Extending the Applicability of Iso-inertial Eccentric Training

Background: Eccentric (ECC) training has been widely studied because it has the potential to produce high forces, which can enhance gains in strength and muscle hypertrophy. In light of this potential, a disconnect exists between laboratory studies on ECC training and what is commonly performed by exercisers. Purpose: The goal of this thesis was to extend the applicability and accessibility of ECC focused training by furthering the knowledge of ECC training performed with common equipment using practical, easy to perform protocols. Study One: Study one compared supramaximal to submaximal ECC training. Results indicated that when training to volitional fatigue, there was no difference in muscle hypertrophy between submaximal and supramaximal ECC training, and submaximal ECC training sessions were perceived to be easier. These results advance the understanding of high vs. low intensity training for muscle hypertrophy and suggest that submaximal ECC training may be an effective alternative strategy to supramaximal ECC training. Study Two: Study two investigated approaches to manipulate the level of involvement of the ECC phase of contractions in conventional lifts. Findings indicated that when comparing CON only to conventional training, or CON with an emphasized (longer) ECC phase, all increased CON strength compared to control, but only the CON with an emphasized ECC increased muscle hypertrophy compared to control. This study provides evidence that emphasizing the ECC phase of a lift is an effective way to enhance muscle hypertrophy without sacrificing CON strength increases. Study Three: The purpose was to explore the interplay of contraction type and intensity on iso-inertial and isokinetic strength and muscle hypertrophy. The main finding of this study was that across both training contraction types, high intensity training was superior to low intensity for increasing both iso-inertial and isokinetic strength. Additionally, ECC was more effective for muscle hypertrophy than CON, regardless of training intensity. Together, these findings highlight the specific response of training intensity and contraction type and add knowledge regarding the transferability of strength across modalities. Conclusion: The findings of this thesis verify the effectiveness of iso-inertial ECC training, advancing both the theoretical understanding, and the practical implementation of these protocols

Immune Priming in A. Mellifera

Trans-generational immune priming (TgIP) is the transfer of maternal immune experience to progeny, producing offspring pathogen resistance and ultimately survival from infections. In colony-forming insects like the honey bee Apis mellifera, TgIP would yield a form of lasting immunity benefiting subsequent generations. TgIP has been demonstrated in multiple social insects, but the efficacy and longevity of this immune protection is yet to be fully understood. To induce "priming" we inoculated honeybee queens with Paenibacillus larvae (Pl), a spore-forming bacterium causing American Foulbrood, a brood disease that once plagued beekeepers worldwide. Following inoculation, offspring of "primed" queens were fed a diet containing P. larvae spores and mortality rates were measured to assess TGIP. Our data reflects a dramatic reduction in larval mortality in A. mellifera colonies with "primed" queens, and demonstrates the efficacy of this protection at multiple timepoints

Anthropometric and physiological predictors of flat-water 1000 m kayak performance in young adolescents and the effectiveness of a high volume training camp.

Our purpose was to determine the relationship of anthropometric and physiological variables with 1000m flat-water kayak (K1000) performance. A secondary purpose was to determine the effectiveness of a high volume training camp. High performance young adolescent kayakers (n=13, 8 males, 5 females, 15±1 yrs) participated in this study. Testing before and after the 3-4 week training camp included anthropometric measurements (height, sitting height, arm span, and body mass), strength (1-RM: bench press and bench pull), flexibility (sit and reach), and an incremental kayak ergometer test to determine peak oxygen uptake (VO2peak) and anaerobic threshold, and an open water K1000 time trial. K1000 time was significantly correlated with height (r=-0.81; p\u3c0.01), sitting height (r=-0.85; p\u3c0.01), arm span (r=-0.87; p\u3c0.01), bench press (r=-0.92; p\u3c0.01), bench pull (r=-0.85; p\u3c0.01), VO2peak (r=-0.87; p\u3c0.01) and anaerobic threshold (r=-0.83; p\u3c0.05). Following the training camp there were no significant differences in body mass, strength, and VO2 peak, however, anaerobic threshold (33.6±6.2 to 42.3±8.8 ml•kg-1•min-1, p=0.001) and K1000 (302±44 to 289±31 sec, p=0.007) significantly improved. The results of this study suggest that K1000 performance in young adolescent kayakers appears to require a high aerobic and strength contribution and that a high volume training camp is effective for improving anaerobic threshold and performance

An ab initio driven model for the trapping and diffusion of hydrogen in Fe- Cr-Ni alloys

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Practical guidance on intensification of insulin therapy with BIAsp 30: a consensus statement

P>Background

Predictors of linkage to care following community-based HIV counseling and testing in rural Kenya

Despite innovations in HIV counseling and testing (HCT), important gaps remain in understanding linkage to care. We followed a cohort diagnosed with HIV through a community-based HCT campaign that trained persons living with HIV/AIDS (PLHA) as navigators. Individual, interpersonal, and institutional predictors of linkage were assessed using survival analysis of self-reported time to enrollment. Of 483 persons consenting to follow-up, 305 (63.2%) enrolled in HIV care within 3 months. Proportions linking to care were similar across sexes, barring a sub-sample of men aged 18–25 years who were highly unlikely to enroll. Men were more likely to enroll if they had disclosed to their spouse, and women if they had disclosed to family. Women who anticipated violence or relationship breakup were less likely to link to care. Enrolment rates were significantly higher among participants receiving a PLHA visit, suggesting that a navigator approach may improve linkage from community-based HCT campaigns.Vestergaard Frandse

