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2.
Arthroplast Today ; 27: 101348, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38690096

RESUMO

Background: The coronoavirus disease 2019 (COVID-19) pandemic had profound impact on elective procedures in the United States. We characterized the longer-term decline and recovery of hip and knee arthroplasty procedures following the onset of the COVID-19 pandemic in the United States. Methods: We conducted a retrospective analysis of patients undergoing primary and revision total knee and hip arthroplasty (TKA and THA) in the United States between 2014 and 2020 using claims from a large national commercial payer data set contaivning deidentified information from patients with commercial health coverage. We calculated the percentage of cases lost by month using a forecast model to predict TKA and THA volumes in the absence of COVID-19. We then calculated the association between COVID-19 positivity rates and THA/TKA procedures by state and month. Results: There was a large initial decline in procedures, with primary TKA and THA volumes declining by 93.2% and 87.1% in April 2020, respectively, with revisions seeing more modest declines. Cases quickly recovered with volumes exceeding expected levels in summer months. However, cumulative 2020 volumes remained below expected with 9.7% and 7.5% of expected primary TKA and THA cases lost, respectively. Higher state COVID-19 positivity rates were associated with lower primary TKA, THA, and revision knee procedure rates. Conclusions: After the initial decline in March and April, knee and hip arthroplasty cases resumed quickly; however, by the end of 2020, the annual procedure volume had still not recovered fully. The loss in case volume within states was worse in months with higher COVID-19 positivity rates.

3.
Eur J Appl Physiol ; 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38386104

RESUMO

PURPOSE: Intestinal permeability is a critical component of gut barrier function. Barrier dysfunction can be triggered by certain stressors such as exercise, and if left unmanaged can lead to local and systemic disorders. The aim of this study was to investigate the effects of a specific whey protein fraction in alleviating exercise-induced gut permeability as assessed by recovery of lactulose/rhamnose (L/R) and lactulose/mannitol (L/M) urinary probes. METHODS: Eight males and eight females (aged 18-50) completed two arms of a double-blind, placebo-controlled, crossover study. For each arm participants performed two baseline intestinal permeability assessments, following which they consumed the treatment (2 g/day of milk powder containing 200 mg of whey protein) or placebo (2 g/day of milk powder) for 14 days, before performing a post-exercise permeability assessment. The exercise protocol involved a 20-min run at 80% of maximal oxygen uptake on a 1% incline. RESULTS: Mixed model analysis revealed an increase in L/R (23%; P < 0.001) and L/M (20%; P < 0.01) recovery following exercise. However, there was no treatment or treatment × exercise effect. CONCLUSION: The exercise protocol utilised in our study induces gut permeability. However, consuming whey protein, at the dose and timing prescribed, is not able to mitigate this effect.

4.
Nutrients ; 15(11)2023 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-37299486

RESUMO

Exercise induced-muscle damage (EIMD) occurs after strenuous and/or novel exercise that involves repeated eccentric contractions [...].


Assuntos
Músculo Esquelético , Dor , Humanos , Músculo Esquelético/fisiologia , Exercício Físico/fisiologia , Contração Muscular
5.
Nutrients ; 15(10)2023 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-37242198

RESUMO

Unaccustomed eccentric exercise results in muscle damage limiting physical performance for several days. This study investigated if Greenshell™ mussel (GSM) powder consumption expedited muscle recovery from eccentric exercise-induced muscle damage (EIMD). Methods: Twenty untrained adult men were recruited into a double-blind, placebo-controlled, cross-over study and were randomly assigned to receive the GSM powder or placebo treatment first. Participants consumed their allocated intervention for four weeks then completed a bench-stepping exercise that induced muscle damage to the eccentrically exercised leg. Muscle function, soreness and biomarkers of muscle damage, oxidative stress and inflammation were measured before exercise, immediately after exercise and 24, 48 and 72 h post exercise. GSM powder promoted muscle function recovery, significantly improving (p < 0.05) isometric and concentric peak torque at 48 h and 72 h post exercise, respectively. Participants on the GSM treatment had faster dissipation of soreness, with significant treatment × time interactions for affective (p = 0.007) and Visual Analogue Scale-assessed pain (p = 0.018). At 72 h, plasma creatine kinase concentrations in the GSM group were lower (p < 0.05) compared with the placebo group. This study provides evidence for GSM powder being effective in supporting muscle recovery from EIMD.


