bluuebunny/crossref_metadata_2025 huggingface dataset:
Something has shifted: Nursing students’ global perspective following international clinical placements
Authors: Gower Shelley , Duggan Ravani , Dantas Jaya A R , Boldy Duncan
Published: April 2017

Aims

To examine understandings of global health issues among nursing students following participation in an international clinical placement during their pre‐registration university education.

Background

Universities use international clinical placements, especially in developing countries, to develop cultural awareness in students; however, little is known about the longer term influences on students’ understandings of global nursing.

Design

A retrospective cross‐sectional design was used, using an exploratory, descriptive qualitative approach.

Methods

Individual semi‐structured interviews were conducted in 2014 with a purposive sample of 25 pre‐registration nursing students from four Western Australian universities who undertook clinical placements across five countries. Data were analysed using inductive thematic analysis.

Results

Findings highlight that students developed new understandings around health systems including fragility of resource access, differences in clinical practice and variances in nursing roles between settings. Students also experienced challenges but were able to appreciate alternative world viewpoints.

Conclusion

International clinical placements can develop greater awareness and help students form realistic strategies for using their nursing skills globally. Pre‐placement training in cultural awareness and health system realities, along with strong supervisory support, is critical to success.
Oxidized LDL, Gamma‐Glutamyltransferase and Adverse Outcomes in Older Adults
Authors: Spoto Belinda , Mattace‐Raso Francesco , Sijbrands Eric J. , D'Arrigo Graziella , Tripepi Giovanni , Volpato Stefano , Bandinelli Stefania , Ferrucci Luigi , Zoccali Carmine
Published: April 2017

Objectives

Gamma‐glutamyltransferase (GGT) is a biomarker of liver disease and oxidative stress which was associated with all‐cause and cardiovascular (CV) mortality in the general population and in patients with high risk conditions. This study aims at assessing whether oxLDL modifies the relationship between GGT, all‐cause, and CV mortality in elderly individuals from the general population.

Design

Observational longitudinal study.

Setting

Population‐based cohort of older individuals (>65 years) free of liver disease.

Participants

One thousand and thirty‐eight individuals from the Invecchiare in Chianti (InCHIANTI) study.

Measurements

Serum GGT level, oxidized low‐density lipoprotein (oxLDL), CV comorbidities, all‐cause and CV mortality.

Results

The median age of the study population (n = 1,038) was 74 years (inter‐quartile range: 69–79), 152 individuals (15%) had past CV events. During a median follow‐up of 9 years, 401 individuals died, 168 of them (42%) for CV causes. In adjusted analyses, GGT predicted all‐cause mortality (HR for 20 U/L increase in serum GGT: 1.11, 95% CI: 1.02–1.21, P = .02) and CV mortality (HR: 1.17, 95% CI: 1.03–1.33; P = .02). Furthermore, in an analysis for interaction circulating oxLDL amplified the effect of GGT on all‐cause mortality (P = .003).

Conclusion

Circulating oxLDL amplifies the effect of GGT on mortality in the elderly. The mechanism for this association remains unknown and requires further research, including studying the potential role of GGT in oxidative stress. These results are consistent with the hypothesis of a causal role of GGT in the CV morbidity and mortality in older individuals and indicate that oxLDL plays a crucial role in the interpretation of the link between GGT and the risk of adverse clinical events in this population.
Clinical Evaluation of Indirect Particle‐Filled Composite Resin CAD/CAM Partial Crowns after 24 Months
Authors: Zimmermann Moritz , Koller Christina , Reymus Marcel , Mehl Albert , Hickel Reinhard
Published: April 2017

Purpose

Resin‐based CAD/CAM compound materials might be promising for single‐tooth restorations. Insufficient clinical data are available for this new material class. The purpose of this study was to describe initial clinical in vivo results for indirect particle‐filled composite resin CAD/CAM restorations after 24 months.

Materials and Methods

Indirect particle‐filled composite resin restorations were fabricated with a CAD/CAM method (CEREC Bluecam intraoral scanner, CEREC MCXL milling unit) by calibrated dental students. Forty‐two partial crown restorations were seated adhesively in 30 patients with caries lesions or insufficient restorations (baseline). Strict inclusion criteria were defined for the patient collective. Follow‐up evaluation comprised 40 restorations after 12 months and 33 restorations after 24 months. Evaluation criteria were modified FDI criteria with grades (1) to (5). Rating with FDI criteria (5) was defined as clinical failure. Statistical analysis was performed with Wilcoxon‐Test (p < 0.05).

Results

The success rate of indirect particle‐filled composite resin CAD/CAM restorations after 12 months was 95.0% with two debondings observed. The cumulative success rate for indirect particle‐filled composite resin CAD/CAM restorations after 24 months was 85.7% with two tooth fractures and one debonding. Statistically significant differences were found for baseline and 24‐month follow‐up evaluation for anatomic form and marginal adaptation criterion examined in respect to FDI criteria guidelines (Wilcoxon‐Test, p < 0.05).

