bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment delays for patients with new‐onset rheumatoid arthritis presenting to an Australian early arthritis clinic
Authors: Ison Matthew , Duggan Emily , Mehdi Ahmed , Thomas Ranjeny , Benham Helen
Published: May 2018

Background

Early treatment ensures optimal outcomes in rheumatoid arthritis (RA) yet there are limited data in Australia quantifying treatment delays in clinical practice.

Aims

To quantify treatment delays in new RA patients and to explore factors influencing delay and resultant patient outcomes.

Methods

Data were obtained for 88 patients presenting with a new diagnosis of RA to an early arthritis clinic (EAC) in Australia between 2008 and 2015. Date and details of symptom onset, initial general practitioner (GP) presentation, GP referral and review at EAC were collected. Patient demographics and clinical features were analysed for outcomes and features predictive of delay.

Results

Median overall delay from symptom onset to rheumatology review was 26.4 weeks. Patient delay (8.7 weeks) was the longest delay and predicted overall delay. Delays in GP referral and time to EAC review were 4 and 8.4 weeks respectively. Increased overall delay was predicted by lower fatigue and disease activity scores (DAS28) and increased tender joint counts (TJC). Patient delay was increased by socioeconomic disadvantage. Increased GP delay was associated with lower DAS28 and higher TJC and ESR. Patients seen within 16 weeks had greater improvement in DAS28 and probability of remission at 6 months.

Conclusions

In this Australian EAC setting, patient delay was the greatest contributor to RA treatment delay. Delays in treatment were associated with lower disease severity and socioeconomic disadvantage. Remission was more likely after prompt initiation of treatment.
Diabetic foot infection: A critical complication
Authors: Hurlow Jennifer J , Humphreys Gavin J , Bowling Frank L , McBain Andrew J
Published: May 2018

The number of people in the world with diabetes has nearly quadrupled in the past 40 years. Current data show that 25% of these diabetics will develop a foot ulcer in their lifetime and that the cost of care for a diabetic foot ulcer (DFU) is over twice that of any other chronic ulcer aetiology. Microbial biofilm has been linked to both wound chronicity and infection. Close to 1 in 2 diabetics with a DFU are predicted to go on to develop a diabetic foot infection (DFI). The majority of these DFIs have been found to evolve even before the diabetic individual has received an initial referral for expert DFU management. Of these infected DFUs, less than half have been shown to heal over the next year; many of these individuals will require costly hospitalisation, and current data show that far too many DFIs will require extremity amputation to achieve infection resolution. The development of an infection in a DFU is critical at least in part because paradigms of infection prevention and management are evolving. The effectiveness of our current practice standards is being challenged by a growing body of research related to the prevalence and recalcitrance of the microbes in biofilm to topical and systemic antimicrobials. This article will review the magnitude of current challenges related to DFI prevention and management along with what is currently considered to be standard of care. These ideas will be compared and contrasted with what is known about the biofilm phenotype; then, considerations to support progress towards the development of more cost‐effective protocols of care are highlighted.
Overestimation of hours dedicated to family caregiving of persons with heart failure
Authors: Timonet‐Andreu Eva , Canca‐Sanchez José Carlos , Sepulveda‐Sanchez Juana , Ortiz‐Tomé Celia , Rivas‐Ruiz Francisco , Toribio‐Toribio Juan Carlos , Mora‐Banderas Ana , Morales‐Asencio José Miguel
Published: May 2018

Aims

The aim of this study is to profile the family caregivers of people living with heart failure, to determine the perceived and real time devoted to daily care and to identify the factors associated with caregivers’ overestimation of time dedicated to care.

Background

The time spent by family caregivers on daily care is related to overload, but there are differences between real and perceived time spent. The reason for this difference is unknown, as is its impact on the caregiver.

Design

Multicentre, cross‐sectional study.

Methods

This study forms part of a longitudinal, multicentre, ambispective cohort investigation. The study population was composed of 478 patient–family caregiver dyads and the data were collected over 2 years from 2014 ‐ 2016.

Results

The mean time perceived to be spent on daily care was 8.79 hr versus a real value of 4.41 hr. These values were positively correlated. A significant correlation was also found between the overestimation of hours spent and the age of the caregiver, the duration of the caregiving relationship and the number of people providing support and with the patient's level of dependence and self‐care.

Conclusion

The overestimation of time dedicated to care seems to be related to patients’ and caregivers’ characteristics, such as functional status, caregiver burden, age and cohabitation. These patterns should be considered by nurses when carrying out assessment and care planning with these patients and their caregivers.
Prohibitin is a positive modulator of mitochondrial function in PC12 cells under oxidative stress
Authors: Anderson Corey J. , Kahl Anja , Qian Liping , Stepanova Anna , Starkov Anatoly , Manfredi Giovanni , Iadecola Costantino , Zhou Ping
Published: May 2018

