Perception of unfamiliar caregivers during sickness - Using the new Caregiver Perception Task (CgPT) during experimental endotoxemia.

Social withdrawal is a well-established part of sickness behavior, but in some contexts sick animals might gain from keeping close instead of keeping away. For instance, sick individuals are more willing to be near known individuals who can provide care and safety (close others) compared to when healthy. Yet, interactions with some strangers might also be beneficial (i.e., healthcare professionals), but it is not known how sickness interplay with social behavior towards such individuals. Here, we assessed if sickness affects perception of caregivers, and developed a new task, the Caregiver Perception Task (CgPT). Twenty-six participants performed the CgPT, once after an injection of lipopolysaccharide (LPS, 0.8 ng/kg body weight, n = 24), and once after an injection of saline (n = 25), one hour and forty-five minutes post-injection. During the task, participants watched short video clips of three types of caregivers: a healthcare professional taking care of a sick individual, a healthcare professional not taking care of a sick individual, and a non-healthcare professional taking care of their sick adult child or partner. After each video clip, the likability, trustworthiness, professionalism, and willingness to interact with and receive care from the caregiver were rated on visual analogue scales. Results showed that participants injected with saline rated healthcare professionals who did not take care of a sick individual less positively on all aspects compared to healthcare professionals who took care of a sick individual. Moreover, compared to saline, LPS increased the participants' willingness to receive care from healthcare professionals and non-healthcare professionals providing care, but not from healthcare professionals not providing care. Thus, our results indicate that sick individuals may approach unknown individuals with potential to provide care and support.

The walking sick: Perception of experimental sickness from biological motion.

Identification of sick conspecifics allows for avoidance of infectious threats, and is therefore an important behavioral defense against diseases. Here, we investigated if humans can identify sick individuals solely from biological motion and posture (using point-light displays). Additionally, we sought to determine which movements and sickness parameters would predict such detection. We collected video clips and derived point-light displays (one stride presented in a loop) of sick walkers (injected with lipopolysaccharide at 2.0 ng/kg body weight) and the same walkers when healthy (injected with saline). We then presented these displays to two groups, one group classified each walker as sick or healthy (study 1, n = 106), and the other group scored the walkers' health on a visual analogue scale (study 2, n = 106). The raters were able to identify sick individuals above chance, and rated sick walkers as having worse health, both from observing video clips and point-light displays. Furthermore, both sickness detection and worse apparent health were predicted by inflammation-induced increase in rigidity and slower walking, but not other cues. Altogether, these findings indicate that biological motion can serve as a sickness cue, possibly allowing humans to identify sick conspecifics from a distance, and thereby allowing for disease avoidance.

Rapid, sensitive, and specific, low-resource molecular detection of Hendra virus.

Efficient and accurate diagnosis of Hendra virus (HeV), a biosafety level 4 (BSL-4) pathogen and zoonotic disease, is of primary importance for surveillance and outbreak control in the Australian equine industry. Sporadic HeV spillover events pose a serious public health concern and are predicted to expand geographically, aligning with the moving distribution of the main reservoir hosts, the flying-foxes. Here we describe the development of a low-resource rapid Hendra test. The test used a fast and simple sample processing protocol followed by reverse transcription isothermal recombinase polymerase amplification (RT-RPA) combined with lateral flow detection (LFD) technology. Results were obtained in 30 min and required only a heating block, ice, and pipettes for liquid handling. The one-step sample processing protocol inactivated HeV in 2 min, providing a simple protocol that could enable safe testing outside of a laboratory. Analytical sensitivity testing demonstrated a detection limit of 1000 copies/µL of synthetic HeV RNA, and analytical specificity testing indicated assays did not detect other pathogens. Gamma-irradiated HeV-spiked in viral transport medium was detected with high sensitivity, down to 10,000 TCID50/mL, the equivalent of 18 RNA copies per reaction. Collectively, our data suggests that our rapid Hendra test offers a potential first-line screening on-site alternative to gold-standard RT-PCR detection, which requires samples to be shipped to central containment laboratories, thermocyclers and labour-intensive viral RNA purification, with testing time of approximately four hours. Our rapid Hendra test provided performance and speed without compromising sensitivity and specificity, and could become a promising more accessible tool for testing under resource-limited conditions for the veterinary community and thoroughbred industry.