Conclusions

This study demonstrates particle‐filled composite resin CAD/CAM restorations having a clinical success rate of 85.7% after 24 months. Adhesive bonding procedures need to be ensured carefully. A longer clinical evaluation period is necessary to draw further conclusions.
Microtensile Bond Strength of a Resin Cement to Silica‐Based and Y‐TZP Ceramics Using Different Surface Treatments
Authors: Keshvad Alireza , Hakimaneh Seyed Mohammad Reza
Published: April 2017

Purpose

To evaluate the effects of different surface treatments on the microtensile bond strength (μTBS) of bonding between resin cement and lithia or zirconia‐based ceramics using an in vitro study.

Materials and Methods

Three zirconia ceramic blocks (IPS e.max ZirCAD) and three lithium disilicate ceramic blocks (IPS e.max CAD) were sintered and duplicated in resin composite. The zirconia specimens underwent various treatments (n = 1): (i) Sandblast + primer (ZiSa); (ii) sandblast + laser irradiation + primer (ZiSaLa); or (iii) laser irradiation + primer (ZiLa). The lithium disilicate specimens also underwent various treatments: (i) sandblast + HF + silane (LiSaE); (ii) sandblast + silane (LiSa); or (iii) sandblast + laser irradiation + silane (LiSaLa). The ceramic–composite blocks were cemented with resin cement and cut to produce bars with approx. 1 mm2 bonding areas. The specimens were thermocycled, and bond strength tests were performed in a universal testing machine. The fracture type was determined by observing the fractured surface under a stereomicroscope. The mean bond strengths of the specimens were statistically analyzed using one‐way ANOVA and Duncan's tests (α = 0.05).

Results

Mean comparison of the μTBS showed no significant difference between LiSaE and LiSa (p > 0.05), but significant differences between LiSaE and other groups (p ≤ 0.01). No significant differences were found between the ZiSaLa and ZiSa groups (p > 0.05). The modes of failure in all groups were mostly adhesive (57% to 80%). The mean bond strengths in laser‐irradiated ceramics were significantly lower than those from other surface treatments. All ZiLa specimens debonded before testing (pretest failure).

Conclusions

Lithium disilicate ceramic surface treated with a combination of sandblasting and silane application provided a bond strength comparable to that provided by sandblasting in combination with acid etching and applying silane. Groups treated with laser irradiation had significantly lower bond strengths than other groups.
Empiric antibiotic regimens for neonatal sepsis in Australian and New Zealand neonatal intensive care units
Authors: Carr Jeremy P , Burgner David P , Hardikar Rohan S , Buttery Jim P
Published: April 2017

Aim

Neonatal sepsis remains an important cause of morbidity and mortality, and requires prompt empiric treatment. However, only a minority of babies who receive antibiotics for suspected sepsis have an infection. Antimicrobial exposure in infancy has important short‐ and long‐term consequences. There is no consensus regarding empirical antimicrobial regimens.

Methods

The study included a survey of empiric antimicrobial regimens in all tertiary neonatal intensive care units in Australia and New Zealand in 2013–2014.

Results

All 27 units responded. For early‐onset sepsis, all units used a combination of gentamicin with either penicillin or ampicillin. For late‐onset sepsis, the frequency of units using empiric vancomycin (41%) versus empiric flucloxacillin (48%) was similar. Gestational age or the presence of a central venous catheter had little influence on using vancomycin instead of flucloxacillin. For late‐onset sepsis with meningitis there was marked variation in antimicrobial combinations, with 15 different regimens described. A total of 93% used a cefotaxime‐based regimen, either as monotherapy (22%) or combined with a second (22%) or third (48%) agent. For suspected necrotising enterocolitis, 89% used an aminoglycoside, metronidazole and a penicillin. Historical outbreaks of multi‐resistant organisms exerted long‐term influence over regimen choice.

Conclusions

There was limited use of broad‐spectrum agents such as carbapenems or third‐generation cephalosporins. In this region with low methicillin‐resistant Staphylococcus aureus prevalence, empiric vancomycin use was common, selected for activity against coagulase‐negative staphylococci. Empiric vancomycin is rarely necessary because coagulase‐negative staphylococci are often contaminants and sepsis is rarely fulminant, occurring almost exclusively in extremely low birthweight infants. Implementation of appropriate, local antimicrobial policies is crucial to minimise antimicrobial exposure in this vulnerable population and halt the development of antimicrobial resistance.
Tokenistic or genuinely effective? Exploring the views of voluntary sector staff regarding the emerging peer support worker role in mental health
Authors: Kilpatrick Emma , Keeney Sinead , McCauley Claire‐Odile
Published: April 2017

Accessible summary

What is known on the subject

The introduction of PSWs within mental health services has grown substantially both internationally and locally; however, no recognized studies have focused on the evolvement of this role within a Northern Ireland (NI) context.

Research is increasingly focusing on service users’ and PSWs perspectives on mental health service provision. Despite this, few studies exist which exclusively report staff views in relation to the PSW role.

What the paper adds to existing knowledge

Results of the current study identified varying perspectives on the peer role. Some participants believed that the PSW role was tokenistic; others opposed these views, highlighting the value of this role. Clearly defined job descriptions and the importance of ensuring the PSW is a cohesive part of the team and not an “add on,” was identified as imperative to avoid tokenistic practice.