Prohibitin (PHB) is a ubiquitously expressed and evolutionarily conserved mitochondrial protein with multiple functions. We have recently shown that PHB up‐regulation offers robust protection against neuronal injury in models of cerebral ischemia in vitro and in vivo, but the mechanism by which PHB affords neuroprotection remains to be elucidated. Here, we manipulated PHB expression in PC12 neural cells to investigate its impact on mitochondrial function and the mechanisms whereby it protects cells exposed to oxidative stress. PHB over‐expression promoted cell survival, whereas PHB down‐regulation diminished cell viability. Functionally, manipulation of PHB levels did not affect basal mitochondrial respiration, but it increased spare respiratory capacity. Moreover, PHB over‐expression preserved mitochondrial respiratory function of cells exposed to oxidative stress. Preserved respiratory capacity in differentiated PHB over‐expressing cells exposed to oxidative stress was associated with an elongated mitochondrial morphology, whereas PHB down‐regulation enhanced fragmentation. Mitochondrial complex I oxidative degradation was attenuated by PHB over‐expression and increased in PHB knockdown cells. Changes in complex I degradation were associated with alterations of respiratory chain supercomplexes. Furthermore, we showed that PHB directly interacts with cardiolipin and that down‐regulation of PHB results in loss of cardiolipin in mitochondria, which may contribute to destabilizing respiratory chain supercomplexes. Taken together, these data demonstrate that PHB modulates mitochondrial integrity and bioenergetics under oxidative stress, and suggest that the protective effect of PHB is mediated by stabilization of the mitochondrial respiratory machinery and its functional capacity, by the regulation of cardiolipin content.

Open Science: This manuscript was awarded with the Open Materials Badge. For more information see: https://cos.io/our-services/open-science-badges/

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Costunolide promotes the proliferation of human hair follicle dermal papilla cells and induces hair growth in C57BL/6 mice
Authors: Kim Young Eun , Choi Hyung Chul , Nam Gaewon , Choi Bu Young
Published: May 2018

Background

Costunolide (COS), a naturally occurring sesquiterpene lactone, is known to exert anti‐inflammatory, antioxidant, and anticancer effects. This study was undertaken to investigate the effects of costunolide on the promotion of hair growth.

Methods

Real‐time cell analyzer (RTCA), measurement of 5α‐reductase activity, mRNA expression, and Western blotting were adopted to address whether COS can stimulate the proliferation of human hair follicle dermal papilla cells (hHFDPCs). The effect of COS on in vivo hair growth was examined by reconstitution assay and shaven dorsal skin in C57BL/6 mice.

Results

Costunolide significantly promoted the proliferation of hHFDPCs, which is comparable to that of tofacitinib. COS also inhibited the 5α‐reductase activity in hHFDPCs. While COS increased the level of β‐catenin and Gli1 mRNA and proteins, it suppressed transforming growth factor (TGF)‐β1–induced phosphorylation of Smad‐1/5 in hHFDPCs. COS increased the number of cultured hHFDPCs to induce hair follicles from mouse epidermal cells in Spheres formation of reconstitution assay. Topical application of COS on the shaven back of C57BL/6 mice significantly improved the hair growth.

Conclusions

Our results illustrate that COS promotes hair growth in vitro and in vivo by regulating the amount of growth factors and/or the activity of cellular responses through coordination of the WNT‐β‐catenin, hedgehog‐Gli, and TGF‐β1–Smad pathways.
Impact of meteorological and geographical factors on the distribution of Phlebotomus chinensis in northwestern mainland China
Authors: Gao X. , Xiao J. H. , Liu B. Y. , Wang H. B.
Published: May 2018

Phlebotomine sandflies (Diptera: Phlebotomidae) are vectors of the zoonotic disease leishmaniasis. To better understand the distribution of phlebotomine sandflies in order to facilitate control of leishmaniasis transmission, the present study explored the impacts of climate and landscape on local abundances of Phlebotomus chinensis in northwestern mainland China. Identification records were used to create a geodatabase for the locations at which P. chinensis had been collected in the region, and a regional‐scale map was developed to show the distribution of P. chinensis. Location data and data on environmental factors during the years in which the samples were collected were incorporated, and a presence‐only modelling method was used to evaluate the species' habitat preferences and to predict its potential distribution in northwestern mainland China. Jackknife analysis revealed that several meteorological variables, including maximum temperature in the warmest quarter, precipitation in the driest month, daily average temperature and daily precipitation, significantly affected the presence of this species. Moreover, the presence of P. chinensis was significantly associated with grassland and shrubland. Probability distributions using maximum entropy were used to map the distribution ranges of P. chinensis based on suitable habitats in northwestern mainland China. The models generated can be used to develop detailed strategies for the prevention and control of leishmaniasis.
Minority politics and the social construction of hierarchy: the case of the Druze community
Authors: Halabi Yakub
Published: May 2018

This article examines the behaviour of a minority as a political unit and its endeavours to construct an informal state‐like hierarchy. The article examines the history of the Druze minority during the major crises of 1830s and 1860 Lebanon, 1925 Syrian Great Uprising, 1936–1939 Palestinian Great Revolt and the 1948 Zionist–Arab War. The article explores how inter‐subjectivity among Druze individuals around principles such as ‘preserving of brotherhood’, their imagination of themselves of belonging to a large community and the inter‐subjectivity around the prominence of certain clans, notables and religious clergies allowed the minority to behave as a community and create its own informal hierarchy within the loose hierarchy of their own state. The hierarchy that was established was based upon elements of inter‐subjectivity that include communal solidarity, faith‐based binding foundations, the seniority of certain clan leaders and the prominence of certain clergies, where the clan leaders and clergies were authorized to settle daily disputes and in steering the foreign affairs of the minority.
Legume nodulation: The host controls the party
Authors: Ferguson Brett J. , Mens Céline , Hastwell April H. , Zhang Mengbai , Su Huanan , Jones Candice H. , Chu Xitong , Gresshoff Peter M.
Published: May 2018

