Confined acoustic line modes within a glide-symmetric waveguide.

Confined coupled acoustic line-modes supported by two parallel lines of periodic holes on opposite surfaces of a glide-symmetric waveguide have a hybrid character combining symmetric and anti-symmetric properties. These hybrid coupled acoustic line-modes have a near constant group velocity over a broad frequency range as no band gap is formed at the first Brillouin zone boundary. We show that the hybrid character of these confined modes is tuneable as a function of the spacing between the two surfaces. Further we explore how the band-gap reappears as the glide symmetry is broken.

Correlates of Balance and Aerobic Indices in Lower-Limb Prostheses Users on Arm Crank Exercise.

BACKGROUND: The HUMAC Balance System (HBS) offers valid measurement of balance, and the arm crank exercise test (ACE) is a valid measure of physiological capacity. Neither have been used to evaluate associations between balance and physiological capacity in lower-limb amputees. METHODS: Thirty-five participants with lower-limb amputations were recruited. Standing balance (center of pressure) was evaluated during eyes opened (EO) and eyes closed (EC) conditions using the HBS. Participants performed ACE graded exercise testing (GXT) to evaluate aerobic capacity. Spearman's rho was used to identify relationships between variables. Cut-points for three groups were generated for time on ACE. Mann-Whitney U tests were used to explore significant differences in variables of balance and ACE between low and high performers. RESULTS: Relationships between variables of eyes open displacement (EOD), eyes open velocity (EOV), eyes closed displacement (ECD), and eyes closed velocity (ECV) were significant (p < 0.05), and high performers with EO also performed best with EC. Longer exercise times were significantly associated with increased HRpeak, VO2peak, VEpeak, and RERpeak (p < 0.05). HRpeak (143.0 ± 30.6 b/min), VO2peak (22.7 ± 7.9 and 10.6 ± 4.7 mL/kg/min), VEpeak (80.2 ± 22.2 and 33.2 ± 12.7 L/min), and RERpeak (1.26 ± 0.08 and 1.13 ± 0.11) were significantly greater in high performers than low performers, respectively (p < 0.05). There was no significant association among VO2peak and any balance task variables; however, there were significant associations between some balance and physiological variables. CONCLUSIONS: Findings differentiated high and low performers; however, participants were still well below able-bodied norms of physical capacity. Training to mitigate deconditioning is suggested.

Quantifying Step Count and Oxygen Consumption with Portable Technology during the 2-Min Walk Test in People with Lower Limb Amputation.

Step counts and oxygen consumption have yet to be reported during the 2-min walk test (2MWT) test in persons with lower-limb amputations (LLA). The purpose of this study was to determine step counts and oxygen consumption during the 2MWT in LLA. Thirty-five men and women walked for two minutes as quickly as possible while wearing activity monitors (ActiGraph Link on the wrist (LW) and ankle (LA), Garmin vivofit®3 on the wrist (VW) and ankle (VA), and a modus StepWatch on the ankle (SA), and a portable oxygen analyzer. The StepWatch on the ankle (SA) and the vivofit3 on the wrist (VW) had the least error and best accuracy of the activity monitors studied. While there were no significant differences in distance walked, oxygen consumption (VO2) or heart rate (HR) between sexes or level of amputation (p > 0.05), females took significantly more steps than males (p = 0.034), and those with unilateral transfemoral amputations took significantly fewer steps than those with unilateral transtibial amputations (p = 0.023). The VW and SA provided the most accurate step counts among the activity monitors and were not significantly different than hand counts. Oxygen consumption for all participants during the 2MWT was 8.9 ± 2.9 mL/kg/min, which is lower than moderate-intensity activity. While some may argue that steady-state activity has not yet been reached in the 2MWT, it may also be possible participants are not walking as fast as they can, thereby misclassifying their performance to a lower standard.

The validity and accuracy of wrist-worn activity monitors in lower-limb prosthesis users.

