Therapeutic Value of Ginkgo biloba Extract EGb 761® in an Animal Model (Meriones unguiculatus) for Noise Trauma Induced Hearing Loss and Tinnitus.

Therapeutic Value of Ginkgo biloba Extract EGb 761® in an Animal Model (Meriones unguiculatus) for Noise Trauma Induced Hearing Loss and Tinnitus.

PLoS One. 2016;11(6):e0157574

Authors: Krauss P, Tziridis K, Buerbank S, Schilling A, Schulze H

Abstract
Noise induced hearing loss (NIHL) is a common disease in modern societies and may lead to maladaptations within the auditory system that finally result in subjective tinnitus. Available therapies may only alleviate the symptoms rather than restore normal hearing. In a previous study we demonstrated that the prophylactic application of Ginkgo biloba extract EGb 761® significantly reduces NIHL and tinnitus development in our Mongolian gerbil (Meriones unguiculatus) animal model. Here, we tested whether the application of EGb 761® has beneficial effects after the formation of permanent NIHL and tinnitus. To this end we monitored the therapeutic effects of EGb 761® on noise trauma-induced changes in signal processing within the auditory system of our animal model by behavioral (acoustic startle response, ASR) and electrophysiological approaches (auditory brainstem responses, ABR). We found that-in contrast to vehicle-three weeks of daily oral EGb 761® treatment (100 mg/kg body weight) led to a restoration of hearing thresholds back to pre-trauma conditions. In addition, all 9 animals that displayed behavioral signs of subjective tinnitus showed improvement, with 7 of them showing complete relief of tinnitus symptoms during the time of EGb 761® treatment. After discontinuation of EGb 761® treatment, tinnitus related behavior reappeared in all but one of these animals while auditory thresholds remained restored. A detailed analysis of ABR waves revealed that EGb 761® treatment did not simply change auditory processing back to pre-trauma conditions, but led to subtle changes of ABR wave amplitude and latency at different levels of the auditory pathway, with an overall increase of response to low stimulus intensities and a decrease at high intensities. The functional relevance of these changes may be the observed improvement of hearing thresholds while at the same time suppression of responses to high stimulus intensities may point to a global inhibitory mechanism that counteracts tinnitus.

PMID: 27315063 [PubMed - as supplied by publisher]

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An exploration of the role of executive functions in preschoolers' phonological development.

An exploration of the role of executive functions in preschoolers' phonological development.

Clin Linguist Phon. 2016 Jun 17;:1-17

Authors: Torrington Eaton C, Ratner NB

Abstract
There is limited yet compelling evidence that domain-general processes may contribute to speech sound change. This study explored whether executive functions contribute to the achievement of adult-like speech production. Children who are 4 to 5 years old - 42 with high-average speech production skills, 11 with low-average and nine with speech sound disorder (SSD) - participated in a battery of executive function and speech production tasks. Performance accuracy was compared across groups and also correlated with speech sound accuracy from a single-word naming task. Children with SSD demonstrated poorer performance than other groups on forward digit span, whereas children with low-average speech skills underperformed their peers on the Flexible Item Selection Task (FIST). These preliminary results suggest that children with speech errors may have less mature working memory than peers who have mastered phonological targets earlier in development.

PMID: 27315456 [PubMed - as supplied by publisher]

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Diagnosing bilectal children with SLI: Determination of identification accuracy.

Diagnosing bilectal children with SLI: Determination of identification accuracy.

Clin Linguist Phon. 2016 Jun 17;:1-19

Authors: Theodorou E, Kambanaros M, Grohmann KK

Abstract
Very little is known about diagnosing specific language impairment (SLI) in children who are exposed daily to a dialect (community language) and a standard variety (school instruction). The research reported here examines the specificity and sensitivity of language tests used so far to evaluate language performance in the context of diglossia (Cyprus). Sixteen children with SLI aged 5-9 years and 22 age-matched typically developing children were examined on a range of language tests modified to include dialectal differences. Properties of each test were evaluated through logistic regression analysis in order to identify children with SLI. The analysis revealed that many of the tests used are sufficiently accurate concerning sensitivity and specificity levels. Furthermore, a combination of tests is proposed as a good tool for diagnostic purposes. Speech and language therapists as well as researchers can now rely on an accurate diagnostic procedure within a practice-based evidence framework.

PMID: 27315368 [PubMed - as supplied by publisher]

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Is it necessary to assess fluent symptoms, duration of dysfluent events and physical concomitants when identifying children who have speech difficulties?

Is it necessary to assess fluent symptoms, duration of dysfluent events and physical concomitants when identifying children who have speech difficulties?

Clin Linguist Phon. 2016 Jun 17;:1-24

Authors: Mirawdeli A, Howell P

Abstract
Riley's (1994) Stuttering Severity Instrument (SSI) has three components: a symptom frequency measure (%SS), average duration of the three longest stutters and a physical concomitant (PC) score. An assessment of whether it was necessary to use all of these when using SSI-3 to identify which children are at risk of speech difficulties was performed. Participants were 879 reception class children aged 4-6 years from UK schools. The distributions of the separate components of SSI-3 were examined. Departures from normality were noted for each component. The features seen in the distribution of the individual components were also apparent in the distribution of the overall scores (this was not normal and had multiple modes). These findings undermine the usefulness of the overall measure for identifying children at risk of speech difficulties. Prior work used a fixed SSI-3 threshold to identify at risk children. Classification of children as fluent or at risk based on this threshold was compared with classifications based on thresholds applied to the individual components. Classifications were comparable for %SS, but less satisfactory for duration and PC. These findings suggest that %SS performs similarly to the overall SSI-3 scores when used to identify at risk children. Procedures for identifying at risk children in schools need to be short and easy to administer. Thus, since there is no justification for including all components of SSI-3 and duration and physical concomitants are not sensitive measures of fluency, a procedure based on the frequency measure alone is appropriate for use in schools.

PMID: 27315282 [PubMed - as supplied by publisher]

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A Maltese adaptation of the Boston Naming Test: A shortened version.

A Maltese adaptation of the Boston Naming Test: A shortened version.

Clin Linguist Phon. 2016 Jun 17;:1-17

Authors: Grima R, Franklin S

Abstract
The Boston Naming Test (BNT) is the most widely used naming test worldwide in research and clinical settings. This study aimed to develop a method for adapting the BNT to suit different linguistic and cultural characteristics using the example of Maltese in a bilingual context. In addition, it investigated the effects in Malta of age and level of education on naming performance. The words of the BNT were first translated into Maltese. The test was then piloted to establish target and alternative responses. Naming performance data were later collected from individuals of different ages and levels of education. Only 38 BNT items had at least 70% name agreement. Main effects of age and education were found. A Maltese adaptation was proposed using 38 items and lenient scoring. Similar procedures may be used in other bilingual populations. The study suggests that normative data should be stratified according to age and education.

PMID: 27315148 [PubMed - as supplied by publisher]

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Indications for intravitreal anti vascular endothelial growth factor in Kano, North Western, Nigeria

2016-06-18T03-19-13Z
Source: International Journal of Research in Medical Sciences
Abdulsalam Shuaib, Sadiq Hassan.
Background: To review the common indications for intravitreal anti vascular endothelial growth factor (VEGF) medications given at the retinal unit of Makkah Specialist Eye Hospital, Kano, Nigeria from January 2014 to December 2015. Methods: The case records of all patients given intravitreal anti VEGF medications were reviewed and age, diagnosis and indication for injection were recorded. Results were analyzed using the PAWS statistics version 18.0 (SPSS Inc., Chicago, IL). Results: A total of 174 injections consisting of 170 bevacizumab and 4 ranibizumab injections were given in the study period. The common indications for intravitreal injections were diabetic macula edema (42.5%), retinal vein occlusion (25.9%) and vitreous heamorrhage (9.8%). Conclusions: Diabetic macula edema and retinal vein occlusions are the major indications for intravitreal anti VEGF injections in Kano.


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Expanding Hematoma's Life-Threatening Neck and Face Emergency Management.

Expanding Hematoma's Life-Threatening Neck and Face Emergency Management.

J Craniofac Surg. 2016 Jun 16;

Authors: Shuker ST

Abstract
This article aims to bring attention to the morbidity and fatality of hemorrhage, how expanding hematoma and air compromise neck/face N/F injuries and present challenges. Large neck vessel ballistic injuries may lead to hemorrhage and expanding hematoma, resulting in airway compromise, due to injuries to the internal and/or external carotid arteries, internal jugular veins "internal carotid artery, external carotid artery, internal jugular vein," and the external carotid artery deep branches. This also leads to injuries to the cervical fascial layers (barriers of deep spaces) that facilitate pooling blood and hematoma into compartmental and large potential space which effects the pharynx, larynx, esophagus, and trachea.The expanding hematomas distort neck anatomical landmarks so "no neck zones" classifications are applicable. As the spectrum of injuries continues to evolve, the clinical characterization needs a new categorization based on compartmental hematoma and potential space anatomical location like retropharyngeal, parapharyngeal, sublingual, submandibular spaces, retrobulbar, and cheek compartment space hematomas.Presence of symptoms and location of the hematoma generally dictate what type of procedure is needed and how urgently it needs to be appropriately performed.Two unusual patients of pseudoaneurysms facial artery injuries with extravasation of blood producing a pulsating hematoma are referred to. Another patient considers large internal carotid artery injuries pseudoaneurysms revealed in angiography.The immediate management of life-saving patients requires aggressive airway maintenance at the scene, conscious victim will often obtain a posture that clears his airway and the semiconscious or unconscious put him in prone position. Air compromise may need emergency intubation, large bore cannula cricothyroidotomy, cricothyrotomy and at medical facilities tracheostomy.