Global demand to increase food production and simultaneously reduce synthetic nitrogen fertilizer inputs in agriculture are underpinning the need to intensify the use of legume crops. The symbiotic relationship that legume plants establish with nitrogen‐fixing rhizobia bacteria is central to their advantage. This plant–microbe interaction results in newly developed root organs, called nodules, where the rhizobia convert atmospheric nitrogen gas into forms of nitrogen the plant can use. However, the process of developing and maintaining nodules is resource intensive; hence, the plant tightly controls the number of nodules forming. A variety of molecular mechanisms are used to regulate nodule numbers under both favourable and stressful growing conditions, enabling the plant to conserve resources and optimize development in response to a range of circumstances. Using genetic and genomic approaches, many components acting in the regulation of nodulation have now been identified. Discovering and functionally characterizing these components can provide genetic targets and polymorphic markers that aid in the selection of superior legume cultivars and rhizobia strains that benefit agricultural sustainability and food security. This review addresses recent findings in nodulation control, presents detailed models of the molecular mechanisms driving these processes, and identifies gaps in these processes that are not yet fully explained.
Single cell‐type analysis of cellular lipid remodelling in response to salinity in the epidermal bladder cells of the model halophyte Mesembryanthemum crystallinum
Authors: Barkla Bronwyn J. , Garibay‐Hernández Adriana , Melzer Michael , Rupasinghe Thusitha W.T. , Roessner Ute
Published: May 2018

Salt stress causes dramatic changes in the organization and dynamic properties of membranes, however, little is known about the underlying mechanisms involved. Modified trichomes, known as epidermal bladder cells (EBC), on the leaves and stems of the halophyte Mesembryanthemum crystallinum can be successfully exploited as a single‐cell‐type system to investigate salt‐induced changes to cellular lipid composition. In this study, alterations in key molecular species from different lipid classes highlighted an increase in phospholipid species, particularly those from phosphatidylcholine and phosphatidic acid (PA), where the latter is central to the synthesis of membrane lipids. Triacylglycerol (TG) species decreased during salinity, while there was little change in plastidic galactolipids. EBC transcriptomic and proteomic data mining revealed changes in genes and proteins involved in lipid metabolism and the upregulation of transcripts for PIPKIB, PI5PII, PIPKIII, and phospholipase D delta suggested the induction of signalling processes mediated by phosphoinositides and PA. TEM and flow cytometry showed the dynamic nature of lipid droplets in these cells under salt stress. Altogether, this work indicates that the metabolism of TG might play an important role in EBC response to salinity as either an energy reserve for sodium accumulation and/or driving membrane biosynthesis for EBC expansion.
Characteristics of oxygenated hemoglobin concentration change during pleasant and unpleasant image‐recall tasks in patients with depression: Comparison with healthy subjects
Authors: Kondo Akihiko , Shoji Yoshihisa , Morita Kiichiro , Sato Mamoru , Ishii Youhei , Yanagimoto Hiroko , Nakano Shinya , Uchimura Naohisa
Published: May 2018

Aim

Patients with major depressive disorder (MDD) have been reported to show cognitive impairment in attention, cognition control, and motivation. The prefrontal cortex plays an important role in the pathophysiology of depression. Neurophysiological abnormalities have been examined in MDD patients by several neuroimaging studies. However, the underlying neural mechanism is still unclear. We evaluated brain function during pleasant and unpleasant image‐recall tasks using multichannel near‐infrared spectroscopy (NIRS) in MDD patients.

Methods

The subjects were 25 MDD patients and 25 age‐ and sex‐matched healthy controls. Patients were classified according to DSM‐IV‐TR criteria. We measured the oxygenated hemoglobin concentration change (δoxyHb) in the forehead and temporal lobe during image‐recall task with pleasant (e.g., puppy) and unpleasant (e.g., snake) images using NIRS. To check whether all subjects understood the task, they were asked to draw pictures of both image tasks after NIRS measurement.

Results

The δoxyHb in the healthy group was significantly higher than that in the MDD group in the bilateral frontal region during the unpleasant condition. A significant negative correlation between the Hamilton Rating Scale for Depression score and δoxyHb was observed in the left frontal region during the unpleasant condition.

Conclusion

We suggest that image‐recall tasks related to emotion measured by NIRS might be a visually useful psychophysiological marker to understand the decrease in the frontal lobe function in MDD patients. In particular, we suggest that the decrease in δoxyHb in the left frontal lobe is related to the severity of depression.
Documentary analysis as an assessment tool
Authors: Lawson Lauren V.
Published: May 2018

Background

Documentary analysis of existing information, such as newspaper articles, is an identified method for use in an assessment to provide a descriptive explanation of existing problems or assets. The intention of this case study is to explore the effectiveness of documentary analysis of newspaper articles as a tool to inform an assessment of factors influencing the implementation of a medical respite for the homeless. Two questions framed the assessment; (a) What was occurring or might occur that will affect the development of a medical respite; and (b) What opportunities or threats are generated as a result?

