Observers’ Agreement on Measurements in Fiberoptic Endoscopic Evaluation of Swallowing

Abstract

This study analyzed the effect that dysphagia etiology, different observers, and bolus consistency might have on the level of agreement for measurements in FEES images reached by independent versus consensus panel rating. Sixty patients were included and divided into two groups according to dysphagia etiology: neurological or head and neck oncological. All patients underwent standardized FEES examination using thin and thick liquid consistencies. Two observers scored the same exams, first independently and then in a consensus panel. Four ordinal FEES variables were analyzed. Statistical analysis was performed using a linear weighted kappa coefficient and Bayesian multilevel model. Intra- and interobserver agreement on FEES measurements ranged from 0.76 to 0.93 and from 0.61 to 0.88, respectively. Dysphagia etiology did not influence observers' agreement level. However, bolus consistency resulted in decreased interobserver agreement for all measured FEES variables during thin liquid swallows. When rating on the consensus panel, the observers deviated considerably from the scores they had previously given on the independent rating task. Observer agreement on measurements in FEES exams was influenced by bolus consistency, not by dysphagia etiology. Therefore, observer agreement on FEES measurements should be analyzed by taking bolus consistency into account, as it might affect the interpretation of the outcome. Identifying factors that might influence agreement levels could lead to better understanding of the rating process and assist in developing a more precise measurement scale that would ensure higher levels of observer agreement for measurements in FEES exams.

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Variability in solar irradiance observed at two contrasting Antarctic sites

Publication date: 15 May–1 June 2016
Source:Atmospheric Research, Volumes 172–173
Author(s): Boyan H. Petkov, Kamil Láska, Vito Vitale, Christian Lanconelli, Angelo Lupi, Mauro Mazzola, Marie Budíková
The features of erythemally weighted (EW) and short-wave downwelling (SWD) solar irradiances, observed during the spring–summer months of 2007–2011 at Johann Gregor Mendel (63°48′S, 57°53′W, 7m a.s.l.) and Dome Concordia (75°06′S, 123°21′E, 3233m a.s.l.) stations, placed at the Antarctic coastal region and on the interior plateau respectively, have been analysed and compared to each other. The EW and SWD spectral components have been presented by the corresponding daily integrated values and were examined taking into account the different geographic positions and different environmental conditions at both sites. The results indicate that at Mendel station the surface solar irradiance is strongly affected by the changes in the cloud cover, aerosols and albedo that cause a decrease in EW between 20% and 35%, and from 0% to 50% in SWD component, which contributions are slightly lower than the seasonal SWD variations evaluated to be about 71%. On the contrary, the changes in the cloud cover features at Concordia station produce only a 5% reduction of the solar irradiance, whilst the seasonal oscillations of 94% turn out to be the predominant mode. The present analysis leads to the conclusion that the variations in the ozone column cause an average decrease of about 46% in EW irradiance with respect to the value found in the case of minimum ozone content at each of the stations. In addition, the ratio between EW and SWD spectral components can be used to achieve a realistic assessment of the radiation amplification factor that quantifies the relationship between the atmospheric ozone and the surface UV irradiance.

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Observers’ Agreement on Measurements in Fiberoptic Endoscopic Evaluation of Swallowing

Abstract

This study analyzed the effect that dysphagia etiology, different observers, and bolus consistency might have on the level of agreement for measurements in FEES images reached by independent versus consensus panel rating. Sixty patients were included and divided into two groups according to dysphagia etiology: neurological or head and neck oncological. All patients underwent standardized FEES examination using thin and thick liquid consistencies. Two observers scored the same exams, first independently and then in a consensus panel. Four ordinal FEES variables were analyzed. Statistical analysis was performed using a linear weighted kappa coefficient and Bayesian multilevel model. Intra- and interobserver agreement on FEES measurements ranged from 0.76 to 0.93 and from 0.61 to 0.88, respectively. Dysphagia etiology did not influence observers' agreement level. However, bolus consistency resulted in decreased interobserver agreement for all measured FEES variables during thin liquid swallows. When rating on the consensus panel, the observers deviated considerably from the scores they had previously given on the independent rating task. Observer agreement on measurements in FEES exams was influenced by bolus consistency, not by dysphagia etiology. Therefore, observer agreement on FEES measurements should be analyzed by taking bolus consistency into account, as it might affect the interpretation of the outcome. Identifying factors that might influence agreement levels could lead to better understanding of the rating process and assist in developing a more precise measurement scale that would ensure higher levels of observer agreement for measurements in FEES exams.

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USE OF A SIMPLE THERMALISED NEUTRON FIELD FOR QUALITY ACCEPTANCE OF WHOLE BODY TLDS.

USE OF A SIMPLE THERMALISED NEUTRON FIELD FOR QUALITY ACCEPTANCE OF WHOLE BODY TLDS.

Radiat Prot Dosimetry. 2016 Jan 21;

Authors: Gilvin PJ, Baker ST, Eakins JS, Tanner RJ

Abstract
The individual monitoring service of Public Health England (PHE) uses Harshaw™ whole-body and extremity thermoluminescent dosemeters (TLDs) with high-sensitivity lithium fluoride LiF:Mg,Cu,P, together with Harshaw 8800™ automated readers. The neutron-insensitive, (6)Li-depleted variety of TLD material is used by PHE because the service provides separate neutron and photon dosemeters. The neutron dosemeters are not sensitive to photons and vice versa. Since insensitivity to neutrons is a supply requirement for TLDs, there is a need to test every new (annual) consignment for this. Because it is thermal neutrons that produce a response in (6)Li TLDs, a thermal field is needed. To this end, PHE has adopted the simple approach of sandwiching the TLDs between two ISO water-filled slab phantoms. In this arrangement, the fast neutrons from an Am-Be source are effectively thermalised. Details of the method are given, together with the results of supporting MCNP calculations and some typical results.