SID: a new carbohydrate blood group system based on a well-characterized but still mysterious antigen of great pathophysiologic interest.

The high-prevalence blood group antigen, Sda, had been puzzling blood bankers and transfusionists for at least a decade when it was reported in 1967. The characteristic mix of agglutinates and free red blood cells (RBCs), caused by anti-Sda, is seen with the RBCs from 90 percent of individuals of European descent. However, only 2-4 percent of individuals are truly Sd(a-) and may produce anti-Sda. The antibodies, generally considered insignificant, may cause hemolytic transfusion reactions with high-expressing Sd(a+) RBCs (e.g., the unusual Cad phenotype, which can also be polyagglutinable). The Sda glycan, GalNAcß1-4(NeuAcα2-3)Gal-R, is produced in the gastrointestinal and urinary systems, while its origin on RBCs is more controversial. According to current theory, Sda is likely to be passively adsorbed in low amounts, except in Cad individuals, where it has been found on erythroid proteins and at higher levels. The long-standing hypothesis that B4GALNT2 encodes the Sda synthase was confirmed in 2019, since homozygosity for a variant allele with rs7224888:C produces a non-functional enzyme associated with most cases of the Sd(a-) phenotype. Thereby, the SID blood group system was acknowledged as number 038 by the International Society of Blood Transfusion. Although the genetic background of Sd(a-) was settled, questions remain. The genetic background of the Cad phenotype has not yet been determined, and the source of the RBC-carried Sda is unknown. Furthermore, the interest of Sda stretches beyond transfusion medicine. Some tantalizing examples are lowered antigen levels in malignant tissue compared with normal tissue and interference with infectious agents like Escherichia coli, influenza virus, and malaria parasites.

Physiological Demands and Characteristics of Movement During Simulated Combat.

INTRODUCTION: Military tasks place considerable physiological demands on the soldier. It is therefore important to know the energy expenditure of soldiers while solving tasks in different environments. The purpose of this study was to describe the cardiorespiratory demands of certain movements and activities on ground combat soldiers during military field operations using body sensors and simulated combat. MATERIALS AND METHODS: Movement characteristics and cardiorespiratory responses were assessed in 42 soldiers (three women) in the Swedish Army. The different posts assessed were commander, combat engineer, driver, and gunner. The military field exercises examined were urban operations and retrograde operations in rough terrain. Measurements included (1) body mass, (2) heart rate (HR) including maximal (HRmax), (3) velocity, (4) accelerations/decelerations, and (5) distance moved. Maximal aerobic capacity (V̇O2peak, mL·kg-1·min-1) was tested in a laboratory setting when wearing combat gear and body armor. RESULTS: There was a weak positive correlation (r = 0.41 and 0.28, both P < .05) between VO2peak and percentage of time over 40% and 50% of maximal aerobic capacity during simulated combat. No differences were found for the different posts in time spent over 40% or 50% of maximal aerobic capacity and 76% of their HRmax (P > .05). Wearing combat gear and additional load while solving tasks resulted in mean HR varying between 98 and 111 beats·min-1, corresponding with 50-57% of the soldiers HRmax. Studying all exercises, mean HR was 105 ± 11 beats min-1, 54 ± 5% of HRmax corresponding to light work intensity. Soldiers performed between 2.8 and 4.9 accelerations/min in the different exercises. A significant correlation between V̇O2peak (mL kg-1 min-1) and acceleration and m/min were found, implying that soldiers with good aerobic capacity were able to cope better with tasks requiring quick movements. CONCLUSION: Conducting military operations in urban terrain and retrograde operations in rough terrain strains ground combat soldiers' cardiorespiratory system, with work intensities close to 40% of maximal aerobic capacity in 15-33% of mission time. Tasks with external load carriage include change of direction, accelerations, bounds, and jumping over obstacles, and physical fitness tests should replicate this. Findings in this study also add objective data to the physiological demands of work performed by combat soldiers while conducting urban operations and retrograde operations in rough terrain. These findings could be used to develop a model for classifying work demands for ground combat forces.

Musculoskeletal pain and its association with health status, maturity, and sports performance in adolescent sport school students: a 2-year follow-up.

