiment revealed that apparently small differences in the sequence and length of pounding and sun-drying of short-soaked roots considerably change the amounts and types of cyanogens that remain in the cassava flour. Elucidation of the chemical mechanisms involved now makes it possible to estimate the risk for cyanide exposure from different shortcuts and also to give appropriate advice to prevent toxic effects from cassava.
Carrots and Dietary Vitamin A Adequacy
Authors: Portocarrero Lilian , Quan De Serrano Julieta , Canfield Louise , Tarara Thomas , Solomons Noel W.
Published: November 2018

Carrots are a leading source e of vitamin A in the Guatemalan diet. Analyses of carrots using high performance liquid chromatography (HPLC’) indicated that carrots have more than twice the amount of β carotene reported in the Latin American food compositio n tables. The consequence for the recalculation of daily vitamin A intake in a data set of pregnant pert-urban women is a 12% reduction in the number of women consuming <750 RE and a 19% reduction in the number with an intake of <600 RE. To the extent that earlier anayses underestimated the β carotene content of’ carrots, the estimates of vitamin A intake in Latin America have been variably and falsely low, depending on the contribution of carrots to the individuals reported diet.
Infant Mortality Rates Before, During, and after a Nutrition and Health Intervention in Rural Guatemalan Villages
Authors: Rose Donald , Martorell Reynaldo , Rivera Juan
Published: November 2018

Village-level infant mortality rates (IMRs) before, during, and after a food supplement and health care intervention in four villages in eastern Guatemala 1969–1977 and in three control villages are compared. Data on all pregnancies and outcomes for 988 women were obtained by means of a retrospective women's life history survey. After controlling for baseline values, the average IMR in two villages receiving supplementation with a protein-and energy-rich drink and health care was 60 per 1,000 live births, compared with an average rate of 113 in the control villages (p<.05). The rate in two villages receiving the same type of health care but a low-energy supplement was 91 per 1,000 and not significantly different from that in the control villages. The decline in the IMR in these villages points strongly to the programme's impact, but the relative importance of food supplements and health care is ambiguous.
Demographic and Socio-Economic Changes in Families in Four Guatemalan Villages, 1967–1987
Authors: Engle Patrice L. , Carmichael Suzan L. , Gorman Kathleen , Pollitt Ernesto
Published: November 2018

The Institute of Nutrition of Central America and Panama (INCAP) carried out a longitudinal study of the effects of nutritional improvements on growth and development in early childhood in four villages in eastern Guatemala, 1969–1977, with a preparatory survey in 1967 and a follow-up study of the participants in 19881989. This paper examines differences among the four villages in education, occupation, quality of housing, and demographic profiles over a 20-year period, focusing on comparisons between the two villages that received a high-energy, high-protein supplement and the two that received a low-energy supplement at two different times: before the initial longitudinal study and before the follow-up study. The results suggest gradual improvement in all the villages on a number of indicators. However, the two pairs of village were not comparable on all measures; of particular concern for the interpretation of effects on cognitive development are differences in education.
History, Design, and Objectives of the Incap Follow-Up Study on the Effects of Nutrition Supplementation in Child Growth and Development
Authors: Martorell Reynaldo , Rivera Juan
Published: November 2018

The 1988–1989 INCAP follow-up study on the effects of early nutrition supplementation in child growth and development was the first long-term, comprehensive follow-up of a nutrition intervention. The subjects were former participants in the longitudinal study of 1969–1977, who were 10–26 years old at the time of measurement. The hypothesis of the follow-up study was that improved nutrition in early childhood leads to enhanced human capital formation. Cross-sectional data were collected on physical growth and body composition, maturation, work capacity, intellectual performance, and school achievement.
Breast-Feeding Decline despite Deteriorating Socio-Economic Conditions
Authors: Melville Bendley
Published: November 2018