Provision of a flexible working environment, both sensitive and responsive to the peers’ own mental health needs, was identified as significant in order for the peer to fulfil their role successfully.

Implications for practice

Services introducing PSWs within teams should engage with nursing staff at all organizational levels in the role development process to minimize the risk of tokenism, for example, the PSW role not integrated or valued within teams.

Clearly defined job/role specifications for PSWs should be devised to ensure that both the PSW and the mental health nursing team have a shared understanding regarding this role.

Aim

Peer support worker (PSW) roles are gaining recognition internationally as a valuable component in mental health service delivery. The aim of this study was to explore the views of mental health voluntary sector staff regarding the emergence of this role.

Method

A qualitative research design was used. A purposive sample was employed. Semi‐structured interviews were undertaken with 10 staff members in various positions in two voluntary mental health organizations. Interview transcripts were analysed thematically.

Results

Views varied on the PSW role with some participants stating that it was tokenistic, whereas others highlighted the value of its contribution. Participants’ expressed concerns regarding professional boundaries and organizational cultural challenges that PSWs may encounter in their role. The provision of reasonable adjustments was recommended as an integral support mechanism.

Conclusion

Successful integration of the PSW requires careful consideration of the role, the workplace environment and the unique needs of the peer, to prevent the role becoming constrained and diluted.

Implications for practice

The PSW role may impact the traditional delivery of mental health nursing services. It is therefore essential that nurses are cognizant of these potential challenges to successfully facilitate the integration of PSWs in practice.
Factors Affecting Platelet Concentration in Platelet Concentrates from Canine Blood Donors
Authors: Raleigh J.S. , Jandrey K.E. , Burges J. , Kent M.S.
Published: April 2017

Background

Physiologic factors in dogs that might contribute to enhanced platelet yield in platelet concentrates (PCs) are largely unknown.

Objective

To determine whether individual differences in weight, age, preprocessing blood chemistry, andCBCvariables predict the final platelet concentrations inPCs. Our hypotheses were (1) increased lipemic indices would be positively associated with increased platelet concentrations inPCs and (2) increased preprocessing platelet concentrations would be associated with higher platelet concentrations in thePCs.

Animals

All blood donation records of dogs from February 2, 2009 through April 1, 2015 at the University of California—Davis Veterinary Blood Bank were examined with 104 cases included in this study.

Methods

In this retrospective study, data were collected from medical records of canine blood donors. Records were reviewed for internal consistency and accuracy and subjects were included in the study if donor screening and donation occurred on the same day and a viablePCwas obtained. Univariate and multivariable regressions were used to test the impact that each variable had on the final platelet concentration inPCs.

Results

Final platelet concentration inPCs was positively associated with the predonationCBCplatelet values (P< .001), lipemic index (P= .01), and phosphorous levels (P= .001). Collectively these 3 variables explained 29% of the variance in platelet concentrations inPCs.

Conclusions and clinical importance

Future prospective studies are required to determine if canine blood donations from dogs with lipemia yieldPCs with higher platelet concentrations without negatively affecting other blood components.
Men Idle, Women Network: How Networks Help Female Legislators Succeed
Authors: Wojcik Stefan , Mullenax Shawnna
Published: April 2017

Why do some lawmakers form denser professional networks than others? We extend existing theories of gendered networks, arguing that legislators use networking as a strategy to compensate for a challenging institutional environment. Using original data from Brazil, we provide survey‐based evidence that female representatives in the Chamber of Deputies engage in higher rates of intragender networking and have more profuse and diverse legislative networks than male deputies. We also provide suggestive evidence that these profuse legislative relationships pay off for women in the form of higher vote shares at election time.
Underwater video reveals decreased activity of rocky intertidal snails during high tides and cooler days
Authors: Taylor Austin W. , Morgan Steven G. , Gravem Sarah A.
Published: April 2017

Nearly all of our understanding of rocky inter‐tidal ecology comes from studies conducted at low tide. To study inter‐tidal organisms at high tide, we anchored waterproof digital GoPro® video cameras in wave‐exposed tidepools and recorded the daytime movements of the black turban snail, Tegula funebralis, over the tidal cycle between May and August 2012 near Bodega Bay, California. Overall, snails moved more quickly and presumably foraged more during low tides and on days with warmer air and perhaps water temperatures. This is similar to other ectotherms that exhibit increased metabolic rates, movement and foraging in warmer conditions. Snails also moved less during flood and high tides, may have moved downward in tidepools at flood tides, and showed evidence of reduced activity on days with larger waves. This inactivity and refuge seeking may have been a strategy to avoid dislodgment by waves. Analysis of snail trajectories showed foraging bouts indicated by alternating zig‐zagging and straight movement. There was no effect of temperature, wave height, or tidal phase on distribution of snail turning angles, suggesting that they may have foraged consistently but moved faster during warm conditions and low tides, thereby grazing a larger area. This is one of few direct recordings of inter‐tidal organisms on wave‐exposed rocky shores during high tide. The methods used here are easily transferable to other studies, which are needed to increase our understanding of behaviors that structure rocky shore communities during high tide.
Conic martingales from stochastic integrals
Authors: Jeanblanc Monique , Vrins Frédéric
Published: April 2017