PMID: 27315316 [PubMed - as supplied by publisher]

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Efficacy of microsurgical tumor removal for treatment of patients with intracanalicular vestibular schwannoma presenting with disabling vestibular symptoms.

Efficacy of microsurgical tumor removal for treatment of patients with intracanalicular vestibular schwannoma presenting with disabling vestibular symptoms.

J Neurosurg. 2016 Jun 17;:1-6

Authors: Samii M, Metwali H, Gerganov V

Abstract
OBJECTIVE The aim of this study was to analyze the efficacy and risks of microsurgery via the hearing-preserving retrosigmoid approach in patients with intracanalicular vestibular schwannoma (VS) suffering from disabling vestibular symptoms, with special attention to vertigo. METHODS This is a retrospective analysis of 19 patients with intracanalicular VS and disabling vestibular dysfunction as the main or only symptom (Group A). All of the patients reported having had disabling vertigo attacks. Subjective evaluation of the impairment of patients was performed before surgery, 3 weeks after surgery, 3 months after surgery, and 1 year after surgery, using the Dizziness Handicap Inventory (DHI). The main outcome measures were improvement in quality of life as measured using the DHI, and general and functional outcomes, in particular facial function and hearing. Patient age, preoperative tumor size, preoperative DHI score, and preservation of the nontumorous vestibular nerve were tested using a multivariate regression analysis to determine factors affecting the postoperative DHI score. The Mann-Whitney U-test was used to compare the postoperative DHI score at 3 weeks, 3 months, and 1 year after surgery with a control group of 19 randomly selected patients with intracanalicular VSs, who presented without vestibular symptoms (Group B). The occurrence of early postoperative discrete vertigo attacks was also compared between groups. RESULTS The preoperative DHI score was ≥ 54 in all patients. All patients reported having had disabling rotational vertigo before surgery. The only significant factor to affect the DHI outcome 3 weeks and 3 months after surgery was the preoperative DHI score. The DHI outcome after 1 year was not affected by the preoperative DHI score. Compared with the control group, the DHI score at 3 weeks and 3 months after surgery was significantly worse. There was no significant difference between the groups after 1 year. Vertigo was improved in all patients and completely resolved after 1 year in 17 patients. CONCLUSIONS Disabling vestibular dysfunction that affects quality of life should be considered an indication for surgery, even in otherwise asymptomatic patients with intracanalicular VS. Surgical removal of the tumor is safe and very effective in regard to symptom relief. All patients had excellent facial nerve function within 1 year after surgery, with a very good chance of hearing preservation.

PMID: 27315031 [PubMed - as supplied by publisher]

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Outcomes among patients discharged from the emergency department with a diagnosis of peripheral vertigo.

Related Articles

Outcomes among patients discharged from the emergency department with a diagnosis of peripheral vertigo.

Ann Neurol. 2016 Jan;79(1):32-41

Authors: Atzema CL, Grewal K, Lu H, Kapral MK, Kulkarni G, Austin PC

Abstract
OBJECTIVE: We aimed to determine the risk of short- and long-term stroke, as well as accidental injury, in patients discharged from an emergency department who were given a diagnosis of a peripheral vestibular disorder.
METHODS: In this population-based, retrospective, cohort study, we identified all adult patients who were discharged from an emergency department in Ontario, Canada, between 2006 and 2011, with a primary diagnosis of a peripheral vestibular disorder. We assessed hospitalized strokes at 7, 30, 90, and 365 days, as well as subsequent falls, motor vehicle accidents, fractures, and burns. To provide context, we assessed the same outcomes in propensity score-matched discharged emergency department patients with renal colic.
RESULTS: Among 41,794 qualifying patients, 76 (0.18%) had a stroke within 30 days. Accidental injury at 30 days ranged from 0.01% (falls) to 0.15% (fractures). The relative risk (RR) of 30-day stroke was 9.3 (95% confidence interval [CI]: 4.3-20.3) times higher than among matched renal colic controls. The RR was highest at 7 days (50.0; 95% CI, 6.9-362.0) and diminished with duration from the emergency department visit: RR 6.1 (95% CI, 3.5-10.7) at 90 days and 2.5 (95% CI, 1.8-3.5) at 1 year. There was no difference in the risk of accidental injury.
INTERPRETATION: The frequency of early stroke after discharge from an emergency department with a diagnosis of a peripheral vestibular disorder was extremely low. However, the relative risk was markedly higher than in matched patients with renal colic, suggesting that some strokes, or sentinel events for strokes, are being misdiagnosed as peripheral vestibular disorders.

PMID: 26385410 [PubMed - indexed for MEDLINE]

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Checkpoint Inhibitors in Head and Neck Cancer: Rationale, Clinical Activity, and Potential Biomarkers.

Checkpoint Inhibitors in Head and Neck Cancer: Rationale, Clinical Activity, and Potential Biomarkers.

Curr Treat Options Oncol. 2016 Aug;17(8):40

Authors: Economopoulou P, Kotsantis I, Psyrri A

Abstract
OPINION STATEMENT: The discovery and antibody targeting of immune regulatory molecules such as programmed cell death protein 1 (PD-1) and cytotoxic T lymphocyte antigen 4 (CTLA-4) pathways have led to clinically meaningful anti-cancer results. Rapid advances are being made in a variety of tumor types resulting in regulatory approvals in melanoma, non small cell lung cancer, and renal cell cancer. Numerous ongoing studies are expected to establish the worth of PD-1 pathway inhibitors in other tumor types as well as in combinations with approved agents. Head and neck squamous cell carcinoma (HNSCC) represents a complex group of malignancies characterized by profound immunosuppression and is an excellent candidate for investigation in this exciting field. However, given the fact that a subset of patients will likely benefit, it is critical to focus on biomarker development for appropriate patient selection and facilitation of trial design. As immunotherapy is settling in cancer treatment, immune checkpoint inhibitors are emerging as one of the most promising agents.

PMID: 27315066 [PubMed - as supplied by publisher]

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Embelin prevents LMP1-induced TRAIL resistance via inhibition of XIAP in nasopharyngeal carcinoma cells.

Embelin prevents LMP1-induced TRAIL resistance via inhibition of XIAP in nasopharyngeal carcinoma cells.

Oncol Lett. 2016 Jun;11(6):4167-4176

Authors: Yang S, Li SS, Yang XM, Yin DH, Wang L

Abstract
The tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) selectively induces apoptosis in the majority of tumor cells, whilst sparing normal cells. However, the potential use of TRAIL in the treatment of cancer is limited by the inevitable emergence of drug resistance. The present study reports the upregulation of latent membrane protein 1 (LMP1)-induced TRAIL resistance via the enhanced expression of X-linked inhibitor of apoptosis protein (XIAP) in nasopharyngeal carcinoma (NPC) cells. LMP1-positive NPC cells were indicated to be more sensitive to TRAIL compared with LMP1-negative NPC cells in three NPC cell lines. CNE-1 is a LMP1-negative NPC cell line that was transfected with pGL6-LMP1; following which, sensitivity to TRAIL decreased. LMP1-induced TRAIL resistance was associated with the decreased cleavage of caspase-8,-3 and -9, BH3 interacting domain death agonist (Bid) and mitochondrial depolarization, without any effects on the expression of the death receptors, B-cell lymphoma (Bcl)-2 and Bcl-extra long. Knockdown of XIAP with small interfering RNA increased caspase-3 and -9 and Bid cleavage, and prevented LMP1-induced TRAIL resistance. Furthermore, embelin, the inhibitor of XIAP, prevented LMP1-induced TRAIL resistance in the Epstein-Barr virus (EBV)-positive CNE-1-LMP1 and C666-1 NPC cell lines. However, embelin did not enhance TRAIL-induced apoptosis in NP-69, which was used as a benign nasopharyngeal epithelial cell line. These data show that LMP1 inhibits TRAIL-mediated apoptosis by upregulation of XIAP. Embelin may be used in an efficacious and safe manner to prevent LMP1-induced TRAIL resistance. The present study may have implications for the development and validation of novel strategies to prevent TRAIL resistance in EBV-positive NPC.

PMID: 27313761 [PubMed - as supplied by publisher]

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Stress relaxation properties of four orthodontic aligner materials: A 24-hour in vitro study.

Stress relaxation properties of four orthodontic aligner materials: A 24-hour in vitro study.