Purpose: To investigate the accuracy of consumer-grade wrist-worn activity monitors during over ground walking in persons using lower-limb prosthetics.Method: Thirty-two participants using lower-limb prosthetics (age = 49.7 ± 14.0 yrs, height = 176.1 ± 11.6 cm, weight = 87.8 ± 21.1 kg) were fitted with a Polar Loop, Fitbit Flex, MOVEBAND, Garmin Vivofit, and a Fitbit Charge on the right and left wrists as well as an Omron HJ-113 pedometer on the right and left hip, then walked 140 m at a self-selected pace on an indoor flat surface.Results: There were no significant differences between any of the respective right and left monitors, p > 0.05. When comparing step counts with actual step counts, Polar Loop (p = 0.001), Fitbit Flex (p = 0.001), and MOVEBAND (p = 0.001) were significantly lower than actual step counts. No significant differences existed between the remaining monitors and actual step counts (p > 0.05). Omron incurred the least error (0.6%), followed by Garmin Vivofit (1.3%) and Fitbit Charge (3.6%), with greatest error in the MOVEBAND (21.4%) and Polar Loop (13.1%). Bland-Altman plots suggest Garmin Vivofit to have the least error along with tightest agreement among the wrist-worn activity monitorsConclusion: When considering the use of consumer-grade wrist-worn activity monitors for assessing step counts in persons using lower-limb prostheses, the Garmin Vivofit seems to be the best option followed by Fitbit Charge.Implications for rehabilitationThis study shows that despite potential of altered gait, some consumer-grade activity monitors can track over ground walking quite well.Clinicians and researchers can use these devices to track activity and prosthetic compliance in their patients.

Leg compressions improve ventilatory efficiency while reducing peak and post exercise blood lactate, but does not improve perceived exertion, exercise economy or aerobic exercise capacity in endurance-trained runners.

PURPOSE: The objective of this study was to determine if leg compressions would alter cardiorespiratory and perceived exertion measures during rest, submaximal and maximal exercise in endurance-trained runners. METHOD: Thirteen young, endurance trained runners (10 males, 20.9±3y, 58.9±5.7mlkgmin-1) completed a randomized design, leg compressions and non-compression control condition. The incremental graded exercise test consisted of baseline rest and submaximal intensities at 23%, 70%, 75%, 85% and then a progressive increase to 100% VO2max. Running economy (RE), rating of perceived exertion (RPE), breathing rate (BR), heart rate (HR), ventilation (VE), blood lactate, VO2max and ventilatory efficiency (VE/VO2) were the primary outcome variables. RESULTS: Relative to the control condition, VO2 at rest, during submaximal and at max were not different. Additionally, RE, RPE, BR, and HR were similar under both conditions. Leg compressions reduced lactate at VO2max by 11% (P<0.05) and at 10min post-exercise recovery by 18% (P<0.01). Additionally, peak VE was significantly reduced in the compression condition by 8% (P<0.0001) relative to the control condition. Ventilatory efficiency was improved in compressions compared to control condition at 85 and 100% VO2max (condition×time interaction, P<0.0001). CONCLUSION: These data suggest that leg compressions do not alter RE, RPE, BR, HR, or VO2, during exercise. However, compressions may be beneficial for submaximal and maximal ventilatory efficiency while improving lactate clearance at VO2max and during recovery in trained runners.

Synthesis and Characterization of bis(Tetrahydrofurfuryl) Ether.

Invited for this month's cover are researchers from the Naval Air Warfare Center Weapons Division (USA). The cover picture shows the elusive symmetric molecule bis (tetrahydrofurfuryl) ether (BTHFE) in the making. For more details, read the full text of the Communication at 10.1002/open.201600013.

Synthesis and Characterization of bis(Tetrahydrofurfuryl) Ether.

Despite the availability of a large number of alkyl tetrahydrofurfuryl ethers that have a wide range of applications, pure bis(tetrahydrofurfuryl) ether (BTHFE) has not been previously synthesized. Here, we report the synthesis of BTHFE (consisting of the RR, SS, and meso stereoisomers) at greater than 99 % purity from tetrahydrofurfuryl alcohol, using (tetrahydrofuran-2-yl)methyl methanesulfonate as an intermediate. Additionally, we demonstrate that BTHFE can be used as a non-volatile solvent in poly(3,4-propylenedioxythiophene)-based supercapacitors. Supercapacitor devices employing solutions of the ionic liquid 1-ethyl-3-methyl-imidizolium bis(trifluoromethylsulfonyl)imide in BTHFE display similar performances to those prepared by using the neat ionic liquid as an electrolyte, although solution-based devices exhibit a somewhat higher resistance.