In this paper, we introduce the concept of conic martingales. This class refers to stochastic processes that have the martingale property but that evolve within given (possibly time‐dependent) boundaries. We first review some results about the martingale property of solution to driftless stochastic differential equations. We then provide a simple way to construct and handle such processes. Specific attention is paid to martingales in [0, 1]. One of these martingales proves to be analytically tractable. It is shown that up to shifting and rescaling constants, it is the only martingale (with the trivial constant, Brownian motion, and geometric Brownian motion) having a separable diffusion coefficient and that can be obtained via a time‐homogeneous mapping of Gaussian diffusions. The approach is exemplified by modeling stochastic conditional survival probabilities in the univariate and bivariate cases.
Optimal cash holdings under heterogeneous beliefs
Authors: Jarrow Robert , Krishenik Andrey , Minca Andreea
Published: April 2017

This paper explores a one‐period model for a firm that finances its operations through debt provided by heterogeneous creditors. Creditors differ in their beliefs about the firm's investment outcomes. We show the existence of Stackelberg equilibria in which the firm holds cash reserves in order to provide incentives for pessimistic creditors to invest in the firm. We find interest rates and cash holdings to be complementary tools for increasing debt capacity. In markets with a high concentration of capital across a small interval of pessimistic creditors or by a few large creditors, cash holdings is the preferred tool to increase the debt capacity of the firm.
Cytoprotective effects of dietary flavonoids against cadmium‐induced toxicity
Authors: Li Xia , Jiang Xinwei , Sun Jianxia , Zhu Cuijuan , Li Xiaoling , Tian Lingmin , Liu Liu , Bai Weibin
Published: April 2017

Cadmium (Cd) damages the liver, kidney, bones, reproductive system, and other organs. Flavonoids, such as anthocyanins and flavonols, which are commonly found in plant foods, have shown protective effects against Cd‐induced damage. The cytoprotective effects of flavonoids against Cd‐induced diseases are mainly attributable to three mechanisms. First, flavonoids clear reactive oxygen species, thereby reducing lipid peroxide production and improving the activity of antioxidation enzymes. Second, flavonoids chelate Cd, thus reducing the accumulation of Cd and altering the levels of other essential metal ions in vivo. Third, flavonoids reduce DNA damage and inhibit apoptosis. In addition, flavonoids were found to inhibit inflammation and fibrosis and improve glycometabolism and the secretion of reproductive hormones. We introduce the daily dosage and absorption rate of flavonoids and then focus on their bioactive effects against Cd‐induced toxicity and reveal the underlying metabolic pathway, which provides a basis for further study of the nutritional prevention of Cd‐induced injury. In particular, a better understanding is needed of the structure–activity relationship of flavonoids against Cd toxicity, which has not yet been reported.
The Intergenerational Effect of Cambodia's Genocide on Children's Education and Health
Authors: Islam Asadul , Ouch Chandarany , Smyth Russell , Wang Liang Choon
Published: April 2017

We investigate the intergenerational impact of conflict on the educational and health outcomes of children born years after the conflict ended by exploiting geographical variation in the intensity of the genocide that occurred during the Khmer Rouge (KR) regime in Cambodia. We find that children of individuals who were of prime marriage age during the genocide and experienced greater intensity of genocide have worse educational and health outcomes. In particular, for each standard deviation increase in the intensity of the genocide, average children's normal grade progression rate decreases by 0.03 standard deviations and average children's height‐for‐ age Z‐score decreases by 0.06 standard deviations. We examine several channels through which genocide could affect children born to survivors after the conflict and find suggestive evidence that the marriage market acts as a channel that transmits the adverse impact of conflict across generations. Our findings are robust to alternative measures of mortality rates and post‐KR internal migration.
Renal Replacement Therapy and Incremental Hemodialysis for Veterans with Advanced Chronic Kidney Disease
Authors: Kalantar‐Zadeh Kamyar , Crowley Susan T. , Beddhu Srinivasan , Chen Joline L.T. , Daugirdas John T. , Goldfarb David S. , Jin Anna , Kovesdy Csaba P. , Leehey David J. , Moradi Hamid , Navaneethan Sankar D. , Norris Keith C. , Obi Yoshitsugu , O'Hare Ann , Shafi Tariq , Streja Elani , Unruh Mark L. , Vachharajani Tushar J. , Weisbord Steven , Rhee Connie M.
Published: April 2017