Assuntos
Músculo Esquelético , Dor , Masculino , Humanos , Adulto , Pós , Estudos Cross-Over , Nova Zelândia , Suplementos Nutricionais , Mialgia/tratamento farmacológico
6.
Front Sports Act Living ; 5: 1335434, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38274033

RESUMO

Introduction: When consumed after eccentric exercise, cow's milk has been shown to improve recovery and alleviate symptoms of exercise induced muscle damage. Although currently less commercially available than cow's milk, sheep's milk may offer similar or greater benefits for recovery as it is higher in protein and energy; however, the effect of sheep's milk in any exercise context has not been explored. This study compared the effects of a sheep's milk beverage and a cow's milk beverage on recovery from strenuous eccentric exercise. Additionally, the effects of each beverage on satiety and gastrointestinal comfort were assessed. Methods: Ten healthy males completed baseline measures of perceived muscle soreness and maximal voluntary concentric, eccentric, and isometric quadriceps force of one leg before completing 200 maximal eccentric knee extensions on an isokinetic dynamometer. Measures were repeated 0.5, 24, 48 and 72 h post-eccentric exercise. After 0.5 h measures, participants consumed either 450 ml of chocolate flavored sheep's milk or chocolate flavored cow's milk. Following a washout period, participants completed a second trial on the contralateral leg and consumed the other beverage. Additionally, a satiety and gastrointestinal comfort questionnaire was completed before and after each beverage was consumed. Results: Eccentric exercise brought about a significant decrease in muscle function over time (all P < 0.012). No difference between treatments (all P > 0.097) was found. Measures of muscle soreness increased over time (all P < 0.002), however no difference was observed between treatments (all P > 0.072). Only sheep's milk altered perceived satiety, however, only the response to "How full do you feel" differed between treatments (P = 0.04). Discussion: The results of this study suggest that consuming sheep's milk may provide similar benefits as cow's milk when recovering from exercise-induced muscle damage. While these findings provide initial support for the use of sheep's milk in a muscle recovery context, further research is warranted to confirm these findings. Given its superior nutritional profile, greater impact on satiety and lower environment impact, sheep's milk may be a more efficient post-exercise recovery beverage, compared to cow's milk.

7.
Ecohealth ; 20(4): 370-380, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38243042

RESUMO

Batrachochytrium dendrobatidis (Bd), the causative agent of the devastating global amphibian disease chytridiomycosis, was not projected to threaten amphibians in hot and arid regions due to its sensitivity to heat and desiccation. However, Bd is being detected more frequently than ever in hot and arid regions of Australia and the USA, challenging our current understanding of the environmental tolerances of the pathogen under natural conditions. We surveyed for Bd in an extremely hot and arid portion of the Sonoran Desert, where the pathogen is not projected to occur, and related presence and prevalence of the pathogen to local environmental conditions. We collected eDNA samples from isolated desert water sites including six tinajas and 13 catchments in June and August of 2020 and swabbed a total of 281 anurans of three species (red-spotted toad Anaxyrus punctatus, Couch's spadefoot Scaphiopus couchii, and the Sonoran Desert toad Incillius alvarius) across five catchments and six tinajas from June to September of 2020. Overall, Bd occurred at 68.4% of sites, despite extreme heat and aridity routinely exceeding tolerances established in laboratory studies. Average summer maximum air and water temperatures were 40.7°C and 30.7°C, respectively, and sites received an average of just 16.9 mm of precipitation throughout the summer monsoon season. Prevalence was low (5.7%) across species and life stage. Our results demonstrate that Bd is capable of persisting and infecting amphibians beyond its projected range, indicating a need to account for higher thermal tolerances when quantifying risk of Bd presence and infection.