PMID: 26801052 [PubMed – as supplied by publisher]

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The Improved Overhearing Backup AODV Protocol in MANET

Mobile ad hoc network (MANET) is one of the most widely used networks, which has attracted attentions, having features such as limited energy resources, limited bandwidth, and security weaknesses due to lack of a central infrastructure. Safe and suitable routing is one of the research aspects of MANET. In this paper, a proposed method, called M-AODV, which is a type of overhearing backup protocol, based on AODV, is presented. The simulation results of this protocol, applied by NS2 simulator, showed the improvement of packet delivery rate and reduction of overhead and delay. Moreover, to assess the security of the proposed protocol, we simulated M-AODV and AODV protocols under black hole and wormhole attacks, using no security solution. The results showed that M-AODV had been improved in terms of packet delivery ratio, and the delay had been reduced as well, but the amount of overhead had been increased.

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Gute Prognose nach endoskopischer Resektion und Radiofrequenzablation

Frühneoplasien des Barrett-Oesophagus
Dysplasien und Frühkarzinome bei Barrett-Ösophagus können heute endoskopisch reseziert und mit Radiofrequenz behandelt werden. Die Ergebnisse einer aktuellen Registerstudie zeigen jedoch, dass eine subtile Diagnostik unabdingbar ist.

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Surgical Results and Oncologic Outcomes for Rectal Cancer with Tailored Mesorectal Excision over Two Decades.

Surgical Results and Oncologic Outcomes for Rectal Cancer with Tailored Mesorectal Excision over Two Decades.

World J Surg. 2016 Jan 22;

Authors: Law WL, Foo DC

Abstract
OBJECTIVE: This study aimed to compare the characteristics of the tumors, the management strategy, and oncologic outcomes of patients with rectal cancer surgery in these two periods: period 1 (1993-2001) and period 2 (2002-2011).
METHODS: All patients who underwent radical resection of rectal cancer from 1993 to 2011 were included. Comparisons of the patients' demographics, characteristics, operating results, and oncologic outcome between the two periods were undertaken.
RESULTS: Radical resection for rectal cancer was performed in 1611 patients (993 men). Patients were significantly older and more had comorbid medical diseases in period 2. More laparoscopic resections were performed and more patients had preoperative chemoradiation in period 2. The postoperative mortality was significantly lower and the hospital stay was significantly shorter in period 2. In those with non-metastatic cancer, the 5-year local recurrences of patients in period 1 and period 2 were 11.9 and 5.9 %, respectively. (p = 0.002) The patients in period 2 had significantly better 5-year overall (68.1 vs. 60.2 %, p = 0.003) and 5-year cancer-specific survival (76.1 vs. 69.4 %, p < 0.001) when compared with those treated in period 1. The improvement occurred mainly in patients with abdominoperineal resection and those with stage III diseases. In the multivariate analysis, among the other histological factors, operations performed in period 2 and laparoscopic surgery were independent factors associated with better overall survival.
CONCLUSIONS: Significant improvement in the surgical outcomes in terms of a lower recurrence rate and better survival was achieved in the recent years with the increase in neoadjuvant therapy and the application of laparoscopic surgery.

PMID: 26801507 [PubMed – as supplied by publisher]

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Surgical Apgar Score Predicted Postoperative Morbidity After Esophagectomy for Esophageal Cancer.

Surgical Apgar Score Predicted Postoperative Morbidity After Esophagectomy for Esophageal Cancer.

World J Surg. 2016 Jan 22;

Authors: Eto K, Yoshida N, Iwatsuki M, Kurashige J, Ida S, Ishimoto T, Baba Y, Sakamoto Y, Miyamoto Y, Watanabe M, Baba H

Abstract
BACKGROUND: Recently, a simple and easy complication prediction system, the Surgical Apgar Sore (SAS) calculated by three intraoperative parameters (estimated blood loss, lowest mean arterial pressure, and lowest heart rate), has been proposed for general surgery. This study aimed to determine if the SAS could accurately predict perioperative morbidity in patients undergoing esophagectomy for esophageal cancer.
METHODS: We investigated 399 patients who underwent esophagectomy at the Kumamoto University Hospital between April 2007 and March 2015. Clinical data, including intraoperative parameters, were collected retrospectively. Patients had postoperative morbidities classified as Clavien-Dindo grade III or more. Univariate and multivariate analyses were performed to elucidate factors that affected the development of complications.
RESULTS: The mean age of the study population was 65.7 years, 357 patients (89.5 %) were male. The frequency of any morbidity was 32.3 %. Univariate analyses showed that the SAS as well as preoperative chemotherapy, volume of bleeding, and reconstruction of organs were associated with morbidities. Multivariate analysis showed that a SAS < 5 was found to be an independent risk factor for morbidities.
CONCLUSION: The SAS is considered to be useful for predicting the development of postoperative morbidities after esophagectomy for esophageal cancer.

PMID: 26801506 [PubMed – as supplied by publisher]

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Gute Prognose nach endoskopischer Resektion und Radiofrequenzablation

Frühneoplasien des Barrett-Oesophagus
Dysplasien und Frühkarzinome bei Barrett-Ösophagus können heute endoskopisch reseziert und mit Radiofrequenz behandelt werden. Die Ergebnisse einer aktuellen Registerstudie zeigen jedoch, dass eine subtile Diagnostik unabdingbar ist.

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Major factors contributing to anterior and posterior relapse after intraoral vertical ramus osteotomy

Publication date: Available online 23 January 2016
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Sung-Hwan Choi, Da-Young Kang, Jung-Yul Cha, Young-Soo Jung, Hyung-Seog Yu, Hyung-Sik Park, Chung–Ju Hwang
The aim of this retrospective cohort study was to investigate the factors contributing to mandibular relapse after intraoral vertical ramus osteotomy (IVRO) while controlling for possible confounders. Forty-seven patients who underwent bimaxillary surgery were divided into three groups according to the direction of horizontal mandibular relapse: a stable group (group S), a posterior relapse group (group P), and an anterior relapse group (group A). Lateral cephalograms were analysed 1 month before and at 7 days and 12 months after surgery. One month before surgery, the pogonion in group A was positioned about 13 mm more anteriorly than in group P (P < 0.05). Immediately after surgery, the mandibles in groups A and S had moved about 6 mm more posteriorly than in group P. At 12 months, both the mandibles (point B) and the maxillae (point A) had moved posteriorly in group P (P < 0.05). A multivariate linear regression analysis showed that the amount of setback was the one key factor predicting postoperative mandibular changes 12 months after IVRO. As the amount of setback decreased, mandibular posterior horizontal relapse increased after IVRO. These findings suggest that the amount of setback can be a key factor predicting postoperative mandibular relapse.

