'Sonic Attacks' on Cuban Diplomats May Have Actually Been Crickets

An echoing cricket call was responsible for the sound in the released recording of persistent, high-pitched sound that American diplomats in Cuba heard during the sonic attack at the embassy in 2016, according to a new study (http://bit.ly/2M7klB0). Two scientists, Alexander Stubbs, a graduate student in integrative biology at the University of California, Berkeley, and Fernando Montealegre-Zapata, PhD, a professor of sensory biology at the University of Lincoln in the United Kingdom, studied a recording of said sound published by the Associated Press and compared it with field recordings of North American insects. They found that the calling song of the Indies short-tailed cricket matches, in nuanced detail, the AP recording in duration, pulse repetition rate, power spectrum, pulse rate stability, and oscillations per pulse. They also discovered that the AP recording exhibits frequency decay in individual pulses, which is a distinct acoustic signature of cricket sound production. This finding disproves the popular theory that the sound that the American diplomats reported hearing was generated by a sonic weapon. The study authors therefore concluded that more rigorous research is needed to identify the source of the ailments that the American diplomats experienced. 

Published: 1/11/2019 1:55:00 PM

from #Audiology via ola Kala on Inoreader http://bit.ly/2SRAeOA
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'Sonic Attacks' on Cuban Diplomats May Have Actually Been Crickets

An echoing cricket call was responsible for the sound in the released recording of persistent, high-pitched sound that American diplomats in Cuba heard during the sonic attack at the embassy in 2016, according to a new study (http://bit.ly/2M7klB0). Two scientists, Alexander Stubbs, a graduate student in integrative biology at the University of California, Berkeley, and Fernando Montealegre-Zapata, PhD, a professor of sensory biology at the University of Lincoln in the United Kingdom, studied a recording of said sound published by the Associated Press and compared it with field recordings of North American insects. They found that the calling song of the Indies short-tailed cricket matches, in nuanced detail, the AP recording in duration, pulse repetition rate, power spectrum, pulse rate stability, and oscillations per pulse. They also discovered that the AP recording exhibits frequency decay in individual pulses, which is a distinct acoustic signature of cricket sound production. This finding disproves the popular theory that the sound that the American diplomats reported hearing was generated by a sonic weapon. The study authors therefore concluded that more rigorous research is needed to identify the source of the ailments that the American diplomats experienced. 

Published: 1/11/2019 1:55:00 PM

from #Audiology via ola Kala on Inoreader http://bit.ly/2SRAeOA

'Sonic Attacks' on Cuban Diplomats May Have Actually Been Crickets

An echoing cricket call was responsible for the sound in the released recording of persistent, high-pitched sound that American diplomats in Cuba heard during the sonic attack at the embassy in 2016, according to a new study (http://bit.ly/2M7klB0). Two scientists, Alexander Stubbs, a graduate student in integrative biology at the University of California, Berkeley, and Fernando Montealegre-Zapata, PhD, a professor of sensory biology at the University of Lincoln in the United Kingdom, studied a recording of said sound published by the Associated Press and compared it with field recordings of North American insects. They found that the calling song of the Indies short-tailed cricket matches, in nuanced detail, the AP recording in duration, pulse repetition rate, power spectrum, pulse rate stability, and oscillations per pulse. They also discovered that the AP recording exhibits frequency decay in individual pulses, which is a distinct acoustic signature of cricket sound production. This finding disproves the popular theory that the sound that the American diplomats reported hearing was generated by a sonic weapon. The study authors therefore concluded that more rigorous research is needed to identify the source of the ailments that the American diplomats experienced. 

Published: 1/11/2019 1:55:00 PM

from #Audiology via ola Kala on Inoreader http://bit.ly/2SRAeOA
via IFTTT

Structure and biological activities of a hexosamine-rich cell wall polysaccharide isolated from the probiotic Lactobacillus farciminis

Abstract

Lactobacillus farciminis CIP 103136 is a bacterial strain with recognized probiotic properties. However, the mechanisms underlying such properties have only been partially elucidated. In this study, we isolated and purified a cell-wall associated polysaccharide (CWPS), and evaluated its biological role in vitro. The structure of CWPS and responses from stimulation of (i) human macrophage-like THP-1 cells, (ii) human embryonal kidney (HEK293) cells stably transfected with Toll-like receptors (TLR2 or TLR4) and (iii) human colonocyte-like T84 intestinal epithelial cells, upon exposure to CWPS were studied. The structure of the purified CWPS from L. farciminis CIP 103136 was analyzed by nuclear magnetic resonance (NMR), MALDI-TOF-TOF MS, and methylation analyses in its native form and following Smith degradation. It was shown to be a novel branched polysaccharide, composed of linear backbone of trisaccharide repeating units of: [→6αGlcpNAc1 → 4βManpNAc1 → 4βGlcpNAc1→] highly substituted with single residues of αGlcp, αGalp and αGlcpNAc. Subsequently, the lack of pro- or anti-inflammatory properties of CWPS was established on macrophage-like THP-1 cells. In addition, CWPS failed to modulate cell signaling pathways dependent of TLR2 and TLR4 in transfected HEK-cells. Finally, in T84 cells, CWPS neither influenced intestinal barrier integrity under basal conditions nor prevented TNF-α/IFN-γ cytokine-mediated epithelium impairment.

http://bit.ly/2slBMVF

Recursive SURE for image recovery via total variation minimization

Abstract

Recently, total variation regularization has become a standard technique, and even a basic tool for image denoising and deconvolution. Generally, the recovery quality strongly depends on the regularization parameter. In this work, we develop a recursive evaluation of Stein's unbiased risk estimate (SURE) for the parameter selection, based on specific reconstruction algorithms. It enables us to monitor the evolution of mean squared error (MSE) during the iterations. In particular, to deal with large-scale data, we propose a Monte Carlo simulation for the practical computation of SURE, which is free of any explicit matrix operation. Experimental results show that the proposed recursive SURE could lead to highly accurate estimate of regularization parameter and nearly optimal restoration performance in terms of MSE.

http://bit.ly/2D4zj81

How is vasospasm screening using transcranial Doppler associated with delayed cerebral ischemia and outcomes in aneurysmal subarachnoid hemorrhage?

Abstract

Background

Delayed cerebral ischemia (DCI) is an independent predictor of an unfavorable outcome after aneurysmal subarachnoid hemorrhage (aSAH). Many centers, but not all, use transcranial Doppler (TCD) to screen for vasospasm to help predict DCI. We used the United Kingdom and Ireland Subarachnoid Haemorrhage (UKISAH) Registry to see if outcomes were better in centers that used TCD to identify vasospasm compared to those that did not.

Methods

TCD screening practices were ascertained by national survey in 13 participating centers of the UKISAH. The routine use of TCD was reported by 5 "screening" centers, leaving 7 "non-screening" centers. Using a cross-sectional cohort study design, prospectively collected data from the UKISAH Registry was used to compare DCI diagnosis and favorable outcome (Glasgow Outcome Score 4 or 5) at discharge based on reported screening practice.

Results

A cohort of 2028 aSAH patients treated ≤ 3 days of hemorrhage was analyzed. DCI was diagnosed in 239/1065 (22.4%) and 220/963 (22.8%) of patients in non-screening and screening centers respectively while 847/1065 (79.5%) and 648/963 (67.2%) achieved a favorable outcome. Odds ratios adjusted for age, injury severity, comorbidities, need for cerebrospinal fluid diversion, and re-bleed returned neutral odds of diagnosing DCI of 0.90 (95% CI 0.72–1.12; p value = 0.347) in screening units compared to those of non-screening units but significantly decreased odds of achieving a favorable outcome 0.56 (95% CI 0.42–0.82; p value < 0.001).

Conclusions

Centers that screened for vasospasm using TCD had poorer in-hospital outcomes and similar rates of DCI diagnosis compared to centers that did not.

http://bit.ly/2SQ8IRR

TrkB neurotrophin receptor at the core of antidepressant effects, but how?

Abstract

The role of brain-derived neurotrophic factor (BDNF) and its receptor TrkB has been studied in the context of mood disorders and their treatments for a couple of decades. Pharmacologically diverse antidepressant drugs increase the synthesis of BDNF in the cortex (and some subcortical structures) and this effect accounts for their ability to facilitate neurotrophic processes eventually leading into heightened plasticity within the cortex. Induction of BDNF-TrkB signaling has also been associated with the mechanism of action of ketamine and more recently with some other anesthetics, even with ones not thought to possess antidepressant potential. Notably, both ketamine and conventional antidepressants activate TrkB receptor and its downstream signaling rapidly within the same time scale in the brain while electroconvulsive therapy (ECT), among the most potent inducers of BDNF, has not been unequivocally shown to produce such acute effects on TrkB. The ability of antidepressants to regulate TrkB signaling is developmentally regulated and requires an intact central nervous system. The purpose of this review is to highlight and discuss some of these peculiarities associated with the effects of ketamine and classical antidepressants and BDNF on TrkB signaling.

http://bit.ly/2FoJ1Vk

Antibiotic use in early childhood and risk of obesity: longitudinal analysis of a national cohort

Abstract

Background

Taking oral antibiotics during childhood has been linked with an increased risk of childhood obesity. This study assessed any potential association in number of courses of antibiotics taken between 2–3 and 4–5 years of age and body mass trajectory up to age 5.

Methods

The study was a secondary analysis of 8186 children and their parents from the infant cohort of the Irish National Longitudinal Study of Children. Antibiotic use was measured by parental recall between ages 2–3 and 4–5. Longitudinal models described the relationship between antibiotic exposure and body mass index (BMI) standard deviation scores and binary outcomes, and examined interactions between covariates, which included socioeconomic status, diet assessed by food frequency questionnaires and maternal BMI.

Results

Any antibiotic usage between 2 and 3 years did not predict risk of overweight or obesity at age 5. Four or more courses of antibiotics between 2 and 3 years were independently associated with obesity at age 5 (odds ratio 1.6, 95% confidence interval 1.11–2.31). Effect size was modest (coefficient + 0.09 body mass SD units, standard error 0.04, P = 0.037). Maternal BMI modified the relationship: ≥ 4 courses of antibiotics between 2 and 3 years were associated with a + 0.12 body mass SD units increase in weight at age 5 among children of normal-weight mothers (P = 0.035), but not in children of overweight mothers.

Conclusions

Number of antibiotic courses, rather than antibiotic use, may be an important factor in any link between early antibiotic exposure and subsequent childhood obesity. Research is needed to confirm differential effects on babies of normal versus overweight/obese mothers independent of socioeconomic factors.

http://bit.ly/2SOpv7K

Mechanic hands: clinical and capillaroscopy manifestations of patients with connective tissue diseases presented with and without mechanic hands

Abstract

Objectives

The condition known as 'Mechanic's Hands' is a thickened, hyperkeratotic eruption, which is bilaterally symmetric along the fingers, and often occurs in patients with some connective tissue diseases. Nail fold capillaroscopy is a non-invasive technique for evaluation of connective tissue diseases. We evaluated the prevalence of mechanic hands in patients with connective tissue diseases and compared the clinical manifestations and capillaroscopic changes in the patients with and without mechanic hands.

