Science.gov

Sample records for cross-country mtb marathon

  1. Cross-Country Skiing Today.

    ERIC Educational Resources Information Center

    Caldwell, John

    This book presents changes in cross country skiing which have taken place in the last several years and is directed toward both beginning and seasoned tour skiers. Discussed are the following topics: (1) the cross-country revolution (new fiberglass skis); (2) equipment (how to choose from the new waxless touring skis); (3) care of equipment; (4)…

  2. The Dissertation Marathon

    ERIC Educational Resources Information Center

    Black, Ronald

    2012-01-01

    We all think of a marathon as a long-distance running event with an official distance of 42.195 kilometers (26 miles and 385 yards). Throughout time marathon runners have pursued their longest goals by allowing their body to adapt to the new stresses through training. Training for a marathon takes intense preparation, dedication and skill. It is…

  3. Half-marathoners are younger and slower than marathoners.

    PubMed

    Knechtle, Beat; Nikolaidis, Pantelis T; Zingg, Matthias A; Rosemann, Thomas; Rüst, Christoph A

    2016-01-01

    Age and performance trends of elite and recreational marathoners are well investigated, but not for half-marathoners. We analysed age and performance trends in 508,108 age group runners (125,894 female and 328,430 male half-marathoners and 10,205 female and 43,489 male marathoners) competing between 1999 and 2014 in all flat half-marathons and marathons held in Switzerland using single linear regression analyses, mixed-effects regression analyses and analyses of variance. The number of women and men increased across years in both half-marathons and marathons. There were 12.3 times more female half-marathoners than female marathoners and 7.5 times more male half-marathoners than male marathoners. For both half-marathons and marathons, most of the female and male finishers were recorded in age group 40-44 years. In half-marathons, women (10.29 ± 3.03 km/h) were running 0.07 ± 0.06 km/h faster (p < 0.001) than men (10.22 ± 3.06 km/h). Also in marathon, women (14.77 ± 4.13 km/h) were running 0.28 ± 0.16 km/h faster (p < 0.001) than men (14.48 ± 4.07 km/h). In marathon, women (42.18 ± 10.63 years) were at the same age than men (42.06 ± 10.45 years) (p > 0.05). Also in half-marathon, women (41.40 ± 10.63 years) were at the same age than men (41.31 ± 10.30 years) (p > 0.05). However, women and men marathon runners were older than their counterpart half-marathon runners (p < 0.001). In summary, (1) more athletes competed in half-marathons than in marathons, (2) women were running faster than men, (3) half-marathoners were running slower than marathoners, and (4) half-marathoners were younger than marathoners. PMID:26844023

  4. Autonomous system for cross-country navigation

    NASA Astrophysics Data System (ADS)

    Stentz, Anthony; Brumitt, Barry L.; Coulter, R. C.; Kelly, Alonzo

    1993-05-01

    Autonomous cross-country navigation is essential for outdoor robots moving about in unstructured environments. Most existing systems use range sensors to determine the shape of the terrain, plan a trajectory that avoids obstacles, and then drive the trajectory. Performance has been limited by the range and accuracy of sensors, insufficient vehicle-terrain interaction models, and the availability of high-speed computers. As these elements improve, higher- speed navigation on rougher terrain becomes possible. We have developed a software system for autonomous navigation that provides for greater capability. The perception system supports a large braking distance by fusing multiple range images to build a map of the terrain in front of the vehicle. The system identifies range shadows and interpolates undersamples regions to account for rough terrain effects. The motion planner reduces computational complexity by investigating a minimum number of trajectories. Speeds along the trajectory are set to provide for dynamic stability. The entire system was tested in simulation, and a subset of the capability was demonstrated on a real vehicle. Results to date include a continuous 5.1 kilometer run across moderate terrain with obstacles. This paper begins with the applications, prior work, limitations, and current paradigms for autonomous cross-country navigation, and then describes our contribution to the area.

  5. Using Xpert MTB/RIF

    PubMed Central

    Nicol, Mark P.; Whitelaw, Andrew; Wendy, Stevens

    2013-01-01

    Xpert MTB/RIF is an automated real-time polymerase chain reaction test for simultaneous detection of tuberculosis and rifampicin resistance. Xpert MTB/RIF has demonstrated excellent accuracy in clinical evaluation studies, but has reduced sensitivity for detection of smear-negative tuberculosis. Since sample processing and detection are largely automated, Xpert MTB/RIF is potentially suitable for implementation in resource-limited settings. There are, however, a number of practical constraints to the use of Xpert at the point-of-care. Xpert remains a relatively costly test, and clear demonstration of cost-effectiveness will be needed to support efforts to scale up testing in high burden countries. PMID:24089608

  6. Venous Thromboembolism and Marathon Athletes

    MedlinePlus

    ... Heart Association Cardiology Patient Page Venous Thromboembolism and Marathon Athletes Claire M. Hull and Julia A. Harris ... general adult population are indisputable. However, for the marathon athlete who trains intensively and for long periods ...

  7. Fitness Levels of University Cross-Country Skiers.

    ERIC Educational Resources Information Center

    Ruhling, Robert O.; Storer, Thomas W.

    Dry-land training in preparation for competitive cross-country skiing proved to be effective in increasing athletes' aerobic capacity and physical fitness. Such training included bicycle racing, roller skiing, fartlek running, cross-country running, simulated ski walking on inclines, and interval training over hills. (JD)

  8. Kick, Glide, Pole! Cross-Country Skiing Fun (Part II)

    ERIC Educational Resources Information Center

    Duoos, Bridget A.

    2012-01-01

    Part I of Kick, Glide, Pole! Cross-Country Skiing Fun, which was published in last issue, discussed how to select cross-country ski equipment, dress for the activity and the biomechanics of the diagonal stride. Part II focuses on teaching the diagonal stride technique and begins with a progression of indoor activities. Incorporating this fun,…

  9. Kick, Glide, Pole! Cross-Country Skiing Fun (Part I)

    ERIC Educational Resources Information Center

    Duoos, Bridget A.

    2011-01-01

    Cross-country skiing is a great activity for taking a physical education class outside during the cold winter months. It is also a diverse activity that appeals to students of all ages, and is an excellent cardio-respiratory activity to keep students active. This article has provided the first steps in preparing a cross-country skiing lesson in…

  10. Physiological Profiles of High School Female Cross Country Runners.

    ERIC Educational Resources Information Center

    Butts, Nancy Kay

    1982-01-01

    Percentage of body fat, ratings of perceived exertion, and maximal oxygen consumption were obtained during a continuous running treadmill test on 127 high school female cross country runners. The relatively low relationships between the variables tested and running performance indicated that other factors may be more important determinants of…

  11. Cross Country Skiing: Special Olympics Sports Skills Instructional Program.

    ERIC Educational Resources Information Center

    Joseph P. Kennedy, Jr. Foundation, Washington, DC.

    The last of five booklets on specific sports instruction in Special Olympics presents information on teaching cross country skiing to mentally retarded persons. The approach uses goals, short term objectives, task analyzed activities, assessments and teaching suggestions for individualizing and integrating the sports skills instruction with other…

  12. Body composition and performance in cross-country skiing.

    PubMed

    Larsson, P; Henriksson-Larsén, K

    2008-12-01

    The purpose of this study was to investigate the relationships between body composition and performance in cross-country skiing. Ten male college-aged elite cross-country skiers (17.9 yrs; S 1.0 yrs) participated in a 5.6-km cross-country skiing time trial and in dual energy X-ray absorptiometry (DXA, Lunar DPX-L, Madison, WI, USA) body composition measurements. A differential global positioning system (dGPS, GPS 12 CX, Garmin Int. Inc., Olathe, KS, USA; RXMAR 2, Aztec SA, Strasbourg, France) was used to compute speed in different sections of the course. Spearman correlation analyses were applied. Total body weight and absolute lean body mass were significantly related to final time (r = - 0.721; p < 0.05 and - 0.830; p < 0.01, respectively). Absolute lean arm mass (kg) was negatively correlated to final time (r = - 0.648; p < 0.05) and the relative lean arm mass was significantly related to speed mainly in uphill sections (r = 0.636 to 0.867; p < 0.05 to p < 0.01). We suggest that large amounts of lean body mass, especially in the arms, seem to be of great importance for cross-country skiing performance. PMID:18600606

  13. Maximum Power Training and Plyometrics for Cross-Country Running.

    ERIC Educational Resources Information Center

    Ebben, William P.

    2001-01-01

    Provides a rationale for maximum power training and plyometrics as conditioning strategies for cross-country runners, examining: an evaluation of training methods (strength training and maximum power training and plyometrics); biomechanic and velocity specificity (role in preventing injury); and practical application of maximum power training and…

  14. Cross-Country Evidence on Teacher Performance Pay

    ERIC Educational Resources Information Center

    Woessmann, Ludger

    2011-01-01

    The general-equilibrium effects of performance-related teacher pay include long-term incentive and teacher-sorting mechanisms that usually elude experimental studies but are captured in cross-country comparisons. Combining country-level performance-pay measures with rich PISA-2003 international achievement micro data, this paper estimates…

  15. The Human Capital Convergence Fallacy: A Cross Country Empirical Investigation

    ERIC Educational Resources Information Center

    Stamatakis, D.; Petrakis, P. E.

    2006-01-01

    This article adapts a modification of Tamura's theoretical proposition and conducts a cross-country empirical investigation in an attempt to evaluate convergence on two different human capital proxies; namely enrollment rates and per capita researchers. The analysis considers three country groups at significantly different development levels:…

  16. Scaling properties of marathon races

    NASA Astrophysics Data System (ADS)

    Alvarez-Ramirez, Jose; Rodriguez, Eduardo

    2006-06-01

    Some regularities in popular marathon races are identified in this paper. It is found for high-performance participants (i.e., racing times in the range [2:15,3:15] h), the average velocity as a function of the marathoner's ranking behaves as a power-law, which may be suggesting the presence of critical phenomena. Elite marathoners with racing times below 2:15 h can be considered as outliers with respect to this behavior. For the main marathon pack (i.e., racing times in the range [3:00,6:00] h), the average velocity as a function of the marathoner's ranking behaves linearly. For this racing times, the interpersonal velocity, defined as the difference of velocities between consecutive runners, displays a continuum of scaling behavior ranging from uncorrelated noise for small scales to correlated 1/f-noise for large scales. It is a matter of fact that 1/f-noise is characterized by correlations extended over a wide range of scales, a clear indication of some sort of cooperative effect.

  17. High prevalence of asthma in cross country skiers.

    PubMed Central

    Larsson, K; Ohlsén, P; Larsson, L; Malmberg, P; Rydström, P O; Ulriksen, H

    1993-01-01

    OBJECTIVES--To study the prevalence of asthma (asthma symptoms and bronchial hyperresponsiveness) in Swedish cross country skiers compared with non-skiers and monitor changes in symptoms and bronchial hyperresponsiveness during the year. DESIGN--Cross sectional study during the winter ski season and in the summer. SETTING--Six ski clubs for élite skiers (total 47) in two different areas of Sweden. SUBJECTS--42 élite cross country skiers and 29 non-skiing referents. MAIN OUTCOME MEASURES--Bronchial responsiveness, asthma symptoms, and lung function. RESULTS--Bronchial responsiveness was significantly greater and asthma symptoms more prevalent in the skiers than in the referents. There was no difference in bronchial responsiveness within either group between winter and summer. 15 of the 42 skiers used antiasthmatic drugs regularly and 23 had a combination of asthma symptoms and hyperresponsive airways or physician diagnosed asthma, or both. Altogether 33 skiers had symptoms of asthma or bronchial hyperresponsiveness. One of the referents had symptoms of asthma and bronchial hyperresponsiveness, and none used antiasthmatic drugs regularly. CONCLUSIONS--Asthma, asthma-like symptoms, and bronchial hyperresponsiveness are much more common in cross country skiers than in the general population and non-skiers. Strenuous exercise at low temperatures entailing breathing large volumes of cold air is the most probable explanation of persistent asthma in skiers. PMID:8257888

  18. Transference of 3D accelerations during cross country mountain biking.

    PubMed

    Macdermid, Paul W; Fink, Philip W; Stannard, Stephen R

    2014-06-01

    Investigations into the work demands of Olympic format cross country mountain biking suggest an incongruent relationship between work done and physiological strain experienced by participants. A likely but unsubstantiated cause is the extra work demand of muscle damping of terrain/surface induced vibrations. The purpose of this study was to describe the relationship between vibration mechanics and their interaction with terrain, bicycle and rider during a race pace effort on a cross country mountain bike track, on both 26″ and 29″ wheels. Participants completed one lap of a cross country track using 26″ and 29″ wheels, at race pace. Power, cadence, speed, heart rate and geographical position were sampled and logged every second for control purposes. Tri-axial accelerometers located on the bicycle and rider, recorded accelerations (128Hz) and were used to quantify vibrations experienced during the whole lap and over terrain sections (uphill and downhill). While there were no differences in power output (p=0.3062) and heart rate (p=0.8423), time to complete the lap was significantly (p=0.0061) faster on the 29″ wheels despite increased vibrations in the larger wheels (p=0.0020). Overall accelerometer data (RMS) showed location differences (p<0.0001), specifically between the point of interface of bike-body compared to those experienced at the lower back and head. The reduction in accelerations at both the lower back and head are imperative for injury prevention and demonstrates an additional non-propulsive, muscular, challenge to riding. Stress was greatest during downhill sections as acceleration differences between locations were greater when compared to uphill sections, and thus possibly prevent the recovery processes that may occur during non-propulsive load. PMID:24735505

  19. Explaining cross-country variation in cigarette consumption

    PubMed Central

    Srinivas, Kolluru; Rao, Bhanoji

    2009-01-01

    This short paper uses cross-country data on per capita cigarette consumption and selected socio-economic variables to explain inter-country differentials in consumption. It is found that the proportion of the aged in the total population and higher literacy among women have relatively greater and positive impact on cigarette consumption. Even after controlling for the effect of the two variables, a country's industrialized status has a positive impact on consumption. It would thus seem that aging and economic, and social developments are pro-cigarette consumption. PMID:19133163

  20. Marathon training and immune function.

    PubMed

    Nieman, David C

    2007-01-01

    Many components of the immune system exhibit adverse change after marathon-type exertion. These immune changes occur in several compartments of the immune system and body (e.g. the skin, upper respiratory tract mucosal tissue, lung, peritoneal cavity, blood and muscle). Of all immune cells, natural killer (NK) cells, neutrophils and macrophages (of the innate immune system) exhibit the greatest changes in response to marathon competition, both in terms of numbers and function. Many mechanisms appear to be involved, including exercise-induced changes in stress hormone and cytokine concentrations, body temperature changes, increases in blood flow and dehydration. During this 'open window' of immune dysfunction (which may last between 3 and 72 hours, depending on the immune measure), viruses and bacteria may gain a foothold, increasing the risk of subclinical and clinical infection. Of the various nutritional and pharmacological countermeasures to marathon-induced immune perturbations that have been evaluated thus far, ingestion of carbohydrate beverages during intense and prolonged exercise has emerged as the most effective. However, carbohydrate ingestion during a marathon attenuates increases in plasma cytokines and stress hormones, but is largely ineffective against changes in other immune components including suppression of NK and T-cell function, and salivary IgA output. Other countermeasures, such as glutamine, antioxidant supplements and ibuprofen, have had disappointing results and thus the search for companion agents to carbohydrate continues. PMID:17465622

  1. Characterization of Electrocardiogram Changes Throughout a Marathon

    PubMed Central

    Callaway, Clifton; Salcido, David; McEntire, Serina; Roth, Ronald; Hostler, David

    2014-01-01

    Purpose There are few data examining cardiovascular physiology throughout a marathon. This study was devised to characterize electrocardiographic activity continuously throughout a marathon. Methods Cardiac activity was recorded from 19 subjects wearing a Holter monitor during a marathon. The 19 subjects (14 men and 5 women) were aged 39 ± 16 years (mean ± SD) and completed a marathon in 4:32:16 ± 1:23:35. Heart rate (HR), heart rate variability (HRV), T-wave amplitude, T-wave amplitude variability, and T-wave alternans (TWA) were evaluated continuously throughout the marathon. Results Averaged across all subjects, HRV, T-wave amplitude variability, and TWA increased throughout the marathon. Increased variability in T-wave amplitude occurred in 86% of subjects, characterized by complex oscillatory patterns and TWA. Three minutes after the marathon, HR was elevated and HRV was suppressed relative to the pre-marathon state. Conclusion HRV and T-wave amplitude variability, especially in the form of TWA, increase throughout a marathon. Increasing TWA as a marathon progresses likely represents a physiologic process as no arrhythmias or cardiac events were observed. PMID:24832192

  2. Marathon Writing--A Letter to Parents.

    ERIC Educational Resources Information Center

    McCoy, Linda Jones

    Based on a year's work with 16 second grade students, this two-part paper reports the successful use of the Marathon Writing (continuous writing for short periods on a regular basis) strategy in encouraging beginning writers to write independently. The first part of the paper explains the technique of marathon writing, and notes that even though…

  3. Myths and Concerns Re: The Marathon.

    ERIC Educational Resources Information Center

    Betz, Robert, L.

    The marathon is a specific form of the psycho-process cluster which has its own identifiable characteristics, the basic one being intensity. The primary objective in structuring the marathon is to intensify physical and emotional contact in order to precipitate, encourage, and accelerate the process of behavior change. Myths which have evolved…

  4. Effects of a Marathon Group Experience

    ERIC Educational Resources Information Center

    Treppa, Jerry A.; Fricke, Lawrence

    1972-01-01

    The present study examined the effects of a weekend marathon group experience on values of self-actualization and on the interpersonal dimnension of personality. Both experimental and control subjects showed significanly positive changes on posttest and follow-up scores. It was premature to believe that the positive effects of a marathon group…

  5. What band rocks the MTB? (Invited)

    NASA Astrophysics Data System (ADS)

    Kind, J.; García-Rubio, I.; Gehring, A. U.

    2013-12-01

    Magnetotactic bacteria (MTB) are a polyphyletic group of bacteria that have been found in marine and lacustrine environments and soils [e.g. 1]. The hallmark of MTB is their intracellular formation of magnetosomes, single-domain ferrimagnetic particles that are aligned in chains. The chain configuration generates a strong magnetic dipole, which is used as magnetic compass to move the MTB into their favorable habit. The term band corresponds to a frequency window of microwaves in the gigahertz (GHz) range. Ferromagnetic resonance (FMR) spectroscopy uses the microwave absorption in a magnetic field to analyze the anisotropy properties and the domain state of magnetic materials. Specific microwave frequency causes absorption in a characteristic magnetic field range. For the investigation of MTB we use S-band (4.02 GHz), X-band (9.47 GHz), and Q-band (34.16 GHz). Experiments on cultured MTB and on sediment samples of Holocene age showed that absorption in X- and Q-band occurs when the sample is in a saturated or nearly saturated state [2, 3]. By contrast, absorption in the S-band appears in lower magnetic fields, where the sample is far from saturation. All FMR spectra show two distinct low-field features that can be assigned to magnetite particles in chains, aligned parallel and perpendicular to the external magnetic field. The detailed separation of the parallel and perpendicular components in the bulk samples is hampered, because of the random orientation of the chains in the sample. The comparison of S-, X-, and Q-band shows that the lower the frequency the better the separation of the components. In the S-band FMR spectroscopy, the separation of chains parallel to the external magnetic field is supported by the internal field of the sample. This field is caused by the remanence that contributes to the external magnetic field to fulfill the resonance condition [3,4]. Considering the different FMR responses, it can be postulated that a lower microwave frequency

  6. 14 CFR 61.93 - Solo cross-country flight requirements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Solo cross-country flight requirements. 61.93 Section 61.93 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN CERTIFICATION: PILOTS, FLIGHT INSTRUCTORS, AND GROUND INSTRUCTORS Student Pilots § 61.93 Solo cross-country flight requirements....

  7. 14 CFR 61.93 - Solo cross-country flight requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... aircraft to be flown. (b) Authorization to perform certain solo flights and cross-country flights. A... the specific category of aircraft to be flown. (2) Logbook endorsement. (i) A student pilot must have... logbook for the specific make and model of aircraft to be flown. (ii) For each cross-country flight,...

  8. 14 CFR 61.111 - Cross-country flights: Pilots based on small islands.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Cross-country flights: Pilots based on small islands. 61.111 Section 61.111 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN CERTIFICATION: PILOTS, FLIGHT INSTRUCTORS, AND GROUND INSTRUCTORS Private Pilots § 61.111 Cross-country...

  9. Marathon Group: A Six Month Followup

    ERIC Educational Resources Information Center

    Foulds, Melvin L.; And Others

    1970-01-01

    The results of this study suggest that marathon groups may be an effective method for fostering the process of personal growth and self actualization in relatively healthy, growth seeking college students. (Author)

  10. Leptin and endocrine parameters in marathon runners.

    PubMed

    Bobbert, T; Mai, K; Brechtel, L; Schulte, H M; Weger, B; Pfeiffer, A F H; Spranger, J; Diederich, S

    2012-03-01

    Endurance training may lead to different hormonal alterations e. g., exercised induced hypothalamic ovarian/testicular dysfunction. The aim of this study was to reveal new connections between physical exercise, leptin and hormonal responses. 36 male participants of the Berlin-Marathon had their blood samples taken 2 days before the marathon. Hormones of the hypothalamic-pituitary axis and leptin were correlated with the training status and the achieved marathon time. Leptin correlated with the achieved marathon time after being adjusted for age and BMI (r=0.607, p<0.001) and was lowest in the best trained runners. Additionally, when the group was divided into quartiles of their achieved marathon time, significantly increased cortisol, fT4, cortisol/DHEAS ratio and decreased IGF-1 levels were observed in the slowest group. In the better trained group, a decrease of testosterone/DHT ratio and an increase of testosterone/cortisol ratio were observed. Our study supports the thesis of a linear relationship between physical fitness and leptin variations in the physiological range. We found an increased anabolic hormonal response in well trained marathon runners and hormonal reactions of increased stress in less trained runners. As the stress-induced neuroendocrine adaptations in our study group are associated with more higher leptin values, the pathophysiological role of decreased leptin values seems to be limited to overtrained athletes. PMID:22261828

  11. Predicting Marathon Time Using Exhaustive Graded Exercise Test in Marathon Runners.

    PubMed

    Till, Eloise S; Armstrong, Stuart A; Harris, Greg; Maloney, Stephen

    2016-02-01

    The study aimed to investigate the correlation between time on a treadmill test and exhaustion 2 weeks before a road marathon and the subsequent road marathon performance time (MPT). The study recruited 59 runners entered in the Melbourne 2012 marathon, Canberra 2013 marathon, and Gold Coast 2013 marathon. Forty runners completed both the graded exercise treadmill test to exhaustion and the 42.2 km marathon. Nineteen participants dropped out of the study due to illness, injury, or did not begin the treadmill test. A statistically significant correlation was found between treadmill time and MPT (adjusted R(2) = 0.447). Sex, weekly running duration (t = -1.58, p = 0.12), years of running (t = 1.10, p = 0.28), and age (t = 0.94, p = 0.36) did not statistically correlate with MPT. The relationship between the graded exercise test and MPT can be used to predict MPT using y = -3.85x + 351.57, where y is MPT and x is treadmill time. This is a simple, accessible, and cost-effective method to aid athletes in predicting their race time over 42.2 km. Prediction of marathon time in a simple and accessible manner was believed to be useful to the growing population of marathon runners around the world. PMID:26815178

  12. Marathon Maternity Oral History Project

    PubMed Central

    Orkin, Aaron; Newbery, Sarah

    2014-01-01

    Abstract Objective To explore how birthing and maternity care are understood and valued in a rural community. Design Oral history research. Setting The rural community of Marathon, Ont, with a population of approximately 3500. Participants A purposive selection of mothers, grandmothers, nurses, physicians, and community leaders in the Marathon medical catchment area. Methods Interviews were conducted with a purposive sample, employing an oral history research methodology. Interviews were conducted non-anonymously in order to preserve the identity and personhood of participants. Interview transcripts were edited into short narratives. Oral histories offer perspectives and information not revealed in other quantitative or qualitative research methodologies. Narratives re-personalize and humanize medical research by offering researchers and practitioners the opportunity to bear witness to the personal stories affected through medical decision making. Main findings Eleven stand-alone narratives, published in this issue of Canadian Family Physician, form the project’s findings. Similar to a literary text or short story, they are intended for personal reflection and interpretation by the reader. Presenting the results of these interviews as narratives requires the reader to participate in the research exercise and take part in listening to these women’s voices. The project’s narratives will be accessible to readers from academic and non-academic backgrounds and will interest readers in medicine and allied health professions, medical humanities, community development, gender studies, social anthropology and history, and literature. Conclusion Sharing personal birthing experiences might inspire others to reevaluate and reconsider birthing practices and services in other communities. Where local maternity services are under threat, Marathon’s stories might contribute to understanding the meaning and challenges of local birthing, and the implications of losing

  13. Empirical Study of Training and Performance in the Marathon

    ERIC Educational Resources Information Center

    Slovic, Paul

    1977-01-01

    Similar systematic relationships exist between personal characteristics, training, and performance on the marathon, regardless of whether they derive from differences among individuals participating in the same run or from differences within the same person in two separate marathons. (Author)

  14. Hematological Changes Following a Marathon Race in Males and Females.

    ERIC Educational Resources Information Center

    Wells, Christine L.; Mushabac, Lillian H.

    This study investigated the question of hemoconcentration-hemodilution and subsequent vascular fluid shifts evidenced by marathon runners. Blood samples were taken from runners before and after the New York City Marathon of 1978 and the Fiesta Bowl Marathon of the same year. Participants were of both sexes. Tables accompanying this report present…

  15. Marathon run: cardiovascular adaptation and cardiovascular risk.

    PubMed

    Predel, Hans-Georg

    2014-11-21

    The first marathon run as an athletic event took place in the context of the Olympic Games in 1896 in Athens, Greece. Today, participation in a 'marathon run' has become a global phenomenon attracting young professional athletes as well as millions of mainly middle-aged amateur athletes worldwide each year. One of the main motives for these amateur marathon runners is the expectation that endurance exercise (EE) delivers profound beneficial health effects. However, with respect to the cardiovascular system, a controversial debate has emerged whether the marathon run itself is healthy or potentially harmful to the cardiovascular system, especially in middle-aged non-elite male amateur runners. In this cohort, exercise-induced increases in cardiac biomarkers-troponin and brain natriuretic peptide-and acute functional cardiac alterations have been observed and interpreted as potential cardiac damage. Furthermore, in the cohort of 40- to 65-year-old males engaged in intensive EE, a significant risk for the development of atrial fibrillation has been identified. Fortunately, recent studies demonstrated a normalization of the cardiac biomarkers and the functional alterations within a short time frame. Therefore, these alterations may be perceived as physiological myocardial reactions to the strenuous exercise and the term 'cardiac fatigue' has been coined. This interpretation is supported by a recent analysis of 10.9 million marathon runners demonstrating that there was no significantly increased overall risk of cardiac arrest during long-distance running races. In conclusion, intensive and long-lasting EE, e.g. running a full-distance Marathon, results in high cardiovascular strain whose clinical relevance especially for middle-aged and older athletes is unclear and remains a matter of controversy. Furthermore, there is a need for evidence-based recommendations with respect to medical screening and training strategies especially in male amateur runners over the age of

  16. Metabolic Factors Limiting Performance in Marathon Runners

    PubMed Central

    Rapoport, Benjamin I.

    2010-01-01

    Each year in the past three decades has seen hundreds of thousands of runners register to run a major marathon. Of those who attempt to race over the marathon distance of 26 miles and 385 yards (42.195 kilometers), more than two-fifths experience severe and performance-limiting depletion of physiologic carbohydrate reserves (a phenomenon known as ‘hitting the wall’), and thousands drop out before reaching the finish lines (approximately 1–2% of those who start). Analyses of endurance physiology have often either used coarse approximations to suggest that human glycogen reserves are insufficient to fuel a marathon (making ‘hitting the wall’ seem inevitable), or implied that maximal glycogen loading is required in order to complete a marathon without ‘hitting the wall.’ The present computational study demonstrates that the energetic constraints on endurance runners are more subtle, and depend on several physiologic variables including the muscle mass distribution, liver and muscle glycogen densities, and running speed (exercise intensity as a fraction of aerobic capacity) of individual runners, in personalized but nevertheless quantifiable and predictable ways. The analytic approach presented here is used to estimate the distance at which runners will exhaust their glycogen stores as a function of running intensity. In so doing it also provides a basis for guidelines ensuring the safety and optimizing the performance of endurance runners, both by setting personally appropriate paces and by prescribing midrace fueling requirements for avoiding ‘the wall.’ The present analysis also sheds physiologically principled light on important standards in marathon running that until now have remained empirically defined: The qualifying times for the Boston Marathon. PMID:20975938

  17. Case Report: Hyponatremia in a Marathoner.

    ERIC Educational Resources Information Center

    Nelson, Paul B; And Others

    1988-01-01

    The first reported case of hyponatremia from participation in endurance running of marathon distance is discussed. Nine earlier cases occurring in subjects who endured greater distances are summarized. Symptoms and treatment of the 21-year-old subject of this case report are presented and preventive measures recommended for endurance-event…

  18. The Marathon Group Hypothesis: An Unanswered Question

    ERIC Educational Resources Information Center

    Marks, Stephen E.; And Others

    1973-01-01

    The authors of this article contend that the Guinan and Foulds study was inadequately designed and executed, and the results indicate little of the "usefulness" of the test, much less illuminate the important hypothesis central to the investigation. Specific suggestions for further research in marathon group evaluation are made. (Author)

  19. Marathon Group Therapy with Female Narcotic Addicts.

    ERIC Educational Resources Information Center

    Kilmann, Peter R.

    This study evaluated the impact of structured and unstructured marathon therapy on institutionalized female narcotic addicts. Subjects were randomly assigned to one of five groups: two structured therapy groups, two unstructured therapy groups, and a no-treatment control group. The Personal Orientation Inventory, the Adjective Check List, and a…

  20. Marathon Group Therapy with Former Drug Users.

    ERIC Educational Resources Information Center

    Page, Richard C.; Mannion, John

    1980-01-01

    Discusses the effects of marathon group therapy on attitudes of former drug users in a residential drug treatment center. Experimental group members responded higher on the group counseling evaluative subscale and lower on the guilt evaluative subscale than control members. (Author)

  1. Behavior Change Outcomes of Marathon Group Treatment

    ERIC Educational Resources Information Center

    Uhlemann, Max R.; Weigel, Richard G.

    1977-01-01

    This study evaluated behavior change occurring after a marathon group experience, with a focus on individualized rather than shared behavioral change criteria. The individualization of behavior change criteria is based on the assertion that few, if any, single change criteria are appropriate or realistic for assessing change in all individuals.…

  2. Marathon Group: Facilitator of Personal Growth?

    ERIC Educational Resources Information Center

    Guinan, James F.; Foulds, Melvin L.

    1970-01-01

    This is a report of changes on scales of the Personal Orientation Inventory following a marathon experience. Pretest and posttest results indicated changes in scores of an experimental group on those scales: Inner Direction, Existentiality, Feeling Reactivity, Spontaneity, Self Acceptance, Acceptance of Aggression, Capacity for Intimate Contact.…

  3. Convection-diffusion effects in marathon race dynamics

    NASA Astrophysics Data System (ADS)

    Rodriguez, E.; Espinosa-Paredes, G.; Alvarez-Ramirez, J.

    2014-01-01

    In the face of the recent terrorist attack event on the 2013 Boston Marathon, the increasing participation of recreational runners in large marathon races has imposed important logistical and safety issues for organizers and city authorities. An accurate understanding of the dynamics of the marathon pack along the race course can provide important insights for improving safety and performance of these events. On the other hand, marathon races can be seen as a model of pedestrian movement under confined conditions. This work used data of the 2011 Chicago Marathon event for modeling the dynamics of the marathon pack from the corral zone to the finish line. By considering the marathon pack as a set of particles moving along the race course, the dynamics are modeled as a convection-diffusion partial differential equation with position-dependent mean velocity and diffusion coefficient. A least-squares problem is posed and solved with optimization techniques for fitting field data from the 2011 Chicago Marathon. It was obtained that the mean pack velocity decreases while the diffusion coefficient increases with distance. This means that the dispersion rate of the initially compact marathon pack increases as the marathon race evolves along the race course.

  4. Drug Resistance Pattern of MTB Isolates from PTB Patients

    PubMed Central

    Ranganath, Rajani; Kumar, Vijay G. S.; Ranganath, Ravi; Goud, Gangadhar; Javali, Veerabhadra

    2013-01-01

    Background. TB is a global pandemic disease. All TB control programs were not successful due to the emergence of multidrug resistance in M. tuberculosis strains. Objective of the present study was to detect the rate of MDR-MTB in this part of India. Methods. One hundred and thirty clinical MTB strains isolated from patients on treatment and confirmed as MTB by MPT64 antigen detection were tested for drug susceptibility against Streptomycin, INH, Rifampicin, and Ethambutol by MBBact automated system. Result. Thirty-two were MDRs (25.61%). 31.2%, 28%, 17.6%, and 21.6% were resistant to INH, RIF, Ethambutol, and Streptomycin, respectively. Resistance to either INH or Rifampicin was 20.8% and 13.88%, respectively. Combined INH and Rifampicin resistance was seen in 18.05% isolates. Conclusion. Drug resistance rate is high in patients treated previously and who have been irregular on treatment. PMID:24282636

  5. Characteristics of the Female Athlete Triad in Collegiate Cross-Country Runners

    ERIC Educational Resources Information Center

    Thompson, Sharon H.

    2007-01-01

    The Female Athlete Triad is a life-threatening syndrome defined by disordered eating, amenorrhea, and osteoporosis. Objective and Participants: The author's purpose in this study was to examine female cross-country runners' (N = 300) calcium consumption, along with the prevalence of 2 components of the triad: disordered eating and menstrual…

  6. Cross-Country Differentials in Work Disability Reporting among Older Europeans

    ERIC Educational Resources Information Center

    Angelini, Viola; Cavapozzi, Danilo; Paccagnella, Omar

    2012-01-01

    Descriptive evidence shows that there is large cross-country variation in self-reported work disability rates of the elderly in Europe. In this paper we analyse whether these differences are genuine or they just reflect heterogeneity in reporting styles. To shed light on the determinants of work-disability differentials across countries, we…

  7. 14 CFR 61.111 - Cross-country flights: Pilots based on small islands.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... small islands. 61.111 Section 61.111 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... INSTRUCTORS Private Pilots § 61.111 Cross-country flights: Pilots based on small islands. (a) Except as provided in paragraph (b) of this section, an applicant located on an island from which the...

  8. Comparing Efficiency in a Cross-Country Perspective: The Case of Italian and Spanish State Universities

    ERIC Educational Resources Information Center

    Agasisti, Tommaso; Perez-Esparrells, Carmen

    2010-01-01

    The growing internationalization of European Higher Education requires more emphasis on cross-country comparisons. In this paper, an efficiency analysis of Italian and Spanish universities is conducted; as well as from a comparative perspective. The efficiency scores are obtained using data envelopment analysis. The results demonstrate a good…

  9. Fast and reliable obstacle detection and segmentation for cross-country navigation

    NASA Technical Reports Server (NTRS)

    Talukder, A.; Manduchi, R.; Rankin, A.; Matthies, L.

    2002-01-01

    Obstacle detection is one of the main components of the control system of autonomous vehicles. In the case of indoor/urban navigation, obstacles are typically defined as surface points that are higher than the ground plane. This characterization, however, cannot be used in cross-country and unstructured environments, where the notion of ground plane is often not meaningful.

  10. 14 CFR 61.93 - Solo cross-country flight requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... magnetic compass; (2) Use of aircraft performance charts pertaining to cross-country flight; (3... navigation using pilotage and dead reckoning with the aid of a magnetic compass; (2) Use of aircraft... using pilotage and dead reckoning with the aid of a magnetic compass; (2) Use of aircraft...

  11. 14 CFR 61.93 - Solo cross-country flight requirements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... magnetic compass; (2) Use of aircraft performance charts pertaining to cross-country flight; (3... navigation using pilotage and dead reckoning with the aid of a magnetic compass; (2) Use of aircraft... using pilotage and dead reckoning with the aid of a magnetic compass; (2) Use of aircraft...

  12. 14 CFR 61.93 - Solo cross-country flight requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... magnetic compass; (2) Use of aircraft performance charts pertaining to cross-country flight; (3... navigation using pilotage and dead reckoning with the aid of a magnetic compass; (2) Use of aircraft... using pilotage and dead reckoning with the aid of a magnetic compass; (2) Use of aircraft...

  13. Educational Attainment and HIV/AIDS Prevalence: A Cross-Country Study

    ERIC Educational Resources Information Center

    Lakhanpal, Manisha; Ram, Rati

    2008-01-01

    Using data for a large cross-country sample, a reasonable model is estimated to judge the effect of adult educational attainment on prevalence of HIV. Three main points are noted. First, there is an indication of a significantly negative effect of educational attainment on HIV prevalence. Second, magnitude of the impact appears sizable. Third, a…

  14. Measuring Statistics Anxiety: Cross-Country Validity of the Statistical Anxiety Scale (SAS)

    ERIC Educational Resources Information Center

    Chiesi, Francesca; Primi, Caterina; Carmona, Jose

    2011-01-01

    The aim of the research was to test the psychometric properties of the Italian version of the Vigil-Colet et al.'s Statistical Anxiety Scale (SAS), taking into account evidences based on (a) internal structure (factorial structure and cross-country invariance) and (b) relationships to other variables (the statistics anxiety's nomological network).…

  15. Measuring Youth Development: A Nonparametric Cross-Country "Youth Welfare Index"

    ERIC Educational Resources Information Center

    Chaaban, Jad M.

    2009-01-01

    This paper develops an empirical methodology for the construction of a synthetic multi-dimensional cross-country comparison of the performance of governments around the world in improving the livelihood of their younger population. The devised "Youth Welfare Index" is based on the nonparametric Data Envelopment Analysis (DEA) methodology and…

  16. Cross-Country Conversations: Techniques for Facilitating Web-Based Collaboration.

    ERIC Educational Resources Information Center

    Reinhart, Julie; Slowinski, Joe; Anderson, Tiffany

    This paper describes an online collaborative process among three university classes in a cross-country project. Two of the classes were undergraduate courses at the Indiana University Bloomington and Northwest campuses, and the third was a graduate course at North Carolina A & T State University. Each course was a traditional campus-based course…

  17. Identifying Social Trust in Cross-Country Analysis: Do We Really Measure the Same?

    ERIC Educational Resources Information Center

    Torpe, Lars; Lolle, Henrik

    2011-01-01

    Many see trust as an important social resource for the welfare of individuals as well as nations. It is therefore important to be able to identify trust and explain its sources. Cross-country survey analysis has been an important tool in this respect, and often one single variable is used to identify social trust understood as trust in strangers,…

  18. Diagnosing pulmonary tuberculosis with the Xpert MTB/RIF test.

    PubMed

    Bodmer, Thomas; Ströhle, Angelika

    2012-01-01

    Tuberculosis (TB) due to Mycobacterium tuberculosis (MTB) remains a major public health issue: the infection affects up to one third of the world population(1), and almost two million people are killed by TB each year. Universal access to high-quality, patient-centered treatment for all TB patients is emphasized by WHO's Stop TB Strategy. The rapid detection of MTB in respiratory specimens and drug therapy based on reliable drug resistance testing results are a prerequisite for the successful implementation of this strategy. However, in many areas of the world, TB diagnosis still relies on insensitive, poorly standardized sputum microscopy methods. Ineffective TB detection and the emergence and transmission of drug-resistant MTB strains increasingly jeopardize global TB control activities. Effective diagnosis of pulmonary TB requires the availability - on a global scale - of standardized, easy-to-use, and robust diagnostic tools that would allow the direct detection of both the MTB complex and resistance to key antibiotics, such as rifampicin (RIF). The latter result can serve as marker for multidrug-resistant MTB (MDR TB) and has been reported in > 95% of the MDR-TB isolates. The rapid availability of reliable test results is likely to directly translate into sound patient management decisions that, ultimately, will cure the individual patient and break the chain of TB transmission in the community. Cepheid's (Sunnyvale, CA, U.S.A.) Xpert MTB/RIF assay meets the demands outlined above in a remarkable manner. It is a nucleic-acids amplification test for 1) the detection of MTB complex DNA in sputum or concentrated sputum sediments; and 2) the detection of RIF resistance-associated mutations of the rpoB gene. It is designed for use with Cepheid's GeneXpert Dx System that integrates and automates sample processing, nucleic acid amplification, and detection of the target sequences using real-time PCR and reverse transcriptase PCR. The system consists of an instrument

  19. Marathon Group Therapy: Potential for University Counseling Centers and Beyond

    ERIC Educational Resources Information Center

    Stanger, Thomas; Harris, Rafael S., Jr.

    2005-01-01

    A descriptive analysis of marathon group therapy was conducted, specifying issues of set-up, screening, preparation, start-up, introduction to group process, facilitating therapeutic moments throughout the weekend, termination, and follow-up. Factors and dynamics unique to this modality are outlined for marathon groups in university counseling…

  20. An Age and Body Mass Handicap for the Marathon

    ERIC Educational Resources Information Center

    Vanderburgh, Paul M.

    2015-01-01

    An age and body mass handicap has been previously developed and validated for the 5-kilometer (5K) run. The purpose of this study was to develop a similar handicap for the marathon but with a different age adjustment based on deviations from age group world best marathon times within each sex. The resulting handicap allowed finish time comparisons…

  1. Self-Actualization Effects Of A Marathon Growth Group

    ERIC Educational Resources Information Center

    Jones, Dorothy S.; Medvene, Arnold M.

