bluuebunny/crossref_metadata_2025 huggingface dataset:
Significant effects of RNAi silencing of the venom allergen‐like protein (Mhi‐vap‐1) of the root‐knot nematodeMeloidogyne hispanicain the early events of infection
Authors: Duarte A. , Maleita C. , Egas C. , Abrantes I. , Curtis R.
Published: January 2017

Gene silencing usingRNAi is a powerful tool for functional analysis of nematode genes and can provide a new strategy for the management of root‐knot nematodes. The transcript of the venom allergen‐like protein gene (Mhi‐vap‐1) ofMeloidogyne hispanicais localized in the subventral oesophageal gland cells of second‐stage juveniles (J2) and the gene is highly transcribed in this developmental nematode stage. The purpose of this study was to assess whether the silencing of theMhi‐vap‐1gene could affect nematode attraction to roots, penetration, development and reproduction in tomato plants. The optimum soaking time to generate silencing of this gene was determined by quantitativeRT‐PCRanalysis of the relative expression of theMhi‐vap‐1gene in the J2 incubated with the soaking solution for 24, 32 and 48 h. At 48 h, the relative expression ofMhi‐vap‐1decreased, which indicates that this period of time is optimum to silence this nematode gene using theRNAi method. Silencing of theMhi‐vap‐1gene interfered with the completion of the nematode life cycle and caused a reduction in nematode attraction to roots, penetration and infection of plants. A small difference in the number of females and galls formed was also observed, which caused a small decrease in the nematode reproduction factor. The use ofRNAi silencing of theMeloidogyneeffector geneMhi‐vap‐1showed that this gene is important for the plant–nematode interaction during the early events of infection and could be a target gene for anti‐nematode strategies.
Facilitation by pioneer shrubs for the ecological restoration of riparian forests in the Central Andes of Colombia
Authors: Galindo Víctor , Calle Zoraida , Chará Julian , Armbrecht Inge
Published: January 2017

Riparian vegetation has great functional importance in agroscapes because it establishes physical connections between natural ecosystems embedded in an agricultural matrix. Throughout the tropics, the historical demand for cropland and pastures in the lands adjacent to streams has led to the replacement of forests by exotic grasses. In order to find new methods for initiating the restoration of riparian forests, we evaluated the use of the pioneer shrubs Tithonia diversifolia and Piper auritum as nurse species for their effects on (1) competition with dominant grasses; (2) natural regeneration and the ecological facilitation of six native tree species of different successional stages; and (3) influence on microclimate. Over a period of 15 months, 4.4% coverage of P. auritum was insufficient to inhibit grasses. In contrast, 81% coverage of T. diversifolia limited the growth of dominant grasses such as Cenchrus purpureus, Paspalum paniculatum, and Cynodon plectostachyus likely by intercepting more than 90% of photosynthetically active radiation (PAR), even though other factors cannot be ruled out. T. diversifolia showed simultaneous effects of facilitation and competition by promoting higher survival of the planted native trees while slowing the growth of pioneer species and inhibiting the regeneration of native woody plants probably as a result of high light interception. This study suggests that planting T. diversifolia as a nurse shrub may facilitate early stages of restoration by inhibiting the growth of pastures, but requires pruning, both to increase light availability and promote the growth of planted trees and the recruitment of woody plants.
Analysis of Affordance, Time, and Adaptation in the Assessment of Industrial Control System Cybersecurity Risk
Authors: Busby J. S. , Green B. , Hutchison D.
Published: January 2017

Industrial control systems increasingly use standard communication protocols and are increasingly connected to public networks—creating substantial cybersecurity risks, especially when used in critical infrastructures such as electricity and water distribution systems. Methods of assessing risk in such systems have recognized for some time the way in which the strategies of potential adversaries and risk managers interact in defining the risk to which such systems are exposed. But it is also important to consider the adaptations of the systems’ operators and other legitimate users to risk controls, adaptations that often appear to undermine these controls, or shift the risk from one part of a system to another. Unlike the case with adversarial risk analysis, the adaptations of system users are typically orthogonal to the objective of minimizing or maximizing risk in the system. We argue that this need to analyze potential adaptations to risk controls is true for risk problems more generally, and we develop a framework for incorporating such adaptations into an assessment process. The method is based on the principle of affordances, and we show how this can be incorporated in an iterative procedure based on raising the minimum period of risk materialization above some threshold. We apply the method in a case study of a small European utility provider and discuss the observations arising from this.
Age and Adaptation: Stronger Decision Updating about Real World Risks in Older Age
Authors: Rolison Jonathan J , Wood Stacey , Hanoch Yaniv
Published: January 2017