Each year approximately 13,000 Veterans transition to maintenance dialysis, mostly in the traditional form of thrice‐weekly hemodialysis from the start. Among >6000 dialysis units nationwide, there are currently approximately 70 Veterans Affairs (VA) dialysis centers. Given this number of VA dialysis centers and their limited capacity, only 10% of all incident dialysis Veterans initiate treatment in a VA center. Evidence suggests that, among Veterans, the receipt of care within the VA system is associated with favorable outcomes, potentially because of the enhanced access to healthcare resources. Data from the United States Renal Data System Special Study Center “Transition‐of‐Care‐in‐CKD” suggest that Veterans who receive dialysis in a VA unit exhibit greater survival compared with the non‐VA centers. Substantial financial expenditures arise from the high volume of outsourced care and higher dialysis reimbursement paid by the VA than by Medicare to outsourced providers. Given the exceedingly high mortality and abrupt decline in residual kidney function (RKF) in the first dialysis year, it is possible that incremental transition to dialysis through an initial twice‐weekly hemodialysis regimen might preserve RKF, prolong vascular access longevity, improve patients’ quality of life, and be a more patient‐centered approach, more consistent with “personalized” dialysis. Broad implementation of incremental dialysis might also result in more Veterans receiving care within a VA dialysis unit. Controlled trials are needed to examine the safety and efficacy of incremental hemodialysis in Veterans and other populations; the administrative and health care as well as provider structure within the VA system would facilitate the performance of such trials.
Phenomenology, Objectivity, and the Explanatory Gap
Authors: Conaill Donnchadh Ó
Published: April 2017

There has been much recent discussion of whether Husserlian phenomenology might be relevant to the explanatory gap—the problem of explaining how conscious experience arises from nonexperiential events or processes. However, some phenomenologists have argued that the explanatory gap is a confused problem, because it starts by assuming a false distinction between the subjective and the objective. Rather than trying to solve this problem, they claim that phenomenology should dissolve it by undermining the distinction upon which it is based. I shall argue that adopting a phenomenological approach does not provide reason to think that the explanatory gap is not a genuine problem. In assessing the assumptions underlying the gap, we must distinguish between objectivity understood as a stance we can take toward the world and objectivity as the world's having a structure independent of any experience. The explanatory gap can be understood as the problem of finding a place for consciousness in this objective structure. This does not force us to take an objective stance or reduce the methods of phenomenology to those of the natural sciences.
The Tactual Ground, Immersion, and the “Space Between”
Authors: Mac Cumhaill Clare
Published: April 2017

I ask whether figure‐ground structure can be realized in touch, and, if so, how. Drawing on the taxonomy of touch sketched in Katz's 1925 The World of Touch, I argue that the form of touch that is relevant to such consideration is a species of immersed touch. I consider whether we can feel the space we are immersed in and, more specifically, the empty space against which the surfaces of objects, as I shall urge, “stand out.” Harnessing M. G. F. Martin's account of bodily awareness and touch, I defend a positive thesis, pace Graham Nerlich on whose The Shape of Space (1994) I otherwise rely, both to defend the supposition that empty space can in principle be felt and to argue that touching empty space is not a mere species of absence perception. Along the way, I defuse a causal worry that might be thought to arise in the case of touching empty space.
University−Urban High School Partnership: Math and Science Professional Learning Communities
Authors: ndunda mutindi , Van Sickle Meta , Perry Lindsay , Capelloni Alison
Published: April 2017

This study focused on science and math professional learning communities (PLCs) that were implemented through a university‐urban high school partnership. These PLCs were part of mandated school‐wide, content‐based PLCs implemented as part of the reform efforts initiated in an urban school to address the school's failure to meet Adequate Yearly Progress (AYP) for four years consecutively and low graduation rate (less than 25%) for male students. The key issues were (a) students had continually earned low test scores; (b) there was continuous principal turnover; (c) faculty morale was at an all‐time low, and the quality of teaching was very poor; and (d) the students were not effectively disciplined. The study examined the impact that university faculty‐led mandated PLCs have on teachers' practices and students' learning and achievement. Analysis of data revealed practices that were effective in developing and implementing these successful math and science PLCs. Three themes emerged: ethics of care, teacher agency, and aesthetics of professional interactions. Each theme contained key features that appeared to contribute to the implementation of a successful PLC.
Identification of a new HLA‐DQB1*06 allele, HLA‐DQB1*06:210, by monoallelic Sanger sequencing
Authors: Kuzmich E. , Nasredinova A. , Alyanskiy A. , Afanasyev B.
Published: April 2017

Sequence of the novel allele, HLA‐DQB1*06:210, differs from HLA‐DQB1*06:03:01 by 1 nucleotide exchange in exon 2.
Evaluation of magnetic resonance imaging for the differentiation of inflammatory, neoplastic, and vascular intradural spinal cord diseases in the dog
Authors: Masciarelli Amanda E. , Griffin John F. , Fosgate Geoffrey T. , Hecht Silke , Mankin Joseph M. , Holmes Shannon P. , Platt Simon R. , Kent Marc , Pancotto Theresa E. , Chen Annie V. , Levine Jonathan M.
Published: April 2017