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Free establishment of primary health care providers: effects on geographical equity

Abstract

Background

A reform in 2010 in Swedish primary care made it possible for private primary care providers to establish themselves freely in the country. In the former, publicly planned system, location was strictly regulated by local authorities. The goal of the new reform was to increase access and quality of health care. Critical arguments were raised that the reform could have detrimental effects on equity if the new primary health care providers chose to establish foremost in socioeconomically prosperous areas.

The aim of this study is to examine how the primary care choice reform has affected geographical equity by analysing patterns of establishment on the part of new private providers.

Methods

The basis of the design was to analyse socio-economic data on individuals who reside in the same electoral areas in which the 1411 primary health care centres in Sweden are established. Since the primary health care centres are located within 21 different county councils with different reimbursement schemes, we controlled for possible cluster effects utilizing generalized estimating equations modelling. The empirical material used in the analysis is a cross-sectional data set containing socio-economic data of the geographical areas in which all primary health care centres are established.

Results

When controlling for the effects of the county council regulation, primary health care centres established after the primary care choice reform were found to be located in areas with significantly fewer older adults living alone as well as fewer single parents – groups which generally have lower socio-economic status and high health care needs. However, no significant effects were observed for other socio-economic variables such as mean income, percentage of immigrants, education, unemployment, and children <5 years.

Conclusions

The primary care choice reform seems to have had some negative effects on geographical equity, even though these seem relatively minor.

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The Long Walk: Considering the Enduring Spatial and Racial Dimensions of Deprivation Two Decades After the Fall of Apartheid

Abstract

This study examines the enduring spatial and racial dimensions of poverty and deprivation in South Africa to assess the progress made by the post-apartheid society and state. A multi-dimensional approach is required to assess progress because it can reflect the reduction in deprivation attributable to the improved affordability and expanded coverage of government services. While there has been previous studies tracking poverty trends over segments of the post-apartheid period, no previous work has considered multi-dimensional deprivation over the two decades following the official fall of apartheid. We adopt the Total Fuzzy and Relative (TFR) approach proposed by Cheli and Lemmi (Econ Notes 24(1):115–134, 1995) to derive a poverty index with nine dimensions of deprivation, including education, employment, dwelling type, overcrowding, access to electricity, water, telephone, sanitation and refuse collection. Our analysis shows that there has been a significant improvement in deprivation levels between 1996 and 2011, but it also finds that geography and race continue to play an important role in explaining patterns of deprivation.

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Atypical Culture-Negative Skull Base Osteomyelitis Masquerading as Advanced Nasopharyngeal Carcinoma

Publication date: Available online 23 January 2016
Source:American Journal of Otolaryngology
Author(s): Anna See, Tiong Yong Tan, Eng Cern Gan
Skull base osteomyelitis typically arises as a complication of otogenic or sinonasal infections in immunocompromised patients. A much rarer entity, atypical skull base osteomyelitis is not associated with an obvious infective source. Atypical and culture-negative skull base osteomyelitis is even rarer and hampers diagnosis, as its clinical presentation is remarkably similar to skull base neoplasms. We report a case of extensive skull base osteomyelitis with orbital apex syndrome and multiple lower cranial nerve palsies which initially masqueraded as possible advanced nasopharyngeal carcinoma. Extensive investigations and consult with an infectious diseases specialist aided in elucidation of the correct diagnosis. Through this article, we emphasize that skull base osteomyelitis must be considered in the setting of headache, cranial neuropathies, elevated inflammatory markers and abnormal imaging findings. Early tissue sampling for histology, stainings and cultures and prompt appropriate treatment may prevent or arrest further complications.

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Needle aspiration of calcific deposits (NACD) for calcific tendinitis is safe and effective: six months follow-up of clinical results and complications in a series of 431 patients

Publication date: Available online 23 January 2016
Source:European Journal of Radiology
Author(s): Bart W. Oudelaar, Relinde Schepers-Bok, Edwin M. Ooms, Rianne Huis in 't Veld, Anne J.H. Vochteloo
BackgroundAlthough needle aspiration of calcific deposits (NACD) has proven to be an effective treatment for calcific tendinitis of the rotator cuff (CTRC) in patients who are resistant to conservative treatment, little is known about the effectiveness of NACD in terms of complete relief of symptoms and the effectiveness of repeated NACD procedures. Furthermore, analyses of complications of the procedure in large series are scarce.Methods431 consecutive patients with symptomatic CTRC treated by NACD were included in this retrospective cohort study. Short-term effects were assessed at two weeks post-treatment by using an 11-point numeric rating scale (NRS). The six months outcome was determined on a dichotomous symptom scale (symptom free or persistence of symptoms). NACD procedures performed within six months of a previous NACD procedure were considered repeated procedures. All complications that occurred within six months of the NACD procedure were registered.ResultsAt two weeks post-treatment, a significant improvement of pain scores was noted (mean reduction of NRS: 4.4 points; p<0.001). 74% of patients had complete relief of symptoms at six months post-treatment. 143 (33.2%) patients required multiple treatments. These repeated procedures were equally effective as the primary procedure. Complications of the NACD procedure were seen in 31 (7.2%) patients: 21 patients (4.9%) developed a subacromial bursitis, seven patients (1.6%) a frozen shoulder and three patients (0.7%) developed a septic bursitis.ConclusionNeedle aspiration of calcific deposits (NACD) is an effective treatment for calcific tendinitis of the rotator cuff in the majority of patients. Approximately one third of the patients will require multiple treatments, which were equally effective as the primary procedure. Based on this, patients should not be withheld a second or even a third treatment in case of persistent symptoms. Furthermore, NACD has a low complication rate, the risk of infection should, however, always be accounted for.Level of evidenceRetrospective study, level IV.