Assuntos
Batrachochytrium , Quitridiomicetos , Animais , Anfíbios , Bufonidae , Temperatura , Água
8.
Nutrients ; 14(23)2022 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-36501099

RESUMO

The metabolic and mechanical stresses associated with muscle-fatiguing exercise result in perturbations to bodily tissues that lead to exercise-induced muscle damage (EIMD), a state of fatigue involving oxidative stress and inflammation that is accompanied by muscle weakness, pain and a reduced ability to perform subsequent training sessions or competitions. This review collates evidence from previous research on a wide range of nutritional compounds that have the potential to speed up post-exercise recovery. We show that of the numerous compounds investigated thus far, only two-tart cherry and omega-3 fatty acids-are supported by substantial research evidence. Further studies are required to clarify the potential effects of other compounds presented here, many of which have been used since ancient times to treat conditions associated with inflammation and disease.


Assuntos
Músculo Esquelético , Prunus avium , Humanos , Músculo Esquelético/metabolismo , Exercício Físico/fisiologia , Estresse Oxidativo , Inflamação/metabolismo , Fadiga/metabolismo
9.
PLoS One ; 17(11): e0277765, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36395119

RESUMO

INTRODUCTION: Contusion injuries are common in sport, but our knowledge of the responses to injury primarily come from animal studies and research using eccentric exercise. Therefore, the aim of this study was to develop a model of contusion injury in human participants and, additionally, investigate and compare physiological responses to four impact loads. METHODS: Thirty-two males were exposed to a single impact of either 4.2, 5.2, 6.2 or 7.2kg, dropped from 67 cm, on to the vastus lateralis of one leg. Maximum voluntary and electrically induced quadriceps force, and pressure pain threshold were measured, and blood sampling carried out, prior to and 30min, 24, 48 and 72h post-impact. Magnetic resonance imaging was carried out 24h post-impact to quantify oedema. RESULTS: Despite impact force with 7.2kg (1681.4 ± 235.6 N) not being different to 6.2kg (1690.7 ± 117.6 N), 7.2kg resulted in greater volume of oedema, voluntary force loss, pain and elevations in creatine kinase than the other loads. Although electrically induced force changed over time, post-hoc analysis failed to identify any changes. Interleukin-6 and prostaglandin-E2 did not change over time for any of the loads. Significant correlations were found between oedema volume, pressure pain threshold and maximum voluntary contraction force. CONCLUSIONS: This is the first experimental study to investigate traumatic loading of skeletal muscle and the subsequent physiological responses associated with contusion injuries in humans. The absence of immediate elevations in creatine kinase and changes in electrically induced force suggest impact, with forces similar to those experienced in contact sport, does not cause significant, direct damage to skeletal muscle. However, the relationship between oedema volume, changes in pressure pain threshold and maximum voluntary contraction force suggests central inhibition plays a role in contusion-related muscle dysfunction.


Assuntos
Contusões , Masculino , Animais , Humanos , Músculo Esquelético/fisiologia , Músculo Quadríceps , Creatina Quinase , Dor , Modelos Teóricos
10.
Nutrients ; 14(20)2022 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-36297022

RESUMO

Astragalosides have been shown to enhance endurance exercise capacity in vivo and promote muscular hypertrophy in vitro. However, it remains unknown whether astragalosides supplementation can alter inflammatory response and enhance muscle recovery after damage in humans. We therefore aimed to evaluate the effect of astragalosides supplementation on muscle's intrinsic capacity to regenerate and repair itself after exercise-induced damage. Using a randomized double-blind placebo-controlled cross-over design, eleven male participants underwent 7 days of astragalosides supplementation (in total containing 4 mg of astragalosides per day) or a placebo control, following an eccentric exercise protocol. Serum blood samples and variables related to muscle function were collected prior to and immediately following the muscle damage protocol and also at 2 h, and 1, 2, 3, 5, and 7 days of the recovery period, to assess the pro-inflammatory cytokine response, the secretion of muscle regenerative factors, and muscular strength. Astragalosides supplementation reduced biomarkers of skeletal muscle damage (serum CK, LDH, and Mb), when compared to the placebo, at 1, 2, and 3 days following the muscle damage protocol. Astragalosides supplementation suppressed the secretion of IL-6 and TNF-α, whilst increasing the release of IGF-1 during the initial stages of muscle recovery. Furthermore, following astragaloside supplementation, muscular strength returned to baseline 2 days earlier than the placebo. Astragalosides supplementation shortens the duration of inflammation, enhances the regeneration process and restores muscle strength following eccentric exercise-induced injury.