Methods

The clinical manifestations and capillaroscopy of 576 patients with scleroderma, dermatomyositis, systemic lupus erythematosus, Sjogren's syndrome, undifferentiated and mixed connective tissue diseases were evaluated and compared in patients with and without mechanic hands.

Results

A total of 576 patients were enrolled. Mechanic hands were observed in 17.2% of patients: 50% of mixed connective tissue disease, 35% of dermatomyositis, 15.4% of scleroderma, 14.9% of undifferentiated connective tissue disease, 14.3% of Sjogren's syndrome, and no patient with SLE. Among them, 80.8% had abnormal capillaroscopic findings. In dermatomyositis patients, Raynaud's phenomenon, anti-Jo-1 positivity, and some capillaroscopy findings were detected more frequently in patients with mechanic hand. In scleroderma, positive Scl70 and capillary loss were observed more frequently in patients without mechanic hands.

Conclusions

Mechanic hands can be a presenting sign of some systemic connective tissue diseases. Probably, finding this sign on examination, especially together with Raynaud's phenomenon or abnormal capillaroscopy, can be helpful in the early diagnosis of the connective tissue diseases and can be used as a predictive and prognostic tool in future studies.

http://bit.ly/2RQEbWR

Dental pulp stem cell transplantation ameliorates motor function and prevents cerebellar atrophy in rat model of cerebellar ataxia

Abstract

Cerebellar ataxias (CA) include a range of neurodegenerative disorders hallmarked by deterioration of the cerebellum. Cell replacement therapy (CRT) offers a potential remedy for the diseases associated with the central nervous system (CNS). This study was designed to assess the neurorestorative/protective effects of dental pulp stem cell (DPSC) implantation on a rat model of CA induced by 3-acetylpyridine (3-AP) as a neurotoxin. To begin, human DPSCs were extracted, cultured and phenotypically characterized. Then, experimental ataxia was induced in 20 male adult rats by a single injection of 3-AP and bilateral DPSC transplantation was performed 3 days after 3-AP administration, followed by stereological analysis of cerebellar layers along with assessment of motor skills and inflammatory response. The findings showed that transplantation of DPSCs in a 3-AP model of ataxia ameliorated motor coordination and muscle activity, increased cerebellar volumes of molecular and granular layers plus white matter, reduced the levels of inflammatory cytokines and thwarted the degeneration of Purkinje cells against 3-AP toxicity. Taken together, human DPSCs could be considered as a suitable candidate for CRT-based therapies with a specific focus on CA.

http://bit.ly/2H5m76Y

Testosterone improves the osteogenic potential of a composite in vitro and in vivo

Abstract

Testosterone (T) has been suggested as a promising agent in the bone osteointegration when incorporated in a bioceramic/polymer combination for the local application. The objective of this study was to evaluate the activity of a testosterone composite of poly (lactic-co-glycolic acid) (PLGA), polycaprolactone (PCL), and biphasic calcium phosphate (BCP) as a strategy for enhancing its osteogenic effect and to evaluate tissue response to the composite implantation. PLGA/PCL/BCP/T and PLGA/PCL/BCP composites were prepared and characterized using thermal analysis. Composite morphology and surface characteristics were assessed by SEM and EDS. The evaluations of in vitro effects of testosterone composite on osteoblasts viability, alkaline phosphatase activity, collagen production, osteocalcin concentration, quantification of mineralization, and nitric oxide concentration, after 7, 14, and 21 days. Testosterone was successfully incorporated and composites showed a homogeneously distributed porous structure. The PLGA/PCL/BCP/T composite had a stimulatory effect on osteoblastic activity on the parameters evaluated, except to nitric oxide production. After 60 days, the PLGA/PCL/BCP/T composite showed no chronic inflammatory infiltrate, whereas the PLGA/PCL/BCP composite showed mild chronic inflammatory infiltrate. Angiogenesis, cellular adsorption, and fibrous deposit were observed on the surfaces of implanted composites. The composites in combination with testosterone can be exploited to investigate the use of this scaffold for bone integration.

http://bit.ly/2RHH7F6

The ascomycete genus Niesslia and associated monocillium-like anamorphs

Abstract

The species of Niesslia including anamorphs formerly known as Monocillium form a distinct group in the Hypocreales and can be delimited by several unique morphological characters. Niesslia species inhabit decaying plant substrates, such as leaf litter or bark of diverse plants, especially coniferous hosts. Certain species occur on and may parasitize lichens, fruiting bodies of other fungi and even nematode eggs. Taxonomically, species of Niesslia are classified in the Niessliaceae. Niesslia species are recognised by their tiny superficial, mostly dark brown, shiny and typically spine covered ascomata. Monocillium-like phialides formed in situ and in culture are usually partly or entirely thick-walled. Phialides with wall thickening only in their basal parts sometimes expand in width to taper again into a conidiiferous neck, while others terminate in a non-sporulating vesicle. Based on the revised generic concept presented here, Niesslia accommodates 50 cultured species plus around 40 species known only from herbarium material. Some of the latter species may eventually have to be excluded from Niesslia but are maintained in the genus ad interim, until DNA sequences necessary for their accurate reclassification are available. The taxonomic concept based on morphological characters is corroborated by DNA sequences of phylogenetic marker loci such as the large subunit (28S) of the ribosomal RNA gene, internal transcribed spacer regions 1 and 2 including the 5.8S ribosomal RNA gene, and partial sequences of translation elongation factor 1-α, β-tubulin 2 and γ-actin genes. These DNA barcodes support most of the morphologically delimited species and the generic concept of Niesslia.

http://bit.ly/2VP1E9E

Stability Control for Dynamic Walking of Bipedal Robot with Real-time Capture Point Trajectory Optimization

Abstract

This paper proposes a stabilization method for dynamic walking of a bipedal robot with real-time optimization of capture point trajectories. We used the capture point trajectories to generate the control input, which is the desired zero moment point (ZMP) with a sliding-mode ZMP controller to follow the desired ZMP. This method enables the robot to implement various dynamic walking commands, such as forward stride, lateral stride, walking direction, single support time, and double support time. We also adopted enhanced dynamics with the three mass linear inverted pendulum model (3M-LIPM). First, the compensated ZMP is calculated by both walking commands and kinematic configuration of the robot in closed form. Then, the walking pattern is obtained by using initial and boundary conditions of the 3M-LIPM, which satisfies the walking commands. The capture point (CP) trajectory is optimized in real time to control the walking stability and a capture point tracking controller is used for tracking the optimized CP trajectory, which generates an optimal control input that is near the center of the support polygon. The performance of the proposed stabilization method was verified by a dynamics simulator, Webots, and comparison with the original capture point controller-based walking algorithm is presented.

http://bit.ly/2ROuOXk

Correction to: Monogenean parasites infect ornamental fish imported to Australia

The phylogenetic tree (Figure 7) in the published document has incorrect Bayesian analysis posterior probabilities. This error prevents accurate analysis by future research in parasitology. The figure is therefore replaced by the corrected figure below.

http://bit.ly/2FpUJye

Cerebellar ataxia associated with anti-glutamic acid decarboxylase antibodies: a case report

http://bit.ly/2RLdTVJ

Five-year clinical outcomes of diabetic patients in the Randomized On/Off Bypass Follow-up (ROOBY-FS) trial—is the evidence enough to change the practice?

http://bit.ly/2RLfYRs

A hybrid nanocomposite of poly(styrene-methyl methacrylate- acrylic acid) /clay as a novel rheology-improvement additive for drilling fluids

Abstract

The hybrid-polymer nanocomposite poly(styrene-methyl methacrylate- acrylic acid) /nanoclay was synthesized by miniemulsion polymerization for novel use as a drilling fluid additive. Three low-solid-drilling fluids (bentonite-based; natural polymer-based; nanoclay-based) were formulated using the hybrid nanocomposite as an additive and their rheological performance compared. The polymer/clay hybrid nanoparticles significantly improve rheological and filtration properties of the drilling fluids and they remain stable at high pressure, high temperature and harsh salinity conditions. The fluids' filtration properties improve as the concentration of the polymer/nanoclay-hybrid-nanoparticles increases. The clay-based nanocomposite additive had the highest positive impact on the rheological behavior of low-solids polymer-based drilling fluid. Analysis of rheological properties and filtration loss of the drilling fluids suggest that the optimum nanoclay concentration in the hybrid-polymer nanocomposite is about 5 wt.%.

Graphical Abstract

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http://bit.ly/2H8bksS

Biliary Disease in Immunocompromised Patients: a Single-Center Retrospective Analysis

Abstract

Background

Acute cholecystitis is a life-threatening disease process in immunocompromised patients. The purpose of this study is to determine the incidence, clinical course, and management of calculous and acalculous acute cholecystitis in immunocompromised patients.

Methods

A single center's database was queried for all patients with a diagnosis of acute cholecystitis from January 1, 2003 to September 30, 2016 with concomitant diagnosis of neutropenia, leukopenia, leukemia, or lymphoma. These cases subsequently underwent chart review. Data on demographics, diagnostic studies, and management were collected and analyzed.

Results

There were 4525 patients diagnosed with acute cholecystitis during the study window. One hundred twenty patients were identified to be immunocompromised at time of diagnosis. Seventy-nine patients (65.8%) had acute calculous cholecystitis while 41 patients (34.2%) had acalculous cholecystitis. There were no significant demographic differences between calculous and acalculous groups. There was similar use of percutaneous cholecystostomy tube (7.6%, 9.8%, p = 0.69), laparoscopic cholecystectomy (70.9%, 61.0%, p = 0.27), and open cholecystectomy (10.3%, 2.4%, p = 0.13) in both calculous and acalculous groups.

Discussion

While immunosuppression is commonly thought to be associated with acalculous cholecystitis, our data suggest the majority of acute cholecystitis in immunocompromised patients are calculous. Most patients in our studies were managed successfully with laparoscopic cholecystectomy with acceptably low complication rates.

Conclusion

Calculous cholecystitis is more common than acalculous cholecystitis in immunocompromised patients. Both are often managed successfully with laparoscopic cholecystectomy with very low rates of conversion to open cholecystectomy.

http://bit.ly/2Ma8oLa

Single-Port Inflatable Mediastinoscopy Combined With Laparoscopic-Assisted Small Incision Surgery for Radical Esophagectomy Is an Effective and Safe Treatment for Esophageal Cancer

Abstract

Background

We previously developed a novel non-trans thoracic esophagectomy, the single-port inflatable mediastinoscopy combined with laparoscopy for the radical esophagectomy of esophageal cancer. The purpose of this study was to report its therapeutic efficacy and safety.

Methods

From May 2016 to August 2017, we have completed 80 cases of radical resection of esophageal carcinoma using this novel surgical technique. The intraoperative findings and postoperative complications were reported.