The impact of deteriorating socio-economic conditions on breast-feeding duration in Jamaica is examined In spite of dramatic increases in the consumer price index for food and drink and consequently in the cost of artificial feeding, breast-feeding duration declined by 10.6% during 19871991. This was apparently due to a reduction in postpartum visits by district midwives. It is concluded that breast-feeding promotion should receive increased support under conditions of severe economic hardship.
Early Supplementary Feeding, Child Development, and Health Policy
Authors: Pollitt Ernesto , Oh Se-Young
Published: November 2018

We carried out a meta-analysis of six field studies that assessed the effects of supplementary feeding on infants’ performance on mental and motor development scales— conducted in nutritionally at-risk populations in Colombia, Guatemala, Indonesia, Jamaica, Taiwan, and the United States—which showed that early high energy and protein supplementary feeding has a beneficial effect on motor development in young infants (8–15 months old) and on both motor and mental development in older infants (1824 months old) who are nutritionally at risk. These findings provide justification for food assistance programmes targeted to young at-risk children. However, positive findings in field studies do not guarantee that similar results will be achieved by large-scale programmes, as complex bureaucracies and inadequate infrastructure are often obstacles to success.
A Low-Cost Tool for Traditional Birth Attendants to Identify Low-Birth-Weight Infants
Authors: Magzoub M. M. A. , Ali T. E. , Ali A. B.
Published: November 2018

One of the most important strategies in health development is inter-sectoral collaboration. This study is an example of collaboration between a medical doctor and an animal-production scientist to develop an easy, low-cost, rapid method for the assessment of birth weight. In developing countries where neonatal and infant mortality are high, birth weight could be a useful measure for identifying high-rise; neonates who need special attention. However, weighing a newborn is often not possible because more than three-fourths of deliveries take place at home. Most are attended by village midwives or traditional birth attendants who do not have weighing scales. Our study in the Wad Medani teaching hospital showed that chest circumference is the best predictor of birth weight (R2 82%, corresponding to a correlation coefficient of .91). A tape was developed with chest circumference measurements corresponding to predicted birth weights. The tape is coloured so that it can be used by illiterate midwives. Both the midwives and their instructors in the midwifery school found this method easy to learn and use.
Toward Understanding the Value of Intrahousehold Survey Data for Age-Based Food Targeting
Authors: Haddad Lawrence , Kanbur Ravi
Published: November 2018

Through the use of a stylized, age-based eligibility feeding programme, we attempt to quantify the benefit of having individual- (as opposed to household-) level food intake data when it comes to targeting food transfers on the basis of age. In this context we show how optimum age eligibility cut-offs depend on the availability of intra-household data on food intake. Second, we provide quantitative estimates of the valeue of intra-household information and of knowledge of the process of intra-household allocation of calvies. Age proved to be a good indicator of individual calorie deficit. However, this was not the case with household-level calorie adequacy, which rendered age apparently less useful as a targeting instrument, often at considerable calorie cost. Food sharing within the household, on the other hand, rendered age impotent as a targeting instrument because of within-household leakage. If age is to be used as an effective eligibility criterion for a food transfer, the implementation of that transfer has to ensure minimum leakage to other household members. This type of exploratory analysis is one step toward quantifying the usefulness of intra-household data in the design of nutrition interventions. The costs of collecting intra-household data may outweigh the benefits, but the experiments presensed begin to answer questions about the costs of not collecting them.
Evaluation of the Impact of a Food-Based Approach to Solving Vitamin A Deficiency in Bangladesh
Authors: Greiner Ted , Mitra S.N.
Published: November 2018

The impact of the third year (March 1992-March 1993) of a World view International Foundation project to increase the production and consumption of high-carotene foods in Gaibandah district, Bangladesh, was evaluated. The mothers of more than 2,500 children age one to six years, representative of Gaibandah, were interviewed at one-year intervals and compared with a similar sample in a geographically adjacent non-project area of equal size. A 24-hour recall was done regarding green leafy vegetables, yellow fruits and vegetables, oil-rich foods, and non-carotene-rich vegetables.