    1975-01-01

    This study examined the effects of a marathon group experience on university student's level of self-actualization two days and six weeks after the experience. Gains in self-actualization as a result of marathon group participation depended upon an individual's level of ego strength upon entering the group. (Author)

  2. Quadrupedal Locomotion-Respiration Entrainment and Metabolic Economy in Cross-Country Skiers.

    PubMed

    Boldt, Kevin; Killick, Anthony; Herzog, Walter

    2016-02-01

    A 1:1 locomotion-respiration entrainment is observed in galloping quadrupeds, and is thought to improve running economy. However, this has not been tested directly in animals, as animals cannot voluntarily disrupt this entrainment. The purpose of this study was to evaluate metabolic economy in a human gait involving all four limbs, cross-country skiing, in natural entrainment and forced nonentrainment. Nine elite cross-country skiers roller skied at constant speed using the 2-skate technique. In the first and last conditions, athletes used the natural entrained breathing pattern: inhaling with arm recovery and exhaling with arm propulsion, and in the second condition, the athletes disentrained their breathing pattern. The rate of oxygen uptake (VO2) and metabolic rate (MR) were measured via expired gas analysis. Propulsive forces were measured with instrumented skis and poles. VO2 and MR increased by 4% and 5% respectively when skiers used the disentrained compared with the entrained breathing pattern. There were no differences in ski or pole forces or in timing of the gait cycle between conditions. We conclude that breathing entrainment reduces metabolic cost of cross-country skiing by approximately 4%. Further, this reduction is likely a result of the entrainment rather than alterations in gait mechanics. PMID:26252735

  3. Diffusion of pharmaceuticals: cross-country evidence of anti-TNF drugs.

    PubMed

    Brekke, Kurt Richard; Dalen, Dag Morten; Holmås, Tor Helge

    2014-12-01

    This article studies the diffusion of biopharmaceuticals across European countries, focusing on anti-TNF drugs, which are used to treat autoimmune diseases (e.g., rheumatism, psoriasis). We use detailed sales information on the three brands Remicade, Enbrel and Humira for nine European countries covering the period from the first launch in 2000 until becoming blockbusters in 2009. Descriptive statistics reveal large variations across countries in per-capita consumption and price levels both overall and at the brand level. We explore potential sources for the cross-country consumption differences by estimating several multivariate regression models. Our results show that large parts of the cross-country variation are explained by time-invariant country-specific factors (e.g., disease prevalence, demographics, health care system). We also find that differences in income [gross domestic product (GDP) per capita] and health spending (share of GDP) explain the cross-country variation in consumption, while relative price differences seem to have limited impact. PMID:24146261

  4. Relative vs. absolute physiological measures as predictors of mountain bike cross-country race performance.

    PubMed

    Gregory, John; Johns, David P; Walls, Justin T

    2007-02-01

    The aims of this study were to document the effect terrain has on the physiological responses and work demands (power output) of riding a typical mountain bike cross-country course under race conditions. We were particularly interested in determining whether physiological measures relative to mass were better predictors of race performance than absolute measures. Eleven A-grade male cross-country mountain bike riders (VO2max 67.1 +/- 3.6 ml x kg(-1) x min(-1)) performed 2 tests: a laboratory-based maximum progressive exercise test, and a 15.5-km (six 2.58-km laps) mountain bike cross-country time trial. There were significant differences among the speed, cadence, and power output measured in each of 8 different terrain types found in the cross-country time trial course. The highest average speed was measured during the 10-15% downhill section (22.7 +/- 2.6 km x h(-1)), whereas the cadence was highest in the posttechnical flat sections (74.3 +/- 5.6 rpm) and lowest on the 15-20% downhill sections (6.4 +/- 12.1 rpm). The highest mean heart rate (HR) was obtained during the steepest (15-20% incline) section of the course (179 +/- 8 b x min(-1)), when the power output was greatest (419.8 +/- 39.7 W). However, HR remained elevated relative to power output in the downhill sections of the course. Physiological measures relative to total rider mass correlated more strongly to average course speed than did absolute measures (peak power relative to mass r = 0.93, p < 0.01, vs. peak power r = 0.64, p < 0.05; relative VO2max r = 0.80, p < 0.05, vs. VO2max r = 0.66, p < 0.05; power at anaerobic threshold relative to mass r = 0.78, p < 0.05, vs. power at anaerobic threshold r = 0.5, p < 0.05). This suggests that mountain bike cross-country training programs should focus upon improving relative physiological values rather than focusing upon maximizing absolute values to improve performance. PMID:17313256

  5. Physiological Demands of Competitive Sprint and Distance Performance in Elite Female Cross-Country Skiing.

    PubMed

    Carlsson, Magnus; Carlsson, Tomas; Wedholm, Lars; Nilsson, Mattias; Malm, Christer; Tonkonogi, Michail

    2016-08-01

    Carlsson, M, Carlsson, T, Wedholm, L, Nilsson, M, Malm, C, and Tonkonogi, M. Physiological demands of competitive sprint and distance performance in elite female cross-country skiing. J Strength Cond Res 30(8): 2138-2144, 2016-The purpose was to investigate the relationship between elite females' competitive performance capability in sprint and distance cross-country skiing and the variables of gross efficiency (GE), work rate at the onset of blood-lactate accumulation (OBLA4mmol), maximal oxygen uptake (V[Combining Dot Above]O2max), maximal speed (Vmax), and peak upper-body oxygen uptake (V[Combining Dot Above]O2peak). Ten elite female cross-country skiers (age 24.5 ± 2.8 years) completed treadmill roller-skiing tests to determine GE, OBLA4mmol, and V[Combining Dot Above]O2max using the diagonal-stride technique as well as Vmax and V[Combining Dot Above]O2peak using the double-poling technique. International Ski Federations ranking points for sprint (FISsprint) and distance (FISdist) races were used as competitive performance data. There were correlations between the FISsprint and the V[Combining Dot Above]O2max expressed absolutely (p = 0.0040), Vmax (p = 0.012), and V[Combining Dot Above]O2peak expressed absolutely (p < 0.001) and as a simple ratio-standard (p = 0.049). The FISdist were correlated with OBLA4mmol (p = 0.048), V[Combining Dot Above]O2max expressed absolutely (L·min) (p = 0.015) and as a simple ratio-standard (p = 0.046), and V[Combining Dot Above]O2peak expressed absolutely (p = 0.036) and as a simple ratio-standard (ml·min·kg) (p = 0.040). The results demonstrate that the physiological abilities reflected by V[Combining Dot Above]O2max and V[Combining Dot Above]O2peak are indicators of competitive sprint and distance performance in elite female cross-country skiing. In addition, the ability to generate a high Vmax indicates the performance in sprint races, whereas the skier's OBLA4mmol reflects the performance capability in distance races

  6. Detection of Mycobacterium tuberculosis (MTB) in Fecal Specimens From Adults Diagnosed With Pulmonary Tuberculosis Using the Xpert MTB/Rifampicin Test

    PubMed Central

    Kokuto, Hiroyuki; Sasaki, Yuka; Yoshimatsu, Shoji; Mizuno, Kazue; Yi, Lina; Mitarai, Satoshi

    2015-01-01

    Background. The Xpert Mycobacterium tuberculosis (MTB)/rifampicin (RIF) is a fully automated diagnostic test that allows for the detection of MTB including its RIF resistance. Although the test is used for the diagnosis of tuberculosis (TB) in sputum samples worldwide, studies using fecal specimens are scarce. We therefore evaluated the efficacy of the Xpert MTB/RIF test for detection of MTB in fecal specimens obtained from adult pulmonary TB patients, confirmed by culture and/or molecular diagnostic methods. Methods. We conducted a retrospective case-control study to provide proof-of-concept regarding the efficacy of the Xpert MTB/RIF test using fecal samples for diagnosing pulmonary TB via detection of MTB in adult patients (≥20 years) at the Fukujuji Hospital in Tokyo, Japan. Results. Fecal specimens were obtained from 56 active pulmonary TB patients (including 48 sputum smear-positive and 8 sputum smear-negative patients), 10 non-TB patients (including 4 Myocobacterium avium complex infections), and 27 healthy individuals who were exposed to active pulmonary TB patients. The sensitivity of the fecal Xpert MTB/RIF was 100% (81.7%–100%) for detection of MTB in specimens from sputum smear-positive (1+ to 3+) patients, 81.0% (58.1%–94.6%) in specimens from sputum smear scanty positive patients, and 50.0% (15.7%–84.3%) in specimens from sputum smear-negative patients. Meanwhile, each of the fecal specimens from the non-TB group was negative for MTB (specificity 100%; 95% confidence interval, 86.2–100). Conclusions. The fecal Xpert MTB/RIF test could detect MTB in a large proportion of smear-positive pulmonary TB patients, without frequent false-positive results at a TB referral hospital in Japan. PMID:26125035

  7. Solar Ultraviolet Radiation Exposure of South African Marathon Runners During Competition Marathon Runs and Training Sessions: A Feasibility Study.

    PubMed

    Nurse, Victoria; Wright, Caradee Y; Allen, Martin; McKenzie, Richard L

    2015-01-01

    Marathon runners spend considerable time in outdoor training for and participating in marathons. Outdoor runners may experience high solar ultraviolet radiation (UVR) exposure. South Africa, where running is popular, experiences high ambient solar UVR levels that may be associated with adverse health effects. This feasibility study explores the use of personal dosimeters to determine solar UVR exposure patterns and possible related acute health risks of four marathon runners during marathons and training sessions in Cape Town and Pretoria. Runners running marathons that started early in the day, and that did not exceed 4 hours, yielded low total solar UVR exposure doses (mean 0.093 SED per exposure period run, median 0.088 SED, range 0.062-0.136 SED; average of 16.54% of ambient solar UVR). Training sessions run during early morning and late afternoon presented similar results. Several challenges hindered analysis including accounting for anatomical position of personal dosimeter and natural shade. To assess health risks, hazard quotients (HQs) were calculated using a hypothetical runner's schedule. Cumulative, annual solar UVR exposure-calculated acute health risks were low (HQ = 0.024) for training sessions and moderate (HQ = 4.922) for marathon runs. While these data and calculations are based on 18 person-days, one can measure marathon runners' personal solar UVR exposure although several challenges must be overcome. PMID:25918823

  8. Cross-country disparity in agricultural productivity: quantifying the role of modern seed adoption.

    PubMed

    O'Gorman, Melanie; Pandey, Manish

    2010-01-01

    Inequality of agricultural labour productivity across the developing world has increased substantially over the past 40 years. This article asks: to what extent did the diffusion of Green Revolution seed varieties contribute to increasing agricultural labour productivity disparity across the developing countries? We find that 22 per cent of cross-country variation in agricultural labour productivity can be attributed to the diffusion of high-yielding seed varieties across countries, and that the impact of such diffusion differed significantly across regions. We discuss the implications of these findings for policy directed at increasing agricultural labour productivity in the developing world. PMID:21280414

  9. Spatial query for decision support of cross-country movement. [in image-based geographic information system

    NASA Technical Reports Server (NTRS)

    Hepner, George F.; Logan, Thomas L.; Bryant, Nevin A.

    1988-01-01

    The use of a query language processor for decision support of cross-country movement in an image-based geographic information system is evaluated. It is found that query processing yields results which are comparable to those obtained using conventional cross-country movement techniques and analysis. Query processing also provides a flexibility of information extraction, rapid display, and flexible decision support in time-critical, limited data situations.

  10. Downhill turn techniques and associated physical characteristics in cross-country skiers.

    PubMed

    Sandbakk, S Bucher; Supej, M; Sandbakk, Ø; Holmberg, H-C

    2014-08-01

    Three dominant techniques are used for downhill turning in cross-country skiing. In this study, kinematic, kinetic, and temporal characteristics of these techniques are described and related to skier strength and power. Twelve elite female cross-country skiers performed six consecutive turns of standardized geometry while being monitored by a Global Navigation Satellite System. Overall time was used as an indicator of performance. Skiing and turning parameters were determined from skier trajectories; the proportional use of each technique was determined from video analysis. Leg strength and power were determined by isometric squats and countermovement jumps on a force plate. Snow plowing, parallel skidding, and step turning were utilized for all turns. Faster skiers employed less snow plowing and more step turning, more rapid deceleration and earlier initiation of step turning at higher speed (r = 0.80-0.93; all P < 0.01). Better performance was significantly correlated to higher mean speed and shorter trajectory (r = 0.99/0.65; both P < 0.05) and to countermovement jump characteristics of peak force, time to peak force, and rate of force development (r = -0.71/0.78/-0.83; all P < 0.05). In conclusion, faster skiers used step turning to a greater extent and exhibited higher maximal leg power, which enabled them to combine high speeds with shorter trajectories during turns. PMID:23517089

  11. The distribution of pace adopted by cyclists during a cross-country mountain bike World Championships.

    PubMed

    Abbiss, Chris R; Ross, Megan L R; Garvican, Laura A; Ross, Neil; Pottgiesser, Torben; Gregory, John; Martin, David T

    2013-01-01

    The purpose of this study was to examine the distribution of pace self-selected by cyclists of varying ability, biological age and sex performing in a mountain bike World Championship event. Data were collected on cyclists performing in the Elite Male (ELITEmale; n = 75), Elite Female (ELITEfemale; n = 50), Under 23 Male (U23male; n = 62), Under 23 Female (U23female; n = 34), Junior Male (JNRmale; n = 71) and Junior Female (JNRfemale; n = 30) categories of the 2009 UCI Cross-Country Mountain Bike World Championships. Split times were recorded for the top, middle and bottom 20% of all finishers of each category. Timing splits were positioned to separate the course into technical and non-technical, uphill, downhill and rolling/flat sections. Compared with bottom performers, top performers in all male categories (ELITEmale, U23male, JNRmale) maintained a more even pace over the event as evidenced by a significantly lower standard deviation and range in average lap speed. Top performers, males, and ELITEmale athletes spent a lower percentage of overall race time on technical uphill sections of the course, compared with middle and bottom placed finishers, females, and JNRmale athletes, respectively. Better male performers adopt a more even distribution of pace throughout cross-country mountain events. Performance of lower placed finishers, females and JNRmale athletes may be improved by enhancing technical uphill cycling ability. PMID:23521618

  12. Bronchoscopy and bronchoalveolar lavage findings in cross-country skiers with and without "ski asthma".

    PubMed

    Sue-Chu, M; Larsson, L; Moen, T; Rennard, S I; Bjermer, L

    1999-03-01

    Bronchial hyperresponsiveness to methacholine with asthma-like symptoms ("ski asthma") is frequent in elite cross-country skiers. To further the understanding of "ski asthma", 10 nonasthmatic, nonatopic controls and 30 adolescent elite skiers were investigated by bronchoscopy and bronchoalveolar lavage (BAL). Nine skiers were atopic without allergy symptoms. Compared with controls, the macroscopic inflammatory index in the proximal airways in skiers was three-fold greater (median (interquartile range) 3.0 (2.0-5.0) versus 1.0 (0.8-2.3), p=0.008). In the BAL fluid, skiers had significantly greater total cell (p<0.05) and percentage lymphocyte (p<0.01) and mast cell counts (p<0.05). Neutrophil and eosinophil counts were not significantly different and eosinophil cationic protein was not detected. Tumour necrosis factor-alpha and myeloperoxidase were detected in 12 (40%) and six (20%) skiers, respectively. In skiers with ski asthma, the inflammatory index was greater than in nonasthmatic skiers. Lymphocyte subtypes and activation markers, and concentration of albumin, fibronectin and hyaluronan were not different from those in controls. Cross-country skiers have a minor to moderate degree of macroscopic inflammation in the proximal airways at bronchoscopy and a bronchoalveolar lavage fluid profile which differs in several respects from healthy controls. Skiers with ski asthma tend to show even higher degrees of bronchial inflammation. PMID:10232438

  13. Correlations between physiological variables and performance in high level cross country off road cyclists

    PubMed Central

    Impellizzeri, F; Marcora, S; Rampinini, E; Mognoni, P; Sassi, A

    2005-01-01

    Objectives: To examine the relations between maximal and submaximal indices of aerobic fitness and off road cycling performance in a homogeneous group of high level mountain bikers. Methods: 12 internationally competitive mountain bikers completed the study. Maximum oxygen uptake (V·O2max), peak power output (PPO), power output (PO), and oxygen uptake (V·O2) at first (VT) and second (RCT) ventilatory thresholds were measured in the laboratory, and correlated with race time during a cross country circuit race. Results: The only physiological indices of aerobic fitness correlated with off road cycling performance were PO and V·O2 at RCT when normalised to body mass (r = –0.63 and r = –0.66, respectively; p<0.05). VT, V·O2max, and PPO were not correlated to performance in this homogeneous group of high level mountain bikers. Conclusions: The results of this study suggest that submaximal indices of aerobic fitness such as PO and V·O2 at RCT are more important determinants of off road cycling performance than maximal indices such as PPO and V·O2max. This study confirms the importance of body mass for mountain biking performance. As aerobic fitness explained only 40% of the variance, other physiological and technical factors should be investigated, as they may be important determinants of cross country performance among elite mountain bikers. PMID:16183772

  14. 9. View of bridge looking west. A fundraising marathon is ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. View of bridge looking west. A fund-raising marathon is in prgress. The traffic levels outside the main arch were added in 1965 when the bridge underwent extensive rehabilitation. - Detroit Superior High Level Bridge, Cleveland, Cuyahoga County, OH

  15. Marathon Training in the University Physical Education Curriculum.

    ERIC Educational Resources Information Center

    Dernbach, Arthur R.

    1983-01-01

    A course at Northern Illinois University trains college students for running marathons. The course offers information about conditioning, injury prevention, and diet requirements, as well as instruction in long-distance running. Techniques for motivating students are discussed. (PP)

  16. Sudden cardiac death in marathons: a systematic review.

    PubMed

    Waite, Oliver; Smith, Andy; Madge, Luke; Spring, Hannah; Noret, Nathalie

    2016-02-01

    The aim of this systematic review is to summarise the results of cohort studies that examined the incidence of SCD in marathons and to assess the quality of the methods used. A search of the PROSPERO international database revealed no prospective or published systematic reviews investigating SCD in marathons. The review was conducted using studies that reported and characterised the incidence of SCD in people participating in marathons. Studies were identified via electronic database searches (Medline, CINAHL, SPORTDiscus and Google Scholar) from January 1, 1966 to October 1, 2014 and through manual literature searches. 7 studies met the inclusion criteria and were included in this review. 6 of the studies were conducted in the USA and 1 in the UK. These studies covered a 34-year period involving between 215,413 and 3,949,000 runners. The SCD of between 4 and 28 people are recorded in the papers and the reported estimates of the incidence of SCD in marathons ranged widely from 0.6 to 1.9 per 100,000 runners. The proportion of those suffering SCD who were male ranged from 57.1% to 100% and the mean age reported in the papers, ranged from 37 to 48. This review raises 4 methodological concerns over i) collating reports of SCD in marathons; ii) time of death in relation to the marathon; iii) the use of registrants rather than runners in the estimates of sample size and iv) limited detail on runners exercise history. These four concerns all threaten the reliability and interpretation of any estimate of SCD incidence rates in marathons.  This review recommends that the methods used to collect data on SCD in marathons be improved and that a central reporting system be established. PMID:26765272

  17. Risk factors for lower extremity injuries among half marathon and marathon runners of the Lage Landen Marathon Eindhoven 2012: A prospective cohort study in the Netherlands.

    PubMed

    van Poppel, D; de Koning, J; Verhagen, A P; Scholten-Peeters, G G M

    2016-02-01

    To determine risk factors for running injuries during the Lage Landen Marathon Eindhoven 2012. Prospective cohort study. Population-based study. This study included 943 runners. Running injuries after the Lage Landen Marathon. Sociodemographic and training-related factors as well as lifestyle factors were considered as potential risk factors and assessed in a questionnaire 1 month before the running event. The association between potential risk factors and injuries was determined, per running distance separately, using univariate and multivariate logistic regression analysis. In total, 154 respondents sustained a running injury. Among the marathon runners, in the univariate model, body mass index ≥ 26 kg/m(2), ≤ 5 years of running experience, and often performing interval training, were significantly associated with running injuries, whereas in the multivariate model only ≤ 5 years of running experience and not performing interval training on a regular basis were significantly associated with running injuries. Among marathon runners, no multivariate model could be created because of the low number of injuries and participants. This study indicates that interval training on a regular basis may be recommended to marathon runners to reduce the risk of injury. PMID:25727692

  18. Mechanical work and physiological responses to simulated cross country mountain bike racing.

    PubMed

    Macdermid, Paul William; Stannard, Stephen

    2012-01-01

    The purpose was to assess the mechanical work and physiological responses to cross country mountain bike racing. Participants (n = 7) cycled on a cross country track at race speed whilst VO2, power, cadence, speed, and geographical position were recorded. Mean power during the designated start section (68.5 ± 5.5 s) was 481 ± 122 W, incurring an O2 deficit of 1.58 ± 0.67 L - min(-1) highlighting a significant initial anaerobic (32.4 ± 10.2%) contribution. Complete lap data produced mean (243 ± 12 W) and normalised (279 ± 15 W) power outputs with 13.3 ± 6.1 and 20.7 ± 8.3% of time spent in high force-high velocity and high force-low velocity, respectively. This equated to, physiological measures for %VO(2max) (77 ± 5%) and % HR(max) (93 ± 2%). Terrain (uphill vs downhill) significantly (P < 0.05) influenced power output (70.9 ± 7.5 vs. 41.0 ± 9.2% W(max)),the distribution of low velocity force production, VO2 (80 ± 1.7 vs. 72 ± 3.7%) and cadence (76 + 2 vs. 55 ± 4 rpm) but not heart rate (93.8 ± 2.3 vs. 91.3 ± 0.6% HR(max)) and led to a significant difference between anaerobic contribution and terrain (uphill, 6.4 ± 3.0 vs. downhill, 3.2 ± 1.8%, respectively) but not aerobic energy contribution. Both power and cadence were highly variable through all sections resulting in one power surge every 32 s and a supra-maximal effort every 106 s. The results show that cross country mountain bike racing consists of predominantly low velocity pedalling with a large high force component and when combined with a high oscillating work rate, necessitates high aerobic energy provision, with intermittent anaerobic contribution. Additional physical stress during downhill sections affords less recovery emphasised by physiological variables remaining high throughout. PMID:22876780

  19. [Physiological effects of ultra-marathon run].

    PubMed

    Akimov, E B; Son'kin, V D

    2012-01-01

    We investigated the performance of vegetative systems of the body, and gas exchange in the implementation of one athlete (master of skiing, 27 years, MaxVO2 = 67 ml/min/kg) during 6 hours ultra-marathon race in a closed stadium at an average speed of 2.7 m/s. Continuous monitoring of heart rate was carried out using the heart rate monitor Polar RS 800. During the first hour and then for 20-30 minutes each hour gas analysis was performed with Metamaxdevice (Germany), mounted on the test subject during all the time of the race. Before and after the passages of the measured interval distance blood lactate content was measured. These data demonstrate a number of features that accompany fatigue in the final stretches a distance: reduction of body economy, which is to increase heart rate and oxygen cost of work; activation of anaerobic-glycolitic energy production mechanism, the intensification of respiratory function. Along with this, the methods of correlation and regression analysis revealed changes (increase or decrease) the relationship between the functions depending on whether the body is in the initial stage of the physical load, sustainable high performance or in either a state of extreme fatigue. These results suggest the interference effects of the central and tissue mechanisms of fatigue in the organization of the oxygen transport function of the body. Apparently, in the case of ultra-marathon run, that is, long-term work of moderate power, the main limiting factor is not the energy of the body, and the autonomic software. PMID:23393784

  20. A Comparison of Frontal Theta Activity During Shooting among Biathletes and Cross-Country Skiers before and after Vigorous Exercise

    PubMed Central

    Luchsinger, Harri; Sandbakk, Øyvind; Schubert, Michael; Ettema, Gertjan; Baumeister, Jochen

    2016-01-01

    Background Previous studies using electroencephalography (EEG) to monitor brain activity have linked higher frontal theta activity to more focused attention and superior performance in goal-directed precision tasks. In biathlon, shooting performance requires focused attention after high-intensity cross-country skiing. Purpose To compare biathletes (serving as experts) and cross-country skiers (novices) and examine the effect of vigorous exercise on frontal theta activity during shooting. Methods EEG frontal theta (4–7 Hz) activity was compared between nine biathletes and eight cross-country skiers at comparable skiing performance levels who fired 100 shots on a 5-m indoor shooting range in quiescent condition followed by 20 shots after each of five 6-min high-intensity roller skiing sessions in the skating technique on a treadmill. Results Biathletes hit 80±14% and 81±10% before and after the roller skiing sessions, respectively. For the cross-country skiers these values were significantly lower than for the biathletes and amounted to 39±13% and 44±11% (p<0.01). Biathletes had on average 6% higher frontal theta activity during shooting as compared to cross-country skiers (F1,15 = 4.82, p = 0.044), but no significant effect of vigorous exercise on frontal theta activity in either of the two groups were found (F1,15 = 0.14, p = 0.72). Conclusions Biathletes had significantly higher frontal theta activity than cross-country skiers during shooting, indicating higher focused attention in biathletes. Vigorous exercise did not decrease shooting performance or frontal theta activity during shooting in biathletes and cross-country skiers. PMID:26981639

  1. Corruption costs lives: a cross-country study using an IV approach.

    PubMed

    Lio, Mon-Chi; Lee, Ming-Hsuan

    2016-04-01

    This study quantitatively estimates the effects of corruption on five major health indicators by using recent cross-country panel data covering 119 countries for the period of 2005-2011. The corruption indicators provided by the World Bank and Transparency International are used, and both the two-way fixed effect and the two-stage least squares approaches are employed for our estimation. The estimation results show that, in general, corruption is negatively associated with a country's health outcomes. A lower level of corruption or a better control of corruption in a country can lead to longer life expectancy, a lower infant mortality rate and a lower under-five mortality rate for citizens. However, our estimation finds no significant association between corruption and individual diseases including human immunodeficiency virus prevalence and tuberculosis incidence. The findings suggest that corruption reduction itself is an effective method to promote health. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26122874

  2. Effects of carbohydrate dose and frequency on metabolism, gastrointestinal discomfort, and cross-country skiing performance.

    PubMed

    Stocks, B; Betts, J A; McGawley, K

    2016-09-01

    This study investigated carbohydrate ingestion of varied doses and frequencies during a simulated cross-country skiing time trial. Ten men and three women (age: 30 ± 7 years; V ˙ O 2 m a x : 59.6 ± 5.7 mL/kg/min) completed four, 30-km classic technique roller skiing time trials on a treadmill. A 1:1 maltodextrin-fructose carbohydrate solution was provided at high (2.4 g/min; HC) and moderate (1.2 g/min; MC) ingestion rates, each at high (six feeds; HF) and low (two feeds; LF) frequencies. In the LF trials, blood glucose was elevated following carbohydrate ingestion (at 4 and 19 km) but was reduced at 14 and 29 km compared with HF strategies (P ≤ 0.05). Gastrointestinal discomfort was higher in HC-LF compared with all other trials (P ≤ 0.05). Whole-body lipid oxidation was lower and carbohydrate oxidation was higher in LF compared with HF trials (P ≤ 0.05). While performance time was not significantly different between trials (140:11 ± 15:31, 140:43 ± 17:40, 139:12 ± 15:32 and 140:33 ± 17:46 min:s in HC-HF, HC-LF, MC-HF, and MC-LF, respectively; P > 0.05), it was improved with trial order (P < 0.001). There was no effect of order on any other variable (P > 0.05). Altering carbohydrate dose or frequency does not affect cross-country ski performance. However, low-frequency carbohydrate ingestion resulted in poorer maintenance of euglycemia, reduced lipid oxidation, and increased gastrointestinal discomfort. PMID:26316418

  3. Motility of magnetotactic bacteria/MTB to Geomagnetic fields

    NASA Astrophysics Data System (ADS)

    Hidajatullah-Maksoed, Fatahillah

    2016-03-01

    Bacteria with motility directed by a local geomagnetic fields have been observed in marine sediments'' discussed by R. Blakemore, 1975. Magnetotactic bacteria/MTB discovered in 1963 by Salvatore Bellini. For ``off-axis electron holography in the transmission electron microscope was used to correlates the physical & magnetic microstructure of magnetite nanocrystals in magnetotactic bacteria'' sought ``single-domain magnetite in hemopelagic sediments'' from JF Stolz. Otherwise, for potential source of bioproducts- product meant from result to multiplier -of magnetotactic bacteria[ACV Araujo, et.al, 2014 ] of marine drugs retrieved the `measurement of cellular chemotaxis with ECIS/Taxis, from KM Pietrosimone, 2012, whereas after ``earth magnetic field role on small living models'' are other interpretation of ``taxis'' as a movement of a cell instead usual ``tax'' for yew's taxus cuspidate, hired car & taxes in financial realms. Acknowledgements to HE. Mr. H. TUK SETYOHADI, Jl. Sriwijaya Raya 3, South-Jakarta, INDONESIA.

  4. 75 FR 27641 - Safety Zone; Marathon Oil Refinery Construction, Rouge River, Detroit, MI

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-18

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Marathon Oil Refinery Construction, Rouge... vessels from a portion of the Rouge River during the Marathon Oil Refinery Construction project. This... offloading of equipment in conjunction with the Marathon Oil Refinery Construction project. The offloading...

  5. Improved Race Times in Marathoners Older than 75 Years in the Last 25 Years in the World's Largest Marathons.

    PubMed

    Ahmadyar, Baschir; Rosemann, Thomas; Rüst, Christoph Alexander; Knechtle, Beat

    2016-06-30

    Performance trends of elite marathoners are well investigated. However, performance of elderly marathoners (> 75 years) competing in the world's largest city marathons is not well-known. We examined marathon race data of 1,691 marathon finishes (i.e. 218 women and 1,473 men) competing between 1990 and 2014 in 5-year age groups 75-79, 80-84, 85-89, and 95-99 years in four races (Berlin, New York, Chicago and Boston) of the 'World Marathon Majors'. The number of female (r² = 0.50, P < 0.0001) and male (r² = 0.88, P < 0.0001) finishers increased significantly across years. The number of women (r² = 0.36, P = 0.0019) and men (r² = 0.88, P < 0.0001) in age group 75-79 years increased. In age group 80-84 years, the number of women (r² = 0.36, P = 0.0111) and men (r² = 0.54, P < 0.0001) also increased. In age groups 85-89 to 95-99 years, however, the number of female and male finishers remained unchanged. Across years, women (r² = 0.26, P = 0.0090) and men (r² = 0.31, P = 0.0035) reduced their race times. Women and men in age group 75-79 years improved race times. In age groups 80-84 to 90-94 years, women and men were not able to reduce race times. In summary, participation increased and performance improved in female and male marathoners competing in age groups 75-79 to 95-99 years where the largest increases in participation and the largest improvements in performance were found in women and men in age group 75-79 years. PMID:27188466

  6. Effect of training intensity on muscle lactate transporters and lactate threshold of cross-country skiers.

    PubMed

    Evertsen, F; Medbø, J I; Bonen, A

    2001-10-01

    The training intensity may affect the monocarboxylate transporters MCT1 and MCT4 in skeletal muscle. Therefore, 20 elite cross-country skiers (11 men and nine women) trained hard for 5 months at either moderate (MIG, 60-70% of VO2max) or high intensity (HIG, 80-90%). The lactate threshold, several performance parameters, and the blood lactate concentration (cLa) after exhausting treadmill running were also determined. Muscle biopsies taken from the vastus lateralis muscle before and after the training period were analysed for the two MCTs and for muscle fibre types and six enzymes. The concentration of MCT1 did not change for HIG (P=0.3) but fell for MIG (-12 +/- 3%, P=0.01); the training response differed between the two groups (P=0.05). The concentration of MCT4 did not change during the training period (P > 0.10). The concentration of the two MCTs did not differ between the two sexes (P=0.9). The running speed at the lactate threshold rose for HIG (+3.2 +/- 0.9%, P=0.003), while no change was seen for MIG (P=0.54); the training response differed between the two groups (P=0.04). The cLa after long-lasting exhausting treadmill running correlated with the concentration of MCT1 (rs=0.69, P=0.002), but not with that of MCT4 (rs=0.2, P=0.2). There were no other significant correlations between the concentrations of the two MCTs and the performance parameters, muscle fibre types, or enzymes (r < or = 0.36, P > 0.10). Thus, the training response differed between MIG and HIG both in terms of performance and of the effect on MCT1. Training at high intensity may be more effective for cross-country skiers. Finally, MCT1 may be important for releasing lactate to the blood during long-lasting exercise. PMID:11683677

  7. Public spending for illegal drug and alcohol treatment in hospitals: an EU cross-country comparison

    PubMed Central

    2014-01-01

    Background In view of the current economic crisis and the resulting austerity measures being implemented by governments across Europe, public expenditure for substance abuse treatment has increasingly become a subject of discussion. An EU cross-country comparison would allow an estimation of the total amount of public resources spent on substance abuse treatment, compare various substance abuse treatment funding options, and evaluate the division of expenditures between alcohol and illegal drugs. The purpose of this study is to estimate the public spending of EU countries for alcohol and illegal drug abuse treatment in hospitals. Methods Our study uses a uniform methodology in order to enable valid cross-national comparisons. Our data are drawn from the Eurostat database, which provides anno 2010 data on government spending for the treatment of illegal drug and alcohol abuse in 21 EU member states. The cross-country comparison is restricted to hospitals, since data were unavailable for other types of treatment providers. The systematic registration of in- and outpatient data is essential to monitoring public expenditures on substance abuse treatment using international databases. Results Total public spending for hospital-based treatment of illegal drug and alcohol abuse in the 21 EU member states studied is estimated to be 7.6 billion euros. Per capita expenditures for treatment of illegal drug abuse vary, ranging from 0.1 euros in Romania to 13 euros in Sweden. For alcohol abuse, that figure varied from 0.9 euros in Bulgaria to 24 euros in Austria. These results confirm other studies indicating that public expenditures for alcohol treatment exceed that for illegal drug treatment. Conclusions Multiple factors may influence the number of hospital days for alcohol or illegal substance abuse treatment, and expenditures fluctuate accordingly. In this respect, we found a strong correlation between gross domestic product (GDP) per capita and public expenditures per

  8. Energy cost of different skating techniques in cross-country skiing.

    PubMed

    Millet, Gregoire P; Boissiere, Denis; Candau, Robin

    2003-01-01

    The aims of this study were to compare the aerobic energy cost of four 'on-snow' skating techniques in cross-country skiing and to examine the relationships between performance and aerobic energy cost. Twelve male skiers from recreational to national standard performed four level skating trials of 6 min duration in random order, each at the same submaximal velocity but with a different skating technique: (1) 'offset' (V1), using a double asymmetrical and asynchronous pole plant as weight is transferred to one ski; (2) 'two-skate' (V2A), where the pole plant is symmetrical; (3) 'one-skate' (V2), where there is a pole plant as weight is transferred to each ski; and (4) 'conventional', without poles. Oxygen uptake (VO2), pulmonary ventilation, the respiratory exchange ratio and heart rate were measured using a K4(b2) portable gas analyser. The aerobic energy cost (VO2/mean speed) and heart rate were higher (P < 0.05) in the one-skate than in the offset condition. This may be explained by the greater and more efficient use of the upper body and the lower variation in centre of gravity velocity in the offset condition. The aerobic energy cost was 5-9% higher (P < 0.01) in the conventional than in the other techniques, probably because of the shorter duration of propulsive forces within a cycle in the conventional skating condition. Moreover, in ski skating, the mechanical efficiency (propulsive forces/total forces) was shown to be higher in the upper than in the lower limbs. The correlation coefficient between performance and aerobic energy cost was significant in the two-skate (r = 0.68, P = 0.02), one-skate (r = 0.72, P = 0.01) and conventional (r = 0.62, P = 0.04) conditions, but not in the offset condition (r = 0.50, P = 0.10). Our results stress the importance of the upper body component in cross-country skiing and that the aerobic energy cost discriminates between skiers of different standards. PMID:12587886

  9. Reduced performance difference between sexes in master mountain and city marathon running

    PubMed Central

    Zingg, Matthias A; Knechtle, Beat; Rüst, Christoph Alexander; Rosemann, Thomas; Lepers, Romuald

    2013-01-01

    Background The performance in master marathoners has been investigated in flat city marathons but not in mountain marathons. This study examined changes in the sex differences in performance across time in female and male master runners competing in a mountain marathon compared to a flat city marathon. Methods The association between age and performance of finishers in the Jungfrau Marathon, Switzerland, with 1830 meter changes in altitude and a flat city marathon (Lausanne Marathon), Switzerland, were analyzed from 2000 to 2011. Results In both events, athletes in the 35–44 years age group showed the highest number of finishers. In the mountain marathon, the number of female master runners aged > 35 years increased in contrast to female finishers aged < 35 years, while the number of male finishers was unchanged in all age groups. In the city marathon, the number of female finishers was unchanged while the number of male finishers in the age groups for 25–34-year-olds and 35–44-year-olds decreased. In female marathoners, performance improved in athletes aged 35–44 and 55–64 years in the city marathon. Male marathoners improved race time in age group 45–54 years in both the city marathon and the mountain marathon. Female master runners reduced the sex difference in performance in the 45–54-year age group in both competitions and in the 35–44-year age group in the mountain marathon. The sex difference in performance decreased in the 35–44-year age group from 19.1% ± 4.7% to 16.6% ± 1.9% in the mountain marathon (r2 = 0.39, P = 0.03). In age groups 45–54 years, the sex difference decreased from 23.4% ± 1.9% to 15.9% ± 6.1% in the mountain marathon (r2 = 0.39, P < 0.01) and from 34.7% ± 4.6% to 11.8% ± 6.2% in the city marathon (r2 = 0.39, P < 0.01). Conclusion These findings suggest that female master runners aged 35–54 years reduced sex differences in their performance in both mountain and city marathon running. PMID:23637550

  10. Preparing for the surge: perspectives on marathon medical preparedness.

    PubMed

    Chiampas, George; Jaworski, Carrie A

    2009-01-01

    In preparing for medical coverage of a mass participation event such as a marathon, race directors and their medical staff members need to account for the unexpected. Extremes in weather as well as the potential for outside threats need to be given consideration before race day in order to adequately prepare. Through the recruitment of local expertise from various agencies in one's community during both the planning stages, and on race day, the added stressors of such extremes will be minimized, if not eliminated. This article will provide concrete examples of how the Chicago Marathon has used its own experiences with such extremes. Readers will be given useful tools to implement in their own marathons or other mass participation events-planning to equip them better for the unexpected surge. PMID:19436168

  11. Comparison of manually produced and automated cross country movement maps using digital image processing techniques

    NASA Technical Reports Server (NTRS)

    Wynn, L. K.

    1985-01-01

    The Image-Based Information System (IBIS) was used to automate the cross country movement (CCM) mapping model developed by the Defense Mapping Agency (DMA). Existing terrain factor overlays and a CCM map, produced by DMA for the Fort Lewis, Washington area, were digitized and reformatted into geometrically registered images. Terrain factor data from Slope, Soils, and Vegetation overlays were entered into IBIS, and were then combined utilizing IBIS-programmed equations to implement the DMA CCM model. The resulting IBIS-generated CCM map was then compared with the digitized manually produced map to test similarity. The numbers of pixels comprising each CCM region were compared between the two map images, and percent agreement between each two regional counts was computed. The mean percent agreement equalled 86.21%, with an areally weighted standard deviation of 11.11%. Calculation of Pearson's correlation coefficient yielded +9.997. In some cases, the IBIS-calculated map code differed from the DMA codes: analysis revealed that IBIS had calculated the codes correctly. These highly positive results demonstrate the power and accuracy of IBIS in automating models which synthesize a variety of thematic geographic data.

  12. Trait and state anxiety in male and female cross-country runners.

    PubMed Central

    Sanderson, F. H.; Reilly, T.

    1983-01-01

    The purpose of this study was to explore the relationships between state/trait anxiety and competitive cross-country performance for males and females. A-trait and A-state pre- and post-competition were monitored in 38 females and 26 males at major meetings. The females' A-trait was correlated with pre-race A-state (p less than .05) which was itself correlated significantly with race performance (p less than .05). A significant post-race A-state reduction occurred only with the better runners. The correlation between A-trait and pre-race A-state was also found in the male athletes (p less than .05) while A-trait significantly correlated with race performance (p less than .05). A-state was significantly reduced post-race, the greatest decrease being observed in the top performers. It is concluded that trait as well as transient dispositions are relevant when psychological determinants of performance are considered. Images p24-a p24-b PMID:6850201

  13. 5-week block periodization increases aerobic power in elite cross-country skiers.

    PubMed

    Rønnestad, B R; Hansen, J; Thyli, V; Bakken, T A; Sandbakk, Ø

    2016-02-01

    The purpose of this study was to compare the effect of two different methods of organizing endurance training in elite cross-country skiers approaching the competition period. During the 5-week intervention period, one group performed block periodization (BP; n = 10) with 5 and 3 high-intensity sessions (HIT) during the first and third training week. One HIT was performed during the remaining weeks in BP, while the group performing traditional training organization (TRAD, n = 9) performed two weekly HIT except during the third week where they performed three HIT. HIT were interspersed with low-intensity training (LIT) and both groups performed similar total amount of both HIT and LIT during the intervention. BP achieved a larger relative increase in peak power output and power output at a blood lactate concentration of 4 mmol/L than TRAD (4 ± 4 vs -3 ± 6% and 11 ± 10 vs 2 ± 4%, respectively, both P < 0.01). BP also increased maximal oxygen uptake by 2 ± 2% (P < 0.05), while no changes occurred in TRAD. The effect sizes of the relative improvement in these measurements revealed moderate effects of BP vs TRAD training. The present study suggests that block periodization of endurance training have superior effects on several endurance and performance indices compared with traditional organization. PMID:25648345

  14. Eye injuries in the extreme environment ultra-marathon runner.

    PubMed

    Cope, Thomas Adam; Kropelnicki, Anna

    2015-01-01

    We present the case of an ultra-marathon runner who developed a painful irritated eye due to prolonged exposure to high wind speed and sub-zero temperatures causing transient freezing and subsequent abrasion of the cornea. We recommend that all ultra-marathon runners racing in windy or exposed conditions should wear wrap-around eye protection or goggles. If runners present to checkpoints or after the race to primary care or the emergency department with ocular pain, corneal freezing and abrasions should be considered. Management should include ocular examination and withdrawing the runner from harmful conditions. PMID:26038387

  15. Anti-VEGF in a Marathon Runner's Retinopathy Case.

    PubMed

    Soon, Alexander Kahjun; de Oliveira, Paulo Ricardo Chaves; Chow, David Robert

    2016-01-01

    Central retinal vein occlusion (CRVO) is one of the most common retinal vascular disorders. Intense exercise associated CRVO have been described in otherwise healthy young patients. We describe a case of a young male ultramarathoner who presented with a CRVO, presumably associated with dehydration, making part of a marathon runner's retinopathy. Resolution of macular edema and subretinal fluid, with visual acuity improvement, was observed after 3 monthly injections of ranibizumab. Our case suggests that dehydration could be involved in the mechanism of CRVO in healthy young patients and ranibizumab may be an effective treatment option for marathon runner's retinopathy. PMID:27418990

  16. Anti-VEGF in a Marathon Runner's Retinopathy Case

    PubMed Central

    Soon, Alexander Kahjun

    2016-01-01

    Central retinal vein occlusion (CRVO) is one of the most common retinal vascular disorders. Intense exercise associated CRVO have been described in otherwise healthy young patients. We describe a case of a young male ultramarathoner who presented with a CRVO, presumably associated with dehydration, making part of a marathon runner's retinopathy. Resolution of macular edema and subretinal fluid, with visual acuity improvement, was observed after 3 monthly injections of ranibizumab. Our case suggests that dehydration could be involved in the mechanism of CRVO in healthy young patients and ranibizumab may be an effective treatment option for marathon runner's retinopathy. PMID:27418990

  17. Cross-Country Variation in Adult Skills Inequality: Why Are Skill Levels and Opportunities so Unequal in Anglophone Countries?

    ERIC Educational Resources Information Center

    Green, Andy; Green, Francis; Pensiero, Nicola

    2015-01-01

    This article examines cross-country variations in adult skills inequality and asks why skills in Anglophone countries are so unequal. Drawing on the Organization for Economic Cooperation and Development's recent Survey of Adult Skills and other surveys, it investigates the differences across countries and country groups in inequality in both…

  18. Production activities and economic dependency by age and gender in Europe: A cross-country comparison

    PubMed Central

    Hammer, Bernhard; Prskawetz, Alexia; Freund, Inga

    2015-01-01

    We compare selected European countries using an economic dependency ratio which emphasizes the role of age-specific levels of production and consumption. Our analysis reveals large differences in the age- and gender-specific level and type of production activities across selected European countries and identifies possible strategies to adjust age-specific economic behaviour to an ageing population. The cross-country differences in economic dependency of children and elderly persons are largely determined by the age at which people enter, respectively exit, the labour market. The ability of the working age population to support children and elderly persons in turn is strongly influenced by the participation of women in paid work. We also provide a measure for the age-specific production and consumption in form of unpaid household work. The inclusion of unpaid household work leads to a decrease of the gender differences in production activities and indicates that the working age population supports children and elderly persons not only through monetary transfers but also through services produced by unpaid work (e.g. childcare, cooking, cleaning…). Given the available data, we cannot distinguish the age profile of consumption by gender and have to assume – in case of unpaid work - that each member of the household consumes the same. Hence, our results have to be regarded as a first approximation only. Our paper aims to argue that a reform of the welfare system needs to take into account not only public transfers but also private transfers, in particular the transfers in form of goods and services produced through unpaid household work. PMID:26110107

  19. Seatbelt wearing rates in middle income countries: a cross-country analysis.

    PubMed

    Vecino-Ortiz, Andres I; Bishai, David; Chandran, Aruna; Bhalla, Kavi; Bachani, Abdulgafoor M; Gupta, Shivam; Slyunkina, Ekaterina; Hyder, Adnan A

    2014-10-01

    In settings with low seatbelt use prevalence, self-reported seatbelt use estimates often lack validity, and routine observational studies are scarce. In this paper, we aim to describe the prevalence of seatbelt use and associated factors in drivers and front-seat passengers across eight sites in four countries (Egypt, Mexico, Russia, Turkey) using observational studies as well as to produce estimates of country-level and site-level variance. As part of the Bloomberg Philanthropies Global Road Safety Program, data on driver and passenger seatbelt use across four middle-income countries was collected between October 2010 and May 2011 (n=122,931 vehicles). Logistic regression and Intraclass Correlation Coefficient analyses for sites- and country-level clustering were performed. We found high variability of seatbelt wearing rates ranging from 4 to 72% in drivers and 3-50% in front-seat passengers. Overall, average seatbelt wearing rates were low (under 60% in most sites). At the individual level, older and female drivers were more likely to wear seatbelts, as well as drivers of vehicles transiting at times of increased vehicle flow. We also found that 26-32% and 37-41% of the variance in seatbelt use among drivers and front-seat passengers respectively was explained by differences across sites and countries. Our results demonstrate that there is room for improvement on seatbelt use in middle-income countries and that standardized cross-country studies on road safety risk factors are feasible, providing valuable information for prevention and monitoring activities. PMID:24906165

  20. Gait models and mechanical energy in three cross-country skiing techniques.

    PubMed

    Pellegrini, Barbara; Zoppirolli, Chiara; Bortolan, Lorenzo; Zamparo, Paola; Schena, Federico

    2014-11-01

    Fluctuations in mechanical energy of the body center of mass (COM) have been widely analyzed when investigating different gaits in human and animal locomotion. We applied this approach to estimate the mechanical work in cross-country skiing and to identify the fundamental mechanisms of this particular form of locomotion. We acquired movements of body segments, skis, poles and plantar pressures for eight skiers while they roller skied on a treadmill at 14 km h(-1) and a 2 deg slope using three different techniques (diagonal stride, DS; double poling, DP; double poling with kick, DK). The work associated with kinetic energy (KE) changes of COM was not different between techniques; the work against gravity associated with potential energy (PE) changes was higher for DP than for DK and was lowest for DS. Mechanical work against the external environment was 0.87 J m(-1) kg(-1) for DS, 0.70 J m(-1) kg(-1) for DP and 0.79 J m(-1) kg(-1) for DK. The work done to overcome frictional forces, which is negligible in walking and running, was 17.8%, 32.3% and 24.8% of external mechanical work for DS, DP and DK, respectively. The pendulum-like recovery (R%) between PE and KE was ~45%, ~26% and ~9% for DP, DK and DS, respectively, but energy losses by friction are not accounted for in this computation. The pattern of fluctuations of PE and KE indicates that DS can be described as a 'grounded running', where aerial phases are substituted by ski gliding phases, DP can be described as a pendular gait, whereas DK is a combination of both. PMID:25355851

  1. Cognitive orientations in marathon running and "hitting the wall"

    PubMed Central

    Stevinson, C. D.; Biddle, S. J.