In later life, people are faced with a multitude of risky decisions that concern their health, finance, and personal security. Older adults often exercise caution in situations that involve risk. In this research, we asked whether older adults are also more responsive to warnings about potential risk. An answer to this question could reveal a factor underlying increased cautiousness in older age. In Study 1, participants decided whether they would engage in risky activities (e.g., using an ATM machine in the street) in four realistic scenarios about which participants could be expected to have relevant knowledge or experience. They then made posterior decisions after listening to audio extracts of real reports relevant to each activity. In Study 2, we explored the role that emotions play in decision updating. As in Study 1, participants made prior and posterior decisions, with the exception that for each scenario the reports were presented in their original audio format (high emotive) or in a written transcript format (low emotive). Following each posterior decision, participants indicated their emotional valence and arousal responses to the reports. In both studies, older adults engaged in fewer risky activities than younger adults, indicative of increased cautiousness in older age, and exhibited stronger decision updating in response to the reports. Older adults also showed stronger emotional responses to the reports, even though emotional responses did not differ for audio and written transcript formats. Finally, age differences in emotional responses to the reports accounted for age differences in decision updating.
Influence of Distribution of Animals between Dose Groups on Estimated Benchmark Dose and Animal Distress for Quantal Responses
Authors: Kalantari Fereshteh , Ringblom Joakim , Sand Salomon , Öberg Mattias
Published: January 2017

Increasingly, dose‐response data are being evaluated with the benchmark dose (BMD) approach rather than by the less precise no‐observed‐adverse‐effect‐level (NOAEL) approach. However, the basis for designing animal experiments, using equally sized dose groups, is still primed for the NOAEL approach. The major objective here was to assess the impact of using dose groups of unequal size on both the quality of the BMD and overall animal distress. We examined study designs with a total number of 200 animals distributed in four dose groups employing quantal data generated by Monte Carlo simulations. Placing more animals at doses close to the targeted BMD provided an estimate of BMD that was slightly better than the standard design with equally sized dose groups. In situations involving a clear dose‐response, this translates into fewer animals receiving high doses and thus less overall animal distress. Accordingly, in connection with risk and safety assessment, animal distress can potentially be reduced by distributing the animals appropriately between dose groups without decreasing the quality of the information obtained.
(Re) Defining Emerging Risks
Authors: Mazri Chabane
Published: January 2017

The concept of emergence in risk management can be seen as a revealing symptom of the increasing need for organizations to update their portfolio of risks and opportunities in a rapidly changing and highly competitive environment. Accordingly, the concept of emerging risks has been widely discussed in both scientific and business communities, with, however, a lack of agreement as to whether we should distinguish these risks from others and, if so, what should be the adopted approach for their governance. After reviewing a large set of definitions and conceptions of emerging risks, this article aims at exploring the existence of distinctive features allowing the characterization of a risk as emerging or not. First, we will demonstrate that the features used in the various definitions are ineffective to achieve this distinction. Furthermore, we will argue that all events and consequences associated with risks are or have been states of nature that emerged from complex interactions involving combinations of hazardous activities and stakes. Accordingly, emerging risks are no longer a specific category of risks; they are rather an early step in every risk life cycle that deserves specific governance approaches.
Determining the effective coverage of maternal and child health services in Kenya, using demographic and health survey data sets: tracking progress towards universal health coverage
Authors: Nguhiu Peter K. , Barasa Edwine W. , Chuma Jane
Published: January 2017

Objectives

Effective coverage (EC) is a measure of health systems’ performance that combines need, use and quality indicators. This study aimed to assess the extent to which the Kenyan health system provides effective and equitable maternal and child health services, as a means of tracking the country's progress towards universal health coverage.

Methods and results

The Demographic Health Surveys (2003, 2008–2009 and 2014) and Service Provision Assessment surveys (2004, 2010) were the main sources of data. Indicators of need, use and quality for eight maternal and child health interventions were aggregated across interventions and economic quintiles to compute EC. EC has increased from 26.7% in 2003 to 50.9% in 2014, but remains low for the majority of interventions. There is a reduction in economic inequalities in EC with the highest to lowest wealth quintile ratio decreasing from 2.41 in 2003 to 1.65 in 2014, but maternal health services remain highly inequitable.

Conclusions

Effective coverage of key maternal and child health services remains low, indicating that individuals are not receiving the maximum possible health gain from existing health services. There is an urgent need to focus on the quality and reach of maternal and child health services in Kenya to achieve the goals of universal health coverage.
Online English Language Learning: Theory-Based Course Design and Pedagogy
Authors: Andrade Maureen Snow
Published: January 2017

The demand for higher education is increasing worldwide. To meet this demand, and to provide increased access, flexible forms of delivery are needed. Although online courses are criticized for a lack of interaction, when intentionally designed, they can provide learners with opportunities for collaboration that supports the achievement of desired learning outcomes. The latter may focus on only content mastery, however, rather than on specific learner needs. The diverse learners entering higher education institutions today due to widening access often need help with how to learn and particularly how to learn in an online context. Inclusion of this element in course design supports immediate and future academic success. This study illustrates how online English language courses, based on distance education, learning, and language acquisition theories and related pedagogical approaches, can result not only in improved linguistic skill, but also broader educational outcomes. The significance of this approach is its focus on how to learn and how to facilitate learning rather than simply on what to learn. The theoretical framework is introduced followed by application of the theories for course design and illustrations of instructor/learner interaction.
Effect of Table Tennis Trainings on Certain Physical and Physiological Parameters in Children Aged 10-12
Authors: Taş Murat , Sinanoğlu Ahmet
Published: January 2017