This project was multidimensional and was based on community participation. It used women volunteers, health assistants, and schools to spread knowledge, skills, and encouragement for growing carotene-rich foods and feeding them to young children. Modern and traditional mass media reinforced the messages. Seeds for mainly local varieties of high-carotene foods were distributed free or in certain cases sold by a network of trained women volunteers.

Knowledge of the problem and its causes increased in response to the communications. Home production of the targeted high-carotene foods increased remarkably in both the project and the non-project areas. Consumption patterns changed markedly but predictably toward more expensive foods during the study year due to an unprecedented drop in the price of rice.

Children's consumption of all but the non-carotene rich vegetables increased significantly in Gaibandah. In the nonproject area, consumption of yellow fruits and vegetables increased as much as in Gaibandah, oil-rich foods less than in Gaibandah, and non-carotene-rich vegetables much more than in Gaibandah. However, consumption of green leafy vegetables decreased significantly in the non-project area and increased significantly in Gaibandah. In March 1993,26 % and 52 % of children, respectively, had eaten green leafy vegetables the day before the interview.
Viewing Disease as the Synergistic Interaction of Host, Agent, and Environment
Authors: Scrimshaw Nevin S.
Published: November 2018

The agent of disease, whether it is an infectious organism, the deficiency or excess of a nutrient, a toxin, or the expression of a gene, is not sufficient to explain its cause. The impact of the agent depends on host factors and the influence of physical, biological, and social factors in the environment. For nutritional disorders those of the social environment, including the complex of educational, economic, religious, political, and other factors, are likely to be the most important and also the most difficult to understand and modify. If nutritional and other diseases are viewed as problems in human ecology, the primary health-care approach to their prevention follows naturally.
Development and Quality Evaluation of a Soy-Fortified Ghanaian Weaning Food
Authors: Annan Nana Tekyiwa , Plahar Wisdom Annorsey
Published: November 2018

Appropriate process characteristics and blend formulations were developed for the preparation of a high protein-energy weaning food, FRI Weaner, using maize, soya beans, groundnut, and milk powder. Its quality was evaluated in terms of its nutritive value; physicochemical, functional, and sensory characteristics; content of antinutritional factors; and biochemical and haematological properties. The FRI Weaner had physical and sensory characteristics similar to those of a traditional Ghanaian cereal-based weaning food but was of superior nutritional quality. The protein content was 171%, with 10.6% fat and 67.8% carbohydrates. Calcium, iron, and phosphorus levels were also high. Animal studies indicated good growth and development in rats fed with the blend, with no adverse biochemical or haematological effects. The blend's protein efficiency ratio was 2.5. The blend can therefore be used as an ideal weaning food to improve the nutrition status of Ghanaian children and help solve problems associated with protein-energy malnutrition.
Can Increased Vegetable Consumption Improve Iron Status?
Authors: de Pee Saskia , West Clive E. , Muhilal  , Karyadi Darwin , Hautvast Joseph G. A. J.
Published: November 2018

Theoretically, vegetable consumption could improve iron status. First, vegetables contain iron. Second, when the provitamin A carotenoids in vegetables improve vitamin A status, the result could be increased iron levels. Most studies on vegetable consumption have focused on improvements in vitamin A status, and only very few have addressed iron status. From a review of the literature and a recent study in Indonesia, we conclude that the data on the effectiveness of vegetables to improve the levels of both nutrients are inconclusive. The bioavailability of both iron and provitamin A carotenoids might be lower than expected. It is necessary to conduct other intervention studies using plant foods, animal foods, and fortified foods. In the meantime, other strategies that have been proved to reduce iron and vitamin A deficiencies should continue.
Iron Deficiency: The Problem and Approaches to its Solution
Authors: West Clive E.
Published: November 2018