Magnetic resonance imaging (MRI) is a common test for dogs with suspected intradural spinal cord lesions, however studies on diagnostic performance for this test are lacking. Objectives of this multi‐institutional, retrospective, case‐control study were to estimate sensitivity and specificity of MRI for (1) distinguishing between histopathologically confirmed intradural spinal cord disease versus degenerative myelopathy in dogs, (2) categorizing intradural spinal cord diseases as neoplastic, inflammatory, or vascular; and (3) determining tumor type within the etiologic category of neoplasia. Additional aims were to (1) determine whether knowledge of clinical data affects sensitivity and specificity of MRI diagnoses; and (2) report interrater agreement for MRI classification of intradural spinal lesions. Cases were recruited from participating hospital databases over a 7‐year period. Three reviewers independently evaluated each MRI study prior to and after provision of clinical information. A total of 87 cases were sampled (17 degenerative myelopathy, 53 neoplasia, nine inflammatory, and eight vascular). Magnetic resonance imaging had excellent (>97.6%) sensitivity for diagnosis of intradural spinal cord lesions but specificity varied before and after provision of clinical data (68.6% vs. 82.4%, P = 0.023). Magnetic resonance imaging had good sensitivity (86.8%) and moderate specificity (64.7–72.5%) for diagnosing neoplasia. Sensitivity was lower for classifying inflammatory lesions but improved with provision of clinical data (48.1% vs. 81.5%, P = 0.015). Magnetic resonance imaging was insensitive for diagnosing vascular lesions (25.0%). Interrater agreement was very good for correctly diagnosing dogs with intradural lesions (ĸ = 0.882–0.833), and good (ĸ = 0.726–0.671) for diagnosing dogs with neoplasia.
An autocrine ATP release mechanism regulates basal ciliary activity in airway epithelium
Authors: Droguett Karla , Rios Mariana , Carreño Daniela V. , Navarrete Camilo , Fuentes Christian , Villalón Manuel , Barrera Nelson P.
Published: April 2017

Key points

Extracellular ATP, in association with [Ca2+]i regulation, is required to maintain basal ciliary beat frequency.

Increasing extracellular ATP levels increases ciliary beating in airway epithelial cells, maintaining a sustained response by inducing the release of additional ATP.

Extracellular ATP levels in the millimolar range, previously associated with pathophysiological conditions of the airway epithelium, produce a transient arrest of ciliary activity.

The regulation of ciliary beat frequency is dependent on ATP release by hemichannels (connexin/pannexin) and P2X receptor activation, the blockage of which may even stop ciliary movement.

The force exerted by cilia, measured by atomic force microscopy, is reduced following extracellular ATP hydrolysis. This result complements the current understanding of the ciliary beating regulatory mechanism, with special relevance to inflammatory diseases of the airway epithelium that affect mucociliary clearance.

Extracellular nucleotides, including ATP, are locally released by the airway epithelium and stimulate ciliary activity in a [Ca2+]i‐dependent manner after mechanical stimulation of ciliated cells. However, it is unclear whether the ATP released is involved in regulating basal ciliary activity and mediating changes in ciliary activity in response to chemical stimulation. In the present study, we evaluated ciliary beat frequency (CBF) and ciliary beating forces in primary cultures from mouse tracheal epithelium, using videomicroscopy and atomic force microscopy (AFM), respectively. Extracellular ATP levels and [Ca2+]i were measured by luminometric and fluorimetric assays, respectively. Uptake of ethidium bromide was measured to evaluate hemichannel functionality. We show that hydrolysis of constitutive extracellular ATP levels with apyrase (50 U ml−1) reduced basal CBF by 45% and ciliary force by 67%. The apyrase effect on CBF was potentiated by carbenoxolone, a hemichannel inhibitor, and oxidized ATP, an antagonist used to block P2X7 receptors, which reduced basal CBF by 85%. Additionally, increasing extracellular ATP levels (0.1–100 μm) increased CBF, maintaining a sustained response that was suppressed in the presence of carbenoxolone. We also show that high levels of ATP (1 mm), associated with inflammatory conditions, lowered basal CBF by reducing [Ca2+]i and hemichannel functionality. In summary, we provide evidence indicating that airway epithelium ATP release is the molecular autocrine mechanism regulating basal ciliary activity and is also the mediator of the ciliary response to chemical stimulation.
Improvement of Performance and Reduction of Fatigue With Low-Level Laser Therapy in Competitive Cyclists
Authors: Lanferdini Fábio J. , Bini Rodrigo R. , Baroni Bruno M. , Klein Kelli D. , Carpes Felipe P. , Vaz Marco A.
Published: April 2017

Evidence indicates that low-level laser therapy (LLLT) minimizes fatigue effects on muscle performance. However, the ideal LLLT dosage to improve athletes’performance during sports activities such as cycling is still unclear. Therefore, the goal of this study was to investigate the effects of different LLLT dosages on cyclists’performance in time-to-exhaustion tests. In addition, the effects of LLLT on the frequency content of the EMG signals to assess fatigue mechanisms were examined. Twenty male competitive cyclists participated in a crossover, randomized, double-blind, placebo-controlled trial. They performed an incremental cycling test to exhaustion (on day 1) followed by 4 time-to-exhaustion tests (on days 2–5) at their individual maximal power output. Before each time-to-exhaustion test, different dosages of LLLT (135, 270, and 405 J/thigh, respectively) or placebo were applied at the quadriceps muscle bilaterally. Power output and muscle activation from both lower limbs were recorded throughout the tests. Increased performance in time-to-exhaustion tests was observed with the LLLT-135 J (∼22 s; P < .01), LLLT-270 J (∼13 s; P = .03), and LLLT-405 J (∼13 s; P = .02) compared to placebo (149 ± 23 s). Although LLLT-270 J and LLLT-405 J did not show significant differences in muscle activation compared with placebo, LLLT-135 J led to an increased high-frequency content compared with placebo in both limbs at the end of the exhaustion test (P ≤ .03). In conclusion, LLLT increased time to exhaustion in competitive cyclists, suggesting this intervention as a possible nonpharmacological ergogenic agent in cycling. Among the different dosages, LLLT-135 J seems to promote the best effects.
Straight-Line and Change-of-Direction Intermittent Running in Professional Soccer Players
Authors: Fessi Mohamed S. , Farhat Fayçal , Dellal Alexandre , Malone James J. , Moalla Wassim
Published: April 2017