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Gute Prognose nach endoskopischer Resektion und Radiofrequenzablation

Frühneoplasien des Barrett-Oesophagus
Dysplasien und Frühkarzinome bei Barrett-Ösophagus können heute endoskopisch reseziert und mit Radiofrequenz behandelt werden. Die Ergebnisse einer aktuellen Registerstudie zeigen jedoch, dass eine subtile Diagnostik unabdingbar ist.

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QoE-Driven, Energy-Aware Video Adaptation in 5G Networks: The SELFNET Self-Optimisation Use Case

Sharp increase of video traffic is expected to account for the majority of traffic in future 5G networks. This paper introduces the SELFNET 5G project and describes the video streaming use case that will be used to demonstrate the self-optimising capabilities of SELFNET's autonomic network management framework. SELFNET's framework will provide an advanced self-organizing network (SON) underpinned by seamless integration of Software Defined Networking (SDN), Network Function Virtualization (NFV), and network intelligence. The self-optimisation video streaming use case is going beyond traditional quality of service approaches to network management. A set of monitoring and analysis components will facilitate a user-oriented, quality of experience (QoE) and energy-aware approach. Firstly, novel SON-Sensors will monitor both traditional network state metrics and new video and energy related metrics. The combination of these low level metrics provides highly innovative health of network (HoN) composite metrics. HoN composite metrics are processed via autonomous decisions not only maintaining but also proactively optimising users' video QoE while minimising the end-to-end energy consumption of the 5G network. This contribution provided a detailed technical overview of this ambitious use case.

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Shafting Alignment Computing Method of New Multibearing Rotor System under Specific Installation Requirement

The shafting of large steam turbine generator set is composed of several rotors which are connected by couplings. The computing method of shafting with different structure under specific installation requirement is studied in this paper. Based on three-moment equation, shafting alignment mathematical model is established. The computing method of bearing elevations and loads under corresponding installation requirements, where bending moment of each coupling is zero and there exist preset sag and gap in some couplings, is proposed, respectively. Bearing elevations and loads of shafting with different structure under specific installation requirement are calculated; calculation results are compared with installation data measured on site which verifies the validity and accuracy of the proposed shafting alignment computing method. The above work provides a reliable approach to analyze shafting alignment and could guide installation on site.

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Thickness Measurement of V2O5 Nanometric Thin Films Using a Portable XRF

Nanometric thin films have always been chiefly used for decoration; however they are now being widely used as the basis of high technology. Among the various physical qualities that characterize them, the thickness strongly influences their properties. Thus, a new procedure is hereby proposed and developed for determining the thickness of V2O5 nanometric thin films deposited on the glass surface using Portable X-Ray Fluorescence (PXRF) equipment and the attenuation of the radiation intensity Kα of calcium present in the glass. It is shown through the present paper that the radiation intensity of calcium Kα rays is proportional to film thickness in nanometric films of vanadium deposited on the glass surface.

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Fracture Forces of Dentin after Surface Treatment with High Speed Drill Compared to Er:YAG and Er,Cr:YSGG Laser Irradiation

Dental tooth restorative procedures may weaken the structural integrity of the tooth, with the possibility of leading to fracture. In this study we present findings of coronal dentin strength after different techniques of surface modification. The fracture strength of dentin beams after superficial material removal with a fine diamond bur high speed drill hand piece, Er:YAG (2.94 μm, 8 J/cm2), and Er,Cr:YSGG (2.78 μm, 7.8 J/cm2) laser irradiation slightly above the ablation threshold was measured by a four-point bending apparatus. Untreated dentin beams served as a control. A total of 58 dentin beams were manufactured from sterilized human extracted molars using the coronal part of the available dentin. Mean values of fracture strength were calculated as  MPa for the control group (),  MPa for high speed drill treatment (),  MPa for Er,Cr:YSGG laser irradiation (), and  MPa for Er:YAG laser irradiation (). Independent Student's -tests showed no significant difference between each two groups (). Within the parameter settings and the limits of the experimental setup used in this study, both lasers systems as well as the high speed drill do not significantly weaken coronal dentin after surface treatment.

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Measuring Gas Concentration and Wind Intensity in a Turbulent Wind Tunnel with a Mobile Robot

This paper presents the measurement of gas concentration and wind intensity performed with a mobile robot in a custom turbulent wind tunnel designed for experimentation with customizable wind and gas leak sources. This paper presents the representation in different information layers of the measurements obtained in the turbulent wind tunnel under different controlled environmental conditions in order to describe the plume of the gas and wind intensities inside the experimentation chamber. The information layers have been generated from the measurements gathered by individual onboard gas and wind sensors carried out by an autonomous mobile robot. On the one hand, the assumption was that the size and cost of these specialized sensors do not allow the creation of a net of sensors or other measurement alternatives based on the simultaneous use of several sensors, and on the other hand, the assumption is that the information layers created will have application on the development and test of automatic gas source location procedures based on reactive or nonreactive algorithms.