    1998-01-01

    OBJECTIVES: To investigate whether runners' cognitions during a marathon are related to "hitting the wall". To test a new and more comprehensive system for classifying cognition of marathon runners. METHODS: Non-elite runners (n = 66) completed a questionnaire after finishing the 1996 London marathon. The runners were recruited through the charity SPARKS for whom they were raising money by running in the race. RESULTS: Most runners reported that during the race their thoughts were internally associative, with internally dissociative thoughts being the least prevalent. Runners who "hit the wall" used more internal dissociation than other runners, indicating that it is a hazardous strategy, probably because sensory feedback is blocked. However, internal association was related to an earlier onset of "the wall", suggesting that too much attention on physical symptoms may magnify them, thereby exaggerating any discomfort. External dissociation was related to a later onset, probably because it may provide a degree of distraction but keeps attention on the race. CONCLUSIONS: "Hitting the wall" for recreational non-elite marathon runners is associated with their thought patterns during the race. In particular, "the wall" is associated with internal dissociation. 




 PMID:9773172

  2. Repeated Stress Fractures in an Amenorrheic Marathoner: A Case Conference.

    ERIC Educational Resources Information Center

    Sutton, John R.; Nilson, Karen L.

    1989-01-01

    Presents a case conference by 2 experts on the relationship between a 26-year-old marathoner's amenorrhea and her sustained unusual stress fractures in 4 ribs (plus previous similar fractures of the calcaneal, navicular, metatarsal, and tibial bones). The experts conclude that she suffers many manifestations of overtraining. (SM)

  3. Marathon Group: Changes in Perceived Locus of Control

    ERIC Educational Resources Information Center

    Foulds, Melvin L.; And Others

    1974-01-01

    Fifteen college students participated in a 24-hour marathon group and responded to the Internal-External Scale immediately before and after the experience. The results disclosed significant positive change at the .001 level in perceived locus of internal-external control of reinforcement expectancies in the direction of increased internality.…

  4. Marathon Group: Changes in Scores on the California Psychological Inventory

    ERIC Educational Resources Information Center

    Foulds, Melvin L.; And Others

    1974-01-01

    Eighteen college students participated in a 24-hour marathon group and responded to the California Psychological Inventory (CPI) immediately before and after the experience. The results disclosed significant positive changes at the .05 level on 11 of 18 scales on this inventory. (Author)

  5. Effects of Marathon Group Therapy on Trait and State Anxiety

    ERIC Educational Resources Information Center

    Kilmann, Peter R.; Auerbach, Stephen M.

    1974-01-01

    Results were interpreted as supporting Spielberger's notion that trait anxiety reflects a dispositional tendency to respond with anxiety in ego-threat situations and as suggesting that personality trait measures may be more relevant outcome indicators than measures of transitory mood states in marathon therapy research. (Author)

  6. Predicting Benefit from a Gestalt Therapy Marathon Workshop.

    ERIC Educational Resources Information Center

    Healy, James; Dowd, E. Thomas

    1981-01-01

    Tested the utility of the Personal Orientation Inventory (POI), the Myers-Briggs Type Indicator, and the Girona Affect Scale in predicting the outcomes of a marathon Gestalt therapy workshop. Signigicant predictive equations were generated that use the POI to predict gains on the Girona Affect Scale. (Author/RC)

  7. Transitions: Preparing Families of Preschoolers for "Marathon Skills".

    ERIC Educational Resources Information Center

    Deitz, Sally J.; Warkala, Catherine Sonen

    1993-01-01

    Skills that families gain in coping with transitions at the early ages of their child with visual impairments provide skills necessary for all the life-stage transitions that follow and, thus, are termed marathon skills. The transition programing of the Lighthouse Child Development Center in New York City is designed to develop those skills. (JDD)

  8. Marathon Group Counseling with Illicit Drug Users: Analysis of Content.

    ERIC Educational Resources Information Center

    Page, Richard C.; Wills, Judy

    1983-01-01

    Summarized a 16-hour marathon group for illicit drug users (N=12) in residential treatment. Content analysis showed the group spent more time on interpersonal relationships and relatively little time on group process. Drug users were able to successfully participate in therapeutic group discussions involving self-investment. (JAC)

  9. Similarities and Differences of Marathon and Ongoing Strength Groups.

    ERIC Educational Resources Information Center

    Barrick, Marilyn C.; Creveling, Patricia

    Marathon groups offer individuals an opportunity to engage in intensified, authentic personal encounter with each other in a small group setting, usually with 10-15 persons in a group. This is a report of tentative findings at the Student Life Center, University of Colorado. There were three matched groups, each with nine sophomores. The first…

  10. A Gestalt Marathon Workshop: Effects on Extraversion and Neuroticism

    ERIC Educational Resources Information Center

    Foulds, Melvin L.; Hannigan, Patricia S.

    1976-01-01

    College students (N=18) participated in a 24-hour marathon gestalt workshop and responded to the Eysenck Personality Inventory before and after the event. Results revealed a significant positive change at the .01 level on a measure of neuroticism-stability and no change on a measure of extroversion-introversion. (Author)

  11. Deadly Serious: The Boston Marathon Tragedy and Education

    ERIC Educational Resources Information Center

    Harney, John O.

    2013-01-01

    Two bombs exploded at the Boston Marathon on Monday, April 15, killing three and injuring more than 260. The pressure-cooker bombs sent shrapnel at leg-level, leading to amputations for 15 victims. An immediate concern was how to deal with the feelings of school children whose sense of safety was shattered by the blasts. As the city healed, Boston…

  12. Aspirin Risks in Perspective: A Comparison against Marathon Running

    ERIC Educational Resources Information Center

    Morgan, Gareth

    2014-01-01

    Aspirin has public health potential to reduce the risk of ischaemic vascular events and sporadic cancer. One objection to the wider use of aspirin for primary prevention, however, is the undesirable effects of the medicine, which include increasing risk of bleeding and haemorrhagic stroke. Marathons also carry risks of serious events such as…

  13. EXERCISE-INDUCED PULMONARY HEMORRHAGE AFTER RUNNING A MARATHON

    EPA Science Inventory

    We report on a healthy 26-year-old male who had an exercise-induced pulmonary hemorrhage (EIPH) within 24 hours of running a marathon. There were no symptoms, abnormalities on exam, or radiographic infiltrates. He routinely participated in bronchoscopy research and the EIPH was e...

  14. Structural style of the Marathon thrust belt, West Texas

    NASA Astrophysics Data System (ADS)

    Hickman, Robert G.; Varga, Robert J.; Altany, Robert M.

    2009-09-01

    The Marathon portion of the Ouachita thrust belt consists of a highly deformed allochthonous wedge of Cambrian-Pennsylvanian slope strata (Marathon facies) that was transported to the northwest and emplaced over Pennsylvanian foredeep sediments. The foredeep strata in turn overlie early-middle Paleozoic shelfal sediments which are deformed by late Paleozoic basement-involved reverse faults. The Dugout Creek thrust is the basal thrust of the allochthon. Shortening in this sheet and overlying sheets is ˜80%. Steep imbricate faults link the Dugout Creek thrust to upper level detachments forming complex duplex zones. Progressive thrusting and shortening within the allochthon folded the upper level detachments and associated thrust sheets. The Caballos Novaculite is the most competent unit within the Marathon facies and controlled development of prominent detachment folds. Deeper imbricate sheets composed of the Late Pennsylvanian foredeep strata, and possibly early-middle Paleozoic shelfal sediments developed concurrently with emplacement of the Marathon allochthon and folded the overlying allochthon. Following termination of thrusting in the earliest Permian, subsidence and deposition shifted northward to the Delaware, Midland and Val Verde foreland basins.

  15. Cost-benefit analysis of Xpert MTB/RIF for tuberculosis suspects in German hospitals.

    PubMed

    Diel, Roland; Nienhaus, Albert; Hillemann, Doris; Richter, Elvira

    2016-02-01

    Our objective was to assess the cost-benefit of enhancing or replacing the conventional sputum smear with the real-time PCR Xpert MTB/RIF method in the inpatient diagnostic schema for tuberculosis (TB).Recent data from published per-case cost studies for TB/multidrug-resistant (MDR)-TB and from comparative analyses of sputum microscopy, mycobacterial culture, Xpert MTB/RIF and drug susceptibility testing, performed at the German National Reference Center for Mycobacteria, were used. Potential cost savings of Xpert MTB/RIF, based on test accuracy and multiple cost drivers, were calculated for diagnosing TB/MDR-TB suspects from the hospital perspective.Implementing Xpert MTB/RIF as an add-on in smear-positive and smear-negative TB suspects saves on average €48.72 and €503, respectively, per admitted patient as compared with the conventional approach. In smear-positive and smear-negative MDR-TB suspects, cost savings amount to €189.56 and €515.25 per person, respectively. Full replacement of microscopy by Xpert MTB/RIF saves €449.98. In probabilistic Monte-Carlo simulation, adding Xpert MTB/RIF is less costly in 46.4% and 76.2% of smear-positive TB and MDR-TB suspects, respectively, but 100% less expensive in all smear-negative suspects. Full replacement by Xpert MTB/RIF is also consistently cost-saving.Using Xpert MTB/RIF as an add-on to and even as a replacement for sputum smear examination may significantly reduce expenditures in TB suspects. PMID:26647440

  16. DIAGNOSTIC TEST OF SPUTUM GENEXPERT MTB/RIF FOR SMEAR NEGATIVE PULMONARY TUBERCULOSIS.

    PubMed

    Reechaipichitkul, Wipa; Phetsuriyawong, Attawoot; Chaimanee, Prajuab; Ananta, Pimjai

    2016-05-01

    The objective of this study was to evaluate the performance of the Gene-Xpert MTB/RIF sputum test for diagnosing pulmonary tuberculosis (TB) among patients sputum acid-fast bacillus (AFB) smear negative results in Thailand, a country with a high prevalence of pulmonary tuberculosis. We studied 151 patients who presented to Srinagarind Hospital, Khon Kaen, Thailand with a 2 week or more history of fever and/or cough and an abnormal chest radiograph between 2010 and 2014; these patients had at least 2 negative sputum AFB smear results. Of these, 76 were diagnosed as having either confirmed or probable pulmonary TB: the 32 confirmed cases were those with a positive sputum culture for Mycobacterium tuberculosis (MTB) and the 44 probable case were those with clinical and radiographic findings consistent with TB and who had a response to anti-TB therapy. Seventy-five cases were diagnosed as not having pulmonary TB. Of the 32 patients with a positive sputum culture for MTB, 26 had a positive GeneXpert MTB/RIF sputum test. Compared to sputum culture for MTB the GeneXpert MTB/ RIF test gave a sensitivity of 83.9% (95% CI: 66.3-94.5) and a specificity of 92.1% (95% CI: 83.6-97), a positive predictive value (PPV) of 81.3% (95% CI: 63.6-92.8) and a negative predictive value (NPV) of 93.3% (95% CI: 85.1-97.8). The GeneXpert MTB/RIF test had a fair sensitivity and specificity for diagnosing smear negative pulmonary TB. It may be useful for diagnosing pulmonary TB in patients with a negative sputum AFB smear. The assay is faster than culture and can detect rifampicin resistant strains of MTB. PMID:27405129

  17. Analysis of Classical Time-Trial Performance and Technique-Specific Physiological Determinants in Elite Female Cross-Country Skiers

    PubMed Central

    Sandbakk, Øyvind; Losnegard, Thomas; Skattebo, Øyvind; Hegge, Ann M.; Tønnessen, Espen; Kocbach, Jan

    2016-01-01

    The present study investigated the contribution of performance on uphill, flat, and downhill sections to overall performance in an international 10-km classical time-trial in elite female cross-country skiers, as well as the relationships between performance on snow and laboratory-measured physiological variables in the double poling (DP) and diagonal (DIA) techniques. Ten elite female cross-country skiers were continuously measured by a global positioning system device during an international 10-km cross-country skiing time-trial in the classical technique. One month prior to the race, all skiers performed a 5-min submaximal and 3-min self-paced performance test while roller skiing on a treadmill, both in the DP and DIA techniques. The time spent on uphill (r = 0.98) and flat (r = 0.91) sections of the race correlated most strongly with the overall 10-km performance (both p < 0.05). Approximately 56% of the racing time was spent uphill, and stepwise multiple regression revealed that uphill time explained 95.5% of the variance in overall performance (p < 0.001). Distance covered during the 3-min roller-skiing test and body-mass normalized peak oxygen uptake (VO2peak) in both techniques showed the strongest correlations with overall time-trial performance (r = 0.66–0.78), with DP capacity tending to have greatest impact on the flat and DIA capacity on uphill terrain (all p < 0.05). Our present findings reveal that the time spent uphill most strongly determine classical time-trial performance, and that the major portion of the performance differences among elite female cross-country skiers can be explained by variations in technique-specific aerobic power. PMID:27536245

  18. Analysis of Classical Time-Trial Performance and Technique-Specific Physiological Determinants in Elite Female Cross-Country Skiers.

    PubMed

    Sandbakk, Øyvind; Losnegard, Thomas; Skattebo, Øyvind; Hegge, Ann M; Tønnessen, Espen; Kocbach, Jan

    2016-01-01

    The present study investigated the contribution of performance on uphill, flat, and downhill sections to overall performance in an international 10-km classical time-trial in elite female cross-country skiers, as well as the relationships between performance on snow and laboratory-measured physiological variables in the double poling (DP) and diagonal (DIA) techniques. Ten elite female cross-country skiers were continuously measured by a global positioning system device during an international 10-km cross-country skiing time-trial in the classical technique. One month prior to the race, all skiers performed a 5-min submaximal and 3-min self-paced performance test while roller skiing on a treadmill, both in the DP and DIA techniques. The time spent on uphill (r = 0.98) and flat (r = 0.91) sections of the race correlated most strongly with the overall 10-km performance (both p < 0.05). Approximately 56% of the racing time was spent uphill, and stepwise multiple regression revealed that uphill time explained 95.5% of the variance in overall performance (p < 0.001). Distance covered during the 3-min roller-skiing test and body-mass normalized peak oxygen uptake (VO2peak) in both techniques showed the strongest correlations with overall time-trial performance (r = 0.66-0.78), with DP capacity tending to have greatest impact on the flat and DIA capacity on uphill terrain (all p < 0.05). Our present findings reveal that the time spent uphill most strongly determine classical time-trial performance, and that the major portion of the performance differences among elite female cross-country skiers can be explained by variations in technique-specific aerobic power. PMID:27536245

  19. Results from early programmatic implementation of Xpert MTB/RIF testing in nine countries

    PubMed Central

    2014-01-01

    Background The Xpert MTB/RIF assay has garnered significant interest as a sensitive and rapid diagnostic tool to improve detection of sensitive and drug resistant tuberculosis. However, most existing literature has described the performance of MTB/RIF testing only in study conditions; little information is available on its use in routine case finding. TB REACH is a multi-country initiative focusing on innovative ways to improve case notification. Methods We selected a convenience sample of nine TB REACH projects for inclusion to cover a range of implementers, regions and approaches. Standard quarterly reports and machine data from the first 12 months of MTB/RIF implementation in each project were utilized to analyze patient yields, rifampicin resistance, and failed tests. Data was collected from September 2011 to March 2013. A questionnaire was implemented and semi-structured interviews with project staff were conducted to gather information on user experiences and challenges. Results All projects used MTB/RIF testing for people with suspected TB, as opposed to testing for drug resistance among already diagnosed patients. The projects placed 65 machines (196 modules) in a variety of facilities and employed numerous case-finding strategies and testing algorithms. The projects consumed 47,973 MTB/RIF tests. Of valid tests, 7,195 (16.8%) were positive for MTB. A total of 982 rifampicin resistant results were found (13.6% of positive tests). Of all tests conducted, 10.6% failed. The need for continuous power supply was noted by all projects and most used locally procured solutions. There was considerable heterogeneity in how results were reported and recorded, reflecting the lack of standardized guidance in some countries. Conclusions The findings of this study begin to fill the gaps among guidelines, research findings, and real-world implementation of MTB/RIF testing. Testing with Xpert MTB/RIF detected a large number of people with TB that routine services failed to

  20. The velocity and energy profiles of elite cross-country skiers executing downhill turns with different radii.

    PubMed

    Sandbakk, Oyvind; Bucher Sandbakk, Silvana; Supej, Matej; Holmberg, Hans-Christer

    2014-01-01

    This study examined the influence of turn radius on velocity and energy profiles when skidding and step turning during more and less effective downhill turns while cross-country skiing. Thirteen elite female cross-country skiers performed single turns with a 9- or 12-m radius using the skidding technique and a 12- or 15-m radius with step turning. Mechanical parameters were monitored using a real-time kinematic Global Navigation Satellite System and video analysis. Step turning was more effective during all phases of a turn, leading to higher velocities than skidding (P < .05). With both techniques, a greater radius was associated with higher velocity (P < .05), but the quality of turning, as assessed on the basis of energy characteristics, was the same. More effective skidding turns involved more pronounced deceleration early in the turn and maintenance of higher velocity thereafter, while more effective step turning involved lower energy dissipation during the latter half of the turn. In conclusion, the single-turn analysis employed here reveals differences in the various techniques chosen by elite cross-country skiers when executing downhill turns of varying radii and can be used to assess the quality of such turns. PMID:24408350

  1. A simulation of cross-country skiing on varying terrain by using a mathematical power balance model

    PubMed Central

    Moxnes, John F; Sandbakk, Øyvind; Hausken, Kjell

    2013-01-01

    The current study simulated cross-country skiing on varying terrain by using a power balance model. By applying the hypothetical inductive deductive method, we compared the simulated position along the track with actual skiing on snow, and calculated the theoretical effect of friction and air drag on skiing performance. As input values in the model, air drag and friction were estimated from the literature, whereas the model included relationships between heart rate, metabolic rate, and work rate based on the treadmill roller-ski testing of an elite cross-country skier. We verified this procedure by testing four models of metabolic rate against experimental data on the treadmill. The experimental data corresponded well with the simulations, with the best fit when work rate was increased on uphill and decreased on downhill terrain. The simulations predicted that skiing time increases by 3%–4% when either friction or air drag increases by 10%. In conclusion, the power balance model was found to be a useful tool for predicting how various factors influence racing performance in cross-country skiing. PMID:24379718

  2. Comparison of ankle kinematics and ground reaction forces between prospectively injured and uninjured collegiate cross country runners.

    PubMed

    Kuhman, Daniel J; Paquette, Max R; Peel, Shelby A; Melcher, Daniel A

    2016-06-01

    Biomechanical comparative studies on running-related injuries have included either currently or retrospectively injured runners. The purpose of this study was to prospectively compare ankle joint and ground reaction force variables between collegiate runners who developed injuries during the cross country season and those who did not. Running gait analyses using a motion capture system and force platform were conducted on 19 collegiate runners prior to the start of their cross country season. Ten runners sustained running-related injuries and 9 remained healthy during the course of the season. Strike index, peak loading rate of the vertical ground reaction force, dorsiflexion range of motion (ROM), eversion ROM, peak eversion angle, peak eversion velocity, and eversion duration from the start of the season were compared between injury groups. Ankle eversion ROM and peak eversion velocity were greater in uninjured runners while peak eversion angle was greater in injured runners. Greater ankle eversion ROM and eversion velocity with lower peak eversion angle may be beneficial in reducing injury risk in collegiate runners. The current data may only be applicable to collegiate cross country runners with similar training and racing schedules and threshold magnitudes of ankle kinematic variables to predict injury risk are still unknown. PMID:26827155

  3. A Comparison between Alpine Skiing, Cross-Country Skiing and Indoor Cycling on Cardiorespiratory and Metabolic Response.

    PubMed

    Stöggl, Thomas; Schwarzl, Christoph; Müller, Edith E; Nagasaki, Masaru; Stöggl, Julia; Scheiber, Peter; Schönfelder, Martin; Niebauer, Josef

    2016-03-01

    Since physical inactivity especially prevails during winter months, we set out to identify outdoor alternatives to indoor cycling (IC) by comparing the metabolic and cardiorespiratory responses during alpine skiing (AS), cross-country skiing (XCS) and IC and analyse the effects of sex, age and fitness level in this comparison. Twenty one healthy subjects performed alpine skiing (AS), cross-country skiing (XCS), and IC. Oxygen uptake (VO2), total energy expenditure (EE), heart rate (HR), lactate, blood glucose and rate of perceived exertion (RPE) were determined during three 4-min stages of low, moderate and high intensity. During XCS and IC VO2max and EE were higher than during AS. At least 2½ hours of AS are necessary to reach the same EE as during one hour of XCS or IC. HR, VO2, lactate, and RPEarms were highest during XCS, whereas RPEwhole-body was similar and RPElegs lower than during AS and IC, respectively. Weight adjusted VO2 and EE were higher in men than in women while fitness level had no effect. Male, fit and young participants were able to increase their EE and VO2 values more pronounced. Both AS and XCS can be individually tailored to serve as alternatives to IC and may thus help to overcome the winter activity deficit. XCS was found to be the most effective activity for generating a high EE and VO2 while AS was the most demanding activity for the legs. Key pointsDuring cross-country skiing and indoor cycling VO2max and energy expenditure were higher than during alpine skiingApproximately 2½ hours of alpine skiing are necessary to reach the same energy expenditure of one hour of cross-country skiing or indoor cycling.Alpine skiing and cross-country skiing can be individually tailored to serve as sports alternatives in winter to activity deficit.By applying different skiing modes as parallel ski steering, carving long radii and short turn skiing, metabolic and cardiorespiratory response can be increased during alpine skiing.Male, fit and young

  4. A Comparison between Alpine Skiing, Cross-Country Skiing and Indoor Cycling on Cardiorespiratory and Metabolic Response

    PubMed Central

    Stöggl, Thomas; Schwarzl, Christoph; Müller, Edith E.; Nagasaki, Masaru; Stöggl, Julia; Scheiber, Peter; Schönfelder, Martin; Niebauer, Josef

    2016-01-01

    Since physical inactivity especially prevails during winter months, we set out to identify outdoor alternatives to indoor cycling (IC) by comparing the metabolic and cardiorespiratory responses during alpine skiing (AS), cross-country skiing (XCS) and IC and analyse the effects of sex, age and fitness level in this comparison. Twenty one healthy subjects performed alpine skiing (AS), cross-country skiing (XCS), and IC. Oxygen uptake (VO2), total energy expenditure (EE), heart rate (HR), lactate, blood glucose and rate of perceived exertion (RPE) were determined during three 4-min stages of low, moderate and high intensity. During XCS and IC VO2max and EE were higher than during AS. At least 2½ hours of AS are necessary to reach the same EE as during one hour of XCS or IC. HR, VO2, lactate, and RPEarms were highest during XCS, whereas RPEwhole-body was similar and RPElegs lower than during AS and IC, respectively. Weight adjusted VO2 and EE were higher in men than in women while fitness level had no effect. Male, fit and young participants were able to increase their EE and VO2 values more pronounced. Both AS and XCS can be individually tailored to serve as alternatives to IC and may thus help to overcome the winter activity deficit. XCS was found to be the most effective activity for generating a high EE and VO2 while AS was the most demanding activity for the legs. Key points During cross-country skiing and indoor cycling VO2max and energy expenditure were higher than during alpine skiing Approximately 2½ hours of alpine skiing are necessary to reach the same energy expenditure of one hour of cross-country skiing or indoor cycling. Alpine skiing and cross-country skiing can be individually tailored to serve as sports alternatives in winter to activity deficit. By applying different skiing modes as parallel ski steering, carving long radii and short turn skiing, metabolic and cardiorespiratory response can be increased during alpine skiing. Male, fit and young

  5. Improved marathon performance by in-race nutritional strategy intervention.

    PubMed

    Hansen, Ernst Albin; Emanuelsen, Anders; Gertsen, Robert Mørkegaard; Sørensen S, S R

    2014-12-01

    It was tested whether a marathon was completed faster by applying a scientifically based rather than a freely chosen nutritional strategy. Furthermore, gastrointestinal symptoms were evaluated. Nonelite runners performed a 10 km time trial 7 weeks before Copenhagen Marathon 2013 for estimation of running ability. Based on the time, runners were divided into two similar groups that eventually should perform the marathon by applying the two nutritional strategies. Matched pairs design was applied. Before the marathon, runners were paired based on their prerace running ability. Runners applying the freely chosen nutritional strategy (n = 14; 33.6 ± 9.6 years; 1.83 ± 0.09 m; 77.4 ± 10.6 kg; 45:40 ± 4:32 min for 10 km) could freely choose their in-race intake. Runners applying the scientifically based nutritional strategy (n = 14; 41.9 ± 7.6 years; 1.79 ± 0.11 m; 74.6 ± 14.5 kg; 45:44 ± 4:37 min) were targeting a combined in-race intake of energy gels and water, where the total intake amounted to approximately 0.750 L water, 60 g maltodextrin and glucose, 0.06 g sodium, and 0.09 g caffeine per hr. Gastrointestinal symptoms were assessed by a self-administered postrace questionnaire. Marathon time was 3:49:26 ± 0:25:05 and 3:38:31 ± 0:24:54 hr for runners applying the freely chosen and the scientifically based strategy, respectively (p = .010, effect size=-0.43). Certain runners experienced diverse serious gastrointestinal symptoms, but overall, symptoms were low and not different between groups (p > .05). In conclusion, nonelite runners completed a marathon on average 10:55 min, corresponding to 4.7%, faster by applying a scientifically based rather than a freely chosen nutritional strategy. Furthermore, average values of gastrointestinal symptoms were low and not different between groups. PMID:24901444

  6. Diagnostic Performance of Xpert MTB/RIF in Tuberculous Pleural Effusion: Systematic Review and Meta-analysis.

    PubMed

    Sehgal, Inderpaul Singh; Dhooria, Sahajal; Aggarwal, Ashutosh Nath; Behera, Digambar; Agarwal, Ritesh

    2016-04-01

    A systematic review investigating the role of Xpert MTB/RIF in the diagnosis of tuberculous pleural effusion (TPE) was conducted. The pooled sensitivities and specificities of Xpert MTB/RIF were 51.4% and 98.6%, respectively, with culture used as a reference standard and 22.7% and 99.8%, respectively, with a composite reference standard (CRS) used as the benchmark. Xpert MTB/RIF has low sensitivity but excellent specificity in the diagnosis of TPE. PMID:26818675

  7. Terrorist bombings: foreign bodies from the Boston Marathon bombing.

    PubMed

    Brunner, John; Singh, Ajay K; Rocha, Tatiana; Havens, Joaquim; Goralnick, Eric; Sodickson, Aaron

    2015-02-01

    On April 15, 2013, 2 improvised explosive devices detonated at the 117th Boston Marathon, killing 3 people and injuring 264 others. In this article, the foreign bodies and injuries that presented at 2 of the responding level 1 trauma hospitals in Boston-Brigham and Women׳s Hospital and Massachusetts General Hospital--are reviewed with a broader discussion of blast injuries and imaging strategies. PMID:25639179

  8. ShopGirls Shine in Eco-Marathon

    ERIC Educational Resources Information Center

    Stowell, Shante

    2011-01-01

    The ShopGirls of Granite Falls (WA) High School are the first-ever all-female team to successfully design, build, and race a prototype diesel car in the Shell Eco-marathon. The team took first place in the diesel fuel-efficiency category with a vehicle that achieved 470 miles per gallon! The idea for the ShopGirls came when Vervia Gabriel, career…

  9. Did recent world record marathon runners employ optimal pacing strategies?

    PubMed

    Angus, Simon D

    2014-01-01

    We apply statistical analysis of high frequency (1 km) split data for the most recent two world-record marathon runs: Run 1 (2:03:59, 28 September 2008) and Run 2 (2:03:38, 25 September 2011). Based on studies in the endurance cycling literature, we develop two principles to approximate 'optimal' pacing in the field marathon. By utilising GPS and weather data, we test, and then de-trend, for each athlete's field response to gradient and headwind on course, recovering standardised proxies for power-based pacing traces. The resultant traces were analysed to ascertain if either runner followed optimal pacing principles; and characterise any deviations from optimality. Whereas gradient was insignificant, headwind was a significant factor in running speed variability for both runners, with Runner 2 targeting the (optimal) parallel variation principle, whilst Runner 1 did not. After adjusting for these responses, neither runner followed the (optimal) 'even' power pacing principle, with Runner 2's macro-pacing strategy fitting a sinusoidal oscillator with exponentially expanding envelope whilst Runner 1 followed a U-shaped, quadratic form. The study suggests that: (a) better pacing strategy could provide elite marathon runners with an economical pathway to significant performance improvements at world-record level; and (b) the data and analysis herein is consistent with a complex-adaptive model of power regulation. PMID:23879745

  10. Comparison of Amplicor and GeneXpert MTB/RIF Tests for Diagnosis of Tuberculous Meningitis

    PubMed Central

    Patel, Vinod B.; Connolly, Cathy; Singh, Ravesh; Lenders, Laura; Matinyenya, Brian; Theron, Grant; Ndung'u, Thumbi

    2014-01-01

    There are no data about the comparative accuracy of commercially available nucleic acid amplification tests (GeneXpert MTB/RIF and Roche Amplicor) for the diagnosis of tuberculous meningitis (TBM). A total of 148 patients with suspected TBM were evaluated, and cultures served as the reference standard. The sensitivities and specificities (95% confidence interval [CI]) for the Amplicor and Xpert MTB/RIF tests were similar: 46 (31–60) versus 50 (33–67) and 99 (93–100) and 94 (84–99), respectively. PMID:25056328

  11. Self-Actualization in a Marathon Growth Group: Do the Strong Get Stronger?

    ERIC Educational Resources Information Center

    Kimball, Ronald; Gelso, Charles J.

    This study examined the effects of a weekend marathon on the level of self-actualization of college students one and four weeks following their group experience. It also studied the relationship between ego strength and extent of change in self-actualization during a marathon. Generally, the group experience did increase self-actualization and the…

  12. Effect of Carbohydrate Ingestion on Ratings of Perceived Exertion during a Marathon.

    ERIC Educational Resources Information Center

    Utter, Alan C.; Kang, Jie; Robertson, Robert J.; Nieman, David C.; Chaloupka, Edward C.; Suminski, Richard R.; Piccinni, Cristiana R.

    2002-01-01

    Investigated the effects of carbohydrate substrate availability on ratings of perceived exertion (RPE) and hormonal regulation during a competitive marathon. Data on marathon runners randomly assigned to receive carbohydrate or placebo indicated that those who ingested carbohydrate rather than placebo beverages were able to run at a higher…

  13. Direct and Nondirect Marathon Group Therapy and Internal---External Control

    ERIC Educational Resources Information Center

    Kilmann, Peter R.

    1974-01-01

    Investigates whether direct and nondirect therapist techniques within a 23-hour marathon format would differentially induce client shifts in locus of control. The no-treatment control group experienced a significant shift toward externality, while the marathon subjects did not fluctuate significantly from pretherapy to posttherapy. (Author)

  14. Marathon Groups. Facilitating the Personal Growth of Imprisoned, Black Female Heroin Abusers.

    ERIC Educational Resources Information Center

    Page, Richard C.; Kubiak, Larry

    1978-01-01

    Apparent success of the marathon groups in altering the perceptions of Black female heroin addicts toward the future, counseling, and themselves offers preliminary evidence that marathons may have potential as a counseling strategy with these clients. Future research needs to be performed to substantiate or reject these findings. (Author/PD)

  15. 76 FR 12222 - Wisconsin Central, Ltd.-Abandonment Exemption-in Marathon County, WI

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION Surface Transportation Board Wisconsin Central, Ltd.--Abandonment Exemption--in Marathon County, WI... ] Abandonments to abandon 1.14 miles of rail line between mileposts 17.50 and 18.64, in Weston, Marathon...

  16. Effect of a Marathon Run on Serum Lipoproteins, Creatine Kinase, and Lactate Dehydrogenase in Recreational Runners

    ERIC Educational Resources Information Center

    Kobayashi, Yoshio; Takeuchi, Toshiko; Hosoi, Teruo; Yoshizaki, Hidekiyo; Loeppky, Jack A.

    2005-01-01

    The objective of this study was to determine the effect of a marathon run on serum lipid and lipoprotein concentrations and serum muscle enzyme activities and follow their recovery after the run. These blood concentrations were measured before, immediately after, and serially after a marathon run in 15 male recreational runners. The triglyceride…

  17. Interpersonal Relationship Styles in Marathon Group Therapy: A Study with Illicit Drug Users.

    ERIC Educational Resources Information Center

    Page, Richard C.; Bridges, Ned

    1983-01-01

    Assessed how illegal drug users (N=12) related to one another during a 16-hour unstructured group marathon. Interaction analysis supported the effectiveness of the marathon group. Members and facilitators were able to relate to each other by confronting significant behaviors and receiving feedback about ways to cope with personal problems. (JAC)

  18. Marathon Group Counseling with Illicit Drug Abusers: Effects on Self-Perceptions.

    ERIC Educational Resources Information Center

    Page, Richard C.; And Others

    1987-01-01

    Compared effects, for illicit drug abusers, of five 16-hour unstructured marathon groups, and five matched, randomly selected control groups. Used semantic differential consisting of the specific adjective pairs and the evaluative scale of the concept My Real Self. Marathon group members rated some adjective pairs differently and rated the…

  19. The Social Determinants of Infant Mortality and Birth Outcomes in Western Developed Nations: A Cross-Country Systematic Review

    PubMed Central

    Kim, Daniel; Saada, Adrianna

    2013-01-01

    Infant mortality (IM) and birth outcomes, key population health indicators, have lifelong implications for individuals, and are unequally distributed globally. Even among western industrialized nations, striking cross-country and within-country patterns are evident. We sought to better understand these variations across and within the United States of America (USA) and Western Europe (WE), by conceptualizing a social determinants of IM/birth outcomes framework, and systematically reviewing the empirical literature on hypothesized social determinants (e.g., social policies, neighbourhood deprivation, individual socioeconomic status (SES)) and intermediary determinants (e.g., health behaviours). To date, the evidence suggests that income inequality and social policies (e.g., maternal leave policies) may help to explain cross-country variations in IM/birth outcomes. Within countries, the evidence also supports neighbourhood SES (USA, WE) and income inequality (USA) as social determinants. By contrast, within-country social cohesion/social capital has been underexplored. At the individual level, mixed associations have been found between individual SES, race/ethnicity, and selected intermediary factors (e.g., psychosocial factors) with IM/birth outcomes. Meanwhile, this review identifies several methodological gaps, including the underuse of prospective designs and the presence of residual confounding in a number of studies. Ultimately, addressing such gaps including through novel approaches to strengthen causal inference and implementing both health and non-health policies may reduce inequities in IM/birth outcomes across the western developed world. PMID:23739649

  20. Biomechanical characteristics and speed adaptation during kick double poling on roller skis in elite cross-country skiers.

    PubMed

    Göpfert, Caroline; Holmberg, Hans-Christer; Stöggl, Thomas; Müller, Erich; Lindinger, Stefan Josef

    2013-06-01

    Recent developments in cross-country ski racing should promote the use of kick double poling. This technique, however, has not been the focus in athletes' training and has barely been investigated. The aims of the present study were to develop a function-based phase definition and to analyse speed adaptation mechanisms for kick double poling in elite cross-country skiers. Joint kinematics and pole/plantar forces were recorded in 10 athletes while performing kick double poling at three submaximal roller skiing speeds. A speed increase was associated with increases in cycle length and rate, while absolute poling and leg push-off durations shortened. Despite maintained impulses of force, the peak and average pole/leg forces increased. During double poling and leg push-off, ranges of motion of elbow flexion and extension increased (p < 0.05) and were maintained for hip/knee flexion and extension. Cycle length increase was correlated to increases in average poling force (r = 0.71) and arm swing time (r = 0.88; both p < 0.05). The main speed adaptation was achieved by changes in double poling technique; however, leg push-off showed high variability among elite skiers, thus illustrating important aspects for technique training. PMID:23898688

  1. Airway inflammation, cough and athlete quality of life in elite female cross-country skiers: A longitudinal study.

    PubMed

    Kennedy, M D; Davidson, W J; Wong, L E; Traves, S L; Leigh, R; Eves, N D

    2016-07-01

    The aim of this study was to investigate the effect of a season of cross-country training and racing on airway inflammation, cough symptoms, and athlete quality of life in female skiers. Eighteen elite female skiers performed sputum induction and completed the Leicester Cough Questionnaire (LCQ) and the Recovery-Stress Questionnaire (REST-Q) at three time points (T1 - May/Jun, T2 - Oct/Nov, T3 - Jan-Mar) during the year. No changes were observed between T1 and T2. However, an increase in sputum eosinophils and lymphocytes (P < 0.05) and a significant change in all three domains of the LCQ were observed between T1 and T3 (P < 0.05). A significant association was found between the total yearly hours of training and the change in the total cell count (r(2)  = 0.74; P = 0.006), and a number of other sputum cell counts between T1 and T3. No changes were observed for any domain of the REST-Q. The results of this study demonstrate that airway inflammation and cough symptoms are significantly increased in elite female cross-country skiers across a year of training and racing. The increase in airway inflammation is related to the total amount of training and is worse during the winter months when athletes are training and racing in cold, dry air. PMID:26283581

  2. Completing the results of the 2013 Boston marathon.

    PubMed

    Hammerling, Dorit; Cefalu, Matthew; Cisewski, Jessi; Dominici, Francesca; Parmigiani, Giovanni; Paulson, Charles; Smith, Richard L

    2014-01-01

    The 2013 Boston marathon was disrupted by two bombs placed near the finish line. The bombs resulted in three deaths and several hundred injuries. Of lesser concern, in the immediate aftermath, was the fact that nearly 6,000 runners failed to finish the race. We were approached by the marathon's organizers, the Boston Athletic Association (BAA), and asked to recommend a procedure for projecting finish times for the runners who could not complete the race. With assistance from the BAA, we created a dataset consisting of all the runners in the 2013 race who reached the halfway point but failed to finish, as well as all runners from the 2010 and 2011 Boston marathons. The data consist of split times from each of the 5 km sections of the course, as well as the final 2.2 km (from 40 km to the finish). The statistical objective is to predict the missing split times for the runners who failed to finish in 2013. We set this problem in the context of the matrix completion problem, examples of which include imputing missing data in DNA microarray experiments, and the Netflix prize problem. We propose five prediction methods and create a validation dataset to measure their performance by mean squared error and other measures. The best method used local regression based on a K-nearest-neighbors algorithm (KNN method), though several other methods produced results of similar quality. We show how the results were used to create projected times for the 2013 runners and discuss potential for future application of the same methodology. We present the whole project as an example of reproducible research, in that we are able to make the full data and all the algorithms we have used publicly available, which may facilitate future research extending the methods or proposing completely different approaches. PMID:24727904

  3. Completing the Results of the 2013 Boston Marathon

    PubMed Central

    Hammerling, Dorit; Cefalu, Matthew; Cisewski, Jessi; Dominici, Francesca; Parmigiani, Giovanni; Paulson, Charles; Smith, Richard L.

    2014-01-01

    The 2013 Boston marathon was disrupted by two bombs placed near the finish line. The bombs resulted in three deaths and several hundred injuries. Of lesser concern, in the immediate aftermath, was the fact that nearly 6,000 runners failed to finish the race. We were approached by the marathon's organizers, the Boston Athletic Association (BAA), and asked to recommend a procedure for projecting finish times for the runners who could not complete the race. With assistance from the BAA, we created a dataset consisting of all the runners in the 2013 race who reached the halfway point but failed to finish, as well as all runners from the 2010 and 2011 Boston marathons. The data consist of split times from each of the 5 km sections of the course, as well as the final 2.2 km (from 40 km to the finish). The statistical objective is to predict the missing split times for the runners who failed to finish in 2013. We set this problem in the context of the matrix completion problem, examples of which include imputing missing data in DNA microarray experiments, and the Netflix prize problem. We propose five prediction methods and create a validation dataset to measure their performance by mean squared error and other measures. The best method used local regression based on a K-nearest-neighbors algorithm (KNN method), though several other methods produced results of similar quality. We show how the results were used to create projected times for the 2013 runners and discuss potential for future application of the same methodology. We present the whole project as an example of reproducible research, in that we are able to make the full data and all the algorithms we have used publicly available, which may facilitate future research extending the methods or proposing completely different approaches. PMID:24727904

  4. Acute renal failure in the "Comrades Marathon" runners.

    PubMed

    Seedat, Y K; Aboo, N; Naicker, S; Parsoo, I

    This study investigated the clinical and biochemical features of acute renal failure in marathon runners. Over a period of 18 years (1969-1986), 19 patients were admitted to the renal unit. The histories and biochemical data of 4 patients seen in 1986 are described. The pathophysiology of acute renal failure is multifactorial and is the combined effect of rhabdomyolysis, dehydration, hypotension, nonsteroidal anti-inflammatory drugs, and hyperuricaemia. Efforts to correct dehydration have resulted in a decrease in the incidence of acute renal failure. The use of nonsteroidal anti-inflammatory drugs is to be deprecated and efforts should be made to publicize this harmful effect. PMID:2485484

  5. Cardiac Output and Performance during a Marathon Race in Middle-Aged Recreational Runners

    PubMed Central

    Billat, Véronique L.; Petot, Hélène; Landrain, Morgan; Meilland, Renaud; Koralsztein, Jean Pierre; Mille-Hamard, Laurence

    2012-01-01

    Purpose. Despite the increasing popularity of marathon running, there are no data on the responses of stroke volume (SV) and cardiac output (CO) to exercise in this context. We sought to establish whether marathon performance is associated with the ability to sustain high fractional use of maximal SV and CO (i.e, cardiac endurance) and/or CO, per meter (i.e., cardiac cost). Methods. We measured the SV, heart rate (HR), CO, and running speed of 14 recreational runners in an incremental, maximal laboratory test and then during a real marathon race (mean performance: 3 hr 30 min ± 45 min). Results. Our data revealed that HR, SV and CO were all in a high but submaximal steady state during the marathon (87.0 ± 1.6%, 77.2 ± 2.6%, and 68.7 ± 2.8% of maximal values, respectively). Marathon performance was inversely correlated with an upward drift in the CO/speed ratio (mL of CO × m−1) (r = −0.65, P < 0.01) and positively correlated with the runner's ability to complete the race at a high percentage of the speed at maximal SV (r = 0.83, P < 0.0002). Conclusion. Our results showed that marathon performance is inversely correlated with cardiac cost and positively correlated with cardiac endurance. The CO response could be a benchmark for race performance in recreational marathon runners. PMID:22645458

  6. Application of an off-road mobility model to autonomous cross-country routing of unmanned ground vehicles

    NASA Astrophysics Data System (ADS)

    Cummins, Christopher L.; Jones, Randolph A.; Gates, Burhman Q., Jr.

    2006-05-01

    This paper describes the application of an Army-standard legacy off-road mobility model to cross-country route planning and negotiation by unmanned ground vehicles. A planned route is created from a movement map generated from existing terrain data. An unmanned ground vehicle negotiates the planned route and makes local routing adjustments based on a trafficability assessment of terrain features which are observed from the platform. This research leverages results from other work investigating the scalability of the existing legacy off-road mobility model to small vehicles (<500 kg). The legacy mobility model is the NATO Reference Mobility Model II (NRMM II), a standard for combat mobility modeling and procurement since the mid-90's.