Methods

Articles from two local newspapers identified themes related to the three external forces of change that impact medical respites; (a) funding; (b) community resistance; and (c) the health care system.

Results

Three themes emerged: a) uncertain funding; b) neighborhood resistance, and c) improved access to healthcare would result from the Affordable Care Act.

Conclusion

Use of documentary analysis of newspaper articles provided applicable content for the assessment. Themes from the assessment informed strategic planning, such as addressing potential neighborhood resistance.
Vitrification of ovarian tissue of Brazilian North‐eastern donkeys (Equus asinus) using different cryoprotectants
Authors: Lopes Kátia Regina F. , Praxedes Erica Camila G. , Campos Livia B. , Bezerra Marcelo B. , Lima Gabriela L. , Saraiva Márcia Viviane A. , Silva Alexandre R.
Published: May 2018

Contents

The aim of this study was to assess a vitrification protocol for asinine ovarian tissue, to preserve preantral follicles using different cryoprotectant solutions, composed of various concentrations (EG 3 M or 6 M) of dimethyl sulfoxide or ethylene glycol isolate, or as a combination (DMSO 3 M + EG 3 M). Ten pairs of ovaries from Brazilian north‐eastern breed jennies were obtained through videolaparoscopy, and cortical fragments were submitted to a solid‐surface vitrification (SSV) using each cryoprotectant solution. The ovarian tissue was evaluated for follicular morphology and viability, DNA integrity (TUNEL technique) and the presence of nucleolar organizing regions in granulosa cells (AgNOR technique). After thawing, the percentage of normal preantral follicles was significantly reduced in the vitrified ovarian tissue fragments compared to the fresh control (p < 0.05). When comparing treatments, the use of DMSO 3 M (81.7 ± 37.5%), EG 3 M (83.7 ± 27.4%) and the combination of both DMSO 3 M + EG 3 M (81.8 ± 46.8%) allowed a greater percentage of follicular survival in contrast to DMSO 6 M (69.8 ± 16.5%) and EG 6 M (72.3 ± 18.0%; p < 0.05). When vitrified using the DMSO + EG combination, a higher percentage (62.5 ± 29.1%) of viable follicles (trypan blue) was observed in relation to the other vitrification treatments (p < 0.05). The TUNEL technique identified that all treatments tested showed DNA fragmentation in the follicular cells, except in the case of the DMSO 3 M + EG 3 M treatment. When evaluating the presence of NORs, no significant differences were observed in the amount of NORs between the fresh and vitrified groups using DMSO 3 M + EG 3 M (p > 0.05). We concluded that the combination DMSO 3 M + EG was more efficient for the vitrification of ovarian tissue taken from Equus asinus, allowing adequate preservation of PAFs morphology, viability, DNA integrity and cell proliferative capacity.
Bad News Has Wings: Dread Risk Mediates Social Amplification in Risk Communication
Authors: Jagiello Robert D. , Hills Thomas T.
Published: May 2018

Social diffusion of information amplifies risk through processes of birth, death, and distortion of message content. Dread risk—involving uncontrollable, fatal, involuntary, and catastrophic outcomes (e.g., terrorist attacks and nuclear accidents)—may be particularly susceptible to amplification because of the psychological biases inherent in dread risk avoidance. To test this, initially balanced information about high or low dread topics was given to a set of individuals who then communicated this information through diffusion chains, each person passing a message to the next. A subset of these chains were also reexposed to the original information. We measured prior knowledge, perceived risk before and after transmission, and, at each link, number of positive and negative statements. Results showed that the more a message was transmitted the more negative statements it contained. This was highest for the high dread topic. Increased perceived risk and production of negative messages was closely related to the amount of negative information that was received, with domain knowledge mitigating this effect. Reexposure to the initial information was ineffectual in reducing bias, demonstrating the enhanced danger of socially transmitted information.
Assessment and misassessment of potassium, phosphorus, and protein in the hemodialysis diet
Authors: St‐Jules David E. , Goldfarb David S. , Pompeii Mary Lou , Liebman Scott E. , Sherman Richard A.
Published: May 2018

Diet is a key determinant of several common and serious disease complications in hemodialysis (HD) patients. The recommended balance and variety of foods in the HD diet is designed to limit high potassium and phosphorus foods while maintaining protein adequacy. In this report, we examine the potassium, phosphorus, and protein content of foods, and identify critical challenges, and potential pitfalls when translating nutrient prescriptions into dietary guidelines. Our findings highlight the importance of individualized counseling based on a comprehensive dietary assessment by trained diet professionals, namely renal dietitians, for managing diet‐related complications in HD patients.
Acid‐base homeostasis during hemodialysis: New insights into the mystery of bicarbonate disappearance during treatment
Authors: Sargent John A. , Marano Marco , Marano Stefano , Gennari F. John
Published: May 2018