Assuntos
Exercício Físico , Músculo Esquelético , Saponinas , Triterpenos , Humanos , Masculino , Biomarcadores , Citocinas , Suplementos Nutricionais , Método Duplo-Cego , Fator de Crescimento Insulin-Like I , Interleucina-6 , Músculo Esquelético/efeitos dos fármacos , Mialgia , Fator de Necrose Tumoral alfa/farmacologia , Exercício Físico/efeitos adversos , Triterpenos/farmacologia , Saponinas/farmacologia , Estudos Cross-Over
11.
J Trauma Acute Care Surg ; 93(6): 727-735, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-36001117

RESUMO

BACKGROUND: The presence of six or more rib fractures or a displaced rib fracture due to cardiopulmonary resuscitation (CPR) has been associated with longer hospital and intensive care unit (ICU) length of stay (LOS). Evidence on the effect of surgical stabilization of rib fractures (SSRF) following CPR is limited. This study aimed to evaluate outcomes after SSRF versus nonoperative management in patients with multiple rib fractures after CPR. METHODS: An international, retrospective study was performed in patients who underwent SSRF or nonoperative management for multiple rib fractures following CPR between January 1, 2012, and July 31, 2020. Patients who underwent SSRF were matched to nonoperative controls by cardiac arrest location and cause, rib fracture pattern, and age. The primary outcome was ICU LOS. RESULTS: Thirty-nine operatively treated patient were matched to 66 nonoperatively managed controls with comparable CPR-related characteristics. Patients who underwent SSRF more often had displaced rib fractures (n = 28 [72%] vs. n = 31 [47%]; p = 0.015) and a higher median number of displaced ribs (2 [P 25 -P 75 , 0-3] vs. 0 [P 25 -P 75 , 0-3]; p = 0.014). Surgical stabilization of rib fractures was performed at a median of 5 days (P 25 -P 75 , 3-8 days) after CPR. In the nonoperative group, a rib fixation specialist was consulted in 14 patients (21%). The ICU LOS was longer in the SSRF group (13 days [P 25 -P 75 , 9-23 days] vs. 9 days [P 25 -P 75 , 5-15 days]; p = 0.004). Mechanical ventilator-free days, hospital LOS, thoracic complications, and mortality were similar. CONCLUSION: Despite matching, those who underwent SSRF over nonoperative management for multiple rib fractures following CPR had more severe consequential chest wall injury and a longer ICU LOS. A benefit of SSRF on in-hospital outcomes could not be demonstrated. A low consultation rate for rib fixation in the nonoperative group indicates that the consideration to perform SSRF in this population might be associated with other nonradiographic or injury-related variables. LEVEL OF EVIDENCE: Therapeutic/Care Management; Level III.


Assuntos
Fraturas das Costelas , Fraturas da Coluna Vertebral , Humanos , Fraturas das Costelas/complicações , Fraturas das Costelas/cirurgia , Estudos Retrospectivos , Estudos de Casos e Controles , Resultado do Tratamento , Tempo de Internação , Fraturas da Coluna Vertebral/complicações
12.
Artigo em Inglês | MEDLINE | ID: mdl-35243121

RESUMO

Blue rubber bleb nevus syndrome (BRBNS) is a rare disease that presents as cutaneous and extra-cutaneous vascular malformations, most commonly affecting the gastrointestinal (GI) tract. We report a case of adult onset BRBNS in an African American male with vascular lesions isolated to the jejunum without any cutaneous manifestations. Physicians should recognize that BRBNS can present without skin involvement and may have complications from visceral organ involvement. Treatment of BRBNS is mainly symptomatic and aims at preserving the GI tract as much as possible. BRBNS may also present as delayed recurrence after surgical or endoscopic interventions.

