The Effects Of Differing Density Of Swim-Training Sessions On Shoulder Range Of Motion and Isometric Force Production In National and University Level Swimmers

# Background Well-developed physical qualities (i.e., greater load capacity) in athletes can provide protection against injuries. Although higher competitive level swimmers have more developed physical qualities, no studies have investigated how physical qualities of the shoulder respond to a swim-training session in different competitive levels. # Purpose To compare baseline shoulder external rotation range of motion (ER ROM) and isometric peak torque of the shoulder internal rotators (IR) and external rotators (ER) between national and university level swimmers with differing training volumes. To compare the post-swim changes of these physical qualities between groups. # Study design Cross-sectional. # Methods Ten male swimmers (age= 18.7 ± 1.2 years) were divided into high-load (N= 5 national-level, weekly swim-volume= 37.0 ± 2.7 km) and low-load groups (N= 5 university-level, weekly swim-volume= 6.8 ± 1.8 km). For each group, shoulder active ER ROM and isometric peak torque of the shoulder IR and ER were measured before and immediately after a high-intensity swim-training session (for each group, the hardest swim-session of the week was analyzed). The results were evaluated by the level of significance (p-value), effect size, and whether changes exceeded the measurement error. # Results University-level swimmers had lower baseline ER torque (p= 0.006; d= 2.55) and IR torque (p= 0.011; d= 2.42) than national-level swimmers. For post-swim analysis, ER ROM decreased more in university swimmers (change= -6.3° to -8.4°; d= 0.75-1.05) than national counterparts (change= -1.9° to -5.7°; d= 0.43-0.95). Greater drops in rotation torque were found in university swimmers (IR change= -15% to -21.0%; d= 0.83-1.66; ER change= -9.0% to -17.0%; d= 1.14-1.28) compared to national swimmers (IR change= -10.0% to -13.0%; d= 0.61-0.91; ER change= -3.7% to -9.1%; d= 0.50-0.96). The average change of all tests in university swimmers exceeded the minimal detectable change (MDC), whereas in national level swimmers some tests exceeded the MDC. Despite this, only post-swim ER torque in the dominant side (p= 0.003; d= 1.18) was significantly lower in university swimmers (possibly due to the small sample size). # Conclusions University swimmers have less baseline shoulder external and internal rotator torque and had greater drops of all shoulder physical qualities after a swim-training session, which may have implications for injury risk. However, due to the sample size, the results have to be interpreted with caution. # Level of evidence

High prevalence of subclass-specific binding and neutralizing antibodies against Clostridium difficile toxins in adult cystic fibrosis sera: possible mode of immunoprotection against symptomatic C. difficile infection

Objectives: Despite multiple risk factors and a high rate of colonization for Clostridium difficile, the occurrence of C. difficile infection in patients with cystic fibrosis is rare. The aim of this study was to compare the prevalence of binding C. difficile toxin-specific immunoglobulin (Ig)A, IgG and anti-toxin neutralizing antibodies in the sera of adults with cystic fibrosis, symptomatic C. difficile infection (without cystic fibrosis) and healthy controls. Methods: Subclass-specific IgA and IgG responses to highly purified whole C. difficile toxins A and B (toxinotype 0, strain VPI 10463, ribotype 087), toxin B from a C. difficile toxin-B only expressing strain (CCUG 20309) and precursor form of B fragment of binary toxin, pCDTb, were determined by protein microarray. Neutralizing antibodies to C. difficile toxins A and B were evaluated using a Caco-2 cell-based neutralization assay. Results: Serum IgA anti-toxin A and B levels and neutralizing antibodies against toxin A were significantly higher in adult cystic fibrosis patients (n=16) compared with healthy controls (n=17) and patients with symptomatic C. difficile infection (n=16); p≤0.05. The same pattern of response prevailed for IgG, except that there was no difference in anti-toxin A IgG levels between the groups. Compared with healthy controls (toxins A and B) and patients with C. difficile infection (toxin A), sera from cystic fibrosis patients exhibited significantly stronger protective anti-toxin neutralizing antibody responses. Conclusion: A superior ability to generate robust humoral immunity to C. difficile toxins in the cystic fibrosis population is likely to confer protection against symptomatic C. difficile infection. This protection may be lost in the post-transplantation setting, where sera-monitoring of anti-C. difficile toxin antibody titers may be of clinical value