BACKGROUND: Musculoskeletal pain and its risk factors are rarely assessed in studies on adolescent athletes. The aim was to identify risk factors at baseline that were associated with the persistence or development of musculoskeletal pain at a two-year follow-up in adolescent sport school students, and to study cross-sectional associations at follow-up between musculoskeletal pain and sports performance. METHODS: Sport school students (79 boys and 52 girls, aged 14 years at baseline) were divided into infrequent (never-monthly) or frequent (weekly-almost daily) pain groups, based on frequency of pain using a pain mannequin. Logistic regression analyses were performed to study longitudinal associations between frequent pain at follow-up and baseline variables: pain group, number of regions with frequent pain, health status by EQ-5D, maturity offset (pre, average, or post peak height velocity), and sports (contact or non-contact). Linear regression analyses were used to study cross-sectional associations between pain groups and 20-m sprint, agility T-test, counter-movement jump, and grip strength at follow-up. Results were stratified by sex. RESULTS: A higher percentage of girls than boys reported frequent pain at follow-up (62% vs. 37%; p = 0.005). In boys, frequent pain at follow-up was associated with being pre peak height velocity at baseline (OR 3.884, CI 1.146-13.171; p = 0.029) and participating in non-contact sports (OR 3.429, CI 1.001-11.748; p = 0.050). In girls, frequent pain at follow-up was associated with having frequent pain in two or more body regions at baseline (OR 3.600, CI 1.033-12.542; p = 0.044), having a worse health status at baseline (OR 3.571, CI 1.026-12.434; p = 0.045), and participating in non-contact sports (OR 8.282, CI 2.011-34.116; p = 0.003). In boys, frequent pain was associated with worse performances in 20-m sprint and counter-movement jump, but not in agility T-test and grip strength. CONCLUSIONS: Baseline risk factors for having frequent pain at follow-up were late maturation in boys, frequent pain and worse health status in girls, and participation in non-contact sports in both sexes. Boys with pain performed worse in sports tests. Coaches and school health-care services should pay attention to the risk factors and work towards preventing pain from becoming persistent.

Structural and immunoendocrine remodeling in gut, pancreas and thymus in weaning rats fed powdered milk diets rich in Maillard reactants.

Western diet is extending worldwide and suspected to be associated with various metabolic diseases. Many food products have skim milk powder added to it and, during processing, lactose reacts with milk proteins and Maillard reaction products (MRPs) are formed. Dietary MRPs are suggested risk factors for metabolic dysregulation, but the mechanisms behind are still enigmatic. Here we describe that weaning rats fed diets rich in MRPs are affected in both their immune and endocrine systems. Marked structural changes in pancreas, intestine and thymus are noted already after 1 week of exposure. The pancreatic islets become sparser, the intestinal mucosa is thinner, and thymus displays increased apoptosis and atrophy. Glucagon- like peptide-1 (GLP-1) seems to play a key role in that the number of GLP-1 expressing cells is up-regulated in endocrine pancreas but down-regulated in the intestinal mucosa. Further, intestinal GLP-1-immunoreactive cells are juxta positioned not only to nerve fibres and tuft cells, as previously described, but also to intraepithelial CD3 positive T cells, rendering them a strategic location in metabolic regulation. Our results suggest dietary MRPs to cause metabolic disorders, dysregulation of intestinal GLP-1- immunoreactive cells, arrest in pancreas development and thymus atrophy.

Cardiorespiratory responses of load carriage in female and male soldiers.

PURPOSE: To investigate the effect of sex and load carriage on cardiorespiratory responses to high intensity exercise in male and female soldiers. METHODS: Soldiers (9 women, 9 men) performed a graded treadmill test until exhaustion with no load (NL) and combat-gear with body armor (CG). Cohen's d effect sizes, paired t-tests and ANOVA were used to study differences between conditions. A mixed linear regression model analyzed the relationship between heart rate (HR) and oxygen uptake (V̇O2) with load and between sexes. RESULTS: Wearing CG resulted in, for both sexes, a decreased time to exhaustion (-11 min), lower V̇O2peak (L/min) ES = 0.56; VO2peak (mL//kg/min) ES = 2.44, both p < 0.001, a net decrease in minute ventilation (ES = 3.53) and no change in HRmax. No sex-difference were present except for absolute V̇O2peak. The VO2 and HR relationship showed a cardiorespiratory reduction wearing CG vs. NL. Added load was equal between sexes, although female soldiers' CG relative to body mass was higher (25%) than male soldiers' (20%), p < 0.01. CONCLUSION: Wearing CG reduces soldiers' cardiorespiratory capacity and exercise performance level, although the reduction cannot be explained solely based on the added load of CG, instead CG seems to restrict the capacity to fully ventilate. No sex differences were found in relative cardiorespiratory responses to wearing CG compared to NL.

