Effects of football simulated fatigue on neuromuscular function and whole-body response to disturbances in balance

© 2018 John Wiley & Sons A/S. The effect of football-specific fatigue on explosive neuromuscular performance and dynamic balance has received little attention in the literature despite the potential consequences for injury risk. This study aimed to investigate the effect of fatigue induced by simulated football match play on maximal and explosive knee flexor (KF) and knee extensor (KE) torque, and thus the maximal and explosive KF/KE ratio, as well as the effect of fatigue induced by simulated football match play on whole-body response to disturbances in balance. Fifteen male team sports players (mean ± SD: age 24.2 ± 4.2 years; stature 1.79 ± 0.09 m; body mass, 77.3 ± 10.7 kg) underwent ~90 minutes of the modified Loughborough Intermittent Shuttle Test (LIST; fatiguing exercise condition) or seated rest (control condition) on separate days. Maximal and explosive isometric KF and KE voluntary torque (MVT/EVT) were assessed pre- and post-condition. Maximal and explosive KF/KE ratios were calculated. Center of mass (COM) response (displacement) to unexpected anterior and posterior platform perturbations were also assessed pre- and post-condition. Football simulated fatigue resulted in reduced KF (15%) and KE (12%) MVT (P ≤ 0.002) but was not found to reduce EVT of either muscle group, or explosive KF/KE ratio. Football simulated fatigue resulted in impaired balance response (11% increase in COM displacement) to unexpected perturbation in the posterior (P = 0.002) but not the anterior direction. Impaired response to dynamic disturbances in balance, rather than explosive torque or changes in muscle balance (H/Q ratios), may be a contributory factor toward increased injury risk in the latter portion of football games, and likely highlights the influence of fatigue on sensory/proprioceptive processes

Efficacy and Safety of Daridorexant in Older and Younger Adults with Insomnia Disorder: A Secondary Analysis of a Randomised Placebo-Controlled Trial.

BACKGROUND AND OBJECTIVE The dual orexin receptor antagonist daridorexant, studied in two phase III trials, dose-dependently improved objective and subjective sleep variables and daytime functioning in adults with insomnia. Because treatment of insomnia in older adults is challenging and has limited options, the purpose of the current analysis was to further analyse the phase III trial studying the higher doses of daridorexant, those that showed efficacy (daridorexant 50 mg, daridorexant 25 mg and placebo, nightly for 3 months), and compare the safety and efficacy of daridorexant in patients aged ≥ 65 ('older adults') to those aged < 65 years ('younger adults'). METHODS Analyses by age (≥ 65 years, n = 364; < 65 years, n = 566) were performed on data from the randomised, double-blind, placebo-controlled Trial 1 in adult patients with insomnia (NCT03545191). Efficacy endpoints included a change from baseline at month 1 and month 3 in polysomnography-measured wake after sleep onset (WASO) and latency to persistent sleep (LPS), self-reported total sleep time (sTST) and daytime functioning assessed using the validated Insomnia Daytime Symptoms and Impacts Questionnaire (IDSIQ). Safety endpoints included adverse events and the Visual Analog Scale for morning sleepiness. RESULTS At baseline, mean [standard deviation] WASO was numerically greater (110 [39] vs 92 [38] min) in older than younger adults, while LPS was comparable (~ 65 min). Mean baseline IDSIQ total and all domain scores were numerically lower (i.e. better) in older adults. Daridorexant caused similar reductions in WASO and LPS, and similar increases in sTST, from baseline, in both age groups; improvements were numerically greater with daridorexant 50 mg than 25 mg. At month 3, daridorexant 50 mg, compared with placebo, decreased WASO by a least-squares mean of 19.6 (95% confidence interval 9.7, 29.5) in older patients versus 17.4 min (10.7, 24.0) in younger patients and decreased LPS by a least-squares mean of 14.9 (7.5, 22.3) in older patients versus 9.7 min (3.7, 15.7) in younger patients. Daridorexant 50 mg increased sTST from baseline to month 3 by a least-squares mean of 59.9 (49.6, 70.3) in older patients versus 57.1 min (48.9, 65.3) in younger patients. Daridorexant 50 mg progressively improved IDSIQ total and domain scores from week 1 onwards similarly in both groups; daridorexant 25 mg improved IDSIQ scores, but only in younger adults. In both age groups, in comparison with placebo, the overall incidence of adverse events was comparable, and there were fewer falls on daridorexant. Daridorexant improved Visual Analog Scale morning sleepiness in both groups; daridorexant 50 mg increased the mean (standard deviation) Visual Analog Scale morning sleepiness score by 15.9 (20.7) in older adults and by 14.9 (18.7) in younger adults from baseline to month 3. In older adults, there was one case of sleep paralysis, and no cases of narcolepsy, cataplexy, or complex sleep behaviour. CONCLUSIONS In older patients with insomnia, as in younger patients, the efficacy of daridorexant is maximal on night-time and daytime variables at the higher dose of 50 mg. Older patients particularly require this dose to improve daytime functioning. Older patients are not at an increased risk of adverse events or residual effects the next morning after night-time administration of daridorexant, even at 50 mg. The dose of daridorexant does not need to be decreased for older patients. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov (NCT03545191) [first posted: 4 June, 4 2018], https://clinicaltrials.gov/ct2/show/NCT03545191