13.
Front Med Technol ; 4: 995526, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36590152

RESUMO

The practice of medicine is rapidly transforming as a result of technological breakthroughs. Artificial intelligence (AI) systems are becoming more and more relevant in medicine and orthopaedic surgery as a result of the nearly exponential growth in computer processing power, cloud based computing, and development, and refining of medical-task specific software algorithms. Because of the extensive role of technologies such as medical imaging that bring high sensitivity, specificity, and positive/negative prognostic value to management of orthopaedic disorders, the field is particularly ripe for the application of machine-based integration of imaging studies, among other applications. Through this review, we seek to promote awareness in the orthopaedics community of the current accomplishments and projected uses of AI and ML as described in the literature. We summarize the current state of the art in the use of ML and AI in five key orthopaedic disciplines: joint reconstruction, spine, orthopaedic oncology, trauma, and sports medicine.

14.
BMC Ecol Evol ; 21(1): 218, 2021 12 06.
Artigo em Inglês | MEDLINE | ID: mdl-34872490

RESUMO

BACKGROUND: Airborne environmental DNA (eDNA) research is an emerging field that focuses on the detection of species from their genetic remnants in the air. The majority of studies into airborne eDNA of plants has until now either focused on single species detection, specifically only pollen, or human health impacts, with no previous studies surveying an entire plant community through metabarcoding. We therefore conducted an airborne eDNA metabarcoding survey and compared the results to a traditional plant community survey. RESULTS: Over the course of a year, we conducted two traditional transect-based visual plant surveys alongside an airborne eDNA sampling campaign on a short-grass rangeland. We found that airborne eDNA detected more species than the traditional surveying method, although the types of species detected varied based on the method used. Airborne eDNA detected more grasses and forbs with less showy flowers, while the traditional method detected fewer grasses but also detected rarer forbs with large showy flowers. Additionally, we found the airborne eDNA metabarcoding survey required less sampling effort in terms of the time needed to conduct a survey and was able to detect more invasive species than the traditional method. CONCLUSIONS: Overall, we have demonstrated that airborne eDNA can act as a sensitive and efficient plant community surveying method. Airborne eDNA surveillance has the potential to revolutionize the way plant communities are monitored in general, track changes in plant communities due to climate change and disturbances, and assist with the monitoring of invasive and endangered species.


Assuntos
DNA Ambiental , Biodiversidade , Código de Barras de DNA Taxonômico , Monitoramento Ambiental , Humanos , Inquéritos e Questionários
15.
Mol Ecol ; 30(19): 4601-4605, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34036646

RESUMO

In a recent paper, "Environmental DNA: What's behind the term? Clarifying the terminology and recommendations for its future use in biomonitoring," Pawlowski et al. argue that the term eDNA should be used to refer to the pool of DNA isolated from environmental samples, as opposed to only extra-organismal DNA from macro-organisms. We agree with this view. However, we are concerned that their proposed two-level terminology specifying sampling environment and targeted taxa is overly simplistic and might hinder rather than improve clear communication about environmental DNA and its use in biomonitoring. This terminology is based on categories that are often difficult to assign and uninformative, and it overlooks a fundamental distinction within eDNA: the type of DNA (organismal or extra-organismal) from which ecological interpretations are derived.


Assuntos
DNA Ambiental , Biodiversidade , DNA/genética , Código de Barras de DNA Taxonômico
16.
Sports (Basel) ; 9(2)2021 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-33503817

