Does a SLAP lesion affect shoulder muscle recruitment as measured by EMG activity during a rugby tackle?

Background: The study objective was to assess the influence of a SLAP lesion on onset of EMG activity in shoulder muscles during a front on rugby football tackle within professional rugby players. Methods: Mixed cross-sectional study evaluating between and within group differences in EMG onset times. Testing was carried out within the physiotherapy department of a university sports medicine clinic. The test group consisted of 7 players with clinically diagnosed SLAP lesions, later verified on arthroscopy. The reference group consisted of 15 uninjured and full time professional rugby players from within the same playing squad. Controlled tackles were performed against a tackle dummy. Onset of EMG activity was assessed from surface EMG of Pectorialis Major, Biceps Brachii, Latissimus Dorsi, Serratus Anterior and Infraspinatus muscles relative to time of impact. Analysis of differences in activation timing between muscles and limbs (injured versus non-injured side and non injured side versus matched reference group). Results: Serratus Anterior was activated prior to all other muscles in all (P = 0.001-0.03) subjects. In the SLAP injured shoulder Biceps was activated later than in the non-injured side. Onset times of all muscles of the noninjured shoulder in the injured player were consistently earlier compared with the reference group. Whereas, within the injured shoulder, all muscle activation timings were later than in the reference group. Conclusions: This study shows that in shoulders with a SLAP lesion there is a trend towards delay in activation time of Biceps and other muscles with the exception of an associated earlier onset of activation of Serratus anterior, possibly due to a coping strategy to protect glenohumeral stability and thoraco-scapular stability. This trend was not statistically significant in all cases

Temperature Modulates Coccolithophorid Sensitivity of Growth, Photosynthesis and Calcification to Increasing Seawater pCO2

Increasing atmospheric CO2 concentrations are expected to impact pelagic ecosystem functioning in the near future by driving ocean warming and acidification. While numerous studies have investigated impacts of rising temperature and seawater acidification on planktonic organisms separately, little is presently known on their combined effects. To test for possible synergistic effects we exposed two coccolithophore species, Emiliania huxleyi and Gephyrocapsa oceanica, to a CO2 gradient ranging from ,0.5–250 mmol kg21 (i.e. ,20–6000 matm pCO2) at three different temperatures (i.e. 10, 15, 20uC for E. huxleyi and 15, 20, 25uC for G. oceanica). Both species showed CO2-dependent optimum-curve responses for growth, photosynthesis and calcification rates at all temperatures. Increased temperature generally enhanced growth and production rates and modified sensitivities of metabolic processes to increasing CO2. CO2 optimum concentrations for growth, calcification, and organic carbon fixation rates were only marginally influenced from low to intermediate temperatures. However, there was a clear optimum shift towards higher CO2 concentrations from intermediate to high temperatures in both species. Our results demonstrate that the CO2 concentration where optimum growth, calcification and carbon fixation rates occur is modulated by temperature. Thus, the response of a coccolithophore strain to ocean acidification at a given temperature can be negative, neutral or positive depending on that strain’s temperature optimum. This emphasizes that the cellular responses of coccolithophores to ocean acidification can only be judged accurately when interpreted in the proper eco-physiological context of a given strain or species. Addressing the synergistic effects of changing carbonate chemistry and temperature is an essential step when assessing the success of coccolithophores in the future ocean

Major adverse kidney events predict reduced survival in ventricular assist device supported patients.

AIMS: There is limited data describing major adverse kidney events (MAKE) in patients supported with ventricular assist devices (VAD). We aim to describe the association between MAKE and survival, risk factors for MAKE, and renal trajectory in VAD supported patients. METHODS AND RESULTS: We conducted a single-centre retrospective analysis of consecutive VAD implants between 2010 and 2019. Baseline demographics, biochemistry, and adverse events were collected for the duration of VAD support. MAKE was defined as the first event to occur of sustained drop (>50%) in estimated glomerular filtration rate (eGFR), progression to stage V chronic kidney disease, initiation or continuation of renal replacement therapy beyond implant admission or death on renal replacement therapy at any time. One-hundred and seventy-three patients were included, median age 56.8 years, 18.5% female, INTERMACS profile 1 or 2 in 75.1%. Thirty-seven patients experienced MAKE. On multivariate analysis, post-implant clinical right ventricular failure and the presence of chronic haemolysis, defined by the presence of schistocytes on blood film analysis, were significantly associated with increased risk of MAKE (adjusted odds ratio 9.88, P < 0.001 and adjusted odds ratio 3.33, P = 0.006, respectively). MAKE was associated with reduced survival (hazard ratio 4.80, P < 0.001). Patients who died or experienced MAKE did not demonstrate the expected transient 3-month improvement in eGFR, seen in other cohorts. CONCLUSIONS: MAKE significantly impacts survival. In our cohort, MAKE was predicted by post-implant right ventricular failure and chronic haemolysis. The lack of early eGFR improvement on VAD support may indicate higher risk for MAKE

