bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasma H2S predicts coronary artery lesions in children with Kawasaki disease
Authors: Sun Yan , Yuan Yue , Yan Hui , Wan Hong , Li Xueying , Chen Siyao , Li Hongxia , Tang Chaoshu , Du Junbao , Liu Guiying , Jin Hongfang
Published: March 2015

Background

The aim of this study was to determine whether plasma hydrogen sulfide (H2S) is a biomarker for predicting coronary artery lesions (CAL) in children with Kawasaki disease (KD).

Methods

A prospective study was conducted on 50 KD patients and 27 healthy children. Plasma H2S was analyzed at the acute stage. Plasma H2S was detected using the sensitive electrode method, and receiver operating characteristic curve (ROC) analysis was carried out.

Results

Plasma H2S in KD patients at the acute stage was significantly lower than that of controls. CAL patients had reduced plasma H2S at acute stage compared with the non‐CAL patients. A plasma H2S cut‐off of 31.2 µmol/L provided a sensitivity of 81% and a specificity of 62.5% for predicting coronary injuries in KD. Optimal specificity and sensitivity were obtained when using plasma H2S to predict CAL in KD children.

Conclusion

Plasma H2S level in the acute period is a potentially useful biomarker for predicting CAL in KD children.
Vitamin D receptor gene polymorphisms and type 1 diabetes mellitus in a Korean population
Authors: Cheon Chong‐Kun , Nam Hyo‐Kyoung , Lee Kee‐Hyoung , Kim Su Yung , Song Ji Sun , Kim Choongrak
Published: March 2015

Background

Vitamin D receptor (VDR) has been suggested to play a role in the pathogenesis of type 1 diabetes mellitus (T1DM). There has been no case–control study examining the association between VDR polymorphisms and T1DM among Korean subjects with a low incidence of T1DM.

Methods

Eighty‐one T1DM patients and 113 unrelated healthy controls with no history of DM or other autoimmune diseases were investigated at either Pusan National University Children's Hospital or Korea University Anam Hospital between March 2009 and September 2013. Polymerase chain reaction–restriction fragment length polymorphism was utilized to genotype single nucleotide substitutions at TaqI, BsmI, and ApaI alleles.

Results

All frequencies in T1DM and control subjects were in Hardy–Weinberg equilibrium, although ApaI in controls and TaqI in T1DM showed relatively weak equilibrium. TaqI and BsmI differences were significant (P = 0.045 and P = 0.012, respectively) after applying Bonferroni correction. The TT genotype carrier frequency among controls was higher than among the T1DM patients (P = 0.015; OR, 2.98; 95%CI: 1.19–7.42). T allele frequency was higher among controls than T1DM patients (P = 0.019; OR, 2.78; 95%CI: 1.15–6.72). The frequency of bb genotype carriers among controls was higher than among T1DM patients (P = 0.004; OR, 4.13; 95%CI: 1.4–12.10). The frequency of the b allele among controls was higher than that among T1DM patients (P = 0.016; OR, 3.20; 95%CI: 1.19–8.60).

Conclusions

T and b TaqI and BsmI alleles are protective against T1DM in Korean subjects.
“I know you're kidding”: Relationship closeness enhances positive perceptions of teasing
Authors: GORMAN GLEN , JORDAN CHRISTIAN H.
Published: March 2015

Feeling close in a relationship may enhance perceptions of teasing within that relationship. In Study 1, participants recalled instances of teasing—as both teaser and target—in close and nonclose relationships. Participants perceived teases in close relationships more positively and better intentioned than those in nonclose relationships, as both teaser and target. The discrepancy between teasers and targets in perceptions of intent was also reduced by felt closeness. In Study 2, interaction partner closeness was manipulated and a tease was staged. Teases delivered by a close (vs. nonclose) partner were perceived as more positive and better intentioned. Each study has limitations but their methods complement each other. Together they provide convergent evidence that relationship closeness increases positive perceptions of teasing.
The incidence of autoimmune hemolytic anemia in pediatric hematopoietic stem cell recipients post‐first and post‐second hematopoietic stem cell transplant
Authors: Ahmed Ibrahim , Teruya Jun , Murray‐Krezan Cristina , Krance Robert
Published: March 2015

The reported incidence of post‐allogeneic HSCT AIHA was between 4.4% and 6% following a single transplant. Cord blood transplantation, T‐cell depletion, and chronic GvHD are significantly associated with post‐transplant AIHA. During an 11‐yr period, data for 500 pediatric HSCT recipients were eligible for evaluation of the incidence of AIHA post‐first and post‐second transplants. Demographic, transplant, and post‐transplant‐related variables were analyzed. Twelve of 500 (2.4%) recipients at a median of 273 days and seven of 72 (9.7%) recipients at a median of 157 days developed AIHA post‐first and post‐second HSCT, respectively. Post‐first HSCT, none of the MRD recipients developed AIHA (0/175 MRD vs. 12/325 other donors, p = 0.04). Four of 12 required a second HSCT to control the AIHA. After the second HSCT, MUD was significantly associated with the development of AIHA. No other variables were associated with the post‐second transplant AIHA. The incidence of AIHA post‐first and post‐second HSCT was less than the reported. The increased incidence of AIHA among recipients of second HSCT is most likely due to the profound immune dysregulation. A much larger, prospective study would be needed to evaluate the incidence, complications, and management of post‐transplant AIHA.
Weight Reduction Goal Achievement with High‐Intensity MOVE!® Treatment
Authors: Garvin Jane T.
Published: March 2015

Objective

The purpose of this study was to examine the effect of high‐intensity treatment with the behavioral weight reduction program, MOVE!®, available at Veterans Administration Medical Centers, on achieving at least a 5% weight reduction 6 months after enrolling in the program. MOVE!® is free to veterans but little is known about the recommended number of sessions.