RESUMO

Limited research has examined the demands of backward locomotion at various speeds using common load monitoring metrics in team sport athletes. Consequently, this study compared the external and internal loads between backward and forward locomotion during intermittent exercise in team sport athletes. Semi-professional, male rugby league players (n = 29) completed the same exercise protocol on two occasions in backward and forward directions. On each occasion, participants performed separate 20 m trials at self-selected walking, jogging, running, and sprinting speeds and then completed a 15 min modified Loughborough intermittent shuttle test (mLIST). Common external and internal load metrics were gathered across testing. Faster speeds (p < 0.001) were attained at all speeds during forward locomotion in the 20 m trials. Non-significant differences in accumulated PlayerLoadTM were found between directions across the mLIST; however, higher relative (per min) PlayerLoadTM (p < 0.001) was apparent during backward locomotion when walking and during forward locomotion when sprinting during the mLIST. RPE and mean heart rate were higher (p < 0.001) during backward locomotion across the mLIST. These data highlight the unique loading patterns experienced during backward locomotion and suggest practitioners should consider the discernment in loading imposed between backward and forward locomotion when measuring athlete demands using common metrics.

17.
J Strength Cond Res ; 35(3): 675-679, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30138236

RESUMO

ABSTRACT: Barnes, MJ, Petterson, A, and Cochrane, DJ. Peak power output and onset of muscle activation during high pull exercise. J Strength Cond Res 35(3): 675-679, 2021-The aim of this study was to determine the percentage of 1 repetition maximum (1RM) at which peak power output occurred during the high pull (HP) exercise. In addition, the onset time of the biceps femoris (BF) and gluteus maximus (GM), across a range of loads, was investigated. Twelve resistance-trained men performed 1RM testing for the HP followed by lifts at 10% increments from 30 to 80% 1RM. During each load of power, output was measured using a linear potentiometer, whereas surface electromyography was recorded from the BF and GM. Peak power output occurred at 70% (1881.9 ± 296.1 W); however, there was no significant difference between loads at 60-80% (all p > 0.05). Loads between 40 and 80% 1RM produced significantly higher power outputs than 30% while 80% generated greater power than 100% 1RM (all p < 0.05). There was no significant (p > 0.05) main effect of muscle or load in the onset of BF (156.5-212.1 ms) or GM (112.1-158.1 ms). Therefore, these results suggest that training at a load between 60 and 80% 1RM may be useful in increasing power in the HP. In addition, activation of 2 of the hip extensors occurs in a relatively synchronous order irrespective of load.


Assuntos
Músculos Isquiossurais , Treinamento Resistido , Exercício Físico , Humanos , Masculino , Força Muscular , Músculo Esquelético , Coxa da Perna , Levantamento de Peso
18.
Mil Med ; 185(7-8): e1016-e1023, 2020 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-32601707

RESUMO

INTRODUCTION: Deployment-limiting medical conditions are the primary reason why service members are not medically ready. Service-specific standards guide clinicians in what conditions are restrictive for duty, fitness, and/or deployment requirements. The Air Force (AF) codifies most standards in the Medical Standards Directory (MSD). Providers manually search this document, among others, to determine if any standards are violated, a tedious and error-prone process. Digitized, standards-based decision-support tools for providers would ease this workflow. This study digitized and mapped all AF occupations to MSD occupational classes and all MSD standards to diagnosis codes and created and validated a readiness decision support system (RDSS) around this mapping. MATERIALS AND METHODS: A medical coder mapped all standards within the May 2018 v2 MSD to 2018 International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. For the publication of new MSDs, we devised an automated update process using Amazon Web Service's Comprehend Medical and the Unified Medical Language System's Metathesaurus. We mapped Air Force Specialty Codes to occupational classes using the MSD and AF classification directories. We uploaded this mapping to a cloud-based MySQL (v5.7.23) database and built a web application to interface with it using R (v3.5+). For validation, we compared the RDSS to the record review of two subject-matter experts (SMEs) for 200 outpatient encounters in calendar year 2018. We performed four separate analyses: (1) SME vs. RDSS for any restriction; (2) SME interrater reliability for any restriction; (3) SME vs. RDSS for specific restriction(s); and (4) SME interrater reliability for categorical restriction(s). This study was approved as "Not Human Subjects Research" by the Air Force Research Laboratory (FWR20190100N) and Boston Children's Hospital (IRB-P00031397) review boards. RESULTS: Of the 709 current medical standards in the September 2019 MSD, 631 (89.0%) were mapped to ICD-10-CM codes. These 631 standards mapped to 42,810 unique ICD codes (59.5% of all active 2019 codes) and covered 72.3% (7,823/10,821) of the diagnoses listed on AF profiles and 92.8% of profile days (90.7/97.8 million) between February 1, 2007 and January 31, 2017. The RDSS identified diagnoses warranting any restrictions with 90.8% and 90.0% sensitivity compared to SME A and B. For specific restrictions, the sensitivity was 85.0% and 44.8%. The specificity was poor for any restrictions (20.5%-43.4%) and near perfect for specific restrictions (99.5+%). The interrater reliability between SMEs for all comparisons ranged from minimal to moderate (κ = 0.33-0.61). CONCLUSION: This study demonstrated key pilot steps to digitizing and mapping AF readiness standards to existing terminologies. The RDSS showed one potential application. The sensitivity between the SMEs and RDSS demonstrated its viability as a screening tool with further refinement and study. However, its performance was not evenly distributed by special duty status or for the indication of specific restrictions. With machine consumable medical standards integrated within existing digital infrastructure and clinical workflows, RDSSs would remove a significant administrative burden from providers and likely improve the accuracy of readiness metrics.