Changes in vector species composition and current vector biology and behaviour will favour malaria elimination in Santa Isabel Province, Solomon Islands

Background: In 2009, Santa Isabel Province in the Solomon Islands embarked on a malaria elimination programme. However, very little is known in the Province about the anopheline fauna, which species are vectors, their bionomics and how they may respond to intensified intervention measures. The purpose of this study was to provide baseline data on the malaria vectors and to ascertain the possibility of successfully eliminating malaria using the existing conventional vector control measures, such as indoor residual spraying (IRS) and long-lasting insecticidal nets (LLIN). Methods. Entomological surveys were undertaken during October 2009. To determine species composition and distribution larval surveys were conducted across on the whole island. For malaria transmission studies, adult anophelines were sampled using human landing catches from two villages - one coastal and one inland. Results: Five Anopheles species were found on Santa Isabel: Anopheles farauti, Anopheles hinesorum, Anopheles lungae, Anopheles solomonis, and Anopheles nataliae. Anopheles hinesorum was the most widespread species. Anopheles farauti was abundant, but found only on the coast. Anopheles punctulatus and Anopheles koliensis were not found. Anopheles farauti was the only species found biting in the coastal village, it was incriminated as a vector in this study; it fed early in the night but equally so indoors and outdoors, and had a low survival rate. Anopheles solomonis was the main species biting humans in the inland village, it was extremely exophagic, with low survival rates, and readily fed on pigs. Conclusion: The disappearance of the two major vectors, An. punctulatus and An. koliensis, from Santa Isabel and the predominance of An. hinesorum, a non-vector species may facilitate malaria elimination measures. Anopheles farauti was identified as the main coastal vector with An. solomonis as a possible inland vector. The behaviour of An. solomonis is novel as it has not been previously found biting humans in any numbers. Both species appear to be short-lived, a characteristic that will limit their transmission potential. The early night feeding behaviour and a degree of outdoor biting seen in An. farauti and particularly in An. solomonis will require that their response to IRS and LLIN be closely monitored. In coastal villages, where large, favourable breeding sites allow for high numbers of An. farauti may require the addition of larval control to achieve elimination

Large-scale excess HI absorption around z≈4z\approx4 galaxies detected in a background galaxy spectrum in the MUSE eXtremely Deep Field

Observationally mapping the relation between galaxies and the intergalactic medium (IGM) is of key interest for studies of cosmic reionization. Diffuse hydrogen gas has typically been observed in HI Lyman-$\alpha$ (Ly$\alpha$) absorption in the spectra of bright background quasars. However, it is important to extend these measurements to background galaxies as quasars become increasingly rare at high redshift and rarely probe closely separated sight-lines. Here we use deep integral field spectroscopy in the MUSE eXtremely Deep Field to demonstrate the measurement of the Ly$\alpha$ transmission at $z\approx4$ in absorption to a background galaxy at $z=4.77$. The HI transmission is consistent with independent quasar sight-lines at similar redshifts. Exploiting the high number of spectroscopic redshifts of faint galaxies (500 between $z=4.0-4.7$ within a radius of 8 arcmin) that are tracers of the density field, we show that Ly$\alpha$ transmission is inversely correlated with galaxy density, i.e. transparent regions in the Ly$\alpha$ forest mark under-dense regions at $z\approx4$. Due to large-scale clustering, galaxies are surrounded by excess HI absorption over the cosmic mean out to 4 cMpc/h. We also find that redshifts from the peak of the Ly$\alpha$ line are typically offset from the systemic redshift by +170 km/s. This work extends results from $z\approx 2 - 3$ to higher redshifts and demonstrates the power of deep integral field spectroscopy to simultaneously measure the ionization structure of the IGM and the large-scale density field in the early Universe.Comment: Submitted to MNRAS. Main text 9 pages, 9 figures. Key results in Fig 4 (Lya forest transmission in the MXDF field) and Fig 9 (transmission - galaxy distance cross-correlation