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

In-orbit aerodynamic coefficient measurements using SOAR (Satellite for Orbital Aerodynamics Research)

The Satellite for Orbital Aerodynamics Research (SOAR) is a CubeSat mission, due to be launched in 2021, to investigate the interaction between different materials and the atmospheric flow regime in very low Earth orbits (VLEO). Improving knowledge of the gas–surface interactions at these altitudes and identification of novel materials that can minimise drag or improve aerodynamic control are important for the design of future spacecraft that can operate in lower altitude orbits. Such satellites may be smaller and cheaper to develop or can provide improved Earth observation data or communications link-budgets and latency. In order to achieve these objectives, SOAR features two payloads: (i) a set of steerable fins which provide the ability to expose different materials or surface finishes to the oncoming flow with varying angle of incidence whilst also providing variable geometry to investigate aerostability and aerodynamic control; and (ii) an ion and neutral mass spectrometer with time-of-flight capability which enables accurate measurement of the in-situ flow composition, density, velocity. Using precise orbit and attitude determination information and the measured atmospheric flow characteristics the forces and torques experienced by the satellite in orbit can be studied and estimates of the aerodynamic coefficients calculated. This paper presents the scientific concept and design of the SOAR mission. The methodology for recovery of the aerodynamic coefficients from the measured orbit, attitude, and in-situ atmospheric data using a least-squares orbit determination and free-parameter fitting process is described and the experimental uncertainty of the resolved aerodynamic coefficients is estimated. The presented results indicate that the combination of the satellite design and experimental methodology are capable of clearly illustrating the variation of drag and lift coefficient for differing surface incidence angle. The lowest uncertainties for the drag coefficient measurement are found at approximately 300 km, whilst the measurement of lift coefficient improves for reducing orbital altitude to 200 km

Quality of care in elder emergency department patients with pneumonia: a prospective cohort study

<p>Abstract</p> <p>Background</p> <p>The goals of the study were to assess the relationship between age and processes of care in emergency department (ED) patients admitted with pneumonia and to identify independent predictors of failure to meet recommended quality care measures.</p> <p>Methods</p> <p>This was a prospective cohort study of a pre-existing database undertaken at a university hospital ED in the Midwest. ED patients ≥18 years of age requiring admission for pneumonia, with no documented use of antibiotics in the 24 hours prior to ED presentation were included. Compliance with Pneumonia National Quality Measures was assessed including ED antibiotic administration, antibiotics within 4 hours, oxygenation assessment, and obtaining of blood cultures. Odds ratios were calculated for elders and non-elders. Logistic regression was used to identify independent predictors of process failure.</p> <p>Results</p> <p>One thousand, three hundred seventy patients met inclusion criteria, of which 560 were aged ≥65 years. In multiple variable logistic regression analysis, age ≥65 years was independently associated with receiving antibiotics in the ED (odds ratio [OR] = 2.03, 95% CI 1.28–3.21) and assessment of oxygenation (OR = 2.10, 95% CI, 1.18–3.32). Age had no significant impact on odds of receiving antibiotics within four hours of presentation (OR 1.10, 95% CI 0.84–1.43) or having blood cultures drawn (OR 1.02, 95%CI 0.78–1.32). Certain other patient characteristics were also independently associated with process failure.</p> <p>Conclusion</p> <p>Elderly patients admitted from the ED with pneumonia are more likely to receive antibiotics while in the ED and to have oxygenation assessed in the ED than younger patients. The independent association of certain patient characteristics with process failure provides an opportunity to further increase compliance with recommended quality measures in admitted patients diagnosed with pneumonia.</p

A review of gas-surface interaction models for orbital aerodynamics applications

Renewed interest in Very Low Earth Orbits (VLEO) - i.e. altitudes below 450 km - has led to an increased demand for accurate environment characterisation and aerodynamic force prediction. While the former requires knowledge of the mechanisms that drive density variations in the thermosphere, the latter also depends on the interactions between the gas-particles in the residual atmosphere and the surfaces exposed to the flow. The determination of the aerodynamic coefficients is hindered by the numerous uncertainties that characterise the physical processes occurring at the exposed surfaces. Several models have been produced over the last 60 years with the intent of combining accuracy with relatively simple implementations. In this paper the most popular models have been selected and reviewed using as discriminating factors relevance with regards to orbital aerodynamics applications and theoretical agreement with gas-beam experimental data. More sophisticated models were neglected, since their increased accuracy is generally accompanied by a substantial increase in computation times which is likely to be unsuitable for most space engineering applications. For the sake of clarity, a distinction was introduced between physical and scattering kernel theory based gas-surface interaction models. The physical model category comprises the Hard Cube model, the Soft Cube model and the Washboard model, while the scattering kernel family consists of the Maxwell model, the Nocilla-Hurlbut-Sherman model and the Cercignani-Lampis-Lord model. Limits and assets of each model have been discussed with regards to the context of this paper. Wherever possible, comments have been provided to help the reader to identify possible future challenges for gas-surface interaction science with regards to orbital aerodynamic applications