  7. Male and female Ethiopian and Kenyan runners are the fastest and the youngest in both half and full marathon.

    PubMed

    Knechtle, Beat; Nikolaidis, Pantelis T; Onywera, Vincent O; Zingg, Matthias A; Rosemann, Thomas; Rüst, Christoph A

    2016-01-01

    In major marathon races such as the 'World Marathon Majors', female and male East African runners particularly from Ethiopia and Kenya are the fastest. However, whether this trend appears for female and male Ethiopians and Kenyans at recreational level runners (i.e. races at national level) and in shorter road races (e.g. in half-marathon races) has not been studied yet. Thus, the aim of the present study was to examine differences in the performance and the age of female and male runners from East Africa (i.e. Ethiopians and Kenyans) between half- and full marathons. Data from 508,108 athletes (125,894 female and 328,430 male half-marathoners and 10,205 female and 43,489 male marathoners) originating from 126 countries and competing between 1999 and 2014 in all road-based half-marathons and marathons held in one country (Switzerland) were analysed using Chi square (χ(2)) tests, mixed-effects regression analyses and one-way analyses of variance. In half-marathons, 48 women (0.038 %) and 63 men (0.019 %) were from Ethiopia and 80 women (0.063 %) and 134 men (0.040 %) from Kenya. In marathons, three women (0.029 %) and 15 men (0.034 %) were from Ethiopia and two women (0.019 %) and 33 men (0.075 %) from Kenya. There was no statistically significant association between the nationality of East Africans and the format of a race. In both women and men, the fastest race times in half-marathons and marathons were achieved by East African runners (p < 0.001). Ethiopian and Kenyan runners were the youngest in both sexes and formats of race (p < 0.001). In summary, women and men from Ethiopia and Kenya, despite they accounted for <0.1 % in half-marathons and marathons, achieved the fastest race times and were the youngest in both half-marathons and marathons. These findings confirmed in the case of half-marathon the trend previously observed in marathon races for a better performance and a younger age in East African runners from Ethiopia and Kenya. PMID

  8. Impact of Environmental Parameters on Marathon Running Performance

    PubMed Central

    El Helou, Nour; Tafflet, Muriel; Berthelot, Geoffroy; Tolaini, Julien; Marc, Andy; Guillaume, Marion; Hausswirth, Christophe; Toussaint, Jean-François

    2012-01-01

    Purpose The objectives of this study were to describe the distribution of all runners' performances in the largest marathons worldwide and to determine which environmental parameters have the maximal impact. Methods We analysed the results of six European (Paris, London, Berlin) and American (Boston, Chicago, New York) marathon races from 2001 to 2010 through 1,791,972 participants' performances (all finishers per year and race). Four environmental factors were gathered for each of the 60 races: temperature (°C), humidity (%), dew point (°C), and the atmospheric pressure at sea level (hPA); as well as the concentrations of four atmospheric pollutants: NO2 – SO2 – O3 and PM10 (μg.m−3). Results All performances per year and race are normally distributed with distribution parameters (mean and standard deviation) that differ according to environmental factors. Air temperature and performance are significantly correlated through a quadratic model. The optimal temperatures for maximal mean speed of all runners vary depending on the performance level. When temperature increases above these optima, running speed decreases and withdrawal rates increase. Ozone also impacts performance but its effect might be linked to temperature. The other environmental parameters do not have any significant impact. Conclusions The large amount of data analyzed and the model developed in this study highlight the major influence of air temperature above all other climatic parameter on human running capacity and adaptation to race conditions. PMID:22649525

  9. Running a Marathon Induces Changes in Adipokine Levels and in Markers of Cartilage Degradation – Novel Role for Resistin

    PubMed Central

    Vuolteenaho, Katriina; Leppänen, Tiina; Kekkonen, Riina; Korpela, Riitta; Moilanen, Eeva

    2014-01-01

    Running a marathon causes strenuous joint loading and increased energy expenditure. Adipokines regulate energy metabolism, but recent studies have indicated that they also exert a role in cartilage degradation in arthritis. Our aim was to investigate the effects of running a marathon on the levels of adipokines and indices of cartilage metabolism. Blood samples were obtained from 46 male marathoners before and after a marathon run. We measured levels of matrix metalloproteinase-3 (MMP-3), cartilage oligomeric protein (COMP) and chitinase 3-like protein 1 (YKL-40) as biomarkers of cartilage turnover and/or damage and plasma concentrations of adipokines adiponectin, leptin and resistin. Mean marathon time was 3∶30∶46±0∶02∶46 (h:min:sec). The exertion more than doubled MMP-3 levels and this change correlated negatively with the marathon time (r = –0.448, p = 0.002). YKL-40 levels increased by 56% and the effect on COMP release was variable. Running a marathon increased the levels of resistin and adiponectin, while leptin levels remained unchanged. The marathon-induced changes in resistin levels were positively associated with the changes in MMP-3 (r = 0.382, p = 0.009) and YKL-40 (r = 0.588, p<0.001) and the pre-marathon resistin levels correlated positively with the marathon induced change in YKL-40 (r = 0.386, p = 0.008). The present results show the impact of running a marathon, and possible load frequency, on cartilage metabolism: the faster the marathon was run, the greater was the increase in MMP-3 levels. Further, the results introduce pro-inflammatory adipocytokine resistin as a novel factor, which enhances during marathon race and associates with markers of cartilage degradation. PMID:25333960

  10. Rapid molecular TB diagnosis: evidence, policy making and global implementation of Xpert MTB/RIF.

    PubMed

    Weyer, Karin; Mirzayev, Fuad; Migliori, Giovanni Battista; Van Gemert, Wayne; D'Ambrosio, Lia; Zignol, Matteo; Floyd, Katherine; Centis, Rosella; Cirillo, Daniela M; Tortoli, Enrico; Gilpin, Chris; de Dieu Iragena, Jean; Falzon, Dennis; Raviglione, Mario

    2013-07-01

    If tuberculosis (TB) is to be eliminated as a global health problem in the foreseeable future, improved detection of patients, earlier diagnosis and timely identification of rifampicin resistance will be critical. New diagnostics released in recent years have improved this perspective but they require investments in laboratory infrastructure, biosafety and staff specialisation beyond the means of many resource-constrained settings where most patients live. Xpert MTB/RIF, a new assay employing automated nucleic acid amplification to detect Mycobacterium tuberculosis, as well as mutations that confer rifampicin resistance, holds the promise to largely overcome these operational challenges. In this article we position Xpert MTB/RIF in today's TB diagnostic landscape and describe its additional potential as an adjunct to surveillance and surveys, taking into account considerations of pricing and ethics. In what could serve as a model for the future formulation of new policy on diagnostics, we trace the unique process by which the World Health Organization consulted international expertise and systematically assessed published evidence and freshly emerging experience from the field ahead of its endorsement of the Xpert MTB/RIF technology in 2010, summarise subsequent research findings and guidance on who to test and how, and provide perspectives on scaling up the new technology. PMID:23180585

  11. Reduction in Post-Marathon Peak Oxygen Consumption: Sign of Cardiac Fatigue in Amateur Runners?

    PubMed Central

    Sierra, Ana Paula Rennó; da Silveira, Anderson Donelli; Francisco, Ricardo Contesini; Barretto, Rodrigo Bellios de Mattos; Sierra, Carlos Anibal; Meneghelo, Romeu Sergio; Kiss, Maria Augusta Peduti Dal Molin; Ghorayeb, Nabil; Stein, Ricardo

    2016-01-01

    Background Prolonged aerobic exercise, such as running a marathon, produces supraphysiological stress that can affect the athlete's homeostasis. Some degree of transient myocardial dysfunction ("cardiac fatigue") can be observed for several days after the race. Objective To verify if there are changes in the cardiopulmonary capacity, and cardiac inotropy and lusitropy in amateur marathoners after running a marathon. Methods The sample comprised 6 male amateur runners. All of them underwent cardiopulmonary exercise testing (CPET) one week before the São Paulo Marathon, and 3 to 4 days after that race. They underwent echocardiography 24 hours prior to and immediately after the marathon. All subjects were instructed not to exercise, to maintain their regular diet, ingest the same usual amount of liquids, and rest at least 8 hours a day in the period preceding the CPET. Results The athletes completed the marathon in 221.5 (207; 250) minutes. In the post-marathon CPET, there was a significant reduction in peak oxygen consumption and peak oxygen pulse compared to the results obtained before the race (50.75 and 46.35 mL.kg-1 .min-1; 19.4 and 18.1 mL.btm, respectively). The echocardiography showed a significant reduction in the s' wave (inotropic marker), but no significant change in the E/e' ratio (lusitropic marker). Conclusions In amateur runners, the marathon seems to promote changes in the cardiopulmonary capacity identified within 4 days after the race, with a reduction in the cardiac contractility. Such changes suggest that some degree of "cardiac fatigue" can occur. PMID:26760783

  12. Neuromuscular Consequences of an Extreme Mountain Ultra-Marathon

    PubMed Central

    Millet, Guillaume Y.; Tomazin, Katja; Verges, Samuel; Vincent, Christopher; Bonnefoy, Régis; Boisson, Renée-Claude; Gergelé, Laurent; Féasson, Léonard; Martin, Vincent

    2011-01-01

    We investigated the physiological consequences of one of the most extreme exercises realized by humans in race conditions: a 166-km mountain ultra-marathon (MUM) with 9500 m of positive and negative elevation change. For this purpose, (i) the fatigue induced by the MUM and (ii) the recovery processes over two weeks were assessed. Evaluation of neuromuscular function (NMF) and blood markers of muscle damage and inflammation were performed before and immediately following (n = 22), and 2, 5, 9 and 16 days after the MUM (n = 11) in experienced ultra-marathon runners. Large maximal voluntary contraction decreases occurred after MUM (−35% [95% CI: −28 to −42%] and −39% [95% CI: −32 to −46%] for KE and PF, respectively), with alteration of maximal voluntary activation, mainly for KE (−19% [95% CI: −7 to −32%]). Significant modifications in markers of muscle damage and inflammation were observed after the MUM as suggested by the large changes in creatine kinase (from 144±94 to 13,633±12,626 UI L−1), myoglobin (from 32±22 to 1,432±1,209 µg L−1), and C-Reactive Protein (from <2.0 to 37.7±26.5 mg L−1). Moderate to large reductions in maximal compound muscle action potential amplitude, high-frequency doublet force, and low frequency fatigue (index of excitation-contraction coupling alteration) were also observed for both muscle groups. Sixteen days after MUM, NMF had returned to initial values, with most of the recovery process occurring within 9 days of the race. These findings suggest that the large alterations in NMF after an ultra-marathon race are multi-factorial, including failure of excitation-contraction coupling, which has never been described after prolonged running. It is also concluded that as early as two weeks after such an extreme running exercise, maximal force capacities have returned to baseline. PMID:21364944

  13. Alumina+Silica+/-Germanium Alteration in Smectite-Bearing Marathon Valley, Endeavour Crater Rim, Mars

    NASA Technical Reports Server (NTRS)

    Mittlefehldt, D. W.; Gellert, R.; Van Bommel, S.; Arvidson, R. E.; Clark, B. C.; Ming, D. W.; Schroeder, C.; Yen, A. S.; Fox, V. K.; Farrand, W. H.; Jolliff, B. L.

    2016-01-01

    Mars Exploration Rover Opportunity has been exploring Mars for 12+ years, and is presently investigating the geology of a western rim segment of 22 kilometers diameter, Noachian- aged Endeavour crater. The Alpha Particle X-ray Spectrometer has determined the compositions of a pre-impact lithology, the Matijevic fm., and polymict impact breccias ejected from the crater, the Shoemaker fm. Opportunity is now investigating a region named Marathon Valley that cuts southwest-northeast through the central portion of the rim segment and provides a window into the lower stratigraphic record. (Geographic names used here are informal.) At the head of Marathon Valley, referred to here as Upper Marathon Valley, is a shallow, ovoid depression approximately 25×35 millimeters in size, named Spirit of Saint Louis. Layering inside Spirit of Saint Louis appears continuous with the Upper Marathon Valley rocks outside, indicating they are coeval. Spirit of Saint Louis is partly bounded by approximately 10-20 centimeters wide zone containing reddish altered rocks (red zone). Red zones also form prominent curvilinear features in Marathon Valley. Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) spectra provide evidence for a really extensive Fe-Mg smectite in the Marathon Valley region, indicating distinct styles of aqueous alteration. The CRISM detections of smectites are based on metal-OH absorptions at approximately 2.3 and 2.4 micron that are at least two times the background noise level.

  14. Changes of Hematological Markers during a Multi-stage Ultra-marathon Competition in the Heat.

    PubMed

    Rama, L M; Minuzzi, L G; Carvalho, H M; Costa, R J S; Teixeira, A M

    2016-02-01

    This study examined the changes in resting hematological variables in ultra-endurance runners throughout a multi-stage ultra-marathon competition, and compared athletes that completed all stages with those that failed to complete at least one stage within the cut-off time of competition. 19 ultra-endurance runners competing in a 230 km multi-stage ultra-marathon, conducted over 5 consecutive days in hot ambient conditions (32-40°C T(max)), volunteered to participate in the study. Each day, whole blood samples were collected prior to stage commencement and analyzed for full cell counts by Coulter counter. Linear increases were observed for leukocytes, monocytes and lymphocytes; with increases until Stage 3 and a decrease thereafter. Granulocytes showed a cubic growth exponent, indicating decrements to baseline after the significant increments until Stage 3. Hemoglobin and hematocrit showed linear decrements throughout the multi-stage ultra-marathon. No changes in erythrocytes and platelets were observed throughout the multi-stage ultra-marathon. Granulocytes, erythrocytes, hemoglobin and hematocrit changes along the multi-stage ultra-marathon differed in runners that completed all stages compared to those who failed to complete at least one stage within the cut-off time. Multi-stage ultra-marathon in the heat has a large impact on hematological responses of ultra-endurance runners associated with altered performance. PMID:26509375

  15. A multiplexed nucleic acid microsystem for point-of-care detection of HIV co-infection with MTB and PCP.

    PubMed

    Xu, Lingjia; Kong, Jilie

    2013-12-15

    Many individuals infected with the human immunodeficiency virus (HIV), especially children in African countries, die of co-infections with Mycobacterium tuberculosis (MTB) (coinfection rate: 50%) or Pneumocystis carinii pneumonia (PCP) (coinfection rate: 81%). The present proposal describes a rapid, portable, low-cost, multiplexed point-of-care diagnostic technique for simultaneously detecting HIV, MTB, and PCP. This technique incorporates a creative micro-device (hardware) and a loop-mediated isothermal amplification strategy (software). PMID:24209377

  16. [Cross-country and downhill skiing in patients with myocardial infarct. Can silent ischemia be prevented by drug therapy?].

    PubMed

    Völker, K; Hoppe, B; Krestin, M; Rost, R

    1990-05-10

    The appearance of ST segment depression in the exercise ECG serves as a threshold criterion when it comes to determining the "loadability" of myocardial infarction patients carrying out sports activities. In 27 MI patients, the question was investigated as to the extent to which abnormalities taking the form of silent ischemic episodes could be found during cross-country skiing on plains or during downhill skiing at an altitude of 800 to 2,000 meters. Such silent ischemic attacks were found in 20 out of the 27 patients. Both the duration and incidence were higher during sports activities than during normal day-to-day activities. The heart rate at the time of the appearance of the ischemic episodes was lower in the 12-hour ECG than during ergometry. During sports activities, however, the heart rates were frequently higher than the given training pulse rates. Treatment with nitrates (Isoket retard 120 mg) reduced the incidence and duration of silent ischemias. On account of the spontaneous variability of the parameter, it needs to be interpreted with caution. The incidence of silent ischemic episodes during sports activities in patients with clinical anomalies should prompt a rigorous treatment with drugs, and careful supervision of training. PMID:2373455

  17. [The application of the emulsified turpentine baths for the correction of the functional state of the cross-country skiers].

    PubMed

    Garnov, I O; Kuchin, A V; Loginova, T P; Varlamova, N G; Boiko, E R

    2016-01-01

    The baths with emulsified turpentine find the wide application in balneotherapy. They produce especially pronounced beneficial prophylactic effects in the patients presenting with microtrombosis and microvascular stasis. Moreover, these baths may be prescribed to improve microcirculation, increase the functional reserves and physical capacity in the athletes. At the same time, the current literature appears to contain no scientific publications on the application of emulsified turpentine baths for the restoration of the physical capacity of the professional ski runners. The lack of relevant information motivated the study reported in the present article. The main objective of the study involving 10 subjects was to evaluate the effectiveness of the modified emulsified turpentine baths as a method by which to restore and enhance the physical capacity of the professional cross-country skiers. The physical capacity of the athletes was evaluated from the results of the bicycle ergometer exercise test with the use of the «Oxycon Pro» system. The data obtained suggest that a course of the emulsified turpentine baths increases the activity of the cardiorespiratory system, improves the physical capacity, and enhances the functional reserves of the body in the anaerobic zone. PMID:27213946

  18. Performance differences when using 26- and 29-inch-wheel bikes in Swiss National Team cross-country mountain bikers.

    PubMed

    Steiner, Thomas; Müller, Beat; Maier, Thomas; Wehrlin, Jon Peter

    2016-08-01

    The purpose of this study was to analyse the effect of bike type - the 26-inch-wheel bike (26" bike) and the 29-inch-wheel bike (29" bike) - on performance in elite mountain bikers. Ten Swiss National Team athletes (seven males, three females) completed six trials with individual start on a simulated cross-country course with 35 min of active recovery between trials (three trials on a 26" bike and three trials on a 29" bike, alternate order, randomised start-bike). The course consisted of two separate sections expected to favour either the 29" bike (section A) or the 26" bike (section B). For each trial performance, power output, cadence and heart rate were recorded and athletes' experiences were documented. Mean overall performance (time: 304 ± 27 s vs. 311 ± 29 s; P < 0.01) and performance in sections A (P < 0.001) and B (P < 0.05) were better when using the 29" bike. No significant differences were observed for power output, cadence or heart rate. Athletes rated the 29" bike as better for performance in general, passing obstacles and traction. The 29" bike supports superior performance for elite mountain bikers, even on sections supposed to favour the 26" bike. PMID:26635310

  19. Possible asphyxiation from carbon dioxide of a cross-country skier in eastern California: a deadly volcanic hazard.

    PubMed

    Hill, P M

    2000-01-01

    This report describes an incident in which exceedingly high levels of carbon dioxide may have contributed to the death of a skier in eastern California. A cross-country skier was found dead inside a large, mostly covered snow cave, 1 day after he was reported missing. The autopsy report suggests that the skier died of acute pulmonary edema consistent with asphyxiation; carbon dioxide measurements inside the hole in which he was found reached 70%. This area is known for having a high carbon dioxide flux attributed to degassing of a large body of magma (molten rock) 10 to 20 km beneath the ski area. The literature describes many incidents of fatal carbon dioxide exposures associated with volcanic systems in other parts of the world. We believe this case represents the first reported death associated with volcanically produced carbon dioxide in the United States. Disaster and wilderness medicine specialists should be aware of and plan for this potential health hazard associated with active volcanoes. PMID:11055566

  20. Cross-country comparisons of health-care costs: the case of cancer treatment in the Nordic countries.

    PubMed

    Kalseth, Jorid; Halvorsen, Thomas; Kalseth, Birgitte; Sarheim Anthun, Kjartan; Peltola, Mikko; Kautiainen, Kirsi; Häkkinen, Unto; Medin, Emma; Lundgren, Jonatan; Rehnberg, Clas; Másdóttir, Birna Björg; Heimisdottir, Maria; Bjarnadóttir, Helga Hrefna; Køtlum, Jóanis Erik; Kilsmark, Janni; Halsteinli, Vidar

    2014-04-01

    The objective of this study is to perform a cross-country comparison of cancer treatment costs in the Nordic countries, and to demonstrate the added value of decomposing documented costs in interpreting national differences. The study is based on individual-level data from national patient and prescription drug registers, and data on cancer prevalence from the NORDCAN database. Hospital costs were estimated on the basis of information on diagnosis-related groups (DRG) cost weights and national unit costs. Differences in per capita costs were decomposed into two stages: stage one separated the price and volume components, and stage two decomposed the volume component, relating the level of activity to service needs and availability. Differences in the per capita costs of cancer treatment between the Nordic countries may be as much as 30 per cent. National differences in the costs of treatment mirror observed differences in total health care costs. Differences in health care costs between countries may relate to different sources of variation with different policy implications. Comparisons of per capita spending alone can be misleading if the purpose is to evaluate, for example, differences in service provision and utilisation. The decomposition analysis helps to identify the relative influence of differences in the prevalence of cancer, service utilisation and productivity. PMID:24462342

  1. Exercise and neuromodulators: choline and acetylcholine in marathon runners

    NASA Technical Reports Server (NTRS)

    Conlay, L. A.; Sabounjian, L. A.; Wurtman, R. J.

    1992-01-01

    Certain neurotransmitters (i.e., acetylcholine, catecholamines, and serotonin) are formed from dietary constituents (i.e., choline, tyrosine and tryptophan). Changing the consumption of these precursors alters release of their respective neurotransmitter products. The neurotransmitter acetylcholine is released from the neuromuscular junction and from brain. It is formed from choline, a common constituent in fish, liver, and eggs. Choline is also incorporated into cell membranes; membranes may likewise serve as an alternative choline source for acetylcholine synthesis. In trained athletes, running a 26 km marathon reduced plasma choline by approximately 40%, from 14.1 to 8.4 uM. Changes of similar magnitude have been shown to reduce acetylcholine release from the neuromuscular junction in vivo. Thus, the reductions in plasma choline associated with strenuous exercise may reduce acetylcholine release, and could thereby affect endurance or performance.

  2. [Sudden cardiac death during a city marathon run].

    PubMed

    Beutler, J; Schmid, E; Fischer, S; Hürlimann, S; Konrad, C

    2015-06-01

    Sudden cardiac death (SCD) in young athletes during physical stress is a rare event with an incidence of 1-3 deaths per 100,000 athletes per year. A coronary anomaly is the second most common cause of death following hypertrophic cardiomyopathy. Symptomatic prodromes occur in 20% of cases prior to the SCD event. This case report describes a 35-year-old male who collapsed near the finishing line of a half marathon run. Despite immediate resuscitation attempts and initial return of spontaneous circulation (ROSC), a pulseless electrical activity (PEA) followed and the patient died 1 h after arrival in the resuscitation unit. The autopsy revealed an anomalous left coronary artery (ALCA), which can lead to ischemia of the respective heart muscles under severe stress. PMID:26031561

  3. MicroRNAs as Biomarkers for Acute Atrial Remodeling in Marathon Runners (The miRathon Study – A Sub-Study of the Munich Marathon Study)

    PubMed Central

    Hildebrand, Bianca; Kääb, Stefan; Hoster, Eva; Klier, Ina; Martens, Eimo; Hanley, Alan; Hanssen, Henner; Halle, Martin; Nickel, Thomas

    2016-01-01

    Introduction Physical activity is beneficial for individual health, but endurance sport is associated with the development of arrhythmias like atrial fibrillation. The underlying mechanisms leading to this increased risk are still not fully understood. MicroRNAs are important mediators of proarrhythmogenic remodeling and have potential value as biomarkers in cardiovascular diseases. Therefore, the objective of our study was to determine the value of circulating microRNAs as potential biomarkers for atrial remodeling in marathon runners (miRathon study). Methods 30 marathon runners were recruited into our study and were divided into two age-matched groups depending on the training status: elite (ER, ≥55 km/week, n = 15) and non-elite runners (NER, ≤40 km/week, n = 15). All runners participated in a 10 week training program before the marathon. MiRNA plasma levels were measured at 4 time points: at baseline (V1), after a 10 week training period (V2), immediately after the marathon (V3) and 24h later (V4). Additionally, we obtained clinical data including serum chemistry and echocardiography at each time point. Results MiRNA plasma levels were similar in both groups over time with more pronounced changes in ER. After the marathon miR-30a plasma levels increased significantly in both groups. MiR-1 and miR-133a plasma levels also increased but showed significant changes in ER only. 24h after the marathon plasma levels returned to baseline. MiR-26a decreased significantly after the marathon in elite runners only and miR-29b showed a non-significant decrease over time in both groups. In ER miRNA plasma levels showed a significant correlation with LA diameter, in NER miRNA plasma levels did not correlate with echocardiographic parameters. Conclusion MiRNAs were differentially expressed in the plasma of marathon runners with more pronounced changes in ER. Plasma levels in ER correlate with left atrial diameter suggesting that circulating miRNAs could potentially serve

  4. Influence of chronic exercise on carotid atherosclerosis in marathon runners

    PubMed Central

    Taylor, Beth A; Zaleski, Amanda L; Capizzi, Jeffrey A; Ballard, Kevin D; Troyanos, Christopher; Baggish, Aaron L; D'Hemecourt, Pierre A; Dada, Marcin R; Thompson, Paul D

    2014-01-01

    Objectives The effect of habitual, high-intensity exercise training on the progression of atherosclerosis is unclear. We assessed indices of vascular health (central systolic blood pressure (SBP) and arterial stiffness as well as carotid intima-medial thickness (cIMT)) in addition to cardiovascular risk factors of trained runners versus their untrained spouses or partners to evaluate the impact of exercise on the development of carotid atherosclerosis. Setting field study at Boston Marathon. Participants 42 qualifiers (mean age±SD: 46±13 years, 21 women) for the 2012 Boston Marathon and their sedentary domestic controls (46±12 years, n=21 women). Outcomes We measured medical and running history, vital signs, anthropometrics, blood lipids, C reactive protein (CRP), 10 years Framingham risk, central arterial stiffness and SBP and cIMT. Results Multiple cardiovascular risk factors, including CRP, non-high-density lipoprotein cholesterol, triglycerides, heart rate, body weight and body mass index (all p<0.05), were reduced in the runners. The left and right cIMT, as well as central SBP, were not different between the two groups (all p>0.31) and were associated with age (all r≥0.41; p<0.01) and Framingham risk score (all r≥0.44; p<0.01) independent of exercise group (all p>0.08 for interactions). The amplification of the central pressure waveform (augmentation pressure at heart rate 75 bpm) was also not different between the two groups (p=0.07) but was related to age (p<0.01) and group (p=0.02) in a multiple linear regression model. Conclusions Habitual endurance exercise improves the cardiovascular risk profile, but does not reduce the magnitude of carotid atherosclerosis associated with age and cardiovascular risk factors. PMID:24531453

  5. Foot-strike pattern and performance in a marathon

    PubMed Central

    Kasmer, Mark E.; Liu, Xue-cheng; Roberts, Kyle G.; Valadao, Jason M.

    2016-01-01

    Purpose To: 1) determine prevalence of heel-strike in a mid-size city marathon, 2) determine if there is an association between foot-strike classification and race performance, and 3) determine if there is an association between foot-strike classification and gender. Methods Foot-strike classification (fore-foot strike, mid-foot strike, heel strike, or split-strike), gender, and rank (position in race) were recorded at the 8.1 kilometer (km) mark for 2,112 runners at the 2011 Milwaukee Lakefront Marathon. Results 1,991 runners were classified by foot-strike pattern, revealing a heel-strike prevalence of 93.67% (n=1,865). A significant difference between foot-strike classification and performance was found using a Kruskal-Wallis test (p < 0.0001), with more elite performers being less likely to heel-strike. No significant difference between foot-strike classification and gender was found using a Fisher’s exact test. Additionally, subgroup analysis of the 126 non-heel strikers found no significant difference between shoe wear and performance using a Kruskal-Wallis test. Conclusions The high prevalence of heel-striking observed in this study reflects the foot-strike pattern of the majority of mid- to long-distance runners and more importantly, may predict their injury profile based on the biomechanics of a heel strike running pattern. This knowledge can aid the clinician in the appropriate diagnosis, management, and training modifications of the injured runner. PMID:23006790

  6. Track and Field Guide including Cross Country, Pentathlon Scoring Tables and Rules for Intercollegiate Meets and Championships with Official Rules. Janauary 1974-January 1976.

    ERIC Educational Resources Information Center

    Thompson, Donnis H., Ed.

    This guide includes information on cross country running, pentathlon scoring tables, and rules for intercollegiate meets and championships, following an introductory portion on the organization's credo and standards. The first section covers track activities for children, coaching techniques, the benefits of weight training, and some practical…

  7. Spinal alignment, mobility of the hip and thoracic spine and prevalence of low back pain in young elite cross-country skiers

    PubMed Central

    Alricsson, Marie; Björklund, Glenn; Cronholm, Martin; Olsson, Oscar; Viklund, Peter; Svantesson, Ulla

    2016-01-01

    This study investigated the association between spinal alignment, mobility of the hips and the thoracic spine and low back pain in adolescent cross-country skiers. Cohort of 51 elite cross-country skiers from a cross-country skiing high school in Sweden participated in the study. Sagittal spinal alignment, active range of motion in flexion, extension and rotation of the thoracic spine as well as passive and active extension of the hips were measured. The participants also completed a questionnaire regarding training, competition, skiing technique and occurrence of low back pain. A simple linear regression was calculated to predict pain score based on thoraco-lumbar relation, with a significant (P<0.05) regression equation of y=−0.069x+2.280 (standard error of estimate, 0.034). Participants with greater lordosis than kyphosis were more likely to suffer from low back pain than subjects without this offset. Thoracic mobility and passive or active hip extension showed no correlation with low back pain. Sagittal spinal alignment seems to be related with low back pain among young elite cross-country skiers. This study shows that range of motion of the thoracic spine and hips do not have an effect on the prevalence of low back pain in this population. PMID:26933656

  8. Reliability, factor structure, and measurement invariance of the Dominic Interactive across European countries: Cross-country utility of a child mental health self-report.

    PubMed

    Kuijpers, Rowella C W M; Otten, Roy; Vermulst, Ad A; Pez, Ondine; Bitfoi, Adina; Carta, Mauro; Goelitz, Dietmar; Keyes, Katherine; Koç, Ceren; Lesinskiene, Sigita; Mihova, Zlatka; Engels, Rutger C M E; Kovess, Viviane

    2016-05-01

    Large-scale international surveys are important to globally evaluate, monitor, and promote children's mental health. However, use of young children's self-reports in these studies is still controversial. The Dominic Interactive, a computerized DSM-IV-based child mental health self-report questionnaire, has unique characteristics that may make it preeminently appropriate for usage in cross-country comparisons. This study aimed to determine scale score reliabilities (omega) of the Dominic Interactive in a sample of 8,135 primary school children, ages 6-11 years old, in 7 European countries, to confirm the proposed 7-scale factor structure, and to test for measurement invariance of scale and item scores across countries. Omega reliability values for scale scores were good to high in every country, and the factor structure was confirmed for all countries. A thorough examination of measurement invariance provided evidence for cross-country test score comparability of 5 of the 7 scales and partial scale score invariance of 2 anxiety scales. Possible explanations for this partial invariance include cross-country differences in conceptualizing items and defining what is socially and culturally acceptable anxiety. The convincing evidence for validity of score interpretation makes the Dominic Interactive an indispensable tool for cross-country screening purposes. (PsycINFO Database Record PMID:26237209

  9. Cross-Country Evidence on Teacher Performance Pay. Program on Education Policy and Governance Working Papers Series. PEPG 10-11

    ERIC Educational Resources Information Center

    Woessmann, Ludger

    2010-01-01

    The general-equilibrium effects of performance-related teacher pay include long-term incentive and teacher-sorting mechanisms that usually elude experimental studies but are captured in cross-country comparisons. Combining country-level performance-pay measures with rich PISA-2003 international achievement microdata, this paper estimates…

  10. Risk Factors for Self-Reported Exercise-Related Leg Pain in High School Cross-Country Athletes

    PubMed Central

    Reinking, Mark F.; Austin, Tricia M.; Hayes, Ann M.

    2010-01-01

    Abstract Context: Prevention of exercise-related leg pain (ERLP) has not been successful because ERLP risk factors are not well known. Objective: To determine the percentage of high school cross-country (XC) athletes who reported a history of ERLP in their running careers, to identify the percentage of athletes who reported an occurrence of ERLP during 1 XC season, and to investigate the association of selected factors (age, high school year, years of high school running, sex, ERLP history, body mass index [BMI], foot type, and training distance) and the occurrence of ERLP. Design: Prospective cohort study. Setting: Six local high schools. Patients or Other Participants: One hundred twenty-five high school XC athletes (62 females, 63 males). Main Outcome Measure(s): All athletes completed an initial ERLP questionnaire, and foot type was visually assessed. After the season, athletes were asked to complete a Web-based questionnaire regarding the seasonal occurrence of ERLP. Statistical analyses of differences (t tests) and associations (χ2, relative risk) were conducted. Results: A total of 103 of the 125 athletes (82.4%) reported a history of ERLP, with 81 athletes reporting ERLP occurrence within the month preceding completion of the initial questionnaire. Bilateral medial leg pain was the most common ERLP presentation. More than half of the athletes (58.4%) with an ERLP history reported that the pain had interfered with XC participation. Ninety-three athletes responded to the postseason questionnaire, and 45 (48.0%) reported ERLP seasonal occurrence. Most athletes (97.8%) who experienced the seasonal occurrence of ERLP had a history of ERLP. No associations were noted between ERLP history or seasonal occurrence and age, high school year, years of high school running, sex, BMI, foot type, or training distance. Conclusions: Both a history of ERLP and the seasonal occurrence of ERLP were common among these XC athletes. The only risk factor identified for ERLP season

  11. Influence of crank length on cycle ergometry performance of well-trained female cross-country mountain bike athletes.

    PubMed

    Macdermid, Paul William; Edwards, Andrew M

    2010-01-01

    The aim of this study was to determine the differential effects of three commonly used crank lengths (170, 172.5 and 175 mm) on performance measures relevant to female cross-country mountain bike athletes (n = 7) of similar stature. All trials were performed in a single blind and balanced order with a 5- to 7-day period between trials. Both saddle height and fore-aft position to pedal axle distance at a crank angle of 90 degrees was controlled across all trials. The laboratory tests comprised a supra-maximal (peak power-cadence); an isokinetic (50 rpm) test; and a maximal test of aerobic capacity. The time to reach supra-maximal peak power was significantly (P < 0.05) shorter in the 170 mm (2.57 +/- 0.79 s) condition compared to 175 mm (3.29 +/- 0.76 s). This effect represented a mean performance advantage of 27.8% for 170 mm compared to 175 mm. There was no further inter-condition differences between performance outcome measurements derived for the isokinetic (50 rpm) maximum power output, isokinetic (50 rpm) mean power output or indices of endurance performance. The decreased time to peak power with the greater rate of power development in the 170 mm condition suggests a race advantage may be achieved using a shorter crank length than commonly observed. Additionally, there was no impediment to either power output produced at low cadences or indices of endurance performance using the shorter crank length and the advantage of being able to respond quickly to a change in terrain could be of strategic importance to elite athletes. PMID:19771448

  12. Assessment of Heart Rate Variability Thresholds from Incremental Treadmill Tests in Five Cross-Country Skiing Techniques

    PubMed Central

    Mendia-Iztueta, Ibai; Monahan, Kristen

    2016-01-01

    The assessment of heart rate variability (HRV) thresholds (HRVTs) as an alternative of Ventilatory thresholds (VTs) is a relatively new approach with increasing popularity which has not been conducted in cross-country (XC) skiing yet. The main purpose of the present study was to assess HRVTs in the five main XC skiing-related techniques, double poling (DP), diagonal striding (DS), Nordic walking (NW), V1 skating (V1), and V2 skating (V2).Ten competitive skiers completed these incremental treadmill tests until exhaustion with a minimum of one to two recovery days in between each test. Ventilatory gases, HRV and poling frequencies were measured. The first HRV threshold (HRVT1) was assessed using two time-domain analysis methods, and the second HRV threshold (HRVT2) was assessed using two non-time varying frequency-domain analysis methods. HRVT1 was assessed by plotting the mean successive difference (MSD) and standard deviation (SD) of normalized R-R intervals to workload. HRVT1 was assessed by plotting high frequency power (HFP) and the HFP relative to respiratory sinus arrhythmia (HFPRSA) with workload. HRVTs were named after their methods (HRVT1-SD; HRVT1-MSD; HRVT2-HFP; HRVT2-HFP-RSA). The results showed that the only cases where the proposed HRVTs were good assessors of VTs were the HRVT1-SD of the DS test, the HRVT1-MSD of the DS and V2 tests, and the HRVT2-HFP-RSA of the NW test. The lack of a wider success of the assessment of HRVTs was reasoned to be mostly due to the high entrainment between the breathing and poling frequencies. As secondary finding, a novel Cardiolocomotor coupling mode was observed in the NW test. This new Cardiolocoomtor coupling mode corresponded to the whole bilateral poling cycle instead of corresponding to each poling action as it was reported to the date by the existing literature. PMID:26727112

  13. Clinical and Laboratory Responses of Cross-Country Skiing for a 24-H World Record: Case Report

    PubMed Central

    Niemelä, Markus; Juvonen, Jukka; Kangastupa, Päivikki; Niemelä, Onni; Juvonen, Tatu

    2015-01-01

    The physiological consequences of ultra-endurance cross-country skiing in cold conditions are poorly known. We report here clinical, echocardiographic and laboratory findings from a 41-y old male elite skier in a world record trial for 24-h skiing. The athlete completed a total of 406.8 km outdoors with the temperature ranging between -24°C and –5°C during the 24-h period. Post exercise, notable increases from baseline values were observed in myoglobin (50-fold), creatinine kinase (30-fold) and proBNP (6-fold), whereas troponin T or troponin I levels remained unchanged. At baseline, echocardiographic findings showed cardiac hypertrophy and after skiing, a 5% reduction of left-ventricular end-diastolic dimension. Increases in markers of kidney (creatinine) and liver function (alanine aminotransferase), serum uric acid, C-reactive protein and white blood cell counts were also noted. In addition, electrolyte disturbances including hyponatremia, hypophosphatemia and hypocalcaemia were noted during the follow-up. The data indicates that a prolonged period of high-intensity skiing leads to muscle, heart and kidney affection and activation of inflammation even in an experienced elite skier. The observed health effects underscore the need for strict medical surveillance of participants in extreme sports with long duration. Key points An elite athlete was able to ski over 400 km during 24 hours with an outdoor temperature ranging between –5 °C and –24 °C. Several postrace abnormalities occurred in biomarkers of muscle, heart, kidney, liver and inflammation status. Serum troponins, specific markers of myocardial cell damage, remained stable. The report supports careful medical surveillance of participants in extreme sports with long duration. PMID:26664265

  14. Compression socks and functional recovery following marathon running: a randomized controlled trial.

    PubMed

    Armstrong, Stuart A; Till, Eloise S; Maloney, Stephen R; Harris, Gregory A

    2015-02-01

    Compression socks have become a popular recovery aid for distance running athletes. Although some physiological markers have been shown to be influenced by wearing these garments, scant evidence exists on their effects on functional recovery. This research aims to shed light onto whether the wearing of compression socks for 48 hours after marathon running can improve functional recovery, as measured by a timed treadmill test to exhaustion 14 days following marathon running. Athletes (n = 33, age, 38.5 ± 7.2 years) participating in the 2012 Melbourne, 2013 Canberra, or 2013 Gold Coast marathons were recruited and randomized into the compression sock or placebo group. A graded treadmill test to exhaustion was performed 2 weeks before and 2 weeks after each marathon. Time to exhaustion, average and maximum heart rates were recorded. Participants were asked to wear their socks for 48 hours immediately after completion of the marathon. The change in treadmill times (seconds) was recorded for each participant. Thirty-three participants completed the treadmill protocols. In the compression group, average treadmill run to exhaustion time 2 weeks after the marathon increased by 2.6% (52 ± 103 seconds). In the placebo group, run to exhaustion time decreased by 3.4% (-62 ± 130 seconds), P = 0.009. This shows a significant beneficial effect of compression socks on recovery compared with placebo. The wearing of below-knee compression socks for 48 hours after marathon running has been shown to improve functional recovery as measured by a graduated treadmill test to exhaustion 2 weeks after the event. PMID:25627452

  15. COMPRESSION SOCKS AND FUNCTIONAL RECOVERY FOLLOWING MARATHON RUNNING: A RANDOMISED CONTROLLED TRIAL.

    PubMed

    Armstrong, Stuart A; Till, Eloise S; Maloney, Stephen; Harris, Gregory

    2014-09-01

    Compression socks have become a popular recovery aid for distance running athletes. Although some physiological markers have been shown to be influenced by wearing these garments, scant evidence exists on their effects on functional recovery. This research aims to shed light onto whether the wearing of compression socks for 48 hours after marathon running can improve functional recovery, as measured by a timed treadmill test to exhaustion 14 days following marathon running.Athletes (n=33, age = 38.5 ±7.2yrs) participating in the 2012 Melbourne, 2013 Canberra or 2013 Gold Coast marathons were recruited and randomised into the compression sock or placebo group. A graded treadmill test to exhaustion was performed 2 weeks prior and 2 weeks following each marathon. Time to exhaustion, average and maximum heart rates were recorded. Participants were asked to wear their socks for 48 hours immediately after completion of the marathon. The change in treadmill times (seconds) was recorded for each participant.33 participants completed the treadmill protocols. In the compression group average treadmill run to exhaustion time 2 weeks following the marathon increased by 2.6% (52s ±103s). In the placebo group run to exhaustion time decreased by 3.4% (-62s ±130s). P=0.009. This shows a significant beneficial effect of compression socks on recovery compared to placebo.The wearing of below knee compression socks for 48 hours after marathon running has been shown to improve functional recovery as measured by a graduated treadmill test to exhaustion 2 weeks following the event. PMID:25187242

  16. Sex differences in elite swimming with advanced age are less than marathon running.

    PubMed

    Senefeld, J; Joyner, M J; Stevens, A; Hunter, S K

    2016-01-01

    The sex difference in marathon performance increases with finishing place and age of the runner but whether this occurs among swimmers is unknown. The purpose was to compare sex differences in swimming velocity across world record place (1st-10th), age group (25-89 years), and event distance. We also compared sex differences between freestyle swimming and marathon running. The world's top 10 swimming times of both sexes for World Championship freestyle stroke, backstroke, breaststroke, and butterfly events and the world's top 10 marathon times in 5-year age groups were obtained. Men were faster than women for freestyle (12.4 ± 4.2%), backstroke (12.8 ± 3.0%), and breaststroke (14.5 ± 3.2%), with the greatest sex differences for butterfly (16.7 ± 5.5%). The sex difference in swimming velocity increased across world record place for freestyle (P < 0.001), breaststroke, and butterfly for all age groups and distances (P < 0.001) because of a greater relative drop-off between first and 10th place for women. The sex difference in marathon running increased with the world record place and the sex difference for marathon running was greater than for swimming (P < 0.001). The sex difference in swimming increased with world record place and age, but was less than for marathon running. Collectively, these results suggest more depth in women's swimming than marathon running. PMID:25648250

  17. Effects of Sprint versus High-Intensity Aerobic Interval Training on Cross-Country Mountain Biking Performance: A Randomized Controlled Trial

    PubMed Central

    Inoue, Allan; Impellizzeri, Franco M.; Pires, Flávio O.; Pompeu, Fernando A. M. S.; Deslandes, Andrea C.; Santos, Tony M.

    2016-01-01

    Objectives The current study compared the effects of high-intensity aerobic training (HIT) and sprint interval training (SIT) on mountain biking (MTB) race simulation performance and physiological variables, including peak power output (PPO), lactate threshold (LT) and onset of blood lactate accumulation (OBLA). Methods Sixteen mountain bikers (mean ± SD: age 32.1 ± 6.4 yr, body mass 69.2 ± 5.3 kg and VO2max 63.4 ± 4.5 mL∙kg-1∙min-1) completed graded exercise and MTB performance tests before and after six weeks of training. The HIT (7–10 x [4–6 min—highest sustainable intensity / 4–6 min—CR100 10–15]) and SIT (8–12 x [30 s—all-out intensity / 4 min—CR100 10–15]) protocols were included in the participants’ regular training programs three times per week. Results Post-training analysis showed no significant differences between training modalities (HIT vs. SIT) in body mass, PPO, LT or OBLA (p = 0.30 to 0.94). The Cohen’s d effect size (ES) showed trivial to small effects on group factor (p = 0.00 to 0.56). The interaction between MTB race time and training modality was almost significant (p = 0.08), with a smaller ES in HIT vs. SIT training (ES = -0.43). A time main effect (pre- vs. post-phases) was observed in MTB race performance and in several physiological variables (p = 0.001 to 0.046). Co-variance analysis revealed that the HIT (p = 0.043) group had significantly better MTB race performance measures than the SIT group. Furthermore, magnitude-based inferences showed HIT to be of likely greater benefit (83.5%) with a lower probability of harmful effects (0.8%) compared to SIT. Conclusion The results of the current study suggest that six weeks of either HIT or SIT may be effective at increasing MTB race performance; however, HIT may be a preferable strategy. Trial Registration ClinicalTrials.gov NCT01944865 PMID:26789124

  18. The effect of HIV coinfection, HAART and TB treatment on cytokine/chemokine responses to Mycobacterium tuberculosis (Mtb) antigens in active TB patients and latently Mtb infected individuals.

    PubMed

    Kassa, Desta; de Jager, Wilco; Gebremichael, Gebremedhin; Alemayehu, Yodit; Ran, Leonie; Fransen, Justin; Wolday, Dawit; Messele, Tsehaynesh; Tegbaru, Belete; Ottenhoff, Tom H M; van Baarle, Debbie

    2016-01-01

    Identification of Mtb specific induced cytokine/chemokine host biomarkers could assist in developing novel diagnostic, prognostic and therapeutic tools for TB. Levels of IFN-γ, IL-2, IL-17, IL-10, IP-10 and MIP-1α were measured in supernatants of whole blood stimulated with Mtb specific fusion protein ESAT-6/CFP-10 using xMAP technology. The study groups were HIV positive TB patients (HIV(+)TB(+)), HIV negative TB patients (HIV(-)TB(+)), HIV positive tuberculin skin test positive (TST+) (HIV(+)TST(+)), HIV negative TST+ (HIV(-)TST(+)), and HIV(-)TST(-) individuals. Compared to HIV(-)TST(-), latent TB infection led to increased levels of IP-10, IFN-γ and IL-17, while levels of IL-2 and IP-10 were increased with active TB. Levels of IFN-γ, IL-17, MIP-1α, and IL-10 were increased in HIV(-)TST(+) individuals compared to HIV(-)TB(+) patients. HIV coinfection decreased the level of IFN-γ, IL-17, IP-10 and IL-2. After six months (M6) of anti-TB treatment (ATT) in HIV(-)TB(+) patients, IFN-γ, IL-10, and MIP-1α levels normalized. After M6 and M18 of ATT plus HAART in HIV(+)TB(+) patients, levels of MIP-1α and IL-10 normalized, while this was not the case for IFN-γ, IL-2, IL-17, and IP-10 levels. In HIV(+)TST(+) patients on HAART, levels of IFN-γ, IL-17, IL-10 and MIP-1α normalized, while no change in the levels of IL-2 and IP-10 were observed. In conclusion, the simultaneous measurement of IFN-γ, IL-17 and IP-10 may assist in diagnosing LTBI; IL-2 and IP-10 may assist in diagnosing active TB; while IFN-γ, IL-17, MIP-1α, and IL-10 levels could help to discriminate LTBI and active TB. In addition, IL-10 and MIP-1α levels could help to monitor responses to TB treatment and HAART. PMID:26631832

  19. The Use of a Modified Marathon in Conjunction with Group Counseling in Short-term Treatment of Alcoholics

    ERIC Educational Resources Information Center

    Gazda, G. M.; And Others

    1971-01-01

    Two conclusions drawn from the application of the modified marathon to a short term treatment center were that the modified marathon had the advantages of holding" alcoholics for treatment once they were sober and it enhanced the quality of typical group counseling and therapy treatment. (Author)

  20. 78 FR 10128 - Expansion/Reorganization of Foreign-Trade Subzone 70T; Marathon Petroleum Company LP; Detroit, MI

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-13

    ... Marathon Petroleum Company LP refinery in Detroit, Michigan. (B-42-2012, docketed 6/1/2012); Whereas, notice inviting public comment has been given in the Federal Register (77 FR 33716-33717) and the... Foreign-Trade Zones Board Expansion/Reorganization of Foreign-Trade Subzone 70T; Marathon...