Results

The operation was successfully performed in all patients except for one patient switched from laparoscopic-assisted operation to open surgery. The mean operation duration was 191.4 ± 27 min, and the mean intraoperative blood loss was 147.3 ± 28.9 mL. The mean number of removed lymph node was 21.9 ± 4.1. Five patients (6.4%) who had preoperative type I respiratory failure needed to stay in the intensive care unit for 24 h postoperatively. Postoperative complications included anastomotic leakage (8.9%), anastomotic stricture (21.25%), pleural effusion (9%), and hoarseness postoperative hoarseness (18.8%). The incidence of hoarseness at 3 months postoperation was reduced to 3.8%. All the complications were Clavien-Dindo grades I–III. There were no perioperative death and postoperative cardiopulmonary complications.

Conclusion

These results showed that the single-port inflatable mediastinoscopy combined with laparoscopy is feasible for radical esophagectomy and possesses good therapeutic efficacy and safety.

http://bit.ly/2sqn9jD

Adjuvant Chemotherapy Improves Survival Following Resection of Locally Advanced Rectal Cancer with Pathologic Complete Response

Abstract

Background

Controversy exists over the use of adjuvant chemotherapy for locally advanced (stages II–III) rectal cancer (LARC) patients who demonstrate pathologic complete response (pCR) following neoadjuvant chemoradiation. We conducted a retrospective analysis to determine whether adjuvant chemotherapy imparts survival benefit among this population.

Methods

The National Cancer Database (NCDB) was queried to identify LARC patients with pCR following neoadjuvant chemoradiation. The cohort was stratified by receipt of adjuvant chemotherapy. Multiple imputation and a Cox proportional hazards model were employed to estimate the effect of adjuvant chemotherapy on overall survival.

Results

There were 24,418 patients identified in the NCDB with clinically staged II or III rectal cancer who received neoadjuvant chemoradiation. Of these, 5606 (23.0%) had pCR. Among patients with pCR, 1401 (25%) received adjuvant chemotherapy and 4205 (75%) did not. Patients who received adjuvant chemotherapy were slightly younger, more likely to have private insurance, and more likely to have clinically staged III disease, but did not differ significantly in comparison to patients who did not receive adjuvant chemotherapy with respect to race, sex, facility type, Charlson comorbidity score, histologic tumor grade, procedure type, length of stay, or rate of 30-day readmission following surgery. On adjusted analysis, receipt of adjuvant chemotherapy was associated with a lower risk of death at a given time compared to patients who did not receive adjuvant chemotherapy (HR 0.808; 95% CI 0.679–0.961; p = 0.016).

Conclusion

Supporting existing NCCN guidelines, the findings from this study suggest that adjuvant chemotherapy improves survival for LARC with pCR following neoadjuvant chemoradiation.

http://bit.ly/2M4Nlto

Prevalence of Dumping Syndrome After Laparoscopic Sleeve Gastrectomy and Comparison with Laparoscopic Roux-en-Y Gastric Bypass

Abstract

Background

Dumping syndrome is a well-known side effect of laparoscopic gastric bypass (LRYGB), and it is commonly believed that dumping syndrome is less likely to occur after laparoscopic sleeve gastrectomy (LSG), due to the preservation of the pyloric sphincter. However, it is not uncommon for patients undergoing LSG at our center to report symptoms suggestive of dumping syndrome.

Objective

To assess the prevalence of symptoms of dumping syndrome after LSG compared with LRYGB.

Setting

A single surgical group at a high-volume (700 cases per year) Bariatric and Metabolic Surgery Center of Excellence.

Methods

One thousand four hundred seventy-one LRYGB (366) and LSG (1105) patients received a questionnaire to assess symptoms of dumping syndrome, utilizing a modified version of the Sigstad scoring system. Dumping syndrome was considered to be present when the questionnaire score exceeded a threshold value.

Results

A total of 360 responses were received (249 LSG, 111 LRYGB). 26.5% (66) LSG and 41.4% (46) LRYGB exceeded the threshold for dumping syndrome (p < 0.01). 84.8% (56) LSG and 84.7% (39) LRYGB reported early dumping syndrome (p > 0.05). Thirty-six percent (24) LSG and 28% (13) LRYGB reported late dumping syndrome (p > 0.05). Twenty-seven percent (62) LSG and 44.4% (44) LRYGB reported at least one symptom of dumping syndrome with sweets (p < 0.05). 34.3% (85) LSG and 35.5% (39) LRYGB reported symptoms when drinking with or within 30 min of a meal (p > 0.05). 14.5% (36) LSG and 17.3% (19) LRYGB reported symptoms after alcohol consumption (p > 0.05).

Conclusion

Dumping syndrome after LSG is prevalent but has not been widely reported. This finding may impact clinicians and patients in their choice of procedure and has relevance in post-operative education and care.

http://bit.ly/2Ha9APC

Water Waves to Sound Waves: Using Zebrafish to Explore Hair Cell Biology

Abstract

Although perhaps best known for their use in developmental studies, over the last couple of decades, zebrafish have become increasingly popular model organisms for investigating auditory system function and disease. Like mammals, zebrafish possess inner ear mechanosensory hair cells required for hearing, as well as superficial hair cells of the lateral line sensory system, which mediate detection of directional water flow. Complementing mammalian studies, zebrafish have been used to gain significant insights into many facets of hair cell biology, including mechanotransduction and synaptic physiology as well as mechanisms of both hereditary and acquired hair cell dysfunction. Here, we provide an overview of this literature, highlighting some of the particular advantages of using zebrafish to investigate hearing and hearing loss.

http://bit.ly/2AGIGcm

Micronemal protein 13 contributes to the optimal growth of Toxoplasma gondii under stress conditions

Abstract

Toxoplasma gondii is a ubiquitous parasitic protozoan infecting humans and a wide variety of animals. Fast-replicating tachyzoites during acute infection and slowly growing bradyzoites during chronic infection are the two basic forms of T. gondii in intermediate hosts. Interconversion between the two contributes to the transmission and pathogenesis of this parasite. Secretory micronemal proteins are thought to mediate interactions with host cells and facilitate parasite invasion, therefore the majority of them are highly expressed in tachyzoites. Micronemal protein 13 (MIC13) is unique in that its expression is low in tachyzoites and is upregulated under bradyzoite-inducing conditions. Previous attempts to disrupt this gene were not successful, implying that it may play critical roles during parasite growth. However, in this study, MIC13 was successfully disrupted in type 1 strain RH and type 2 strain ME49 using CRISPR/Cas9-mediated gene disruption techniques. Consistent with its low expression in tachyzoites and increased expression under stress or bradyzoite-inducing conditions, MIC13-inactivated mutants displayed normal growth, host cell invasion, intracellular replication, and egress, as well as acute virulence at the tachyzoite stage. However, under stress conditions, such as high pH or oxygen limitation, MIC13-disrupted parasites showed significantly slower growth rates compared to the parental strains, suggesting that it is required for optimal parasite growth under bradyzoite-inducing or stress conditions. This is the first micronemal protein reported to have such expression pattern and function modes, which expands our understanding of the diverse functions of micronemal proteins.

http://bit.ly/2D6taZ5

Nucleic Acid Therapies for Ischemic Stroke

Abstract

Stroke remains a leading cause of disability and death worldwide despite significant scientific and therapeutic advances. Therefore, there is a critical need to improve stroke prevention and treatment. In this review, we describe several examples that leverage nucleic acid therapeutics to improve stroke care through prevention, acute treatment, and recovery. Aptamer systems are under development to increase the safety and efficacy of antithrombotic and thrombolytic treatment, which represent the mainstay of medical stroke therapy. Antisense oligonucleotide therapy has shown some promise in treating stroke causes that are genetically determined and resistant to classic prevention approaches such as elevated lipoprotein (a) and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Targeting microRNAs may be attractive because they regulate factors involved in neuronal cell death and reperfusion-associated injury, as well as neurorestorative pathways. Lastly, microRNAs may aid reliable etiologic classification of stroke subtypes, which is important for effective secondary stroke prevention.

http://bit.ly/2FpaDbU

The effect of dopamine for focal hand dystonia after stroke

http://bit.ly/2HaIwzQ

Adverse events in brain tumor surgery: incidence, type, and impact on current quality metrics

Abstract

Background

The aim of the study was to determine pre-operative factors associated with adverse events occurring within 30 days after neurosurgical tumor treatment in a German center, adjusting for their incidence in order to prospectively compare different centers.

Methods

Adult patients that were hospitalized due to a benign or malignant brain were retrospectively assessed for quality indicators and adverse events. Analyses were performed in order to determine risk factors for adverse events and reasons for readmission and reoperation.

Results

A total of 2511 cases were enrolled. The 30 days unplanned readmission rate to the same hospital was 5.7%. The main reason for readmission was tumor progression. Every 10th patient had an unplanned reoperation. The incidence of surgical revisions due to infections was 2.3%. Taking together all monitored adverse events, male patients had a higher risk for any of these complications (OR 1.236, 95%CI 1.025–1.490, p = 0.027). Age, sex, and histological diagnosis were predictors of experiencing any complication. Adjusted by incidence, the increased risk ratios greater than 10.0% were found for male sex, age, metastatic tumor, and hemiplegia for various quality indicators.

Conclusions

We found that most predictors of outcome rates are based on preoperative underlying medical conditions and are not modifiable by the surgeon. Comparing our results to the literature, we conclude that differences in readmission and reoperation rates are strongly influenced by standards in decision making and that comparison of outcome rates between different health-care providers on an international basis is challenging. Each health-care system has to develop own metrics for risk adjustment that require regular reassessment.

http://bit.ly/2M4ef4A

Identification of the visco-hyperelastic properties of brain white matter based on the combination of inverse method and experiment

Abstract

To fully understand the brain injury mechanism and develop effective protective approaches, an accurate constitutive model of brain tissue is firstly required. Generally, the brain tissue is regarded as a kind of viscoelastic material and is simply used in the simulation of brain injury. In fact, the brain tissue has the behavior of the visco-hyperelastic property. Therefore, this paper presents an effective computational inverse method to determine the material parameters of visco-hyperelastic constitutive model of brain white matter through compression experiments. First, with the help of 3D hand scanner, 3D geometries of brain white matter specimens are obtained to make it possible to establish the accurate simulation models of the specific specimens. Then, the global sensitivity analysis is adopted to evaluate the importance of the material parameters and further determine the parameters which may be identified. Subsequently, based on the genetic algorithm, the optimal material parameters of brain white matter can be identified by minimizing the match error between the experimental and simulated responses. Finally, by comparing the experiment and simulation results on the other specific specimen, and the simulation results with the material parameters from the references, respectively, the accuracy and reliability of the constitutive model parameters of brain white matter are demonstrated.

Graphical abstract

The main flowchart of the computational inverse technique for determining the material parameters of specimen-specific on brain white matter. Generalization: Combining the computational inverse method and unconfined uniaxial compression experiment of the specific specimen, an effective identification method is presented to accurately determine the hyperelastic and viscoelastic parameters of brain white matter in this paper.

http://bit.ly/2CesAXD

Weight Loss After Bariatric Surgery Predicts an Improvement in the Non-alcoholic Fatty Liver Disease (NAFLD) Fibrosis Score

Abstract

Purpose

Non-alcoholic fatty liver disease (NAFLD) is present in up to 90% of bariatric surgery patients. Previous literature has demonstrated an improvement in liver steatosis and fibrosis in post-bariatric surgery patients. Our study aims to investigate if bariatric surgery results in an improvement in NAFLD fibrosis scores, and if this correlates with weight loss.