In patients receiving hemodialysis, it has long been recognized that much more bicarbonate is delivered during treatment than ultimately appears in the blood. To gain insight into this mystery, we developed a model that allows a quantitative analysis of the patient's response to rapid alkalinization during hemodialysis. Our model is unique in that it is based on the distribution of bicarbonate in the extracellular fluid and assesses its removal from this compartment by mobilization of protons (H+) from buffers and other sources. The model was used to analyze the pattern of rise in blood bicarbonate concentration ([HCO3−]), calculated from measurements of pH and PCO2, in patients receiving standard bicarbonate hemodialysis. Model analysis demonstrated two striking findings: (1) 35% of the bicarbonate added during hemodialysis was due to influx and metabolism of acetate, despite its low concentration in the bath solution, because of the rapidly collapsing gradient for bicarbonate influx. (2) Almost 90% of the bicarbonate delivered to the patients was neutralized by H+ generation. Virtually all the new H+ came from intracellular sources and included both buffering and organic acid production. The small amount of added bicarbonate retained in the extracellular fluid increased blood [HCO3−], on average, by 6 mEq/L in our patients. Almost all this rise occurred during the first 2 hours. Thereafter, blood [HCO3−] changed minimally and always remained less than bath [HCO3−]. This lack of equilibrium was due to the continued production of organic acid. Release of H+ from buffers is a reversible physiological response, restoring body alkali stores. By contrast, organic acid production is an irreversible process during hemodialysis and is metabolically inefficient and potentially catabolic. Our analysis underscores the need to develop new approaches for alkali repletion during hemodialysis that minimize organic acid production.
Effects of tillage and liming on macropore networks derived from X‐ray tomography images of a silty clay soil
Authors: Hellner Q. , Koestel J. , Ulén B. , Larsbo M.
Published: May 2018

Soil structure influences water infiltration, aeration and root growth and, thereby, also the conditions for sustainable crop production. Our objective was to quantify the effects of different soil management methods and land uses on the topsoil structure of a silty clay soil. We sampled 32 intact soil columns (18 cm high, 12.7 cm diameter) from an experimental silty clay field with four treatments: conventional tillage (CT), conventional tillage followed by liming (CTL), reduced tillage (RT) and unfertilized fallow (UF). The columns were analysed using 3‐D X‐ray tomography. The samples were taken in autumn after harvest, 7 yr after quick lime was applied to the CTL plots. Despite a relatively large number of replicates per treatment (8, 8, 8 and 6 (two UF samples were excluded), respectively), there were no significant differences between any of the investigated macropore network properties related to tilled treatments. The UF treatment, in contrast, exhibited more vertically oriented macropores, which were also better connected compared to the other treatments. This confirms previous findings that tillage may disrupt the vertical continuity of macropore clusters. The impact of liming on soil pore network properties may have been limited to pores smaller than the resolution in our X‐ray images. It is also possible that the effects of lime on soil structure were limited to a few years which means that any effect would have diminished by the time of this study. These matters should be further investigated in follow‐up studies to understand better the potential of lime amendments to clay soil.
Assessment of risk for transplant‐transmissible infectious encephalitis among deceased organ donors
Authors: Smalley Hannah K. , Anand Nishi , Buczek Dylan , Buczek Nicholas , Lin Timothy , Rajore Tanay , Wacker Muriel , Basavaraju Sridhar V. , Gurbaxani Brian M. , Hammett Teresa , Keskinocak Pinar , Sokol Joel , Kuehnert Matthew J.
Published: May 2018

Background

There were 13 documented clusters of infectious encephalitis transmission via organ transplant from deceased donors to recipients during 2002‐2013. Hence, organs from donors diagnosed with encephalitis are often declined because of concerns about the possibility of infection, given that there is no quick and simple test to detect causes of infectious encephalitis.

Methods

We constructed a database containing cases of infectious and non‐infectious encephalitis. Using statistical imputation, cross‐validation, and regression techniques, we determined deceased organ donor characteristics, including demographics, signs, symptoms, physical exam, and laboratory findings, predictive of infectious vs non‐infectious encephalitis, and developed a calculator which assesses the risk of infection.

Results

Using up to 12 predictive patient characteristics (with a minimum of 3, depending on what information is available), the calculator provides the probability that a donor may have infectious vs non‐infectious encephalitis, improving the prediction accuracy over current practices. These characteristics include gender, fever, immunocompromised state (other than HIV), cerebrospinal fluid elevation, altered mental status, psychiatric features, cranial nerve abnormality, meningeal signs, focal motor weakness, Babinski's sign, movement disorder, and sensory abnormalities.

Conclusion

In the absence of definitive diagnostic testing in a potential organ donor, infectious encephalitis can be predicted with a risk score. The risk calculator presented in this paper represents a prototype, establishing a framework that can be expanded to other infectious diseases transmissible through solid organ transplantation.
Early viral‐specific T‐cell testing predicts late cytomegalovirus reactivation following liver transplantation
Authors: Sood S. , Haifer C. , Yu L. , Pavlovic J. , Gow P.J. , Jones R.M. , Visvanathan K. , Angus P.W. , Testro A.G.
Published: May 2018

Introduction

Although antiviral prophylaxis is effective in preventing early cytomegalovirus (CMV) reactivation following liver transplantation (OLT), it predisposes patients to late CMV after prophylaxis has ceased. QuantiFERON–CMV (QFN‐CMV, Qiagen, The Netherlands) measures an individual's viral‐specific immune response.

Methods

Fifty‐nine OLT recipients were prospectively monitored post‐OLT in an observational cohort study. QFN‐CMV was performed at regular time‐points. An absolute QFN‐CMV <0.1 IU/mL was considered non‐reactive.