  1. The Effects of 16 Hour Long Marathon Groups on the Ways that Female Drug Users Perceive Women.

    ERIC Educational Resources Information Center

    Page, Richard C.

    1984-01-01

    Evaluated the effectiveness of three 16-hour-long unstructured marathon groups composed of female illicit drug users in a woman's prison (N=78), using evaluative adjective pairs of the semantic differential concept Women. Marathon groups rated women as more successful and more pleasurable than did controls. (JAC)

  2. 76 FR 54764 - Marathon Power LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes Request...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-02

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Marathon Power LLC; Supplemental Notice That Initial Market-Based Rate...-referenced proceeding of Marathon Power LLC's application for market-based rate authority, with...

  3. Plantar Pressures During Long Distance Running: An Investigation of 10 Marathon Runners.

    PubMed

    Hohmann, Erik; Reaburn, Peter; Tetsworth, Kevin; Imhoff, Andreas

    2016-06-01

    The objective of this study was to record plantar pressures using an in-shoe measuring system before, during, and after a marathon run in ten experienced long-distance runners with a mean age of 37.7 ± 11.5 years. Peak and mean plantar pressures were recorded before, after, and every three km during a marathon race. There were no significant changes over time in peak and mean plantar pressures for either the dominant or non-dominant foot. There were significant between foot peak and mean plantar pressure differences for the total foot (p = 0.0001), forefoot (p = 0.0001), midfoot (p = 0.02 resp. p = 0.006), hindfoot (p = 0.0001), first ray (p = 0.01 resp. p = 0.0001) and MTP (p = 0.05 resp. p = 0.0001). Long-distance runners do not demonstrate significant changes in mean or peak plantar foot pressures over the distance of a marathon race. However, athletes consistently favoured their dominant extremity, applying significantly higher plantar pressures through their dominant foot over the entire marathon distance. Key pointsFatigue does not increase foot pressuresEvery runner has a dominant foot where pressures are higher and that he/she favoursFoot pressures do not increase over the distance of a marathon run. PMID:27274662

  4. Effects of training and anthropometric factors on marathon and 100 km ultramarathon race performance

    PubMed Central

    Tanda, Giovanni; Knechtle, Beat

    2015-01-01

    Background Marathon (42 km) and 100 km ultramarathon races are increasing in popularity. The aim of the present study was to investigate the potential associations of anthropometric and training variables with performance in these long-distance running competitions. Methods Training and anthropometric data from a large cohort of marathoners and 100 km ultramarathoners provided the basis of this work. Correlations between training and anthropometric indices of subjects and race performance were assessed using bivariate and multiple regression analyses. Results A combination of volume and intensity in training was found to be suitable for prediction of marathon and 100 km ultramarathon race pace. The relative role played by these two variables was different, in that training volume was more important than training pace for the prediction of 100 km ultramarathon performance, while the opposite was found for marathon performance. Anthropometric characteristics in terms of body fat percentage negatively affected 42 km and 100 km race performance. However, when this factor was relatively low (ie, less than 15% body fat), the performance of 42 km and 100 km races could be predicted solely on the basis of training indices. Conclusion Mean weekly training distance run and mean training pace were key predictor variables for both marathon and 100 km ultramarathon race performance. Predictive correlations for race performance are provided for runners with a relatively low body fat percentage. PMID:25995653

  5. Plantar Pressures During Long Distance Running: An Investigation of 10 Marathon Runners

    PubMed Central

    Hohmann, Erik; Reaburn, Peter; Tetsworth, Kevin; Imhoff, Andreas

    2016-01-01

    The objective of this study was to record plantar pressures using an in-shoe measuring system before, during, and after a marathon run in ten experienced long-distance runners with a mean age of 37.7 ± 11.5 years. Peak and mean plantar pressures were recorded before, after, and every three km during a marathon race. There were no significant changes over time in peak and mean plantar pressures for either the dominant or non-dominant foot. There were significant between foot peak and mean plantar pressure differences for the total foot (p = 0.0001), forefoot (p = 0.0001), midfoot (p = 0.02 resp. p = 0.006), hindfoot (p = 0.0001), first ray (p = 0.01 resp. p = 0.0001) and MTP (p = 0.05 resp. p = 0.0001). Long-distance runners do not demonstrate significant changes in mean or peak plantar foot pressures over the distance of a marathon race. However, athletes consistently favoured their dominant extremity, applying significantly higher plantar pressures through their dominant foot over the entire marathon distance. Key points Fatigue does not increase foot pressures Every runner has a dominant foot where pressures are higher and that he/she favours Foot pressures do not increase over the distance of a marathon run PMID:27274662

  6. Integrating the Xpert MTB/RIF Assay into a Diagnostic Workflow for Rapid Detection of Mycobacterium tuberculosis in a Low-Prevalence Area

    PubMed Central

    Deggim, Vanessa; Somoskovi, Akos; Voit, Antje; Böttger, Erik C.

    2013-01-01

    The Xpert MTB/RIF assay is a rapid and fully automated real-time PCR assay. The performance of the Xpert MTB/RIF assay as a primary screening test for urgent clinical specimens was evaluated during a 2-year period. The results showed that replacing smear microscopy with the Xpert MTB/RIF assay facilitates laboratory handling and improves the sensitivity and specificity of Mycobacterium tuberculosis detection. PMID:23616455

  7. Thermal Responses in Football and Cross-Country Athletes During Their Respective Practices in a Hot Environment

    PubMed Central

    Godek, Joseph J.; Bartolozzi, Arthur R.

    2004-01-01

    Objective: To determine if football (FB) players and cross-country (CC) runners had different thermal responses to their respective training sessions. Design and Setting: On days 4 and 8 of preseason training, we assessed core (Tc) and skin (Tsk) temperatures. Subjects: Fifteen collegiate athletes volunteered: 10 FB players (age = 21.2 ± 1.14 years, height = 193.5 ± 4.8 cm, mass = 116.6 ± 16.3 kg, and V2max = 44.7 ± 9.4 mL·kg−1·min−1) and 5 CC runners (age = 22.8 ± 2.77 years, height = 176.3 ± 8.9 cm, mass = 71.16 ± 8.9 kg, and V2max = 71.3 ± 6.18 mL·kg−1·min−1). Measurements: We measured Tc using ingestible sensors before, during, and immediately after exercise. The Tsk was measured at the calf, forearm, back, chest, and forehead sites. Level of dehydration was assessed by urine specific gravity. Results: Mean wet-bulb temperature was 74°F (23.33°C). Resting Tc in shorts and T-shirts was higher in the FB group. The Tc midway through practices and runs was higher in the CC and FB subjects when active, compared with the FB subjects when inactive. Postexercise Tc was higher in the CC group than the FB group with pads, and postconditioning Tc was higher in the FB subjects with pads versus no pads. Forehead, chest, back, and mean weighted Tsk were higher in the FB group. The Tc and urine specific gravity were not correlated. Conclusions: The Tc fluctuated in the FB subjects during practice depending on exercise intensity, whereas Tc increased steadily in the CC subjects during continuous running. Thus, CC athletes may have to decrease intensity to maintain thermoregulation. Our FB players seemed to dissipate heat adequately during rest periods. PMID:15496992

  8. A systematic assessment of the current capacity to act in nutrition in West Africa: cross-country similarities and differences

    PubMed Central

    Sodjinou, Roger; Bosu, William K.; Fanou, Nadia; Déart, Lucie; Kupka, Roland; Tchibindat, Félicité; Baker, Shawn

    2014-01-01

    Background Although it is widely accepted that lack of capacity is one of the barriers to scaling up nutrition in West Africa, there is a paucity of information about what capacities exist and the capacities that need to be developed to accelerate progress toward improved nutrition outcomes in the region. Objective To systematically assess the current capacity to act in nutrition in the West Africa region and explore cross-country similarities and differences. Design Data were collected from 13 West African countries through interviews with government officials, key development partners, tertiary-level training institutions, and health professional schools. The assessment was based on a conceptual framework of four interdependent levels (tools; skills; staff and infrastructure; and structures, systems and roles). In each of the surveyed countries, we assessed capacity assets and gaps at individual, organizational, and systemic levels. Results Important similarities and differences in capacity assets and gaps emerged across all the surveyed countries. There was strong momentum to improve nutrition in nearly all the surveyed countries. Most of the countries had a set of policies on nutrition in place and had set up multisectoral, multi-stakeholder platforms to coordinate nutrition activities, although much remained to be done to improve the effectiveness of these platforms. Many initiatives aimed to reduce undernutrition were ongoing in the region, but there did not seem to be clear coordination between them. Insufficient financial resources to implement nutrition activities were a major problem in all countries. The bulk of financial allocations for nutrition was provided by development partners, even though some countries, such as Niger, Nigeria, and Senegal, had a national budget line for nutrition. Sporadic stock-outs of nutrition supplies were reported in most of the countries as a result of a weak logistic and supply chain system. They also had a critical

  9. Marathon without a colon: salt and water balance in endurance running ileostomates.

    PubMed Central

    Isaacs, P.

    1984-01-01

    Five trained ileostomates completed a marathon in a cool environment without ill effect. During the race, the ileostomy losses of sodium (1.0-2.7 mmol.h-1) and of water (9.2-19 ml.h-1) were small, but urinary excretion of sodium was very low (0.2-0.75 mmol.h-1) despite drinking a combination of water and glucose-electrolyte solution. The concentration of potassium in the ileostomy discharge tended to increase, also suggesting a sodium retaining state. Healthy ileostomates after suitable training are successful marathon runners, but the prevalence of mild salt depletion in ileostomates generally suggests that it may be advisable for them to take only glucose-electrolyte solutions when competing at any ambient temperature or when preparing for a marathon which is to take place in a warm environment. Images p295-a PMID:6525499

  10. Impact of the Boston Marathon Bombing and Its Aftermath on Refugees and Survivors of Torture.

    PubMed

    Piwowarczyk, Linda; Rous, Dana; Mancuso, Anna; Flinton, Kathleen; Hastings, Erica; Forbush, Leigh; Shepherd, Amy

    2016-08-01

    On April 15, 2013, Boston residents and guests gathered for the Boston Marathon. Two explosives at the finish line killed three people and injured hundreds of others. As part of our clinical encounters, patients of the Boston Center for Refugee Health & Human Rights were asked about the marathon bombing. We were concerned about the high level of armed security as many of our patients had been detained in their countries of origin. Eighty patients seen between April 16 and July 7, 2013 were asked about their experience of the Boston Marathon bombing and its aftermath. A retrospective chart review was undertaken and data analyzed using Atlas.ti & SPSS. Approximately 86 % of those interviewed were reminded of their past trauma. The following themes emerged: triggering and trauma related symptoms, content specific cognitive schemas, recognition of the universality of violence, fears of discrimination, issues surrounding safety, and specific concerns of Muslims. PMID:26289501

  11. Recognition and treatment of exertional heat illness at a marathon race.

    PubMed

    Hostler, David; Franco, Vanessa; Martin-Gill, Chris; Roth, Ronald N

    2014-01-01

    Exertional heat illness is rarely encountered by individual EMS providers but can be common in certain settings and events. The notion that significantly altered mental status must accompany elevated core temperature in heat illness may delay recognition and treatment. We report on a series of marathon and half-marathon runners who suffered exertional heat illness during a marathon race in relatively mild conditions. Altered mental status was not uniformly present. All patients were treated in the finish line medical tent and responded well to cooling. More than half were discharged from the medical tent without being transported to the hospital. This case series demonstrates that many runners respond to early identification and treatment of exertional heat illness. Significant preparation is required by the medical providers to handle the rapid influx of patients at the conclusion of the event. PMID:24460521

  12. Fluoride concentrations in a crystalline bedrock aquifer Marathon County, Wisconsin

    NASA Astrophysics Data System (ADS)

    Ozsvath, David L.

    2006-05-01

    Water samples from 2,789 private water-supply wells in Marathon County, Wisconsin reveal that fluoride concentrations in the crystalline bedrock range from <0.01 to 7.60 mg/L, with 0.6% of the values exceeding the Environmental Protection Agency’s (EPA’s) maximum contaminant level of 4 mg/L, and 8.6% exceeding the EPA’s secondary maximum contaminant level of 2.0 mg/L. Roughly a quarter of the wells contain dissolve fluoride within the range considered optimal for human health (between 0.5 and 1.5 mg/L), whereas 63.3% fall below 0.5 mg/L. Consistent with studies conducted in other regions, felsic rocks have significantly higher fluoride concentrations than mafic and metasedimentary rocks. Syenites yield the most fluoriferous groundwaters, but the highest median concentration occurs in a sodium-plagioclase granite. A relationship between plagioclase composition and fluoride concentrations suggests that dissolved fluoride levels are controlled by fluorite solubility and that higher fluoride concentrations are found in soft, sodium-rich groundwater.

  13. THE ROLE OF THE SPORTS PHYSICAL THERAPIST-MARATHON EVENTS

    PubMed Central

    Schuemann, Teresa; Hoogenboom, Barbara J.

    2013-01-01

    The role of the Sports physical therapist (PT) as a part of the sports medical team at marathon-type events varies widely. The PT can assume the role of an emergency medical responder (EMR) whose primary role is the management of the athlete in emergency type situations. The role of the EMR extends beyond the care of the athlete to the care and safety of the spectators. In this role, the PT must be prepared to handle any type of emergency situation, which may occur from medical conditions to acute orthopedic/sports injuries, to medical conditions which may be found in the participants of the race or the spectators. Additional roles of the PT can be in pre-race education, pre-participation screening/physicals, and other concerns by the participant related to injury prevention. Regardless of the role assumed by the PT, prior planning is essential for the safety, security, and maximal performance of the participant and to make the race enjoyable and safe for everyone. Level of Evidence: 5 PMID:24175136

  14. Imaging of lower extremity trauma from Boston Marathon bombing.

    PubMed

    Konwinski, Ryan R; Singh, Ajay; Soto, Jorge

    2016-10-01

    The goal of this study is to describe the imaging features of lower extremity blast injuries in patients encountered in the radiology departments from the Boston Marathon bombings. A total of 115 patients presented to four acute care hospitals on April 15, 2013, 43 of whom presented with lower extremity injuries and were included in this study. The imaging findings of primary, secondary, tertiary, and quaternary blast injuries were evaluated. Forty-one of 43 patients sustained secondary blast injuries to the lower extremities with 31 patients (70 %) having retained shrapnel, seven patients (16 %) having soft tissue lacerations without retained shrapnel, and ten patients (23 %) having lower extremity amputation (7 % double amputees). Eight of these patients (20 %) had lower extremity fractures, and five patients (12 %) had vascular injuries. Two of the 43 patients (5 %) had only tertiary injuries, and five of 43 patients (12 %) were noted to have lower extremity burns, consistent with quaternary blast injury. No primary blast injury occurred in the lower extremities. A vast majority of lower extremity injuries were from secondary blast injury, most commonly from retained shrapnel in 70 % of patients and 23 % of patients sustaining lower extremity amputation. Retained shrapnel in the lower extremity was most commonly ball bearings and pressure cooker fragments, and most injuries affected the leg, followed by the thigh and foot. PMID:27272899

  15. Systematic review: Comparison of Xpert MTB/RIF, LAMP and SAT methods for the diagnosis of pulmonary tuberculosis.

    PubMed

    Yan, Liping; Xiao, Heping; Zhang, Qing

    2016-01-01

    Technological advances in nucleic acid amplification have led to breakthroughs in the early detection of PTB compared to traditional sputum smear tests. The sensitivity and specificity of loop-mediated isothermal amplification (LAMP), simultaneous amplification testing (SAT), and Xpert MTB/RIF for the diagnosis of pulmonary tuberculosis were evaluated. A critical review of previous studies of LAMP, SAT, and Xpert MTB/RIF for the diagnosis of pulmonary tuberculosis that used laboratory culturing as the reference method was carried out together with a meta-analysis. In 25 previous studies, the pooled sensitivity and specificity of the diagnosis of tuberculosis were 93% and 94% for LAMP, 96% and 88% for SAT, and 89% and 98% for Xpert MTB/RIF. The I(2) values for the pooled data were >80%, indicating significant heterogeneity. In the smear-positive subgroup analysis of LAMP, the sensitivity increased from 93% to 98% (I(2) = 2.6%), and specificity was 68% (I(2) = 38.4%). In the HIV-infected subgroup analysis of Xpert MTB/RIF, the pooled sensitivity and specificity were 79% (I(2) = 72.9%) and 99% (I(2) = 64.4%). In the HIV-negative subgroup analysis for Xpert MTB/RIF, the pooled sensitivity and specificity were 72% (I(2) = 49.6%) and 99% (I(2) = 64.5%). LAMP, SAT and Xpert MTB/RIF had comparably high levels of sensitivity and specificity for the diagnosis of tuberculosis. The diagnostic sensitivity and specificity of three methods were similar, with LAMP being highly sensitive for the diagnosis of smear-positive PTB. The cost effectiveness of LAMP and SAT make them particularly suitable tests for diagnosing PTB in developing countries. PMID:26786658

  16. A comparison between the efficiency of the Xpert MTB/RIF assay and nested PCR in identifying Mycobacterium tuberculosis during routine clinical practice

    PubMed Central

    Kim, Cheol-Hong; Woo, Heungjeong; Kim, Changhwan; Choi, Jeong-Hee; Jang, Seung-Hun; Park, Sang Myeon; Lee, Myung Goo; Jung, Ki-Suck; Hyun, Jeongwon; Kim, Hyun Soo

    2014-01-01

    Objectives Polymerase chain reaction (PCR) for the detection of Mycobacterium tuberculosis (MTB) is more sensitive, specific, and rapid than the conventional methods of acid-fast bacilli (AFB) smear and culture. The aim of this study was to determine if the Xpert MTB/rifampicin (RIF) assay had additional advantages over nested PCR for the detection of MTB in a geographical area with intermediate tuberculosis (TB) incidence. Methods Between February and December 2013, the Xpert MTB/RIF assay and MTB nested PCR, as well as AFB smear and culture, were simultaneously performed on 198 clinical samples (160 pulmonary and 38 non-pulmonary specimens) collected from 171 patients hospitalized at Hallym University Medical Center for possible TB. The accuracy of the diagnosis of MTB culture-positive TB and the turnaround time of reporting laboratory results were calculated and compared. Rifampin resistance by the Xpert MTB/RIF assay was reviewed with that of conventional drug susceptibility testing (DST). Results The sensitivity, specificity, and positive and negative predictive values of the Xpert MTB/RIF assay and MTB nested PCR for diagnosis of MTB culture-positive pulmonary TB were 86.1% vs. 69.4% (P=0.1563), 97.8% vs. 94.1% (P=0.2173), 91.2% vs. 75.8% (P=0.1695), and 96.4% vs. 92.0% (P=0.2032), respectively. The median turnaround times of the Xpert MTB/RIF assay and MTB nested PCR were 0 [0-4] days and 4 [1-11] days, respectively (P<0.001). Two cases of rifampin resistance, as determined by the Xpert MTB/RIF assay, were found to be multi-drug resistant (MDR) pulmonary TB by DST. Conclusions The Xpert MTB/RIF assay seemed to be sensitive, specific, and comparable to nested PCR for identifying MTB among clinically suspected TB patients, and the assay can be valuable in giving a timely identification of resistance to rifampin. PMID:24976983

  17. Myosin Light Chain Kinase (MLCK) Gene Influences Exercise Induced Muscle Damage during a Competitive Marathon.

    PubMed

    Del Coso, Juan; Valero, Marjorie; Lara, Beatriz; Salinero, Juan José; Gallo-Salazar, César; Areces, Francisco

    2016-01-01

    Myosin light chain kinase (MLCK) phosphorylates the regulatory light chain (RLC) of myosin producing increases in force development during skeletal muscle contraction. It has been suggested that MLCK gene polymorphisms might alter RLC phosphorylation thereby decreasing the ability to produce force and to resist strain during voluntary muscle contractions. Thus, the genetic variations in the MLCK gene might predispose some individuals to higher values of muscle damage during exercise, especially during endurance competitions. The aim of this investigation was to determine the influence of MLCK genetic variants on exercise-induced muscle damage produced during a marathon. Sixty-seven experienced runners competed in a marathon race. The MLCK genotype (C37885A) of these marathoners was determined. Before and after the race, a sample of venous blood was obtained to assess changes in serum myoglobin concentrations and leg muscle power changes were measured during a countermovement jump. Self-reported leg muscle pain and fatigue were determined by questionnaires. A total of 59 marathoners (88.1%) were CC homozygotes and 8 marathoners (11.9%) were CA heterozygotes. The two groups of participants completed the race with a similar time (228 ± 33 vs 234 ± 39 min; P = 0.30) and similar self-reported values for fatigue (15 ± 2 vs 16 ± 2 A.U.; P = 0.21) and lower-limb muscle pain (6.2 ± 1.7 vs 6.6 ± 1.8 cm; P = 0.29). However, CC marathoners presented higher serum myoglobin concentrations (739 ± 792 vs 348 ± 144 μg·mL-1; P = 0.03) and greater pre-to-post- race leg muscle power reduction (-32.7 ± 15.7 vs -21.2 ± 21.6%; P = 0.05) than CA marathoners. CA heterozygotes for MLCK C37885A might present higher exercise-induced muscle damage after a marathon competition than CC counterparts. PMID:27483374

  18. Myosin Light Chain Kinase (MLCK) Gene Influences Exercise Induced Muscle Damage during a Competitive Marathon

    PubMed Central

    Valero, Marjorie; Lara, Beatriz; Salinero, Juan José; Gallo-Salazar, César; Areces, Francisco

    2016-01-01

    Myosin light chain kinase (MLCK) phosphorylates the regulatory light chain (RLC) of myosin producing increases in force development during skeletal muscle contraction. It has been suggested that MLCK gene polymorphisms might alter RLC phosphorylation thereby decreasing the ability to produce force and to resist strain during voluntary muscle contractions. Thus, the genetic variations in the MLCK gene might predispose some individuals to higher values of muscle damage during exercise, especially during endurance competitions. The aim of this investigation was to determine the influence of MLCK genetic variants on exercise-induced muscle damage produced during a marathon. Sixty-seven experienced runners competed in a marathon race. The MLCK genotype (C37885A) of these marathoners was determined. Before and after the race, a sample of venous blood was obtained to assess changes in serum myoglobin concentrations and leg muscle power changes were measured during a countermovement jump. Self-reported leg muscle pain and fatigue were determined by questionnaires. A total of 59 marathoners (88.1%) were CC homozygotes and 8 marathoners (11.9%) were CA heterozygotes. The two groups of participants completed the race with a similar time (228 ± 33 vs 234 ± 39 min; P = 0.30) and similar self-reported values for fatigue (15 ± 2 vs 16 ± 2 A.U.; P = 0.21) and lower-limb muscle pain (6.2 ± 1.7 vs 6.6 ± 1.8 cm; P = 0.29). However, CC marathoners presented higher serum myoglobin concentrations (739 ± 792 vs 348 ± 144 μg·mL-1; P = 0.03) and greater pre-to-post- race leg muscle power reduction (-32.7 ± 15.7 vs -21.2 ± 21.6%; P = 0.05) than CA marathoners. CA heterozygotes for MLCK C37885A might present higher exercise-induced muscle damage after a marathon competition than CC counterparts. PMID:27483374

  19. False-positive rifampin resistant results with Xpert MTB/RIF version 4 assay in clinical samples with a low bacterial load.

    PubMed

    Ocheretina, Oksana; Byrt, Erin; Mabou, Marie-Marcelle; Royal-Mardi, Gertrude; Merveille, Yves-Mary; Rouzier, Vanessa; Fitzgerald, Daniel W; Pape, Jean W

    2016-05-01

    We report investigation of 22 TB cases with positive Xpert MTB/RIF result for resistance to Rifampin and "Very Low" MTB detection level. Twelve cases were false positive without rpoB mutations, 2 were false-positives with a silent mutation in rpoB codon T508, and only 10 were true positives. PMID:26915638

  20. Evaluation of the eukaryotic expression of mtb32C-hbha fusion gene of Mycobacterium tuberculosis in Hepatocarcinoma cell line

    PubMed Central

    Teimourpour, Roghayeh; Zare, Hosna; Rajabnia, Ramazan; Yahyapour, Yousef; Meshkat, Zahra

    2016-01-01

    Background and Objectives: HBHA and Mtb32C have been isolated from culture supernatants of Mycobacterium tuberculosis (M. tuberculosis) and Mycobacterium bovis (M. bovis) and their immunogenicity previously studies have been confirmed. In this study, capability of constructed vector containing two mycobacterial immunodaminant antigens (Mtb32C-HBHA), in producing new chimeric protein under the in-vitro condition was examined. Materials and Methods: In present study Huh7.5 cells was transfected with Mtb32C-HBHA −pCDNA3.1+ recombinant vector using the calcium phosphate method and expression of chimeric protein was assessed by RT-PCR and Western blot methods. Results: Results of RT-PCR and Western blot showed expression of 35.5 KD recombinant protein (Mtb32C-HBHA) in this cell line. Conclusion: The constructed vector can produce two highly immunogenic antigens that fusion of them to gather makes chimeric antigen with new traits. Other attempts are needed to evaluate specific properties of this new antigen such as molecular conformation modeling and immunologic characteristics in future studies. PMID:27307979

  1. The Use of Xpert MTB/Rif for Active Case Finding among TB Contacts in North West Province, South Africa.

    PubMed

    Lebina, Limakatso; Fuller, Nigel; Osoba, Tolu; Scott, Lesley; Motlhaoleng, Katlego; Rakgokong, Modiehi; Abraham, Pattamukkil; Variava, Ebrahim; Martinson, Neil Alexander

    2016-01-01

    Introduction. Tuberculosis is a major cause of morbidity and mortality especially in high HIV burden settings. Active case finding is one strategy to potentially reduce TB disease burden. Xpert MTB/Rif has recently been recommended for diagnosis of TB. Methods. Pragmatic randomized trial to compare diagnosis rate and turnaround time for laboratory testing for Xpert MTB/Rif with TB microscopy and culture in household contacts of patients recently diagnosed with TB. Results. 2464 household contacts enrolled into the study from 768 active TB index cases. 1068 (44%) were unable to give sputum, but 24 of these were already on TB treatment. 863 (53%) participants sputum samples were tested with smear and culture and 2.7% (23/863; CI: 1.62-3.78) were diagnosed with active TB. Xpert MTB/Rif was used in 515 (21%) participants; active TB was diagnosed in 1.6% (8/515; CI: 0.52-2.68). Discussion and Conclusions. Additional 31 cases were diagnosed with contact tracing of household members. When Xpert MTB/Rif is compared with culture, there is no significant difference in diagnostic yield. PMID:27493800

  2. The Use of Xpert MTB/Rif for Active Case Finding among TB Contacts in North West Province, South Africa

    PubMed Central

    Osoba, Tolu; Scott, Lesley; Motlhaoleng, Katlego; Rakgokong, Modiehi; Martinson, Neil Alexander

    2016-01-01

    Introduction. Tuberculosis is a major cause of morbidity and mortality especially in high HIV burden settings. Active case finding is one strategy to potentially reduce TB disease burden. Xpert MTB/Rif has recently been recommended for diagnosis of TB. Methods. Pragmatic randomized trial to compare diagnosis rate and turnaround time for laboratory testing for Xpert MTB/Rif with TB microscopy and culture in household contacts of patients recently diagnosed with TB. Results. 2464 household contacts enrolled into the study from 768 active TB index cases. 1068 (44%) were unable to give sputum, but 24 of these were already on TB treatment. 863 (53%) participants sputum samples were tested with smear and culture and 2.7% (23/863; CI: 1.62–3.78) were diagnosed with active TB. Xpert MTB/Rif was used in 515 (21%) participants; active TB was diagnosed in 1.6% (8/515; CI: 0.52–2.68). Discussion and Conclusions. Additional 31 cases were diagnosed with contact tracing of household members. When Xpert MTB/Rif is compared with culture, there is no significant difference in diagnostic yield. PMID:27493800

  3. Marathon Running Fails to Influence RBC Survival Rates in Iron-Replete Women.

    ERIC Educational Resources Information Center

    Steenkamp, Irene; And Others

    1986-01-01

    This study used radiolabeling to measure red blood cell (RBC) survival rates in six iron-replete female marathon runners, and urinary tests were conducted to search for secondary evidence of RBC damage. The hypothesized RBC fragmentation was not disclosed. (Author/MT)

  4. The Boston Marathon Medical Care Team: A Ten-Year Experience.

    ERIC Educational Resources Information Center

    Adner, Marvin M.; And Others

    1988-01-01

    The composition, ojbectives, and perceptions of the medical care team which has evolved over the last 10 years to provide acute care for injured persons at the finish line of the Boston Marathon are described, as well as as an ancillary group which maintains medical records and defines injury patterns. (Author/CB)

  5. A brief review: the implications of iron supplementation for marathon runners on health and performance.

    PubMed

    Zourdos, Michael C; Sanchez-Gonzalez, Marcos A; Mahoney, Sara E

    2015-02-01

    The marathon is considered one of the most demanding endurance events, imposing an enormous amount of physiological stress on bodily structures, the metabolic machinery, and organ systems. Scientific evidence has conclusively shown that marathoners are in need of special nutritional strategies to maintain performance and health. Indeed, among competitive athletes, marathoners are at greater risk to develop anemia, bone mineral density loss, immunosuppression, and other clinical syndromes that may affect performance. Inadequate dietary intake of the micronutrient iron has been identified as one key factor in the development of the above mentioned anomalies. In fact, iron is one of the few nutrients recommended as a supplement by the American College of Sports Medicine (ACSM), the Academy of Nutrition and Dietetics (AND), and Dietitians of Canada. Therefore, the aim of this review article is to discuss the role of iron on the marathoner's health and performance. Special emphasis will be given to the physiological mechanisms accounting for the additional iron need in this group of athletes and the nutritional strategies intended to counteract iron deficiency. PMID:25072667

  6. Marathons versus Spaced Groups: Skin Conductance and the Effects of Time Distribution on Encounter Group Learning.

    ERIC Educational Resources Information Center

    Loomis, Thomas P.

    1988-01-01

    Randomly assigned 41 students to 2 twice-weekly groups, which met for 3 hours eight times; 2 marathons, which met continuously for 24 hours; and nontreatment control group. Treatment groups had significant positive changes on 14 of 15 measured personality variables between pre- and post-test, and positive change on all dependent measures between…

  7. Effects of Structure of Marathon Group Therapy and Locus of Control on Therapeutic Outcome

    ERIC Educational Resources Information Center

    Kilmann, Peter R.; Howell, Robert J.

    1974-01-01

    This study compared the outcome of external and internal scorers on the locus of control scale and considered the association between internal-external orientation and direct and nondirect marathon group therapy. The findings suggest that internals are better therapeutic risks than externals, regardless of a direct or nondirect therapist…

  8. Self-Perception and Interpersonal Behavior Changes in Marathon and Time-Extended Encounter Groups

    ERIC Educational Resources Information Center

    Marks, Michael W.; Vestre, Norris D.

    1974-01-01

    College students (N=27) were assigned to a time-extended or a marathon group or a control condition to evaluate the effects of encounter experiences on self-perception and interpersonal behavior. Both experimental groups showed significantly greater changes in self-perceptions from pretest to posttest than the control group. (Author)

  9. Self-Actualization in a Marathon Growth Group: Do the Strong Get Stronger?

    ERIC Educational Resources Information Center

    Kimball, Ronald; Gelso, Charles J.

    1974-01-01

    This study examined the effects of a weekend marathon on the level of self-actualization of college students and the relationship between ego strength and extent of change in self-actualization. The group experience did increase self-actualization, but participants' initial level of ego strength was unrelated to changes in self-actualization.…

  10. Attracting Primary School Children to Mathematics: The Case of a City Mathematical Marathon

    ERIC Educational Resources Information Center

    Applebaum, Mark; Freiman, Viktor

    2013-01-01

    In this paper we report on the first year of an online competition in which 480 students took part. After a brief presentation of the organizational structure of the marathon and general data about students' participation, we discuss findings from questionnaires about participants' attitudes towards mathematics, technology, and their perception of…

  11. The University of California Institute of Environmental Stress Marathon Field Studies

    ERIC Educational Resources Information Center

    Maron, Michael B.

    2014-01-01

    In 1973, the Institute of Environmental Stress of the University of California-Santa Barbara, under the direction of Steven M. Horvath, began a series of field and laboratory studies of marathon runners during competition. As one of Horvath's graduate students, many of these studies became part of my doctoral dissertation. The rationale for…

  12. Writing Marathons Help Build Middle School Students' College Aspirations and Strengthen Their Literacy Skills

    ERIC Educational Resources Information Center

    Radcliffe, Rich A.; Stephens, Liz C.

    2010-01-01

    Young adolescents' low scores on the National Assessment of Educational Progress (NAEP) force the question of whether these students will be ready for college in four years. Our efforts to build a college-going culture emphasize strengthening students' writing skills by using preservice teachers to lead writing marathons for at-risk middle school…

  13. Gait Characteristics over the Course of a Race in Recreational Marathon Competitors

    ERIC Educational Resources Information Center

    Bertram, John E. A.; Prebeau-Menezes, Leif; Szarko, Matthew J.

    2013-01-01

    We analyzed gait and function of the supporting limb in participants of a marathon race at three stages: prerace, midrace (18 km), and near the end of the race (36 km). We confirmed that the most successful runners were able to maintain running speed for the duration of the race with little change in speed or gait. Speed slowed progressively…

  14. The effectiveness of stretch-shortening cycling in upper-limb extensor muscles during elite cross-country skiing with the double-poling technique.

    PubMed

    Zoppirolli, Chiara; Holmberg, Hans-Christer; Pellegrini, Barbara; Quaglia, Diego; Bortolan, Lorenzo; Schena, Federico

    2013-12-01

    This investigation was designed to evaluate the effectiveness of stretch-shortening cycling (SSC(EFF)) in upper-limb extensor muscles while cross-country skiing using the double-poling technique (DP). To this end, SSC(EFF) was analyzed in relation to DP velocity and performance. Eleven elite cross-country skiers performed an incremental test to determine maximal DP velocity (V(max)). Thereafter, cycle characteristics, elbow joint kinematics and poling forces were monitored on a treadmill while skiing at two sub-maximal and racing velocity (85% of V(max)). The average EMG activities of the triceps brachii and latissimus dorsi muscles were determined during the flexion and extension sub-phases of the poling cycle (EMG(FLEX), EMG(EXT)), as well as prior to pole plant (EMG(PRE)). SSC(EFF) was defined as the ratio of aEMG(FLEX) to aEMG(EXT). EMG(PRE) and EMG(FLEX) increased with velocity for both muscles (P < 0.01), as did SSC(EFF) (from 0.9 ± 0.3 to 1.3 ± 0.5 for the triceps brachii and from 0.9 ± 0.4 to 1.5 ± 0.5 for the latissimus dorsi) and poling force (from 253 ± 33 to 290 ± 36N; P < 0.05). Furthermore, SSC(EFF) was positively correlated to Vmax, to EMG(PRE) and EMG(FLEX) (P < 0.05). The neuromuscular adaptations made at higher velocities, when more poling force must be applied to the ground, exert a major influence on the DP performance of elite cross-country skiers. PMID:24064180

  15. 'How to know what you need to do': a cross-country comparison of maternal health guidelines in Burkina Faso, Ghana and Tanzania

    PubMed Central

    2012-01-01

    Background Initiatives to raise the quality of care provided to mothers need to be given priority in Sub Saharan Africa (SSA). The promotion of clinical practice guidelines (CPGs) is a common strategy, but their implementation is often challenging, limiting their potential impact. Through a cross-country perspective, this study explored CPGs for maternal health in Burkina Faso, Ghana, and Tanzania. The objectives were to compare factors related to CPG use including their content compared with World Health Organization (WHO) guidelines, their format, and their development processes. Perceptions of their availability and use in practice were also explored. The overall purpose was to further the understanding of how to increase CPGs' potential to improve quality of care for mothers in SSA. Methods The study was a multiple case study design consisting of cross-country comparisons using document review and key informant interviews. A conceptual framework to aid analysis and discussion of results was developed, including selected domains related to guidelines' implementability and use by health workers in practice in terms of usability, applicability, and adaptability. Results The study revealed few significant differences in content between the national guidelines for maternal health and WHO recommendations. There were, however, marked variations in the format of CPGs between the three countries. Apart from the Ghanaian and one of the Tanzanian CPGs, the levels of both usability and applicability were assessed as low or medium. In all three countries, the use of CPGs by health workers in practice was perceived to be limited. Conclusion Our cross-country study suggests that it is not poor quality of content or lack of evidence base that constitute the major barrier for CPGs to positively impact on quality improvement in maternal care in SSA. It rather emphasises the need to prioritise the format of guidelines to increase their usability and applicability and to consider

  16. Xpert MTB/RIF detection of rifampin resistance and time to treatment initiation in Harare, Zimbabwe

    PubMed Central

    Metcalfe, John Z.; Makumbirofa, Salome; Makamure, Beauty; Sandy, Charles; Bara, Wilbert; Mason, Peter; Hopewell, Philip C.

    2016-01-01

    Background Patients at elevated risk of drug-resistant tuberculosis are prioritized for testing with Xpert MTB/RIF® (“Xpert”), though clinical utility in this population is understudied. Design From November 2011 to June 2014, consecutive outpatients with history of prior tuberculosis in high-density suburbs of Harare, Zimbabwe were tested with Xpert, solid and liquid culture, and the microscopically-observed drug susceptibility assay. Diagnostic accuracy for rifampin-resistance and time to second-line regimens were ascertained. The rpoB gene was sequenced in cases of culture-confirmed rifampin resistance and genotypic sensitivity. Results Among 352 retreatment patients, 71 (20%) had rifampin-resistant, 98 (28%) rifampin-susceptible, 64 (18%) culture-negative/Xpert-positive, and 119 (34%) culture-negative/Xpert-negative TB. Xpert was 86% (95% CI 75-93%) sensitive and 98% (95% CI 92-100%) specific for rifampin-resistant TB. The positive predictive value of Xpert-determined rifampin resistance for MDR-TB was 82% (95% CI 70-91%). Fifty-nine of 71 (83%) participants initiated SLDs, with a median time to regimen initiation of 18 days (IQR, 10-44 days). Conclusion The diagnostic accuracy of Xpert for rifampin-resistance is high, though predictive value for MDR-TB is lower than anticipated. Xpert allows for faster SLD initiation under programmatic conditions, relative to culture-based drug susceptibility testing. PMID:27287639

  17. Mixed impact of Xpert® MTB/RIF on tuberculosis diagnosis in Cambodia

    PubMed Central

    Moore, B. K.; Kyle, R. P.; Eng, B.; Nong, K.; Pevzner, E. S.; Eam, K. K.; Eang, M. T.; Killam, W. P.

    2016-01-01

    Setting: National Tuberculosis (TB) Program sites in northwest Cambodia. Objective: To evaluate the impact of Xpert® MTB/RIF at point of care (POC) as compared to non-POC sites on the diagnostic evaluation of people living with the human immunodeficiency virus (PLHIV) with TB symptoms and patients with possible multidrug-resistant (MDR) TB. Design: Observational cohort of patients undergoing routine diagnostic evaluation for TB following the rollout of Xpert. Results: Between October 2011 and June 2013, 431 of 822 (52%) PLHIV with TB symptoms and 240/493 (49%) patients with possible MDR-TB underwent Xpert. Xpert was more likely to be performed when available as POC. A smaller proportion of PLHIV at POC sites were diagnosed with TB than at non-POC sites; however, at POC sites, a higher proportion of those diagnosed with TB were bacteriologically positive. There was poor agreement between Xpert and other tests such as smear microscopy and culture. Overall, the evaluation of patients with possible MDR-TB increased following Xpert rollout, yet for patients confirmed as having drug resistance on drug susceptibility testing, only 46% had rifampin resistance that would be identified with Xpert. Conclusion: Although utilization of Xpert was low, it may have contributed to an increase in evaluations for possible MDR-TB and a decline in empiric treatment for PLHIV when available as POC. PMID:27358807

  18. Polyclonal antibody against conserved sequences of mce1A protein blocks MTB infection in macrophages.

    PubMed

    Sivagnanam, Sasikala; Namasivayam, Nalini; Chellam, Rajamanickam

    2012-03-01

    The pathogenesis of Mycobacterium tuberculosis is largely due to its ability to enter and survive within human macrophages. It is suggested that a specific protein namely mammalian cell entry protein is involved in the pathogenesis and the specific gene for this protein mce1A has been identified in several pathogenic organisms such as Rickettsia, Shigella, Escherichia coli, Helicobacter, Streptomyces, Klebsiella, Vibrio, Neisseria, Rhodococcus, Nocardioides, Saccharopolyspora erthyrae, and Pseudomonas. Analysis of mce1 operons in the above mentioned organisms through bioinformatics tools has revealed the presence of unique sequences (conserved regions) suggesting that these sequences may be involved in the process of infection. Presently, the mce1A full-length (1,365 bp) region from Mycobacterium bovis and its conserved regions (303 bp) were cloned in to an expression vector and the purified expressed proteins of molecular weight ~47 and ~11 kDa, respectively, were injected to rabbits to raise the polyclonal antibodies. The purified polyclonal antibodies were checked for their ability to inhibit the Mycobacterium infection in cultured human macrophages. In macrophage invasion assay, when antibody added at high concentration, decrease in viable counts was observed in all cell cultures within the first 5 days after infection, where the intracellular bacterial CFU obtained from the infected MTB increased by the 3rd day at low concentration of antibody. The macrophage invasion assay has indicated that the purified antibodies of mce1A conserved region can inhibit the infection of Mycobacterium. PMID:22159737

  19. Human CD8+ T-cells recognizing peptides from Mycobacterium tuberculosis (Mtb) presented by HLA-E have an unorthodox Th2-like, multifunctional, Mtb inhibitory phenotype and represent a novel human T-cell subset.

    PubMed

    van Meijgaarden, Krista E; Haks, Mariëlle C; Caccamo, Nadia; Dieli, Francesco; Ottenhoff, Tom H M; Joosten, Simone A

    2015-03-01

    Mycobacterial antigens are not exclusively presented to T-cells by classical HLA-class Ia and HLA-class II molecules, but also through alternative antigen presentation molecules such as CD1a/b/c, MR1 and HLA-E. We recently described mycobacterial peptides that are presented in HLA-E and recognized by CD8+ T-cells. Using T-cell cloning, phenotyping, microbiological, functional and RNA-expression analyses, we report here that these T-cells can exert cytolytic or suppressive functions, inhibit mycobacterial growth, yet express GATA3, produce Th2 cytokines (IL-4,-5,-10,-13) and activate B-cells via IL-4. In TB patients, Mtb specific cells were detectable by peptide-HLA-E tetramers, and IL-4 and IL-13 were produced following peptide stimulation. These results identify a novel human T-cell subset with an unorthodox, multifunctional Th2 like phenotype and cytolytic or regulatory capacities, which is involved in the human immune response to mycobacteria and demonstrable in active TB patients' blood. The results challenge the current dogma that only Th1 cells are able to inhibit Mtb growth and clearly show that Th2 like cells can strongly inhibit outgrowth of Mtb from human macrophages. These insights significantly expand our understanding of the immune response in infectious disease. PMID:25803478

  20. Human CD8+ T-cells Recognizing Peptides from Mycobacterium tuberculosis (Mtb) Presented by HLA-E Have an Unorthodox Th2-like, Multifunctional, Mtb Inhibitory Phenotype and Represent a Novel Human T-cell Subset

    PubMed Central

    van Meijgaarden, Krista E.; Haks, Mariëlle C.; Caccamo, Nadia; Dieli, Francesco; Ottenhoff, Tom H. M.; Joosten, Simone A.

