Acute muscle swelling effects of a knee rehabilitation exercise performed with and without blood flow restriction

This study assessed the acute effect of adding blood flow restriction (BFR) to quad sets on muscle-cross sectional area (mCSA), muscle thickness (MT), echo intensity (EI), and subcutaneous fat-normalized EI (EINORM) of the superficial quadriceps muscles. Twelve males and 12 females (mean±SD; age (yrs): 21.4±2.9; stature (m): 1.76±0.1; body mass (kg): 77.7±2.9) performed 70 repetitions (one set of 30, three sets of 15 repetitions) of bodyweight quad sets separately on each leg, with or without BFR (CON) applied. Rating of perceived exertion was recorded following each set. Panoramic ultrasound images of the vastus lateralis (VL), vastus medialis (VM), and rectus femoris (RF) were captured prior to (PRE), immediately after (IMM-POST), 30- (30-POST), and 60-minutes after (60-POST) after exercise. Sex x condition x time repeated measures ANOVAs assessed differences at p0.05). There was a 3-way interaction in VL mCSA (p = 0.025) which indicated BFR was greater than CON at IMM-POST by 7.6% (p = 0.019) for males only. Females had greater EI in the VM and VL than males (p0.05) and EINORM did not change over time or treatment (p>0.05). The lack of changes in MT, EI, and EINORM indicate that unloaded quad sets do not provide a stimulus to promote fluid shifts or acute changes in muscle size with the exception of IMM-POST in the VL for males. Future research should attempt to elucidate the acute muscular responses of BFR application for lightly loaded rehabilitation exercises in the clinical populations for which they are prescribed

Comparisons Between Supercell Kinematics and Lightning Optical Energy Output from GLM

No abstract availabl

Clinical-insurer engagement to improve maternity safety in the UK, Ireland, Sweden and Australia

Objective To explore different models of clinical–insurer engagement around maternity safety and to understand how state insurers could and should engage with clinical staff to improve outcomes and reduce harm. Design Semi-structured interviews and focus groups were conducted with senior representatives from state insurers. Transcripts were analysed to identify different models of engagement. Themes were also elicited from the transcripts. A further one-day focus group allowed for clarification and elaboration of these themes. Participants Senior representatives from state insurers in England, Scotland, Wales, Republic of Ireland, Sweden and Victoria, Australia. Results A variety of clinical engagement activities were undertaken by the insurers. These included training on claims and risk management, hospital site visits, facilitating multi-professional network meetings and working with clinical experts to develop best practice recommendations. Some insurers engaged with frontline clinical staff through collaborative patient safety programmes. The themes (identity and size, data and research, incentivising improvement and system integration) were important for considering the role of state insurers within health systems and how insurers could engage with clinical teams. Conclusions This study identified different examples of clinical–insurer engagement. Whilst this was encouraging, the relationships between insurers and clinical teams could be developed further. Insurers and clinical staff could still collaborate more closely and work together in improving patient outcomes. Whilst not specifically their domain, insurers do have a role in patient safety. Closer clinical collaboration may strengthen this contribution. </jats:sec

Hydrothermal cooling of the ocean crust: Insights from ODP Hole 1256D

publisher: Elsevier articletitle: Hydrothermal cooling of the ocean crust: Insights from ODP Hole 1256D journaltitle: Earth and Planetary Science Letters articlelink: http://dx.doi.org/10.1016/j.epsl.2017.01.010 content_type: article copyright: © 2017 The Author(s). Published by Elsevier B.V

A dualistic model of primary anal canal adenocarcinoma with distinct cellular origins, etiologies, inflammatory microenvironments and mutational signatures: implications for personalised medicine.