Angle Orthod. 2016 Jun 17;

Authors: Lombardo L, Martines E, Mazzanti V, Arreghini A, Mollica F, Siciliani G

Abstract
OBJECTIVE: To investigate the stress release properties of four thermoplastic materials used to make orthodontic aligners when subjected to 24 consecutive hours of deflection.
MATERIALS AND METHODS: Four types of aligner materials (two single and two double layered) were selected. After initial yield strength testing to characterize the materials, each sample was subjected to a constant load for 24 hours in a moist, temperature-regulated environment, and the stress release over time was measured. The test was performed three times on each type of material.
RESULTS: All polymers analyzed released a significant amount of stress during the 24-hour period. Stress release was greater during the first 8 hours, reaching a plateau that generally remained constant. The single-layer materials, F22 Aligner polyurethane (Sweden & Martina, Due Carrare, Padova, Italy) and Duran polyethylene terephthalate glycol-modified (SCHEU, Iserlohn, Germany), exhibited the greatest values for both absolute stress and stress decay speed. The double-layer materials, Erkoloc-Pro (Erkodent, Pfalzgrafenweiler, Germany) and Durasoft (SCHEU), exhibited very constant stress release, but at absolute values up to four times lower than the single-layer samples tested.
CONCLUSIONS: Orthodontic aligner performance is strongly influenced by the material of their construction. Stress release, which may exceed 50% of the initial stress value in the early hours of wear, may cause significant changes in the behavior of the polymers at 24 hours from the application of orthodontic loads, which may influence programmed tooth movement.

PMID: 27314603 [PubMed - as supplied by publisher]

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Pathophysiological basis of human papillomavirus in penile cancer: Key to prevention and delivery of more effective therapies.

Pathophysiological basis of human papillomavirus in penile cancer: Key to prevention and delivery of more effective therapies.

CA Cancer J Clin. 2016 Jun 17;

Authors: Spiess PE, Dhillon J, Baumgarten AS, Johnstone PA, Giuliano AR

Abstract
Answer questions and earn CME/CNE Squamous cell carcinoma (SCC) of the penis is a rare malignancy in the United States, with a significantly higher incidence-up to 20 to 30 times greater-in areas of Africa and South America. This can be explained in part by the significantly greater prevalence of sexually transmitted diseases among high-risk males often having unprotected sex with multiple sexual partners. Human papillomavirus (HPV) has been implicated as the infectious pathway by which several these penile neoplasms originate from precursor lesions. In this regard, a fundamental understanding of HPV in penile carcinogenesis can have meaningful implications in understanding 1) the diagnosis of HPV-related precursor penile lesions, 2) targeting HPV-specific molecular pathways, and 3) cancer prevention. Using vaccination programs not only may improve patient outcomes but also may minimize the need for highly aggressive and often debilitating surgical resection. CA Cancer J Clin 2016. © 2016 American Cancer Society.

PMID: 27314890 [PubMed - as supplied by publisher]

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[Infection with human papillomavirus in men].

[Infection with human papillomavirus in men].

Ginecol Obstet Mex. 2015 Nov;83(11):697-706

Authors: Aranda-Flores CE

Abstract
OBJECTIVE: Review updated (HPV) HPV in Man virus information, the role as a sexually transmitted infection (STI) that negatively impacts your partner(s) sexual(s) and represents a public health problem globally. In the case of men they have been identified specific risk factors that place it as the main factor in the transmission of the disease (infection, cancer and cancer precursor lesions in the genital tract), both heterosexual and homosexual practice as the subjects infected with HIV (HIV) in whom HPV prevalence rises to 95%. SEARCH METHODOLOGY: A systematic review of the literature of the past six years to date (2015) was made. Human papilloma virus vaccine, warts and sexually transmitted: In the database PubMed, LILACS and EMBASE were searched keywords. Only items that directly related to studies in men and that referred to the vaccine were analyzed.
RESULTS: The mean time of disappearance of persistent injuries HPV-6, 11, 16, and 18 (defined as two consecutive negative results) was 6.7; 3.2; 9.2; and 4.7 months respectively. In conclusion, this study showed that the acquisition of HPV-6, 11, 16, or 18 is common among men. Differences in detection rates of HPV DNA in anogenital different anatomical sites were found. It has been found that the average time of dlisappearance of lesions is ≥ 6 months. In another study conducted on a sample that included Mexican population, the median duration of HPV infection was 7.52 months (6.80-8.61) for any type of HPV and 12-19 months (7.16-18.17) for HPV-16.
CONCLUSION: The prevention of this disease has had a significant change with the introduction of the HPV vaccine, which has led organizations like the World Health Organization (WHO) to take a position in favor of including these biological in national immunization programs, to thereby contribute to the eradication of not only genital cancer in women, also in man, which is being reflected gradually in such programs.

PMID: 27311168 [PubMed - in process]

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Correlation between brain natriuretic peptide levels and the prognosis of patients with left ventricular diastolic dysfunction.

Correlation between brain natriuretic peptide levels and the prognosis of patients with left ventricular diastolic dysfunction.

Exp Ther Med. 2016 Jun;11(6):2583-2589

Authors: Gong H, Wang X, Shi YJ, Shang WJ, Ling YI, Pan LJ, Shi HM

Abstract
The present study aimed to investigate the association between brain natriuretic peptide (BNP) levels and the prognosis of patients with left ventricular (LV) diastolic dysfunction. A total of 708 inpatients with cardiovascular disease (mean age, 66 years; 395 males and 313 females) were grouped according to initial BNP and were followed-up for 20-51 months (average, 30.86 months) until endpoint events occurred. Endpoints were defined as mortality or readmission due to cardiovascular disease, or mortality due to any other reason. A total of 67 and 77 events were reported in the BNP ≤80 pg/ml and BNP >80 pg/ml groups, respectively. The occurrence rate of the endpoint was significantly higher in the BNP >80 pg/ml group, as compared with the BNP ≤80 pg/ml group (26.28 vs. 16.14%; relative risk=1.63). Furthermore, the durations of patient survival were significantly shorter in the BNP >80 pg/ml group, as compared with the BNP ≤80 pg/ml group (P=0.0006), and patient survival decreased as BNP levels rose (P=0.0074). Among the 708 patients, 677 underwent echocardiographic detection at the same time. No significant correlation was detected between BNP levels and survival time in 178 patients with normal LV diastolic function [mitral Doppler flow, early diastolic (E)/late diastolic (A)>1] (P=0.2165); whereas a negative correlation was determined in 499 patients with LVD dysfunction (E/A≤1) (Spearman's rho=-0.0899; P=0.0447). The prognoses of patients with elevated BNP levels were correspondingly worse in the present study and these correlations were demonstrated to be significant in patients with LV diastolic dysfunction. Therefore, BNP levels may be used to predict the prognosis of patients with cardiovascular disease.

PMID: 27313677 [PubMed - as supplied by publisher]

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Effects of astragalosides from Radix Astragali on high glucose-induced proliferation and extracellular matrix accumulation in glomerular mesangial cells.

Effects of astragalosides from Radix Astragali on high glucose-induced proliferation and extracellular matrix accumulation in glomerular mesangial cells.

Exp Ther Med. 2016 Jun;11(6):2561-2566

Authors: Chen X, Wang DD, Wei T, He SM, Zhang GY, Wei QL

Abstract
Diabetic nephropathy (DN) exhibits a deteriorating course that may lead to end-stage renal failure. Astragalosides have been clinically tested for the treatment of DN, but the mechanism is unclear at present. In this study, the effects of astragalosides were investigated on high glucose-induced proliferation and expression of transforming growth factor-β1 (TGF-β1), connective tissue growth factor (CTGF), type IV collagen (colIV) and fibronectin (FN) in glomerular mesangial cells (MCs). Cell proliferation was determined by 5-bromo-2'-deoxyuridine assay, and the expression of TGF-β1, CTGF, colIV and FN mRNA and proteins in MCs was detected by reverse transcription-polymerase chain reaction and ELISA assay, respectively. The results showed that high glucose clearly induced the proliferation of MCs and increased the expression of TGF-β1, CTGF, colIV and FN. Treatment with 50, 100, 200 µg/ml astragalosides inhibited cell proliferation and the expression of TGF-β1, CTGF, colIV and FN induced by high glucose. Thus, it is concluded that astragalosides inhibit the increased cell proliferation and expression of major extracellular matrix proteins that are induced by high glucose, indicating their value for the prophylaxis and therapy of DN.

PMID: 27313676 [PubMed - as supplied by publisher]

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Use of cystourethroscopy to remove an indwelling double-J ureteral stent 6 years following simultaneous radical sigmoid colon cancer and partial bladder resection: A case report.

Use of cystourethroscopy to remove an indwelling double-J ureteral stent 6 years following simultaneous radical sigmoid colon cancer and partial bladder resection: A case report.

Exp Ther Med. 2016 Jun;11(6):2467-2469

Authors: Gu Y, Zhang J, Wang G

Abstract
Ureteral stents are widely used to ensure good urinary drainage and to relieve obstruction, pain and infection during urologic procedures. However, long-term indwelling ureteral stents can cause various complications, such as encrustation, hematuria and infection. Here, the case of an 88-year-old man who had undergone simultaneous radical resection of sigmoid colon cancer and partial resection of the bladder 6 years prior is presented. The patient complained of urinary frequency and urgency, dysuria and intermittent fever. A kidney ureter bladder X-ray examination revealed the presence of an entire coiled double-J stent with calculi from the kidney to the bladder. A computed tomography scan revealed mild hydronephrosis of the left kidney and one J end of the stent in the bladder. The stent was removed successfully by cystourethroscopy and holmium laser lithotripsy. This report describes the clinical experience of the removal of a long-term stent by endoscopic manipulation.