Assuntos
Militares , Bases de Dados Factuais , Humanos , Classificação Internacional de Doenças , Padrões de Referência , Reprodutibilidade dos Testes
19.
Front Nutr ; 7: 74, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32537457

RESUMO

Objectives: We examined the acute effects of anthocyanin-rich New Zealand blackcurrant extract and a placebo on hemodynamics during 120 min of sedentary sitting in healthy males. Additionally, we investigated whether changes in resting hemodynamics altered repeated isometric hand-grip exercise performance and post exercise forearm blood flow (FBF). Methods: Ten healthy males completed two trials during which they ingested either blackcurrant extract (1.87 mg total anthocyanins/kg bodyweight) or placebo powder. Heart rate, blood pressure and forearm blood flow were measured, and venous blood was sampled, prior to and 30, 60, 90 and 120 min-post ingestion. Participants remained seated for the duration of each trial. At 120 min post-ingestion participants completed as many repetitions of isometric hand-grip contractions as possible. Results: Heart rate, blood pressure and mean arterial pressure changed over time (all p < 0.001) but did not differ between treatments. A treatment x time interaction for FBF (p = 0.025) and forearm vascular resistance (FVR) (p = 0.002) was found. No difference in the number of isometric hand-grip contractions was observed between treatments (p = 0.68) nor was there any treatment x time interaction in post-exercise FBF (p = 0.997). Plasma endothelin-1 (p = 0.023) and nitrate (p = 0.047) changed over time but did not differ between treatments (both p > 0.1). Plasma nitrite did not change over time (p = 0.732) or differ between treatments (p = 0.373). Conclusion: This study demonstrated that acute ingestion of a single dose of blackcurrant extract maintained FBF and FVR during an extended period of sitting; however, this did not influence exercise performance during hand-grip exercise.

20.
J Wildl Dis ; 56(3): 702-706, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32243244

RESUMO

Environmental DNA (eDNA) methods provide novel options for the detection of pathogens. The amphibian pathogens Batrachochytrium dendrobatidis (Bd) and Ranavirus have been relatively understudied in Texas, US, so we applied eDNA assays for the surveillance of these pathogens in the upper Brazos River basin near the Texas panhandle. We collected water samples from five urban playa lakes and one reservoir in and around Lubbock, Texas. Quantitative PCR detected both Bd and Ranavirus at one playa lake, representing novel detection of both pathogens in the region. Based on these results, we recommend increased monitoring for the pathogens and symptoms of amphibian disease throughout the region.


Assuntos
Batrachochytrium/isolamento & purificação , DNA Ambiental/isolamento & purificação , Ranavirus/isolamento & purificação , Rios , Anfíbios , Animais , Infecções por Vírus de DNA/epidemiologia , Infecções por Vírus de DNA/veterinária , Infecções por Vírus de DNA/virologia , DNA Ambiental/genética , Micoses/epidemiologia , Micoses/microbiologia , Micoses/veterinária , Texas
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