Purpose:To investigate the difference between straight-line (STL) and change-of-direction (COD) intermittent-running exercises in soccer players.Methods:Seventeen male professional soccer players performed the agility T test and 6 intermittent-running exercises: 10 s at 130% of maximal aerobic speed (MAS) alternated with 10 s of rest (10-10), 15 s at 120% of MAS alternated with 15 s of rest (15-15), and 30 s at 110% of MAS alternated with 30 s of rest (30-30) both in STL and with COD. All exercises were monitored using a global positioning system. Heart rate was measured during exercises, and rating of perceived exertion (RPE) was collected postexercise. The difference (Δ) between covered distance in STL and COD exercises at a similar load was calculated, and relationships between T test and Δ distance were analyzed.Results:COD intermittent exercises showed a significantly decreased distance covered and an increase in the number of accelerations, peak heart rate, and RPE compared with STL intermittent exercises at a similar load. High relationships were observed between T-test performance and Δ distance in 10-10 (r = .72,P < .01) and 15-15 (r = .77,P < .01), whereas no significant relationships were observed between T-test performance and Δ distance in 30-30 (r = −.37,P = .2).Conclusion:Intermittent COD exercises were associated with higher acceleration, peak heart rate, and RPE than STL during 10-10 and 15-15 exercises. The ability to rapidly change direction is crucial to perform intense sport-specific running in professional soccer players.
Alterations in Redox Homeostasis During Recovery From Unexplained Underperformance Syndrome in an Elite International Rower
Authors: Lewis Nathan A. , Redgrave Ann , Homer Mark , Burden Richard , Martinson Wendy , Moore Brian , Pedlar Charles R.
Published: April 2017

Purpose: To examine a diagnosis of unexplained underperformance syndrome (UUPS, or overtraining syndrome) in an international rower describing a full recovery and return to elite competition the same year. Methods: On diagnosis and 4 and 14 mo postdiagnosis, detailed assessments including physiological, nutritional, and biomarkers were made. Results: Clinical examination and laboratory results for hematology, biochemistry, thyroid function, immunology, vitamins, and minerals were unremarkable and did not explain the presentation and diagnosis. Redox biomarkers including hydroperoxides, plasma antioxidant capacity, red blood cell glutathione, superoxide dismutase, coenzyme Q10, vitamin E (α- and γ-tocopherol), and carotenoids (lutein, α-carotene, β-carotene) provided evidence of altered redox homeostasis. The recovery strategy began with 12 d of training abstinence and nutritional interventions, followed by 6 wk of modified training. At 4 mo postintervention, performance had recovered strongly, resulting in the athlete’s becoming European champion that same year. Further improvements in physiological and performance indices were observed at 14 mo postintervention. Physiologically relevant increases in concentrations of carotenoids were achieved at each postintervention time point, exceeding the reported critical-difference values. Conclusions: Increasing athlete phytonutrient intake may enhance recovery and tolerance of training and environmental stressors, reducing the risk of unexplained UUPS. Alterations in redox homeostasis should be considered as part of the medical management in UUPS. This is the first reported case study of an elite athlete with alterations in redox homeostasis in conjunction with a diagnosis of UUPS.
The Effects of Observing a Learning Model (or Two) on Motor Skill Acquisition
Authors: Hebert Edward
Published: April 2017

Modeling, which enhances skill acquisition, is an often-used means of conveying information to learners. While models typically provide a demonstration of correct movements or successful performance, skill acquisition is also enhanced by observing a “learning model,” who practices, receives feedback, and improves. The effect is proposed to be due to the observer engaging in problem-solving, error detection, and strategy evaluation. The purpose of this experiment was to examine the effects of observing one or two learning models in combination with physical practice, and the temporal placement of model observation during physical practice, on the acquisition and retention of a motor skill. College students practiced a 3 × 6 × 3 cup stacking task in groups of three, and had opportunities to observe their peers’ physical practice. Treatment groups differed in the order of observation and physical practice; some participants engaged in physical practice prior to observation, while others observed one or two learning models before practice. Data indicated observation prior to engaging in physical practice enhanced learning. In addition, participants were able to identify strategies they observed that enhanced skill performance. These results support and add to existing research on modeling, and provide insight into the types of cognition that occur during observational learning.
Combining Activity-Related Behaviors and Attributes Improves Prediction of Health Status in NHANES
Authors: Keadle Sarah Kozey , Bluethmann Shirley , Matthews Charles E. , Graubard Barry I. , Perna Frank M.
Published: April 2017

Background:

This paper tested whether a physical activity index (PAI) that integrates PA-related behaviors (ie, moderate-to-vigorous physical activity [MVPA] and TV viewing) and performance measures (ie, cardiorespiratory fitness and muscle strength) improves prediction of health status.