PMID: 27313675 [PubMed - as supplied by publisher]

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Notoginsenoside Rb1 inhibits activation of ERK and p38 MAPK pathways induced by hypoxia and hypercapnia.

Notoginsenoside Rb1 inhibits activation of ERK and p38 MAPK pathways induced by hypoxia and hypercapnia.

Exp Ther Med. 2016 Jun;11(6):2455-2461

Authors: Qiu X, Zheng M, Song D, Huang L, Tang L, Ying L, Wang W

Abstract
The aim of the present study was to investigate the effect of notoginsenoside Rb1 (Rb1) on the ERK and p38 MAPK pathways in primary cultured pulmonary arterial smooth muscle cells (PASMCs) exposed to hypoxia and hypercapnia, in order to elucidate the mechanism underlying the effect of Rb1 on hypoxia and hypercapnia-induced pulmonary vasoconstriction (HHPV). PASMCs were isolated from Sprague-Dawley rats. The cells were divided into five groups: Normal (N), hypoxia and hypercapnia (H), RbL, RbM and RbH groups. N group cells were cultured under 5% CO2 and 21% O2. H, RbL, RbM and RbH groups were cultured under 6% CO2 and 1% O2. Prior to the hypoxia and hypercapnia exposure, RbL, RbM and RbH groups were treated with 8, 40 and 100 mg/ml Rb1 for 30 min, respectively. Phosphorylated extracellular signal-regulated kinase (P-ERK) and P-p38 protein, and ERK1/2 and p38 mRNA expression levels were detected using western blot and semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) analyses, respectively. The correlations between P-ERK protein and ERK1/2 mRNA, and between P-p38 protein and p38 mRNA were evaluated. Results of western blot and RT-PCR showed hypoxia and hypercapnia increased P-ERK and P-p38 protein, and ERK1/2 mRNA, respectively (P<0.05). Rb1 suppressed the increased P-ERK and P-p38 protein, and ERK1/2 and p38 mRNA by hypoxia and hypercapnia (P<0.05). P-ERK protein was positively correlated with ERK1 (r=0.5, P<0.01) and ERK2 mRNA (r=0.977, P<0.01). P-p38 protein was positively correlated with p38 mRNA (r=0.884, P<0.01). Thus, the present results indicate that Rb1 may ameliorate HHPV by suppressing ERK and p38 pathways. The study provides an experimental basis for investigating the clinical use of Rb1 in the management of HHPV-related disorders.

PMID: 27313674 [PubMed - as supplied by publisher]

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L-asparaginase-based regimen as a first-line treatment for newly diagnosed nasal type extranodal natural killer cell/T-cell lymphoma.

L-asparaginase-based regimen as a first-line treatment for newly diagnosed nasal type extranodal natural killer cell/T-cell lymphoma.

Exp Ther Med. 2016 Jun;11(6):2437-2445

Authors: Bu S, Yuan F, Wei X, Yin Q, Li Y, Mi R, Yang H, Li H, Ge S, Liu Y, Song Y

Abstract
The aim of the present study was to compare the efficacy of an L-asparaginase-based regimen and a CHOP regimen followed by radiotherapy as first-line treatments for newly diagnosed nasal type extranodal natural killer cell/T-cell lymphoma (ENKTL). A total of 69 patients received the CHOP regimen as the first-line treatment and 112 patients received the L-asparaginase-based regimen. All patients received radical radiotherapy following two cycles of chemotherapy. The overall response rates of the L-asparaginase-based and CHOP treatment groups were 90.18 and 72.46%, respectively (P=0.002). The one, two, and five-year overall survival (OS) rates and progression-free survival (PFS) rates of the L-asparaginase group were 96.0, 88.3, 65.1, 94.2, 79.8 and 50.0%, respectively. The one, two, and five-year OS and PFS rates of the CHOP group were 82.6, 61.9, 25.8, 63.8, 44.0 and 21.0%, respectively (P<0.001). Compared with CHOP treatment, L-asparaginase-based chemotherapy combined with radiotherapy was a safe and highly effective treatment for newly diagnosed ENKTL.

PMID: 27313673 [PubMed - as supplied by publisher]

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Why hypofractionate stereotactic radiosurgery for brain metastases?

Why hypofractionate stereotactic radiosurgery for brain metastases?

CNS Oncol. 2016 Jun 17;

Authors: Myrehaug S, Soliman H, Tseng CL, Ruschin M, Larson D, Sahgal A

PMID: 27314746 [PubMed - as supplied by publisher]

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Rituximab plus reduced-dose cyclophosphamide, doxorubicin, vincristine and prednisone (RD R-CHOP) chemotherapy is feasible for very elderly patients (≥80 years) with B-cell lymphoma: analysis of treatment outcome.

Rituximab plus reduced-dose cyclophosphamide, doxorubicin, vincristine and prednisone (RD R-CHOP) chemotherapy is feasible for very elderly patients (≥80 years) with B-cell lymphoma: analysis of treatment outcome.

J Chemother. 2016 Jun 17;:1-7

Authors: Shi Z, Tang X, Wang J, Shen Q, Chen X, Chen J, Zhuang J

Abstract
OBJECTIVE: The aim of this trial was to evaluate the treatment outcome of reduced-dose (RD)R-CHOP treatment in very elderly patients with B-cell lymphoma.
METHODS: This trial comprised 40 patients, aged ≥80 years, who were diagnosed with B-cell lymphoma and recruited at a single centre from 2007 to 2013. They received four to eight cycles of reduced-dose R-CHOP (rituximab 375 mg/m(2) Day 0, cyclophosphamide 400 mg/m(2) Day 1, epirubicin 35 mg/m(2) Day 1, vincristine 1 mg Day 1 and prednisone 50 mg/m(2) Days 1-5). The data of treatment responses and survival were collected and analysed comprehensively.
RESULTS: The median age was 83 years old (range, 80-93 years old) and the median follow-up duration was 40.86 months. The overall response rate (ORR) was 87.5%. With a 40.9-month follow-up, 3-year overall survival (OS), 3-year progression free survival (PFS) and 3-year event-free survival (EFS) were 17.2, 46.5 and 39.1%, respectively. Using multivariate analysis, we concluded that age ≥85 years; LVEF ≤70%; M-CIRS score ≥6 and ECOG-PS ≥2 were predictive poor prognostic factors.
CONCLUSIONS: High response rate was concluded on very elderly B-cell lymphoma patients (≥80 years old) with reduced-dose R-CHOP. However, the very elderly patients with poor performance status and more complications benefit less from treatment.

PMID: 27315156 [PubMed - as supplied by publisher]

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Wiring dendrites in layers and columns

10.3109/01677063.2016.1173038<br/>Jiangnan Luo

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Overexpressed Targeting protein for Xklp2 (TPX2) serves as a promising prognostic marker and therapeutic target for gastric cancer.

Overexpressed Targeting protein for Xklp2 (TPX2) serves as a promising prognostic marker and therapeutic target for gastric cancer.

Cancer Biol Ther. 2016 Jun 17;:0

Authors: Liang B, Zheng W, Fang L, Wu L, Zhou F, Yin X, Yu X, Zou Z

Abstract
The targeting protein for Xenopus kinesin-like protein 2 (TPX2) is a putative oncogene in different human cancers. This study assessed TPX2 expression in gastric cancer tissue samples and then determined the effects of TPX2 knockdown on the regulation of gastric cancer cell malignant behaviors in vitro. Tissue samples from 115 gastric cancer patients were analyzed for TPX2 expression. The effects of TPX2 siRNA on gastric cancer cells were assessed in vitro, including cell viability, cell cycle distribution, apoptosis, migration, and invasion. The data showed that TPX2 was overexpressed in gastric cancer tissues compared to that in the adjacent normal epithelia. Moreover, TPX2 overexpression was associated with a poor overall survival and was an independent prognostic predictor of gastric cancer. In addition, the in vitro study further confirmed the ex vivo data, i.e., knockdown of TPX2 expression reduced gastric cancer cell viability but induced apoptosis and arrested cells at the G2/M phase of the cell cycle. Knockdown of TPX2 expression also inhibited the tumor cell migration and invasion capacity in vitro. At the gene level, knockdown of TPX2 expression upregulated the levels of cyclin B1, cdk4, p53, Bax, caspase-3, and E-cadherin, but downregulated the levels of cyclin D1, cdk2, N-cadherin, slug, matrix metalloprotease (MMP)-2, and MMP-9, suggesting that knockdown of TPX2 expression suppressed tumor cell epithelial-mesenchymal transition (EMT). This study demonstrated that detection of TPX2 overexpression could serve as a prognostic marker and therapeutic target for gastric cancer.