Methods

A retrospective study was conducted on all patients who underwent bariatric surgery from 2010 to 2016 in our institution. Patients who had a redo bariatric surgery or concomitant gastric pathologies were excluded. Indications for bariatric surgery followed the Asia-Pacific Metabolic and Bariatric Surgery Society guidelines.

Results

There were 192 patients in this study, with the majority being females (n = 120, 63%). Mean age was 42.7 ± 10.2 years old. Pre-operative mean weight and body mass index (BMI) were 113 ± 27.9 kg and 41.6 ± 7.98 kg/m² respectively. The mean pre-operative NAFLD fibrosis score was − 1.27. Six-month and 1-year follow-up post-surgery demonstrated a decrease in mean weight to 90.6 and 85.9 kg and a decrease in mean BMI to 33.8 and 31.6 kg/m². Mean NAFLD scores improved from − 1.27 to − 1.56 to − 2.00. The correlation between weight loss and NAFLD fibrosis score improvement was statistically significant at the first post-operative year (r-coefficient = 0.36, p value ≤ 0.001).

Conclusion

Bariatric surgery results in weight reduction as well as an improvement in the NAFLD fibrosis score. The degree of weight loss predicts the extent of improvement in NAFLD fibrosis scores. More long-term studies need to be conducted to assess if this effect is permanent.

http://bit.ly/2RIcYFn

Plasma Periostin and Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage

Abstract

Delayed cerebral ischemia (DCI) is a serious complication of aneurysmal subarachnoid hemorrhage (SAH). Matricellular protein periostin (POSTN) has been found to be upregulated and linked with early brain injury after experimental SAH. The aim of the present study was to investigate the relationship between plasma POSTN levels and various clinical factors including serum levels of C-reactive protein (CRP), an inflammatory marker, in 109 consecutive SAH patients whose POSTN levels were measured at days 1–12 after aneurysmal obliteration. DCI developed in 16 patients associated with higher incidence of angiographic vasospasm, cerebral infarction, and 90-day worse outcomes. POSTN levels peaked at days 4–6 before DCI development. Cerebrospinal fluid (CSF) drainage was associated with reduced POSTN levels, but did not influence CRP levels. There was no correlation between POSTN levels and other treatments or CRP levels. To predict DCI development, receiver-operating characteristic curves indicated that the most reasonable cutoff POSTN levels were obtained at days 1–3 in patients without CSF drainage (80.5 ng/ml; specificity, 77.6%; sensitivity, 85.7%). Multivariate analyses using variables obtained by day 3 revealed that POSTN level was an independent predictor of DCI. POSTN levels over the cutoff value were associated with higher incidence of DCI, but not angiographic vasospasm. This study shows for the first time that CSF drainage may reduce plasma POSTN levels, and that POSTN levels may increase prior to the development of DCI with and without vasospasm irrespective of systemic inflammatory reactions in clinical settings. These findings suggest POSTN as a new therapeutic molecular target against post-SAH DCI.

http://bit.ly/2RNKlGS

Quantitative characterization of temperature-independent polymer–polymer interaction and temperature-dependent protein–protein and protein–polymer interactions in concentrated polymer solutions

Abstract

To study the effect of non-specific interactions arising from proteins being in a crowded environment on physiological processes, the self-interaction of concentrated Dextran T70 and Ficoll 70 and the interactions between a dilute protein and these polymeric macromolecules were quantified using non-ideal tracer sedimentation equilibrium. Sedimentation equilibria of each polymer were measured between 5 and 37 °C, and sedimentation equilibria of 2 mg cm⁻³ superoxide dismutase (SOD) in 0–0.1 g cm⁻³ of each polymer was also measured. Results were analyzed using a model-free thermodynamic virial expression of activity coefficients in terms of the concentration of polymer and a structural model using a statistical thermodynamics approximation. The equilibrium gradients of each of the polymers suggest repulsive interaction, which is independent of temperature. However, the net repulsive interaction between superoxide dismutase (SOD) species and the polymers is dependent on temperature. The ratio of the solvation energy of SOD in Dextran T70 to that in Ficoll 70, lnγ_SOD(Dex)/lnγ_SOD(Fic) at the same w/v concentration was about 1.8 at 37 °C, 1.6 at the intermediate temperature, and ranges from 1.2 to 1.6 at 5 °C over the entire concentration range. The enthalpy and entropy of interaction of SOD with dilute Dextran T70 are − 14 kJ mol⁻¹ and − 5.6 J K⁻¹ mol⁻¹, respectively. For SOD in dilute Ficoll 70, the enthalpy and entropy are − 8.1 kJ mol⁻¹ and 12.9 J K⁻¹ mol⁻¹, respectively. Thus, Dextran T70 contributes more to the attractive protein–polymer interaction and to self-association of protein than Ficoll 70 and reasons for this are discussed.

http://bit.ly/2RDMyVu

Do thermal treatments influence the ultrafast opto-thermal processes of eumelanin?

Abstract

After light absorption, melanin converts very rapidly the energy gained into heat. The time scale of this process ranges from tens of femtoseconds to a few nanoseconds. Femtosecond transient absorption allows for exploration of such photo-induced carrier dynamics to observe the de-excitation pathways of the biological complex. Here, we report on the ultrafast relaxation of suspensions of Sepia melanin in DMSO at room temperature using a femtosecond broadband pump and probe technique by photoexciting in the UV and probing in the entire visible range. In particular, we focus on the possible role that different heat treatments, performed in the temperature range 30–80 °C  might have on the relaxation of charge carriers photogenerated by UV radiation in such suspensions. Experimental data indicate that in all the investigated suspensions, photoexcited carriers always follow a tri-exponential route to relaxation. Moreover, we find that the relaxation time constants are essentially the same in all cases, within the experimental error. We take this as evidence that all the investigated suspensions essentially exhibit the same relaxation dynamics, regardless of the temperature at which the heat treatment has been performed and of the heat-induced denaturation of the proteinaceous compounds bound to the photoactive pigment. Our experiments represent a significant step towards the understanding of the stability of melanin with respect to temperature changes.

http://bit.ly/2H73MX7

The familiar-melody advantage in auditory perceptual development: Parallels between spoken language acquisition and general auditory perception

Abstract

How do learners build up auditory pattern knowledge? Findings from children's spoken word learning suggest more robust auditory representations for highly familiar words than for newly learned words. This argues against spoken language learning as a process of simply acquiring a fixed set of speech sound categories, suggesting instead that specific words may be the relevant units. More generally, one might state this as the specific-learning hypothesis—that acquiring sound pattern knowledge involves learning specific patterns, rather than abstract pattern components. To understand the nature of human language knowledge, it is important to determine whether this specific learning reflects processes unique to spoken language learning or instead reflects more general auditory-learning processes. To investigate whether the specific-learning hypothesis extends to auditory pattern learning more generally, the present study tested the perceptual processing of familiar melodies versus carefully matched unfamiliar melodies. Children performed better at both audiovisual mapping (Exp. 1) and same–different auditory discrimination (Exp. 2) when hearing familiar melodies than when hearing unfamiliar melodies. This is consistent with the specific-learning hypothesis and with exemplar-style general-auditory accounts of pattern learning, although alternative explanations are possible.

http://bit.ly/2QFppgB

Effects of Stromal Vascular Fraction on Breast Cancer Growth and Fat Engraftment in NOD/SCID Mice

Abstract

Background

To overcome unpredictable fat graft resorption, cell-assisted lipotransfer using stromal vascular fraction (SVF) has been introduced. However, its effect on cancer growth stimulation and its oncological safety are debatable. We investigated the effect of SVF on adjacent breast cancer and transplanted fat in a mouse model.

Methods

A breast cancer xenograft model was constructed by injecting 2 × 10⁶ MDA-MB-231-luc breast cancer cells into the right lower back of 40 NOD/SCID mice. Two weeks later, cancer size was sorted according to signal density using an in vivo optical imaging system, and 36 mice were included. Human fat was extracted from the abdomen, and SVFs were isolated using a component isolator. The mice were divided into four groups: A, controls; B, injected with 30 μl SVF; C, injected with 0.5 ml fat and 30 μl saline; group D, injected with 0.5 ml fat and 30 μl SVF. Magnetic resonance imaging and three-dimensional micro-computed tomography volumetric analysis were performed at 4 and 8 weeks.

Results

Tumor volume was 43.6, 42.3, 48.7, and 42.4 mm³ at the initial time point and 6780, 5940, 6080, and 5570 mm³ at 8 weeks in groups A, B, C, and D, respectively. Fat graft survival volume after 8 weeks was 49.32% and 62.03% in groups C and D, respectively. At 2-month follow-up after fat grafting in the xenograft model, SVF injection showed an increased fat survival rate and did not increase the adjacent tumor growth significantly.

Conclusion

Fat grafting with SVF yields satisfactory outcome in patients who undergo breast reconstruction surgery.

No Level Assigned

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

http://bit.ly/2QEsygW

The effect of population density on gene flow between adult trees and the seedling bank in Abies alba Mill.

Abstract

Populations of smaller effective sizes or subjected to strong environmental filtering have a higher risk of stochastic changes in their genetic properties. This study tested the hypothesis that reducing the density of parent trees combined with environmental filtering during the stage of regeneration establishment affects gene flow between the parent and offspring populations of Abies alba Mill. The genetic variation and spatial genetic structure of parent trees and seedlings were compared in the Western Carpathians (southern Poland) in 27 stands with varying adult tree and regeneration densities. The analysis comprised 1592 individuals and was based on five nuclear microsatellite markers. The proportion of stands with significant spatial genetic structure in the adult tree and seedling cohorts increased as the density of adult trees decreased. The genetic differentiation between adult trees and seedlings expressed by the fixation index F_ST was between 0.005 and 0.021 and increased as the density of adult trees decreased but was not correlated with the seedling abundance. At the within-stand level, the analysis revealed shifts in the average number of alleles per locus (between − 15% and + 28%), the observed heterozygosity (between − 25% and + 20%) and expected heterozygosity (between − 8% and + 11%) between the populations of adult trees and seedlings. It was concluded that in mixed stands with densities of A. alba trees about 50 adult individuals per ha, there may be some risk of reduced effective population size and disturbed vertical gene flow, but significant shifts in the level of genetic variation are less likely.

http://bit.ly/2skYNrE

Early injection of human adipose tissue-derived mesenchymal stem cell after inflammation ameliorates dextran sulfate sodium-induced colitis in mice through the induction of M2 macrophages and regulatory T cells