Results

50/59 (84.7%) had a reactive QFN‐CMV by M6. 38/59 (64.4%) had antiviral prophylaxis or treatment before M6, with 31/38 (81.6%) developing a reactive QFN‐CMV by 6 months. Over 90% already had a reactive result as early as 3 months post transplant, 3 patients (5.08%) developed late CMV between 6‐12 months (median 251 days)—all had a non‐reactive M6 QFN‐CMV. And 2/3 experienced CMV disease. Non‐reactive M6 QFN‐CMV was significantly associated with late CMV (OR = 54.4, PPV = 0.33, NPV = 1.00, P = .003).

Conclusion

Although only 5% of recipients developed late CMV, 2/3 suffered CMV disease. M6 QFN‐CMV has an excellent NPV for late CMV, suggesting patients who exhibit a robust ex vivo immune response at M6 can safely cease CMV monitoring. Furthermore, >90% already express viral‐specific immunity as early as 3 months. Conceivably, antiviral prophylaxis could be discontinued early in these patients.
Access to medicines for asthma, diabetes and hypertension in eight counties of Kenya
Authors: Wirtz Veronika J. , Turpin Kristen , Laing Richard O. , Mukiira Carol K. , Rockers Peter C.
Published: May 2018

Objective

To assess access to noncommunicable diseases (NCD) medicines in Kenya for patients diagnosed and prescribed treatment for asthma, diabetes and hypertension.

Methods

Households in eight purposively chosen counties were randomly selected. To be eligible, a household needed to have at least one member aged 18 years or older who had been previously diagnosed and prescribed medicines for one of the following NCDs: asthma, diabetes or hypertension. Using a logistic regression model, we explored the relationship between patient characteristics and the probability that patients had the medicines available at the time of the survey visit.

Results

A total of 627 individuals were included in the analysis. The highest percentage of medicines availability was in households with diabetes patients (83.1%), followed by hypertension (77.1%) patients. The lowest availability of medicines was found in households with asthma patients (53.1%). The median household expenditure on medicines per month was US$7.00 for households with diabetes patients; it was US$4.00 for asthma. In general, strong predictors of having medicines at home was being older, having some education compared to no education, few household members, wealth, being diagnosed at private nonprofit facilities and having only one patient with NCDs in the household.

Conclusions

Our study found that nearly three‐quarters of patients diagnosed and prescribed a medicine for hypertension, asthma or diabetes had the medicine available at home. Access challenges remain, in particular for patients from low‐income households and for those diagnosed with asthma.
Dynamic lateral organization of opioid receptors (kappa, muwt and muN40D) in the plasma membrane at the nanoscale level
Authors: Rogacki Maciej K. , Golfetto Ottavia , Tobin Steven J. , Li Tianyi , Biswas Sunetra , Jorand Raphael , Zhang Huiying , Radoi Vlad , Ming Yu , Svenningsson Per , Ganjali Daniel , Wakefield Devin L. , Sideris Athanasios , Small Alexander R. , Terenius Lars , Jovanović‐Talisman Tijana , Vukojević Vladana
Published: May 2018

Opioid receptors are important pharmacological targets for the management of numerous medical conditions (eg, severe pain), but they are also the gateway to the development of deleterious side effects (eg, opiate addiction). Opioid receptor signaling cascades are well characterized. However, quantitative information regarding their lateral dynamics and nanoscale organization in the plasma membrane remains limited. Since these dynamic properties are important determinants of receptor function, it is crucial to define them. Herein, the nanoscale lateral dynamics and spatial organization of kappa opioid receptor (KOP), wild type mu opioid receptor (MOPwt), and its naturally occurring isoform (MOPN40D) were quantitatively characterized using fluorescence correlation spectroscopy and photoactivated localization microscopy. Obtained results, supported by ensemble‐averaged Monte Carlo simulations, indicate that these opioid receptors dynamically partition into different domains. In particular, significant exclusion from GM1 ganglioside‐enriched domains and partial association with cholesterol‐enriched domains was observed. Nanodomain size, receptor population density and the fraction of receptors residing outside of nanodomains were receptor‐specific. KOP‐containing domains were the largest and most densely populated, with the smallest fraction of molecules residing outside of nanodomains. The opposite was true for MOPN40D. Moreover, cholesterol depletion dynamically regulated the partitioning of KOP and MOPwt, whereas this effect was not observed for MOPN40D.
The independent effects of hypovolaemia and pulmonary vasoconstriction on ventricular function and exercise capacity during acclimatisation to 3800 m
Authors: Stembridge Mike , Ainslie Philip N. , Boulet Lindsey M. , Anholm James , Subedi Prajan , Tymko Michael M. , Willie Christopher K. , Cooper Stephen‐Mark , Shave Rob
Published: May 2018

Key points

We sought to determine the isolated and combined influence of hypovolaemia and hypoxic pulmonary vasoconstriction on the decrease in left ventricular (LV) function and maximal exercise capacity observed under hypobaric hypoxia.

We performed echocardiography and maximal exercise tests at sea level (344 m), and following 5–10 days at the Barcroft Laboratory (3800 m; White Mountain, California) with and without (i) plasma volume expansion to sea level values and (ii) administration of the pulmonary vasodilatator sildenafil in a double‐blinded and placebo‐controlled trial.