    2015-01-01

    Mycobacterial antigens are not exclusively presented to T-cells by classical HLA-class Ia and HLA-class II molecules, but also through alternative antigen presentation molecules such as CD1a/b/c, MR1 and HLA-E. We recently described mycobacterial peptides that are presented in HLA-E and recognized by CD8+ T-cells. Using T-cell cloning, phenotyping, microbiological, functional and RNA-expression analyses, we report here that these T-cells can exert cytolytic or suppressive functions, inhibit mycobacterial growth, yet express GATA3, produce Th2 cytokines (IL-4,-5,-10,-13) and activate B-cells via IL-4. In TB patients, Mtb specific cells were detectable by peptide-HLA-E tetramers, and IL-4 and IL-13 were produced following peptide stimulation. These results identify a novel human T-cell subset with an unorthodox, multifunctional Th2 like phenotype and cytolytic or regulatory capacities, which is involved in the human immune response to mycobacteria and demonstrable in active TB patients’ blood. The results challenge the current dogma that only Th1 cells are able to inhibit Mtb growth and clearly show that Th2 like cells can strongly inhibit outgrowth of Mtb from human macrophages. These insights significantly expand our understanding of the immune response in infectious disease. PMID:25803478

  1. Evaluation of GenoFlow DR-MTB Array Test for Detection of Rifampin and Isoniazid Resistance in Mycobacterium tuberculosis.

    PubMed

    Molina-Moya, B; Kazdaglis, G; Lacoma, A; Prat, C; Gómez, A; Villar-Hernández, R; García-García, E; Haba, L; Maldonado, J; Samper, S; Ruiz-Manzano, J; Ausina, V; Domínguez, J

    2016-04-01

    The aim of this study was to evaluate the GenoFlow DR-MTB array test (DiagCor Bioscience, Hong Kong) on 70 cultured isolates and 50 sputum specimens. The GenoFlow array test showed good sensitivity and specificity compared to the phenotypic Bactec 460TB. This array accurately detected mutations inrpoB,katG, andinhAassociated with resistance to rifampin and isoniazid. PMID:26865688

  2. The sea urchin metallothionein system: Comparative evaluation of the SpMTA and SpMTB metal-binding preferences☆

    PubMed Central

    Tomas, Mireia; Domènech, Jordi; Capdevila, Mercè; Bofill, Roger; Atrian, Sílvia

    2013-01-01

    Metallothioneins (MTs) constitute a superfamily of ubiquitous metal-binding proteins of low molecular weight and high Cys content. They are involved in metal homeostasis and detoxification, amongst other proposed biological functions. Two MT isoforms (SpMTA and SpMTB) have been reported in the echinoderm Strongylocentrotus purpuratus (sea urchin), both containing 20 Cys residues and presenting extremely similar sequences, although showing distinct tissular and ontogenic expression patterns. Although exhaustive information is available for the Cd(II)-SpMTA complex, this including the full resolution of its 3D structure, no data has been reported concerning either SpMTA Zn(II) and Cu(I) binding properties, or the characterization of SpMTB at protein level. In this work, both the SpMTA and SpMTB isoforms, as well as their separate α and β domains, have been recombinantly synthesized in the presence of Zn(II), Cd(II) or Cu(II), and the corresponding metal complexes have been analyzed using electrospray mass spectrometry, and CD, ICP-AES and UV–vis spectroscopies. The results clearly show a better performance of isoform A when binding Zn(II) and Cd(II), and of isoform B when coordinating Cu(I). Thus, our results confirm the differential metal binding preference of SpMTA and SpMTB, which, together with the reported induction pattern of the respective genes, highlights how also in Echinodermata the MT polymorphism may be linked to the evolution of different physiological roles. PMID:23847757

  3. Improved rapid molecular diagnosis of multidrug-resistant tuberculosis using a new reverse hybridization assay, REBA MTB-MDR

    PubMed Central

    Bang, Hyeeun; Park, Sangjung; Hwang, Joohwan; Jin, Hyunwoo; Cho, Eunjin; Kim, Dae Yoon; Song, Taeksun; Shamputa, Isdore Chola; Via, Laura E.; Barry, Clifton E.; Cho, Sang-Nae

    2011-01-01

    Rapid diagnosis of multidrug-resistant tuberculosis (MDR-TB) is essential for the prompt initiation of effective second-line therapy to improve treatment outcome and limit transmission of this obstinate disease. A variety of molecular methods that enable the rapid detection of mutations implicated in MDR-TB have been developed. The sensitivity of the methods is dependent, in principle, on the repertoire of mutations being detected, which is typically limited to mutations in the genes rpoB, katG and the promoter region of inhA. In this study, a new reverse hybridization assay, REBA MTB-MDR (M&D), that probes mutations in the oxyR–ahpC intergenic region, in addition to those in rpoB, katG and the inhA promoter region, was evaluated. A set of 240 Mycobacterium tuberculosis clinical isolates from patients receiving retreatment regimens was subjected to conventional phenotypic drug-susceptibility testing (DST) and the REBA MTB-MDR assay. The nucleotide sequences of the loci known to be involved in drug resistance were determined for comparison. In brief, the results showed that the REBA MTB-MDR assay efficiently recognized nucleotide changes in the oxyR–ahpC intergenic region as well as those in rpoB, katG and the inhA promoter region with higher sensitivity, resulting in an 81.0 % detection rate for isoniazid resistance. Inclusion of the oxyR–ahpC intergenic region in the REBA MTB-MDR assay improved the overall sensitivity of molecular DST for MDR-TB from 73.1 to 79.9 %. PMID:21596910

  4. Multicenter feasibility study to assess external quality assessment panels for Xpert MTB/RIF assay in South Africa.

    PubMed

    Scott, Lesley; Albert, Heidi; Gilpin, Chris; Alexander, Heather; DeGruy, Kyle; Stevens, Wendy

    2014-07-01

    External quality assessment (EQA) for the Xpert MTB/RIF assay is part of the quality system required for clinical and laboratory practice. Five newly developed EQA panels that use different matrices, including a lyophilized sample (Vircell, Granada, Spain), a dried tube specimen (CDC), liquid (Maine Molecular Quality Control, Inc. [MMQCI], Scarborough, ME), artificial sputum (Global Laboratory Initiative [GLI]), and a dried culture spot (National Health Laboratory Services [NHLS]), were evaluated at 11 GeneXpert testing sites in South Africa. The panels comprised Mycobacterium tuberculosis complex (MTBC)-negative, MTBC-positive (including rifampin [RIF] susceptible and RIF resistant), and nontuberculosis mycobacterial material that was inactivated and safe for transportation. Twelve qualitative and quantitative variables were scored as acceptable (1) or unacceptable (0); the overall panel performance score for the Vircell, CDC, GLI, and NHLS panels was 9 of 12, while the MMQCI panel scored 6 of 12 (owing to the need for cold chain maintenance). All panels showed good compatibility with Xpert MTB/RIF testing, and none showed PCR inhibition. The use of a liquid or dry matrix did not appear to be a distinguishing criterion, as both matrices had reduced scores on insufficient volumes, a need for extra consumables, and the ability to transfer to the Xpert MTB/RIF cartridge. EQA is an important component of the quality system required for diagnostic testing programs, but it must be complemented by routine monitoring of performance indicators and instrument verification. This study aims to introduce EQA concepts for Xpert MTB/RIF testing and evaluates five potential EQA panels. PMID:24789182

  5. Decreased Time to Treatment Initiation for Multidrug-Resistant Tuberculosis Patients after Use of Xpert MTB/RIF Test, Latvia.

    PubMed

    Stagg, Helen R; White, Peter J; Riekstiņa, Vija; Cīrule, Andra; Šķenders, Ģirts; Leimane, Vaira; Kuksa, Liga; Dravniece, Gunta; Brown, James; Jackson, Charlotte

    2016-03-01

    Few studies have examined whether the Xpert MTB/RIF test improves time to treatment initiation for persons with multidrug-resistant tuberculosis (MDR TB). We determined the impact of this test in Latvia, where it was introduced in 2010. After descriptive analyses of pulmonary MDR TB patients in Latvia during 2009-2012, time to treatment initiation was calculated, and univariate and multivariable accelerated failure time models were constructed. Univariate results showed strong evidence of an association between having rifampin-resistant TB detected by Xpert MTB/RIF and reduced time to treatment initiation versus the test not being used. A multivariable model stratifying by previous TB showed similar results. Our finding that in Latvia, time to treatment initiation was decreased for MDR TB cases that were rifampin-resistant TB by XpertMTB/RIF has implications for the use of this test in other settings with a high burden of MDR TB in which rifampin resistance is highly predictive of MDR TB. PMID:26889608

  6. Decreased Time to Treatment Initiation for Multidrug-Resistant Tuberculosis Patients after Use of Xpert MTB/RIF Test, Latvia

    PubMed Central

    White, Peter J.; Riekstiņa, Vija; Cīrule, Andra; Šķenders, Ģirts; Leimane, Vaira; Kuksa, Liga; Dravniece, Gunta; Brown, James; Jackson, Charlotte

    2016-01-01

    Few studies have examined whether the Xpert MTB/RIF test improves time to treatment initiation for persons with multidrug-resistant tuberculosis (MDR TB). We determined the impact of this test in Latvia, where it was introduced in 2010. After descriptive analyses of pulmonary MDR TB patients in Latvia during 2009–2012, time to treatment initiation was calculated, and univariate and multivariable accelerated failure time models were constructed. Univariate results showed strong evidence of an association between having rifampin-resistant TB detected by Xpert MTB/RIF and reduced time to treatment initiation versus the test not being used. A multivariable model stratifying by previous TB showed similar results. Our finding that in Latvia, time to treatment initiation was decreased for MDR TB cases that were rifampin-resistant TB by XpertMTB/RIF has implications for the use of this test in other settings with a high burden of MDR TB in which rifampin resistance is highly predictive of MDR TB. PMID:26889608

  7. The effect of chain length and unsaturation on Mtb Dxr inhibition and antitubercular killing activity of FR900098 analogs.

    PubMed

    Jackson, Emily R; San Jose, Géraldine; Brothers, Robert C; Edelstein, Emma K; Sheldon, Zachary; Haymond, Amanda; Johny, Chinchu; Boshoff, Helena I; Couch, Robin D; Dowd, Cynthia S

    2014-01-15

    Inhibition of the nonmevalonate pathway (NMP) of isoprene biosynthesis has been examined as a source of new antibiotics with novel mechanisms of action. Dxr is the best studied of the NMP enzymes and several reports have described potent Dxr inhibitors. Many of these compounds are structurally related to natural products fosmidomycin and FR900098, each bearing retrohydroxamate and phosphonate groups. We synthesized a series of compounds with two to five methylene units separating these groups to examine what linker length was optimal and tested for inhibition against Mtb Dxr. We synthesized ethyl and pivaloyl esters of these compounds to increase lipophilicity and improve inhibition of Mtb growth. Our results show that propyl or propenyl linker chains are optimal. Propenyl analog 22 has an IC50 of 1.07 μM against Mtb Dxr. The pivaloyl ester of 22, compound 26, has an MIC of 9.4 μg/mL, representing a significant improvement in antitubercular potency in this class of compounds. PMID:24360562

  8. Marathon: An Open Source Software Library for the Analysis of Markov-Chain Monte Carlo Algorithms.

    PubMed

    Rechner, Steffen; Berger, Annabell

    2016-01-01

    We present the software library marathon, which is designed to support the analysis of sampling algorithms that are based on the Markov-Chain Monte Carlo principle. The main application of this library is the computation of properties of so-called state graphs, which represent the structure of Markov chains. We demonstrate applications and the usefulness of marathon by investigating the quality of several bounding methods on four well-known Markov chains for sampling perfect matchings and bipartite graphs. In a set of experiments, we compute the total mixing time and several of its bounds for a large number of input instances. We find that the upper bound gained by the famous canonical path method is often several magnitudes larger than the total mixing time and deteriorates with growing input size. In contrast, the spectral bound is found to be a precise approximation of the total mixing time. PMID:26824442

  9. Marathon: An Open Source Software Library for the Analysis of Markov-Chain Monte Carlo Algorithms

    PubMed Central

    Rechner, Steffen; Berger, Annabell

    2016-01-01

    We present the software library marathon, which is designed to support the analysis of sampling algorithms that are based on the Markov-Chain Monte Carlo principle. The main application of this library is the computation of properties of so-called state graphs, which represent the structure of Markov chains. We demonstrate applications and the usefulness of marathon by investigating the quality of several bounding methods on four well-known Markov chains for sampling perfect matchings and bipartite graphs. In a set of experiments, we compute the total mixing time and several of its bounds for a large number of input instances. We find that the upper bound gained by the famous canonical path method is often several magnitudes larger than the total mixing time and deteriorates with growing input size. In contrast, the spectral bound is found to be a precise approximation of the total mixing time. PMID:26824442

  10. Smectite deposits in Marathon Valley, Endeavour Crater, Mars, identified using CRISM hyperspectral reflectance data

    NASA Astrophysics Data System (ADS)

    Fox, V. K.; Arvidson, R. E.; Guinness, E. A.; McLennan, S. M.; Catalano, J. G.; Murchie, S. L.; Powell, K. E.

    2016-05-01

    The ~100 m wide Marathon Valley crosscuts the Cape Tribulation rim segment of the 22 km diameter, Noachian-age Endeavour impact crater on Mars. Single-scattering albedo spectra retrieved from three Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) Full-Resolution Targeted (FRT, regularized to 18 m/pixel) and two Along Track Oversampled (ATO, regularized to 12 m/pixel) observations indicate the presence of Fe3+-Mg2+ smectite exposures located in Marathon Valley with combination vibration metal-OH absorption strength comparable to smectite spectral signatures in Mawrth Vallis. The Opportunity rover was directed to the exposures and documented the presence of Shoemaker formation impact breccias that have been isochemically altered, likely by fracture-controlled aqueous fluids.

  11. Runners as sport tourists: the experience and travel behaviors of Ljubljana Marathon participants.

    PubMed

    Rauter, Samo; Doupona Topić, Mojca

    2014-09-01

    The study analysed the experiences of participants on mass sport events, and explained the influence of such sport events on the lifestyle of runners. The study sample consisted of 664 participants of the 15th Ljubljana Marathon. The TRPS questionnaire was adjusted to establish the tourist roles. The role of sport tourists was assumed by 29.8% of all participants. Sport tourists who take various trips mainly for sport purposes (66.7%) participate more often in mass sport events at home and abroad and are more physically active in their leisure time. Moreover, 13 in-depth interviews were conducted with selected marathon participants. It was established that different travel behaviour and experiences from earlier sport events have influenced on their lifestyles. PMID:25507357

  12. Runners as sport tourists: the experience and travel behaviors of Ljubljana Marathon participants.

    PubMed

    Rauter, Samo; Doupona Topić, Mojca

    2014-09-01

    The study analysed the experiences of participants on mass sport events, and explained the influence of such sport events on the lifestyle of runners. The study sample consisted of 664 participants of the 15th Ljubljana Marathon. The TRPS questionnaire was adjusted to establish the tourist roles. The role of sport tourists was assumed by 29.8% of all participants. Sport tourists who take various trips mainly for sport purposes (66.7%) participate more often in mass sport events at home and abroad and are more physically active in their leisure time. Moreover, 13 in-depth interviews were conducted with selected marathon participants. It was established that different travel behaviour and experiences from earlier sport events have influenced on their lifestyles. PMID:25420373

  13. Devonian Novaculites as source of oil in Marathon-Ouachita thrust system

    SciTech Connect

    Zemmels, I.; Grizzle, P.L.; Walters, C.C.; Haney, F.R.

    1985-02-01

    The Arkansas Novaculite of southern Oklahoma and the Caballos Novaculite of west Texas (both Devonian) form fractured reservoirs in the Marathon-Ouachita thrust system. These formations were examined to ascertain their petroleum potential. Findings include the following. (1) The thermal maturity of the thrust system conforms to the maturity of the sequence that it has overthrust, suggesting that this allochthonous facies is not anomalously mature. (2) Shale units within the novaculites contain oil-prone organic matter in sufficient concentrations to constitute source rocks. (3) The composition of oils from Isom Springs field in southern Oklahoma and from McKay Creek field in west Texas is virtually identical and generally resembles Devonian oils in Oklahoma and west Texas. The authors concluded that the Devonian novaculites of the Marathon-Ouachita thrust system are self sourcing and do not require a fortuitous juxtaposition of source rocks of a different age to produce a commercial deposit.

  14. Will the age of peak ultra-marathon performance increase with increasing race duration?

    PubMed Central

    2014-01-01

    Background Recent studies found that the athlete’s age of the best ultra-marathon performance was higher than the athlete’s age of the best marathon performance and it seemed that the athlete’s age of peak ultra-marathon performance increased in distance-limited races with rising distance. Methods We investigated the athlete’s age of peak ultra-marathon performance in the fastest finishers in time-limited ultra-marathons from 6 hrs to 10 d. Running performance and athlete’s age of the fastest women and men competing in 6 hrs, 12 hrs, 24 hrs, 48 hrs, 72 hrs, 144 hrs (6 d) and 240 hrs (10 d) were analysed for races held between 1975 and 2012 using analysis of variance and multi-level regression analysis. Results The athlete’s ages of the ten fastest women ever in 6 hrs, 12 hrs, 24 hrs, 48 hrs, 72 hrs, 6 d and 10 d were 41 ± 9, 41 ± 6, 42 ± 5, 46 ± 5, 44 ± 6, 42 ± 4, and 37 ± 4 yrs, respectively. The athlete’s age of the ten fastest women was different between 48 hrs and 10 d. For men, the athlete’s ages were 35 ± 6, 37 ± 9, 39 ± 8, 44 ± 7, 48 ± 3, 48 ± 8 and 48 ± 6 yrs, respectively. The athlete’s age of the ten fastest men in 6 hrs and 12 hrs was lower than the athlete’s age of the ten fastest men in 72 hrs, 6 d and 10 d, respectively. Conclusion The athlete’s age of peak ultra-marathon performance did not increase with rising race duration in the best ultra-marathoners. For the fastest women ever in time-limited races, the athlete’s age was lowest in 10 d (~37 yrs) and highest in 48 hrs (~46 yrs). For men, the athlete’s age of the fastest ever in 6 hrs (~35 yrs) and 12 hrs (~37 yrs) was lower than the athlete’s age of the ten fastest in 72 hrs (~48 yrs), 6 d (~48 yrs) and 10 d (~48 yrs). The differences in the athlete’s age of peak performance between female and male ultra-marathoners for the different race durations need further

  15. Twitter as a Sentinel in Emergency Situations: Lessons from the Boston Marathon Explosions

    PubMed Central

    Cassa, Christopher A.; Chunara, Rumi; Mandl, Kenneth; Brownstein, John S

    2013-01-01

    Immediately following the Boston Marathon attacks, individuals near the scene posted a deluge of data to social media sites. Previous work has shown that these data can be leveraged to provide rapid insight during natural disasters, disease outbreaks and ongoing conflicts that can assist in the public health and medical response. Here, we examine and discuss the social media messages posted immediately after and around the Boston Marathon bombings, and find that specific keywords appear frequently prior to official public safety and news media reports. Individuals immediately adjacent to the explosions posted messages within minutes via Twitter which identify the location and specifics of events, demonstrating a role for social media in the early recognition and characterization of emergency events. *Christopher Cassa and Rumi Chunara contributed equally to this work. PMID:23852273

  16. Analysis of performance and age of the fastest 100-mile ultra-marathoners worldwide

    PubMed Central

    Rüst, Christoph Alexander; Knechtle, Beat; Rosemann, Thomas; Lepers, Romuald

    2013-01-01

    OBJECTIVES: The performance and age of peak ultra-endurance performance have been investigated in single races and single race series but not using worldwide participation data. The purpose of this study was to examine the changes in running performance and the age of peak running performance of the best 100-mile ultra-marathoners worldwide. METHOD: The race times and ages of the annual ten fastest women and men were analyzed among a total of 35,956 finishes (6,862 for women and 29,094 for men) competing between 1998 and 2011 in 100-mile ultra-marathons. RESULTS: The annual top ten performances improved by 13.7% from 1,132±61.8 min in 1998 to 977.6±77.1 min in 2011 for women and by 14.5% from 959.2±36.4 min in 1998 to 820.6±25.7 min in 2011 for men. The mean ages of the annual top ten fastest runners were 39.2±6.2 years for women and 37.2±6.1 years for men. The age of peak running performance was not different between women and men (p>0.05) and showed no changes across the years. CONCLUSION: These findings indicated that the fastest female and male 100-mile ultra-marathoners improved their race time by ∼14% across the 1998–2011 period at an age when they had to be classified as master athletes. Future studies should analyze longer running distances (>200 km) to investigate whether the age of peak performance increases with increased distance in ultra-marathon running. PMID:23778421

  17. Case study: Nutrition and training periodization in three elite marathon runners.

    PubMed

    Stellingwerf, Trent

    2012-10-01

    Laboratory-based studies demonstrate that fueling (carbohydrate; CHO) and fluid strategies can enhance training adaptations and race-day performance in endurance athletes. Thus, the aim of this case study was to characterize several periodized training and nutrition approaches leading to individualized race-day fluid and fueling plans for 3 elite male marathoners. The athletes kept detailed training logs on training volume, pace, and subjective ratings of perceived exertion (RPE) for each training session over 16 wk before race day. Training impulse/load calculations (TRIMP; min × RPE = load [arbitrary units; AU]) and 2 central nutritional techniques were implemented: periodic low-CHO-availability training and individualized CHO- and fluid-intake assessments. Athletes averaged ~13 training sessions per week for a total average training volume of 182 km/wk and peak volume of 231 km/wk. Weekly TRIMP peaked at 4,437 AU (Wk 9), with a low of 1,887 AU (Wk 16) and an average of 3,082 ± 646 AU. Of the 606 total training sessions, ~74%, 11%, and 15% were completed at an intensity in Zone 1 (very easy to somewhat hard), Zone 2 (at lactate threshold) and Zone 3 (very hard to maximal), respectively. There were 2.5 ± 2.3 low-CHO-availability training bouts per week. On race day athletes consumed 61 ± 15 g CHO in 604 ± 156 ml/hr (10.1% ± 0.3% CHO solution) in the following format: ~15 g CHO in ~150 ml every ~15 min of racing. Their resultant marathon times were 2:11:23, 2:12:39 (both personal bests), and 2:16:17 (a marathon debut). Taken together, these periodized training and nutrition approaches were successfully applied to elite marathoners in training and competition. PMID:23011657

  18. Exercise-associated hyponatremia in marathon runners: a two-year experience.

    PubMed

    Davis, D P; Videen, J S; Marino, A; Vilke, G M; Dunford, J V; Van Camp, S P; Maharam, L G

    2001-07-01

    This study was conducted to better define the pathophysiology, risk factors, and therapeutic approach to exercise-associated hyponatremia. Medical records from all participants in the 1998 Suzuki Rock 'N' Roll Marathon who presented to 14 Emergency Departments (EDs) were retrospectively reviewed to identify risk factors for the development of hyponatremia. Hyponatremic patients were compared to other runners with regard to race time and to other marathon participants seen in the ED with regard to gender, clinical signs of dehydration, and use of nonsteroidal anti-inflammatory drugs (NSAIDs). An original treatment algorithm incorporating the early use of hypertonic saline (HTS) was evaluated prospectively in our own ED for participants in the 1999 marathon to evaluate improvements in sodium correction rate and incidence of complications. A total of 26 patients from the 1998 and 1999 marathons were hyponatremic [serum sodium (SNa) < or =135 mEq/L] including 15 with severe hyponatremia (SNa < or = 125 mEq/L). Three developed seizures and required intubation and admission to an intensive care unit. Hyponatremic patients were more likely to be female, use NSAIDS, and have slower finishing times. Hyponatremic runners reported drinking "as much as possible" during and after the race and were less likely to have clinical signs of dehydration. An inverse relationship between initial SNa and time of presentation was observed, with late presentation predicting lower SNa values. The use of HTS in selected 1999 patients resulted in faster SNa correction times and fewer complications than observed for 1998 patients. It is concluded that the development of exercise-associated hyponatremia is associated with excessive fluid consumption during and after extreme athletic events. Additional risk factors include female gender, slower race times, and NSAID use. The use of HTS in selected patients seems to be safe and efficacious. PMID:11399389

  19. In Silico Screening for Novel Inhibitors of DNA Polymerase III Alpha Subunit of Mycobacterium tuberculosis (MtbDnaE2, H37Rv)

    PubMed Central

    Jadaun, Alka; Sudhakar D, Raja; Subbarao, N.; Dixit, Aparna

    2015-01-01

    Tuberculosis, a pandemic disease is caused by Mycobacterium tuberculosis (Mtb). DNA polymerase III encoded by DnaE2 of Mtb is specifically required for its survival in vivo, and hence can be considered to be a potential drug target. Amino acid sequence analysis of the MtbDnaE2 and its human counterpart does not show any significant similarity. Therefore, a 3D model of the MtbDnaE2 was generated using Modeller 9v10 with the template structure of E. Coli DNA polymerase III alpha subunit (2HNH_A). The generated models were validated using a number of programmes such as RAMPAGE/PROCHECK, VERIFY_3D, and ProSA. MtbDnaE2 has few conserved residues and four conserved domains similar to that present in DNA polymerase III of E. coli. In silico screening was performed with bioactive anti-tuberculosis compounds and 6-AU (a known inhibitor of DNA polymerase III of Bacillus subtilis) and its analogues against the modeled MtbDnaE2 structure. Docking was performed using GOLD v5.2 software which resulted in the identification of top ten compounds with high GOLD fitness scores and binding affinity (X-Score). To further evaluate the efficacy of these compounds, in silico ADMET analysis was performed using MedChem Designer v3. Given their high binding affinity to the targeted MtbDnaE2, which is essential for DNA replication in the Mtb and good ADMET properties, these compounds are promising candidates for further evaluation and development as anti-tubercular agents. PMID:25811866

  20. Implementation of Xpert MTB/RIF in Uganda: Missed Opportunities to Improve Diagnosis of Tuberculosis

    PubMed Central

    Hanrahan, Colleen F.; Haguma, Priscilla; Ochom, Emmanuel; Kinera, Irene; Cobelens, Frank; Cattamanchi, Adithya; Davis, Luke; Katamba, Achilles; Dowdy, David

    2016-01-01

    Background. The effect of Xpert MTB/RIF (Xpert) scale-up on patient outcomes in low-income settings with a high tuberculosis (TB) burden has not been established. We sought to characterize the effectiveness of Xpert as implemented across different levels of the healthcare system in Uganda. Methods. We reviewed laboratory records from 2012 to 2014 at 18 health facilities throughout Uganda. In 8 facilities, Xpert had been implemented onsite since 2012, and in 10 sites Xpert was available as an offsite referral test from another facility. We describe Xpert testing volumes by facility, Xpert and smear microscopy results, and downtime due to malfunction and cartridge stockouts. We compare TB treatment initiation as well as time to treatment between facilities implementing Xpert and those that did not. Results. The median number of Xpert assays run at implementing facilities was 25/month (interquartile range [IQR], 10–63), amounting to 8% of total capacity. Among 1251 assays run for a new TB diagnosis, 19% were positive. Among 1899 patients with smear-negative presumptive TB, the proportion starting TB treatment was similar between Xpert facilities (11%; 95% confidence interval [CI], 9%–13%) and non-Xpert facilities (9%; 95% CI, 8%–11%; P = .325). In Xpert facilities, a positive Xpert preceded TB treatment initiation in only 12 of 70 (17%) smear-negative patients initiated on treatment. Conclusions. Xpert was underutilized in Uganda and did not significantly increase the number of patients starting treatment for TB. Greater attention must be paid to appropriate implementation of novel diagnostic tests for TB if these new tools are to impact patient important outcomes. PMID:27186589

  1. Optimal V.O2max-to-mass ratio for predicting 15 km performance among elite male cross-country skiers

    PubMed Central

    Carlsson, Tomas; Carlsson, Magnus; Hammarström, Daniel; Rønnestad, Bent R; Malm, Christer B; Tonkonogi, Michail

    2015-01-01

    The aim of this study was 1) to validate the 0.5 body-mass exponent for maximal. oxygen uptake (V.O2max) as the optimal predictor of performance in a 15 km classical-technique skiing competition among elite male cross-country skiers and 2) to evaluate the influence of distance covered on the body-mass exponent for V.O2max among elite male skiers. Twenty-four elite male skiers (age: 21.4±3.3 years [mean ± standard deviation]) completed an incremental treadmill roller-skiing test to determine their V.O2max. Performance data were collected from a 15 km classical-technique cross-country skiing competition performed on a 5 km course. Power-function modeling (ie, an allometric scaling approach) was used to establish the optimal body-mass exponent for V.O2max to predict the skiing performance. The optimal power-function models were found to be racespeed=8.83⋅(V˙O2maxm−0.53)0.66 and lapspeed=5.89⋅(V˙O2maxm−(0.49+0.0181lap))0.43e0.010age, which explained 69% and 81% of the variance in skiing speed, respectively. All the variables contributed to the models. Based on the validation results, it may be recommended that V.O2max divided by the square root of body mass (mL · min−1 · kg−0.5) should be used when elite male skiers’ performance capability in 15 km classical-technique races is evaluated. Moreover, the body-mass exponent for V.O2max was demonstrated to be influenced by the distance covered, indicating that heavier skiers have a more pronounced positive pacing profile (ie, race speed gradually decreasing throughout the race) compared to that of lighter skiers. PMID:26719730

  2. THE RELATIONSHIP BETWEEN ISOTONIC PLANTAR FLEXOR ENDURANCE, NAVICULAR DROP, AND EXERCISE-RELATED LEG PAIN IN A COHORT OF COLLEGIATE CROSS-COUNTRY RUNNERS

    PubMed Central

    Reinking, Mark F.; Rauh, Mitchell J.

    2012-01-01

    Purpose: The purpose of this study was to examine the relationships between isotonic ankle plantar flexor endurance (PFE), foot pronation as measured by navicular drop, and exercise-related leg pain (ERLP). Background: Exercise-related leg pain is a common occurrence in competitive and recreational runners. The identification of factors contributing to the development of ERLP may help guide methods for the prevention and management of overuse injuries. Methods: Seventy-seven (44 males, 33 females) competitive runners from five collegiate cross-country (XC) teams consented to participate in the study. Isotonic ankle PFE and foot pronation were measured using the standing heel-rise and navicular drop (ND) tests, respectively. Demographic information, anthropometric measurements, and ERLP history were also recorded. Subjects were then prospectively tracked for occurrence of ERLP during the 2009 intercollegiate cross-country season. Multivariate logistic regression analysis was used to examine the relationships between isotonic ankle joint PFE and ND and the occurrence of ERLP. Results: While no significant differences were identified for isotonic ankle PFE between groups of collegiate XC runners with and without ERLP, runners with a ND >10 mm were almost 7 times (OR=6.6, 95% CI=1.2–38.0) more likely to incur medial ERLP than runners with ND <10 mm. Runners with a history of ERLP in the month previous to the start of the XC season were 12 times (OR=12.3, 95% CI=3.1–48.9) more likely to develop an in-season occurrence of ERLP. Conclusion: While PFE did not appear to be a risk factor in the development of ERLP in this group of collegiate XC runners, those with a ND greater than 10 mm may be at greater odds of incurring medial ERLP. Level of Evidence: 2b. PMID:22666641

  3. Petroleum geochemistry of Texas and Oklahoma oils from the Marathon/Ouachita fold belt

    SciTech Connect

    Curiale, J.A. )

    1991-03-01

    The Marathon uplift of west Texas and the Ouachita Mountains of Oklahoma and Arkansas comprise the surface expressions of a Paleozoic orogenic belt extending across the south-central United States. A century of petroleum exploration in the Marathon and Ouachita exposures has yielded several oil discoveries. In this study, detailed molecular, elemental, and isotopic data are presented for nine Texas oils, five Oklahoma oils, and four Oklahoma solid bitumens, all associated with thrust belt rocks of the Marathons and Ouachitas. Oil-oil and oil-solid bitumen correlations are proposed, and the character of the organic matter in the source rock(s) is deduced from the chemistry of the oils and solid bitumens. All 18 samples are sourced from the same (or very similar) organic matter. This indicates that they are probably cogenetic, despite geographic separations of hundreds of miles. Chemical differences in these samples derive from secondary effects, including biodegradation (e.g., solid bitumens) and differing levels of thermal maturity. The occurrence of unusual chemical compounds (certain bisnor- and trisnor-hopanes) in all samples probably indicates the presence of anaerobic bacteria in the depositional environment. Source deductions from oil chemistry suggest that an Ordovician unit is responsible for these oils and solid bitumens. This conclusion is consistent with previous literature suggesting an Upper Ordovician source for Oklahoma Ouachita oils and supports tectonic reconstructions of the region during Ordovician time.

  4. Strategies to enhance immune function for marathon runners : what can be done?

    PubMed

    Akerström, Thorbjörn C A; Pedersen, Bente K

    2007-01-01

    Marathoners are at an increased risk of developing upper respiratory tract infections (URTIs) following races and periods of hard training, which are associated with temporary changes in the immune system. The majority of the reported changes are decreases in function or concentration of certain immune cells. During this period of immune suppression, by some referred to as an 'open window' in immune function, it has been hypothesised that viruses and bacteria might gain a foothold, which would increase the risk of infections. In light of this, nutritional interventions that can enhance immune function and reduce the risk of URTIs have been sought. This paper focuses on the effect of glutamine, vitamin C, bovine colostrum and glucose. Although, some of these supplements can affect the physiological and immune changes associated with marathon racing, none of the supplements discussed have consistently been shown to reduce the risk of URTIs and therefore cannot be recommended for use as enhancers of immune function in marathon runners. PMID:17465623

  5. Prior Design for Dependent Dirichlet Processes: An Application to Marathon Modeling

    PubMed Central

    F. Pradier, Melanie; J. R. Ruiz, Francisco; Perez-Cruz, Fernando

    2016-01-01

    This paper presents a novel application of Bayesian nonparametrics (BNP) for marathon data modeling. We make use of two well-known BNP priors, the single-p dependent Dirichlet process and the hierarchical Dirichlet process, in order to address two different problems. First, we study the impact of age, gender and environment on the runners’ performance. We derive a fair grading method that allows direct comparison of runners regardless of their age and gender. Unlike current grading systems, our approach is based not only on top world records, but on the performances of all runners. The presented methodology for comparison of densities can be adopted in many other applications straightforwardly, providing an interesting perspective to build dependent Dirichlet processes. Second, we analyze the running patterns of the marathoners in time, obtaining information that can be valuable for training purposes. We also show that these running patterns can be used to predict finishing time given intermediate interval measurements. We apply our models to New York City, Boston and London marathons. PMID:26821155

  6. Do women reduce the gap to men in ultra-marathon running?

    PubMed

    Knechtle, Beat; Valeri, Fabio; Nikolaidis, Pantelis T; Zingg, Matthias A; Rosemann, Thomas; Rüst, Christoph A

    2016-01-01

    The aim of the present study was to examine sex differences across years in performance of runners in ultra-marathons lasting from 6 h to 10 days (i.e. 6, 12, 24, 48, 72, 144, and 240 h). Data of 32,187 finishers competing between 1975 and 2013 with 93,109 finishes were analysed using multiple linear regression analyses. With increasing age, the sex gap for all race durations increased. Across calendar years, the gap between women and men decreased in 6, 72, 144 and 240 h, but increased in 24 and 48 h. The men-to-women ratio differed among age groups, where a higher ratio was observed in the older age groups, and this relationship varied by distance. In all durations of ultra-marathon, the participation of women and men varied by age (p < 0.001), indicating a relatively low participation of women in the older age groups. In summary, between 1975 and 2013, women were able to reduce the gap to men for most of timed ultra-marathons and for those age groups where they had relatively high participation. PMID:27350909

  7. Prior Design for Dependent Dirichlet Processes: An Application to Marathon Modeling.

    PubMed

    F Pradier, Melanie; J R Ruiz, Francisco; Perez-Cruz, Fernando

    2016-01-01

    This paper presents a novel application of Bayesian nonparametrics (BNP) for marathon data modeling. We make use of two well-known BNP priors, the single-p dependent Dirichlet process and the hierarchical Dirichlet process, in order to address two different problems. First, we study the impact of age, gender and environment on the runners' performance. We derive a fair grading method that allows direct comparison of runners regardless of their age and gender. Unlike current grading systems, our approach is based not only on top world records, but on the performances of all runners. The presented methodology for comparison of densities can be adopted in many other applications straightforwardly, providing an interesting perspective to build dependent Dirichlet processes. Second, we analyze the running patterns of the marathoners in time, obtaining information that can be valuable for training purposes. We also show that these running patterns can be used to predict finishing time given intermediate interval measurements. We apply our models to New York City, Boston and London marathons. PMID:26821155

  8. Head and neck injuries from the Boston Marathon bombing at four hospitals.

    PubMed

    Singh, Ajay K; Buch, Karen; Sung, Edward; Abujudeh, Hani; Sakai, Osamu; Aaron, Sodickson; Lev, Michael

    2015-10-01

    The aim of this study was to evaluate the imaging findings of head and neck injuries in patients from the Boston Marathon bombing. A total of 115 patients from the Boston Marathon bombing presenting to four hospitals who underwent imaging to evaluate for head and neck injuries were included in the study. Twelve patients with positive findings on radiography or cross-sectional imaging were included in the final analysis. The radiographic, computed tomography (CT), and magnetic resonance (MR) imaging features of these patients were evaluated for the presence of shrapnel and morphological abnormality. Head and neck injuries were seen in 12 out of 115 patients presenting to the four hospitals. There were secondary blast injuries to the head and neck in eight patients, indicated by the presence of shrapnel on imaging. In the four patients without shrapnel, there were two with subgaleal hematomas, one with facial contusion and one with mastoid injury. There were two patients with subarachnoid hemorrhage, one with brain contusion, one with cerebral laceration, and one with globe rupture. There was frontal bone, nasal bone, and orbital wall fracture in one patient each. Imaging identified 26 shrapnel fragments, 21 of which were ball bearings. Injuries to the head and neck region identified on imaging from the Boston Marathon bombing were not common. The injuries seen were predominantly secondary blast injuries from shrapnel, and did not result in calvarial penetration of the shrapnel fragments. PMID:25962489

  9. Cardiorespiratory demands during an inline speed skating marathon race: a case report.

    PubMed

    Stangier, Carolin; Abel, Thomas; Mierau, Julia; Hollmann, Wildor; Strüder, Heiko K

    2016-09-01

    This study was designed to investigate the intensity profile during an inline speed skating marathon road race. A highly-trained male athlete (20 y, 73.4 kg, 178 cm, V̇O2 peak: 60.8 mL·kg-1·min-1) participated in a marathon road race. Oxygen uptake (V̇O2), respiratory exchange ratio (RER), heart rate (HR) and speed were measured using a portable gas analysis system with a HR monitor and GPS-Sensor integrated. The athlete´s peak V̇O2, HR and speed at ventilatory thresholds were assessed during an incremental field test (22 km·h-1, increase 2 km·h-1 every 5 min) one week before the race. During the race, the absolute time spent in the "easy intensity zone" (V̇O2 below VT1) was 1 min, 49 min "moderate intensity zone" (V̇O2 between VT1 and VT2), and 26 min in the "hard intensity zone" (V̇O2 above VT2). The average HR was 171±6 bpm, corresponding to 95% of the maximum. This study shows that inline speed skating road races over a marathon are conducted at moderate to high V̇O2 and heart rate levels. The physiological racing pattern is very intermittent, requiring both a high level of aerobic and anaerobic capacity. PMID:26745782

  10. Added value of molecular assay Xpert MTB/RIF compared to sputum smear microscopy to assess the risk of tuberculosis transmission in a low-prevalence country.

    PubMed

    Opota, O; Senn, L; Prod'hom, G; Mazza-Stalder, J; Tissot, F; Greub, G; Jaton, K

    2016-07-01

    Airborne precautions are required at hospital admission for patients with suspected pulmonary tuberculosis. The isolation is maintained until 3 serially collected sputum smears are acid-fast bacilli negative, a time- and labor-intensive method with limited sensitivity and specificity, which has a great impact on patient flow management. We evaluated the possibility of replacing the result of microscopy by the semiquantitative result of the molecular point-of-care test Xpert MTB/RIF to assess patients' transmission risk to quickly guide airborne isolation decisions in low-endemic countries. The performance of the Xpert MTB/RIF, used as a first-line test, was compared to the results of microscopy for specimens (n=242) collected from May 2010 to December 2014 in Lausanne, Switzerland. The sensitivity and specificity of Xpert MTB/RIF were 91.5% (65/71) and 99.6% (170/171), respectively, vs. 64.8% (46/71) and 94.2% (161/171) for microscopy. Samples with negative Xpert MTB/RIF were all smear negative for Mycobacterium tuberculosis (negative predictive value, 100%). The semiquantitative results of Xpert MTB/RIF-high, medium, low or very low-were found to correlate with acid-fast bacilli detection: positive predictive value of 100% (6/6), 96.5% (27/28), 52.2% (12/23) and 11.1% (1/9) respectively. Finally, when including clinical criteria, we identified 11 smear-negative but Xpert MTB/RIF-positive patients with a significant transmission potential. In conclusion, our data support the introduction of an Xpert MTB/RIF-based strategy as a replacement of smear microscopy for a faster and more accurate management of tuberculosis patients' transmission risk in a low-prevalence country. PMID:27139592

  11. Xpert®MTB/RIF for the Diagnosis of Tuberculosis in a Remote Arctic Setting: Impact on Cost and Time to Treatment Initiation

    PubMed Central

    Oxlade, Olivia; Sugarman, Jordan; Alvarez, Gonzalo G.; Pai, Madhukar; Schwartzman, Kevin

    2016-01-01

    Background Tuberculosis (TB) remains a significant health problem in the Canadian Arctic. Substantial health system delays in TB diagnosis can occur, in part due to the lack of capacity for onsite microbiologic testing. A study recently evaluated the yield and impact of a rapid automated PCR test (Xpert®MTB/RIF) for the diagnosis of TB in Iqaluit (Nunavut). We conducted an economic analysis to evaluate the expected cost relative to the expected reduction in time to treatment initiation, with the addition of Xpert®MTB/RIF to the current diagnostic and treatment algorithms used in this setting. Methods A decision analysis model compared current microbiologic testing to a scenario where Xpert®MTB/RIF was added to the current diagnostic algorithm for active TB, and incorporated costs and clinical endpoints from the Iqaluit study. Several sensitivity analyses that considered alternative use were also considered. We estimated days to TB diagnosis and treatment initiation, health system costs, and the incremental cost per treatment day gained for each individual evaluated for possible TB. Results With the addition of Xpert®MTB/RIF, costs increased while days to TB treatment initiation were reduced. The incremental cost per treatment day gained (per individual investigated for TB) was $164 (95% uncertainty range $85, $452). In a sensitivity analysis that considered hospital discharge after a single negative Xpert®MTB/RIF, the Xpert®MTB/RIF scenario was cost saving. Interpretation Adding Xpert®MTB/RIF to the current diagnostic algorithm for TB in Nunavut appears to reduce time to diagnosis and treatment at reasonable cost. It may be especially well suited to overcome some of the other logistical barriers that are unique to this and other remote communities. PMID:26990299

  12. The impact of Xpert® MTB/RIF depends on service coordination: experience in Burkina Faso.

    PubMed

    Moyenga, I; Roggi, A; Sulis, G; Diande, S; Tamboura, D; Tagliani, E; Castelli, F; Matteelli, A

    2015-03-01

    Translating the potential of Xpert(®) MTB/RIF into more effective tuberculosis (TB) care and control in low-income settings is challenged by operational issues. We report the experience in introducing this technology in Burkina Faso through a centralised approach. Xpert was successfully integrated into the diagnostic algorithm of multidrug-resistant TB cases. However, barriers to Xpert use for the diagnosis of TB in vulnerable populations, such as persons living with human immunodeficiency virus infection and children, were observed, mainly due to lack of coordination between services. Lessons learnt can be exploited to optimise the roll-out of this technology at country level. PMID:25686135

  13. HIV/AIDS health care challenges for cross-country migrants in low- and middle-income countries: a scoping review

    PubMed Central

    Suphanchaimat, Rapeepong; Sommanustweechai, Angkana; Khitdee, Chiraporn; Thaichinda, Chompoonut; Kantamaturapoj, Kanang; Leelahavarong, Pattara; Jumriangrit, Pensom; Topothai, Thitikorn; Wisaijohn, Thunthita; Putthasri, Weerasak

    2014-01-01

    Introduction HIV/AIDS has been one of the world’s most important health challenges in recent history. The global solidarity in responding to HIV/AIDS through the provision of antiretroviral therapy (ART) and encouraging early screening has been proved successful in saving lives of infected populations in past decades. However, there remain several challenges, one of which is how HIV/AIDS policies keep pace with the growing speed and diversity of migration flows. This study therefore aimed to examine the nature and the extent of HIV/AIDS health services, barriers to care, and epidemic burdens among cross-country migrants in low-and middle-income countries. Methods A scoping review was undertaken by gathering evidence from electronic databases and gray literature from the websites of relevant international initiatives. The articles were reviewed according to the defined themes: epidemic burdens of HIV/AIDS, barriers to health services and HIV/AIDS risks, and the operational management of the current health systems for HIV/AIDS. Results Of the 437 articles selected for an initial screening, 35 were read in full and mapped with the defined research questions. A high HIV/AIDS infection rate was a major concern among cross-country migrants in many regions, in particular sub-Saharan Africa. Despite a large number of studies reported in Africa, fewer studies were found in Asia and Latin America. Barriers of access to HIV/AIDS services comprised inadequate management of guidelines and referral systems, discriminatory attitudes, language differences, unstable legal status, and financial hardship. Though health systems management varied across countries, international partners consistently played a critical role in providing support for HIV/AIDS services to uninsured migrants and refugees. Conclusion It was evident that HIV/AIDS health care problems for migrants were a major concern in many developing nations. However, there was little evidence suggesting if the current

  14. Contribution of Upper-Body Strength, Body Composition, and Maximal Oxygen Uptake to Predict Double Poling Power and Overall Performance in Female Cross-Country Skiers.