Abstract

Inflammatory bowel diseases (IBDs) are sometimes refractory to current therapy or associated with severe adverse events during immunosuppressive therapy; thus, new therapies are urgently needed. Recently, mesenchymal stem cells (MSCs) have attracted attention based on their multitude of functions including anti-inflammatory effects. However, proper timing of MSC therapy and the mechanisms underlying the therapeutic effects of MSCs on colitis are not fully elucidated. Human adipose tissue-derived mesenchymal stem cells (hAdMSCs; 1 × 10⁶) were administrated via the tail vein on day 3 (early) or 11 (delayed) using a 7-day dextran sulfate sodium (DSS)-induced mouse model of colitis. The effects were evaluated based on colon length, disease activity index (DAI) and histological score. Cytokine-encoding mRNA levels T cells and macrophages were evaluated by real-time PCR and flow cytometry. Regarding the timing of administration, early (day 3) injection significantly ameliorated DSS-induced colitis in terms of both DAI and histological score, compared to those parameters with delayed (day 11) injection. With early cell injection, the tissue mRNA levels of anti-inflammatory cytokine genes (Il10, Tgfb) increased, whereas those of inflammatory cytokine genes (Il6, Tnfa and Il17a) decreased significantly. Regarding the associated mechanism, hAdMSCs suppressed T cell proliferation and activation in vitro, increased the number of regulatory T cells in vivo and changed the polarity of macrophages (into the anti-inflammatory M2 phenotype) in vitro. Timing of injection is critical for the effective therapeutic effects of hAdMSCs. Furthermore, part of the associated mechanism includes T cell activation and expansion and altered macrophage polarization.

http://bit.ly/2FrvJ9N

Alveolus-like organoid from isolated tip epithelium of embryonic mouse lung

Abstract

Embryonic lungs were obtained from embryonic day 13.5 ICR mice. The lung-tip epithelium isolated using dispase treatment was embedded in low-growth factor Matrigel, cultured in DMEM/F12 medium containing 0.1% bovine serum albumin, supplemented with insulin, transferrin, and selenium (ITS), with or without fibroblast growth factor 7 (FGF7), and were observed for 14 days. With the addition of FGF7, the tip epithelium grew to form a cyst by culture day 7. Then, tubular tufts-like alveolus appeared around the cyst surface. Reverse transcription-polymerase chain reaction revealed that, with the addition of FGF7, the cultured lung explants expressed alveolar-type 1 cell markers, such as HopX and Aquaporin5, and type 2 cell markers, such as Lamp3 and Surfactant apoproteins (Sftp) C and D. Paraffin-embedded sections were stained with hematoxylin and eosin, and alveolar structures at culture day 14 were composed of squamous and cuboidal epithelial cells. Immunohistochemical studies showed that the squamous epithelial cells were positive for HopX, and the cuboidal epithelial cells were positive for pro-SftpC. Furthermore, transmission electron microscopic observation confirmed that the squamous epithelial cells were alveolar-type 1 cells and the cuboidal cells were type 2 cells, because they had many lamellar inclusion bodies. Embryonic lung-tip epithelium forms an alveolus-like organoid through the self organization with the aid of Matrigel, ITS, and FGF7. This method to make alveolus-like organoid in vitro is easy, reproducible, and economical. This method could have potential to solve many issues in alveolar epithelial cells in normal and pathological conditions.

http://bit.ly/2smnvbl

Symptomatischer Bauchwandtumor

http://bit.ly/2VJU9Rv

Ultrasound evaluation of diaphragmatic mobility in patients with idiopathic lung fibrosis: a pilot study

Abstract

Background

Some previous works have tested LUS use in diagnosing and monitoring interstitial lung diseases. B-lines are main sonographic signs for interstitial diseases. Increasing evidences suggest that dyspnea and impaired exercise capacity in IPF patients can be related, at least in part, to respiratory muscle dysfunction, in particular to diaphragm functionality. Both B-mode and M-mode ultrasound techniques have been employed to assess diaphragm excursion (DE), which measures the distance that the diaphragm is able to move during the respiratory cycle.

Methods

The main objective of this case-control study was to evaluate if differences exist between diaphragmatic excursions in IPF patients and in a control group of healthy subjects. Secondary objectives were to evaluate possible correlations among respiratory excursions, anthropometric parameters and respiratory function parameters. All patients performed spirometry and body plethysmography (PC). Diaphragm was examined by ultrasound imaging in B-MODE, and respiratory excursions were evaluated in M-MODE. Examination consisted of 3 measurements of the inspiratory phase at rest and after deep inspiration.

Results

Twelve patients with IPF and 12 healthy subjects were enrolled. There were no significant differences between respiratory excursions in patients and controls during spontaneous breathing, while there was a statistically significant difference between the mean values of the deep respiratory excursion in the two groups (p value < 0.001). There was a positive correlation between respiratory excursion with normal breath and chest circumference in controls (p = 0.034; R = 0.614) and in patients (p = 0.032; R = 0.37), but this relationship was not found even in subjects in deep breathing. A positive correlation was found between FVC values and diaphragmatic motility both at rest and in deep breathing in fibrotic patients.

Conclusions

Diaphragmatic mobility is lower in IPF patients than in healthy controls, especially during deep inspiration. The correlation between reduced FVC and diaphragmatic excursion values in IPF patients can be of interest, since it could represent an index of functional respiratory function performed by a non-invasive, low-cost, simple and reliable imaging technique, such as LUS.

http://bit.ly/2FsiWDV

Kinematic risk factors for lower limb tendinopathy in distance runners: A systematic review and meta-analysis

Publication date: Available online 11 January 2019

Source: Gait & Posture

Author(s): Seyed Hamed Mousavi, Juha M. Hijmans, Reza Rajabi, Ron Diercks, Johannes Zwerver, Henk van der Worp

Abstract

Introduction

Abnormal kinematics have been implicated as one of the major risk factors for lower limb tendinopathy (LLT).

Objective

To systematically review evidence for kinematic risk factors for LLT in runners.

Methods

Individual electronic searches in PubMed, EMBASE and Web of Science were conducted. Two reviewers screened studies to identify observational studies reporting kinematic risk factors in runners with LLT compared to healthy controls. The Down and Black appraisal scale was applied to assess quality. A meta-analysis was performed provided that at least two studies with similar methodology reported the same factor.

Results

Twenty-eight studies were included: Achilles tendinopathy (AT) (9), iliotibial band syndrome (ITBS) (17), plantar fasciopathy (PF) (2), patellar tendinopathy (PT) (1), posterior tibial tendon dysfunction (PTTD) (1). Eighteen studies were rated high-quality and ten medium-quality. The meta-analyses revealed strong evidence of higher peak knee internal rotation and moderate evidence of lower peak rearfoot eversion and knee flexion at heel strike and greater peak hip adduction in runners with ITBS. Very limited evidence revealed higher peak ankle eversion in runners with PF and PTTD or higher peak hip adduction in PT.

Significance

Peak rearfoot eversion was the only factor reported in all included LLTs; it is a significant factor in ITBS, PT and PTTD but not in AT and PF. More prospective studies are needed to accurately evaluate the role of kinematic risk factors as a cause of LLT. Taken together, addressing rearfoot kinematic and kinematic chain movements accompanied by peak eversion should be considered in the prevention and management of LLT.

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Age- and low back pain-related differences in trunk muscle activation during a one-legged stance balance task

Publication date: Available online 11 January 2019

Source: Gait & Posture

Author(s): Rubens A. da Silva, Edgar R. Vieira, Guillaume Léonard, Louis-David Beaulieu, Suzy Ngomo, Alexandre H. Nowotny, César F. Amorim

Abstract

Background

Postural control declines with age and can be affected by low back pain. The changes in trunk muscle activation may also help to better explain these negative results on postural control measures.

Aim

The objective of this study was to compare the trunk muscle activity of younger and older subjects, with and without chronic low back pain (CLBP), during a one-legged stance task.

Methods and procedures

Twenty (20) with, and 20 subjects without nonspecific CLBP participated in the study. Each group was comprised of 10 younger (50% males; mean age: 31 years) and 10 older adults (50% males; mean age: 71 years). Subjects performed 3 × 30-second trials of a one-legged stance, with eyes open, on a force platform, while surface electromyography (EMG) measurements were obtained bilaterally on the multifidus at L5, iliocostalis lumborum at L3, rectus abdominis and biceps femoris muscles.

Outcomes and results

EMG amplitude analysis was processed by the Root Mean Square (250 ms window epochs) and normalized by the peak of activation during the balance tasks, to determine the muscular activity of each muscle. Participants with CLBP presented 15% lower lumbar muscle activation (p <  0.05), and 23% higher co-activation (ratio between rectus adominis by multifidus) than participants without CLBP, regardless of age. Significant differences (p <  0.05) between older and young groups were observed only for lower lumbar muscles (mean 24% lower in older than younger adults) and rectus adominis muscles (mean 17% lower in older than younger adults).

Conclusion and implications

CLBP individuals have different trunk muscle activity than those without CLBP, and older adults exhibit lower trunk activation during a one-legged stance balance task. The use of the EMG in evaluation of trunk neuromuscular function during one-legged stance may thus be a valuable tool when assessing balance in CLBP and older people.

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The effect of different running shoes on treadmill running mechanics and muscle activity assessed using statistical parametric mapping (SPM)

Publication date: Available online 10 January 2019

Source: Gait & Posture

Author(s): Corina Nüesch, Elena Roos, Christian Egloff, Geert Pagenstert, Annegret Mündermann

Abstract

Background

Difference in joint mechanics between running shoes are commonly assessed using discrete parameters, yet statistically significant differences in these parameters between shoes are often scarce with small effect sizes. Statistical parametric mapping (SPM) has been suggested as suitable method for analyzing one-dimensional data such as kinematic, kinetic or muscle intensity time series.

Research question

The purpose of this study was to determine differences in treadmill running mechanics between novel running shoes using SPM.

Methods

Joint kinematics, muscle activity and ground reaction force were assessed in 19 rearfoot runners in their own shoes and in two test shoes during treadmill running (test shoe 1: 13 distinct rubber elements in the outer sole, springboard within EVA midsole with posterior elements shifted anteriorly by approximately 1.5 cm; test shoe 2: 17 distinct EVA elements with conventional heel geometry). Joint kinematics were measured using an inertial sensor system, and ground reaction force was measured using an instrumented treadmill.

Results

SPM analysis with repeated measures ANOVA revealed significant reductions in the ankle angle and in tibialis anterior, peroneus longus, vastus medialis and lateralis muscle activity during weight acceptance and in peroneus longus muscle activity during early and late swing and in semitendinosus muscle activity during late swing for the test shoes. Significant differences in muscle activity were observed in the interval of the main activity of the respective muscle. SPM on individual data revealed statistically significant and relevant within-subject differences between conditions in kinematic, muscle activity and ground reaction force patterns.

Significance

Inertial sensor systems and SPM may provide an efficient way of detecting changes in joint mechanics between running shoes within runners. Detecting within-subject differences in running mechanics between conditions not only requires statistical criteria but also criteria on the relevance of the magnitude of differences.

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Can runners maintain a newly learned gait pattern outside a laboratory environment following gait retraining?