Men’s perceptions and preferences regarding prostate cancer radiation therapy: A systematic scoping review

Purpose: To assess the literature on men’s preferences and perceptions regarding prostate cancer radiation therapy. Methods: A scoping review was undertaken as per JBI guidelines. Searches were conducted in PubMed, CINAHL, Scopus and Science Direct with search terms including “prostate cancer,” “radiotherapy,” “radiation therapy,” “radiation oncology,” “patient preferences,” “patient perceptions” and “patient experience.” The resultant studies were mapped and grouped according to the emergent themes and pathway stages. Results: A total of 779 titles and abstracts were screened by two independent reviewers. Fifty-two full-text studies were reviewed, with 27 eligible for inclusion. There were 4 pre-treatment, 13 during treatment and 10 post-treatment studies covering broad themes of information needs (n = 3), preferences and decisions (n = 6), general experiences (n = 8), side effects (n = 6), and support (n = 4). There were a mix of methodologies, including 11 qualitative, 14 quantitative (including four preference studies), one mixed methods and one narrative review. Conclusion: There were only four preference studies, with the remaining 23 reporting on perceptions. Overall, there is a paucity of literature regarding patient preferences and perceptions of prostate cancer radiation therapy, particularly when considering how many clinical and technical studies are published in the area. This highlights opportunities for future research

Assault injury rates, social capital, and fear of neighborhood crime

This study develops an explanatory framework for fear of neighborhood crime based on respondents' social context and local rates of assault injuries. Rates of assault injuries within zip codes are based on hospital discharge records. We find that only four variables have a significant unique contribution to fear of crime: respondent's sex, perceptions of neighborhood social capital, and the rates of struck by/against assault injuries for the 10–24 and 50+ age groups. We also find that the perception of neighborhood social capital moderates the impact of assault injury rates on fear of crime; those who perceive a high level of neighborhood social capital exhibit less sensitivity to assault injury rates. We include a map of assault injury rates and fear of crime by ZIP Code and describe the community context related to our results. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 483–498, 2007.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55999/1/20160_ftp.pd

A landscape of genomic alterations at the root of a near-untreatable tuberculosis epidemic

Abstract Background Atypical Beijing genotype Mycobacterium tuberculosis strains are widespread in South Africa and have acquired resistance to up to 13 drugs on multiple occasions. It is puzzling that these strains have retained fitness and transmissibility despite the potential fitness cost associated with drug resistance mutations. Methods We conducted Illumina sequencing of 211 Beijing genotype M. tuberculosis isolates to facilitate the detection of genomic features that may promote acquisition of drug resistance and restore fitness in highly resistant atypical Beijing forms. Phylogenetic and comparative genomic analysis was done to determine changes that are unique to the resistant strains that also transmit well. Minimum inhibitory concentration (MIC) determination for streptomycin and bedaquiline was done for a limited number of isolates to demonstrate a difference in MIC between isolates with and without certain variants. Results Phylogenetic analysis confirmed that two clades of atypical Beijing strains have independently developed resistance to virtually all the potent drugs included in standard (pre-bedaquiline) drug-resistant TB treatment regimens. We show that undetected drug resistance in a progenitor strain was likely instrumental in this resistance acquisition. In this cohort, ethionamide (ethA A381P) resistance would be missed in first-line drug-susceptible isolates, and streptomycin (gidB L79S) resistance may be missed due to an MIC close to the critical concentration. Subsequent inadequate treatment historically led to amplification of resistance and facilitated spread of the strains. Bedaquiline resistance was found in a small number of isolates, despite lack of exposure to the drug. The highly resistant clades also carry inhA promoter mutations, which arose after ethA and katG mutations. In these isolates, inhA promoter mutations do not alter drug resistance, suggesting a possible alternative role. Conclusion The presence of the ethA mutation in otherwise susceptible isolates from ethionamide-naïve patients demonstrates that known exposure is not an adequate indicator of drug susceptibility. Similarly, it is demonstrated that bedaquiline resistance can occur without exposure to the drug. Inappropriate treatment regimens, due to missed resistance, leads to amplification of resistance, and transmission. We put these results into the context of current WHO treatment regimens, underscoring the risks of treatment without knowledge of the full drug resistance profile

A branching, positive relief network in the middle member of the Medusae Fossae Formation, Equatorial Mars - evidence for sapping?