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Caffeic Acid Phenethyl Ester Regulates PPAR’s Levels in Stem Cells-Derived Adipocytes

Hypertrophic obesity inhibits activation of peroxisome proliferators-activated receptor gamma (PPARγ), considered the key mediator of the fully differentiated and insulin sensitive adipocyte phenotype. We examined the effects of Caffeic Acid Phenethyl Ester (Cape), isolated from propolis, a honeybee hive product, on Adipose Stem Cells (ASCs) differentiation to the adipocyte lineage. Finally we tested the effects of Cape on insulin-resistant adipocytes. Quantification of Oil Red O-stained cells showed that lipid droplets decreased following Cape treatment as well as radical oxygen species formation. Additionally, exposure of ASC to high glucose levels decreased adiponectin and increased proinflammatory cytokines mRNA levels, which were reversed by Cape-mediated increase of insulin sensitivity. Cape treatment resulted in decreased triglycerides synthesis and increased beta-oxidation. Exposure of ASCs to Lipopolysaccharide (LPS) induced a reduction of PPARγ, an increase of IL-6 levels associated with a well-known stimulation of lipolysis; Cape partially attenuated the LPS-mediated effects. These observations reveal the main role of PPARγ in the adipocyte function and during ASC differentiation. As there is now substantial interest in functional food and nutraceutical products, the observed therapeutic value of Cape in insulin-resistance related diseases should be taken into consideration.

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Understanding the Crystallinity Indices Behavior of Burned Bones and Teeth by ATR-IR and XRD in the Presence of Bioapatite Mixed with Other Phosphate and Carbonate Phases

We have critically investigated the ATR-IR spectroscopy data behavior of burned human teeth as opposed to the generally observed behavior in human bones that were subjected to heat treatment, whether deliberate or accidental. It is shown that the deterioration of the crystallinity index (CI) behavior sometimes observed in bones subjected to high temperature appears to be of higher frequency in the case of bioapatite from teeth. This occurs because the formation of the β-tricalcium phosphate (β-TCP) phase, otherwise known as whitlockite, clearly ascertained by the X-ray diffraction (XRD) patterns collected on the same powdered specimens investigated by ATR-IR. These results point to the need of combining more than one physicochemical technique even if apparently well suitable, in order to verify whether the assumed conditions assessed by spectroscopy are fully maintained in the specimens after temperature and/or mechanical processing.

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Positional Nystagmus in Patients Evaluated for Dizziness and Imbalance

There is variability in the literature regarding the presence of positional nystagmus in healthy participants with reportedly normal vestibular and central nervous system function. This ranges from 7.5% to 88% and raises an important clinical question. If 88% of healthy participants have positional nystagmus then how is the clinician to interpret the presence of positional nystagmus in a patient presenting with dizziness and/or disequilibrium? The primary purpose of this investigation was to examine the prevalence and characteristics of positional nystagmus in patients evaluated specifically for dizziness and imbalance. Data was collected using retrospective chart review. 200 charts were randomly selected from all patients seen for evaluation of dizziness and imbalance over a period of eight months. Clinicians independently reviewed the data from positional testing for each chart. Nystagmus was present if there was a clear slow and fast phase component and there were three beats in a 10 s time window. Nystagmus direction and intensity data were collected. Results indicate positional nystagmus is present in 10.5% to 21% of patients evaluated for dizziness and imbalance. Use of liberal criteria for determining presence of positional nystagmus (i.e., 3 beats in 20 sec) may account for higher prevalence rates across other studies.

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Shouldering the Burden of Evidence-Based Practice: The Experiences of Physiotherapists Partaking in a Community of Practice

The study aim was to elicit the motivators, barriers, and benefits of participation in a Community of Practice (CoP) for primary care physiotherapists. We used a qualitative approach using semistructured interviews. The participants were twelve physiotherapists partaking in a newly formed Shoulder CoP. A desire for peer support was the strongest motivator for joining, with improving clinical practice being less apparent. Barriers to participation included time and work pressures and poor research skills. The structure of the CoP, in terms of access to meetings and the provision of preparation work and deadlines for the journal clubs, was reported to be a facilitator. Multiple benefits ensued from participation. The role of teamwork was emphasised in relation to reducing isolation and achieving goals. The majority of participants reported positive clinical practice changes in terms of improved patient education, increased confidence, and availability of new resources. All participants reported some element of personal growth and development, in particular in their evidence-based practice skills. The results provide support for the use of CoPs as a means of continuing professional development for physiotherapists in the workplace, as significant benefits are gained in terms of evidence-based practice (EBP), patient care, and therapist personal development.

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Vascular Health in American Football Players: Cardiovascular Risk Increased in Division III Players

Studies report that football players have high blood pressure (BP) and increased cardiovascular risk. There are over 70,000 NCAA football players and 450 Division III schools sponsor football programs, yet limited research exists on vascular health of athletes. This study aimed to compare vascular and cardiovascular health measures between football players and nonathlete controls. Twenty-three athletes and 19 nonathletes participated. Vascular health measures included flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT). Cardiovascular measures included clinic and 24 hr BP levels, body composition, , and fasting glucose/cholesterol levels. Compared to controls, football players had a worse vascular and cardiovascular profile. Football players had thicker carotid artery IMT (0.49 ± 0.06 mm versus 0.46 ± 0.07 mm) and larger brachial artery diameter during FMD ( mm versus  mm), but no difference in percent FMD. Systolic BP was significantly higher in football players at all measurements: resting ( mmHg versus  mmHg), submaximal exercise ( mmHg versus  mmHg), maximal exercise ( mmHg versus  mmHg), and 24-hour BP ( mmHg versus  mmHg). Football players also had higher fasting glucose ( mg/dL versus  mg/dL), lower HDL ( mg/dL versus  mg/dL), and higher body fat percentage (% versus %). Division III collegiate football players remain an understudied population and may be at increased cardiovascular risk.

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A Rationale for Pollutograph Evaluation in Ungauged Areas, Using Daily Rainfall Patterns: Case Studies of the Apulian Region in Southern Italy

In the context of the implementation of sustainable water treatment technologies for soil pollution prevention, a methodology that try to overcome the lack of runoff quality data in Puglia (Southern Italy) is firstly tackled in this paper. It provides a tool to obtain total suspended solid (TSS) pollutographs in areas without availability of monitoring campaigns. The proposed procedure is based on the relationship between rainfall characteristics and pollutant wash-off. In particular, starting from the evaluation of the observed regional rainfall patterns by using a rainfall generator model, the storm water management model (SWMM) was applied on five case studies located in different climatic subareas. The quantity SWMM parameters were evaluated starting from the drainage network and catchments characteristics, while the quality parameters were obtained from results of a monitoring campaign conducted for quality model calibration and validation with reference to the pollutograph's shape and the peak-time. The research yields a procedure useful to evaluate the first flush phenomenon in ungauged sites and, in particular, it provides interesting information for designing efficient and sustainable drainage systems for first flush treatment and diffuse pollution treatment.