Anaemia is associated with increased perinatal mortality, increased child morbidity and mortality, behavioural changes and impaired mental development, decreased work performance, increased susceptibility to lead poisoning, and impaired immune competence. Iron-deficiency anaemia is an intractable problem, as indicated by the goal set by world leaders of reducing nutritional anaemia to one-third of 1990 levels by the year 2000, compared with the goals of virtually eliminating deficiencies of vitamin A and of iodine during the same period. To a large extent, this is because intake is less associated with status for iron than for iodine and vitamin A. The demand for iron varies throughout the life cycle, and the bioavailability of iron varies over a wide range because of a number of factors, such as the species of iron compound, the molecular linkage, the amount of nutrient consumed in a meal, the matrix in which the nutrient is incorporated, the absorption modifiers, the nutrient status of the host, genetic factors, other host-related factors, and interactions among factors.
Evaluation of a Breastfeeding-Support Programme with Health Promoters’ Participation
Authors: Reynaldo Alvarado M. , Eduardo Atalah S. , Soledad Diaz F. , Soledad Rivero V. , Maria Labbe D. , Yolanda Escudero P.
Published: November 2018

We assessed the effect of a programme promoting breastfeeding that included the participation of monitors chosen from the community and the combined follow-up of mother and child, in families of low socio-economic level. The results obtained in a non-governmental health centre (experimental group) were compared with those obtained in a health centre of the same geographic area (control group), in a cohort of 62 and 66 infants, respectively. The prevalence of exclusive breastfeeding was significantly greater in the experimental group during the entire period. At six months, 41.9% of the children in the experimental group and none of the children in the control group were exclusively breastfed (p <<.01), and the percentages of children weaned were 1.6% and 378%, respectively. Height and weight were significantly higher in the experimental group from the fourth to the sixth month, with a lower level of malnutrition (p < .05). We conclude that a programme with active community participation can be effective in promoting exclusive breastfeeding and improving infant growth.
Symptoms of Primary Adult-Type Lactose Maldigestion in Tswana Children
Authors: de Villiers François P. R.
Published: November 2018

We investigated the milk-drinking habits in a population with a high frequency of lactose maldigestion to establish the clinical (rather than biochemical) importance of this condition. The occurrence of symptoms after milk intake was established. The research took place at a rural hospital and school in Bophuthatswana. The relevance to lifestyle of milk intolerance was established using symptoms reported in a quesfionnaire by 486 subjects, and symptom scores were calculated after standard milk meals for 92 subjects. A further 32 hospitalized children, age three to seven years, had symptom scores calculated after they underwent milk tolerance tests. Although only 38% of teenagers had no symptoms after a 500-ml milk meal, almost 80% had previously ascribed no symptoms to milk drinking. A higher proportion (61 %) of younger children had no symptoms after a standard milk meal. The symptoms produced by lactose maldigestion were not very troublesome in this population. Most lactose maldigesters said they would continue drinking milk, and only 20% of those who suffered symptoms stated they would not Subjects with a symptom score of 3 or more (out of 12) and those who reported bloating tended to drink less milk than others. The total symptom score (>3) or the severity of bloating (2 or 3 out of a possible 3) influenced subjects to assert that they would reduce future milk consumption. Symptoms were less likely to occur in younger children, 61% having no symptoms after a large milk load, compared with 38% of teenagers.
Nutrition and Health from Womb to Tomb
Authors: Scrimshaw Nevin S.
Published: November 2018