Primary adenocarcinoma of the anal canal is a rare and aggressive gastrointestinal disease with unclear pathogenesis. Because of its rarity, no clear clinical practice guideline has been defined and a targeted therapeutic armamentarium has yet to be developed. The present article aimed at addressing this information gap by in-depth characterising the anal glandular neoplasms at the histologic, immunologic, genomic and epidemiologic levels. In this multi-institutional study, we first examined the histological features displayed by each collected tumour (n = 74) and analysed their etiological relationship with human papillomavirus (HPV) infection. The intratumoural immune cell subsets (CD4, CD8, Foxp3), the expression of immune checkpoints (PD-1, PD-L1), the defect in mismatch repair proteins and the mutation analysis of multiple clinically relevant genes in the gastrointestinal cancer setting were also determined. Finally, the prognostic significance of each clinicopathological variable was assessed. Phenotypic analysis revealed two region-specific subtypes of anal canal adenocarcinoma. The significant differences in the HPV status, density of tumour-infiltrating lymphocytes, expression of immune checkpoints and mutational profile of several targetable genes further supported the separation of these latter neoplasms into two distinct entities. Importantly, anal gland/transitional-type cancers, which poorly respond to standard treatments, displayed less mutations in downstream effectors of the EGFR signalling pathway (i.e., KRAS and NRAS) and demonstrated a significantly higher expression of the immune inhibitory ligand-receptor pair PD-1/PD-L1 compared to their counterparts arising from the colorectal mucosa. Taken together, the findings reported in the present article reveal, for the first time, that glandular neoplasms of the anal canal arise by HPV-dependent or independent pathways. These etiological differences leads to both individual immune profiles and mutational landscapes that can be targeted for therapeutic benefits

A LAK of Direction Misalignment Between the Goals of Learning Analytics and its Research Scholarship

Learning analytics defines itself with a focus on data from learners and learning environments, with corresponding goals of understanding and optimizing student learning. In this regard, learning analytics research, ideally, should be characterized by studies that make use of data from learners engaged in education systems, should measure student learning, and should make efforts to intervene and improve these learning environments

International collaborative study to assess cardiovascular risk and evaluate long-term health in cats with preclinical hypertrophic cardiomyopathy and apparently healthy cats:The REVEAL Study

Background: Hypertrophic cardiomyopathy is the most prevalent heart disorder in cats and principal cause of cardiovascular morbidity and mortality. Yet, the impact of preclinical disease is unresolved. Hypothesis/Objectives: Observational study to characterize cardiovascular morbidity and survival in cats with preclinical nonobstructive (HCM) and obstructive (HOCM) hypertrophic cardiomyopathy and in apparently healthy cats (AH). Animals: One thousand seven hundred and thirty client-owned cats (430 preclinical HCM; 578 preclinical HOCM; 722 AH). Methods: Retrospective multicenter, longitudinal, cohort study. Cats from 21 countries were followed through medical record review and owner or referring veterinarian interviews. Data were analyzed to compare long-term outcomes, incidence, and risk for congestive heart failure (CHF), arterial thromboembolism (ATE), and cardiovascular death. Results: During the study period, CHF, ATE, or both occurred in 30.5% and cardiovascular death in 27.9% of 1008 HCM/HOCM cats. Risk assessed at 1, 5, and 10 years after study entry was 7.0%/3.5%, 19.9%/9.7%, and 23.9%/11.3% for CHF/ATE, and 6.7%, 22.8%, and 28.3% for cardiovascular death, respectively. There were no statistically significant differences between HOCM compared with HCM for cardiovascular morbidity or mortality, time from diagnosis to development of morbidity, or cardiovascular survival. Cats that developed cardiovascular morbidity had short survival (mean \ub1 standard deviation, 1.3 \ub1 1.7 years). Overall, prolonged longevity was recorded in a minority of preclinical HCM/HOCM cats with 10% reaching 9-15 years. Conclusions and Clinical Importance: Preclinical HCM/HOCM is a global health problem of cats that carries substantial risk for CHF, ATE, and cardiovascular death. This finding underscores the need to identify therapies and monitoring strategies that decrease morbidity and mortality