Differences in kinematics and driver performance in elite female and male golfers.

The aim of this study was to compare swing kinematic differences between women and men and investigate which variables predict clubhead speed (CHS) and carry distance (CD) whilst accounting for individual variation. METHODS: Swing kinematics and driver performance data were collected on 20 (10 women) elite golfers (HCP 0.7 ± 1.4). We used Bayesian T-test for between sex comparison of swing kinematics and Bayesian Analysis of covariance (ANCOVA) to produce general linear models for CHS and carry distance for elite female and male golfers separately. RESULTS: There was strong evidence that the driver performance variables CHS and CD were decreased in women compared to men, and two kinematic variables; time to arm peak speed downswing and angular wrist peak speed were slower in women. The ANCOVAs identified very strong to overwhelming evidence that participant as a fixed factor was a determinant of CHS for both women and men but was not a determinant of CD. CONCLUSION: when looking to enhance driver performance among high-level golfers, coaches should be aware that variables that determine CHS and CD differ among women and men and if the aim is to improve CHS coaches should not forget the importance of individual swing characteristics.

Yes, MAM: how the cancer-related EMP3 protein became a regulator of erythropoiesis and the key protein underlying a new blood group system.

The MAM blood group system (International Society of Blood Transfusion [ISBT] 041) consists of one high-prevalence antigen to date, first detected in a 31-year-old woman during her third pregnancy. Epithelial membrane protein 3 (EMP3) was recently identified as the gene coding the MAM antigen. Six unique genetic variants have been described in EMP3 in 11 MAM- individuals. EMP3 is an 18-kDa glycoprotein with a large extracellular domain containing at least one N-glycosylation site. The normal function of EMP3 is still unclear, but ex vivo culture of erythropoietic progenitor cells from MAM- individuals shows an increased yield of reticulocytes, suggesting that EMP3 acts as a brake during normal erythropoiesis. EMP3 is abundant on different cell types, including many epithelial tissues and blood cells. Interestingly, EMP3 expression has been suggested as a prognostic marker for a number of cancer types, both for good and poor prognoses. EMP3 may act as a tumor suppressor or an oncogene in different cancer contexts. The protein appears to interact with other cell surface receptors and affects the downstream signaling and function of these proteins. MAM- red blood cells express low levels of CD44 and, consequently, the antigens of the Indian blood group system are only weakly expressed. Clinically, the MAM blood group antigen is important with regard to blood transfusion and pregnancy. Anti-MAM can cause severe hemolytic disease of the fetus and newborn in some pregnancies but have little to no effect in other pregnancies. Cases are typically not detected until problems occur during pregnancy, making the availability of compatible blood a challenge.

Individual telomere dynamics and their links to life history in a viviparous lizard.

Emerging patterns suggest telomere dynamics and life history are fundamentally linked in endotherms through life-history traits that mediate the processes underlying telomere attrition. Unlike endotherms, ectotherms maintain the ability to lengthen somatic telomeres throughout life and the link between life-history strategies and ectotherm telomere dynamics is unknown. In a well-characterized model system (Niveoscincus ocellatus), we used long-term longitudinal data to study telomere dynamics across climatically divergent populations. We found longer telomeres in individuals from the cool highlands than those from the warm lowlands at birth and as adults. The key determinant of adult telomere length across populations was telomere length at birth, with population-specific effects of age and growth on adult telomere length. The reproductive effort had no proximate effect on telomere length in either population. Maternal factors influenced telomere length at birth in the warm lowlands but not the cool highlands. Our results demonstrate that life-history traits can have pervasive and context-dependent effects on telomere dynamics in ectotherms both within and between populations. We argue that these telomere dynamics may reflect the populations' different life histories, with the slow-growing cool highland population investing more into telomere lengthening compared to the earlier-maturing warm lowland population.

Low sun exposure habits is associated with a dose-dependent increased risk of hypertension: a report from the large MISS cohort.