Design and Sample

Using longitudinal clinical data from electronic health records of 216 MOVE!® program participants, weight reduction was examined in this secondary data analysis.

Measures

Based on the 2013 guidelines for overweight and obesity management, weights were evaluated at baseline and 6 months following enrollment in the program, and high‐intensity MOVE!® was determined by attending 14 or more sessions within the first 6 months following enrollment.

Results

High‐intensity MOVE!® participants were five times as likely to achieve at least the 5% weight reduction goal at 6 months compared to those participants with low intensity, while controlling for age, gender, and race (OR = 4.74; CI: 1.3, 17.2; p < .02).

Conclusion

This research supports the 2013 recommendations for high‐intensity lifestyle intervention as participants who completed 14 or more sessions were almost five times more likely to achieve a 5% weight reduction.
The potential long‐term effect of previous schistosome infection reduces the risk of metabolic syndrome among Chinese men
Authors: Shen S.‐W. , Lu Y. , Li F. , Shen Z.‐H. , Xu M. , Yao W.‐F. , Feng Y.‐B. , Yun J.‐T. , Wang Y.‐P. , Ling W. , Qi H.‐J. , Tong D.‐X.
Published: March 2015

The association between potential long‐term effects of previous schistosome infection (PSI) and the development of metabolic syndrome remains unknown. Therefore, we aimed to evaluate the association between them. Participants were from regions which were all reportedly heavily endemic for S. japonicum in China 40 years ago. One thousand five hundred and ninety‐seven men were enrolled. Among these, 465 patients with PSI were selected as study subjects and 1132 subjects served as controls. We found PSI significantly correlated with lower prevalences of metabolic syndrome and its components, including central obesity, hypertriglyceridemia and low high‐density lipoprotein cholesterol, which indicates that the potential long‐term effects of PSI may reduce the risk of metabolic syndrome. However, further studies are needed to investigate the protective immune effects of PSI.
Early Pregnancy Maternal Vitamin D Concentrations and Risk of Gestational Diabetes Mellitus
Authors: Arnold Dodie L. , Enquobahrie Daniel A. , Qiu Chungfang , Huang Jonathan , Grote Nancy , VanderStoep Ann , Williams Michelle A.
Published: March 2015

Background

While associations of vitamin D deficiency with type 2 diabetes have been well demonstrated, investigations of vitamin D and risk of gestational diabetes mellitus (GDM) reported inconsistent findings. We examined associations of vitamin D status with GDM.

Methods

In a nested case‐cohort study (135 GDM cases and 517 non‐GDM controls), we measured maternal serum vitamin D status (total 25[OH]D and 25[OH]D3) in early pregnancy (16 weeks on average) using liquid chromatography‐tandem mass spectroscopy. GDM was diagnosed according to the American Diabetes Association guidelines. We calculated adjusted odds ratios and 95% confidence intervals (CIs) using logistic regression models.

Results

GDM cases had lower mean total 25[OH]D (27.3 vs. 29.3 ng/mL) and 25[OH]D3 (23.9 vs. 26.7 ng/mL) concentrations compared with women who did not develop GDM (both P‐values < 0.05). Overall, 25[OH]D3 concentrations, but not total 25[OH]D concentrations, were significantly associated with GDM risk. A 5‐ng/mL increase in 25[OH]D3 concentration was associated with a 14% decrease in GDM risk (P‐value = 0.02). Women in the lowest quartile for 25[OH]D3 concentration had a twofold [95% CI 1.15, 3.58] higher risk of GDM compared with women in the highest quartile (P‐value for trend < 0.05).

Conclusions

Early pregnancy vitamin D status, particularly 25[OH]D3, is inversely associated with GDM risk.
Exploring Educational Disparities in Risk of Preterm Delivery: A Comparative Study of 12 European Birth Cohorts
Authors: Poulsen Gry , Strandberg‐Larsen Katrine , Mortensen Laust , Barros Henrique , Cordier Sylvaine , Correia Sofia , Danileviciute Asta , van Eijsden Manon , Fernández‐Somoano Ana , Gehring Ulrike , Grazuleviciene Regina , Hafkamp‐de Groen Esther , Henriksen Tine Brink , Jensen Morten Søndergaard , Larrañaga Isabel , Magnus Per , Pickett Kate , Raat Hein , Richiardi Lorenzo , Rouget Florence , Rusconi Franca , Stoltenberg Camilla , Uphoff Eleonora P. , Vrijkotte Tanja G. M. , Wijga Alet H. , Vrijheid Martine , Osler Merete , Andersen Anne‐Marie Nybo
Published: March 2015

Background

An association between education and preterm delivery has been observed in populations across Europe, but differences in methodology limit comparability. We performed a direct cross‐cohort comparison of educational disparities in preterm delivery based on individual‐level birth cohort data.

Methods

The study included data from 12 European cohorts from Denmark, England, France, Lithuania, the Netherlands, Norway, Italy, Portugal, and Spain. The cohorts included between 2434 and 99 655 pregnancies. The association between maternal education and preterm delivery (22–36 completed weeks of gestation) was reported as risk ratios, risk differences, and slope indexes of inequality with 95% confidence intervals (CIs).