Curricular Factors that Unintentionally Affect Learning in a Community-Based Interprofessional Education Program: The Student Perspective

Background: The Dalhousie Health Mentors Program (DHMP) is a community-based, pre-licensure interprofessional education initiative that aims to prepare health professional students for collaborative practice in the care of patients with chronic conditions. This program evaluation explores the students’ 1) learning and plans to incorporate skills into future practice; 2) ratings of program content, delivery, and assignments; 3) perspectives of curricular factors that inadvertently acted as barriers to learning; and 4) program improvement suggestions.Methods: All students (N = 745) from the 16 participating health programs were invited to complete an online mixed methods program evaluation survey at the conclusion of the 2012–2013 DHMP. A total of 295 students (40% response rate) responded to the Likert-type questions analyzed using descriptive and non-parametric statistics. Of these students, 204 (69%) provided responses to 10 open-ended questions, which were analyzed thematically.Findings: While the majority of respondents agreed that they achieved the DHMP learning objectives, the mixed-methods approach identified curriculum integration, team composition, and effectiveness of learning assignments as factors that unintentionally acted as barriers to learning, with three key student recommendations for program improvement.Conclusions: Educators and program planners need to be aware that even well-intended learning activities may result in unintended experiences that hamper interprofessional learning

Perspectives in machine learning for wildlife conservation

Data acquisition in animal ecology is rapidly accelerating due to inexpensive and accessible sensors such as smartphones, drones, satellites, audio recorders and bio-logging devices. These new technologies and the data they generate hold great potential for large-scale environmental monitoring and understanding, but are limited by current data processing approaches which are inefficient in how they ingest, digest, and distill data into relevant information. We argue that machine learning, and especially deep learning approaches, can meet this analytic challenge to enhance our understanding, monitoring capacity, and conservation of wildlife species. Incorporating machine learning into ecological workflows could improve inputs for population and behavior models and eventually lead to integrated hybrid modeling tools, with ecological models acting as constraints for machine learning models and the latter providing data-supported insights. In essence, by combining new machine learning approaches with ecological domain knowledge, animal ecologists can capitalize on the abundance of data generated by modern sensor technologies in order to reliably estimate population abundances, study animal behavior and mitigate human/wildlife conflicts. To succeed, this approach will require close collaboration and cross-disciplinary education between the computer science and animal ecology communities in order to ensure the quality of machine learning approaches and train a new generation of data scientists in ecology and conservation

Protective antibodies against Clostridium difficile are present in intravenous immunoglobulin and are retained in humans following its administration

The prevalence of serum antibodies against Clostridium difficile (CD) toxins A and B in healthy populations have prompted interest in evaluating the therapeutic activity of intravenous immunoglobulin (IVIg) in individuals experiencing severe or recurrent C. difficile infection (CDI). Despite some promising case reports, a definitive clinical role for IVIg in CDI remains unclear. Contradictory results may be attributed to a lack of consensus regarding optimal dose, timing of administration and patient selection as well as variability in specific antibody content between commercial preparations. The purpose of this study was to investigate retrospectively the efficacy of three commercial preparations of IVIg for treating severe or recurrent CDI. In subsequent mechanistic studies using protein microarray and toxin neutralization assays, all IVIg preparations were analysed for specific binding and neutralizing antibodies (NAb) to CD antigens in vitro and the presence of anti-toxin NAbs in vivo following IVIg infusion. A therapeutic response to IVIg was observed in 41% (10 of 17) of the CDI patients. Significant variability in multi-isotype specific antibodies to a 7-plex panel of CD antigens and toxin neutralization efficacies were observed between IVIg preparations and also in patient sera before and after IVIg administration. These results extend our current understanding of population immunity to CD and support the inclusion of surface layer proteins and binary toxin antigens in CD vaccines. Future strategies could enhance IVIg treatment response rates by using protein microarray to preselect donor plasma/serum with the highest levels of anti-CD antibodies and/or anti-toxin neutralizing capacities prior to fractionation

Bionomics of the malaria vector Anopheles farauti in Temotu Province, Solomon Islands: issues for malaria elimination