In prospective observational cohort studies, increasing sun exposure habits have been associated with reduced risk of cardiovascular mortality. Our aim was to assess possible observational mechanisms for this phenomenon. A written questionnaire was answered by 23,593 women in the year 2000 regarding risk factors for melanoma, including factors of possible interest for hypertension, such as detailed sun exposure habits, hypertension, marital status, education, smoking, alcohol consumption, BMI, exercise, and chronic high stress. Hypertension was measured by the proxy "use of hypertension medication" 2005-2007, and high stress by "need of anti-depressive medication". Sun exposure habits was assessed by the number of `yes' to the following questions; Do you sunbath during summer?, During winter vacation?, Do you travel south to sunbath?, Or do you use sun bed? Women answering 'yes' on one or two questions had moderate and those answering 'yes' on three or four as having greatest sun exposure. The main outcome was the risk of hypertension by sun exposure habits adjusted for confounding. As compared to those women with the greatest sun exposure, women with low and moderate sun exposure were at 41% and 15% higher odds of hypertension (OR 1.41, 95% CI 1.3‒1.6, p < 0.001 and OR 1.15, 95% CI 1.1‒1.2, p < 0.001), respectively. There was a strong age-related increased risk of hypertension. Other risk factors for hypertension were lack of exercise (OR 1.36), a non-fair phenotype (OR 1.08), chronic high stress level (OR 1.8), and lack of university education (OR 1.3). We conclude that in our observational design sun exposure was associated with a dose-dependent reduced risk of hypertension, which might partly explain the fewer deaths of cardiovascular disease with increasing sun exposure.

Transcriptomes from German shepherd dogs reveal differences in immune activity between atopic dermatitis affected and control skin.

Canine atopic dermatitis (CAD) is an inflammatory and pruritic allergic skin disease with both genetic and environmental risk factors described. We performed mRNA sequencing of non-lesional axillary skin biopsies from nine German shepherd dogs. Obtained RNA sequences were mapped to the dog genome (CanFam3.1) and a high-quality skin transcriptome was generated with 23,510 expressed gene transcripts. Differentially expressed genes (DEGs) were defined by comparing three controls to five treated CAD cases. Using a leave-one-out analysis, we identified seven DEGs: five known to encode proteins with functions related to an activated immune system (CD209, CLEC4G, LOC102156842 (lipopolysaccharide-binding protein-like), LOC480601 (regakine-1-like), LOC479668 (haptoglobin-like)), one (OBP) encoding an odorant-binding protein potentially connected to rhinitis, and the last (LOC607095) encoding a novel long non-coding RNA. Furthermore, high mRNA expression of inflammatory genes was found in axillary skin from an untreated mild CAD case compared with healthy skin. In conclusion, we define genes with different expression patterns in CAD case skin helping us understand post-treatment atopic skin. Further studies in larger sample sets are warranted to confirm and to transfer these results into clinical practice.

Clinical characteristics distinguishing tramadol-using adolescents from other substance-using adolescents in an out-patient treatment setting.

BACKGROUND: Non-medical Prescription Opioid Use (NMPOU) has increased worldwide during the last decades, and specifically, tramadol misuse may represent a novel pattern of substance use among adolescents. The present study aims to analyze characteristics distinguishing tramadol-using adolescents from other substance-using adolescents seeking out-patient treatment. METHODS: This is a cross-sectional study of treatment-seeking patients between 13 and 24 years of age in an out-patient facility for substance use problems in Malmö, Sweden. A total of 526 treatment-seeking adolescents at an out-patient treatment center were included. Data on substance use, treatment history and socio-demographic variables were extracted through a semi-structured interview method aimed specifically for adolescents with alcohol or drug problems (Ung-DOK). Lifetime tramadol users were compared to non-users, and also, primary tramadol users were compared to remaining subjects. RESULTS: Thirty-one percent (n = 162) were tramadol users (lifetime prevalence). In logistic regression, the tramadol group showed a significantly increased risk of tobacco use, problematic lifetime cocaine, benzodiazepine and amphetamine use, and were more likely to report contacts with the judicial system, and less likely to report contacts with child or adult psychiatry, and more likely to have parents born outside the Scandinavian countries. In logistic regression, primary tramadol use was negatively associated with frequent cannabis use. CONCLUSIONS: Tramadol use appears to be a novel pattern among treatment-seeking adolescents. They showed a significantly increased risk of initiation of other illicit drugs and criminal behaviour, despite less contact with psychiatric care. More attention may be needed to this relatively novel pattern of opioid use.