Fulfilment of the genetic potential of individuals is impaired by malnutrition and other environmental factors throughout life. The impact of nutritional factors in early childhood helps to explain why the known adult risk factors, demonstrable in populations, are poor predictors of cardiovascular disease in individuals. The combined findings of early and later risk factors strengthen the conclusion that the bulk of so-called degenerative diseases and many other functional impairments in adult life occur because of environmental factors, of which diet may be the most important. The apparent increased susceptibility to degenerative diseases of adults born small-for-date suggests that the increase in meat, fat, and calorie consumption with rising affluence is particularly hazardous for formerly poorly nourished populations. Articles confirming the nutritional origins of a wide range of diseases and disabilities at all ages increasingly predominate in the health-related scientific literature. Recognition that so much disease can be prevented or delayed by improved diet and related lifestyles constitutes a new paradigm applicable to the populations of both developing and industrialized countries.
The molecular genetics of sideroblastic anemia
Authors: Ducamp Sarah , Fleming Mark D.
Published: November 2018

The sideroblastic anemias (SAs) are a group of inherited and acquired bone marrow disorders defined by pathological iron accumulation in the mitochondria of erythroid precursors. Like most hematological diseases, the molecular genetic basis of the SAs has ridden the wave of technology advancement. Within the last 30 years, with the advent of positional cloning, the human genome project, solid-state genotyping technologies, and next-generation sequencing have evolved to the point where more than two-thirds of congenital SA cases, and an even greater proportion of cases of acquired clonal disease, can be attributed to mutations in a specific gene or genes. This review focuses on an analysis of the genetics of these diseases and how understanding these defects may contribute to the design and implementation of rational therapies.
Salmonella-induced thrombi in mice develop asynchronously in the spleen and liver and are not effective bacterial traps
Authors: Beristain-Covarrubias Nonantzin , Perez-Toledo Marisol , Flores-Langarica Adriana , Zuidscherwoude Malou , Hitchcock Jessica R. , Channell Will M. , King Lloyd D. W. , Thomas Mark R. , Henderson Ian R. , Rayes Julie , Watson Steve P. , Cunningham Adam F.
Published: November 2018

Thrombosis is a frequent, life-threatening complication of systemic infection associated with multiple organ damage. We have previously described a novel mechanism of inflammation-driven thrombosis induced by Salmonella Typhimurium infection of mice. Thrombosis in the liver develops 7 days after infection, persisting after the infection resolves, and is monocytic cell dependent. Unexpectedly, thrombosis was not prominent in the spleen at this time, despite carrying a similar bacterial burden as the liver. In this study, we show that thrombosis does occur in the spleen but with strikingly accelerated kinetics compared with the liver, being evident by 24 hours and resolving rapidly thereafter. The distinct kinetics of thrombosis and bacterial burden provides a test of the hypothesis that thrombi form in healthy vessels to trap or remove bacteria from the circulation, often termed immunothrombosis. Remarkably, despite bacteria being detected throughout infected spleens and livers in the early days of infection, immunohistological analysis of tissue sections show that thrombi contain very low numbers of bacteria. In contrast, bacteria are present throughout platelet aggregates induced by Salmonella in vitro. Therefore, we show that thrombosis develops with organ-specific kinetics and challenge the universality of immunothrombosis as a mechanism to capture bacteria in vivo.
Alterations in exosomal miRNA profile upon epithelial-mesenchymal transition in human lung cancer cell lines
Authors: Tang Yue-Ting , Huang Yi-Yao , Li Jing-Huan , Qin Si-Hua , Xu Yong , An Tai-Xue , Liu Chun-Chen , Wang Qian , Zheng Lei
Published: November 2018

Background

Epithelial–mesenchymal transition (EMT) is regarded as a critical event during tumor metastasis. Recent studies have revealed changes and the contributions of proteins in/on exosomes during EMT. Besides proteins, microRNA (miRNA) is another important functional component of exosomes. We hypothesized that the miRNA profile of exosomes may change following EMT and these exosomal miRNAs may in return promote EMT, migration and invasion of cancer cells.

Results

The small RNA profile of exosomes was altered following EMT. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis revealed that the specific miRNAs of M-exosomes have the potential to drive signal transduction networks in EMT and cancer progression. Co-culture experiments confirmed that M-exosomes can enter epithelial cells and promote migration, invasion and expression of mesenchymal markers in the recipient cells.