PMID: 27314162 [PubMed - as supplied by publisher]

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Changes In Imaging And Cognition In Juveniles Rats After Whole Brain Irradiation

Publication date: Available online 16 June 2016
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Robert J. Brown, Brandon J. Jun, Jesse D. Cushman, Christine Nguyen, Adam H. Beighley, Johnny Blanchard, Kei Iwamoto, Dorthe Schaue, Neil G. Harris, James D. Jentsch, Stefan Bluml, William H. McBride
PurposePediatric cancer survivors treated with whole brain irradiation (WBI) develop long-term cognitive deficits and morbidity that are poorly understood and for which there is no treatment. We describe similar cognitive defects in juvenile WBI rats and correlate them with alterations in diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS) during brain development.MethodsJuvenile Fischer rats received clinically relevant fractionated doses of WBI, or a high dose exposure. DTI and MRS were performed at the time of WBI and during the subacute (3-mo) and late (6-mo) phases, prior to behavioral testing.ResultsFractional anisotropy (FA) in the splenium of the corpus callosum increased steadily over the study period, reflecting brain development. WBI did not alter the subacute response, but thereafter there was no further increase in FA, especially in the high dose group. Similarly, the ratios of various MRS metabolites to creatine increased over the study period and, in general, the most significant changes after WBI were during the late phase and with the higher dose. The most dramatic changes observed were in glutamine:creatine ratios that failed to increase normally between 3 and 6 months after either radiation dose. WBI did not affect the ambulatory response to novel open field testing in the subacute phase, but locomotor habituation was impaired and anxiety-like behaviors increased. As for cognitive measures, the most dramatic impairments were in novel object recognition late after either dose of WBI.ConclusionsThe developing brains of juvenile rats given clinically relevant fractionated doses of WBI demonstrate few abnormalities in the subacute phase but marked late cognitive alterations that may be linked with perturbed MRS signals measured in the corpus callosum. This pathomimetic phenotype of clinically relevant cranial irradiation effects may be useful for modeling, mechanistic evaluations, and testing mitigation approaches.

Teaser

Few animal models of whole brain irradiation take into account young age and dose fractionation. We present both imaging and behavioral data following clinically relevant fractionated whole brain irradiation in juvenile rats pathomimetic to those observed in survivors of pediatric brain tumors including development of early prefrontal dysfunction and late memory deficits that correlate with developmental imaging abnormalities.


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Predicting The 5-Year Risk of Biochemical Relapse after Post-Prostatectomy Radiation Therapy In ≥pT2, pN0 Patients with A Comprehensive TCP Model

Publication date: Available online 18 June 2016
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Claudio Fiorino, Sara Broggi, Nicola Fossati, Cesare Cozzarini, Gregor Goldner, Thomas Wiegel, Wolfgang Hinkelbein, R. Jeffrey Karnes, Stephen A. Boorjian, Karin Haustermans, Steven Joniau, Federica Palorini, Shahrokh Shariat, Francesco Montorsi, Hein Van Poppel, Nadia Di Muzio, Riccardo Calandrino, Alberto Briganti
PurposeTo fit the individual biochemical-recurrence-free survival (bRFS) data of patients treated with post-prostatectomy radiation therapy (RT) with a comprehensive tumor control probability (TCP) model.Methods and MaterialsConsidering pre-RT prostate specific antigen (PSA) as a surrogate of the number of clonogens, bRFS may be expressed as a function of dose-per-fraction dependent radiosensitivity (αeff), the number of clonogens for pre-RT PSA=1ng/mL (C) and the fraction of patients that relapse due to clonogens outside the treated volume (K), assumed to depend (linearly or exponentially) on pre-RT PSA and Gleason score (GS). Data of 894 node-negative, ≥pT2,pN0 hormono-naive patients treated with adjuvant (n=331) or salvage (n=563) intent were available: 5-year bRFS data were fitted grouping patients according to GS (<7:392,=7:383,>7:119).ResultsMedian follow-up, pre-RT PSA and dose were 72 months, 0.25ng/mL and 66.6Gy (range:59.4-77.4Gy) respectively. Best-fit values were 0.23-0.26 Gy^-1 and 10⁷ for αeff and C for the model considering a linear dependence between K and PSA. Calibration plots showed good agreement between expected and observed incidences (slope:0.90-0.93) and moderately high discriminative power (AUC:0.68-0.69). Cross validation showed satisfactory results (average AUCs in the training/validation groups: 0.66-0.70). The resulting dose-effect curves strongly depend on pre-RT PSA and GS. bRFS rapidly decreases with PSA: the maximum obtainable bRFS (defined as 95% of the maximum) declined by about 2.7 and 4.5% for each increment of 0.1 ng/ml for GS< and ≥7 respectively.ConclusionsIndividual data were fitted by a TCP model and the resulting best-fit parameters were radiobiologically consistent. The model suggests that relapses frequently result from clonogens outside the irradiated volume, supporting the choice of lymph-nodal irradiation and/or systemic therapy for specific subgroups (GS<7:PSA>0.8-1.0ng/ml; GS≥7:PSA>0.3 ng/ml). Early RT should be preferred over delayed RT: the detrimental effect of PSA increase can never be fully compensated by increasing the dose, especially for patients with GS≥7.

Teaser

A comprehensive TCP model accurately fit the 5-year biochemical-relapse-free survival after post-prostatectomy radiotherapy of 894 ≥pT2, pN0 hormono-naive patients pooled from 5 large prospective data-bases. The model suggests that the optimal dose depends on pre-RT PSA/GS. Even when the optimal dose is delivered, the fraction of relapsing patients is never zero and dramatically increases with pre-RT PSA/GS, suggesting a potential benefit from pelvic-node irradiation and/or systemic therapy in selected groups (GS<7:PSA>0.8-1.0ng/ml; GS≥7:PSA>0.3 ng/ml).


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The outcome for pathological node positive prostate cancer patients treated with intensity-modulated radiotherapy and androgen deprivation therapy: a case-matched analysis of pN1 and pN0 patients

Publication date: Available online 16 June 2016
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): A. Van Hemelryk, G. De Meerleer, P. Ost, F. Poelaert, W. De Gersem, K. Decaestecker, P. De Visschere, V. Fonteyne
Introductionand Objective: Improved outcome is reported after surgery or external beam radiotherapy (EBRT) + androgen deprivation therapy (ADT) for patients with lymph node (LN) positive (N1) prostate cancer (PC). Surgical series showed that not all patients with pathological (p)N1 PC behave the same. The aim of this study is to perform a matched-case analysis to compare the outcome of pN1 and pN0 PC after high dose EBRT+ADT.Material and MethodsRadiotherapy up to 80Gy was delivered to the prostate with a minimal dose of 45Gy to the pelvis for pN1 patients. After matching, Kaplan Meier statistics were used to compare 5-year biochemical and clinical relapse free survival (bRFS and cRFS), prostate cancer specific (PCSS) and overall survival (OS). Acute and late rectal and urinary toxicity was evaluated.ResultsSixty-nine pN1 PC patients were matched 1:1 with pN0 PC patients. Median follow-up was 60 months. Five-year bRFS and cRFS for pN1 versus pN0 PC patients were 65±7% versus 79±5% (p=0.08) and 70±6% versus 83±5% (p=0.04) respectively. No significant difference was found in bRFS or cRFS rates between low volume pN1 (≤2 positive LNs) and pN0 patients. Five-year PCSS and OS were comparable between pN1 and pN0 PC patients (PCSS: 92%±4% vs. 93%±3%, p=0.66; OS: 82%±5% vs. 80%±5%, p=0.58). Severe toxicity was rare for both groups, although pN1 patients experienced significantly more acute rectal toxicity grade 2.ConclusionPrimary EBRT plus 2-3 years of ADT is a legitimate treatment option for pN1 PC patients, especially those with ≤2 positive LNs, and this with bRFS and cRFS rates comparable to pN0 PC patients. For pN1 PC with >2 positive LNs bRFS and cRFS are worse compared to pN0 patients, but even in this subgroup long term disease control is obtained.

Teaser

In this matched case analysis, the outcome of pathological node positive (pN1) prostate cancer (PC) patients is compared to pathological node negative (pN0) PC patients after external beam radiotherapy (EBRT) + androgen deprivation (ADT). This study confirms that EBRT plus 2-3 years of ADT is a legitimate treatment option for pN1 PC patients, especially those with ≤2 positive lymph nodes (LNs). Also for pN1 PC with >2 positive lymph nodes long term disease control is obtained.


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Neural response differences in the rat primary auditory cortex under anesthesia with ketamine versus the mixture of medetomidine, midazolam and butorphanol

Publication date: Available online 16 June 2016
Source:Hearing Research
Author(s): Hisayuki Osanai, Takashi Tateno
Anesthesia affects central auditory processing. However, it is unclear to what extent the choice of anesthetic agent affects neural responses to sound stimulation. A mixture of three anesthetics (medetomidine, midazolam and butorphanol; MMB) was recently developed as an alternative to ketamine owing to the latter's addictive potential, yet the effect of this combination of anesthetics on neural responses is not known. Here, we compared the spontaneous activity, tuning properties and temporal responses of primary auditory cortical neurons under these two anesthetic conditions, using electrophysiological and flavoprotein autofluorescence imaging methods. Frequency tuning properties were not significantly different between ketamine and MMB anesthesia. However, neural activity under MMB showed decreases in the spontaneous and tone-evoked firing rates in a layer-dependent manner. Moreover, the temporal response patterns were also different between the anesthetics in a layer-dependent manner, which may reflect differences in the anesthetic mechanisms. These results demonstrated how response properties in the primary auditory cortex are affected by the choice of anesthesia.