De novo donor HLA-specific antibodies predict development of bronchiolitis obliterans syndrome after lung transplantation.

BACKGROUND: Bronchiolitis obliterans syndrome (BOS) is the major cause of late graft failure after lung transplantation. The objective was to determine whether de novo donor human leukocyte antigen (HLA)-specific antibodies (DSA) are associated with the development of BOS or patient survival. Data were analyzed from 188 lung transplant recipients with a follow-up period up to 8 years. METHODS: HLA antibody monitoring was performed at 3-month intervals post-transplant at routine outpatient clinic attendances and during the investigation of any acute deterioration. HLA antibody data were available for 148 patients; 66 (45%) had produced HLA antibodies after transplant, of which 38 (26%) were DSA and 28 (19%) non-donor-specific HLA antibodies. RESULTS: De novo DSA was associated with development of BOS Stage 1 (BOS1; hazard ratio [HR] = 2.302, p = 0.0015), BOS2 (HR = 3.627, p < 0.0001) and BOS3 (HR = 5.736, p < 0.0001). De novo persistent DSA correlated strongly with shorter time to onset of BOS3 (HR = 6.506, p = 0.0001). There was a significant reduction in patient survival associated with de novo DSA (HR = 1.886, p = 0.047). In multivariable analyses, de novo DSA was an independent predictor for development of all stages of BOS as well as an independent predictor of poor patient survival. CONCLUSIONS: De novo DSA is a major risk factor for progression to BOS and shorter patient survival. Treatments to remove antibodies or limit antibody-mediated damage could be considered when DSA are first detected. However, a randomized, controlled trial of treatment options would enable a clearer understanding of the benefits, if any, of antibody-removal therapies.

Role of anti-vimentin antibodies in renal transplantation.

BACKGROUND: The role of non-HLA antibodies in rejection is not clear. We investigate whether antibodies to vimentin are made after renal transplantation and if production is associated with interstitial fibrosis and tubular atrophy (IFTA). METHODS: In this retrospective study, sera from 70 recipients of renal allografts (40 controls, 30 IFTA) were studied. The biopsy diagnosis of interstitial fibrosis and tubular atrophy (IFTA) was based on random, cause-indicating biopsies. Sera were collected pretransplant and at 3 monthly intervals up to 5 years posttransplant or diagnosis of IFTA and assayed by ELISA for IgM and IgG anti-vimentin antibodies (AVA) and HLA antibodies. RESULTS: Mean titers of IgM AVA were higher at every year after transplantation compared with pretransplant for both IFTA and controls groups (P<0.001). There was no difference in the mean level of IgM AVA achieved by IFTA and control groups. The mean pretransplant levels of IgG AVA in the IFTA and control group were 18.2±11.7 and 11.0±8.1, respectively (P=0.001). There was a significant increase between the pretransplant mean levels of IgG AVA and the levels at years 1 to 4 in the IFTA group (years 1-3, P<0.0001, year 4 P=0.003) but not in the controls. There was no significant difference between the numbers of IFTA or control patients achieving a positive value (mean+2SD of pretransplant antibody titers) of IgM AVA (50% versus 37.5%, respectively) or IgG AVA (26.6% versus 12.5%, respectively). There was no association between production of HLA and AVA antibodies. CONCLUSION: Posttransplant production of IgM AVA is not associated with IFTA. The production of IgG AVA by a minority of IFTA patients suggests that in some individuals, IgG AVA may be involved in the pathology of IFTA.

Pre-transplant donor HLA-specific antibodies: characteristics causing detrimental effects on survival after lung transplantation.