Publication date: Available online 10 January 2019

Source: Gait & Posture

Author(s): Janet H. Zhang, Zoe Y.S. Chan, Ivan P.H. Au, Winko W. An, Roy T.H. Cheung

Abstract

Background

Previous peak tibial shock gait retraining programs, which were usually conducted on a treadmill, were reported to be effective on impact loading reduction in runners. However, whether the trained runners can translate the training effect at different running modes (treadmill/overground), or running slopes (uphill/downhill), remains unknown.

Research question

Is the training effect from a treadmill-based gait retraining translatable to unconstrained running conditions, including overground and uphill/downhill running?

Methods

The peak tibial shock was measured during treadmill/overground running, as well as level/uphill/downhill running before and after a course of treadmill-based gait retraining. The 8-session training aimed to soften footfalls using real-time biofeedback of tibial shock data. Repeated measures ANOVA was used to examine the effect of training, running mode, and running slope, on a group level. Reliable change index of each participant was used to assess the individual response to the training protocol used in this study.

Results

Eighty percent of the participants were responsive to the gait retraining and managed to reduce their peak tibial shock following training. They managed to translate the training effect to treadmill slope running (Level: p < 0.05, Cohen’s d = 1.65; Uphill: p = 0.001, Cohen’s d = 0.91; Downhill: p < 0.05; Cohen’s d = 1.29) and overground level running (p = 0.014, Cohen’s d = 0.85). However, their peak tibial shock were not reduced during overground slope running (Uphill: p = 0.054; Cohen’s d = 0.62; Downhill p = 0.12; Cohen’s d = 0.48).

Significance

Our findings indicated that a newly learned gait pattern may not fully translate to running outside of the laboratory environment.

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The Relationship Between Foot Arch Flexibility and Medial-Lateral Ground Reaction Force Distribution

Publication date: Available online 10 January 2019

Source: Gait & Posture

Author(s): Rebecca Zifchock, Regina Parker, Willahelm Wan, Michael Neary, Jinsup Song, Howard Hillstrom

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Kinematic risk factors for lower limb tendinopathy in distance runners: A systematic review and meta-analysis

Publication date: Available online 11 January 2019

Source: Gait & Posture

Author(s): Seyed Hamed Mousavi, Juha M. Hijmans, Reza Rajabi, Ron Diercks, Johannes Zwerver, Henk van der Worp

Abstract

Introduction

Abnormal kinematics have been implicated as one of the major risk factors for lower limb tendinopathy (LLT).

Objective

To systematically review evidence for kinematic risk factors for LLT in runners.

Methods

Individual electronic searches in PubMed, EMBASE and Web of Science were conducted. Two reviewers screened studies to identify observational studies reporting kinematic risk factors in runners with LLT compared to healthy controls. The Down and Black appraisal scale was applied to assess quality. A meta-analysis was performed provided that at least two studies with similar methodology reported the same factor.

Results

Twenty-eight studies were included: Achilles tendinopathy (AT) (9), iliotibial band syndrome (ITBS) (17), plantar fasciopathy (PF) (2), patellar tendinopathy (PT) (1), posterior tibial tendon dysfunction (PTTD) (1). Eighteen studies were rated high-quality and ten medium-quality. The meta-analyses revealed strong evidence of higher peak knee internal rotation and moderate evidence of lower peak rearfoot eversion and knee flexion at heel strike and greater peak hip adduction in runners with ITBS. Very limited evidence revealed higher peak ankle eversion in runners with PF and PTTD or higher peak hip adduction in PT.

Significance

Peak rearfoot eversion was the only factor reported in all included LLTs; it is a significant factor in ITBS, PT and PTTD but not in AT and PF. More prospective studies are needed to accurately evaluate the role of kinematic risk factors as a cause of LLT. Taken together, addressing rearfoot kinematic and kinematic chain movements accompanied by peak eversion should be considered in the prevention and management of LLT.

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Age- and low back pain-related differences in trunk muscle activation during a one-legged stance balance task

Publication date: Available online 11 January 2019

Source: Gait & Posture

Author(s): Rubens A. da Silva, Edgar R. Vieira, Guillaume Léonard, Louis-David Beaulieu, Suzy Ngomo, Alexandre H. Nowotny, César F. Amorim

Abstract

Background

Postural control declines with age and can be affected by low back pain. The changes in trunk muscle activation may also help to better explain these negative results on postural control measures.

Aim

The objective of this study was to compare the trunk muscle activity of younger and older subjects, with and without chronic low back pain (CLBP), during a one-legged stance task.

Methods and procedures

Twenty (20) with, and 20 subjects without nonspecific CLBP participated in the study. Each group was comprised of 10 younger (50% males; mean age: 31 years) and 10 older adults (50% males; mean age: 71 years). Subjects performed 3 × 30-second trials of a one-legged stance, with eyes open, on a force platform, while surface electromyography (EMG) measurements were obtained bilaterally on the multifidus at L5, iliocostalis lumborum at L3, rectus abdominis and biceps femoris muscles.

Outcomes and results

EMG amplitude analysis was processed by the Root Mean Square (250 ms window epochs) and normalized by the peak of activation during the balance tasks, to determine the muscular activity of each muscle. Participants with CLBP presented 15% lower lumbar muscle activation (p <  0.05), and 23% higher co-activation (ratio between rectus adominis by multifidus) than participants without CLBP, regardless of age. Significant differences (p <  0.05) between older and young groups were observed only for lower lumbar muscles (mean 24% lower in older than younger adults) and rectus adominis muscles (mean 17% lower in older than younger adults).

Conclusion and implications

CLBP individuals have different trunk muscle activity than those without CLBP, and older adults exhibit lower trunk activation during a one-legged stance balance task. The use of the EMG in evaluation of trunk neuromuscular function during one-legged stance may thus be a valuable tool when assessing balance in CLBP and older people.

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The effect of different running shoes on treadmill running mechanics and muscle activity assessed using statistical parametric mapping (SPM)

Publication date: Available online 10 January 2019

Source: Gait & Posture

Author(s): Corina Nüesch, Elena Roos, Christian Egloff, Geert Pagenstert, Annegret Mündermann

Abstract

Background

Difference in joint mechanics between running shoes are commonly assessed using discrete parameters, yet statistically significant differences in these parameters between shoes are often scarce with small effect sizes. Statistical parametric mapping (SPM) has been suggested as suitable method for analyzing one-dimensional data such as kinematic, kinetic or muscle intensity time series.

Research question

The purpose of this study was to determine differences in treadmill running mechanics between novel running shoes using SPM.

Methods

Joint kinematics, muscle activity and ground reaction force were assessed in 19 rearfoot runners in their own shoes and in two test shoes during treadmill running (test shoe 1: 13 distinct rubber elements in the outer sole, springboard within EVA midsole with posterior elements shifted anteriorly by approximately 1.5 cm; test shoe 2: 17 distinct EVA elements with conventional heel geometry). Joint kinematics were measured using an inertial sensor system, and ground reaction force was measured using an instrumented treadmill.

Results

SPM analysis with repeated measures ANOVA revealed significant reductions in the ankle angle and in tibialis anterior, peroneus longus, vastus medialis and lateralis muscle activity during weight acceptance and in peroneus longus muscle activity during early and late swing and in semitendinosus muscle activity during late swing for the test shoes. Significant differences in muscle activity were observed in the interval of the main activity of the respective muscle. SPM on individual data revealed statistically significant and relevant within-subject differences between conditions in kinematic, muscle activity and ground reaction force patterns.

Significance

Inertial sensor systems and SPM may provide an efficient way of detecting changes in joint mechanics between running shoes within runners. Detecting within-subject differences in running mechanics between conditions not only requires statistical criteria but also criteria on the relevance of the magnitude of differences.

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Can runners maintain a newly learned gait pattern outside a laboratory environment following gait retraining?

Publication date: Available online 10 January 2019

Source: Gait & Posture

Author(s): Janet H. Zhang, Zoe Y.S. Chan, Ivan P.H. Au, Winko W. An, Roy T.H. Cheung

Abstract

Background

Previous peak tibial shock gait retraining programs, which were usually conducted on a treadmill, were reported to be effective on impact loading reduction in runners. However, whether the trained runners can translate the training effect at different running modes (treadmill/overground), or running slopes (uphill/downhill), remains unknown.

Research question

Is the training effect from a treadmill-based gait retraining translatable to unconstrained running conditions, including overground and uphill/downhill running?

Methods

The peak tibial shock was measured during treadmill/overground running, as well as level/uphill/downhill running before and after a course of treadmill-based gait retraining. The 8-session training aimed to soften footfalls using real-time biofeedback of tibial shock data. Repeated measures ANOVA was used to examine the effect of training, running mode, and running slope, on a group level. Reliable change index of each participant was used to assess the individual response to the training protocol used in this study.

Results

Eighty percent of the participants were responsive to the gait retraining and managed to reduce their peak tibial shock following training. They managed to translate the training effect to treadmill slope running (Level: p < 0.05, Cohen’s d = 1.65; Uphill: p = 0.001, Cohen’s d = 0.91; Downhill: p < 0.05; Cohen’s d = 1.29) and overground level running (p = 0.014, Cohen’s d = 0.85). However, their peak tibial shock were not reduced during overground slope running (Uphill: p = 0.054; Cohen’s d = 0.62; Downhill p = 0.12; Cohen’s d = 0.48).

Significance

Our findings indicated that a newly learned gait pattern may not fully translate to running outside of the laboratory environment.

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The Relationship Between Foot Arch Flexibility and Medial-Lateral Ground Reaction Force Distribution

Publication date: Available online 10 January 2019

Source: Gait & Posture

Author(s): Rebecca Zifchock, Regina Parker, Willahelm Wan, Michael Neary, Jinsup Song, Howard Hillstrom

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Evidenz für chirurgische Standardverfahren: Appendizitis, Divertikulitis und Cholezystitis

Zusammenfassung

Hintergrund

Die akute Appendizitis, Cholezystitis und Sigmadivertikulitis sind die häufigsten entzündlichen viszeralchirurgischen Notfälle. Der evidenzbasierten Medizin entsprechend sollten chirurgische Indikation und Therapie stetig durch hochwertige Studien hinterfragt bzw. validiert werden.

Ziel der Arbeit

Darstellung und Einordnung der aktuellen Studienlage bzw. des Evidenzniveaus zu den o. g. Indikationen und Therapien.

Material und Methoden

Selektive Literaturrecherche Medline, Cochrane Library und Studienregister (clinicaltrials.gov).

Ergebnisse und Diskussion

Die genannten Indikationen unterliegen durch zunehmend hochwertige klinische Studien einem Wandel; in frühen Stadien scheinen konservative Therapien erfolgreich durchführbar zu sein. Dem gegenüber sind viele chirurgische Teilschritte bisher nicht ausreichend validiert. Weiterhin besteht ein großer Bedarf an hochwertigen, prospektiv-randomisierten klinischen Studien, sodass eine Förderung von Studien und der Studienkultur in der Chirurgie von größtem Interesse sein sollte.

http://bit.ly/2Fmp6X1

Perioperative Antibiotikaprophylaxe bei Pankreasresektionen mit und ohne präoperative Galleableitung

Zusammenfassung

Hintergrund

Ob bei einem obstruktiven Ikterus durch ein Pankreaskarzinom eine zeitnahe operative Versorgung oder eine präoperative Galleableitung („pre-operative biliary drainage", PBD) durchgeführt werden sollte, wird seit Jahrzehnten kontrovers diskutiert. Ziel der vorliegenden Arbeit war es, einerseits am eigenen Patientenkollektiv den Einfluss der PBD auf septische Komplikationen zu evaluieren und andererseits die intraoperativen Gallengangabstriche bei Patienten mit PBD zu analysieren, um eine aktuelle Antibiotikaempfehlung zu erarbeiten.