Results

Singleton preterm live delivery proportion varied between 3.7% and 7.5%. There were large variations between the cohorts in the distribution of education and maternal characteristics. Nevertheless, there were similar educational differences in risk of preterm delivery in 8 of the 12 cohorts with slope index of inequality varying between 2.2 [95% CI 1.1, 3.3] and 4.0 [95% CI 1.4, 6.6] excess preterm deliveries per 100 singleton deliveries among the educationally most disadvantaged, and risk ratio between the lowest and highest education category varying from 1.4 [95% CI 1.1, 1.8] to 1.9 [95% CI 1.2, 3.1]. No associations were found in the last four cohorts.

Conclusions

Educational disparities in preterm delivery were found all over Europe. Despite differences in the distributions of education and preterm delivery, the results were remarkably similar across the cohorts. For those few cohorts that did not follow the pattern, study and country characteristics did not explain the differences.
Operational Models of Infrastructure Resilience
Authors: Alderson David L. , Brown Gerald G. , Carlyle W. Matthew
Published: March 2015

We propose a definition of infrastructure resilience that is tied to the operation (or function) of an infrastructure as a system of interacting components and that can be objectively evaluated using quantitative models. Specifically, for any particular system, we use quantitative models of system operation to represent the decisions of an infrastructure operator who guides the behavior of the system as a whole, even in the presence of disruptions. Modeling infrastructure operation in this way makes it possible to systematically evaluate the consequences associated with the loss of infrastructure components, and leads to a precise notion of “operational resilience” that facilitates model verification, validation, and reproducible results. Using a simple example of a notional infrastructure, we demonstrate how to use these models for (1) assessing the operational resilience of an infrastructure system, (2) identifying critical vulnerabilities that threaten its continued function, and (3) advising policymakers on investments to improve resilience.
Will the Occupational Safety and Health Administration's Proposed Standards for Occupational Exposure to Respirable Crystalline Silica Reduce Workplace Risk?
Authors: Dudley Susan E. , Morriss Andrew P.
Published: March 2015

The Occupational Safety and Health Administration (OSHA) is developing regulations to amend existing standards for occupational exposure to respirable crystalline silica by establishing a new permissible exposure limit as well as a series of ancillary provisions for controlling exposure. This article briefly reviews OSHA's proposed regulatory approach and the statutory authority on which it is based. It then evaluates OSHA's preliminary determination of significant risk and its analysis of the risk reduction achievable by its proposed controls. It recognizes that OSHA faces multiple challenges in devising a regulatory approach that reduces exposures and health risks and meets its statutory goal. However, the greatest challenge to reducing risks associated with silica exposure is not the lack of incentives (for either employers or employees) but rather lack of information, particularly information on the relative toxicity of different forms of silica. The article finds that OSHA's proposed rule would contribute little in the way of new information, particularly since it is largely based on information that is at least a decade old—a significant deficiency, given the rapidly changing conditions observed over the last 45 years. The article concludes with recommendations for alternative approaches that would be more likely to generate information needed to improve worker health outcomes.
Predicting Vaccination Intention and Benefit and Risk Perceptions: The Incorporation of Affect, Trust, and Television Influence in a Dual‐Mode Model
Authors: Nancy Chen Nien‐Tsu
Published: March 2015

Major health behavior change models tend to consider health decisions as primarily resulting from a systematic appraisal of relevant beliefs, such as the perceived benefits and risks of a pharmacological intervention. Drawing on research from the disciplines of risk management, communication, and psychology, this study proposed the inclusion of a heuristic route in established theory and tested the direction of influence between heuristic and systematic process variables. Affect and social trust were included as key heuristics in the proposed dual‐mode framework of health decision making. Furthermore, exposure to health‐related coverage on television was considered potentially influential over both heuristic and systematic process variables. To test this framework, data were collected from a national probability sample of 584 adults in the United States in 2012 regarding their decision to vaccinate against a hypothetical avian flu. The results provided some support for the bidirectional influence between heuristic and systematic processing. Affect toward flu vaccination and trust in the Food and Drug Administration were found to be powerful predictors of vaccination intention, enhancing intention both directly and indirectly via certain systematic process variables. The direction of influence between perceived susceptibility and severity, on the one hand, and affect, on the other, is less clear, suggesting the need for further research. Contrary to the opinion of media critics, exposure to televised health coverage was negatively associated with the perceived risks of vaccination. Results from this study carry theoretical and practical implications, and applying this model to the acceptance of different health interventions constitutes an area for future inquiries.
Assessing Major Accident Risks to Support Land‐Use Planning Using a Severity‐Vulnerability Combination Method: A Case Study in Dagushan Peninsula, China
Authors: Ma Shuming , Zhang Shushen , Yu Chen , Zheng Hongbo , Song Guobao , Semakula Henry Musoke , Chai Yingying
Published: March 2015

Major accident risks posed by chemical hazards have raised major social concerns in today's China. Land‐use planning has been adopted by many countries as one of the essential elements for accident prevention. This article aims at proposing a method to assess major accident risks to support land‐use planning in the vicinity of chemical installations. This method is based on the definition of risk by the Accidental Risk Assessment Methodology for IndustrieS (ARAMIS) project and it is an expansion application of severity and vulnerability assessment tools. The severity and vulnerability indexes from the ARAMIS methodology are employed to assess both the severity and vulnerability levels, respectively. A risk matrix is devised to support risk ranking and compatibility checking. The method consists of four main steps and is presented in geographical information‐system‐based maps. As an illustration, the proposed method is applied in Dagushan Peninsula, China. The case study indicated that the method could not only aid risk regulations on existing land‐use planning, but also support future land‐use planning by offering alternatives or influencing the plans at the development stage, and thus further enhance the roles and influence of land‐use planning in the accident prevention activities in China.
Is repetition failure critical for the development of muscle hypertrophy and strength?
Authors: Sampson J. A. , Groeller H.
Published: March 2015