In the research it was aimed to examine the effects of basic table tennis trainings, which were implemented on girls aged 10-12 for 16 weeks, on certain physical and physiological parameters.A total of 40 students, as randomly selected 20 test groups and 20 control groups at an age range of 10-12 participated in the research. These students were first applied pre-test measurement, and final test measurement was performed following application of basic table tennis trainings for 16 weeks.Statistical analysis of data was performed using SPSS 20.0 statistical package program. Mann Whitney U test was used in comparison of two variable groups, and the result being p<0.05 was considered significant when examined statistically.Statistical differences between measurements of body fat percentage, flexibility, vertical jumping, standing long jump, 30 m sprint, anaerobic strength, right and left hand grip strength, visual and audio reaction times, resting heart rate, and VC, FVC, FEV and FEV1 were found to be significant in favour of the test group (p<0.05). No statistically significant differences occurred between the two groups in height, body weight, body-mass index, maxVo2, and systolic and diastolic blood pressure values (p<0.05).Consequently, it was observed that the table tennis trainings, which were performed for 16 weeks, provided positive contributions to certain physical and physiological properties of girls aged 10-12, and improved them.
Sex, drugs and rock and roll: tales from preterm fetal life
Authors: Bennet Laura
Published: January 2017

Premature fetuses and babies are at greater risk of mortality and morbidity than their term counterparts. The underlying causes are multifactorial, but include exposure to hypoxia. Immaturity of organs and their functional control may impair the physiological defence responses to hypoxia and the preterm fetal responses, or lack thereof, to moderate hypoxia appear to support this concept. However, as this review demonstrates, despite immaturity, the preterm fetus responds to asphyxia in a qualitatively similar manner to that seen at term. This highlights the importance in understanding metabolism versus homeostatic threat when assessing fetal responses to adverse challenges such as hypoxia. Data are presented to show that the preterm fetal adaptation to asphyxia is triphasic in nature. Phase one represents the rapid institution of maximal defences, designed to maintain blood pressure and central perfusion at the expense of peripheral organs. Phase two is one of adaptive compensation. Controlled reperfusion partially offsets peripheral tissue oxygen debt, while maintaining sufficient vasoconstriction to limit the fall in perfusion. Phase three is about decompensation. Strikingly, the preterm fetus generally performs better during phases two and three, and can survive for longer without injury. Paradoxically, however, the ability to survive can lead to longer exposure to hypotension and hypoperfusion and thus potentially greater injury. The effects of fetal sex, inflammation and drugs on the triphasic adaptations are reviewed. Finally, the review highlights the need for more comprehensive studies to understand the complexity of perinatal physiology if we are to develop effective strategies to improve preterm outcomes.

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Pre‐ischaemic mitochondrial substrate constraint by inhibition of malate‐aspartate shuttle preserves mitochondrial function after ischaemia–reperfusion
Authors: Jespersen Nichlas Riise , Yokota Takashi , Støttrup Nicolaj Brejnholt , Bergdahl Andreas , Pælestik Kim Bolther , Povlsen Jonas Agerlund , Dela Flemming , Bøtker Hans Erik
Published: January 2017

Key points

Pre‐ischaemic administration of aminooxiacetate (AOA), an inhibitor of the malate‐aspartate shuttle (MAS), provides cardioprotection against ischaemia–reperfusion injury. The underlying mechanism remains unknown.

We examined whether transient inhibition of the MAS during ischaemia and early reperfusion by AOA treatment could prevent mitochondrial damage at later reperfusion.

The AOA treatment preserved mitochondrial respiratory capacity with reduced mitochondrial oxidative stress during late reperfusion to the same extent as ischaemic preconditioning (IPC).

However, AOA treatment, but not IPC, reduced the myocardial interstitial concentration of tricarboxylic acid cycle intermediates at the onset of reperfusion.

The results obtained in the present study demonstrate that metabolic regulation by inhibition of the MAS at the onset of reperfusion may be beneficial for the preservation of mitochondrial function during late reperfusion in an IR‐injured heart.

Mitochondrial dysfunction plays a central role in ischaemia–reperfusion (IR) injury. Pre‐ischaemic administration of aminooxyacetate (AOA), an inhibitor of the malate‐aspartate shuttle (MAS), provides cardioprotection against IR injury, although the underlying mechanism remains unknown. We hypothesized that a transient inhibition of the MAS during ischaemia and early reperfusion could preserve mitochondrial function at later phase of reperfusion in the IR‐injured heart to the same extent as ischaemic preconditioning (IPC), which is a well‐validated cardioprotective strategy against IR injury. In the present study, we show that pre‐ischaemic administration of AOA preserved mitochondrial complex I‐linked state 3 respiration and fatty acid oxidation during late reperfusion in IR‐injured isolated rat hearts. AOA treatment also attenuated the excessive emission of mitochondrial reactive oxygen species during state 3 with complex I‐linked substrates during late reperfusion, which was consistent with reduced oxidative damage in the IR‐injured heart. As a result, AOA treatment reduced infarct size after reperfusion. These protective effects of MAS inhibition on the mitochondria were similar to those of IPC. Intriguingly, the protection of mitochondrial function by AOA treatment appears to be different from that of IPC because AOA treatment, but not IPC, downregulated myocardial tricarboxilic acid (TCA)‐cycle intermediates at the onset of reperfusion. MAS inhibition thus preserved mitochondrial respiratory capacity and decreased mitochondrial oxidative stress during late reperfusion in the IR‐injured heart, at least in part, via metabolic regulation of TCA cycle intermediates in the mitochondria at the onset of reperfusion.
Presynaptic inhibition of transient receptor potential vanilloid type 1 (TRPV1) receptors by noradrenaline in nociceptive neurons
Authors: Chakraborty Saikat , Elvezio Vincent , Kaczocha Martin , Rebecchi Mario , Puopolo Michelino
Published: January 2017