The Medusae Fossae Formation (MFF) is a geological formation comprising three geological units (members) spread across five principal lobes. It dominates a quarter of the longitudinal extent of the equatorial region of Mars. Positive relief features referred to as ‘sinuous ridges' (commonly interpreted as inverted paleoflow channel or valley fills) have been observed in the lowest member of the western MFF, but have not been identified within the central and eastern portions of the formation, in the middle and upper members. This paper presents the identification and analysis of a branching, positive relief system which occurs in the central lobe of the MFF in what appears to be an exposure of the middle member. A simple geomorphological map of the system is presented, from which we have adopted the working hypothesis that this is an inverted fill of a branching fluvial channel or valley system. A suite of morphological and topographic evidence supporting this hypothesis is presented, including analysis of the network using a~15 m per pixel digital terrain model derived from a Context Imager (CTX) stereo image pair. The evidence supporting this hypothesis includes: 1) The local slope and topography of the upper surface of the network are consistent with a contributory network, 2) The braided, fan-like form at the termination of the branching network is consistent in morphology with it being a depositional fan at the end of a fluvial system, 3) The terminal fan and surrounding deposits show layering and polygonization, 4) There is strong association between the lower order branches and amphitheater shaped scarps in the depression walls. We evaluate the possible origins of this fluvial system and suggest that seepage sapping is the most probable. Two possible models for the evolution of the network and related features are presented; both require melt of ice within the MFF to form liquid water. We conclude that at least some portions of the Medusae Fossae Formation, if not the entire formation, were once volatile-rich. Finally, we note that our observations do not rule out the case that this network formed before MFF emplacement, and has since been exhumed. However, this conclusion would suggest that much of the surrounding terrain, currently mapped as middle-member MFF, is not in fact MFF material at all

Ethical and methodological issues in engaging young people living in poverty with participatory research methods

This paper discusses the methodological and ethical issues arising from a project that focused on conducting a qualitative study using participatory techniques with children and young people living in disadvantage. The main aim of the study was to explore the impact of poverty on children and young people's access to public and private services. The paper is based on the author's perspective of the first stage of the fieldwork from the project. It discusses the ethical implications of involving children and young people in the research process, in particular issues relating to access and recruitment, the role of young people's advisory groups, use of visual data and collection of data in young people's homes. The paper also identifies some strategies for addressing the difficulties encountered in relation to each of these aspects and it considers the benefits of adopting participatory methods when conducting research with children and young people

Global-local dynamics in the transformation of the Jakarta Metropolitan Area into a global city-region

This paper investigates the way in which factors at the global and local level interact in the emergence and development of “global city-regions”, which are deemed to be the contemporary growth machines of the global economy. To this end, this paper takes the Jakarta metropolitan area (JMA) as a case to investigate its evolution in the context of the intertwined dynamics of foreign direct investment (FDI) inflow and state intervention over the past three decades. The findings indicate that from a macro-level perspective the JMA has maintained its position as the country’s hotspot for manufacturing investment embedded in East Asian production networks. In addition, we find that the national state has continuously privileged the JMA as the main grounds for national economic development in spite of the country’s shifting political system. We reveal how the nexus between “global” forces (incoming FDI) and “local” conditions (the state’s strategic intervention) has led to the development and restructuring of the JMA as a global city-region

Plasmodium knowlesi Genome Sequences from Clinical Isolates Reveal Extensive Genomic Dimorphism.

Plasmodium knowlesi is a newly described zoonosis that causes malaria in the human population that can be severe and fatal. The study of P. knowlesi parasites from human clinical isolates is relatively new and, in order to obtain maximum information from patient sample collections, we explored the possibility of generating P. knowlesi genome sequences from archived clinical isolates. Our patient sample collection consisted of frozen whole blood samples that contained excessive human DNA contamination and, in that form, were not suitable for parasite genome sequencing. We developed a method to reduce the amount of human DNA in the thawed blood samples in preparation for high throughput parasite genome sequencing using Illumina HiSeq and MiSeq sequencing platforms. Seven of fifteen samples processed had sufficiently pure P. knowlesi DNA for whole genome sequencing. The reads were mapped to the P. knowlesi H strain reference genome and an average mapping of 90% was obtained. Genes with low coverage were removed leaving 4623 genes for subsequent analyses. Previously we identified a DNA sequence dimorphism on a small fragment of the P. knowlesi normocyte binding protein xa gene on chromosome 14. We used the genome data to assemble full-length Pknbpxa sequences and discovered that the dimorphism extended along the gene. An in-house algorithm was developed to detect SNP sites co-associating with the dimorphism. More than half of the P. knowlesi genome was dimorphic, involving genes on all chromosomes and suggesting that two distinct types of P. knowlesi infect the human population in Sarawak, Malaysian Borneo. We use P. knowlesi clinical samples to demonstrate that Plasmodium DNA from archived patient samples can produce high quality genome data. We show that analyses, of even small numbers of difficult clinical malaria isolates, can generate comprehensive genomic information that will improve our understanding of malaria parasite diversity and pathobiology