This investigation sought to determine the effect of resistance training to failure on functional, structural and neural elbow flexor muscle adaptation. Twenty‐eight males completed a 4‐week familiarization period and were then counterbalanced on the basis of responsiveness across; non‐failure rapid shortening (RS; rapid concentric, 2 s eccentric), non‐failure stretch‐shortening (SSC; rapid concentric, rapid eccentric), and failure control (C, 2 s concentric, 2 s eccentric), for a 12‐week unilateral elbow flexor resistance training regimen, 3 × week using 85% of one repetition maximum (1RM). 1RM, maximal voluntary contraction (MVC), muscle cross‐sectional area (CSA), and muscle activation (EMGRMS) of the agonist, antagonist, and stabilizer muscles were assessed before and after the 12‐week training period. The average number of repetitions per set was significantly lower in RS 4.2 [confidence interval (CI): 4.2, 4.3] and SSC 4.2 (CI: 4.2, 4.3) compared with C 6.1 (CI: 5.8, 6.4). A significant increase in 1RM (30.5%), MVC (13.3%), CSA (11.4%), and agonist EMGRMS (22.1%) was observed; however, no between‐group differences were detected. In contrast, antagonist EMGRMS increased significantly in SSC (40.5%) and C (23.3%), but decreased in RS (13.5%). Similar adaptations across the three resistance training regimen suggest repetition failure is not critical to elicit significant neural and structural changes to skeletal muscle.
Real‐time supervised detection of pink areas in dermoscopic images of melanoma: importance of color shades, texture and location
Authors: Kaur R. , Albano P. P. , Cole J. G. , Hagerty J. , LeAnder R. W. , Moss R. H. , Stoecker W. V.
Published: March 2015

Background/Purpose

Early detection of malignant melanoma is an important public health challenge. In the USA, dermatologists are seeing more melanomas at an early stage, before classic melanoma features have become apparent. Pink color is a feature of these early melanomas. If rapid and accurate automatic detection of pink color in these melanomas could be accomplished, there could be significant public health benefits.

Methods

Detection of three shades of pink (light pink, dark pink, and orange pink) was accomplished using color analysis techniques in five color planes (red, green, blue, hue, and saturation). Color shade analysis was performed using a logistic regression model trained with an image set of 60 dermoscopic images of melanoma that contained pink areas. Detected pink shade areas were further analyzed with regard to the location within the lesion, average color parameters over the detected areas, and histogram texture features.

Results

Logistic regression analysis of a separate set of 128 melanomas and 128 benign images resulted in up to 87.9% accuracy in discriminating melanoma from benign lesions measured using area under the receiver operating characteristic curve. The accuracy in this model decreased when parameters for individual shades, texture, or shade location within the lesion were omitted.

Conclusion

Texture, color, and lesion location analysis applied to multiple shades of pink can assist in melanoma detection. When any of these three details: color location, shade analysis, or texture analysis were omitted from the model, accuracy in separating melanoma from benign lesions was lowered. Separation of colors into shades and further details that enhance the characterization of these color shades are needed for optimal discrimination of melanoma from benign lesions.
Perspective Measurement of the Out‐of‐plane Displacement and Normal Strain Field Distributions Inside Glass Fibre‐reinforced Resin Matrix Composite
Authors: Liu Y. , Dong B. , Bai Y. , Xu J. , Zhang Y. , Ye S. , Zhou Y.
Published: March 2015

A depth‐resolved wavenumber‐scanning interferometer (DRWSI) was built up to measure the out‐of‐plane displacement and normal strain field distributions on the front surface, rear surface and internal glass fibres of a glass fibre‐reinforced resin matrix composite before and after loading. Series of the fringe patterns were recorded, while the wavenumber of the laser, monitored online by an optical wedge, was scanned by tuning the temperature. Random sampling Fourier transform is used to overcome the non‐linearity of the wavenumber series. In the end, the distributions of the out‐of‐plane displacements and normal strain field are presented as the applied loads were 10 µm, 20 µm and 30 µm, respectively. In conclusion, DRWSI is a suitable method to measure the mechanical properties inside resin composite non‐destructively.
Penicillium marneffei infection in a lung transplant recipient
Authors: Stathakis A. , Lim K.P. , Boan P. , Lavender M. , Wrobel J. , Musk M. , Heath C.H.
Published: March 2015

Penicillium marneffei is a thermally dimorphic fungus that can cause severe opportunistic infections in endemic regions of Southeast Asia, particularly in individuals infected with human immunodeficiency virus‐1, but has rarely been reported in solid organ transplant recipients. Herein, we report the first case, to our knowledge, of P. marneffei infection in a lung transplant recipient, occurring in a 41‐year‐old woman 28 months post lung transplantation, after recent travel to Vietnam. We have reviewed the literature to derive some management principles for this rare infection in this clinical context. The number of P. marneffei infections in transplant recipients may increase, as a result of increasing rates of transplantation and travel to endemic areas.
Point‐of‐care ultrasound education for non‐physician clinicians in a resource‐limited emergency department
Authors: Stolz Lori A. , Muruganandan Krithika M. , Bisanzo Mark C. , Sebikali Mugisha J. , Dreifuss Bradley A. , Hammerstedt Heather S. , Nelson Sara W. , Nayabale Irene , Adhikari Srikar , Shah Sachita P.
Published: March 2015

Objective

To describe the outcomes and curriculum components of an educational programme to train non‐physician clinicians working in a rural, Ugandan emergency department in the use of POC ultrasound.