The high altitude‐induced reduction in LV filling and ejection was abolished by plasma volume expansion but to a lesser extent by sildenafil administration; however, neither intervention had a positive effect on maximal exercise capacity.

Both hypovolaemia and hypoxic pulmonary vasoconstriction play a role in the reduction of LV filling at 3800 m, but the increase in LV filling does not influence exercise capacity at this moderate altitude.

We aimed to determine the isolated and combined contribution of hypovolaemia and hypoxic pulmonary vasoconstriction in limiting left ventricular (LV) function and exercise capacity under chronic hypoxaemia at high altitude. In a double‐blinded, randomised and placebo‐controlled design, 12 healthy participants underwent echocardiography at rest and during submaximal exercise before completing a maximal test to exhaustion at sea level (SL; 344 m) and after 5–10 days at 3800 m. Plasma volume was normalised to SL values, and hypoxic pulmonary vasoconstriction was reversed by administration of sildenafil (50 mg) to create four unique experimental conditions that were compared with SL values: high altitude (HA), Plasma Volume Expansion (HA‐PVX), Sildenafil (HA‐SIL) and Plasma Volume Expansion with Sildenafil (HA‐PVX‐SIL). High altitude exposure reduced plasma volume by 11% (P < 0.01) and increased pulmonary artery systolic pressure (19.6 ± 4.3 vs. 26.0 ± 5.4, P < 0.001); these differences were abolished by PVX and SIL respectively. LV end‐diastolic volume (EDV) and stroke volume (SV) were decreased upon ascent to high altitude, but were comparable to sea level in the HA‐PVX trial. LV EDV and SV were also elevated in the HA‐SIL and HA‐PVX‐SIL trials compared to HA, but to a lesser extent. Neither PVX nor SIL had a significant effect on the LV EDV and SV response to exercise, or the maximal oxygen consumption or peak power output. In summary, at 3800 m both hypovolaemia and hypoxic pulmonary vasoconstriction contribute to the decrease in LV filling, but restoring LV filling does not confer an improvement in maximal exercise performance.
Integrated calculation method of acoustic radiation and propagation for floating bodies in shallow water
Authors: Jiang Lingwen , Zou Mingsong , Huang He , Feng Xuelei
Published: May 2018

Based on the three-dimensional sono-elasticity theory for ship structures, the Green's function is incorporated and an integrated calculation method of acoustic radiation and propagation for floating bodies in shallow water considering the sound velocity profile is proposed. The near-field and arbitrary far-field acoustic radiation problem can be efficiently calculated. A numerical example of a rigid sphere is given and the results are compared with the finite element method solution to validate the reliability and demonstrate improvements in efficiency. The method is applied to an elastic capsular shell, verifying the applicability of the method for any elastic floating bodies.
Divergent Performance Outcomes Following Resistance Training Using Repetition Maximums or Relative Intensity
Authors: Carroll Kevin M. , Bernards Jake R. , Bazyler Caleb D. , Taber Christopher B. , Stuart Charles A. , DeWeese Brad H. , Sato Kimitake , Stone Michael H.
Published: May 2018

Purpose: To compare repetition maximum (RM) to relative intensity using sets and repetitions (RISR) resistance training on measures of training load, vertical jump, and force production in well-trained lifters. Methods: Fifteen well-trained (isometric peak force = 4403.61 [664.69] N, mean [SD]) males underwent resistance training 3 d/wk for 10 wk in either an RM group (n = 8) or RISR group (n = 7). Weeks 8 to 10 consisted of a tapering period for both groups. The RM group achieved a relative maximum each day, whereas the RISR group trained based on percentages. Testing at 5 time points included unweighted (<1 kg) and 20-kg squat jumps, countermovement jumps, and isometric midthigh pulls. Mixed-design analyses of variance and effect size using Hedge’s g were used to assess within- and between-groups alterations. Results: Moderate between-groups effect sizes were observed for all squat-jump and countermovement-jump conditions supporting the RISR group (g = 0.76–1.07). A small between-groups effect size supported RISR for allometrically scaled isometric peak force (g = 0.20). Large and moderate between-groups effect sizes supported RISR for rate of force development from 0 to 50 ms (g = 1.25) and 0 to 100 ms (g = 0.89). Weekly volume load displacement was not different between groups (P > .05); however, training strain was statistically greater in the RM group (P < .05). Conclusions: Overall, this study demonstrated that RISR training yielded greater improvements in vertical jump, rate of force development, and maximal strength compared with RM training, which may be explained partly by differences in the imposed training stress and the use of failure/nonfailure training in a well-trained population.
Fortune Favors the Brave: Tactical Behaviors in the Middle-Distance Running Events at the 2017 IAAF World Championships
Authors: Casado Arturo , Renfree Andrew
Published: May 2018