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David Bowie, Prettiest Star – Hyperallergic

Hyperallergic

David Bowie, Prettiest Star Hyperallergic He timed the release of his new album, Blackstar, to his impending death from liver cancer, an illness he kept secret until the end — he was already receiving plenty of media attention for the release of Blackstar, by several accounts his best album … and more »

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Executive functions improvement following a 5-month aquaerobics program in older adults: Role of cardiac vagal control in inhibition performance

Publication date: Available online 23 January 2016
Source:Biological Psychology
Author(s): Cédric T. Albinet, Amira Abou-Dest, Nathalie André, Michel Audiffren
The aims of this study were to examine the effects of aerobic exercise on measures of executive performance and their relationships with changes in cardiorespiratory fitness, cardiac vagal control (HRV) and psychological variables. Thirty-six sedentary seniors aged 60–75 years were randomly assigned to a swimming and aquaerobics program or a stretching program two times a week for 21 weeks. Executive functions (inhibition, updating of working memory and cognitive flexibility) and cardiorespiratory fitness (estimated VO2max) were assessed at the start, after 10 weeks of program and at the end of the program. Resting HRV and measures of psychological outcomes (depression, self-efficacy, decisional balance) were obtained at the start and at the end of the program. Participants of both groups significantly improved their VO2max level, their psychological state and their performance for the 2-back task. Only the participants in the aquaerobics group significantly improved their vagally-mediated HRV and their performance for the Stroop test and the verbal running-span test at the end of the program. Only improvements in cardiac vagal control and in inhibition were shown to be functionally related. These results are discussed in line with the model of neurovisceral integration.

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Wen-Xin Decoction ameliorates vascular endothelium dysfunction via the PI3K/AKT/eNOS pathway in experimental atherosclerosis in rats

Nitric oxide (NO) is the most powerful vasodilator that inhibits leukocyte adhesion, platelet aggregation, and vascular smooth muscle cell proliferation. However, excessive NO can cause lipid peroxidation and …

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Gehirn ruft Erinnerungen schneller ab als angenommen

100 bis 200 Millisekunden
Bei der Erinnerung an Erlebtes werden die damit verbundenen Sinneseindrücke im Gehirn wieder reaktiviert. Das gehe weit rascher als bisher gedacht, sagen Forscher. Und gerade die ersten rasanten Prozesse seien die wichtigsten.

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Model and Processes of Acceptance and Commitment Therapy (ACT) for Chronic Pain Including a Closer Look at the Self

Abstract

Acceptance and commitment therapy (ACT) is one of the so called "third-wave" cognitive behavioral therapies. It has been increasingly applied to chronic pain, and there is accumulating evidence to support its effectiveness. ACT is based on a model of general human functioning called the psychological flexibility (PF) model. Most facets of the PF model have been examined in chronic pain. However, a potential key facet related to "self" appears underappreciated. Indeed, a positive or healthy sense of self seems essential to our well-being, and there have been numerous studies of the self in chronic pain. At the same time, these studies are not currently well organized or easy to summarize. This lack of clarity and integration creates barriers to progress in this area of research. PF with its explicit inclusion of self-related therapeutic processes within a broad, integrative, theoretical model may help. The current review summarizes the PF model in the context of chronic pain with a specific emphasis on the parts of the model that address self-related processes.

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Peptide microarray patterning for controlling and monitoring cell growth

Publication date: Available online 21 January 2016
Source:Acta Biomaterialia
Author(s): Edith Lin, Adhirath Sikand, Jessica Wickware, Yubin Hao, Ratmir Derda
The fate of cells is influenced by their microenvironment and many cell types undergo differentiation when stimulated by extracellular cues, such as soluble growth factors and the insoluble extracellular matrix (ECM). Stimulating differentiation by insoluble or "immobilized" cues is particularly attractive because it allows for the induction of differentiation in a spatially-defined cohort of cells within a larger subpopulation. To improve the design of de novo screening of such insoluble factors, we describe a methodology for producing high-density peptide microarrays suitable for extended cell culture and fluorescence microscopy. As a model, we used normal murine mammary gland (NMuMG) cells, which undergo epithelial-to-mesenchymal transition (EMT) in response to soluble transforming factor beta (TGF-β) and surface-immobilized peptides that target TGF-β receptors (TGFβRI/II). We repurposed a well-established DNA microarray printing technique to produce arrays of micro patterned surfaces that displayed TGFβRI/II-binding peptides and integrin binding peptides. Upon long-term culture on these arrays, only NMuMG cells residing on EMT-stimulating areas exhibit growth arrest and a decrease in E-cadherin expression. We believe that the methodology developed in this report will aid the development of peptide-decorated surfaces that can locally stimulate defined cells surface receptors in cells and control EMT and other well-characterized differentiation events.

Graphical abstract

Highlights

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Gehirn ruft Erinnerungen schneller ab als angenommen

100 bis 200 Millisekunden
Bei der Erinnerung an Erlebtes werden die damit verbundenen Sinneseindrücke im Gehirn wieder reaktiviert. Das gehe weit rascher als bisher gedacht, sagen Forscher. Und gerade die ersten rasanten Prozesse seien die wichtigsten.