BACKGROUND: The impact of Luminex-detected HLA antibodies on outcomes after lung transplantation is unclear. Herein we have undertaken a retrospective study of pre-transplant sera from 425 lung transplants performed between 1991 and 2003. METHODS: Pre-transplant sera, originally screened by complement-dependent cytotoxicity (CDC) assays, were retrospectively tested for the presence of HLA-specific antibodies using HLA-coated Luminex beads and C4d deposition on Luminex beads. The results were correlated with graft survival at 1 year. RESULTS: Twenty-seven patients were retrospectively identified as having been transplanted against donor-specific HLA antibodies (DSA) and 36 patients against non-donor-specific HLA antibodies (NDSA). DSA-positive patients had 1-year survival of 51.9% compared with 77.8% for NDSA and 71.8% for antibody-negative patients (p = 0.029). One-year survival of patients with complement-fixing DSA was 12.5% compared with 62.5% for non-complement-fixing DSA, 75.8% for non-complement-fixing NDSA and 71.8% for antibody-negative patients (p < 0.0001). DSA-positive patients with mean fluorescence intensity (MFI) >5,000 had 1-year survival of 33.3% compared with 71.4% for MFI 2,000 to 5000 and 62.5% for MFI <2,000 (p = 0.0046). Multivariable analysis revealed DSA to be an independent predictor of poor patient survival within 1 year (p = 0.0010, hazard ratio [HR] = 3.569) as well as complement-fixing DSA (p < 0.0001, HR = 11.083) and DSA with MFI >5,000 (p = 0.0001, HR = 5.512). CONCLUSIONS: Pre-formed DSA, particularly complement-fixing DSA, and high MFI are associated with poor survival within the first year after lung transplantation. Risk stratification according to complement fixation or MFI levels may allow for increased transplantation in sensitized patients.

Poly(2,5-bis(N-Methyl-N-Hexylamino)Phenylene Vinylene) (BAM-PPV) as Pretreatment Coating for Aerospace Applications: Laboratory and Field Studies.

In this study, an electroactive polymer (EAP), poly(2,5-bis(N-methyl-N-hexylamino)phenylene vinylene) (BAM-PPV) was investigated as a potential alternative surface pretreatment for hexavalent chromium (Cr(VI))-based aerospace coatings. BAM-PPV was tested as a pretreatment coating on an aerospace aluminum alloy (AA2024-T3) substrate in combination with a non-Cr(VI) epoxy primer and a polyurethane Advanced Performance Coating (APC) topcoat. This testing was undertaken to determine BAM-PPV's adhesion, corrosion-inhibition, compatibility and survivability in laboratory testing and during outdoor field-testing. BAM-PPV showed excellent adhesion and acceptable corrosion performance in laboratory testing. The BAM-PPV aerospace coating system (BAM-PPV, non-Cr(VI) epoxy primer and polyurethane APC topcoat) was field tested for one year on the rear hatch door of the United States Air Force C-5 cargo plane. After one year of field testing there was no evidence of delamination or corrosion of the BAM-PPV aerospace coating system.

Solid phase assay measuring C4d deposition to determine complement fixation by HLA-specific antibodies.

The definition of HLA-specific antibodies in solid organ transplant patients is a necessary tool for recipient selection prior to transplantation and monitoring for rejection post transplant. Solid phase assays can detect both complement fixing and non-complement fixing HLA-specific antibodies. Here we describe a method for determining the presence of complement fixing HLA-specific antibodies using a sensitive solid phase assay.

Influence of weight classification on walking and jogging energy expenditure prediction in women.

The purpose of this study was to determine the influence of weight classification on predicting energy expenditure (EE) in women. Twelve overweight (body mass index [BMI] = 25-29.99 kg/m(2)) and 12 normal-weight (BMI = 18.5-24.99 kg/m(2)) women walked and jogged 1,609 m at 1.34 ms(-1) and 2.23 ms(-1), respectively, while EE was assessed using indirect calorimetry and compared to several other prediction methods (American College of Sports Medicine [ACSM], 2010; Heyward, 2006; Léger & Mercier, 1984; McArdle, Katch, & Katch, 2006; Pandolf Givoni, & Goldman, 1978; van der Walt & Wyndham, 1973). More error occurred with overweight EE prediction compared to normal-weight EE prediction. The ACSM and Heyward methods for walking and the McArdle et al. method for jogging most accurately predicted EE for both groups. Weight classification influences EE prediction accuracy and, thus, is important to consider when using these prediction methods.

Late antibody-mediated rejection after heart transplantation following the development of de novo donor-specific human leukocyte antigen antibody.