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White Matter Structure in the right Planum Temporale Region Correlates with Visual Motion Detection Thresholds in Deaf People

Publication date: Available online 16 June 2016
Source:Hearing Research
Author(s): Martha M. Shiell, Robert J. Zatorre
The right planum temporale region is typically involved in higher-order auditory processing. After deafness, this area reorganizes to become sensitive to visual motion. This plasticity is thought to support compensatory enhancements to visual ability. In earlier work we showed that enhanced visual motion detection abilities in early-deaf people correlate with cortical thickness in a subregion of the right planum temporale. In the current study, we build on this earlier result by examining the relationship between enhanced visual motion detection ability and white matter structure in this area in the same sample. We used diffusion-weighted magnetic resonance imaging and extracted the measures of white matter structure from a region-of-interest just below the grey matter surface where cortical thickness correlates with visual motion detection ability. We also tested control regions-of-interest in the auditory and visual cortices where we did not expect to find a relationship between visual motion detection ability and white matter. We found that in the right planum temporale subregion, and in no other tested regions, fractional anisotropy, radial diffusivity, and mean diffusivity correlated with visual motion detection thresholds. We interpret this change as further evidence of a structural correlate of cross-modal reorganization after deafness.



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Gross Morphometry of Pectoral Girdle of Domestic Pigeon (Columba livia)

2016-06-18T02-14-52Z
Source: International Journal of Livestock Research
Md. Parvez, Mrs. Akter, Md. Gofur, Md. Sarder.
The pectoral girdle gives strength and range of motion to the wings of birds and plays functional role in flight mechanism of birds. Pectoral girdle of adult domestic pigeon (Columba livia) (n=10) was studied with special reference to the morphological and morphometric parameters. The girdle was composed of three pairs of bones viz. the scapulae, the coracoids and fused clavicles (furcula). The scapula was sword shaped with proximal extremity and a blade. The length and maximum width of scapula were 4.23 cm and 0.56 cm, respectively. The clavicle was in the form of thick curved plate to join the bone of opposite side forming the broad 'U' shaped furculum with rudimentary hypocleideum. The width of clavicle gradually decreased from proximal to distal end. Hypocleideum was not prominent at their meeting point. The curvature length and maximum width of clavicle were 6.38 cm and 1.61 cm, respectively. Coracoid was directed downwards and backwards to articulate the sternum distally. The length was 3.53 cm and width of distal extremity (1.45 cm) was about twice that of proximal one (0.70 cm). The proximal extremity of coracoid was hook like and articulated with proximal extremity of scapula and clavicle to form foramen triosseum (0.35 cm diameter).


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Effect of genotype on reproductive and productive performances of dairy cows under rural context in Bangladesh

2016-06-18T02-14-52Z
Source: International Journal of Livestock Research
Md. Rahman, Md. Gofur, Md. Rahman, Farida Bari, Nasrin Juyena.
Influence of genotypes (breed) on reproductive and productive attributes has been assessed in the local (L), Local x Friesian (LF) and Local x Friesian × Friesian (LFF) dairy cows (n=76) raised in randomly selected smallholder dairy farms in Barisal, Bangladesh. With regard to reproductive attributes, significant (p


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Whole-Body Vibration Intensities in Chronic Stroke: A Randomized Controlled Trial

Purpose: A single-blinded randomized controlled study was conducted to investigate the effects of different whole-body vibration (WBV) intensities on body functions/structures, activity, and participation in individuals with stroke. Methods: Eighty-four individuals with chronic stroke (mean age = 61.2 yr, SD = 9.2) with mild to moderate motor impairment (Chedoke–McMaster Stroke Assessment lower limb motor score: median = 9 out of 14, interquartile range = 7–11.8) were randomly assigned to a low-intensity WBV, high-intensity WBV, or control group. The former two groups performed various leg exercises while receiving low-intensity and high-intensity WBV, respectively. Controls performed the same exercises without WBV. All individuals received 30 training sessions over an average period of 75.5 d (SD = 5.2). Outcome measurements included knee muscle strength (isokinetic dynamometry), knee and ankle joint spasticity (Modified Ashworth Scale), balance (Mini Balance Evaluation Systems Test), mobility (Timed-Up-and-Go test), walking endurance (6-Minute Walk Test), balance self-efficacy (Activities-specific Balance Confidence scale), participation in daily activities (Frenchay Activity Index), perceived environmental barriers to societal participation (Craig Hospital Inventory of Environmental Factors), and quality of life (Short-Form 12 Health Survey). Assessments were performed at baseline and postintervention. Results: Intention-to-treat analysis revealed a significant time effect for muscle strength, Timed-Up-and-Go distance, and oxygen consumption rate achieved during the 6-Minute Walk Test, the Mini Balance Evaluation Systems Test, the Activities-specific Balance Confidence scale, and the Short-Form 12 Health Survey physical composite score domain (P 0.05). Conclusion: The addition of the 30-session WBV paradigm to the leg exercise protocol was no more effective in enhancing body functions/structures, activity, and participation than leg exercises alone in chronic stroke patients with mild to moderate motor impairments.

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Exercise in Eating Disorders Treatment: Systematic Review and Proposal of Guidelines

Introduction: Although exercise is an effective intervention for many psychological health issues, it has often been overlooked as a potential adjunct to eating disorder (ED) treatment. Thus, our objective was to summarize the literature by synthesizing themes identified in clinical studies and explicit guidelines or recommendations for the use or management of exercise in ED interventions into a proposed set of guidelines for the use of exercise in ED treatment. Methods: A literature search in exercise science, health psychology, and the ED literature was conducted. The focus was to obtain articles that reported on therapeutic effects and/or guidelines for the therapeutic use of exercise in individuals with ED. Results: Our review identified 11 core themes describing techniques that have been successful in using exercise therapeutically in ED treatment. These 11 guidelines are as follows: employ a team of relevant experts, monitor medical status, screen for exercise-related psychopathology, create a written contract of how therapeutic exercise will be used, include a psychoeducational component, focus on positive reinforcement, create a graded exercise program, begin with mild-intensity exercise, tailor the mode of exercise to the needs of the individual, include a nutritional component, and debrief after exercise sessions. Conclusion: Our review identifies specific guidelines that may enhance ED treatment outcomes. It is the first to summarize divergent literature and synthesizes previous successes that may guide the use of therapeutic exercise in some, but not all ED patients. This review provides a practical set of guidelines for the clinical management and therapeutic use of exercise in ED treatment by focusing on empowering individuals with exercise as a tool for healthy living.

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The Effect of Head Impact Location on Day of Diagnosed Concussion in College Football

Introduction: Scientists and clinicians have attempted to identify and understand biomechanical factors that influence concussion likelihood. The effect of impact frequency to a given head location before the concussion has not been evaluated. The purpose of this study was to compare the frequency of impacts to a given head location on days of diagnosed concussion to the frequency of impacts to a given head location before kinematically matched nonconcussive impacts. Methods: Head impact data were gathered from 33 Division I National Collegiate Athletic Association football players. Twenty-four concussions were identified and matched with impacts of similar kinematic and injury criterion values (linear acceleration, rotational acceleration, Gadd severity index, and head injury criterion) that occurred during the same event type (game, practice, or scrimmage). In addition, these same matching criteria were used to match all players to the closest kinematic/same player group. All impacts within a session before the impact of interest (concussive or matched impact) were analyzed. Results: On days of diagnosed concussion, the concussive group sustained a lower percentage of impacts to the front of the head (34.5%) and a greater frequency of impacts to the sides (19.6%) and top (18.9%) of the head (χ2(3) = 10.23, P = 0.017) as compared with the matched nonconcussive group (front = 42.5%, sides = 16.6%, top = 14.0%). No significant difference in frequency was found in impacts to the back of the head. Conclusion: It may be more difficult to mitigate concussive forces sustained in impacts to the top and sides of the head than the front of the head. These findings fall in line with previous research demonstrating that reduced impact magnitudes may lessen concussion risk. Studying appropriate training paradigms to develop safer playing techniques on the field is warranted.

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Effectiveness of Exercise on Visceral Adipose Tissue in Older South Asian Women

Introduction: Individuals of South Asian (SA) origin have a greater risk for type 2 diabetes and cardiovascular disease than other ethnic populations. This increased risk is in part explained by the unique obesity phenotype of elevated visceral adipose tissue (VAT) among this population. Aerobic exercise in Europeans is effective at reducing VAT, but this has not been studied in SA, who have some of the lowest levels of physical activity in the world. Therefore, the purpose of this study was to determine whether exercise can reduce VAT given the unique obesity phenotype and associated disease risk in the SA population. Methods: A total of 75 physically inactive, postmenopausal SA women were randomized to either culturally based (Bhangra dance), standard (gym-based), or control (nonexercise) program for 12-wk. The primary outcome was change in VAT. Results: The average attendance in the culturally based and standard program was 78% ± 33% and 67% ± 25%, respectively. After an intention-to-treat analysis, VAT was not significantly reduced in culturally based (−60 cm3, 95% confidence interval [CI] = −172 to 54, P = 0.300) or standard (−98 cm3, 95% CI = −216 to 21, P = 0.106) exercise compared with control after adjustment for baseline physical activity and age. In those participants who attended more than two-thirds of the exercise classes, VAT was significantly reduced compared with control (−109 cm3, 95% CI = −204 to −13, P = 0.026). Conclusion: In intention-to-treat analysis VAT was not significantly reduced after 12 wk of either standard or culturally based exercise. However, attendance in both standard and culturally based exercise was high, and VAT was significantly reduced among SA women who adhered to these programs.