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Prevalence and predictors of complications following facial reconstruction procedures

Publication date: Available online 24 January 2016
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): S. Prakasam, K. Stein, M.K. Lee, S. Rampa, R. Nalliah, V. Allareddy, V. Allareddy
Facial reconstruction procedures are immensely challenging and are done for a multitude of reasons. The purpose of this report is to provide nationally representative estimates of different types of facial reconstructive procedures and to examine prevalence and predictors of a wide range of complications associated with these procedures in the USA. The Nationwide Inpatient Sample, the largest inpatient dataset for the USA, was used. Data for the years 2004–2010 related to facial reconstruction procedures were identified through ICD-9-CM procedure codes. Associated complications were identified using secondary diagnosis field codes. Multivariable logistic regression models were used to examine the association between patient/hospital-level factors and the occurrence of complications. A total 26,374 facial reconstruction procedures were performed. About 20% of all patients who had facial reconstruction procedures developed a complication. Frequently occurring complications included postoperative pneumonia (4.9% of hospitalizations), hemorrhage (3.9%), other infections (3.6%), non-healing wounds (3.5%), and iatrogenically induced complications (3.2%). Significant factors found to be consistently associated with different types of complications included age, co-morbid burden, sex, and type of admission. The reported results are generalizable within limitations and can be used by health care providers to tailor quality improvement initiatives to minimize or better treat complications in the high-risk cohorts.

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Distinctive injury deaths: the role of environment, policy and measurement across states

Background

Maps identifying the most distinctive feature of each state have become popular on social media, but may also have important public health applications. A map identifying the most distinctive injury death in each state could be a useful tool for policymakers, enabling them to identify potential gaps in prevention efforts.

Objective

To identify the most distinctive cause of injury death in each state and explore potential reasons for the geographical variation.

Methods

The Centers for Disease Control Web-based Injury Statistics Query and Reporting System was used to identify the injury death for each state with a rate which was the largest multiple of the national rate. Analyses were conducted with and without inclusion of 'indefinite' codes, which include injury causes of death of undetermined intent, unspecified person killed in a motor vehicle crash (MVC; vehicle occupant, cyclist, pedestrian, etc) or unspecified injury.

Results

Noteworthy patterns included seven states in Appalachia and the Southeast with high relative rates of unintentional firearm deaths (2.14–4.06 times the national average) and five states on the West Coast with high relative rates of legal intervention deaths (1.76–3.49 times the national average). Sensitivity analyses indicated that use of 'undetermined intent' classifications and the level of detail in coding MVCs vary substantially by state.

Conclusions

These analyses highlight potential areas for prevention, such as promotion of safe storage laws in states with relatively high rates of unintentional firearm deaths and areas where standardisation of cause of death codes could be improved.

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The neuritogenic and neuroprotective potential of senegenin against Aβ-induced neurotoxicity in PC 12 cells

Improved therapeutics aimed at ameliorating the devastating effects of neurodegenerative diseases, such as Alzheimer's disease (AD), are pertinent to help attenuate their growing prevalence worldwide. One prom…

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Wen-Xin Decoction ameliorates vascular endothelium dysfunction via the PI3K/AKT/eNOS pathway in experimental atherosclerosis in rats

Nitric oxide (NO) is the most powerful vasodilator that inhibits leukocyte adhesion, platelet aggregation, and vascular smooth muscle cell proliferation. However, excessive NO can cause lipid peroxidation and …

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David Bowie, Prettiest Star – Hyperallergic

Hyperallergic

David Bowie, Prettiest Star Hyperallergic He timed the release of his new album, Blackstar, to his impending death from liver cancer, an illness he kept secret until the end — he was already receiving plenty of media attention for the release of Blackstar, by several accounts his best album … and more »

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Executive functions improvement following a 5-month aquaerobics program in older adults: Role of cardiac vagal control in inhibition performance

Publication date: Available online 23 January 2016
Source:Biological Psychology
Author(s): Cédric T. Albinet, Amira Abou-Dest, Nathalie André, Michel Audiffren
The aims of this study were to examine the effects of aerobic exercise on measures of executive performance and their relationships with changes in cardiorespiratory fitness, cardiac vagal control (HRV) and psychological variables. Thirty-six sedentary seniors aged 60–75 years were randomly assigned to a swimming and aquaerobics program or a stretching program two times a week for 21 weeks. Executive functions (inhibition, updating of working memory and cognitive flexibility) and cardiorespiratory fitness (estimated VO2max) were assessed at the start, after 10 weeks of program and at the end of the program. Resting HRV and measures of psychological outcomes (depression, self-efficacy, decisional balance) were obtained at the start and at the end of the program. Participants of both groups significantly improved their VO2max level, their psychological state and their performance for the 2-back task. Only the participants in the aquaerobics group significantly improved their vagally-mediated HRV and their performance for the Stroop test and the verbal running-span test at the end of the program. Only improvements in cardiac vagal control and in inhibition were shown to be functionally related. These results are discussed in line with the model of neurovisceral integration.

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Wen-Xin Decoction ameliorates vascular endothelium dysfunction via the PI3K/AKT/eNOS pathway in experimental atherosclerosis in rats

Nitric oxide (NO) is the most powerful vasodilator that inhibits leukocyte adhesion, platelet aggregation, and vascular smooth muscle cell proliferation. However, excessive NO can cause lipid peroxidation and …

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Gehirn ruft Erinnerungen schneller ab als angenommen

100 bis 200 Millisekunden
Bei der Erinnerung an Erlebtes werden die damit verbundenen Sinneseindrücke im Gehirn wieder reaktiviert. Das gehe weit rascher als bisher gedacht, sagen Forscher. Und gerade die ersten rasanten Prozesse seien die wichtigsten.

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Model and Processes of Acceptance and Commitment Therapy (ACT) for Chronic Pain Including a Closer Look at the Self

Abstract

Acceptance and commitment therapy (ACT) is one of the so called "third-wave" cognitive behavioral therapies. It has been increasingly applied to chronic pain, and there is accumulating evidence to support its effectiveness. ACT is based on a model of general human functioning called the psychological flexibility (PF) model. Most facets of the PF model have been examined in chronic pain. However, a potential key facet related to "self" appears underappreciated. Indeed, a positive or healthy sense of self seems essential to our well-being, and there have been numerous studies of the self in chronic pain. At the same time, these studies are not currently well organized or easy to summarize. This lack of clarity and integration creates barriers to progress in this area of research. PF with its explicit inclusion of self-related therapeutic processes within a broad, integrative, theoretical model may help. The current review summarizes the PF model in the context of chronic pain with a specific emphasis on the parts of the model that address self-related processes.