The benefits of very low earth orbit for earth observation missions

Very low Earth orbits (VLEO), typically classified as orbits below approximately 450 km in altitude, have the potential to provide significant benefits to spacecraft over those that operate in higher altitude orbits. This paper provides a comprehensive review and analysis of these benefits to spacecraft operations in VLEO, with parametric investigation of those which apply specifically to Earth observation missions. The most significant benefit for optical imaging systems is that a reduction in orbital altitude improves spatial resolution for a similar payload specification. Alternatively mass and volume savings can be made whilst maintaining a given performance. Similarly, for radar and lidar systems, the signal-to-noise ratio can be improved. Additional benefits include improved geospatial position accuracy, improvements in communications link-budgets, and greater launch vehicle insertion capability. The collision risk with orbital debris and radiation environment can be shown to be improved in lower altitude orbits, whilst compliance with IADC guidelines for spacecraft post-mission lifetime and deorbit is also assisted. Finally, VLEO offers opportunities to exploit novel atmosphere-breathing electric propulsion systems and aerodynamic attitude and orbit control methods. However, key challenges associated with our understanding of the lower thermosphere, aerodynamic drag, the requirement to provide a meaningful orbital lifetime whilst minimising spacecraft mass and complexity, and atomic oxygen erosion still require further research. Given the scope for significant commercial, societal, and environmental impact which can be realised with higher performing Earth observation platforms, renewed research efforts to address the challenges associated with VLEO operations are required

Epithelial-Mesenchymal Transition in Cells Expanded In Vitro from Lineage-Traced Adult Human Pancreatic Beta Cells

BACKGROUND: In-vitro expansion of functional beta cells from adult human islets is an attractive approach for generating an abundant source of cells for beta-cell replacement therapy of diabetes. Using genetic cell-lineage tracing we have recently shown that beta cells cultured from adult human islets undergo rapid dedifferentiation and proliferate for up to 16 population doublings. These cells have raised interest as potential candidates for redifferentiation into functional insulin-producing cells. Previous work has associated dedifferentiation of cultured epithelial cells with epithelial-mesenchymal transition (EMT), and suggested that EMT generates cells with stem cell properties. Here we investigated the occurrence of EMT in these cultures and assessed their stem cell potential. METHODOLOGY/PRINCIPAL FINDINGS: Using cell-lineage tracing we provide direct evidence for occurrence of EMT in cells originating from beta cells in cultures of adult human islet cells. These cells express multiple mesenchymal markers, as well as markers associated with mesenchymal stem cells (MSC). However, we do not find evidence for the ability of such cells, nor of cells in these cultures derived from a non-beta-cell origin, to significantly differentiate into mesodermal cell types. CONCLUSIONS/SIGNIFICANCE: These findings constitute the first demonstration based on genetic lineage-tracing of EMT in cultured adult primary human cells, and show that EMT does not induce multipotency in cells derived from human beta cells

Prognostic role of EGFR gene copy number and KRAS mutation in patients with locally advanced rectal cancer treated with preoperative chemoradiotherapy

Epidermal growth factor receptor (EGFR), evaluated by immunohistochemistry, has been shown to have prognostic significance in patients with colorectal cancer. Gene copy number (GCN) of EGFR and KRAS status predict response and outcome in patients treated with anti-EGFR therapy, but their prognostic significance in colorectal cancer patients is still unclear.We have retrospectively reviewed the baseline EGFR GCN, KRAS status and clinical outcome of 146 locally advanced rectal cancer (LARC) patients treated with preoperative chemoradiotherapy. Pathological response evaluated by Dworak's tumour regression grade (TRG), disease-free survival (DFS) and overall survival (OS) were analysed.Tumour regression grade 4 and TRG3-4 were achieved in 14.4 and 30.8\% of the patients respectively. Twenty-nine (19.9\%) and 33 patients (19.2\%) had an EGFR/nuclei ratio >2.9 and CEP7 polisomy >50\% respectively; 28 patients (19.2\%) had a KRAS mutation. Neither EGFR GCN nor KRAS status was statistically correlated to TRG. 5-year DFS and OS were 63.3 and 71.5\%, respectively, and no significant relation with EGFR GCN or KRAS status was found.Our data show that EGFR GCN and KRAS status are not prognostic factors in LARC treated with preoperative chemoradiation