    PubMed

    Østerås, Sindre; Welde, Boye; Danielsen, Jørgen; van den Tillaar, Roland; Ettema, Gertjan; Sandbakk, Øyvind

    2016-09-01

    Østerås, S, Welde, B, Danielsen, J, van den Tillaar, R, Ettema, G, and Sandbakk, Ø. Contribution of upper-body strength, body composition, and maximal oxygen uptake to predict double poling power and overall performance in female cross-country skiers. J Strength Cond Res 30(9): 2557-2564, 2016-Maximal oxygen uptake (V[Combining Dot Above]O2max) is regarded as the most performance-differentiating physiological measure in cross-country (XC) skiing. In addition, upper-body strength and lean mass have been associated with double poling (DP) power in XC skiers. In this study, we tested upper-body maximal strength, lean mass, and V[Combining Dot Above]O2max's contributions to predict DP power production of different durations and the overall XC skiing performance level of elite female XC skiers. Thirteen skiers (V[Combining Dot Above]O2max: 64.9 ± 4.2 ml·kg·min) performed one 30-second and one 3-minute DP performance test using a ski ergometer. The International Ski Federation's (FIS) ranking points determined their overall XC skiing performance. The skiers performed three 1-repetition maximal strength tests in poling-specific exercises that isolated the elbow extension, shoulder extension, and trunk flexion movements. Body composition was determined by a DXA scan, and V[Combining Dot Above]O2max was tested in an incremental running test. Multiple regressions were used to predict power production in the 30-second and 3-minute tests and FIS points. The 2 best predictions of 30-second DP power were lean upper-body mass and maximal upper-body strength (with the 3 strength tests normalized and pooled together as one variable) (R = 0.84 and 0.81, p < 0.001). Along with V[Combining Dot Above]O2max, the same 2 variables were the best predictions of both 3-minute DP power (R = 0.60 and 0.44, p ≤ 0.05) and overall XC skiing performance (R = 0.43 and 0.40, p ≤ 0.05). Although the importance of upper-body strength and lean mass to predict DP power production and the

  15. Opportunity, Geologic and Structural Context of Aqueous Alteration in Noachian Outcrops, Marathon Valley and Rim and Endeavour Crater

    NASA Technical Reports Server (NTRS)

    Crumpler, L. S.; Arvidson, R. E.; Mittlefehldt, D. W.; Jolliff, B. L.; Farrand, W. H.; Fox, V.; Golombek, M. P.

    2016-01-01

    In its 12th year of exploration and 1600 sols since arrival at the rim of the 22 km-diameter Noachian Endeavour impact crater, Mars Exploration Rover Opportunity traversed from the summit of the western rim segment "Cape Tribulation" to "Marathon Valley", a shallow trough dissecting the rim and the site of strong orbital detection of smectites. In situ analysis of the exposures within Marathon Valley is establishing some of the geologic and geochemical controls on the aqueous alteration responsible for smectite detection known to occur in crater rims throughout Noachian terrains of Mars.

  16. How Hinge Positioning in Cross-Country Ski Bindings Affect Exercise Efficiency, Cycle Characteristics and Muscle Coordination during Submaximal Roller Skiing

    PubMed Central

    Bolger, Conor M.; Sandbakk, Øyvind; Ettema, Gertjan; Federolf, Peter

    2016-01-01

    The purposes of the current study were to 1) test if the hinge position in the binding of skating skis has an effect on gross efficiency or cycle characteristics and 2) investigate whether hinge positioning affects synergistic components of the muscle activation in six lower leg muscles. Eleven male skiers performed three 4-min sessions at moderate intensity while cross-country ski-skating and using a klapskate binding. Three different positions were tested for the binding’s hinge, ranging from the front of the first distal phalange to the metatarsal-phalangeal joint. Gross efficiency and cycle characteristics were determined, and the electromyographic (EMG) signals of six lower limb muscles were collected. EMG signals were wavelet transformed, normalized, joined into a multi-dimensional vector, and submitted to a principle component analysis (PCA). Our results did not reveal any changes to gross efficiency or cycle characteristics when altering the hinge position. However, our EMG analysis found small but significant effects of hinge positioning on muscle coordinative patterns (P < 0.05). The changed patterns in muscle activation are in alignment with previously described mechanisms that explain the effects of hinge positioning in speed-skating klapskates. Finally, the within-subject results of the EMG analysis suggested that in addition to the between-subject effects, further forms of muscle coordination patterns appear to be employed by some, but not all participants. PMID:27203597

  17. The efficiency of health care production in OECD countries: A systematic review and meta-analysis of cross-country comparisons.

    PubMed

    Varabyova, Yauheniya; Müller, Julia-Maria

    2016-03-01

    There has been an ongoing interest in the analysis and comparison of the efficiency of health care systems using nonparametric and parametric applications. The objective of this study was to review the current state of the literature and to synthesize the findings on health system efficiency in OECD countries. We systematically searched five electronic databases through August 2014 and identified 22 studies that analyzed the efficiency of health care production at the country level. We summarized these studies with view on their sample, methods, and utilized variables. We developed and applied a checklist of 14 items to assess the quality of the reviewed studies along four dimensions: reporting, external validity, bias, and power. Moreover, to examine the internal validity of findings we meta-analyzed the efficiency estimates reported in 35 models from ten studies. The qualitative synthesis of the literature indicated large differences in study designs and methods. The meta-analysis revealed low correlations between country rankings suggesting a lack of internal validity of the efficiency estimates. In conclusion, methodological problems of existing cross-country comparisons of the efficiency of health care systems draw into question the ability of these comparisons to provide meaningful guidance to policy-makers. PMID:26819140

  18. The impact of health care resources, socioeconomic status, and demographics on life expectancy: a cross-country study in three Southeast Asian countries.

    PubMed

    Chan, Moon Fai

    2015-03-01

    This study aimed to examine the impact of health care resources, socioeconomic status, and demographic changes on life expectancy in Indonesia, Philippines, and Vietnam. This was a cross-country study to collect annual data (1980-2008) from each target country. Life expectancy was the dependent variable and health care resources, socioeconomic status, and demographics were the 3 main determinants. Structural equation modeling was employed, and the results indicate that the availability of more health care resources (Indonesia: coefficient = .47, P = .008; Philippines: coefficient = .48, P = .017; Vietnam: coefficient = .48, P = .004) and higher levels of socioeconomic advantages (Indonesia: coefficient = .41, P = .014; Vietnam: coefficient = .34, P = .026) are more likely to increase life expectancy. In contrast, demographic changes are more likely to increase life expectancy because of the wide range of health care resources. These findings suggest that more effort, particularly during economic downturns, should be put into removing the barriers that impede access to health care services and increasing preventive care for the population that currently has less access to health care in communities where there is a shortage of medical resources. PMID:23417906

  19. Natural Killer cell activation distinguishes M. tuberculosis-mediated Immune reconstitution syndrome (IRIS) from chronic HIV and HIV-MTB co-infection

    PubMed Central

    Conradie, F.; Foulkes, A.S.; Ive, P.; Yin, X.; Roussos, K.; Glencross, D.K.; Lawrie, D.; Stevens, W.; Montaner, L.J.; Sanne; Azzoni, L.

    2011-01-01

    Background With increased access to antiretroviral treatment (ART), Immune Reconstitution Inflammatory Syndrome (IRIS) in Mycobacterium tuberculosis (MTB)-infected populations remains a clinical challenge. We studied a cross-sectional cohort of HIV-infected subjects in Johannesburg (South Africa) to help define the immune correlates that best distinguish IRIS from ongoing MTB cases. Methods We studied HIV+ subjects developing MTB-related unmasking IRIS (u-TB-IRIS) after ART initiation; control groups were HIV subjects and HIV-TB co-infected subjects with comparable ART treatment. Testing was conducted with whole blood-based 4-color flow cytometry and plasma-based Luminex cytokine assessment. Results NK cell activation, C-reactive protein and IL-8 serum concentration were significantly higher in u-TB-IRIS subjects as compared to both control groups. In addition, all MTB co-infected subjects, independent of clinical presentation, had higher neutrophils and T cell activation, together with lower lymphocytes, CD4+ T cell and myeloid DC counts. Using conditional inference tree analysis we show that elevated NK cell activation in combination with lymphocyte count characterizes the immunological profile of u-TB-IRIS. Conclusions Our results support a role for innate immune effectors in the immunopathogenesis of unmasking MTB-related IRIS, and identify new immune parameters defining this pathology. PMID:21826013

  20. Design of Potential Bisubstrate Inhibitors against Mycobacterium tuberculosis (Mtb) 1-Deoxy-D-Xylulose 5-Phosphate Reductoisomerase (Dxr)-Evidence of a Novel Binding Mode.

    PubMed

    San Jose, Géraldine; Jackson, Emily R; Uh, Eugene; Johny, Chinchu; Haymond, Amanda; Lundberg, Lindsay; Pinkham, Chelsea; Kehn-Hall, Kylene; Boshoff, Helena I; Couch, Robin D; Dowd, Cynthia S

    2013-07-01

    In most bacteria, the nonmevalonate pathway is used to synthesize isoprene units. Dxr, the second step in the pathway, catalyzes the NADPH-dependent reductive isomerization of 1-deoxy-D-xylulose-5-phosphate (DXP) to 2-C-methyl-D-erythritol-4-phosphate (MEP). Dxr is inhibited by natural products fosmidomycin and FR900098, which bind in the DXP binding site. These compounds, while potent inhibitors of Dxr, lack whole cell activity against Mycobacterium tuberculosis (Mtb) due to their polarity. Our goal was to use the Mtb Dxr-fosmidomycin co-crystal structure to design bisubstrate ligands to bind to both the DXP and NADPH sites. Such compounds would be expected to demonstrate improved whole cell activity due to increased lipophilicity. Two series of compounds were designed and synthesized. Compounds from both series inhibited Mtb Dxr. The most potent compound (8) has an IC50 of 17.8 µM. Analysis shows 8 binds to Mtb Dxr via a novel, non-bisubstrate mechanism. Further, the diethyl ester of 8 inhibits Mtb growth making this class of compounds interesting lead molecules in the search for new antitubercular agents. PMID:23914289

  1. Pre-race dietary carbohydrate intake can independently influence sub-elite marathon running performance.

    PubMed

    Atkinson, G; Taylor, C E; Morgan, N; Ormond, L R; Wallis, G A

    2011-08-01

    We examined whether selected anthropometric and nutritional factors influenced field-based marathon running performance. An internet-based data collection tool allowed competitors in the 2009 London Marathon (n=257, mean ± SD age: 39 ± 8 years, finish time: 273.8 ± 59.5 min) to record a range of anthropometric, training and nutritional predictors. Multivariate statistical methods were used to quantify the change in running speed mediated by a unit change in each predictor via the 95% confidence interval for each covariate-controlled regression slope ( B). Gender ( B=1.22 to 1.95 km/h), body mass index ( B=-0.14 to -0.27 km/h), training distance ( B=0.01 to 0.04 km/h) and the amount of carbohydrate consumed the day before the race ( B=0.08 to 0.26 km/h) were significant predictors, collectively accounting for 56% of the inter-individual variability in running speed (P<0.0005). Further covariate-adjusted analysis revealed that those competitors who consumed carbohydrate the day before the race at a quantity of >7 g/kg body mass had significantly faster overall race speeds (P=0.01) and maintained their running speed during the race to a greater extent than with those who consumed <7 g/kg body mass (P=0.02). We conclude that, in addition to gender, body size and training, pre-race day carbohydrate intake can significantly and independently influence marathon running performance. PMID:21590642

  2. Anthropometric Characteristics of Chinese Professional Female Marathoners and Predicted Variables for Their Personal Bests.

    PubMed

    Yang, Xian-Gang; Wang, Yang; Bao, Da-Peng; Hu, Yang

    2015-12-01

    To investigate anthropometric characteristics of Chinese professional female marathoners and suitable predicted variables correlated with their personal bests (PB), 96 Chinese female long-distance runners were divided into international (< 2 h 34 min), national (2 h 34 min~2 h 45 min) and average (2 h 45 min~3 h 19 min) levels according to their PB in marathon during the process of talent identification for London Olympic Games. Selected anthropometric variables, including height, body mass, percentages of body fat, girths, breadths, lengths and skin-folds were measured. Only iliac crest skin-fold of international athletes was significantly lower than it is in national group. Girth of forearm and lower limbs, length of lower limbs, and all skin-folds of national athletes were significantly lower than those from average level group. Percentages of body fat, girth of forearm and calf, length of lower limbs, and skin-folds at sites of subscapular, abdominal and iliac crest of athletes from average level group were significantly higher than those in international athletes. Positive correlation was found between forearm girth and PB, and between the subscapular, abdominal, iliac crest and triceps surae skin-folds and PB for total athletes. Negative correlation between biiliac breadth and PB in international athletes, and positive correlations between abdominal and triceps surae skin-folds and PB in national athletes were found. For average runners, high positive correlation was found between upper arm girth and PB, and between subscapular, abdominal, iliac crest and triceps surae skin-folds and PB. The findings suggested that compared to stride length, stride frequency and efficiency were more important factors influencing running performance, which were in accordance with running technique in Chinese female marathoners. PMID:26987158

  3. Regulation of electrolyte and fluid metabolism in multi-stage ultra-marathoners.

    PubMed

    Knechtle, B; Knechtle, P; Rüst, C A; Gnädinger, M; Imoberdorf, R; Kohler, G; Rosemann, T; Ballmer, P

    2012-11-01

    The purposes of this study were (i) to determine the prevalence of exercise-associated hyponatremia (EAH) in multi-stage ultra-marathoners and (ii) to gain more insight into fluid and electrolyte regulation during a multi-stage race. Body mass, sodium concentration ([Na⁺]), potassium concentration ([K⁺]), creatinine, urea, specific gravity, and osmolality in urine were measured in 25 male ultra-marathoners in the 'Swiss Jura Marathon' 2008 with 11,000 m gain of altitude over 7 stages covering 350 km, before and after each stage. Haemoglobin, haematocrit, creatinine, urea, [Na⁺], [K⁺], and osmolality were measured in plasma before stage 1 and after stages 1, 3, 5, and 7. Two athletes (8%) showed plasma [Na⁺] <135 mmol/l. Body mass, plasma [Na⁺], and plasma [K⁺] remained unchanged (p>0.05). Urine specific gravity (p<0.001) and osmolality in both plasma (p<0.01) and urine (p<0.001) were increased and haematocrit (p<0.0001), haemoglobin (p<0.0001) and plasma albumin were decreased (p<0.001). Plasma volume (p<0.01) and plasma urea (p<0.001) were increased. The K⁺/Na⁺ ratio in urine increased >1.0 after each stage and returned to <1.0 the morning of the next stage (p<0.001). To summarize, more sodium than potassium was excreted during rest. The increased urinary sodium losses during rest are compatible with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) or the cerebral salt-wasting syndrome (CSWS). Further studies are needed to determine the antidiuretic hormone (ADH) and both the atrial natriuretic peptide (ANP) and the brain natriuretic peptide (BNP) during multi-stage races. PMID:22638835

  4. Structure of the Mycobacterium tuberculosis Flavin Dependent Thymidylate Synthase (MtbThyX) at 2.0 Å Resolution

    SciTech Connect

    Sampathkumar, Parthasarathy; Turley, Stewart; Ulmer, Jonathan E.; Rhie, Ho Gun; Hopkins Sibley, Carol; Hol, Wim G.J.

    2010-07-20

    A novel flavin-dependent thymidylate synthase was identified recently as an essential gene in many archaebacteria and some pathogenic eubacteria. This enzyme, ThyX, is a potential antibacterial drug target, since humans and most eukaryotes lack the thyX gene and depend upon the conventional thymidylate synthase (TS) for their dTMP requirements. We have cloned and overexpressed the thyX gene (Rv2754c) from Mycobacterium tuberculosis in Escherichia coli. The M. tuberculosis ThyX (MtbThyX) enzyme complements the E. coli {chi}2913 strain that lacks its conventional TS activity. The crystal structure of the homotetrameric MtbThyX was determined in the presence of the cofactor FAD and the substrate analog, 5-bromo-2'-deoxyuridine-5'-monophosphate (BrdUMP). In the active site, which is formed by three monomers, FAD is bound in an extended conformation with the adenosine ring in a deep pocket and BrdUMP in a closed conformation near the isoalloxazine ring. Structure-based mutational studies have revealed a critical role played by residues Lys165 and Arg168 in ThyX activity, possibly by governing access to the carbon atom to be methylated of a totally buried substrate dUMP.

  5. [Hyponatremic encephalopathy with non-cardiogenic pulmonary edema. Development following marathon run].

    PubMed

    Wellershoff, G

    2013-04-01

    This article presents the case of a 52-year-old woman who developed exercise-associated hyponatremia (EAH) complicated by non-cardiogenic pulmonary edema after a marathon run. The condition of EAH is a potentially life-threatening complication of endurance exercise. The main cause seems to be inadequate intake of free water during or following exercise with enduring antidiuresis due to nonosmotic stimulation of ADH secretion. Known risk factors are female gender, slow running pace and lack of weight loss. Emergency therapy is fluid restriction and bolus infusion of 3% NaCl solution to rapidly reduce brain edema. PMID:23381723

  6. Compositions of Diverse Noachian Lithologies at Marathon Valley, Endeavour Crater Rim, Mars

    NASA Technical Reports Server (NTRS)

    Mittlefehldt, David W.; Gellert, Ralf; Yen, Albert S.; Ming, Douglas W.; Van Bommel, Scott; Farrand, William H.; Arvidson, Raymond E.; Rice, James W., Jr.

    2015-01-01

    Mars Exploration Rover Opportunity has been exploring Meridiani Planum for 11+ years, and is presently investigating the geology of rim segments of 22 km diameter, Noachian-aged Endeavour crater. The Alpha Particle X-ray Spectrometer has determined the compositions of a pre-impact lithology and impact breccias representing ejecta from the crater. Opportunity is now investigating the head (higher elevation, western end) of Marathon Valley. This valley cuts eastward through the central portion of the Cape Tribulation rim segment and provides a window into the lower stratigraphic record of the rim. At the head of Marathon Valley is a shallow (few 10s of cm), ovoid depression approximately 27×36 m in size, named Spirit of Saint Louis, that is surrounded by approximately 20-30 cm wide zone of more reddish rocks (red zone). Opportunity has just entered a region of Marathon Valley that shows evidence for Fe-Mg smectite in Compact Reconnaissance Imaging Spectrometer for Mars spectra indicating areally extensive and distinct lithologic units and/or styles of aqueous alteration. Rocks at the head of Marathon Valley and within Spirit of Saint Louis are breccias (valley-head rocks). In some areas, layering inside Spirit of Saint Louis appears continuous with the rocks outside. The valley-head rocks are of similar, generally basaltic composition. The continuity in composition, texture and layering suggest the valley-head rocks are coeval breccias, likely from the Endeavour impact. These local breccias are similar in non-volatile-element composition to breccias investigated elsewhere on the rim. Rocks within the red zone are like those on either side in texture, but have higher Al, Si and Ge, and lower S, Mn, Fe, Ni and Zn as compared to rocks on either side. The valley-head rocks have higher S than most Endeavour rim breccias, while red zone rocks are like those latter breccias in S. Patches within the rocks outside Spirit of Saint Louis have higher Al, Si and Ge indicating

  7. Effects of running the Bostom Marathon on plasma concentrations of large neutral amino acids

    NASA Technical Reports Server (NTRS)

    Conlay, L. A.; Wurtman, R. J.; Lopez G-Coviella, I.; Blusztajn, J. K.; Vacanti, C. A.; Logue, M.; During, M.; Caballero, B.; Maher, T. J.; Evoniuk, G.

    1989-01-01

    Plasma large neutral amino acid concentrations were measured in thirty-seven subjects before and after completing the Boston Marathon. Concentrations of tyrosine, phenylalanine, and methionine increased, as did their 'plasma ratios' (i.e., the ratio of each amino acid's concentration to the summed plasma concentrations of the other large neutral amino acids which compete with it for brain uptake). No changes were noted in the plasma concentrations of tryptophan, leucine, isoleucine, nor valine; however, the 'plasma ratios' of valine, leucine, and isoleucine all decreased. These changes in plasma amino acid patterns may influence neurotransmitter synthesis.

  8. Rhythm Analyses Of Melodies Used To Obtain Women Marathon Gold Medal

    NASA Astrophysics Data System (ADS)

    Tacano, Munecazu; Yokokura, Saburo; Kajiwara, Yoko; Pavelka, Jan; Tanuma, Nobuhisa; Uemura, Tatsuhisa; Hashiguchi, Sumihisa; Sikula, Josef

    2005-11-01

    In Athena Olympics in 2004 a Japanese girl got the gold medal in Women Marathon games. Just before the beginning, she was listening to some domestic melodies in order to concentrate on the race. The rhythm or power of that music is found to have the typical 1/f noise characteristics. The 1/f music is found effective to concentrate as well as to relax themselves for a fairly long time range, while some short time trial runner uses a kind of white noise like music.

  9. VNIR Multispectral Observations of Rocks at Spirit of St. Louis Crater and Marathon Valley on Th Rim of Endeavour Crater Made by the Opportunity Rover Pancam

    NASA Technical Reports Server (NTRS)

    Farrand, W. H.; Johnson, J. R.; Bell, J. F., III; Mittlefehldt, D.W.

    2016-01-01

    The Mars Exploration Rover Opportunity has been exploring the western rim of the 22 km diameter Endeavour crater since August, 2011. Recently, Opportunity has reached a break in the Endeavour rim that the rover team has named Mara-thon Valley. This is the site where orbital observations from the MRO CRISM imaging spectrometer indicated the presence of iron smectites. On the outer western portion of Marathon Valley, Opportunity explored the crater-form feature dubbed Spirit of St. Louis (SoSL) crater. This presentation describes the 430 to 1009 nm (VNIR) reflectance, measured by the rover's Pancam, of rock units present both at Spirit of St. Louis and within Marathon Valley.

  10. Predictors for MTB Culture-Positivity among HIV-Infected Smear-Negative Presumptive Tuberculosis Patients in Uganda: Application of New Tuberculosis Diagnostic Technology

    PubMed Central

    Nakiyingi, Lydia; Nonyane, Bareng A. S.; Ssengooba, Willy; Kirenga, Bruce J.; Nakanjako, Damalie; Lubega, Gloria; Byakika-Kibwika, Pauline; Joloba, Moses L.; Ellner, Jerry J.; Dorman, Susan E.; Mayanja-Kizza, Harriet; Manabe, Yukari C.

    2015-01-01

    Background The existing World Health Organization diagnostic algorithms for smear-negative TB perform poorly in HIV-infected individuals. New TB diagnostics such as urine TB lipoarabinomannan (LAM) could improve the accuracy and reduce delays in TB diagnosis in HIV-infected smear-negative presumptive TB. We sought to determine predictors for MTB culture-positivity among these patients. Methods This study was nested into a prospective evaluation of HIV-infected outpatients and inpatients clinically suspected to have TB who were screened by smear-microscopy on two spot sputum samples. Data on socio-demographics, clinical symptoms, antiretroviral therapy, CXR, CD4 count, mycobacterial sputum and blood cultures and TB-LAM were collected. Logistic regression and conditional inference tree analysis were used to determine the most predictive indicators for MTB culture-positivity. Results Of the 418 smear-negative participants [female, 64%; median age (IQR) 32 (28-39) years, median CD4 106 (IQR 22 - 298) cells/mm3], 96/418 (23%) were sputum and/ or blood culture-positive for Mycobacterium tuberculosis (MTB) complex. Abnormal CXR (aOR 3.68, 95% CI 1.76- 7.71, p=0.001) and positive urine TB-LAM (aOR 6.21, 95% CI 3.14-12.27, p< 0.001) were significantly associated with MTB culture-positivity. Previous TB treatment (aOR 0.41, 95% CI 0.17-0.99, p=0.049) reduced the likelihood of a positive MTB culture. A conditional inference tree analysis showed that positive urine TB-LAM and abnormal CXR were the most predictive indicators of MTB culture-positivity. A combination of urine TB-LAM test and CXR had sensitivity and specificity of 50% and 86.1% respectively overall, and 70.8% and 84.1% respectively among those with CD4<100 cells/mm3. Conclusions A positive urine TB-LAM test and an abnormal CXR significantly predict MTB culture-positivity among smear-negative HIV-infected presumptive TB patients while previous TB treatment reduces the likelihood of a positive MTB culture

  11. A Diagnostic Accuracy Study of Xpert®MTB/RIF in HIV-Positive Patients with High Clinical Suspicion of Pulmonary Tuberculosis in Lima, Peru

    PubMed Central

    Carriquiry, Gabriela; Otero, Larissa; González-Lagos, Elsa; Zamudio, Carlos; Sánchez, Eduardo; Nabeta, Pamela; Campos, Miguel; Echevarría, Juan; Seas, Carlos; Gotuzzo, Eduardo

    2012-01-01

    Background Diagnosis of pulmonary tuberculosis (TB) among human immunodeficiency virus (HIV) patients remains complex and demands easy to perform and accurate tests. Xpert®MTB/RIF (MTB/RIF) is a molecular TB diagnostic test which is rapid and convenient; the test requires minimal human resources and reports results within two hours. The majority of performance studies of MTB/RIF have been performed in high HIV burden settings, thus TB diagnostic studies among HIV patients in low HIV prevalence settings such as Peru are still needed. Methodology/Principal Findings From April 2010 to May 2011, HIV-positive patients with high clinical suspicion of TB were enrolled from two tertiary hospitals in Lima, Peru. Detection of TB by MTB/RIF was compared to a composite reference standard Löwenstein-Jensen (LJ) and liquid culture. Detection of rifampicin resistance was compared to the LJ proportion method. We included 131 patients, the median CD4 cell count was 154.5 cells/mm3 and 45 (34.4%) had TB. For TB detection among HIV patients, sensitivity of MTB/RIF was 97.8% (95% CI 88.4–99.6) (44/45); specificity was 97.7% (95% CI 91.9–99.4) (84/86); the positive predictive value was 95.7% (95% CI 85.5–98.8) (44/46); and the negative predictive value, 98.8% (95% CI 93.6–99.8) (84/85). MTB/RIF detected 13/14 smear-negative TB cases, outperforming smear microscopy [97.8% (44/45) vs. 68.9% (31/45); p = 0.0002]. For rifampicin resistance detection, sensitivity of MTB/RIF was 100% (95% CI 61.0–100.0) (6/6); specificity was 91.0% (95% CI 76.4–96.9) (30/33); the positive predictive value was 66.7% (95% CI 35.4–87.9) (6/9); and the negative predictive value was 100% (95% CI 88.7 –100.0) (30/30). Conclusions/Significance In HIV patients in our population with a high clinical suspicion of TB, MTB/RIF performed well for TB diagnosis and outperformed smear microscopy. PMID:22970271

  12. Comparing results of an exact vs. an approximate (Bayesian) measurement invariance test: a cross-country illustration with a scale to measure 19 human values

    PubMed Central

    Cieciuch, Jan; Davidov, Eldad; Schmidt, Peter; Algesheimer, René; Schwartz, Shalom H.

    2014-01-01

    One of the most frequently used procedures for measurement invariance testing is the multigroup confirmatory factor analysis (MGCFA). Muthén and Asparouhov recently proposed a new approach to test for approximate rather than exact measurement invariance using Bayesian MGCFA. Approximate measurement invariance permits small differences between parameters otherwise constrained to be equal in the classical exact approach. However, extant knowledge about how results of approximate measurement invariance tests compare to the results of the exact measurement invariance test is missing. We address this gap by comparing the results of exact and approximate cross-country measurement invariance tests of a revised scale to measure human values. Several studies that measured basic human values with the Portrait Values Questionnaire (PVQ) reported problems of measurement noninvariance (especially scalar noninvariance) across countries. Recently Schwartz et al. proposed a refined value theory and an instrument (PVQ-5X) to measure 19 more narrowly defined values. Cieciuch et al. tested its measurement invariance properties across eight countries and established exact scalar measurement invariance for 10 of the 19 values. The current study applied the approximate measurement invariance procedure on the same data and established approximate scalar measurement invariance even for all 19 values. Thus, the first conclusion is that the approximate approach provides more encouraging results for the usefulness of the scale for cross-cultural research, although this finding needs to be generalized and validated in future research using population data. The second conclusion is that the approximate measurement invariance is more likely than the exact approach to establish measurement invariance, although further simulation studies are needed to determine more precise recommendations about how large the permissible variance of the priors may be. PMID:25249996

  13. Comparing results of an exact vs. an approximate (Bayesian) measurement invariance test: a cross-country illustration with a scale to measure 19 human values.

    PubMed

    Cieciuch, Jan; Davidov, Eldad; Schmidt, Peter; Algesheimer, René; Schwartz, Shalom H

    2014-01-01

    One of the most frequently used procedures for measurement invariance testing is the multigroup confirmatory factor analysis (MGCFA). Muthén and Asparouhov recently proposed a new approach to test for approximate rather than exact measurement invariance using Bayesian MGCFA. Approximate measurement invariance permits small differences between parameters otherwise constrained to be equal in the classical exact approach. However, extant knowledge about how results of approximate measurement invariance tests compare to the results of the exact measurement invariance test is missing. We address this gap by comparing the results of exact and approximate cross-country measurement invariance tests of a revised scale to measure human values. Several studies that measured basic human values with the Portrait Values Questionnaire (PVQ) reported problems of measurement noninvariance (especially scalar noninvariance) across countries. Recently Schwartz et al. proposed a refined value theory and an instrument (PVQ-5X) to measure 19 more narrowly defined values. Cieciuch et al. tested its measurement invariance properties across eight countries and established exact scalar measurement invariance for 10 of the 19 values. The current study applied the approximate measurement invariance procedure on the same data and established approximate scalar measurement invariance even for all 19 values. Thus, the first conclusion is that the approximate approach provides more encouraging results for the usefulness of the scale for cross-cultural research, although this finding needs to be generalized and validated in future research using population data. The second conclusion is that the approximate measurement invariance is more likely than the exact approach to establish measurement invariance, although further simulation studies are needed to determine more precise recommendations about how large the permissible variance of the priors may be. PMID:25249996

  14. 33 CFR 165.T09-0333 - Safety zone; Marathon Oil Refinery construction, Rouge River, Detroit, MI.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... safety zone effectively covers all of the Rouge River from the Dix Ave. bridge to the north end of... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Safety zone; Marathon Oil... Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PORTS AND WATERWAYS SAFETY...

  15. Development and Application of a Next Generation Air Sensor Network for the Hong Kong Marathon 2015 Air Quality Monitoring

    PubMed Central

    Sun, Li; Wong, Ka Chun; Wei, Peng; Ye, Sheng; Huang, Hao; Yang, Fenhuan; Westerdahl, Dane; Louie, Peter K.K.; Luk, Connie W.Y.; Ning, Zhi

    2016-01-01

    This study presents the development and evaluation of a next generation air monitoring system with both laboratory and field tests. A multi-parameter algorithm was used to correct for the impact of environmental conditions on the electrochemical sensors for carbon monoxide (CO) and nitrogen dioxide (NO2) pollutants. The field evaluation in an urban roadside environment in comparison to designated monitors showed good agreement with measurement error within 5% of the pollutant concentrations. Multiple sets of the developed system were then deployed in the Hong Kong Marathon 2015 forming a sensor-based network along the marathon route. Real-time air pollution concentration data were wirelessly transmitted and the Air Quality Health Index (AQHI) for the Green Marathon was calculated, which were broadcast to the public on an hourly basis. The route-specific sensor network showed somewhat different pollutant patterns than routine air monitoring, indicating the immediate impact of traffic control during the marathon on the roadside air quality. The study is one of the first applications of a next generation sensor network in international sport events, and it demonstrated the usefulness of the emerging sensor-based air monitoring technology in rapid network deployment to supplement existing air monitoring. PMID:26861336

  16. "We Are Not Terrorists," but More Likely Transnationals: Reframing Understandings about Immigrants in Light of the Boston Marathon Bombings

    ERIC Educational Resources Information Center

    Kasun, G. Sue

    2013-01-01

    The Boston Marathon bombings in April 2013 created a new kind of discomfort in the United States about "self-radicalized" terrorists, particularly related to Muslim immigrants. The two suspected bombers, brothers with Chechen backgrounds, had attended U.S. public schools. News media portrayed the brothers as "immigrants" and…

  17. Expanding What It Means to Make Evidence-Based Claims: Online Comments and the Boston Marathon Bombings

    ERIC Educational Resources Information Center

    Chandler-Olcott, Kelly

    2014-01-01

    This article argues that exploration of media coverage of a story like the Boston Marathon bombings, including online comments posted by readers, can support youth in reflecting on and thinking critically about a tragedy while offering opportunities for literacy pedagogy consistent with the goals of the Common Core State Standards for English…

  18. Development and Application of a Next Generation Air Sensor Network for the Hong Kong Marathon 2015 Air Quality Monitoring.

    PubMed

    Sun, Li; Wong, Ka Chun; Wei, Peng; Ye, Sheng; Huang, Hao; Yang, Fenhuan; Westerdahl, Dane; Louie, Peter K K; Luk, Connie W Y; Ning, Zhi

    2016-01-01

    This study presents the development and evaluation of a next generation air monitoring system with both laboratory and field tests. A multi-parameter algorithm was used to correct for the impact of environmental conditions on the electrochemical sensors for carbon monoxide (CO) and nitrogen dioxide (NO2) pollutants. The field evaluation in an urban roadside environment in comparison to designated monitors showed good agreement with measurement error within 5% of the pollutant concentrations. Multiple sets of the developed system were then deployed in the Hong Kong Marathon 2015 forming a sensor-based network along the marathon route. Real-time air pollution concentration data were wirelessly transmitted and the Air Quality Health Index (AQHI) for the Green Marathon was calculated, which were broadcast to the public on an hourly basis. The route-specific sensor network showed somewhat different pollutant patterns than routine air monitoring, indicating the immediate impact of traffic control during the marathon on the roadside air quality. The study is one of the first applications of a next generation sensor network in international sport events, and it demonstrated the usefulness of the emerging sensor-based air monitoring technology in rapid network deployment to supplement existing air monitoring. PMID:26861336

  19. Impact of different running distances on muscle and lymphocyte DNA damage in amateur marathon runners.

    PubMed

    Ryu, Jae Hoon; Paik, Il Young; Woo, Jin Hee; Shin, Ki Ok; Cho, Su Youn; Roh, Hee Tae

    2016-01-01

    [Purpose] The aim of this study was to investigate the impact of different marathon running distances (10 km, 21 km, and 42.195 km) on muscle and lymphocyte DNA damage in amateur marathon runners. [Subjects and Methods] Thirty male amateur runners were randomly assigned to 10 km, 21 km, and 42 km groups, with 10 subjects in each group. Blood samples were collected before and after the races and on the 3rd day of recovery to examine levels of muscle damage (creatine kinase and lactate dehydrogenase) and lymphocyte DNA damage (DNA in the tail, tail length, and tail moment). [Results] Serum creatine kinase, serum lactate dehydrogenase, and tail moment were significantly higher after the races compared with before the races in all groups. In addition, the 42 km group showed significantly higher levels of creatine kinase, lactate dehydrogenase, and tail moment than the 10 km and 21 km groups after the races. [Conclusion] Strenuous endurance exercise can cause muscle and lymphocyte DNA damage, and the extent of such damage can increase as running distance increases. PMID:27065529

  20. Turning laboratory findings into therapy: a marathon goal that has to be reached

    PubMed Central

    Kotlan, Beatrix; Stroncek, David F.; Marincola, Francesco M.

    2012-01-01

    The mission of translational research involves difficult tasks to be accomplished for its ultimate goal, i.e. the introduction of novel, effective therapeutic strategies in the clinic to diminish human suffering and cure life-threatening diseases. Translational research (also referred to as translational medicine) facilitates the translation of investment in biomedical research into successful medical treatment. This includes the transfer of diagnostic and therapeutic advances by proving their efficacy in large evidence-based trials. Through the study of humans novel insights about disease are brought back to the laboratory to identify new, observation-based strategies. This “two-way road” (“bench to bedside and bedside to bench”) process includes formulating guidelines for drug development and principles for new therapeutic strategies; initiating clinical investigations that provide the biological basis for new therapies, and related clinical trials; defining therapeutic targets and clinical endpoints. It requires a systematic approach beginning with specimen sampling, patient data collection, laboratory investigations, data analysis, preclinical testing, clinical trials, treatment efficacy monitoring, and finally the evaluation of therapeutic result. The marathon well symbolizes the enormous efforts undertaken by clinicians, scientists, regulators, ethicists, patient advocates, drug developers, and others, coordinately attempting to overcome obstacles along this road toward the final “marathon goal in medicine”. PMID:19776705

  1. The Boston Marathon bombings: a post-event review of the robust emergency response.

    PubMed

    2013-07-01

    With as many as five level I trauma centers, Boston is well-positioned to mount an emergency response, but the two terrorist bombs that went off near the finish line of the city's annual marathon on April 15 put high levels of stress and demand on emergency personnel. In post-crisis reviews, hospital administrators say that all the emergency planning and drilling that they carry out on a regular basis was instrumental in helping them quickly care for nearly 200 victims while also securing their facilities at a time when the threat to the city was not well understood. Medical personnel working in tents on site at the marathon were able to respond to the injured quickly, while also giving area EDs a heads-up on what to expect. ED leaders report that a robust effort from the upper floors of their hospitals was critical in: helping them clear their EDs for incoming patients; establishing a security perimeter around the facilities to thoroughly check any people entering or leaving to guard against potential external threats; and focusing on improving how many extra staff show up to help during the crisis because it actually requires extra resources to manage the personnel. PMID:23828966

  2. Impact of different running distances on muscle and lymphocyte DNA damage in amateur marathon runners

    PubMed Central

    Ryu, Jae Hoon; Paik, Il Young; Woo, Jin Hee; Shin, Ki Ok; Cho, Su Youn; Roh, Hee Tae

    2016-01-01

    [Purpose] The aim of this study was to investigate the impact of different marathon running distances (10 km, 21 km, and 42.195 km) on muscle and lymphocyte DNA damage in amateur marathon runners. [Subjects and Methods] Thirty male amateur runners were randomly assigned to 10 km, 21 km, and 42 km groups, with 10 subjects in each group. Blood samples were collected before and after the races and on the 3rd day of recovery to examine levels of muscle damage (creatine kinase and lactate dehydrogenase) and lymphocyte DNA damage (DNA in the tail, tail length, and tail moment). [Results] Serum creatine kinase, serum lactate dehydrogenase, and tail moment were significantly higher after the races compared with before the races in all groups. In addition, the 42 km group showed significantly higher levels of creatine kinase, lactate dehydrogenase, and tail moment than the 10 km and 21 km groups after the races. [Conclusion] Strenuous endurance exercise can cause muscle and lymphocyte DNA damage, and the extent of such damage can increase as running distance increases. PMID:27065529

  3. The impact of a 24-h ultra-marathon on salivary antimicrobial protein responses.

    PubMed

    Gill, S K; Teixeira, A M; Rosado, F; Hankey, J; Wright, A; Marczak, S; Murray, A; Costa, R J S

    2014-10-01

    Depressed oral respiratory mucosal immunity and increased incidence of upper respiratory symptoms are commonly reported after bouts of prolonged exercise. The current study observed the impact of a 24-h continuous overnight ultra-marathon competition (distance range: 122-208 km; ambient temperature range: 0-20 °C) on salivary antimicrobial protein responses and incidence of upper respiratory symptoms. Body mass, unstimulated saliva and venous blood samples were taken from ultra-endurance runners (n=25) and controls (n=17), before and immediately after competition. Upper respiratory symptoms were assessed during and until 4-weeks after event completion. Samples were analyzed for salivary IgA, lysozyme, α-amylase and cortisol in addition to plasma osmolality. Decreased saliva flow rate (p<0.001), salivary IgA (p<0.001) and lysozyme (p=0.015) secretion rates, and increased salivary α-amylase secretion rate (p<0.001) and cortisol responses (p<0.001) were observed post-competition in runners, with no changes being observed in controls. No incidences of upper respiratory symptoms were reported by participants. A 24-h continuous overnight ultra-marathon resulted in the depression of some salivary antimicrobial protein responses, but no incidences of upper respiratory symptoms were evident during or following competition. Salivary antimicrobial protein synergism, effective management of non-infectious episodes, maintaining euhydration, and (or) favourable environmental influences could have accounted for the low prevalence of upper respiratory symptoms. PMID:24886918

  4. Imaging of abdominal and pelvic injuries from the Boston Marathon bombing.

    PubMed

    Singh, Ajay K; Sodickson, Aaron; Abujudeh, Hani

    2016-02-01

    The aim of this study is to describe the imaging findings of abdominal and pelvic injuries in victims of the Boston Marathon bombing. A retrospective review of 87 patients following the Boston Marathon bombing was performed to evaluate for abdominal and pelvic injuries on plain radiography or CT scans of the abdomen and pelvis. Imaging exams were evaluated for shrapnel, soft tissue injury, visceral damage, vascular disruption, and fractures. The injuries were classified as primary, secondary, tertiary, and quaternary blast injuries. Eleven of the 87 patients had positive findings in the abdomen or pelvis (M:F = 7:4, average age 34.6 years). There were 22 ball bearings, two nails, one screw, and two irregular metal fragments in the 11 patients with secondary blast (shrapnel) injuries. There was no peritoneal penetration or visceral injury seen in any of the patients. One patient had multiple transverse process fractures, representing tertiary blast injury. All but one patient had superficial penetrating abdominal or pelvic injuries secondary to shrapnel. There were no cases of bowel or solid visceral organ injuries due to the lack of peritoneal violation from the relatively low-powered explosions. Absence of peritoneal penetration by shrapnel indicates no need for laparotomy following low-powered explosions. PMID:26445949

  5. Pacing, packing and sex-based differences in Olympic and IAAF World Championship marathons.

    PubMed

    Hanley, Brian

    2016-09-01

    The aim of this study was to describe pacing profiles and packing behaviours of athletes in Olympic and World Championship marathons. Finishing and split times were collated for 673 men and 549 women across nine competitions. The mean speeds for each intermediate 5 km and end 2.2 km segments were calculated. Medallists of both sexes maintained even-paced running from 10 km onwards whereas slower finishers dropped off the lead pack at approximately half-distance. Athletes who ran with the same opponents throughout slowed the least in the second half (P < 0.001, men: ES ≥ 1.19; women: ES ≥ 1.06), whereas other strategies such as moving between packs or running alone were less successful. Overall, women slowed less (P < 0.001, ES = 0.44) and were more likely to run a negative split (P < 0.001), and their more conservative start meant fewer women dropped out (P < 0.001). This also meant that women medallists sped up in the final 2.2 km, which might have decided the medal positions. Marathon runners are advised to identify rivals with similar abilities and ambitions to run alongside provided they start conservatively. Coaches should note important sex-based differences in tactics adopted and design training programmes accordingly. PMID:26736042

  6. Detection of changes in the fractal scaling of heart rate and speed in a marathon race

    NASA Astrophysics Data System (ADS)

    Billat, Véronique L.; Mille-Hamard, Laurence; Meyer, Yves; Wesfreid, Eva

    2009-09-01

    The aim of this study was to detect changes in the fractal scaling behavior of heart rate and speed fluctuations when the average runner’s speed decreased with fatigue. Scaling analysis in heart rate (HR) and speed (S) dynamics of marathon runners was performed using the detrended fluctuation analysis (DFA) and the wavelet based structure function. We considered both: the short-range ( α1) and the long-range ( α2) scaling exponents for the DFA method separated by a change-point, n0=64=5.3 min (box length), the same for all the races. The variability of HR and S decreased in the second part of the marathon race, while the cardiac cost time series (i.e. the number of cardiac beats per meter) increased due to the decreasing speed behavior. The scaling exponents α1 and α2 of HR and α1 of S, increased during the race ( p<0.01) as did the HR wavelet scaling exponent ( τ). These findings provide evidence of the significant effect of fatigue induced by long exercise on the heart rate and speed variability.

  7. Detachment levels in the Marathon fold and thrust belt, west Texas

    NASA Astrophysics Data System (ADS)

    Chapman, James B.; McCarty, Reid S.

    2013-04-01

    Surface and subsurface data are integrated to characterize the structural architecture of the Marathon fold and thrust belt in west Texas. Multiple detachment levels are present within the thrust belt and result in distinct structural domains. In addition to the basal décollement, whose stratigraphic position varies along strike, we recognize a regionally extensive detachment zone in the late Mississippian to early Pennsylvanian lower Tesnus Formation. The Lower Tesnus Detachment forms a structural domain boundary that can be observed along strike in the surface data and at depth in the subsurface. The stratigraphic intervals above and below this detachment exhibit characteristic patterns of deformation. The Lower Tesnus Detachment is folded by imbrication and the formation of duplexes in the early Mississippian to Ordovician section, suggesting that the detachment may have initially formed as a perched décollement in the foreland that was subsequently exploited as a roof thrust in a duplex system as deformation progressed in a break-forward sequence and older strata were incorporated into the toe of the allochthonous wedge. The structural model presented here for the Marathon region may be applicable across much of the Ouachita orogenic system.