Methods

The use of point‐of‐care ultrasound was taught to emergency care providers through lectures, bedsides teaching and hands‐on practical sessions. Lectures were tailored to care providers' knowledge base and available therapeutic means. Every ultrasound examination performed by these providers was recorded over 4.5 years. Findings of these examinations were categorised as positive, negative, indeterminate or procedural. Other radiologic studies ordered over this same time period were also recorded.

Results

A total of 22 639 patients were evaluated in the emergency department by emergency care providers, and 2185 point‐of‐care ultrasound examinations were performed on 1886 patients. Most commonly used were the focused assessment with sonography in trauma examination (53.3%) and echocardiography (16.4%). Point‐of‐care ultrasound studies were performed more frequently than radiology department‐performed studies. Positive findings were documented in 46% of all examinations.

Conclusions

We describe a novel curriculum for point‐of‐care ultrasound education of non‐physician emergency practitioners in a resource‐limited setting. These non‐physician clinicians integrated ultrasound into clinical practice and utilised this imaging modality more frequently than traditional radiology department imaging with a large proportion of positive findings.
A Spatial Model of Insulin‐Granule Dynamics in Pancreatic β‐Cells
Authors: Dehghany Jaber , Hoboth Peter , Ivanova Anna , Mziaut Hassan , Müller Andreas , Kalaidzidis Yannis , Solimena Michele , Meyer‐Hermann Michael
Published: March 2015

Insulin secretion from pancreatic β‐cells in response to sudden glucose stimulation is biphasic. Prolonged secretion in vivo requires synthesis, delivery to the plasma membrane (PM) and exocytosis of insulin secretory granules (SGs). Here, we provide the first agent‐based space‐resolved model for SG dynamics in pancreatic β‐cells. Using recent experimental data, we consider a single β‐cell with identical SGs moving on a phenomenologically represented cytoskeleton network. A single exocytotic machinery mediates SG exocytosis on the PM. This novel model reproduces the measured spatial organization of SGs and insulin secretion patterns under different stimulation protocols. It proposes that the insulin potentiation effect and the rising second‐phase secretion are mainly due to the increasing number of docking sites on the PM. Furthermore, it shows that 6 min after glucose stimulation, the ‘newcomer’ SGs are recruited from a region within less than 600 nm from the PM.
Red blood cell storage affects the stability of cytosolic native protein complexes
Authors: Pallotta Valeria , Rinalducci Sara , Zolla Lello
Published: March 2015

BACKGROUND

Refrigerated storage of red blood cell (RBC) units promotes the progressive accumulation of the so‐called storage lesions, a widespread series of alterations to morphology, metabolism, and proteome integrity of stored RBCs. However, while storage lesions targeting the RBC membrane fraction have been widely documented, the cytosolic fraction is as yet an underinvestigated cause of the technical inconveniences related to the high abundance of hemoglobin.

STUDY DESIGN AND METHODS

By exploiting a recently ideated preparative two‐dimensional clear native electrophoresis, followed by mass spectrometry analysis, we could monitor the changes of soluble multiprotein complexes (MPCs) in RBCs after 0, 21, and 35 days of storage under standard blood banking conditions.

RESULTS

Data indicate a substantial storage‐dependent alteration of RBC MPCs, particularly of those involved in energy and redox metabolism, confirming previous evidence about the progressive dysregulation of these pathways in long‐stored units.

CONCLUSION

The use of native gel–based proteomics to investigate MPCs present in the RBC cytosolic fraction proved to be a powerful tool. Results collected represent a preliminary advance in the knowledge of the key role of native cytosolic MPCs in context of RBC storage lesion. Multiprotein organization and interacting partners of some key enzymes have been found to change during storage duration, suggesting that future studies will be needed to assess whether such alterations could influence their activity and efficiency.
Western immunoblotting as a new tool for investigating direct antiglobulin test–negative autoimmune hemolytic anemias
Authors: Bloch Evgenia M. , Sakac Darinka , Branch Haley A. , Cserti‐Gazdewich Christine , Pendergrast Jacob , Pavenski Katerina , Branch Donald R.
Published: March 2015

BACKGROUND

Direct antiglobulin test–negative (DAT(–)) autoimmune hemolytic anemia, characterized by hemolysis without detectable immunoglobulin or complement on patient red blood cells (RBCs), poses a diagnostic challenge. To select therapy, classification of the hemolysis as immune‐ or non–immune‐mediated is important. We developed a method using Western immunoblot (WB) to classify DAT(–) patients by measuring and comparing levels of RBC immunoglobulin (Ig)G to normal donors.

STUDY DESIGN AND METHODS

RBC samples from 42 normal donors were made into ghosts and analyzed by WB and densitometry to establish a normal mean relative quantity of IgG (RQIgG) on the RBCs. RQIgG on eight DAT(–) and eluate‐negative patients with hemolytic anemia was determined and compared to RQIgG on normal RBCs.