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Influence of Step Rate on Shin Injury and Anterior Knee Pain in High School Runners

Purpose: High school cross-country runners have a high incidence of injury, particularly at the shin and knee. An increased step rate during running has been shown to reduce impact forces and loading of the lower extremity joints. The purpose of this prospective study was to examine step rate as a risk factor for injury occurrence. Materials and Methods: Running step rates of 68 healthy high school cross-country runners (47 females; 21 males; mean age 16.2 ± 1.3 yr) were assessed at a fixed speed (3.3 ± 0.0 m·s−1) and self-selected speed (mean, 3.8 ± 0.5 m·s−1). Runners were prospectively followed during the interscholastic season to determine athletic exposures, occurrences of shin injury and anterior knee pain (AKP), and days lost to injury. Results: During the season, 19.1% of runners experienced a shin injury and 4.4% experienced AKP. Most injuries (63.6%) were classified as minor (1–7 d lost). At the fixed speed, runners in the lowest tertile of step rate (≤164 steps per minute) were more likely (odds ratio, 6.67; 95% confidence interval, 1.2–36.7; P = 0.03) to experience a shin injury compared with runners in the highest tertile (≥174 steps per minute). Similarly, for self-selected speed, runners in the lowest tertile (≤166 steps per minute) (odds ratio, 5.85; 95% confidence interval, 1.1–32.1; P

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Heat Tolerance Test or Race Simulation Test for Return to Activity after Heat Stroke

No abstract available

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Environmental Endocrine Disruptor Affects Voluntary Physical Activity in Mice

Introduction: Voluntary physical activity levels are regulated by sex hormones. The purpose of this study was to determine the effect of the endocrine disruptor benzyl butyl phthalate (BBP) on the regulation of physical activity in mice. Methods: Mouse dams were treated with 500 mg·kg−1·d−1 of BBP or vehicle on gestation days 9–16. Pups were weaned and analyzed for voluntary physical activity levels, puberty development, sex hormone levels, and body composition during the 20-wk period. Results: Seventy-three offspring from BBP-treated dams were studied (n = 43 males and n = 30 females). Endocrine disruption was indicated by decreased anogenital distances in BBP-treated male offspring at 10 (P = 0.001) and 20 wk (P = 0.038) and delayed vaginal openings in BBP-treated female offspring (P = 0.001). Further, there was a significant decrease in serum testosterone concentration in male mice between control and BBP at 10 wk (P = 0.039) and at 20 wk (P = 0.022). In female mice, there was a significant increase in serum testosterone concentration in BBP mice at 20 wk (P = 0.002) and a significant increase in estrogen (estradiol) concentrations at 20 wk in the control female mice (P = 0.015). Overall, BBP mice ran significantly less distance (males, P = 0.008; females, P = 0.042) than controls. Other than a significant increase in BBP-treated males in fat mass at 20 wk (P = 0.040), there was no significant decrease in weight, lean mass, or fat mass in either female or male mice, regardless of treatment. Conclusion: Maternal endocrine disruption altered hormone response, but not body composition in either sex of offspring, with a corresponding decreased activity throughout early adulthood in all offspring. These results suggest that exposure to common environmental endocrine disruptors in utero can reduce and alter physical activity levels in offspring.

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Adaptations to Speed Endurance Training in Highly Trained Soccer Players

Purpose: The present study examined whether a period of additional speed endurance training would improve intense intermittent exercise performance in highly trained soccer players during the season and whether the training changed aerobic metabolism and the level of oxidative enzymes in type I and type II muscle fibers. Methods: During the last 9 wk of the season, 13 semiprofessional soccer players performed additional speed endurance training sessions consisting of two to three sets of 8–10 repetitions of 30-m sprints with 10 s of passive recovery (SET). Before and after SET, subjects completed a double-step exercise protocol that included transitions from standing to moderate-intensity running (~75% HRmax), followed by transitions from moderate- to high-intensity running (~90% HRmax) in which pulmonary oxygen uptake (V˙O2) was determined. In addition, the yo-yo intermittent recovery test level 1 was performed, and a muscle biopsy was obtained at rest. Results: The yo-yo intermittent recovery test level 1 performance was 11.6% ± 6.4% (mean ± SD) better (2803 ± 330 vs 3127 ± 383 m, P

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Ovariectomized Highly Fit Rats Are Protected against Diet-Induced Insulin Resistance

Introduction: In the absence of exercise training, rats selectively bred for high intrinsic aerobic capacity (high-capacity running (HCR)) are protected against ovariectomy (OVX)-induced insulin resistance (IR) and obesity compared with those bred for low intrinsic aerobic capacity (low-capacity running (LCR)). Purpose: This study determined whether OVX HCR rats remain protected with exposure to high-fat diet (HFD) compared with OVX LCR rats. Methods: Female HCR and LCR rats (n = 36; age, 27–33 wk) underwent OVX and were randomized to a standard chow diet (NC, 5% kcal fat) or HFD (45% kcal fat) ad libitum for 11 wk. Total energy expenditure, resting energy expenditure, spontaneous physical activity (SPA), and glucose tolerance were assessed midway, whereas fasting circulating metabolic markers, body composition, adipose tissue distribution, and skeletal muscle adenosine monophosphate-activated protein kinase (AMPK), and mitochondrial markers were assessed at sacrifice. Results: Both HCR and LCR rats experienced HFD-induced increases in total and visceral adiposity after OVX. Despite similar gains in adiposity, HCR rats were protected from HFD-induced IR and reduced total energy expenditure observed in LCR rats (P

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Stretching of Active Muscle Elicits Chronic Changes in Multiple Strain Risk Factors

Introduction: The muscle stretch intensity imposed during "flexibility" training influences the magnitude of joint range of motion (ROM) adaptation. Thus, stretching while the muscle is voluntarily activated was hypothesized to provide a greater stimulus than passive stretching. The effect of a 6-wk program of stretch imposed on an isometrically contracting muscle (i.e., qualitatively similar to isokinetic eccentric training) on muscle–tendon mechanics was therefore studied in 13 healthy human volunteers. Methods: Before and after the training program, dorsiflexion ROM, passive joint moment, and maximal isometric plantarflexor moment were recorded on an isokinetic dynamometer. Simultaneous real-time motion analysis and ultrasound imaging recorded gastrocnemius medialis muscle and Achilles tendon elongation. Training was performed twice weekly and consisted of five sets of 12 maximal isokinetic eccentric contractions at 10°·s−1. Results: Significant increases (P 0.05), a significant increase in tendon stiffness (31.2%, P

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Genetic Variant in ACVR2B Is Associated with Lean Mass

Introduction: Low lean mass (LM) is a risk factor for chronic disease, a major cause of disability and diminished quality of life, and is a heritable trait. However, relatively few specific genetic factors have been identified as potentially influencing this trait. Methods: In this study, we selected 1493 single-nucleotide polymorphisms (SNP) in 155 candidate genes involved in anabolic, catabolic, growth hormone, and other related pathways and examined their association with LM, assessed by dual-energy x-ray absorptiometry, in a sample of 2760 non-Hispanic and Hispanic white postmenopausal women from the Women's Health Initiative (WHI) Observational Study. We assessed the replication of our top findings in a meta-analysis of 20 genome-wide association studies (n = 38,292) conducted by the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium Musculoskeletal Working Group. Results: We identified 32 SNPs that had nominally significant associations with LM in the WHI cohort. In the replication stage, we find that SNP rs2276541 in the activin A receptor, type IIB (ACVR2B), was significantly associated with LM (β = 0.15, P = 2.17 × 10−5). ACVR2B codes for a receptor for a negative regulator of skeletal muscle, myostatin, and has previously been identified in a candidate gene study as a determinant of skeletal muscle mass. Conclusions: Our findings support a previously proposed role of ACVR2B allelic variation as a determinant of muscle mass and extend prior findings in men and women. Additional large-scale studies will be needed to confirm our findings in different populations.

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Hemoglobin Mass Expansion during 13 d of Altitude Training: Altitude or Training?