Conclusion

Our results reveal changes in the function and miRNA profile of exosomes upon EMT. M-exosomes can promote transfer of the malignant (mesenchymal) phenotype to epithelial recipient cells. Further, the miRNAs specifically expressed in M-exosomes are associated with EMT and metastasis, and may serve as new biomarkers for EMT-like processes in lung cancer.
Development and clinical assessment of new objective adherence markers for four microbicide delivery systems used in HIV prevention studies
Authors: Jacot Terry A. , Clark Meredith R. , Adedipe Oluwatosin E. , Godbout Susan , Peele Abby G. , Ju Susan , Schwartz Jill L. , Thurman Andrea R. , Doncel Gustavo F.
Published: November 2018

Background

Adherence is critical for successful topical, vaginally delivered anti‐retroviral (ARV)‐based HIV pre‐exposure prophylaxis (PrEP). Quantitating systemic or tissue ARV levels through LC–MS/MS is currently viewed as the most reliable measure of adherence. However, for placebo‐controlled trials, this is a high cost analysis that measures adherence only in the drug treatment group. A desirable marker of adherence is one that is measured in both placebo and drug treatment groups using a simple on‐site clinical laboratory test, which allows necessary interventions for supporting participant adherence. Our objective was to develop adherence markers for four vaginal placebo products currently used as microbicide delivery systems: gel, film, insert, and intravaginal ring. Excipient and spectroscopy‐based approaches were used for preclinical development of the placebo markers and subsequently validated by the CONRAD 135 study. The study collected vaginal swabs collected each day for 1 week post vaginal application of gel, film, or insert in the clinic with or without sex. Intravaginal rings were collected after 1 day, 7, and 30 days of use.

Results

Placebo gel, film, and insert in vaginal swabs were successfully detected by specific excipient colorimetric or probe‐based assays for hydroxyethylcellulose, glycerin, and sorbitol respectively, as well as spectroscopy‐based prediction models. The range of detection for gel, film, and insert in swabs collected up to 16 h post vaginal application was 70‐100% of the total swabs per time point, with some markers showing potential for longer duration. Decreasing residual glycerin levels and increasing bioanalyte penetration of vaginally used intravaginal rings showed significant changes between 1 and 30 days of use.

Conclusions

We demonstrated clinical proof‐of‐concept that adherence markers for placebo product can be measured using simple, lower cost approaches. Measuring adherence in both placebo and drug arms of a HIV PrEP study would better inform future trial designs.
Feasibility of Patient Navigation to Improve Breast Cancer Care in Malaysia
Authors: Yeoh Zi-Yi , Jaganathan Maheswari , Rajaram Nadia , Rawat Sudha , Tajudeen Nurul Ain , Rahim Norlia , Zainal Nur Hidayati , Maniam Sakthi , Suvelayutnan Ushananthiny , Yaacob Rahani , Krishnapillai Vijayalakshmi , Kamal Meor Zamari Meor , Teo Soo-Hwang , Wahab Mohamed Yusof Abdul
Published: November 2018

Purpose

Late stage at presentation and poor adherence to treatment remain major contributors to poor survival in low- and middle-income countries (LMICs). Patient navigation (PN) programs in the United States have led to improvement in diagnostic or treatment timeliness, particularly for women in lower socioeconomic classes or minority groups. To date, studies of PN in Asia have been limited. We aimed to assess the feasibility of PN in a state-run hospital in an LMIC and to report the impact on diagnostic and treatment timeliness for patients in its first year of implementation.

Methods

We established PN in a dedicated breast clinic of a Malaysian state-run hospital. We compared diagnostic and treatment timeliness between navigated patients (n = 135) and patients diagnosed in the prior year (n = 148), and described factors associated with timeliness.