Methods:

Participants were a nationally representative sample of US adults from 2011 to 2012 NHANES. Dependent variables (self-reported health status, multimorbidity, functional limitations, and metabolic syndrome) were dichotomized. Wald-F tests tested whether the model with all PAI components had statistically significantly higher area under the curve (AUC) values than the models with behavior or performance scores alone, adjusting for covariates and complex survey design.

Results:

The AUC (95% CI) for PAI in relation to health status was 0.72 (0.68, 0.76), and PAI-AUC for multimorbidity was 0.72 (0.69, 0.75), which were significantly higher than the behavior or performance scores alone. For functional limitations, the PAI AUC was 0.71 (0.67, 0.74), significantly higher than performance, but not behavior scores, while the PAI AUC for metabolic syndrome was 0.69 (0.66, 0.73), higher than behavior but not performance scores.

Conclusions:

These results provide empirical support that an integrated PAI may improve prediction of health and disease. Future research should examine the clinical utility of a PAI and verify these findings in prospective studies.
Active Travel Behavior in a Border Region of Texas and New Mexico: Motivators, Deterrents, and Characteristics
Authors: Sener Ipek N. , Lee Richard J.
Published: April 2017

Background:

Active travel has been linked with improved transportation and health outcomes, such as reduced traffic congestion and air pollution, improved mobility, accessibility, and equity, and increased physical and mental health. The purpose of this study was to better understand active travel characteristics, motivators, and deterrents in the El Paso, TX, region.

Methods:

A multimodal transportation survey brought together elements of transportation and health, with a focus on attitudinal characteristics. The analysis consisted of an initial descriptive analysis, spatial analysis, and multivariate binary and ordered-response models of walking and bicycling behavior.

Results:

The motivators and deterrents of active travel differed for walkers, bicyclists, and noncyclists interested in bicycling. The link between active travel and life satisfaction was moderated by age, with a negative association for older travelers. This effect was stronger for bicycling than it was for walking.

Conclusions:

Based on the findings, several interventions to encourage walking and bicycling were suggested. These included infrastructure and built environment enhancements, workplace programs, and interventions targeting specific subpopulations.
Clinical chemoproteomics—Opportunities and obstacles
Authors: Jones Lyn H. , Neubert Hendrik
Published: April 2017

The prospects for applying chemoproteomics in the clinical setting are discussed.
Tolerant, Growing Cells from Nutrient Shifts Are Not Persister Cells
Authors: Kim Jun-Seob , Wood Thomas K.
Published: April 2017

There is much controversy about the metabolic state of cells that are tolerant to antibiotics, known as persister cells. In this opinion piece, we offer an explanation for the discrepancy seen: some laboratories are studying metabolically active and growing cell populations (e.g., as a result of nutrient shifts) and attributing the phenotypes that they discern to persister cells while other labs are studying dormant cells. We argue here that the metabolically active cell population should more accurately be considered tolerant cells, while the dormant cells are the true persister population.
SAR202 Genomes from the Dark Ocean Predict Pathways for the Oxidation of Recalcitrant Dissolved Organic Matter
Authors: Landry Zachary , Swan Brandon K. , Herndl Gerhard J. , Stepanauskas Ramunas , Giovannoni Stephen J.
Published: April 2017

Deep-ocean regions beyond the reach of sunlight contain an estimated 615 Pg of dissolved organic matter (DOM), much of which persists for thousands of years. It is thought that bacteria oxidize DOM until it is too dilute or refractory to support microbial activity. We analyzed five single-amplified genomes (SAGs) from the abundant SAR202 clade of dark-ocean bacterioplankton and found they encode multiple families of paralogous enzymes involved in carbon catabolism, including several families of oxidative enzymes that we hypothesize participate in the degradation of cyclic alkanes. The five partial genomes encoded 152 flavin mononucleotide/F420-dependent monooxygenases (FMNOs), many of which are predicted to be type II Baeyer-Villiger monooxygenases (BVMOs) that catalyze oxygen insertion into semilabile alicyclic alkanes. The large number of oxidative enzymes, as well as other families of enzymes that appear to play complementary roles in catabolic pathways, suggests that SAR202 might catalyze final steps in the biological oxidation of relatively recalcitrant organic compounds to refractory compounds that persist.

IMPORTANCE
Carbon in the ocean is massively sequestered in a complex mixture of biologically refractory molecules that accumulate as the chemical end member of biological oxidation and diagenetic change. However, few details are known about the biochemical machinery of carbon sequestration in the deep ocean. Reconstruction of the metabolism of a deep-ocean microbial clade, SAR202, led to postulation of new biochemical pathways that may be the penultimate stages of DOM oxidation to refractory forms that persist. These pathways are tied to a proliferation of oxidative enzymes. This research illuminates dark-ocean biochemistry that is broadly consequential for reconstructing the global carbon cycle.