Relative Age Effect of Sport Academy Adolescents, a Physiological Evaluation.

The relationship between birth quarter distribution and physiological characteristics related to athletic skills, in adolescent sport academy students has not been fully investigated. In a cross-sectional study, we recruited 86 boys and 52 girls aged 12-14 years during their first term at a sport academy school. We measured body size, cardiac size, pulmonary function, body composition, lower body power, cardiorespiratory fitness parameters, and running endurance by standard methods and analyzed these estimates in relation to birth quarter by ANOVA. Birth quarter distribution in our cohort was compared with birth quarter distribution in the same ages in the whole of Sweden and analyzed by logistic regression. The academy had an overrepresentation of students born in the first quartile of the year compared to those born in the last quartile (odds ratio 2.3 (95% CI: 1.1-4.7)). When comparing the physiological characteristics between birth quarters, uniformity is prominent since out of 26 performed physiological and anthropometric tests only four showed statistically significant group differences. We thus believe that the selection process to the sport academy favours athletes with higher chronological age, i.e., a so-called relative age effect is present.

The cost of childhood atopic dermatitis in a multi-ethnic Asian population: a cost-of-illness study.

BACKGROUND: Childhood atopic dermatitis can often have a negative impact on quality of life for affected children and their caregivers. The condition contributes to increased healthcare costs and can pose heavy economic burdens on healthcare systems and societies. OBJECTIVES: The objective of this study is to provide a comprehensive estimate of the economic burden of childhood atopic dermatitis in a Singaporean sample and to investigate associated factors. METHODS: This cross-sectional cost-of-illness study applied a societal perspective. Data was collected between December 2016 and December 2017 in Singapore. Caregivers to children below 16 years of age with a physician-confirmed diagnosis of atopic dermatitis were recruited and sociodemographics, clinical characteristics, health service utilization data and time spent on caregiving were collected from all eligible participants. RESULTS: The average annual cost per child with atopic dermatitis was estimated at U.S. dollars (USD) 7943 (mild USD 6651, moderate USD 7935 and severe USD 14 335) in 2017 prices. The major cost was for informal caregiving (46% of the total cost) followed by out-of-pocket expenses (37%). Healthcare utilization contributed to 17% of the total cost of which 43% was for medications. CONCLUSIONS: Childhood atopic dermatitis imposes substantial costs with a large proportion arising from informal caregiving and out-of-pocket expenses. The costs related to atopic dermatitis are also strongly related to disease severity. This information is important for policy makers and other health planners when considering how to better support affected families. What's already known about the topic? Childhood atopic dermatitis is a costly disease for society. However, comprehensive cost estimations are lacking. Previous cost studies are old, based on small sample sizes or are healthcare-setting specific. What does this study add? This study comprises a health economic evaluation assessing different levels of care and includes various categories of costs. The result showed that informal caregiving was the most prominent cost for children with atopic dermatitis.

Development and application of a questionnaire to self-rate physical work demands for ground combat soldiers.

PURPOSE: The aim of the present study was to identify the most physically demanding work tasks for Swedish ground combat soldiers through the development and application of a questionnaire survey. This is the first in a series of studies aiming to describe the development process and validation of physical selection standards in the Swedish armed forces. METHODS: Based on procedural documentation, combat manuals and job analyses, a questionnaire was developed that defined and rated the perceived physical strain of 30 work tasks for ground combat soldiers. To assess validity, an expert focus group was used and psychometric analysis performed. The questionnaire was then distributed to 231 ground combat soldiers, of whom 165 responded (71%). RESULTS: The questionnaire was validated in three steps to achieve face and content validity, and internal consistency was acceptable (Chronbach's alpha ≥0.95). Of the 30 work tasks included in the survey, transport of wounded was rated as the most demanding task for both aerobic capacity and strength. Other highly demanding tasks for aerobic capacity included combat movement (low/high crawl), dismounted attack in close country, urban and rough terrain and carrying heavy loads. There were no gender differences for either aerobic or strength demands in the top five most challenging tasks based on proportions. CONCLUSIONS: This study identified the most physically demanding tasks performed in the Swedish ground combat forces. Almost all the physically demanding tasks found in the present study contain elements of lifting and carrying, which require muscular strength and muscular endurance, with no gender differences.

Biological motion during inflammation in humans.