Background: In the Solomon Islands, the Malaria Eradication Programmes of the 1970s virtually eliminated the malaria vectors: Anopheles punctulatus and Anopheles koliensis, both late night biting, endophagic species. However, the vector, Anopheles farauti, changed its behaviour to bite early in the evening outdoors. Thus, An. farauti mosquitoes were able to avoid insecticide exposure and still maintain transmission. Thirty years on and the Solomon Islands are planning for intensified malaria control and localized elimination; but little is currently known about the behaviour of the vectors and how they will respond to intensified control. Methods. In the elimination area, Temotu Province, standard entomological collection methods were conducted in typical coastal villages to determine the vector, its ecology, biting density, behaviour, longevity, and vector efficacy. These vector surveys were conducted pre-intervention and post-intervention following indoor residual spraying and distribution of long-lasting insecticidal nets. Results: Anopheles farauti was the only anopheline in Temotu Province. In 2008 (pre-intervention), this species occurred in moderate to high densities (19.5-78.5 bites/person/night) and expressed a tendency to bite outdoors, early in the night (peak biting time 6-8 pm). Surveys post intervention showed that there was little, if any, reduction in biting densities and no reduction in the longevity of the vector population. After adjusting for human behaviour, indoor biting was reduced from 57% pre-intervention to 40% post-intervention. Conclusion: In an effort to learn from historical mistakes and develop successful elimination programmes, there is a need for implementing complimentary vector control tools that can target exophagic and early biting vectors. Intensified indoor residual spraying and long-lasting insecticide net use has further promoted the early, outdoor feeding behaviour of An. farauti in the Solomon Islands. Consequently, the effectiveness of IRS and the personal protection provided by bed nets is compromised. To achieve elimination, any residual transmission should be targeted using integrated vector control incorporating complementary tools such as larviciding and/or zooprophylaxis

Tracking genomic cancer evolution for precision medicine: The Lung TRACERx Study

The importance of intratumour genetic and functional heterogeneity is increasingly recognised as a driver of cancer progression and survival outcome. Understanding how tumour clonal heterogeneity impacts upon therapeutic outcome, however, is still an area of unmet clinical and scientific need. TRACERx (TRAcking non-small cell lung Cancer Evolution through therapy [Rx]), a prospective study of patients with primary non-small cell lung cancer (NSCLC), aims to define the evolutionary trajectories of lung cancer in both space and time through multiregion and longitudinal tumour sampling and genetic analysis. By following cancers from diagnosis to relapse, tracking the evolutionary trajectories of tumours in relation to therapeutic interventions, and determining the impact of clonal heterogeneity on clinical outcomes, TRACERx may help to identify novel therapeutic targets for NSCLC and may also serve as a model applicable to other cancer types

Exploring the Trypanosoma brucei Hsp83 Potential as a Target for Structure Guided Drug Design

Human African trypanosomiasis is a neglected parasitic disease that is fatal if untreated. The current drugs available to eliminate the causative agent Trypanosoma brucei have multiple liabilities, including toxicity, increasing problems due to treatment failure and limited efficacy. There are two approaches to discover novel antimicrobial drugs--whole-cell screening and target-based discovery. In the latter case, there is a need to identify and validate novel drug targets in Trypanosoma parasites. The heat shock proteins (Hsp), while best known as cancer targets with a number of drug candidates in clinical development, are a family of emerging targets for infectious diseases. In this paper, we report the exploration of T. brucei Hsp83--a homolog of human Hsp90--as a drug target using multiple biophysical and biochemical techniques. Our approach included the characterization of the chemical sensitivity of the parasitic chaperone against a library of known Hsp90 inhibitors by means of differential scanning fluorimetry (DSF). Several compounds identified by this screening procedure were further studied using isothermal titration calorimetry (ITC) and X-ray crystallography, as well as tested in parasite growth inhibitions assays. These experiments led us to the identification of a benzamide derivative compound capable of interacting with TbHsp83 more strongly than with its human homologs and structural rationalization of this selectivity. The results highlight the opportunities created by subtle structural differences to develop new series of compounds to selectively target the Trypanosoma brucei chaperone and effectively kill the sleeping sickness parasite