Key points

The transient receptor potential vanilloid type 1 (TRPV1) receptor is a polymodal molecular integrator in the pain pathway expressed in Aδ‐ and C‐fibre nociceptors and is responsible for the thermal hyperalgesia associated with inflammatory pain.

Noradrenaline strongly inhibited the activity of TRPV1 channels in dorsal root ganglia neurons. The effect of noradrenaline was reproduced by clonidine and antagonized by yohimbine, consistent with contribution of α2 adrenergic receptors.

The inhibitory effect of noradrenaline on TRPV1 channels was dependent on calcium influx and linked to calcium/calmodulin‐dependent protein kinase II.

In spinal cord slices, clonidine reduced the frequency of capsaicin‐induced miniature EPSCs in the presence of tetrodotoxin and ω‐conotoxin‐MVIIC, consistent with inhibition of presynaptic TRPV1 channels by α2 adrenergic receptors.

We suggest that modulation of presynaptic TRPV1 channels in nociceptive neurons by descending noradrenergic inputs may constitute a mechanism for noradrenaline to modulate incoming noxious stimuli in the dorsal horn of the spinal cord.

The transient receptor potential vanilloid type 1 (TRPV1) receptor is a well‐known contributor to nociceptor excitability. To address whether noradrenaline can down‐regulate TRPV1 channel activity in nociceptors and reduce their synaptic transmission, the effects of noradrenaline and clonidine were tested on the capsaicin‐activated current recorded from acutely dissociated small diameter (<27 μm) dorsal root ganglia (DRG) neurons and on miniature (m)EPSCs recorded from large lamina I neurons in horizontal spinal cord slices. Noradrenaline or clonidine inhibited the capsaicin‐activated current by ∼60%, and the effect was reversed by yohimbine, confirming that it was mediated by activation of α2 adrenergic receptors. Similarly, clonidine reduced the frequency of capsaicin‐induced mEPSCs by ∼60%. Inhibition of capsaicin‐activated current by noradrenaline was mediated by GTP binding proteins, and was highly dependent on calcium influx. The inhibitory effect of noradrenaline on the capsaicin‐activated current was not affected either by blocking the activity of protein kinase A with H89, or by blocking the activity of protein kinase C with bisindolylmaleimide II. In contrast, when the calcium/calmodulin‐dependent protein kinase II (CaMKII) was blocked with KN‐93, the inhibitory effect of noradrenaline on the capsaicin‐activated current was greatly reduced, suggesting that activation of adrenergic receptors in DRG neurons is preferentially linked to CaMKII activity. We suggest that modulation of TRPV1 channels by noradrenaline in nociceptive neurons is a mechanism whereby noradrenaline may suppress incoming noxious stimuli at the primary synaptic afferents in the dorsal horn of the spinal cord.
A Hit on American Football: A Case Study of Bottom-up Framing Through Op-Ed Readers’ Comments
Authors: Bell Travis R. , Sanderson Jimmy
Published: January 2017

In December 2015, the movie Concussion was released. The film portrayed the story of Dr Bennet Omalu, who is credited with discovering chromic traumatic encephalopathy in the brains of deceased National Football League players. Before the release, on December 7, 2015, Omalu penned an op-ed in The New York Times in which he opined that children should not play tackle football. This research explores 114 reader comments on Omalu’s op-ed through the lens of Nisbet’s bottom-up framing. Using a mixed-methods approach, the results indicated that participants framed the issue through health and safety, American cultural values, parenting liability, and skepticism. Linguistic analysis revealed that comments contained a negative tone, with women’s comments being more negative than men’s. The analysis suggests that online news forums function as spaces where public deliberation around the viability of children playing tackle football occurs and illustrates the tensions around risk, sport participation, and health and safety that confront parents as they grapple with the decision to let their children play tackle football
A Pilot Study Using Entropy as a Noninvasive Assessment of Running
Authors: Murray Andrew M. , Ryu Joong Hyun , Sproule John , Turner Anthony P. , Graham-Smith Phil , Cardinale Marco
Published: January 2017

Purpose:

Running performance is influenced by the interaction of biomechanical and physiological factors. Miniaturized accelerometers worn by athletes can be used to quantify mechanical aspects of running and as a noninvasive tool to assess training status and progression. The aim of this study was to define and validate a method to assess running regularity and allow the estimation of an individual’s oxygen uptake (V̇O2) and/or blood lactate—[La]b—based on data collected with accelerometers and heart rate.