BACKGROUND: Antibody-mediated rejection (AMR) is an important problem after heart transplantation. Most cases seem to occur in sensitized recipients with preformed donor-specific human leukocyte antigen antibody (DSA) early after transplantation. Few data exist on AMR in patients who form de novo DSA. We describe the clinical features and treatment outcome for late AMR secondary to de novo DSA. METHODS: This was a retrospective, observational cohort study. All heart transplant patients treated for symptomatic AMR secondary to de novo DSA between November 2005 and August 2011. RESULTS: Fifteen patients were treated for AMR giving an incidence of 3.1 cases per 1000 person years and a prevalence of 1.4%. All had evidence of heart failure on presentation and de novo DSA at diagnosis. There was a spectrum of histologic and immunohistochemical findings. Despite treatment with immunepheresis, intravenous immunoglobulin, and rituximab, and in some cases total lymph node irradiation (n=3) and bortezomib (n=2), clinical outcomes were poor. DSA antibody levels, measured using Labscreen single antigen kits, were reduced by a mean of 76% with a median of 77% and a range of 35% to 99%, but were not eliminated. Forty-six percent had persistent cardiac allograft dysfunction. Mean and median survival was 1.3 and 0.8 years after diagnosis of AMR. Only 40% were alive at the end of the study period. CONCLUSION: Late cardiac AMR caused by de novo DSA was an uncommon but serious problem. Despite treatment consistent with current best practice, 46% of patients developed persistent cardiac dysfunction and their medium-term survival was poor.

The effect of abdominal exercise on abdominal fat.

The purpose of this study was to investigate the effect of abdominal exercises on abdominal fat. Twenty-four healthy, sedentary participants (14 men and 10 women), between 18 and 40 years, were randomly assigned to 1 of the following 2 groups: control group (CG) or abdominal exercise group (AG). Anthropometrics, body composition, and abdominal muscular endurance were tested before and after training. The AG performed 7 abdominal exercises, for 2 sets of 10 repetitions, on 5 d·wk(-1) for 6 weeks. The CG received no intervention, and all participants maintained an isocaloric diet throughout the study. Significance was set at p = 0.05 for all tests. There was no significant effect of abdominal exercises on body weight, body fat percentage, android fat percentage, android fat, abdominal circumference, abdominal skinfold and suprailiac skinfold measurements. The AG performed significantly greater amount of curl-up repetitions (47 ± 13) compared to the CG (32 ± 9) on the posttest. Six weeks of abdominal exercise training alone was not sufficient to reduce abdominal subcutaneous fat and other measures of body composition. Nevertheless, abdominal exercise training significantly improved muscular endurance to a greater extent than the CG.

Pedometer use in university freshmen: a randomized controlled pilot study.

OBJECTIVES: To describe activity patterns associated with a pedometer intervention in university freshmen and compare the intervention participants to controls for several health outcomes. METHODS: Forty-six university freshmen were randomized to a group that wore a pedometer across the academic year with a goal of 10,000 steps/day or to a control group. RESULTS: Pedometer counts were highest initially but decreased over the academic year. December presented the fewest counts. There was little difference between groups in fitness or body composition. CONCLUSIONS: Consideration of high-risk months and recommended steps/day may be important to effectively use pedometers to influence some health outcomes in university freshmen.

Diffraction from the edge of a thin elastic half plane and implications for panel measurements.

Solutions for the diffraction of a plane wave from the edge of a semi-infinite, thin elastic plate are presented. A thin plate formulation that takes into account the coupling into both symmetric and antisymmetric waves on the plate is used. The symmetric contributions are found to be small for steel in water but can be significant for plastic plates. Expansions in terms of the fluid loading parameter are used in the far field of the edge to explore the effect of the diffraction from a single edge on transmission measurements. Examples for steel and polymethylmethacrylate in water are presented.

Clinical relevance of complement-fixing antibodies in cardiac transplantation.