Effect of Immediate Initiation of Antiretroviral Treatment in HIV-Positive Individuals Aged 50 Years or Older

BACKGROUND: Clinical guidelines recommend immediate initiation of combined antiretroviral therapy for all HIV-positive individuals. However, those guidelines are based on trials of relatively young participants. METHODS: We included HIV-positive antiretroviral therapy-naive, AIDS-free individuals aged 50-70 years after 2004 in the HIV-CAUSAL Collaboration. We used the parametric g-formula to estimate the 5-year risk of all-cause and non-AIDS mortality under (1) immediate initiation at baseline and initiation at CD4 count, (2) <500 cells/mm, and (3) <350 cells/mm. Results were presented separately for the general HIV population and for a US Veterans cohort with high mortality. RESULTS: The study included 9596 individuals (28% US Veterans) with median (interquantile range) age of 55 (52-60) years and CD4 count of 336 (182-513) at baseline. The 5-year risk of all-cause mortality was 0.40% (95% confidence interval (CI): 0.10 to 0.71) lower for the general HIV population and 1.61% (95% CI: 0.79 to 2.67) lower for US Veterans when comparing immediate initiation vs initiation at CD4 <350 cells/mm. The 5-year risk of non-AIDS mortality was 0.17% (95% CI: -0.07 to 0.43) lower for the general HIV population and 1% (95% CI: 0.31 to 2.00) lower for US Veterans when comparing immediate initiation vs initiation at CD4 <350 cells/mm. CONCLUSIONS: Immediate initiation seems to reduce all-cause and non-AIDS mortality in patients aged 50-70 years

Missed Opportunities for HIV Testing and Late-Stage Diagnosis among HIV-Infected Patients in Uganda

BACKGROUND: Late diagnosis of HIV infection is a major challenge to the scale-up of HIV prevention and treatment. In 2005 Uganda adopted provider-initiated HIV testing in the health care setting to ensure earlier HIV diagnosis and linkage to care. We provided HIV testing to patients at Mulago hospital in Uganda, and performed CD4 tests to assess disease stage at diagnosis. METHODS: Patients who had never tested for HIV or tested negative over one year prior to recruitment were enrolled between May 2008 and March 2010. Participants who tested HIV positive had a blood draw for CD4. Late HIV diagnosis was defined as CD4≤250 cells/mm. Predictors of late HIV diagnosis were analyzed using multi-variable logistic regression. RESULTS: Of 1966 participants, 616 (31.3%) were HIV infected; 47.6% of these (291) had CD4 counts ≤250. Overall, 66.7% (408) of the HIV infected participants had never received care in a medical clinic. Receiving care in a non-medical setting (home, traditional healer and drug stores) had a threefold increase in the odds of late diagnosis (OR = 3.2; 95%CI: 2.1-4.9) compared to receiving no health care. CONCLUSIONS: Late HIV diagnosis remains prevalent five years after introducing provider-initiated HIV testing in Uganda. Many individuals diagnosed with advanced HIV did not have prior exposure to medical clinics and could not have benefitted from the expansion of provider initiated HIV testing within health facilities. In addition to provider-initiated testing, approaches that reach individuals using non-hospital based encounters should be expanded to ensure early HIV diagnosis

Healthcare utilization of patients accessing an African national treatment program

<p>Abstract</p> <p>Background</p> <p>The roll-out of antiretroviral therapy (ART) in Africa will have significant resource implications arising from its impact on demand for healthcare services. Existing studies of healthcare utilization on HAART have been conducted in the developed world, where HAART is commenced when HIV illness is less advanced.</p> <p>Methods</p> <p>This paper describes healthcare utilization from program entry by treatment-naïve patients in a peri-urban settlement in South Africa. Treatment criteria included a CD4 cell count <200 cells/μl or an AIDS-defining illness. Data on health service utilization were collected retrospectively from the primary-care clinic and secondary and tertiary referral hospitals. Hospital visits were reviewed to determine the clinical reason for each visit.</p> <p>Results</p> <p>212 patients were followed for a median of 490 days. Outpatient visits per 100 patient years of observation (PYO), excluding scheduled primary-care follow-up, fell from 596 immediately prior to ART to 334 in the first 48 weeks on therapy and 245 thereafter. Total inpatient time fell from 2,549 days per 100 PYO pre-ART to 476 in the first 48 weeks on therapy and 73 thereafter. This fall in healthcare utilization occurred at every level of care. The greatest causes of utilization were tuberculosis, cryptococcal meningitis, HIV-related neoplasms and adverse reactions to stavudine. After 48 weeks on ART demand reverted to primarily non-HIV-related causes.</p> <p>Conclusion</p> <p>Utilization of both inpatient and outpatient hospital services fell significantly after commencement of ART for South African patients in the public sector, with inpatient demand falling fastest. Earlier initiation might reduce early on-ART utilization rates.</p