Methods:

Male adolescent endurance athletes completed an incremental submaximal aerobic stage test where V̇O2 and [La]b were measured. The test was terminated when [La]b concentration at the end of the stage exceeded 4 mmol/L. Two wireless triaxial accelerometers were placed on participants’ right shank and lower back throughout the test. The root mean square (RMS) and sample entropy (SampEn) were calculated for the vertical, mediolateral, and anteroposterior components of acceleration.

Results:

There were significant positive correlations of acceleration and entropy variables with [La]b and V̇O2, with moderate to high coefficients (r = .43–.87). RMS of the shank acceleration was the most highly related with both physiological variables. When the accelerometer was attached on the trunk, SampEn of the vertical acceleration had the strongest relationship with V̇O2 (r = .76, P < .01).

Conclusions:

The described method analyzing running complexity may allow an assessment of gait variability, which noninvasively tracks V̇O2 and/or [La]b, allowing monitoring of fatigue or training readiness for trained adolescent individuals.
Impaired Player–Coach Perceptions of Exertion and Recovery During Match Congestion
Authors: Doeven Steven H. , Brink Michel S. , Frencken Wouter G.P. , Lemmink Koen A.P.M.
Published: January 2017

During intensified phases of competition, attunement of exertion and recovery is crucial to maintain performance. Although a mismatch between coach and player perceptions of training load is demonstrated, it is unknown if these discrepancies also exist for match exertion and recovery.

Purpose:

To determine match exertion and subsequent recovery and to investigate the extent to which the coach is able to estimate players’ match exertion and recovery.

Methods:

Rating of perceived exertion (RPE) and total quality of recovery (TQR) of 14 professional basketball players (age 26.7 ± 3.8 y, height 197.2 ± 9.1 cm, weight 100.3 ± 15.2 kg, body fat 10.3% ± 3.6%) were compared with observations of the coach. During an in-season phase of 15 matches within 6 wk, players gave RPEs after each match. TQR scores were filled out before the first training session after the match. The coach rated observed exertion (ROE) and recovery (TQ-OR) of the players.

Results:

RPE was lower than ROE (15.6 ± 2.3 and 16.1 ± 1.4; P = .029). Furthermore, TQR was lower than TQ-OR (12.7 ± 3.0 and 15.3 ± 1.3; P < .001). Correlations between coach- and player-perceived exertion and recovery were r = .25 and r = .21, respectively. For recovery within 1 d the correlation was r = .68, but for recovery after 1–2 d no association existed.

Conclusion:

Players perceive match exertion as hard to very hard and subsequent recovery reasonable. The coach overestimates match exertion and underestimates degree of recovery. Correspondence between coach and players is thus not optimal. This mismatch potentially leads to inadequate planning of training sessions and decreases in performance during fixture congestion in basketball.
Monitoring Fatigue Status in Elite Team-Sport Athletes: Implications for Practice
Authors: Thorpe Robin T. , Atkinson Greg , Drust Barry , Gregson Warren
Published: January 2017

The increase in competition demands in elite team sports over recent years has prompted much attention from researchers and practitioners to the monitoring of adaptation and fatigue in athletes. Monitoring fatigue and gaining an understanding of athlete status may also provide insights and beneficial information pertaining to player availability, injury, and illness risk. Traditional methods used to quantify recovery and fatigue in team sports, such as maximal physical-performance assessments, may not be feasible to detect variations in fatigue status throughout competitive periods. Faster, simpler, and nonexhaustive tests such as athlete self-report measures, autonomic nervous system response via heart-rate-derived indices, and to a lesser extent, jump protocols may serve as promising tools to quantify and establish fatigue status in elite team-sport athletes. The robust rationalization and precise detection of a meaningful fluctuation in these measures are of paramount importance for practitioners working alongside athletes and coaches on a daily basis. There are various methods for arriving at a minimal clinically important difference, but these have been rarely adopted by sport scientists and practitioners. The implementation of appropriate, reliable, and sensitive measures of fatigue can provide important information to key stakeholders in team-sport environments. Future research is required to investigate the sensitivity of these tools to fundamental indicators such as performance, injury, and illness.
Effects of Cycling Training at Imposed Low Cadences: A Systematic Review
Authors: Hansen Ernst A. , Rønnestad Bent R.
Published: January 2017

The present article reviews effects of training at low imposed cadences in cycling. The authors performed a systematic literature search of MEDLINE and SPORTDiscus up to April 2016 to identify potentially relevant articles. Based on the titles and abstracts of the identified articles, a subset of articles was selected for evaluation. These articles constituted original-research articles on adaptation to training at different imposed cadences in cycling. Seven articles were selected for evaluation. With regard to the terminology in the present article, low cadences are those below the freely chosen cadence. The rate of 80 rpm can, eg, be considered a low cadence if effort is maximal. On the other hand, the cadence has to be lower than 80 rpm (eg, 40–70 rpm) to be considered low if cycling is performed at low power output. The reason is that the choice of cadence depends on power output. In conclusion, there is presently no strong evidence for a benefit of training at low cadences. It can tentatively be recommended to consider including training bouts of cycling at low cadence at moderate to maximal intensity. The reason for the restrained recommendation is that some of the selected studies indicate no clear performance-enhancing effect of training at low cadence or even indicate a superior effect from training at freely chosen cadence. Furthermore, the selected studies are considerably dissimilar with respect to, eg, participant characteristics and to the applied training regimens.
Physiological Capacity and Training Routines of Elite Cross-Country Skiers: Approaching the Upper Limits of Human Endurance
Authors: Sandbakk Øyvind , Holmberg Hans-Christer
Published: January 2017