No abstract available

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Exercise Reduces Lung Fibrosis Involving Serotonin/Akt Signaling

Purpose: Idiopathic pulmonary fibrosis (IPF) is a chronic fibrosing interstitial pneumonia, which involves aberrant serotonin (5-hydroxytryptamine [5-HT]) and Akt signaling. As protective effects of chronic aerobic training (AT) have been demonstrated in the context of lung injury, this study investigated whether AT attenuates bleomycin-induced lung fibrosis partly via a reduction of 5-HT and AKT signaling. Methods: Seventy-two C57BL/6 male mice were distributed in Control (Co), Exercise (Ex), Fibrosis (Fi), and Fibrosis + Exercise (Fi + Ex) groups. Bleomycin (1.5 UI·kg−1) was administered on day 1 and treadmill AT began on day 15 and continued for 60 min·d−1, 5 d·wk−1 for 4 wk. We evaluated total and differential cell counts in bronchoalveolar lavage (BAL), interleukin (IL)-1β, IL-6, CXCL1/KC, IL-10, tumor necrosis factor α, and transforming growth factor β levels in BAL, collagen content in lung parenchyma, 5-HT levels in BAL fluid and in serum, the expression of 5-HT2B receptor, and Akt phosphorylation in lung tissue. Results: AT reduced bleomycin-increased number of total cells (P

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Functional Atlas of the Human Fascial System

No abstract available

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Intensive Exercise Does Not Preferentially Mobilize Skin-Homing T Cells and NK Cells

Purpose: This study investigated whether natural killer (NK) cells and CD8+ T cells expressing cutaneous lymphocyte antigen (CLA)—a homing molecule for endothelial cell leukocyte adhesion molecule 1, which enables transmigration to the skin—are selectively mobilized in response to acute exercise. Methods: Nine healthy men (mean ± SD age: 22.1 ± 3.4 yr) completed two exercise sessions: high-intensity continuous cycling ("continuous exercise" at 80% V˙O2max for 20 min) and low-volume high-intensity interval exercise (at 90% V˙O2max 10 × 1 min repetitions with 1 min recovery intervals). Blood was collected before, immediately and 30 min postexercise for cryopreservation of peripheral blood mononuclear cells. CLA+ and CLA− cells were quantified within NK subpopulations (CD56bright "regulatory" and CD56dim "cytotoxic" cells) as well as the following CD8+ T cell subpopulations: naive ("NA"; CD45RA+ CCR7+), central memory ("CM"; CD45RA− CCR7+), effector-memory ("EM"; CD45RA− CCR7−), and CD45RA-expressing effector-memory cells ("EMRA"; CD45RA+ CCR7−). Results: CLA+ NK cells and CD8+ memory T cells increased in response to both exercise bouts, but, overall, their numerical contribution to the exercise lymphocytosis was inferior to CLA− cells, which increased to a much greater extent during exercise. Tellingly, the most exercise-responsive cells—effector memory CD8+ cells and CD56dim cells—were CLA−. Conclusions: A small subset of CLA+ lymphocytes are mobilized into blood during acute intensive exercise, but CLA+ cells are not major contributors to exercise lymphocytosis, thus providing preliminary evidence that the skin is not a major origin, or homing destination, of exercise-sensitive lymphocytes.

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Individual Endurance Training Prescription with Heart Rate Variability

Introduction: Measures of HR variability (HRV) have shown potential to be of use in training prescription. Purpose: The aim of this study was to investigate the effectiveness of using HRV in endurance training prescription. Methods: Forty recreational endurance runners were divided into the HRV-guided experimental training group (EXP) and traditional predefined training group (TRAD). After a 4-wk preparation training period, TRAD trained according to a predefined training program including two to three moderate- (MOD) and high-intensity training (HIT) sessions per week during an 8-wk intensive training period. The timing of MOD and HIT sessions in EXP was based on HRV, measured every morning. The MOD/HIT session was programmed if HRV was within an individually determined smallest worthwhile change. Otherwise, low-intensity training was performed. Maximal oxygen consumption (V˙O2max) and 3000-m running performance (RS3000m) were measured before and after both training periods. Results: The number of MOD and HIT sessions was significantly lower (P = 0.021, effect size = 0.98) in EXP (13.2 ± 6.0 sessions) compared with TRAD (17.7 ± 2.5 sessions). No other differences in training were found between the groups. RS3000m improved in EXP (2.1% ± 2.0%, P = 0.004) but not in TRAD (1.1% ± 2.7%, P = 0.118) during the intensive training period. A small between-group difference (effect size = 0.42) was found in the change in RS3000m. V˙O2max improved in both groups (EXP: 3.7% ± 4.6%, P = 0.027; TRAD: 5.0% ± 5.2%, P = 0.002). Conclusion: The results of the present study suggest the potential of resting HRV to prescribe endurance training by individualizing the timing of vigorous training sessions.

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Skeletal Muscle Erythropoietin Expression Is Responsive to Hypoxia and Exercise

Purpose: Erythropoietin is responsible for regulating the growth and development of red blood cells. Reports conflict on whether skeletal muscle is able to produce erythropoietin and release it into circulation and if exercise affects this. We set out to determine how erythropoietin is regulated in skeletal muscle and to determine whether skeletal muscle-derived erythropoietin can stimulate erythropoiesis. Methods: Using an in vitro approach, we exposed proliferating and differentiated skeletal muscle cells to various forms of exercise-induced physiological stimuli and measured erythropoietin gene expression. To understand if skeletal muscle cells were able to stimulate erythropoiesis, independent of other cell types found in skeletal muscle, we used myoblast-conditioned media to treat bone marrow and to measure erythropoiesis through flow cytometry. We also measured erythropoietin expression and hypoxia in mice subjected to an exercise protocol designed to induce skeletal muscle oxygen stress. Results: Hypoxia increased erythropoietin expression in C2C12 myoblasts, myotubes, and primary myoblasts in vitro by 50% to 130%. Bone marrow treated with media conditioned with hypoxic myoblasts for 24 h increased the number of Ter-119-positive cells by 32%. An erythropoietin-neutralizing antibody prevented this increase. Compared with unexercised controls, exhaustive exercise increased skeletal muscle HIF1α levels by 50% and HIF2α levels by 20%. Moreover, exercised skeletal muscle erythropoietin expression was 70% higher. Conclusion: These results demonstrate that skeletal muscle produces erythropoietin in a hypoxia and HIF-dependent manner and that hypoxia-treated muscle is capable of stimulating erythropoiesis in vitro.

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Multicomponent Fitness Training Improves Walking Economy in Older Adults

Background: Walking economy declines with increasing age, possibly leading to mobility limitation in older adults. Multicomponent fitness training could delay the decline in walking economy. Purpose: This study aimed to determine the effect of multicomponent fitness training on walking economy in older adults. Methods: Participants were untrained adults, age 50 to 83 yr (N = 26, 10 males, age = 63 ± 6 yr, BMI = 25.6 ± 2.1 kg·m−2, mean ± SD). A control group was also recruited (N = 16, 9 males, age = 66 ± 10 yr, BMI = 25.4 ± 3.0 kg·m−2), matching the intervention group for age, weight, body composition, and fitness. The intervention group followed a multicomponent fitness program of 1 h, twice per week during 1 yr. The control group did not take part in any physical training. Fat-free mass, walking economy, and maximal oxygen uptake (V˙O2max) were measured in both groups before and after the year. Walking economy was measured with indirect calorimetry as the lowest energy needed to displace 1 kg of body mass for 1 m while walking on a treadmill. The data were compared between the two groups with repeated-measures ANOVA. Results: Thirty-two subjects completed all measurements. There was an interaction between the effects of time and group on V˙O2max (P

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Studies of Sedentary Behavior, Activity, and Mortality: Duplication or Replication?

No abstract available

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Musculoskeletal Asymmetry in Football Athletes: A Product of Limb Function over Time

Purpose: Asymmetrical loading patterns are commonplace in football sports. Our aim was to examine the influence of training age and limb function on lower-body musculoskeletal morphology. Methods: Fifty-five elite football athletes were stratified into less experienced (≤3 yr; n = 27) and more experienced (>3 yr; n = 28) groups by training age. All athletes underwent whole-body dual-energy x-ray absorptiometry scans and lower-body peripheral quantitative computed tomography tibial scans on the kicking and support limbs. Results: Significant interactions between training age and limb function were evident across all skeletal parameters (F16, 91 = 0.182, P = 0.031, Wilks Λ = 0.969). Asymmetries between limbs were significantly larger in the more experienced players than the less experienced players for tibial mass (P ≤ 0.044, d ≥ 0.50), total cross-sectional area (P ≤ 0.039, d ≥ 0.53), and stress–strain indices (P ≤ 0.050, d ≥ 0.42). No significant asymmetry was evident for total volumetric density. More experienced players also exhibited greater lower-body tibial mass (P ≤ 0.001, d ≥ 1.22), volumetric density (P ≤ 0.009, d ≥ 0.79), cross-sectional area (P ≤ 0.387, d ≥ 0.21), stress–strain indices (P ≤ 0.012, d ≥ 0.69), fracture loads (P ≤ 0.018, d ≥ 0.57), and muscle mass and cross-sectional area (P ≤ 0.016, d ≥ 0.68) than less experienced players. Conclusions: Asymmetries were evident in athletes as a product of limb function over time. Chronic exposure to routine high-impact gravitational loads afforded to the support limb preferentially improved bone mass and structure (cross-sectional area and cortex thickness) as potent contributors to bone strength relative to the high-magnitude muscular loads predominantly afforded to the kicking limb.

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