Material und Methoden

Relevante Daten aller durchgeführten Pankreasresektionen in unserer Klinik von Januar 2013 bis Dezember 2017 wurden in einer prospektiven Datenbank gesammelt und retrospektiv analysiert. Die erhobenen Daten wurden, abhängig vom Vorliegen einer PBD, auf postoperative Komplikationen überprüft. Weiter wurde das Keimspektrum der Gallengangabstriche bei Patienten mit PBD analysiert und auf die resistogrammgerechte Sensibilität gegenüber Ampicillin-Sulbactam überprüft. Anschließend wurde eine Antibiotikaempfehlung für die Praxis erarbeitet.

Ergebnisse

Im Untersuchungszeitraum wurden in unserer Klinik 197 Pankreasresektionen durchgeführt, davon waren 122 Duodenopankreatektomien und 20 totale Pankreatektomien (n = 142). Es erfolgte bei 28,2 % (40/142) der Patienten eine PBD. Es zeigte sich abhängig von einer PBD kein signifikanter Unterschied für die Mortalität, das Auftreten eines intraabdominellen Abszesses, einer postoperativen Pankreasfistel (POPF) und einer postoperativen Nachblutung („post pancreatectomy haemorrhage", PPH). Demgegenüber ließ sich eine signifikant höhere Rate an postoperativen Wundheilungsstörungen bei Patienten mit PBD (+PBD: 18/40; 45,0 % vs. −PBD: 13/102; 12,7 %; p < 0,0001) nachweisen. Eine Bakteriobilie zeigte sich bei 86,8 % (33/38) der Patienten mit PBD. Bei Patienten mit PBD war in 47,4 % (18/38) der Fälle mindestens ein nachgewiesenes Bakterium des Gallengangabstrichs nicht sensibel gegenüber Ampicillin-Sulbactam. Gegenüber den Antibiotika Piperacillin-Tazobactam wiesen 8 Patienten (21,1 %) und gegenüber Ciprofloxacin oder Imipenem jeweils 4 Patienten (10,5 %) ein Bakterium mit einer Resistenz auf.

Schlussfolgerung

Generell ist die Indikation zur PBD streng zu stellen. Wenn eine PBD durchgeführt werden muss, sollte die perioperative Antibiose optimiert werden, um Folgekomplikationen zu minimieren. Eine dem Krankenhaus angepasste perioperative Antibiotikaprophylaxe sollte erarbeitet und präoperativ gewonnene Abstrichergebnisse (z. B. im Rahmen der ERCP) sollten genutzt werden, um die Wirksamkeit der perioperativen Antibiose zu steigern. Aufgrund der internen Analyse der intraoperativ gewonnen Gallengangabstriche erfolgt in unserer Klinik bei Patienten mit PBD die perioperative Antibiose mit Ciprofloxacin.

http://bit.ly/2FonFqi

Kinematic risk factors for lower limb tendinopathy in distance runners: A systematic review and meta-analysis

Publication date: Available online 11 January 2019

Source: Gait & Posture

Author(s): Seyed Hamed Mousavi, Juha M. Hijmans, Reza Rajabi, Ron Diercks, Johannes Zwerver, Henk van der Worp

Abstract

Introduction

Abnormal kinematics have been implicated as one of the major risk factors for lower limb tendinopathy (LLT).

Objective

To systematically review evidence for kinematic risk factors for LLT in runners.

Methods

Individual electronic searches in PubMed, EMBASE and Web of Science were conducted. Two reviewers screened studies to identify observational studies reporting kinematic risk factors in runners with LLT compared to healthy controls. The Down and Black appraisal scale was applied to assess quality. A meta-analysis was performed provided that at least two studies with similar methodology reported the same factor.

Results

Twenty-eight studies were included: Achilles tendinopathy (AT) (9), iliotibial band syndrome (ITBS) (17), plantar fasciopathy (PF) (2), patellar tendinopathy (PT) (1), posterior tibial tendon dysfunction (PTTD) (1). Eighteen studies were rated high-quality and ten medium-quality. The meta-analyses revealed strong evidence of higher peak knee internal rotation and moderate evidence of lower peak rearfoot eversion and knee flexion at heel strike and greater peak hip adduction in runners with ITBS. Very limited evidence revealed higher peak ankle eversion in runners with PF and PTTD or higher peak hip adduction in PT.

Significance

Peak rearfoot eversion was the only factor reported in all included LLTs; it is a significant factor in ITBS, PT and PTTD but not in AT and PF. More prospective studies are needed to accurately evaluate the role of kinematic risk factors as a cause of LLT. Taken together, addressing rearfoot kinematic and kinematic chain movements accompanied by peak eversion should be considered in the prevention and management of LLT.

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Age- and low back pain-related differences in trunk muscle activation during a one-legged stance balance task

Publication date: Available online 11 January 2019

Source: Gait & Posture

Author(s): Rubens A. da Silva, Edgar R. Vieira, Guillaume Léonard, Louis-David Beaulieu, Suzy Ngomo, Alexandre H. Nowotny, César F. Amorim

Abstract

Background

Postural control declines with age and can be affected by low back pain. The changes in trunk muscle activation may also help to better explain these negative results on postural control measures.

Aim

The objective of this study was to compare the trunk muscle activity of younger and older subjects, with and without chronic low back pain (CLBP), during a one-legged stance task.

Methods and procedures

Twenty (20) with, and 20 subjects without nonspecific CLBP participated in the study. Each group was comprised of 10 younger (50% males; mean age: 31 years) and 10 older adults (50% males; mean age: 71 years). Subjects performed 3 × 30-second trials of a one-legged stance, with eyes open, on a force platform, while surface electromyography (EMG) measurements were obtained bilaterally on the multifidus at L5, iliocostalis lumborum at L3, rectus abdominis and biceps femoris muscles.

Outcomes and results

EMG amplitude analysis was processed by the Root Mean Square (250 ms window epochs) and normalized by the peak of activation during the balance tasks, to determine the muscular activity of each muscle. Participants with CLBP presented 15% lower lumbar muscle activation (p <  0.05), and 23% higher co-activation (ratio between rectus adominis by multifidus) than participants without CLBP, regardless of age. Significant differences (p <  0.05) between older and young groups were observed only for lower lumbar muscles (mean 24% lower in older than younger adults) and rectus adominis muscles (mean 17% lower in older than younger adults).

Conclusion and implications

CLBP individuals have different trunk muscle activity than those without CLBP, and older adults exhibit lower trunk activation during a one-legged stance balance task. The use of the EMG in evaluation of trunk neuromuscular function during one-legged stance may thus be a valuable tool when assessing balance in CLBP and older people.

from #Audiology via ola Kala on Inoreader http://bit.ly/2VJEr8S

The effect of different running shoes on treadmill running mechanics and muscle activity assessed using statistical parametric mapping (SPM)

Publication date: Available online 10 January 2019

Source: Gait & Posture

Author(s): Corina Nüesch, Elena Roos, Christian Egloff, Geert Pagenstert, Annegret Mündermann

Abstract

Background

Difference in joint mechanics between running shoes are commonly assessed using discrete parameters, yet statistically significant differences in these parameters between shoes are often scarce with small effect sizes. Statistical parametric mapping (SPM) has been suggested as suitable method for analyzing one-dimensional data such as kinematic, kinetic or muscle intensity time series.

Research question

The purpose of this study was to determine differences in treadmill running mechanics between novel running shoes using SPM.

Methods

Joint kinematics, muscle activity and ground reaction force were assessed in 19 rearfoot runners in their own shoes and in two test shoes during treadmill running (test shoe 1: 13 distinct rubber elements in the outer sole, springboard within EVA midsole with posterior elements shifted anteriorly by approximately 1.5 cm; test shoe 2: 17 distinct EVA elements with conventional heel geometry). Joint kinematics were measured using an inertial sensor system, and ground reaction force was measured using an instrumented treadmill.

Results

SPM analysis with repeated measures ANOVA revealed significant reductions in the ankle angle and in tibialis anterior, peroneus longus, vastus medialis and lateralis muscle activity during weight acceptance and in peroneus longus muscle activity during early and late swing and in semitendinosus muscle activity during late swing for the test shoes. Significant differences in muscle activity were observed in the interval of the main activity of the respective muscle. SPM on individual data revealed statistically significant and relevant within-subject differences between conditions in kinematic, muscle activity and ground reaction force patterns.

Significance

Inertial sensor systems and SPM may provide an efficient way of detecting changes in joint mechanics between running shoes within runners. Detecting within-subject differences in running mechanics between conditions not only requires statistical criteria but also criteria on the relevance of the magnitude of differences.

from #Audiology via ola Kala on Inoreader http://bit.ly/2QGsey2

Can runners maintain a newly learned gait pattern outside a laboratory environment following gait retraining?

Publication date: Available online 10 January 2019

Source: Gait & Posture

Author(s): Janet H. Zhang, Zoe Y.S. Chan, Ivan P.H. Au, Winko W. An, Roy T.H. Cheung

Abstract

Background

Previous peak tibial shock gait retraining programs, which were usually conducted on a treadmill, were reported to be effective on impact loading reduction in runners. However, whether the trained runners can translate the training effect at different running modes (treadmill/overground), or running slopes (uphill/downhill), remains unknown.

Research question

Is the training effect from a treadmill-based gait retraining translatable to unconstrained running conditions, including overground and uphill/downhill running?

Methods

The peak tibial shock was measured during treadmill/overground running, as well as level/uphill/downhill running before and after a course of treadmill-based gait retraining. The 8-session training aimed to soften footfalls using real-time biofeedback of tibial shock data. Repeated measures ANOVA was used to examine the effect of training, running mode, and running slope, on a group level. Reliable change index of each participant was used to assess the individual response to the training protocol used in this study.

Results

Eighty percent of the participants were responsive to the gait retraining and managed to reduce their peak tibial shock following training. They managed to translate the training effect to treadmill slope running (Level: p < 0.05, Cohen's d = 1.65; Uphill: p = 0.001, Cohen's d = 0.91; Downhill: p < 0.05; Cohen's d = 1.29) and overground level running (p = 0.014, Cohen's d = 0.85). However, their peak tibial shock were not reduced during overground slope running (Uphill: p = 0.054; Cohen's d = 0.62; Downhill p = 0.12; Cohen's d = 0.48).