Biological motion is a powerful perceptual cue that can reveal important information about the inner state of an individual. Activation of inflammatory processes likely leads to changes in gait, posture, and mobility patterns, but the specific characteristics of inflammation-related biological motion have not been characterized. The aim of this study was to determine the effect of inflammation on gait and motion in humans. Systemic inflammation was induced in 19 healthy volunteers with an intravenous injection of lipopolysaccharide (2 ng/kg body weight). Biological motion parameters (walking speed, stride length and time, arm, leg, head, and shoulder angles) were assessed during a walking paradigm and the timed-up-and-go test. Cytokine concentrations, body temperature, and sickness symptoms were measured. During inflammation, compared to placebo, participants exhibited shorter, slower, and wider strides, less arm extension, less knee flexion, and a more downward-tilting head while walking. They were also slower and took a shorter first step in the timed-up-and-go test. Higher interleukin-6 concentrations, stronger sickness symptoms, and lower body temperature predicted the inflammation-related alterations in biological motion. These findings show that biological motion contains clear information about the inflammatory status of an individual, and may be used by peers or artificial intelligence to recognize that someone is sick or contagious.

Pregnancy-associated plasma protein-A2 levels are increased in early-pregnancy gestational diabetes: a novel biomarker for early risk estimation.

AIM: To determine whether pregnancy-associated plasma protein-A2 levels are increased in early pregnancies complicated by gestational diabetes and whether gestation age influences levels. The possible use of pregnancy-associated plasma protein-A2 as a pre-screening biomarker to reduce the need for performing oral glucose tolerance tests in pregnant women was also investigated. METHODS: Pregnant women were diagnosed with gestational diabetes in early pregnancy after a 2-hour 75 g oral glucose tolerance test in the catchment area of Skåne University Hospital, Lund, Sweden during 2011-2015 (n = 99). Age- and BMI-matched pregnant women without diabetes were recruited at similar gestational ages from maternal healthcare centres in the same geographical area during 2014-2015 to act as controls (n = 100). Circulating pregnancy-associated plasma protein-A2 was analysed in participant serum using commercially available enzyme-linked immunosorbent assay kits. RESULTS: Circulating pregnancy-associated plasma protein-A2 was increased in women diagnosed with gestational diabetes [13.5 (9.58-18.8) ng/ml] compared with controls [8.11 (5.74-11.3) ng/ml; P < 0.001]. Pregnancy-associated plasma protein-A2 was associated with gestational diabetes independent of age, BMI, C-peptide and adiponectin (P < 0.001). Pregnancy-associated plasma protein-A2 as a pre-screening biomarker to identify women at a decreased risk of gestational diabetes resulted in a negative predictive value of 99.7%, with a sensitivity of 96% and a specificity of 30% at a cut-off level of 6 ng/ml. CONCLUSIONS: This is the first study to show increased pregnancy-associated plasma protein-A2 levels in gestational diabetes. Pregnancy-associated plasma protein-A2 also shows promise as a pre-screening biomarker with the potential to reduce the need for performing oral glucose tolerance tests in early pregnancy. Future prospective cohort studies in a larger group of both high- and low-risk women are, however, needed to further confirm this observation.

A Novel Method for Classification of Running Fatigue Using Change-Point Segmentation.

Blood lactate accumulation is a crucial fatigue indicator during sports training. Previous studies have predicted cycling fatigue using surface-electromyography (sEMG) to non-invasively estimate lactate concentration in blood. This study used sEMG to predict muscle fatigue while running and proposes a novel method for the automatic classification of running fatigue based on sEMG. Data were acquired from 12 runners during an incremental treadmill running-test using sEMG sensors placed on the vastus-lateralis, vastus-medialis, biceps-femoris, semitendinosus, and gastrocnemius muscles of the right and left legs. Blood lactate samples of each runner were collected every two minutes during the test. A change-point segmentation algorithm labeled each sample with a class of fatigue level as (1) aerobic, (2) anaerobic, or (3) recovery. Three separate random forest models were trained to classify fatigue using 36 frequency, 51 time-domain, and 36 time-event sEMG features. The models were optimized using a forward sequential feature elimination algorithm. Results showed that the random forest trained using distributive power frequency of the sEMG signal of the vastus-lateralis muscle alone could classify fatigue with high accuracy. Importantly for this feature, group-mean ranks were significantly different (p < 0.01) between fatigue classes. Findings support using this model for monitoring fatigue levels during running.