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Peptide microarray patterning for controlling and monitoring cell growth

Publication date: Available online 21 January 2016
Source:Acta Biomaterialia
Author(s): Edith Lin, Adhirath Sikand, Jessica Wickware, Yubin Hao, Ratmir Derda
The fate of cells is influenced by their microenvironment and many cell types undergo differentiation when stimulated by extracellular cues, such as soluble growth factors and the insoluble extracellular matrix (ECM). Stimulating differentiation by insoluble or "immobilized" cues is particularly attractive because it allows for the induction of differentiation in a spatially-defined cohort of cells within a larger subpopulation. To improve the design of de novo screening of such insoluble factors, we describe a methodology for producing high-density peptide microarrays suitable for extended cell culture and fluorescence microscopy. As a model, we used normal murine mammary gland (NMuMG) cells, which undergo epithelial-to-mesenchymal transition (EMT) in response to soluble transforming factor beta (TGF-β) and surface-immobilized peptides that target TGF-β receptors (TGFβRI/II). We repurposed a well-established DNA microarray printing technique to produce arrays of micro patterned surfaces that displayed TGFβRI/II-binding peptides and integrin binding peptides. Upon long-term culture on these arrays, only NMuMG cells residing on EMT-stimulating areas exhibit growth arrest and a decrease in E-cadherin expression. We believe that the methodology developed in this report will aid the development of peptide-decorated surfaces that can locally stimulate defined cells surface receptors in cells and control EMT and other well-characterized differentiation events.

Graphical abstract

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The neuritogenic and neuroprotective potential of senegenin against Aβ-induced neurotoxicity in PC 12 cells

Improved therapeutics aimed at ameliorating the devastating effects of neurodegenerative diseases, such as Alzheimer's disease (AD), are pertinent to help attenuate their growing prevalence worldwide. One prom…

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Effect of Tualang honey on the anastomotic wound healing in large bowel anastomosis in rats-A randomized controlled trial

Honey has long been used for the treatment of number of ailments and diseases including surgical wounds. Current study evaluates the effectiveness of Tualang honey (TH) for large bowel anastomotic healing in W…

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Effect of Tualang honey on the anastomotic wound healing in large bowel anastomosis in rats-A randomized controlled trial

Honey has long been used for the treatment of number of ailments and diseases including surgical wounds. Current study evaluates the effectiveness of Tualang honey (TH) for large bowel anastomotic healing in W…

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Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174

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Added sugars: Don’t get sabotaged by sweeteners

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Prevalence and predictors of complications following facial reconstruction procedures

Publication date: Available online 24 January 2016
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): S. Prakasam, K. Stein, M.K. Lee, S. Rampa, R. Nalliah, V. Allareddy, V. Allareddy
Facial reconstruction procedures are immensely challenging and are done for a multitude of reasons. The purpose of this report is to provide nationally representative estimates of different types of facial reconstructive procedures and to examine prevalence and predictors of a wide range of complications associated with these procedures in the USA. The Nationwide Inpatient Sample, the largest inpatient dataset for the USA, was used. Data for the years 2004–2010 related to facial reconstruction procedures were identified through ICD-9-CM procedure codes. Associated complications were identified using secondary diagnosis field codes. Multivariable logistic regression models were used to examine the association between patient/hospital-level factors and the occurrence of complications. A total 26,374 facial reconstruction procedures were performed. About 20% of all patients who had facial reconstruction procedures developed a complication. Frequently occurring complications included postoperative pneumonia (4.9% of hospitalizations), hemorrhage (3.9%), other infections (3.6%), non-healing wounds (3.5%), and iatrogenically induced complications (3.2%). Significant factors found to be consistently associated with different types of complications included age, co-morbid burden, sex, and type of admission. The reported results are generalizable within limitations and can be used by health care providers to tailor quality improvement initiatives to minimize or better treat complications in the high-risk cohorts.

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Wen-Xin Decoction ameliorates vascular endothelium dysfunction via the PI3K/AKT/eNOS pathway in experimental atherosclerosis in rats

Nitric oxide (NO) is the most powerful vasodilator that inhibits leukocyte adhesion, platelet aggregation, and vascular smooth muscle cell proliferation. However, excessive NO can cause lipid peroxidation and …

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Executive functions improvement following a 5-month aquaerobics program in older adults: Role of cardiac vagal control in inhibition performance

Publication date: Available online 23 January 2016
Source:Biological Psychology
Author(s): Cédric T. Albinet, Amira Abou-Dest, Nathalie André, Michel Audiffren
The aims of this study were to examine the effects of aerobic exercise on measures of executive performance and their relationships with changes in cardiorespiratory fitness, cardiac vagal control (HRV) and psychological variables. Thirty-six sedentary seniors aged 60–75 years were randomly assigned to a swimming and aquaerobics program or a stretching program two times a week for 21 weeks. Executive functions (inhibition, updating of working memory and cognitive flexibility) and cardiorespiratory fitness (estimated VO2max) were assessed at the start, after 10 weeks of program and at the end of the program. Resting HRV and measures of psychological outcomes (depression, self-efficacy, decisional balance) were obtained at the start and at the end of the program. Participants of both groups significantly improved their VO2max level, their psychological state and their performance for the 2-back task. Only the participants in the aquaerobics group significantly improved their vagally-mediated HRV and their performance for the Stroop test and the verbal running-span test at the end of the program. Only improvements in cardiac vagal control and in inhibition were shown to be functionally related. These results are discussed in line with the model of neurovisceral integration.

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