Results

Women with PN received timely mammography compared with patients in the prior year (96.4% v 74.4%; P < .001), biopsy (92.5% v 76.1%; P = .003), and communication of news (80.0% v 58.5%; P < .001). PN reduced treatment default rates (4.4% v 11.5%; P = .048). Among navigated patients, late stage at presentation was independently associated with having emotional and language barriers ( P = .01). Finally, the main reason reported for delay, default, or refusal of treatment was the preference for alternative therapy.

Conclusion

PN is feasible for addressing barriers to cancer care when integrated with a state-run breast clinic of an LMIC. Its implementation resulted in improved diagnostic timeliness and reduced treatment default. Wider adoption of PN could be a key element of cancer control in LMICs.
Clinical and Pathologic Profiles of Esophageal Cancer in Mozambique: A Study of Consecutive Patients Admitted to Maputo Central Hospital
Authors: Come Jotamo , Castro Clara , Morais Atílio , Cossa Matchecane , Modcoicar Prassad , Tulsidâs Satish , Cunha Lina , Lobo Vitória , Morais Alberto Gudo , Cotton Sofia , Lunet Nuno , Carrilho Carla , Santos Lúcio Lara
Published: November 2018

Purpose

Eastern Africa was recently described as a high-incidence geographic area for esophageal cancer. Mozambique is included in this region. This study aimed to characterize this malignant disease at Maputo Central Hospital (MCH) to develop a global program for esophageal cancer management in Mozambique.

Methods

MCH records from between 2012 and 2016 were used to assess the clinical, pathologic, and outcome profiles of esophageal tumors. A descriptive analysis of data collected was performed. Overall survival was evaluated using Kaplan-Meier curves.

Results

In the study, 522 consecutive patient cases of esophageal cancer were recorded. The median patient age was 56.1 years (range, 27 to 97 years); 291 (55.7%) patients were women, and 230 (44.1%) were men. Regarding tumor site, 113 patients (21.6%) had a tumor in the lower third, 154 (29.5%) in the middle, and 50 (9.6%) in the upper third of the esophagus; in the remaining 196 (37.5%), tumor site was unknown. Squamous cell carcinoma comprised 94.4% of cases with documented histopathology (74.9% of the sample). Surgical treatment was possible in 32 patients (6.1%). Disease stage was documented only in these 32 surgical patients; 28.1%, 53.1%, and 18.8% had stage I, II, and III disease, respectively. The remaining patient cases seemed to involve clinically advanced tumors. The median follow-up time was of 1.6 months. The median survival time was of 3.5 months for all patients; for patients treated with curative intent, it was of 8.7 months.

Conclusion

Esophageal carcinoma is a common malignant tumor at MCH and is diagnosed in the advanced stages resulting in poor prognosis. Therefore, implementation of an Esophageal Cancer Program in Mozambique is essential.
Adrenal Venous Sampling With or Without Adrenocorticotropic Hormone Stimulation: A Meta-Analysis
Authors: Laurent Irakoze , Astère Manirakiza , Zheng Fengfan , Chen Xiangjun , Yang Jun , Cheng Qingfeng , Li Qifu
Published: November 2018

Context

Adrenal venous sampling (AVS), with or without adrenocorticotropic hormone (ACTH) stimulation, is the test of choice to identify patients with a surgically curable subtype of primary aldosteronism (PA). Whether AVS with ACTH stimulation is more effective than AVS without ACTH stimulation remains controversial.

Objective

To compare the effectiveness of AVS with ACTH stimulation and AVS without ACTH stimulation in patients with PA.

Design

The Cochrane Library, PubMed, Embase, and Web of Science databases were searched to identify relevant articles. All cohort studies comparing the two techniques (AVS with ACTH stimulation and AVS without ACTH stimulation in a patient with PA) were included in the analysis.