Cross-country (XC) skiing is one of the most demanding of endurance sports, involving protracted competitions on varying terrain employing a variety of skiing techniques that require upper- and/or lower-body work to different extents. Through more effective training and extensive improvements in equipment and track preparation, the speed of cross-country ski races has increased more than that of any other winter Olympic sport, and, in addition, new types of racing events have been introduced. To a certain extent this has altered the optimal physiological capacity required to win, and the training routines of successful skiers have evolved accordingly. The long-standing tradition of researchers working closely with XC-ski coaches and athletes to monitor progress, improve training, and refine skiing techniques has provided unique physiological insights revealing how these athletes are approaching the upper limits of human endurance. This review summarizes current scientific knowledge concerning the demands involved in elite XC skiing, as well as the physiological capacity and training routines of the best athletes.
Regular Latin Dancing and Health Education May Improve Cognition of Late Middle-Aged and Older Latinos
Authors: Marquez David X. , Wilson Robert , Aguiñaga Susan , Vásquez Priscilla , Fogg Louis , Yang Zhi , Wilbur JoEllen , Hughes Susan , Spanbauer Charles
Published: January 2017

Disparities exist between Latinos and non-Latino Whites in cognitive function. Dance is culturally appropriate and challenges individuals physically and cognitively, yet the impact of regular dancing on cognitive function in older Latinos has not been examined. A two-group pilot trial was employed among inactive, older Latinos. Participants (N = 57) participated in the BAILAMOS© dance program or a health education program. Cognitive test scores were converted to z-scores and measures of global cognition and specific domains (executive function, episodic memory, working memory) were derived. Results revealed a group × time interaction for episodic memory (p < .05), such that the dance group showed greater improvement in episodic memory than the health education group. A main effect for time for global cognition (p < .05) was also demonstrated, with participants in both groups improving. Structured Latin dance programs can positively influence episodic memory, and participation in structured programs may improve overall cognition among older Latinos.
Targeting TNFR2 with antagonistic antibodies inhibits proliferation of ovarian cancer cells and tumor-associated T
regs
Authors: Torrey Heather , Butterworth John , Mera Toshiyuki , Okubo Yoshiaki , Wang Limei , Baum Danielle , Defusco Audrey , Plager Sara , Warden Sarah , Huang Daniel , Vanamee Eva , Foster Rosemary , Faustman Denise L.
Published: January 2017

An antibody against TNFR2 may treat ovarian cancer by killing tumor cells while limiting the activity of suppressive immune cells.
Haemodialysis in acute paracetamol poisoning
Authors: Serjeant L , Evans J , Sampaziotis F , Petchey W G
Published: January 2017

A woman aged 23 years presented late with clinical and biochemical features of a life-threatening paracetamol (acetaminophen) overdose. Despite instigatingN-acetylcysteine treatment, due to evidence of mitochondrial dysfunction together with an exceedingly high paracetamol level, the decision was made to dialyse the patient acutely to remove the parent drug. This was highly effective, and with on-going supportive care, the patient made a full recovery without the need for transplantation. This case highlights the role of extracorporeal therapy as atreatmentoption in selected cases of paracetamol overdose, consistent with the international guidelines.
Paediatric ED BiPAP continuous quality improvement programme with patient analysis: 2005–2013
Authors: Abramo Thomas , Williams Abby , Mushtaq Samaiya , Meredith Mark , Sepaule Rawle , Crossman Kristen , Burney Jones Cheryl , Godbold Suzanne , Hu Zhuopei , Nick Todd
Published: January 2017

Objective

In paediatric moderate-to-severe asthmatics, there is significant bronchospasm, airway obstruction, air trapping causing severe hyperinflation with more positive intraplural pressure preventing passive air movement. These effects cause an increased respiratory rate (RR), less airflow and shortened inspiratory breath time. In certain asthmatics, aerosols are ineffective due to their inadequate ventilation. Bilevel positive airway pressure (BiPAP) in acute paediatric asthmatics can be an effective treatment. BiPAP works by unloading fatigued inspiratory muscles, a direct bronchodilation effect, offsetting intrinsic PEEP and recruiting collapsed alveoli that reduces the patient's work of breathing and achieves their total lung capacity quicker. Unfortunately, paediatric emergency department (PED) BiPAP is underused and quality analysis is non-existent. A PED BiPAP Continuous Quality Improvement Program (CQIP) from 2005 to 2013 was evaluated using descriptive analytics for the primary outcomes of usage, safety, BiPAP settings, therapeutics and patient disposition.

Interventions

PED BiPAP CQIP descriptive analytics.

Setting

Academic PED.

Participants

1157 patients.

Interventions

A PED BiPAP CQIP from 2005 to 2013 for the usage, safety, BiPAP settings, therapeutic response parameters and patient disposition was evaluated using descriptive analytics.