Significance

Our findings indicated that a newly learned gait pattern may not fully translate to running outside of the laboratory environment.

from #Audiology via ola Kala on Inoreader http://bit.ly/2VFzePD

The Relationship Between Foot Arch Flexibility and Medial-Lateral Ground Reaction Force Distribution

Publication date: Available online 10 January 2019

Source: Gait & Posture

Author(s): Rebecca Zifchock, Regina Parker, Willahelm Wan, Michael Neary, Jinsup Song, Howard Hillstrom

from #Audiology via ola Kala on Inoreader http://bit.ly/2QGrMjk

Lattice Boltzmann Simulation of Immiscible Displacement in Porous Media: Viscous Fingering in a Shear-Thinning Fluid

Abstract

In this work, we investigate immiscible displacement in porous media with the displaced fluid being shear-thinning. We focus on the influence the heterogeneous viscosity field in the shear-thinning fluid brings on viscous fingering, which has received little attention in the existing researches. Lattice Boltzmann simulations of immiscible displacement with a power law model implementation in the displaced fluid are conducted. The lattice Boltzmann algorithm is validated against Newtonian and non-Newtonian flows in a channel. The effects of the shear-thinning property and the viscosity heterogeneity on viscous fingering are considered in the simulations. The results show that with stronger shear-thinning property (lower power law exponent n), there is stronger viscosity heterogeneity in the displaced fluid, and the viscous fingering shows weaker instability. The influence of a heterogeneous viscosity field on viscous fingering is dominated by the viscosity in the low-viscosity regions, while the high-viscosity regions show little influence. The influence of the local viscosity on viscous fingering is dependent upon the local shear rate. A concept of 'effective field viscosity' is introduced to quantitatively characterize a heterogeneous viscosity field. A shear rate weighted averaging algorithm is proposed to calculate the effective field viscosity from a heterogeneous viscosity field. The algorithm is tested in several cases and shows good performance to represent the influence of the heterogeneous viscosity field.

http://bit.ly/2VKjk6x

2019 Everett Mendelsohn Prize

http://bit.ly/2VK2eFV

Qualitätsindikatoren bei der Therapie des Hämorrhoidalleidens

Zusammenfassung

Hintergrund

Ein Qualitätsindikator ist ein quantitatives Maß, welches zum Monitoring und zur Bewertung der Qualität (u. a.) bestimmter Operationen genutzt werden kann, die sich auf ein Behandlungsergebnis auswirkt. Ein Indikator ist kein direktes Maß der Qualität. Es ist mehr ein Werkzeug, das zur Leistungsbewertung benutzt werden kann und Aufmerksamkeit auf potenzielle Problembereiche lenkt.

Material und Methoden

Es wurde in der Literatur nach Faktoren gesucht, die als Qualitätsindikator bei Hämorrhoidaloperationen herangezogen werden könnten.

Ergebnisse und Diskussion

Bei der Versorgung gutartiger Erkrankungen (wie das Hämorrhoidalleiden) können objektive Indikatoren (wie Rezidiv- und Überlebensraten) nicht als Qualitätsindikator benutzt werden. Es müssen daher andere Indikatoren herangezogen werden. Für den Patienten stehen andere Indikatoren im Vordergrund (wie Schmerzen, Komplikationen, Kontinenz usw.) als für den kolorektalen Chirurg, die Kostenträger oder das Krankenhaus. Die wichtigsten Indikatoren bei der Hämorrhoidaltherapie sind: Rezidiv- bzw. Restbeschwerden, Patientenzufriedenheit, Komplikationen, Schmerzen, Lebensqualität, Kosten, Dauer der Arbeitsunfähigkeit usw. Es zeigt sich, dass im Hinblick auf die Ergebnisqualität verschiedene Indikatoren, die auch in Leitlinien eine Rolle spielen, identifiziert werden können. Allerdings existieren für diese Indikatoren nur in wenigen Fällen etablierte Fragebögen oder Scores, die eine einheitliche Beurteilung ermöglichen. Vielmehr werden sogar einige Indikatoren (z. B. Kosten, Dauer des Krankenhausaufenthaltes) stark durch Faktoren wie das Gesundheitssystem beeinflusst, sodass deren Wertigkeit als Indikator angezweifelt werden muss.

http://bit.ly/2FlwwJY

Deep neural networks for efficient steganographic payload location

Abstract

The prevailing method for steganographic payload location aimed at LSB matching is the MAP method, which requires a few hundreds of stego images with load-carrying pixels at same locations and relatively high embedding rates. However, in practice, especially communication security, it is unwise for steganographers to generate stego images with high payloads or heavily utilize a same embedding key. Thus, the requirement of MAP is actually to some degree out of reach which leads to a performance degradation when faced with insufficient stego images with low embedding rates. To this end, we propose a tailored deep neural network (DNN) equipped with the improved feature named the "mean square of adjacency pixel difference", which remarkably outperforms the previous state-of-the-art methods not only in terms of accuracy but also efficiency. Our approach can considerably reduce computational costs because no cover estimate, as represented by the key in MAP, is involved. This merit stems from the methodology we adopted that takes payload location as a binary classification problem for each pixel. Additionally, our DNN is consistently superior than MAP irrespective of embedding rates. The significance of our main design points in DNN and the improved features are verified, by experiment results. Besides, the time required in our method to handle 256 × 256 pixel images is 82.54 ms on the average, which is nearly 14 times faster than that of MAP. On the basis of relevant knowledge, the incorporation of feature extraction into DNN architecture is likely to enable future researchers to specify real-time payload locations.

http://bit.ly/2FoWhbG

Fast background removal of JPEG images based on HSV polygonal cuts for a foot scanner device

Abstract

Foot scanning devices aim to provide information on a patient's foot and to help in diagnosing issues to be corrected with orthoses. The Galaxy foot scanner developed by the Aetrex company aims to provide a computer-aided framework to help physicians in their diagnoses. As numerous embedded devices, used for image processing and 3D-reconstruction, it includes cameras which provide JPEG pictures of the object to reconstruct. In this framework, an important step is the segmentation of the image, to isolate the object of interest, but the JPEG compression introduces artifacts which can lower the performance of any segmentation procedure. In this paper, we suggest a model which takes the artifacts stemming from the JPEG compression into account. The pixels are first sorted into layers of pixels with similar value V in the HSV color space, and the background is modeled by a polygon from an additional picture. Segmentation based on the knowledge of the background and the layer to be processed is then performed. Results obtained with the Galaxy foot scanner illustrate that this method provides good results for segmentation, while being sufficiently fast to be implemented for near real-time applications.

http://bit.ly/2Fo79qU

Generation of differential topographic images for surface inspection of long products

Abstract

The current manufacturing industries need efficient quality control systems to ensure their products are free of defects. In most cases, surface inspection is carried out by automatic systems that process 2D images which lack measurable information such as the height or depth of the surface defects. An alternative technology for surface inspection is laser scanning. Using this technique, a 3D representation of a product can be generated and therefore, defects can be easily measured. This paper proposes a real-time algorithm to generate differential topographic images of the surface of a product using laser scanning. The images generated by the proposed method are a flattened representation of the surface of the product which compare it to a perfect-shaped product. In these images, the volumetric defects can be easily segmented and measured using computer vision techniques to fulfill the requirements of the international standards of quality. The proposed algorithm is tested on 500,000 profiles meeting the constraints of real time.

http://bit.ly/2FpQL8F

Pruritus in Deutschland – eine Google-Suchmaschinenanalyse

Zusammenfassung

Hintergrund

Die Prävalenz von chronischem und akutem Pruritus in der Allgemeinbevölkerung ist schwer zu ermitteln, da Betroffene häufig nicht zum Arzt gehen.

Ziel der Arbeit

Ziel dieser Studie ist es, mithilfe von Analysen des Google-Suchvolumens Rückschlüsse auf die Häufigkeit sowie die häufigsten Lokalisationen von Pruritus in der internetnutzenden Bevölkerung in Deutschland zu ziehen, die mit 62,4 Mio. Personen einen Großteil der deutschen Allgemeinbevölkerung umfasst.

Material und Methoden

Mithilfe des Google-AdWords-Keyword-Planner wurden relevante Keywords zum Thema „Juckreiz" im Zeitraum von Januar 2015 bis Dezember 2016 identifiziert und hinsichtlich des Suchvolumens analysiert.

Ergebnisse

Insgesamt wurden 701 Keywords zum Thema „Juckreiz" vom Google-AdWords-Keyword-Planner identifiziert, die im Analysezeitraum 7.531.890 Suchanfragen bei Google erzielten. Die häufigsten Suchbegriffe waren dabei „Neurodermitis" (23,7 %), „Schuppenflechte" (17,8 %) und „Psoriasis" (13 %), erst auf Platz 6 folgte der Begriff „Juckreiz" (3 %). Die meisten Suchanfragen (72 %) thematisierten Einflussfaktoren und dabei v. a. Hauterkrankungen und Hautveränderungen. Die häufigste Lokalisation war Pruritus am ganzen Körper, gefolgt von Juckreiz im Analbereich. Im jahreszeitlichen Verlauf zeigte sich ein höheres monatliches Suchvolumen zum Thema Pruritus im Winterhalbjahr.

Diskussion

Die vorliegende Studie erlaubt mit ihrer unkonventionellen Methodik von Google-Suchmaschinenanalysen erstmalig eine grobe Schätzung des „medical needs" von Pruritus in Deutschland auf Bevölkerungsebene, der höher als bisher angenommen erscheint. Dabei wurde v. a. auch Pruritus im Analbereich als „unmet need" identifiziert.

http://bit.ly/2VNniLR

Panorama Dermatologische Praxis

http://bit.ly/2QHx4eJ

Personalisierte Medizin

http://bit.ly/2VKL2A8

Protective Effects of 1-Methylnicotinamide on Aβ 1–42 -Induced Cognitive Deficits, Neuroinflammation and Apoptosis in Mice

Abstract

The neurotoxicity of Aβ peptides has been well documented, but effective neuroprotective approaches against Aβ neurotoxicity are unavailable. In the present study, we investigated effects of 1-Methylnicotinamide (MNA), known as a main metabolite of nicotinamide (NA), on the impairment of learning and memory induced by Aβ and the underlying mechanisms. We found that intragastric administration of MNA at 100 or 200 mg/kg for 3 weeks significantly reversed bilateral intrahippocampal injection of Aβ_1–42-induced cognitive impairments in the Morris water maze (MWM), Y-maze and Novel object recognition tests. Furthermore, MNA suppressed Aβ_1–42-induced neuroinflammation, characterized by suppressed activation of microglia, decreased the expression of IL-6, TNF-α and nuclear translocation of NF-κB p65, as well as attenuated neuronal apoptosis as indicated by decreased TUNEL-positive cells and ratio of caspase-3 fragment to procaspase-3, and increased ratio of Bcl-2/Bax in the hippocampus. Our results show that MNA may ameliorate Aβ_1–42-induced cognition deficits, which is involved in inhibition of neuroinflammation and apoptosis mediated by NF-κB signaling, suggesting that MNA could have potential therapeutic value for AD.

Graphical Abstract

Neuroprotective affect of MNA on Aβ_1–42-induced cognitive deficits.

http://bit.ly/2Fsk3Dt