Results

A total of 14 studies met the inclusion criteria, and they were analyzed. AVS with ACTH stimulation did not significantly reduce the number of incorrect lateralization more than AVS without ACTH stimulation in patients with PA (OR: 0.76; 95% CI: 0.36, 1.59; P = 0.47). AVS with ACTH stimulation significantly reduced the number of unsuccessful cannulations of both adrenal veins more than AVS without ACTH stimulation in patients with PA (OR: 0.26; 95% CI: 0.17, 0.40; P < 0.00001). For subgroup analyses, it also significantly reduced the number of unsuccessful cannulations of left adrenal vein and right adrenal vein (OR: 0.14, 95% CI: 0.06, 0.33, P < 0.00001; and OR: 0.30, 95% CI: 0.12, 0.71, P = 0.007, respectively).

Conclusion

AVS with ACTH stimulation can significantly reduce the number of unsuccessful cannulations, without significantly reducing the number of incorrect lateralization. Further studies are still needed to verify these findings.
Photoplethysmography Detection of Overreaching
Authors: BOURDILLON NICOLAS , NILCHIAN MASIH , MILLET GRÉGOIRE P.
Published: November 2018

Introduction

Detecting the onset of functional overreaching (FOR) or nonfunctional overreaching in endurance athletes is of prior importance to ensure reactive amendment of the scheduled training program. The objective of this study was to assess photoplethysmography (PPG) in overloaded athletes and test whether 1) it would be affected differently in functional overreached (FOR) or nonoverreached acutely fatigued (AF) athletes and 2) specific PPG characteristics would allow for timely distinction of FOR and AF.

Methods

Fifteen athletes performed 2-wk baseline training followed by 3-wk overload (+45%; OVL) and 2-wk recovery (−20%). Three-thousand-meter time-trial running was used to assess performance at the end of baseline, OVL, and recovery and distinguish FOR and AF. PPG was recorded overnight using a wearable sensor, every third night. Overnight means and variances of systolic, diastolic, and dicrotic amplitudes and times as well as systolic and diastolic slopes were used to discriminate FOR and AF athletes.

Results

Performance was decreased in FOR and improved in AF at the end of OVL. Diastolic time was greater in AF than FOR, whereas systolic slope was smaller in AF than in FOR during OVL. The variances of systolic, diastolic, dicrotic amplitudes, systolic, diastolic slopes, and pulse areas were smaller in AF compared with FOR in the last week of OVL.

Conclusion

PPG is an efficient tool for the detection of overreaching because it distinguished FOR and AF athletes during OVL (prior performance decrement). This fast-responding method would therefore allow for adjusting the daily training content to prevent nonfunctional overreaching.
Effect of Clinical Pilates training on the fear of movement in patients with ankylosing spondylitis
Authors: Oskay Deran , Tuna Zeynep , Baglan-Yentur Songül
Published: November 2018

Background/Aims:

Exercise training has been shown to be beneficial in reducing symptoms in patients with ankylosing spondilitis. However, exercise effect on fear and avoidance of movement has not been assessed. The aim of this study was to evaluate the effect of Pilates training on kinesiophobia, disease activity, functional status and quality of life in patients with ankylosing spondilitis.

Methods:

A total of 21 patients with ankylosing spondilitis with stable medication participated in the study. Tampa Scale for Kinesiophobia, Bath Ankylosing Spondilitis Disease Activity Index, Bath Ankylosing Spondilitis Functional Index, ankylosing spondilitis Quality of Life Questionnaire and Beck Depression Inventory were completed by patients before and after a 6-week modified Pilates training programme.

Findings:

The patients were 41.6 ± 11.8 years old and the mean disease duration was 68 ± 87months. Mobility, disease acitivity and functional scores improved with exercise training (P<0.05). Moreover, quality of life, depression and kinesiophobia levels also showed significant improvement (P<0.05).

Conclusions:

The results of this study showed that 6-week supervised modified Pilates training programme improved clinical symptoms in patients with Aankylosing spondilitis. Moreover, patients benefited from this exercise method regarding quality of life, depression and fear of movement (kinesiophobia) considerably.