RESULTS

RQIgG of 42 normal donors indicated a calculated mean ± SD of 0.0016 ± 0.0015 and we used a cutoff of 0.0047, the mean + 2SD. This was compared with a receiver operating curve cutoff of 0.0041 with 100% sensitivity and 93% specificity. Of the eight patients tested, three were classified as non–immune‐mediated (one had pyruvate kinase deficiency) and five as immune‐mediated. Two of the patients in the latter group underwent splenectomy, followed by remission.

CONCLUSION

WB analysis is more sensitive than conventional test tube DAT or elution analysis. Our assay confirms: 1) previous studies showing normal RBCs are sensitized with IgG, perhaps due to natural autoantibody to senescence; 2) that some normal RBCs have increased levels of IgG without signs of disease; and 3) that WB distinguishes between non–immune‐ and immune‐mediated hemolytic anemia in DAT(–) patients and may be useful for clinical diagnosis.
Cost‐effectiveness of becaplermin gel on wound healing of diabetic foot ulcers
Authors: Gilligan Adrienne M. , Waycaster Curtis R. , Motley Travis A.
Published: March 2015

We sought to determine the long‐term cost effectiveness (payer's perspective) of becaplermin gel plus good wound care (BGWC) vs. good wound care (GWC) alone in terms of wound healing and risk of amputation in patients with diabetic foot ulcers (DFUs). Outcomes data were derived from a propensity score‐matched cohort from the Curative Health Services database between 1998 and 2004, which was followed for 20 weeks. A four‐state Markov model was used to predict costs and outcomes of wound healing and risk of amputation for BGWC vs. GWC alone over 1 year in patients with DFU. The primary outcome was closed‐wound weeks. Transition probabilities for healing and amputation were derived from the aforementioned propensity score‐matched cohorts. Ulcer recurrence was estimated from the medical literature. Utilization for becaplermin was calculated using the dosing algorithm in the product labeling. Of 24,898 eligible patients, 9.6% received BGWC. Based on the model, patients treated with BGWC had substantially more closed‐wound weeks compared with GWC (16.1 vs. 12.5 weeks, respectively). More patients receiving BGWC had healed wounds at 1 year compared with those receiving GWC (48.1% vs. 38.3%). Risk of amputation was lower in the BGWC cohort (6.8% vs. 9.8%). Expected annual direct costs for DFU were $21,920 for BGWC and $24,640 for GWC. BGWC was economically dominant over GWC, providing better outcomes at a lower cost in patients with DFU. Compared with GWC alone, BGWC is more effective in healing wounds and lowering amputation risk, thereby decreasing long‐term costs for DFU.
Cryptosporidium parvum Caused a Large Outbreak Linked to Frisée Salad in Finland, 2012
Authors: Åberg R. , Sjöman M. , Hemminki K. , Pirnes A. , Räsänen S. , Kalanti A. , Pohjanvirta T. , Caccio S. M. , Pihlajasaari A. , Toikkanen S. , Huusko S. , Rimhanen‐Finne R.
Published: March 2015

Over 250 individuals fell ill in five outbreaks caused by Cryptosporidium parvum in Finland, October–November 2012. The cases were connected by lunch meals at restaurants in four different cities. In two outbreaks, the same C. parvumIIdA17G1 subtype was found in patients’ stool samples which supports a single source of infection. Frisée salad was the only common food item served at the restaurants, and consumption of lunch salad containing the frisée salad was associated with the illness. Lunch customers who responded that they had eaten lunch salad were three times more likely to have become ill than those who had not answered whether they had eaten the salad or not (RR 2.66; 95% Cl 1.02–6.9, P‐value <0.01). Cryptosporidiosis should be considered as a causal agent in long‐lasting watery diarrhoea combined with abdominal cramps, and clinical samples should be tested for Cryptosporidium at the same time bacteria and viruses are tested. Measures to prevent contamination of ‘ready‐to‐eat vegetables’ with Cryptosporidium oocysts and methods to test frozen food samples should be developed.
Large Ca2+‐dependent facilitation of CaV2.1 channels revealed by Ca2+ photo‐uncaging
Authors: Lee Shin‐Rong , Adams Paul J. , Yue David T.
Published: March 2015

Key points

CaV2.1 channels constitute a dominant Ca2+ entry pathway into brain neurons, triggering downstream Ca2+‐dependent processes such as neurotransmitter release.

CaV2.1 is itself modulated by Ca2+, resulting in activity‐dependent enhancement of channel opening termed Ca2+‐dependent facilitation (CDF).

Real‐time Ca2+ imaging and Ca2+ uncaging here reveal that CDF turns out to be strikingly faster, more Ca2+ sensitive, and larger than anticipated on previous grounds.

Robust resolution of the quantitative profile of CDF enables deduction of a realistic biophysical model for this process.

These results suggest that CaV2.1 CDF would figure most prominently in short‐term synaptic plasticity and cerebellar Purkinje cell rhythmicity.