Primary and secondary outcomes

Safety, usage, compliance, therapeutic response parameters, BiPAP settings and patient disposition.

Results

1157 patients had excellent compliance without complications. Only 6 (0.5%) BiPAP patients were intubated. BiPAP median settings: IPAP 18 (16,20) cm H2O range 12–28; EPAP 8 cmH2O (8,8) range 6–10; inspiratory-to-expiratory time (I:E) ratio 1.75 (1.5,1.75). Pediatric Asthma Severity score and RR decreased (p<0.001) while tidal volume increased (p<0.001). Patient disposition: 325 paediatric intensive care units (PICU), 832 wards, with 52 of these PED ward patients were discharged home with only 2 hours of PED BiPAP with no returning to the PED within 72 hours.

Conclusions

BiPAP is a safe and effective therapeutic option for paediatric patients with asthma presenting to a PED or emergency department. This BiPAP CQIP showed significant patient compliance, no complications, improved therapeutics times, very low intubations and decreased PICU admissions. CQIP analysis demonstrated that using a higher IPAP, low EPAP with longer I:E optimises the patient's BiPAP settings and showed a significant improvement in PAS, RR and tidal volume. BiPAP should be considered as an early treatment in the PED severe or non-responsive moderate asthmatics.
Development and validation of a prediction model for gestational hypertension in a Ghanaian cohort
Authors: Antwi Edward , Groenwold Rolf H H , Browne Joyce L , Franx Arie , Agyepong Irene A , Koram Kwadwo A , Klipstein-Grobusch Kerstin , Grobbee Diederick E
Published: January 2017

Objective

To develop and validate a prediction model for identifying women at increased risk of developing gestational hypertension (GH) in Ghana.

Design

A prospective study. We used frequencies for descriptive analysis, χ2test for associations and logistic regression to derive the prediction model. Discrimination was estimated by the c-statistic. Calibration was assessed by calibration plot of actual versus predicted probability.

Setting

Primary care antenatal clinics in Ghana.

Participants

2529 pregnant women in the development cohort and 647 pregnant women in the validation cohort. Inclusion criterion was women without chronic hypertension.

Primary outcome

Gestational hypertension.

Results

Predictors of GH were diastolic blood pressure, family history of hypertension in parents, history of GH in a previous pregnancy, parity, height and weight. The c-statistic of the original model was 0.70 (95% CI 0.67–0.74) and 0.68 (0.60 to 0.77) in the validation cohort. Calibration was good in both cohorts. The negative predictive value of women in the development cohort at high risk of GH was 92.0% compared to 94.0% in the validation cohort.

Conclusions

The prediction model showed adequate performance after validation in an independent cohort and can be used to classify women into high, moderate or low risk of developing GH. It contributes to efforts to provide clinical decision-making support to improve maternal health and birth outcomes.
Burden of disease associated with lower levels of income among US adults aged 65 and older
Authors: Lubetkin Erica I , Jia Haomiao
Published: January 2017

Background

Persons aged 65 years and older represent a heterogeneous group whose prevalence in the USA is expected to markedly increase. Few investigations have examined the total burden of disease attributable to lower levels of income in a single number that accounts for morbidity and mortality.

Methods

We ascertained respondents' health-related quality of life (HRQOL) scores and mortality status from the 2003 to 2004, 2005 to 2006, 2007 to 2008 and 2009 to 2010 cohorts of the National Health and Nutrition Examination Survey (NHANES) with mortality follow-up through 31 December 2011. A mapping algorithm based on respondents' age and answers to the 4 core Healthy Days questions was used to obtain values of a preference-based measure of HRQOL, the EuroQol five dimensions questionnaire (EQ-5D) index, which enables quality-adjusted life years (QALYs) to be calculated. We included only respondents aged 65 years and older at the baseline, yielding a total sample size of 4952. We estimated mean QALYs according to different categories of income based on the percentage of Federal Poverty Level (FPL).

Results

After adjusting for age, gender and education, the remaining QALYs decreased with each successive decrement of category of income, ranging from 18.4 QALY (≥500% FPL) to 8.6 QALY (<100% FPL). Compared with participants with a mean income of ≥250% FPL, participants with an income <250% FPL had significant losses in QALY for most of the sociodemographic groups examined. In contrast, persons with a lower educational attainment did not show a corresponding loss in QALY according to income category.