This paper includes a review of the relative importance of pretransplant complement-fixing and non-complementing-fixing human leukocyte antigen (HLA) and non-HLA antibodies (Abs). Sera from 565 adult cardiac transplant recipients were retrospectively analysed for the presence of HLA antibodies using complement-dependent cytotoxicity (CDC), HLA-coated Luminex beads, and C4d deposition on Luminex beads and results were correlated with graft survival. Of 565 patients, 14 had CDC-positive donor-specific Abs (DSA) before their transplant. This number was increased by 53 using Luminex beads; of these, 19 had DSA by Luminex. Patients negative for CDC crossmatch, but Luminex positive with DSA demonstrated poor 1-year survival (42%) compared with 77% 1-year survival of patients with CDC-negative, Luminex positive non-donor-specific Abs. The effect of donor-specific Abs on allograft survival was further analyzed according to titer, immunoglobulin subclass, and ability to fix C4d onto Luminex beads. The ability to fix C4d, but not Ab titer or Ig subclass, was strongly associated with poor allograft survival (p = 0.0002). A retrospective analysis of sera from 616 cardiac transplant patients indicated the presence of immunoglobulin M complement-fixing non-HLA Abs was associated with early graft failure and a diagnosis of primary graft failure. In conclusion, complement-fixing Abs to relevant antigens are associated with poor allograft survival after heart transplantation.

A reevaluation of the role of IgM Non-HLA antibodies in cardiac transplantation.

BACKGROUND: Preexisting IgG antibodies to donor human leukocyte antigens (HLA) are a risk factor for rapid allograft rejection. However, non-HLA antibodies, of the IgM class, also called autoreactive antibodies, are not believed to affect graft survival. The aim of this study was to determine the incidence and clinical relevance of pretransplant lymphocytotoxic non-HLA IgM antibodies on long-term cardiac allograft survival. METHODS: A retrospective study of 616 adult recipients of cardiac allografts, transplanted at this center between 1991 and 2003, has been performed. Antibodies in pretransplant sera were initially defined using complement-dependent cytotoxicity assays, and subsequently analyzed for HLA specificities using solid phase assays. RESULTS: HLA antibodies were present in 69 of 616 heart recipients (58 IgG, 11 IgM); in 22 of these, the antibodies were donor-specific. Non-HLA IgM antibodies were detected in 59 of 616 recipients who did not have HLA-specific antibodies; these patients had a 1, 2, 5, and 10 year survival of 55.9%, 54.2%, 49.9%, and 43.3% compared with 75.8%, 73.7%, 66.6%, and 52.8% for those without antibodies (P=0.0085 log-rank test). Multivariate analysis demonstrated pretransplant non-HLA IgM antibodies to be an independent risk factor for mortality (P=0.0001). Myocardial histology of postmortem heart and cardiac biopsies suggested an association with ischemic damage and "primary" allograft failure. CONCLUSIONS: We propose the hypothesis that the presence of cytotoxic IgM antibodies to non-HLAs before heart transplantation maybe a risk factor for early allograft failure.

Timing Carbohydrate Beverage Intake During Prolonged Moderate Intensity Exercise Does Not Affect Cycling Performance.

Carbohydrate beverages consumed during long-term exercise have been shown to attenuate fatigue and improve performance; however, the optimal timing of ingestion is unclear. Therefore, the purpose of this study was to determine if timing the carbohydrate ingestion (continual loading (CL), front-loading (FL), and end-loading (EL)) during prolonged exercise influenced exercise performance in competitive cyclists. Ten well-trained cyclists completed three separate exercise bouts on a bicycle ergometer, each lasting 2 hours at an intensity of ~67% VO2 max, followed by a 15-minute "all out" time trial. In the CL trial, a carbohydrate beverage was ingested throughout the trial. In the FL trial, participants ingested a carbohydrate beverage during the first hour and a placebo beverage during the second hour. In the EL trial, a carbohydrate beverage was ingested during the second hour and a placebo during the first hour. The amount of carbohydrate consumed (75 g) was the same among conditions. The order of conditions was single-blinded, counterbalanced, and determined randomly. Performance was measured by the work output during the 15-minute performance ride. There were no differences in work output among the three conditions during the final time trial. In the first hour of exercise, peak venous blood glucose was highest in the FL condition. In the second hour, peak venous blood glucose was highest in the EL condition. Following the time trial, venous blood glucose levels were similar among CL, FL, and EL. Overall, the timing of carbohydrate beverage consumption during prolonged moderate intensity cycling did not alter cycling performance.