CaV2.1 (P‐type) voltage‐gated Ca2+ channels constitute a major source of neuronal Ca2+ current, strongly influencing rhythmicity and triggering neurotransmitter release throughout the central nervous system. Fitting with such stature among Ca2+ entry pathways, CaV2.1 is itself feedback regulated by intracellular Ca2+, acting through calmodulin to facilitate channel opening. The precise neurophysiological role of this calcium‐dependent facilitation (CDF) remains uncertain, however, in large measure because the very magnitude, Ca2+ dependence and kinetics of CDF have resisted quantification by conventional means. Here, we utilize the photo‐uncaging of Ca2+ with CaV2.1 channels fluxing Li+ currents, so that voltage‐dependent activation of channel gating is no longer conflated with Ca2+ entry, and CDF is then driven solely by light‐induced increases in Ca2+. By using this strategy, we now find that CDF can be unexpectedly large, enhancing currents by as much as twofold at physiological voltages. CDF is steeply Ca2+ dependent, with a Hill coefficient of approximately two, a half‐maximal effect reached by nearly 500 nm Ca2+, and Ca2+ on/off kinetics in the order of milliseconds to tens of milliseconds. These properties were established for both native P‐type currents in cerebellar Purkinje neurons, as well as their recombinant channel counterparts under heterologous expression. Such features suggest that CDF of CaV2.1 channels may substantially enhance the regularity of rhythmic firing in cerebellar Purkinje neurons, where regularity is believed crucial for motor coordination. In addition, this degree of extensive CDF would be poised to exert large order‐of‐magnitude effects on short‐term synaptic plasticity via rapid modulation of presynaptic Ca2+ entry.
Passive motion reduces vestibular balance and perceptual responses
Authors: Fitzpatrick Richard C. , Watson Shaun R. D.
Published: March 2015

Key points

Human activity exposes the vestibular organs to a wide dynamic range of motion.

We aimed to discover whether the CNS regulates sensitivity to vestibular afference during exposure to ambient motion.

Balance and perceptual responses to vestibular stimulation were measured before and after a 10 min period of imposed, moderate intensity, stochastic whole‐body rotation.

After this conditioning, vestibular balance reflexes evoked by galvanic vestibular stimulation were halved in amplitude.

Conditioning doubled the thresholds for perceiving small rotations, and reduced perceptions of the amplitude of real rotations, and illusory rotation evoked by galvanic stimulation.

We conclude that the CNS auto‐regulates sensitivity to vestibular sensory afference and that this probably involves central and peripheral mechanisms, as might arise from vestibular efferent regulation.

Failure of these regulatory mechanisms at different levels could lead to disorders of movement perception and balance control during standing.

With the hypothesis that vestibular sensitivity is regulated to deal with a range of environmental motion conditions, we explored the effects of passive whole‐body motion on vestibular perceptual and balance responses. In 10 subjects, vestibular responses were measured before and after a period of imposed passive motion. Vestibulospinal balance reflexes during standing evoked by galvanic vestibular stimulation (GVS) were measured as shear reaction forces. Perceptual tests measured thresholds for detecting angular motion, perceptions of suprathreshold rotation and perceptions of GVS‐evoked illusory rotation. The imposed conditioning motion was 10 min of stochastic yaw rotation (0.5–2.5 Hz ≤ 300 deg s−2) with subjects seated. This conditioning markedly reduced reflexive and perceptual responses. The medium latency galvanic reflex (300–350 ms) was halved in amplitude (48%; P = 0.011) but the short latency response was unaffected. Thresholds for detecting imposed rotation more than doubled (248%; P < 0.001) and remained elevated after 30 min. Over‐estimation of whole‐body rotation (30–180 deg every 5 s) before conditioning was significantly reduced (41.1 to 21.5%; P = 0.033). Conditioning reduced illusory vestibular sensations of rotation evoked by GVS (mean 113 deg for 10 s at 1 mA) by 44% (P < 0.01) and the effect persisted for at least 1 h (24% reduction; P < 0.05). We conclude that a system of vestibular sensory autoregulation exists and that this probably involves central and peripheral mechanisms, possibly through vestibular efferent regulation. We propose that failure of these regulatory mechanisms at different levels could lead to disorders of movement perception and balance control during standing.
Training-Load Distribution in Endurance Runners: Objective Versus Subjective Assessment
Authors: Manzi Vincenzo , Bovenzi Antonio , Castagna Carlo , Salimei Paola Sinibaldi , Volterrani Maurizio , Iellamo Ferdinando
Published: March 2015

Purpose:

To assess the distribution of exercise intensity in long-distance recreational athletes (LDRs) preparing for a marathon and to test the hypothesis that individual perception of effort could provide training responses similar to those provided by standardized training methodologies.

Methods:

Seven LDRs (age 36.5 ± 3.8 y) were followed during a 5-mo training period culminating with a city marathon. Heart rate at 2.0 and 4.0 mmol/L and maximal heart rate were used to establish 3 intensity training zones. Internal training load (TL) was assessed by training zones and TRIMPi methods. These were compared with the session-rating-of-perceived-exertion (RPE) method.

Results:

Total time spent in zone 1 was higher than in zones 2 and 3 (76.3% ± 6.4%, 17.3% ± 5.8%, and 6.3% ± 0.9%, respectively; P = .000 for both, ES = 0.98, ES = 0.99). TL quantified by session-RPE provided the same result. The comparison between session-RPE and training-zones-based methods showed no significant difference at the lowest intensity (P = .07, ES = 0.25). A significant correlation was observed between TL RPE and TL TRIMPi at both individual and group levels (r = .79, P < .001). There was a significant correlation between total time spent in zone 1 and the improvement at the running speed of 2 mmol/L (r = .88, P < .001). A negative correlation was found between running speed at 2 mmol/L and the time needed to complete the marathon (r = –.83, P < .001).