Purpose: To assess tactical and performance factors associated with progression from qualification rounds in the 800-m and 1500-m running events at the 2017 International Association of Athletics Federations World Championships. Methods: Official results were used to access final and intermediate positions and times, as well as performance characteristics of competitors. Shared variance between intermediate positions and rank order lap times with finishing positions were calculated, along with probability of automatic qualification, for athletes in each available race position at the end of every 400-m lap. Differences in race positions and lap times relative to season’s best performances were assessed between automatic qualifiers, fastest losers, and nonqualifiers. Results: Race positions at the end of each 400-m lap remained more stable through 800-m races than 1500-m races. Probability of automatic qualification decreased with both race position and rank order lap times on each lap, although rank order lap times accounted for a higher degree of shared variance than did intermediate position. In the 1500-m event, fastest losers ran at a higher percentage of season’s best speed and adopted positions closer to the race lead in the early stages. This was not the case in the 800-m. Conclusions: Intermediate positioning and the ability to produce a fast final race segment are strongly related to advancement from qualification rounds in middle-distance running events. The adoption of a more “risky” strategy characterized by higher speeds relative to season’s best may be associated with an increased likelihood of qualification as fastest losers in the 1500-m event.
Improvement of Flutter-Kick Performance in Novice Surface Combat Swimmers With Increased Hip Strength
Authors: Beethe Anne Z. , Nagle Elizabeth F. , Lovalekar Mita , Nagai Takashi , Nindl Bradley C. , Connaboy Christopher
Published: May 2018

Purpose: To examine strength, range of motion, anthropometric, and physiological contributions to novice surface-combat-swimming (sCS) performance and establish differences from freestyle-swimming (FS) performance to further understand the transition of FS to sCS performance. Methods: A total of 13 competitive swimmers (7 male and 6 female; 27.7 [2.3] y; 176.2 [2.6] cm; 75.4 [3.9] kg) completed 8 testing sessions consisting of the following: physiological land-based measurements for maximal anaerobic and aerobic capacity and upper- and lower-extremity strength and range of motion, an sCS anaerobic capacity swim test measuring peak and mean force and fatigue index, 2 aerobic capacity tests measuring maximal aerobic capacity for both FS and sCS, and four 500-m performance swims for time, 1 FS, and 3 sCS. Separate multiple linear-regression analysis was used to analyze predictors of both sCS and FS performance models. Results: FS performance was predicted by the final FS maximal oxygen uptake with an R2 of 42.03% (F1,10 = 7.25; P = .0226), whereas sCS performance was predicted by isometric hip-extension peak strength with an R2 of 41.46% (F1,11 = 7.79; P = .0176). Conclusions: Results demonstrate that different physiological characteristics predict performance, suggesting that an altered strategy is used for novice sCS than FS. It is suggested that this may be due to the added constraints as mandated by mission requirements including boots, weighted gear, and clandestine requirements with hips lowered beneath the surface. Further research should examine the kinematics of the sCS flutter kick to improve performance by developing training strategies specific for the task.
OpenSim Versus Human Body Model: A Comparison Study for the Lower Limbs During Gait
Authors: Falisse Antoine , Van Rossom Sam , Gijsbers Johannes , Steenbrink Frans , van Basten Ben J.H. , Jonkers Ilse , van den Bogert Antonie J. , De Groote Friedl
Published: May 2018

Musculoskeletal modeling and simulations have become popular tools for analyzing human movements. However, end users are often not aware of underlying modeling and computational assumptions. This study investigates how these assumptions affect biomechanical gait analysis outcomes performed with Human Body Model and the OpenSim gait2392 model. The authors compared joint kinematics, kinetics, and muscle forces resulting from processing data from 7 healthy adults with both models. Although outcome variables had similar patterns, there were statistically significant differences in joint kinematics (maximal difference: 9.8° [1.5°] in sagittal plane hip rotation), kinetics (maximal difference: 0.36 [0.10] N·m/kg in sagittal plane hip moment), and muscle forces (maximal difference: 8.51 [1.80] N/kg for psoas). These differences might be explained by differences in hip and knee joint center locations up to 2.4 (0.5) and 1.9 (0.2) cm in the posteroanterior and inferosuperior directions, respectively, and by the offset in pelvic reference frames of about 10° around the mediolateral axis. The choice of model may not influence the conclusions in clinical settings, where the focus is on interpreting deviations from the reference data, but it will affect the conclusions of mechanical analyses in which the goal is to obtain accurate estimates of kinematics and loading.
Decision Making Influences Tibial Impact Accelerations During Lateral Cutting
Authors: Lucas Logan A. , England Benjamin S. , Mason Travis W. , Lanning Christopher R. , Miller Taylor M. , Morgan Alexander M. , Almonroeder Thomas Gus
Published: May 2018

Lower-extremity musculoskeletal injuries are common in sports such as basketball and soccer. Athletes competing in sports of this nature must maneuver in response to the actions of their teammates, opponents, etc. This limits their ability to preplan movements. The purpose of this study was to compare impact accelerations during preplanned versus unplanned lateral cutting. A total of 30 subjects (15 males and 15 females) performed preplanned and unplanned cuts while the authors analyzed impact accelerations using an accelerometer secured to their tibia. For the preplanned condition, subjects were aware of the movement to perform before initiating a trial. For the unplanned condition, subjects initiated their movement and then reacted to the illumination of one of 3 visual stimuli which dictated whether they would cut, land, or land-and-jump. A mixed-model analysis of variance with a between factor of sex (male and female) and a within factor of condition (preplanned and unplanned) was used to analyze the magnitude and variability of the impact accelerations for the cutting trials. Both males and females demonstrated higher impact accelerations (P = .01) and a trend toward greater intertrial variability (P = .07) for the unplanned cutting trials (vs preplanned cuts). Unplanned cutting may place greater demands on the musculoskeletal system.