Conclusions

This study confirmed the association between lower income category and greater burden of disease, as measured by QALYs lost, among the US population aged 65 years and older. Our findings provide additional evidence of the role played by other key determinants of health and how factors not traditionally addressed by the healthcare system impact the life cycle of individuals and communities.
Improving visual assessment documentation in patients with periorbital trauma through an eye assessment teaching session and a proforma sticker
Authors: Myuran Tharsika
Published: January 2017

Up to 30% of patients who have periorbital trauma will have ocular injury with devastating consequences if missed. All staff working with acutely injured Oral and Maxillofacial Surgery (OMFS) patients should be competent in a basic eye examination with documentation of visual acuity, gross visual fields, eye movements, diplopia, and pupillary responses at a minimum. As a standard we adapted guidance published by the Emergency Care Institute New South Wales to assess the documentation of the eye examination in OMFS patients at King's College Hospital with any periorbital injury. After initial assessment we presented the data in the departmental audit meeting, then gave a detailed teaching session to junior doctors and introduced an ‘eye exam’ proforma sticker designed to act as an aide memoir. At baseline, 38 eye assessments across all clinical environments and by all seniority of clinician were assessed at random. Of these, 41% of these had visual acuity documented, 5% visual fields, 47% pupils, and 83% movements. After presentation of data, reaudit showed progress to 81%, 0%, 94%, and 100% respectively. Following the teaching session reaudit showed final progression to 83%, 46%, 83%, and 100%. Teaching sessions and use of an eye sticker proforma has been shown to improve rates of documentation of the eye exam for those OMFS patients presenting with periorbital injuries.
Percutaneous PFO closure for cryptogenic stroke in the setting of a systematic cardiac and neurological screening and a standardised follow-up protocol
Authors: Noble Stéphane , Bonvini Robert F , Rigamonti Fabio , Sztajzel Roman , Perren Fabienne , Meyer Philippe , Müller Hajo , Roffi Marco
Published: January 2017

Background

There are no uniform workup and follow-up (FU) protocols for patients presenting with cryptogenic embolism (CE) who undergo percutaneous closure of a patent foramen ovale (PFO).

Methods

We prospectively performed a systematic cardiac and neurological FU protocol in all patients who underwent percutaneous PFO closure in order to assess the incidence of subsequent cardiac and neurological adverse events. All patients received dual antiplatelet therapy for 6 months and were systematically included in a 12-month standardised FU protocol including: clinical evaluation—transthoracic and transoesophageal echocardiography, 24-hour Holter monitoring and/or 1-week R-test, and transcranial Doppler. Late FU (>12 months) was performed by reviewing medical records.

Results

Over a 10-year period, 221 consecutive patients underwent PFO closure for CE and 217 of them (98%) completed the 12-month FU. Ischaemic event recurrence at 12-month and late FU (mean time 69±35 months, median time 65 months, Q1:38 months, Q3:98 months) was observed in 6 (2.8%) and 3 patients (1.4%), respectively. The initial diagnosis of CE was reconsidered in 17 cases (7.8%), as the clinical and paraclinical FU exams showed possible alternative aetiologies for the initial event: 13 patients (6.0%) presented at least 1 episode of atrial fibrillation, while in 4 cases (1.8%) a non-ischaemic origin of the initial symptoms was identified.

Conclusions

Alternative diagnoses explaining the initial symptoms are rarely detected with an in-depth screening for alternative diagnoses before PFO closure. Despite extensive screening, atrial fibrillation is the most frequently observed alternative aetiology for cryptogenic stroke.
Cardiac mechanics and dysfunction with anthracyclines in the community: results from the PREDICT study
Authors: Narayan Hari K , Wei Wei , Feng Ziding , Lenihan Daniel , Plappert Ted , Englefield Virginia , Fisch Michael , Ky Bonnie
Published: January 2017

Background

Our objective was to determine the relevance of changes in myocardial mechanics in diagnosing and predicting cancer therapeutics-related cardiac dysfunction (CTRCD) in a community-based population treated with anthracyclines.

Methods

Quantitative measures of cardiac mechanics were derived from 493 echocardiograms in 165 participants enrolled in the PREDICT study (A Multicenter Study inPatients Undergoing AnthRacycline-Based Chemotherapy to Assess theEffectiveness of Using Biomarkers toDetect andIdentifyCardiotoxicity and DescribeTreatment). Echocardiograms were obtained primarily at baseline (prior to anthracyclines), 6 and 12 months. Predictors included changes in strain; strain rate; indices of contractile function derived from the end-systolic pressure–volume relationship (end-systolic elastance (Eessb) and the left ventricular (LV) volume at an end-systolic pressure of 100 mm Hg (V100)); total arterial load (effective arterial elastance (Ea)) and ventricular–arterial coupling (Ea/Eessb). Logistic regression models determined the diagnostic and prognostic associations of changes in these measures and CTRCD, defined as a LV ejection fraction decline ≥10 to <50%.

Results

By 12 months, 31 participants developed CTRCD. Longitudinal and circumferential strain and strain rate, V100, Ea, and Ea/Eessbeach demonstrated significant diagnostic associations, with a 1–7% increased odds of CTRCD (p<0.05). Changes in longitudinal strain rate (area under the curve (AUC) 0.719 (95% CI 0.595 to 0.843)), V100(AUC 0.796 (95% CI 0.686 to 0.903)) and Ea (AUC 0.742 (95% CI 0.632 to 0.852)) from baseline to 6 months were individually predictive of CTRCD at 12 months.

Conclusions

Changes in non-invasively derived measures of myocardial mechanics are diagnostic and predictive of cardiac dysfunction with anthracycline chemotherapy in community populations. Our findings support the non-invasive assessment of measures of myocardial mechanics more broadly in clinical practice and emphasise the role of serial assessments of these measures during and after cardiotoxic cancer therapy.

Trial registration number

NCT01032278; Pre-results.