Conclusions:

These findings suggest that in recreational LDRs most of the training time is spent at low intensity and that this is associated with improved performances. Session-RPE is an easy-to-use training method that provides responses similar to those obtained with standardized training methodologies.
Development and Evaluation of a Simple, Multifactorial Model Based on Landing Performance to Indicate Injury Risk in Surfing Athletes
Authors: Lundgren Lina E. , Tran Tai T. , Nimphius Sophia , Raymond Ellen , Secomb Josh L. , Farley Oliver R.L. , Newton Robert U. , Steele Julie R. , Sheppard Jeremy M.
Published: March 2015

Purpose:

To develop and evaluate a multifactorial model based on landing performance to estimate injury risk for surfing athletes.

Methods:

Five measures were collected from 78 competitive surfing athletes and used to create a model to serve as a screening tool for landing tasks and potential injury risk. In the second part of the study, the model was evaluated using junior surfing athletes (n = 32) with a longitudinal follow-up of their injuries over 26 wk. Two models were compared based on the collected data, and magnitude-based inferences were applied to determine the likelihood of differences between injured and noninjured groups.

Results:

The study resulted in a model based on 5 measures—ankle-dorsiflexion range of motion, isometric midthigh-pull lower-body strength, time to stabilization during a drop-and-stick (DS) landing, relative peak force during a DS landing, and frontal-plane DS-landing video analysis—for male and female professional surfers and male and female junior surfers. Evaluation of the model showed that a scaled probability score was more likely to detect injuries in junior surfing athletes and reported a correlation of r = .66, P = .001, with a model of equal variable importance. The injured (n = 7) surfers had a lower probability score (0.18 ± 0.16) than the noninjured group (n = 25, 0.36 ± 0.15), with 98% likelihood, Cohen d = 1.04.

Conclusions:

The proposed model seems sensitive and easy to implement and interpret. Further research is recommended to show full validity for potential adaptations for other sports.
Assessment of Accelerometers for Measuring Upper-Extremity Physical Activity
Authors: Lawinger Elizabeth , Uhl Tim L. , Abel Mark , Kamineni Srinath
Published: March 2015

Objective:

The overarching goal of this study was to examine the use of triaxial accelerometers in measuring upper-extremity motions to monitor upper-extremity-exercise compliance. There were multiple questions investigated, but the primary objective was to investigate the correlation between visually observed arm motions and triaxial accelerometer activity counts to establish fundamental activity counts for the upper extremity.

Study Design:

Cross-sectional, basic research.

Setting:

Clinical laboratory.

Participants:

Thirty healthy individuals age 26 ± 6 y, body mass 24 ± 3 kg, and height 1.68 ± 0.09 m volunteered.

Intervention:

Participants performed 3 series of tasks: activities of daily living (ADLs), rehabilitation exercises, and passive shoulder range of motion at 5 specific velocities on an isokinetic dynamometer while wearing an accelerometer on each wrist. Participants performed exercises with their dominant arm to examine differences between sides. A researcher visually counted all arm motions to correlate counts with physical activity counts provided by the accelerometer.

Main Outcome Measure:

Physical activity counts derived from the accelerometer and visually observed activity counts recorded from a single investigator.

Results:

There was a strong positive correlation (r = .93, P < .01) between accelerometer physical activity counts and visual activity counts for all ADLs. Accelerometers activity counts demonstrated side-to-side difference for all ADLs (P < .001) and 5 of the 7 rehabilitation activities (P < .003). All velocities tested on the isokinetic dynamometer were shown to be significantly different from each other (P < .001).

Conclusion:

There is a linear relationship between arm motions counted visually and the physical activity counts generated by an accelerometer, indicating that arm motions could be potentially accounted for if monitoring arm usage. The accelerometers can detect differences in relatively slow arm-movement velocities, which is critical if attempting to evaluate exercise compliance during early phases of shoulder rehabilitation. These results provide fundamental information that indicates that triaxial accelerometers have the potential to objectively monitor and measure arm activities during rehabilitation and ADLs.
The Use of a Dynamic Elastomeric Fabric Orthosis in Supporting the Management of Athletic Pelvic and Groin Injury
Authors: Sawle Leanne , Freeman Jennifer , Marsden Jonathan
Published: March 2015

Context:

Athletic pelvic and groin injuries are a common yet challenging problem. Pelvic belts have been successfully used to reduce pain and improve function but are not a practical solution for athletes. Therefore, there is scope to explore the use of a more dynamic intervention developed to aid in the management of this type of injury.

Objectives:

To undertake a preliminary investigation into the effectiveness of a dynamic elastomeric fabric orthosis (DEFO) in supporting the management of athletic pelvic and groin injury.

Design:

A case series with an AB design. Daily assessments were undertaken over 15 days; the onset of intervention was randomized with a minimum baseline period of 6 d. Follow-up assessment was undertaken after 1 mo.

Settings:

Community and university.

Participants:

8 athletes presenting with pelvic or groin injury confirmed through clinical screening.

Intervention:

A bespoke DEFO.

Main Outcome Measures:

Force produced on bilateral resisted hip adduction and self-scored pain (using a numerical rating scale of 0–10) at rest and during an active straight-leg raise and a broad jump.

Results:

In 7 cases a significant improvement was observed on at least 1 measure (2-SD method, celeration line, and/or the point of nonoverlapping data). The remaining case showed minimal symptoms during testing.
Keeping stem cells in tip-top condition
Authors: Hurtley Stella M.
Published: March 2015

Deregulation of a pathway from mitochondria that impinges on the cell cycle interfered with stem cell quiescence and compromised regenerative function.