  8. Cumulative exposure to prior collective trauma and acute stress responses to the Boston marathon bombings.

    PubMed

    Garfin, Dana Rose; Holman, E Alison; Silver, Roxane Cohen

    2015-06-01

    The role of repeated exposure to collective trauma in explaining response to subsequent community-wide trauma is poorly understood. We examined the relationship between acute stress response to the 2013 Boston Marathon bombings and prior direct and indirect media-based exposure to three collective traumatic events: the September 11, 2001 (9/11) terrorist attacks, Superstorm Sandy, and the Sandy Hook Elementary School shooting. Representative samples of residents of metropolitan Boston (n = 846) and New York City (n = 941) completed Internet-based surveys shortly after the Boston Marathon bombings. Cumulative direct exposure and indirect exposure to prior community trauma and acute stress symptoms were assessed. Acute stress levels did not differ between Boston and New York metropolitan residents. Cumulative direct and indirect, live-media-based exposure to 9/11, Superstorm Sandy, and the Sandy Hook shooting were positively associated with acute stress responses in the covariate-adjusted model. People who experience multiple community-based traumas may be sensitized to the negative impact of subsequent events, especially in communities previously exposed to similar disasters. PMID:25896419

  9. [Evaluation of the diagnostic performance of Xpert MTB/RIF test for the detection of Mycobacterium tuberculosis and rifampin resistance in clinical samples].

    PubMed

    Gürsoy, Nafia Canan; Yakupoğulları, Yusuf; Tekerekoğlu, Mehmet Sait; Otlu, Barış

    2016-04-01

    Rapid and accurate detection of active tuberculosis (TB) cases is one of the most important goal of tuberculosis control programme. For this purpose, new methods are being developed to isolate, serotype and determine the drug resistance of the agent. Xpert MTB/RIF test (CepheidGeneXpert® System, USA) that has been recently developed, is a real-time polymerase chain reaction-based method which detects Mycobacterium tuberculosis complex and resistance of the strain to rifampicin (RIF) from the clinical sample directly within a couple of hours. However, there are not sufficient data about the performance of that test for extrapulmonary samples and pulmonary samples other than sputum. The aims of this study were to investigate the sensitivity, specificity, positive and negative predictive values of Xpert MTB/RIF test in detection of M. tuberculosis and the performance in the determination of rifampicin resistance of the isolates from pulmonary and extrapulmonary clinical samples. A total of 2160 clinical samples, in which 1141 (52.8%) were pulmonary and 1019 (47.2%) were extrapulmonary samples, sent to our laboratory between July 2013 to December 2014, were included in the study. Sixty seven of the evaluated samples (3.1%) were positive with microscopy (acid-fast stain; AFS), 116 samples (5.1%) were positive with culture and 98 samples (4.5%) were positive with Xpert MTB/RIF test. When the culture was considered as the reference method, the sensitivity and specificity of Xpert MTB/RIF test were determined as 73.3% and 99.3%, respectively for all samples; 77.5% and 99.5%, respectively for pulmonary samples and 63.9% and 99.2%, respectively for extrapulmonary samples. Among AFS positive samples, the sensitivity was 100% and specificity was 66.7%; whereas among AFS negative samples those values were 40.4% and 99.4%, respectively. Among all the samples involved in the study, RIF resistance was determined only in three samples with Xpert MTB/ RIF test and that was also

  10. Personal best marathon time and longest training run, not anthropometry, predict performance in recreational 24-hour ultrarunners.

    PubMed

    Knechtle, Beat; Knechtle, Patrizia; Rosemann, Thomas; Lepers, Romuald

    2011-08-01

    In recent studies, a relationship between both low body fat and low thicknesses of selected skinfolds has been demonstrated for running performance of distances from 100 m to the marathon but not in ultramarathon. We investigated the association of anthropometric and training characteristics with race performance in 63 male recreational ultrarunners in a 24-hour run using bi and multivariate analysis. The athletes achieved an average distance of 146.1 (43.1) km. In the bivariate analysis, body mass (r = -0.25), the sum of 9 skinfolds (r = -0.32), the sum of upper body skinfolds (r = -0.34), body fat percentage (r = -0.32), weekly kilometers ran (r = 0.31), longest training session before the 24-hour run (r = 0.56), and personal best marathon time (r = -0.58) were related to race performance. Stepwise multiple regression showed that both the longest training session before the 24-hour run (p = 0.0013) and the personal best marathon time (p = 0.0015) had the best correlation with race performance. Performance in these 24-hour runners may be predicted (r2 = 0.46) by the following equation: Performance in a 24-hour run, km) = 234.7 + 0.481 (longest training session before the 24-hour run, km) - 0.594 (personal best marathon time, minutes). For practical applications, training variables such as volume and intensity were associated with performance but not anthropometric variables. To achieve maximum kilometers in a 24-hour run, recreational ultrarunners should have a personal best marathon time of ∼3 hours 20 minutes and complete a long training run of ∼60 km before the race, whereas anthropometric characteristics such as low body fat or low skinfold thicknesses showed no association with performance. PMID:21642857

  11. Study of weather and thermal comfort influence on sport performance: prognostic analysis applied to Rio de Janeiro's city marathon

    NASA Astrophysics Data System (ADS)

    Pallotta, M.; Herdies, D. L.; Gonçalves, L. G.

    2013-05-01

    There is nowadays a growing interest in the influence and impacts of weather and climate in human life. The weather conditions analysis shows the utility of this type of tool when applied in sports. These conditions act as a differential in strategy and training, especially for outdoor sports. This study had as aim objective develop weather forecast and thermal comfort evaluation targeted to sports, and hoped that the results can be used to the development of products and weather service in the Olympic Games 2016 in Rio de Janeiro City. The use of weather forecast applied to the sport showed to be efficient for the case of Rio de Janeiro City Marathon, especially due to the high spatial resolution. The WRF simulations for the three marathons studied showed good results for temperature, atmospheric pressure, and relative humidity. On the other hand, the forecast of the wind showed a pattern of overestimation of the real situation in all cases. It was concluded that the WRF model provides, in general, more representative simulations from 36 hours in advance, and with 18 hours of integration they were even better, describing efficiently the synoptic situation that would be found. A review of weather conditions and thermal comfort at specific points of the marathon route showed that there are significant differences between the stages of the marathon, which makes possible to plan the competition strategy under the thermal comfort. It was concluded that a relationship between a situation more thermally comfortable (uncomfortable) and the best (worst) time in Rio de Janeiro City Marathon

  12. Magnetic behaviour of the MTbF6 fluoroterbates (M=Cd, Ca, Sr, (α/β)-Ba)

    NASA Astrophysics Data System (ADS)

    Josse, M.; El-Ghozzi, M.; Avignant, D.; André, G.; Bourée, F.; Isnard, O.

    2012-01-01

    Neutron powder diffraction has been performed on the MTbF6 fluorides (M=Cd, Ca, Sr, (α/β)-Ba). Four of these fluorides (Cd, Ca, Sr, β-Ba) are built of a (pseudo-) tetragonal packing of [TbF6]2- chains and only differs by the chains relative orientations. Thus this series represents a valuable opportunity to evaluate the Tb4+-Tb4+ magnetic interactions. All the compounds displayed antiferromagnetic order (TN=2.70 K (Cd), 2.15 K (Ca), 2.60 K (Sr), 2.10 K (β-Ba)), except for the α form of BaTbF6. The crystal structure of this latter fluoroterbate has also been investigated by means of high-resolution neutron powder diffraction. From Neutron Powder Diffraction data, CdTbF6 and β-BaTbF6 magnetic structures were determined, together with the metamagnetic behaviour of β-BaTbF6 as a function of an external magnetic field. A tentative phase diagram is then given for β-BaTbF6. Advantage was taken of the polymorphism of the BaTbF6 fluoroterbate to analyse, on the basis of topological parameters such as bond distances and angles, the magnetic behaviour of its α and β forms. It was shown that superexchange interactions are present in β-BaTbF6, and that these interactions may also rule the magnetic behaviour of the other MTbF6 (M=Ca, Sr, Cd) tetravalent terbium fluorides.

  13. Evaluation of the Efficiency of the Sample Inactivation Reagent in the Abbott RealTime MTB Assay for Inactivation of Mycobacterium tuberculosis

    PubMed Central

    Wallis, Carole; Pahalawatta, Vihanga; Frank, Andrea; Ramdin, Neeshan; Viana, Raquel; Abravaya, Klara; Leckie, Gregor; Tang, Ning

    2015-01-01

    The Abbott RealTime MTB assay is a nucleic acid amplification test (NAAT) for the detection of Mycobacterium tuberculosis complex DNA. The sample inactivation procedure used in the assay, consisting of one part sample treated with 3 parts inactivation reagent for 60 min, effectively reduced viscosity and inactivated M. tuberculosis in clinical specimens. PMID:26085611

  14. CFTR genotype-related body water and electrolyte balance during a marathon.

    PubMed

    Del Coso, J; Lara, B; Salinero, J J; Areces, F; Ruiz-Vicente, D; Gallo-Salazar, C; Abián-Vicén, J; Cacabelos, R

    2016-09-01

    The aim of this investigation was to determine the influence of CFTR genotype on body water and electrolyte balance during a marathon. Fifty-one experienced runners completed a marathon race. Before and after the race, body mass and a sample of venous blood were obtained. During the race, sweat samples were collected using sweat patches, and fluid and electrolyte intake were obtained using self-reported questionnaires. Thirty-eight participants (74.5% of the total) were 7T/7T homozygotes, 11 (21.6%) were 7T/9T heterozygotes, and one participant presented the rare genotype 5T/7T. Another participant with 9T/9T presented the mutation p.L206W. Participants with 7T/7T showed higher sweat sodium concentrations (42.2 ± 21.6 mmol/L) than 7T/9T (29.0 ± 24.7 mmol/L; P = 0.04). The runner with the 5T/7T genotype (10.2 mmol/L) and the participant with the p.L206W mutation (20.5 mmol/L) exhibited low-range sweat sodium concentrations. However, post-race serum sodium concentration was similar in 7T/7T and 7T/9T (142.1 ± 1.3 and 142.4 ± 1.6 mmol/L, respectively; P = 0.27) and did not show abnormalities in participants with the 5T/7T genotype (140.0 mmol/L) and the p.L206W mutation (143.0 mmol/L). Runners with the CFTR-7T/7T genotype exhibited increased sweat sodium concentrations during a marathon. However, this phenotype was not related with increased likelihood of suffering body water and electrolyte imbalances during real competitions. PMID:26282188

  15. Localized and Areally Extensive Alterations in Marathon Valley, Endeavour Crater Rim, Mars

    NASA Technical Reports Server (NTRS)

    Mittlefehldt, David W.; Gellert, Ralf; Van Bommel, Scott; Arvidson, Raymond E.; Clark, Benton C.; Cohen, Barbara A.; Farrand, William H.; Ming, Douglas W.; Schroeder, Christian; Yen, Albert S.; Jolliff, Bradley L.

    2016-01-01

    Mars Exploration Rover Opportunity is exploring the rim of 22 km diameter, Noachian-aged Endeavour crater. Marathon Valley cuts through the central region of the western rim providing a window into the local lower rim stratigraphic record. Spectra from the Compact Reconnaissance Imaging Spectrometer for Mars show evidence for the occurrence of Fe-Mg smectite in this valley, indicating areally extensive and distinct lithologic units and/or styles of aqueous alteration. The Alpha Particle X-ray Spectrometer has determined the compositions of 59 outcrop targets on untreated, brushed and abraded surfaces. Rocks in the Marathon Valley region are soft breccias composed of mm- to cm-sized darker clasts set in a lighter-toned, finegrained matrix. They are basaltic in non-volatile-element composition and compositionally similar to breccias investigated elsewhere on the rim. Alteration styles recorded in the rocks include: (1) Enrichments in Si, Al, Ti and Cr in more reddish-colored rock, consistent with leaching of more soluble cations and/or precipitation of Si +/- Al, Ti, Cr from fluids. Coprecipitation of Ge-rich phases with Si occurred in the western area only; high water:rock is indicated. Pancam multispectral observations indicate higher nanophase ferric oxide contents, but the rocks have lower Fe contents. The highly localized nature of the red zones indicate they cannot be the source of the widespread smectite signature observed from orbit. (2) Outcrops separated by approximately 65 m show common compositional changes between brushed and abraded (approximately 1 mm deep) targets: increases in S and Mg; decreases in Al, Cl and Ca. These changes are likely due to relatively recent, surface-related alteration of valley rocks and formation of surface coatings under low water:rock. (3) One target, from the center of a region of strong CRISM smectite signature, shows modest differences in composition (higher Si, K; lower Mn) compared to most Marathon Valley rocks, while

  16. Accuracy of Lipoarabinomannan and Xpert MTB/RIF Testing in Cerebrospinal Fluid To Diagnose Tuberculous Meningitis in an Autopsy Cohort of HIV-Infected Adults

    PubMed Central

    Lukande, Robert L.; Kalungi, Sam; Van Marck, Eric; Lammens, Martin; Van de Vijver, Koen; Kambugu, Andrew; Nelson, Ann M.; Colebunders, Robert; Manabe, Yukari C.

    2015-01-01

    Point-of-care tests for tuberculous meningitis (TBM) are needed. We studied the diagnostic accuracy of the lipoarabinomannan (LAM) lateral flow assay (LFA), LAM enzyme-linked immunosorbent assay (ELISA), and Xpert MTB/RIF in cerebrospinal fluid (CSF) in an autopsy cohort of Ugandan HIV-infected adults. We obtained written informed consent postmortem from the next of kin. A complete autopsy was done and CSF obtained. We performed LAM LFA (on unprepared and supernatant CSF after heating and spinning), LAM ELISA, and Xpert MTB/RIF on the CSF samples. Accuracy parameters were calculated for histopathological TBM and also for the composite standard, including Xpert MTB/RIF-positive cases. We tested CSF of 91 patients. LAM LFA had a sensitivity of 75% for definite histopathological TBM, ELISA a sensitivity of 43%, and Xpert MTB/RIF a sensitivity of 100% and specificities of 87%, 91%, and 87%, respectively. LAM LFA had a sensitivity of 50% for definite and probable histopathological TBM, ELISA a sensitivity of 38%, and Xpert MTB/RIF a sensitivity of 86% and specificities of 70%, 91%, and 87%, respectively. LAM LFA had a sensitivity of 68% for the composite standard and ELISA a sensitivity of 48% and specificities of 78% and 98%, respectively. The rapid diagnostic tests detected TBM in 22% to 78% of patients not on anti-TB treatment. Point-of-care tests have high accuracy in diagnosis of TBM in deceased HIV-infected adults. LAM LFA in CSF is a useful additional diagnostic tool. PMID:26063865

  17. Personal best times in an Olympic distance triathlon and in a marathon predict Ironman race time in recreational male triathletes

    PubMed Central

    Rüst, Christoph Alexander; Knechtle, Beat; Knechtle, Patrizia; Rosemann, Thomas; Lepers, Romuald

    2011-01-01

    Background The purpose of this study was to define predictor variables for recreational male Ironman triathletes, using age and basic measurements of anthropometry, training, and previous performance to establish an equation for the prediction of an Ironman race time for future recreational male Ironman triathletes. Methods Age and anthropometry, training, and previous experience variables were related to Ironman race time using bivariate and multivariate analysis. Results A total of 184 recreational male triathletes, of mean age 40.9 ± 8.4 years, height 1.80 ± 0.06 m, and weight 76.3 ± 8.4 kg completed the Ironman within 691 ± 83 minutes. They spent 13.9 ± 5.0 hours per week in training, covering 6.3 ± 3.1 km of swimming, 194.4 ± 76.6 km of cycling, and 45.0 ± 15.9 km of running. In total, 149 triathletes had completed at least one marathon, and 150 athletes had finished at least one Olympic distance triathlon. They had a personal best time of 130.4 ± 44.2 minutes in an Olympic distance triathlon and of 193.9 ± 31.9 minutes in marathon running. In total, 126 finishers had completed both an Olympic distance triathlon and a marathon. After multivariate analysis, both a personal best time in a marathon (P < 0.0001) and in an Olympic distance triathlon (P < 0.0001) were the best variables related to Ironman race time. Ironman race time (minutes) might be partially predicted by the following equation: (r2 = 0.65, standard error of estimate = 56.8) = 152.1 + 1.332 × (personal best time in a marathon, minutes) + 1.964 × (personal best time in an Olympic distance triathlon, minutes). Conclusion These results suggest that, in contrast with anthropometric and training characteristics, both the personal best time in an Olympic distance triathlon and in a marathon predict Ironman race time in recreational male Ironman triathletes. PMID:24198578

  18. Marathon runners presented lower serum cholesteryl ester transfer activity than sedentary subjects.

    PubMed

    Serrat-Serrat, J; Ordóñez-Llanos, J; Serra-Grima, R; Gómez-Gerique, J A; Pellicer-Thoma, E; Payés-Romero, A; González-Sastre, F

    1993-06-01

    Acute exercise promotes raised HDL cholesterol concentrations by lipolysis stimulation, but this effect is insufficient to explain the more permanent HDL increases seen during regular exercise. During training periods in a group of marathon runners, we measured lipid transfer protein I (LTP-I)-mediated cholesteryl ester transfer activity (CETA) and its relationship to their HDL concentrations. Runners of both sexes showed significantly lower CETA values than those of sedentary controls. Male runners also had significantly lower serum concentrations of triglyceride, VLDL cholesterol and apolipoprotein B, and significantly higher concentrations of HDL cholesterol and apolipoprotein A-I than male controls. Results indicate that regular practice of aerobic exercise promotes modifications of lipoprotein metabolism related not only to lipolysis, but also to lower CETA. Such modifications are associated with reduced risk of atherosclerosis. PMID:8216501

  19. Psychiatry department response to the Boston Marathon bombings within a level-1 trauma center.

    PubMed

    Oser, Megan; Shah, Sejal B; Gitlin, David

    2015-01-01

    In this article we present how the consultation-liaison and psychology divisions of an academic medical center's Department of Psychiatry responded in the first week after the Boston Marathon bombings, specifically in the context of disaster response guidelines and evidence-based approaches to acute trauma. Since the department had to address several complicated matters at multiple levels within the hospital system, we highlight unexpected issues unique to this particular event as they arose within the primary domains of our involvement. This article aims to (1) provide a descriptive analysis of how we enacted disaster and trauma guidelines and evidence-based care within a hospital setting, (2) shed light on the unique and unexpected administrative and systemic issues encountered in our response, and (3) discuss lessons learned, including opportunities to improve trauma-related care. PMID:25943313

  20. Threat perception after the Boston Marathon bombings: The effects of personal relevance and conceptual framing.

    PubMed

    Wormwood, Jolie Baumann; Lynn, Spencer K; Feldman Barrett, Lisa; Quigley, Karen S

    2016-01-01

    We examined how the Boston Marathon bombings affected threat perception in the Boston community. In a threat perception task, participants attempted to "shoot" armed targets and avoid shooting unarmed targets. Participants viewing images of the bombings accompanied by affectively negative music and text (e.g., "Terror Strikes Boston") made more false alarms (i.e., more errors "shooting" unarmed targets) compared to participants viewing the same images accompanied by affectively positive music and text (e.g., "Boston Strong") and participants who did not view bombing images. This difference appears to be driven by decreased sensitivity (i.e., decreased ability to distinguish guns from non-guns) as opposed to a more liberal bias (i.e., favouring the "shoot" response). Additionally, the more strongly affected the participant was by the bombings, the more their sensitivity was reduced in the negatively framed condition, suggesting that this framing was particularly detrimental to the most vulnerable individuals in the affected community. PMID:25707419

  1. Dose-response relationship of autonomic nervous system responses to individualized training impulse in marathon runners.

    PubMed

    Manzi, Vincenzo; Castagna, Carlo; Padua, Elvira; Lombardo, Mauro; D'Ottavio, Stefano; Massaro, Michele; Volterrani, Maurizio; Iellamo, Ferdinando

    2009-06-01

    In athletes, exercise training induces autonomic nervous system (ANS) adaptations that could be used to monitor training status. However, the relationship between training and ANS in athletes has been investigated without regard for individual training loads. We tested the hypothesis that in long-distance athletes, changes in ANS parameters are dose-response related to individual volume/intensity training load and could predict athletic performance. A spectral analysis of heart rate (HR), systolic arterial pressure variability, and baroreflex sensitivity by the sequences technique was investigated in eight recreational athletes during a 6-mo training period culminating with a marathon. Individualized training load responses were monitored by a modified training impulse (TRIMP(i)) method, which was determined in each athlete using the individual HR and lactate profiling determined during a treadmill test. Monthly TRIMP(i) steadily increased during the training period. All the ANS parameters were significantly and very highly correlated to the dose of exercise with a second-order regression model (r(2) ranged from 0.90 to 0.99; P < 0.001). Variance, high-frequency oscillations of HR variability (HRV), and baroreflex sensitivity resembled a bell-shaped curve with a minimum at the highest TRIMP(i), whereas low-frequency oscillations of HR and systolic arterial pressure variability and the low frequency (LF)-to-high frequency ratio resembled an U-shaped curve with a maximum at the highest TRIMP(i). The LF component of HRV assessed at the last recording session was significantly and inversely correlated to the time needed to complete the nearing marathon. These results suggest that in recreational athletes, ANS adaptations to exercise training are dose related on an individual basis, showing a progressive shift toward a sympathetic predominance, and that LF oscillations in HRV at peak training load could predict athletic achievement in this athlete population. PMID

  2. ADJUSTMENT AMONG CHILDREN WITH RELATIVES WHO PARTICIPATED IN THE MANHUNT FOLLOWING THE BOSTON MARATHON ATTACK

    PubMed Central

    Comer, Jonathan S.; Kerns, Caroline E.; Elkins, R. Meredith; Edson, Aubrey L.; Chou, Tommy; Dantowitz, Annie; Miguel, Elizabeth; Brown, Bonnie; Coxe, Stefany; Green, Jennifer Greif

    2014-01-01

    Background Following the Boston Marathon attack, the extraordinary interagency manhunt and shelter-in-place made for a truly unprecedented experience for area families. Although research on Boston youth has found robust associations between manhunt-related experiences and post-attack functioning, such work does little to identify the specific needs of a particularly vulnerable population—i.e., children with a relative who participated in the manhunt. Understanding the adjustment of these youth is critical for informing clinical efforts. Methods Survey of Boston-area parents/caretakers (N = 460) reporting on their child’s attack/manhunt-related experiences, as well as psychosocial functioning in the first six post-attack months; analyses compared youth with and without a relative in law enforcement or the armed services who participated in the manhunt. Results The proportion of youth with likely PTSD was 5.7 times higher among youth with relatives in the manhunt than among youth without. After accounting for child demographics, blast exposure, and children’s own exposure to manhunt events (e.g., hearing/seeing gunfire/explosions, having officers enter/search home), having a relative in the manhunt significantly predicted child PTSD symptoms, emotional symptoms, and hyperactivity/inattention. Fear during the manhunt that a loved one could be hurt mediated relationships between having a relative in the manhunt and clinical outcomes; living within the zone of greatest manhunt activity did not moderate observed relationships. Conclusions Children with relatives called upon to participate in the unprecedented interagency manhunt following the Boston Marathon attack carried a particularly heavy mental health burden. Continued research is needed to clarify the clinical needs of youth with relatives in high-risk occupations. PMID:24865569

  3. School- and Classroom-Based Supports for Children Following the 2013 Boston Marathon Attack and Manhunt

    PubMed Central

    Holt, Melissa K.; Kwong, Lana; Reid, Gerald; Xuan, Ziming; Comer, Jonathan S.

    2015-01-01

    School staff provide key mental health services following mass crisis events and teachers, in particular, can provide important supports within their classrooms. This study examines Boston-area teachers’ perception of classroom-wide psychiatric distress and the types of supports that schools and teachers provided following the 2013 Boston Marathon bombing and subsequent manhunt. Boston-area K-12 teachers (N = 147) in communities with varying levels of exposure to the bombing and manhunt completed an anonymous web-based survey 2–5 months after the attack. Teachers reported on students’ exposure to the bombings and manhunt, classroom-wide psychiatric distress, and the types of supports they and their schools provided students. Teacher reports of student exposure to the bombings and manhunt were significantly associated with their perceptions of greater classroom-wide psychiatric distress. Almost half indicated that their school had no formal policy for responding to the crisis, half reported no training to address events, and even the most common classroom-based support strategy—reassuring students of their safety—was provided by only 76 % of teachers. Teacher perceptions of student exposure to the manhunt, but not the bombing, were significantly associated with greater provision of these supports. In the aftermath of the Boston Marathon bombings and manhunt, teachers and schools provided supports; however, the extent and types of supports varied considerably. Working with teachers to most effectively and consistently serve in this complex role has the potential to improve school-based crisis response plans, as well as student outcomes. PMID:26005502

  4. Magnetic behaviour of the MTbF{sub 6} fluoroterbates (M=Cd, Ca, Sr, ({alpha}/{beta})-Ba)

    SciTech Connect

    Josse, M.; El-Ghozzi, M.; Avignant, D.; Andre, G.; Bouree, F.; Isnard, O.

    2012-01-15

    Neutron powder diffraction has been performed on the MTbF{sub 6} fluorides (M=Cd, Ca, Sr, ({alpha}/{beta})-Ba). Four of these fluorides (Cd, Ca, Sr, {beta}-Ba) are built of a (pseudo-) tetragonal packing of [TbF{sub 6}]{sup 2-} chains and only differs by the chains relative orientations. Thus this series represents a valuable opportunity to evaluate the Tb{sup 4+}-Tb{sup 4+} magnetic interactions. All the compounds displayed antiferromagnetic order (T{sub N}=2.70 K (Cd), 2.15 K (Ca), 2.60 K (Sr), 2.10 K ({beta}-Ba)), except for the {alpha} form of BaTbF{sub 6}. The crystal structure of this latter fluoroterbate has also been investigated by means of high-resolution neutron powder diffraction. From Neutron Powder Diffraction data, CdTbF{sub 6} and {beta}-BaTbF{sub 6} magnetic structures were determined, together with the metamagnetic behaviour of {beta}-BaTbF{sub 6} as a function of an external magnetic field. A tentative phase diagram is then given for {beta}-BaTbF{sub 6}. Advantage was taken of the polymorphism of the BaTbF{sub 6} fluoroterbate to analyse, on the basis of topological parameters such as bond distances and angles, the magnetic behaviour of its {alpha} and {beta} forms. It was shown that superexchange interactions are present in {beta}-BaTbF{sub 6}, and that these interactions may also rule the magnetic behaviour of the other MTbF{sub 6} (M=Ca, Sr, Cd) tetravalent terbium fluorides. - Graphical abstract: Powder neutron diffraction revealed magnetic order in four of the five investigated fluoroterbates, while crystal chemical analyses of {alpha} and {beta} forms of BaTbF{sub 6} evidenced the existence of superexchange interactions. Highlights: Black-Right-Pointing-Pointer Five fluoroterbates are investigated by Powder Neutron Diffraction (PND). Black-Right-Pointing-Pointer Four of them are antiferromagnetically ordered at 1.4 K. Black-Right-Pointing-Pointer Magnetic structures of {beta}-BaTbF{sub 6} and CdTbF{sub 6} are determined. Black

  5. Evading the fate of Pheidippides: acute coronary thrombosis in a young marathon runner with minimal atherosclerosis but sickle cell trait.

    PubMed

    Murray, Scott W; Cooper, Robert M; Mills, Joseph D; Palmer, Nicholas D

    2015-08-01

    Marathon running transiently increases the risk of sudden cardiac death. Some previous studies have suggested that this is due to relatively advanced but asymptomatic atherosclerosis. Other theories suggest that potentiation of inflammation and the coagulation cascade, by extremes of exertion, is more important. We present a clinical case of a young, previously fit athlete who felt chest discomfort eight miles into a marathon but finished the race. Shortly after completion he felt very unwell and had chest pain. Ambulance electrocardiograms showed evidence of an evolving anterior myocardial infarction. Invasive assessment with coronary angiography and intravascular ultrasound was able to show the mechanism of thrombosis. Fissuring of a small rim of atherosclerosis potentiated a large pro-thrombotic response, the patient was also found to have sickle cell trait. Medical treatment with blood thinning drugs was able to restore normality to the vessel over a period of two weeks, without the need for angioplasty or stent implantation. PMID:26331117

  6. Isolation and Characterization of a Novel Magnetotactic Bacterium From Iran: Iron Uptake and Producing Magnetic Nanoparticles in Alphaproteobacterium MTB-KTN90

    PubMed Central

    Tajer Mohammad Ghazvini, Parisa; Kermanshahi, Rouha Kasra; Nozad Golikand, Ahmad; Sadeghizadeh, Majid

    2014-01-01

    Background: Magnetotactic bacteria (MTB) have the ability to biomineralize unique intracellular magnetic nanosize particles. These bacteria and their magnetosomes are under special attraction because of their great useful potential in nano-biotechnological and biomedical applications. MTB are ubiquitous in aquatic environments, but their isolation and axenic cultivation in pure culture is very difficult and only a limited number of them have been isolated in pure culture. Objectives: The main goal of this study was screening, isolation and cultivation of a new strain of these fastidious bacteria in pure culture from Iran to use them and their magnetosomes. Materials and Methods: Thirty samples were collected from various aquatic habitats. Most important physicochemical environmental factors that are involved in growth of MTB in the microcosms were investigated using inductively coupled plasma atomic emission spectroscopy (ICP-AES), portable dissolved oxygen meter, etc. Capillary racetrack technique and magnetic separation were used to purify and enrich MTB. Various isolation media were simultaneously used for isolation of a new magnetotactic bacterium in pure culture. Two imaging techniques were used to visualize the characterizations and cell division: transmission electron microscopy (TEM) and field-emission scanning electron microscopy (FESEM). Polymerase chain reaction (PCR), ChromasPro software and MEGA5 were applied for sequence analysis of the 16S rRNA gene. Results: The results revealed a correlation of important physicochemical factors such as pH and iron with growth and blooms of these bacteria in the microcosms. New strain MTB-KTN90 was isolated in a modified isolation medium at microaerophilic zone from Anzali lagoon, Iran and cultured in a modified growth medium subsequently. The phylogenetic analysis showed that the strain belongs to Alphaproteobacteria. Growth and iron uptake studies indicated an important role by this bacterium in the iron

  7. Write-a-Thon: How To Conduct a Writing Marathon in Your Third-to-Fifth-Grade Class.

    ERIC Educational Resources Information Center

    Wilde, Susie

    This book takes the elementary school teacher through all the paces needed to conduct a 2-day writing marathon in the classroom. According to the book, working as a team and having the opportunity to write without interruption are the main goals of a "write-a-thon," but play is a key element to its success. The book explains step-by-step how to:…

  8. A case of unprovoked venous thromboembolism in a marathon athlete presenting atypical sequelae: What are the chances?

    PubMed

    Hull, C M; Hopkins, C L; Purdy, N J; Lloyd, R C; Harris, J A

    2015-10-01

    Marathon runners are exposed to multiple thrombogenic risk factors including dehydration and hemoconcentration, injury and inflammation, long-distance travel between events, and contraceptive usage. However, despite awareness about thromboembolism and several case reports detailing life-threatening hypercoagulopathies in athletes, the prevalence of venous thromboembolism in marathon runners remains uncharted. There is a lack of data and evidence-based guidelines for these athletes and for healthcare providers, including general medical practitioners and sports physicians. We present an episode of unprovoked deep vein thrombosis (DVT) and pulmonary embolism (PE) in a female marathon athlete who presented with atypical sequelae over the course of 8 months, and identify some "easy-to-miss" warning signs and symptoms. Through dialogue with the patient regarding their personal questions and anxieties surrounding idiopathic DVT-PE, we identify a clear need for more accessible information and comprehensive research concerning the detection, prevalence, and long-term management of venous thromboembolism in athletes. We discuss the possibility that being an athlete might constitute a more significant risk factor for venous thromboembolism than is currently estimated by commonly used diagnostic protocols and conclude that there is quite possibly a need for more specific clinical guidelines for athletes in this area. PMID:24869910

  9. Power law scaling behavior of physiological time series in marathon races using wavelet leaders and detrended fluctuation analysis

    NASA Astrophysics Data System (ADS)

    Wesfreid, Eva; Billat, Véronique

    2009-02-01

    Data power law scaling behavior is observed in many fields. Velocity of fully developed turbulent flow, telecommunication traffic in networks, financial time series are some examples among many others. The goal of the present contribution is to show the scaling behavior of physiological time series in marathon races using wavelet leaders and the Detrended Fluctuation Analysis. Marathon race is an exhausting exercise, it is referenced as being a model for studying the limits of human ambulatory abilities. We analyzed the athlete's heart rate and speed time series recorded simultaneously. We find that the heart cost time series, number of heart beats per meter, increases with the fatigue appearing during the marathon race, its tendency grows in the second half of the race for all athletes. For most physiological time series, we observed a concave behavior of the wavelet leaders scaling exponents which suggests a multifractal behavior. Otherwise, the Detrended Fluctuation Analysis shows short and long range time-scale power law exponents with the same break point for each physiological time series and each athlete. The short range time-scale exponent increases with fatigue in most physiological signals.

  10. Countrywide roll-out of Xpert® MTB/RIF in Swaziland: the first three years of implementation

    PubMed Central

    Dlamini, T.; Khumalo, D.; Maphalala, G.; Dlamini, S.; Zikalala, T.; Albert, H.; Wambugu, J.; Tayler-Smith, K.; Ali, E.; Ade, S.; Harries, A. D.

    2015-01-01

    Setting: All 19 public health laboratories in Swaziland that had Xpert® MTB/RIF machines installed as part of a countrywide roll-out between June 2011 and June 2014. Objective: To evaluate the utilisation and functionality of Xpert from 2011 to mid-2014. Design: Descriptive study of Xpert implementation using routinely collected data. Results: Of 48 829 Xpert tests conducted, 93% were successful: 14% detected Mycobacterium tuberculosis and 12% showed rifampicin resistance. The most common cause of unsuccessful tests was an ‘Error’ result (62%). Similar findings were obtained in government-supported and partner-supported laboratories. Annual utilisation of Xpert improved from 51% of maximum capacity in 2011 and 2012 to 74% in 2013 and 2014. A monitoring and supervision exercise of all Xpert testing sites in 2014 showed a generally good performance, with over 50% of laboratories achieving a ⩾80% score on most components. However, poor scores were obtained with equipment use and maintenance (6% achieving a score of ⩾80%), internal audit (19% achieving a score of ⩾80%) and process control (25% achieving a score of ⩾80%). Conclusion: Countrywide roll-out of Xpert in Swaziland has been successful, although operational issues have been identified and need to be resolved. PMID:26400386

  11. The patient impact of point-of-care vs. laboratory placement of Xpert® MTB/RIF

    PubMed Central

    Hanrahan, C. F.; Clouse, K.; Bassett, J.; Mutunga, L.; Selibas, K.; Stevens, W.; Scott, L.; Sanne, I.; Van Rie, A.

    2015-01-01

    SUMMARY BACKGROUND The Xpert® MTB/RIF assay can diagnose tuberculosis (TB) rapidly and with great accuracy. The effect of Xpert placement at point of care (POC) vs. at an off-site laboratory on patient management remains unknown. DESIGN At a primary care clinic in Johannesburg, South Africa, we compared TB diagnosis and treatment initiation among 1861 individuals evaluated for pulmonary TB using Xpert performed either at POC or offsite. RESULTS When Xpert was performed at POC, a higher proportion of Xpert-positive individuals started treatment (95% vs. 87%, P = 0.047) and time to treatment initiation was shorter (median 0 vs. 5 days, P < 0.001). In contrast, among Xpert-negative TB cases, a higher proportion (87% vs. 72%, P =0.001) started treatment when the sample was sent to the laboratory, with a shorter time to treatment (median 9 vs. 13 days, P = 0.056). While the overall proportion of presumed TB patients starting treatment was independent of Xpert placement, the proportion started based on a bacteriologically confirmed diagnosis was higher when Xpert was performed at POC (73% vs. 58%, P = 0.006). CONCLUSIONS Placement of Xpert at POC resulted in more Xpert-positive patients receiving treatment, but did not increase the total number of presumed TB patients starting treatment. When samples were sent to a laboratory for Xpert testing, empiric decision making increased. PMID:26056107

  12. Rollout of Xpert® MTB/RIF in Northwest Cambodia for the diagnosis of tuberculosis among PLHA

    PubMed Central

    Auld, S. C.; Killam, W. P.; Eng, B.; Nong, K.; Pevzner, E. C.; Eam, K. K.; Eang, M. T.; Warren, D.; Whitehead, S. J.

    2014-01-01

    Objective: To describe the implementation and utilization of the Xpert® MTB/RIF (Xpert) assay to diagnose tuberculosis (TB) among people living with the human immunodeficiency virus/acquired immune-deficiency syndrome (HIV/AIDS, PLHA) in Cambodia. Design: Following the rollout of Xpert, an evaluation was conducted in four provinces of Cambodia from March to December 2012 to determine the utilization, performance, and turnaround time (TAT) of Xpert among PLHA. Data were collected from paper-based patient registers. Results: Of 497 PLHA with a positive TB symptom screen, 357 (72%) were tested with smear microscopy, and 250 (50%) with Xpert; 25 (10%) PLHA tested with Xpert were positive for TB and none were rifampicin-resistant. The utilization of Xpert increased from 23% to 75%, with a median TAT of 1 day. Across districts, utilization ranged from zero to 85%, while the TAT ranged from zero to 22 days. Conclusion: While early data show increasing utilization of Xpert for PLHA with a positive symptom screen, most patients underwent smear microscopy as an initial diagnostic test. Training delays and challenges associated with specimen referral may have contributed to variability in Xpert uptake and TAT, particularly for sites without onsite Xpert testing. Enhanced programmatic support, particularly for specimen referral and results reporting, may facilitate appropriate utilization. PMID:26400699

  13. GeneXpert MTB/Rif to Diagnose Tuberculous Meningitis: Perhaps the First Test but not the Last.

    PubMed

    Bahr, Nathan C; Marais, Suzaan; Caws, Maxine; van Crevel, Reinout; Wilkinson, Robert J; Tyagi, Jaya S; Thwaites, Guy E; Boulware, David R

    2016-05-01

    Tuberculous meningitis (TBM) is the most severe form of tuberculous with substantial mortality. In May 2015, 54 researchers from 10 countries met in Da Lat, Vietnam, to discuss advances in TBM. Among the attendees were researchers involved in pivotal studies on the use of Xpert MTB/Rif for TBM diagnosis. Attendees discussed the 2014 World Health Organization strong recommendation favoring the use of Xpert "in preference to conventional microscopy and culture as the initial diagnostic test for cerebrospinal fluid (CSF) if the sample volume is low or if additional specimens cannot be obtained to make a quick diagnosis." Attendees were concerned that the limitations of Xpert testing for TBM are not emphasized. Clear guidance is needed for the investigational pathway for TBM, including recommendations on the diagnostic package of investigations, which does not stop with Xpert testing. Second, emphasis on the large CSF volumes (ideally 8-10 mL) needed for Xpert testing is required. Guidelines should also emphasize that TBM is a medical emergency and early treatment reduces mortality. PMID:26966284

  14. Diagnosis and treatment of TB patients with rifampicin resistance detected using Xpert® MTB/RIF in Zimbabwe

    PubMed Central

    Ade, S.; Harries, A. D.; Ncube, R. T.; Zishiri, C.; Sandy, C.; Mutunzi, H.; Takarinda, K.; Owiti, P.; Mafaune, P.; Chonzi, P.

    2016-01-01

    Setting: In Zimbabwe, there are concerns about the management of tuberculosis (TB) patients with rifampicin (RMP) resistance diagnosed using Xpert® MTB/RIF. Objective: To assess linkages between diagnosis and treatment for these patients in Harare and Manicaland provinces in 2014. Design: A retrospective cohort study. Results: Of 20 329 Xpert assays conducted, 90% were successful, 11% detected Mycobacterium tuberculosis and 4.5% showed RMP resistance. Of 77 patients with RMP-resistant TB diagnosed by Xpert, 70% had samples sent to the reference laboratory for culture and drug susceptibility testing (CDST); 53% of the samples arrived. In 21% the samples showed M. tuberculosis growth, and in 17% the DST results were recorded, all of which confirmed RMP resistance. Of the 77 patients, 34 (44%) never started treatment for multidrug-resistant (MDR) TB, with documented reasons being death, loss to follow-up and incorrect treatment. Of the 43 patients who started MDR-TB treatment, 12 (71%) in Harare and 17 (65%) in Manicaland started within 2 weeks of diagnosis. Conclusion: Xpert has been rolled out successfully in two Zimbabwe provinces. However, the process of confirming CDST for Xpert-diagnosed RMP-resistant TB works poorly, and many patients are either delayed or never initiate MDR-TB treatment. These shortfalls must be addressed at the programmatic level. PMID:27358806

  15. Yield of intensified tuberculosis case-finding activities using Xpert® MTB/RIF among risk groups in Nepal

    PubMed Central

    Baral, S.; Shrestha, P.; Puri, M.; Kandel, S.; Lamichanne, B.; Elsey, H.; Brouwer, M.; Goel, S.; Chinnakali, P.

    2016-01-01

    Setting: Twenty-two districts of Nepal, where intensified case-finding (ICF) activities for tuberculosis (TB) were implemented among risk groups under the TB REACH initiative in collaboration with the National TB Programme from July 2013 to November 2015. Objectives: To assess the yield of TB screening using an algorithm with smear microscopy followed by Xpert® MTB/RIF. Design: A descriptive study using routinely collected data. Results: Of 145 679 individuals screened, 28 574 (19.6%) had presumptive TB; 1239 (4.3%) of these were diagnosed with TB and 1195 (96%) were initiated on anti-tuberculosis treatment. The yield of screening was highest among people living with the human immunodeficiency virus (PLHIV) (6.1%), followed by household contacts (3.5%) and urban slum dwellers (0.5%). Among other risk groups, such as prisoners, factory workers, refugees and individuals with diabetes, the yield was less than 0.5%. The number needed to screen to diagnose an active TB case was 17 for PLHIV, 29 for household contacts and 197 for urban slum dwellers. Of 11 525 patients from ICF and the routine programme, 112 (1%) were diagnosed with multidrug-resistant TB. Conclusion: There was a substantial yield of TB cases among risk groups such as PLHIV and household contacts. Although the yield in urban slum dwellers was found to be moderate, some intervention should nonetheless be targeted because of the large population and poor access to care in this group. PMID:27358808

  16. Effects of the fusion design and immunization route on the immunogenicity of Ag85A-Mtb32 in adenoviral vectored tuberculosis vaccine.

    PubMed

    Zhang, Yiling; Feng, Liqiang; Li, Liang; Wang, Dimin; Li, Chufang; Sun, Caijun; Li, Pingchao; Zheng, Xuehua; Liu, Yichu; Yang, Wei; Niu, Xuefeng; Zhong, Nanshan; Chen, Ling

    2015-01-01

    Vaccines containing multiple antigens may induce broader immune responses and provide better protection against Mycobacterium tuberculosis (Mtb) infection as compared to a single antigen. However, strategies for incorporating multiple antigens into a single vector and the immunization routes may affect their immunogenicity. In this study, we utilized recombinant adenovirus type 5 (rAd5) as a model vaccine vector, and Ag85A (Rv3804c) and Mtb32 (Rv0125) as model antigens, to comparatively evaluate the influence of codon usage optimization, signal sequence, fusion linkers, and immunization routes on the immunogenicity of tuberculosis (TB) vaccine containing multiple antigens in C57BL/6 mice. We showed that codon-optimized Ag85A and Mtb32 fused with a GSG linker induced the strongest systemic and pulmonary cell-mediated immune (CMI) responses. Strong CMI responses were characterized by the generation of a robust IFN-γ ELISPOT response as well as antigen-specific CD4(+) T and CD8(+) T cells, which secreted mono-, dual-, or multiple cytokines. We also found that subcutaneous (SC) and intranasal (IN)/oral immunization with this candidate vaccine exhibited the strongest boosting effects for Mycobacterium bovis bacille Calmette-Guérin (BCG)-primed systemic and pulmonary CMI responses, respectively. Our results supported that codon optimized Ag85A and Mtb32 fused with a proper linker and immunized through SC and IN/oral routes can generate the strongest systemic and pulmonary CMI responses in BCG-primed mice, which may be particularly important for the design of TB vaccines containing multiple antigens. PMID:26076321

  17. A Prospective Study of the Prevalence of Tuberculosis and Bacteraemia in Bangladeshi Children with Severe Malnutrition and Pneumonia Including an Evaluation of Xpert MTB/RIF Assay

    PubMed Central

    Chisti, Mohammod Jobayer; Graham, Stephen M.; Duke, Trevor; Ahmed, Tahmeed; Ashraf, Hasan; Faruque, Abu Syed Golam; La Vincente, Sophie; Banu, Sayera; Raqib, Rubhana; Salam, Mohammed Abdus

    2014-01-01

    Background Severe malnutrition is a risk factor for pneumonia due to a wide range of pathogens but aetiological data are limited and the role of Mycobacterium tuberculosis is uncertain. Methods We prospectively investigated severely malnourished young children (<5 years) with radiological pneumonia admitted over a 15-month period. Investigations included blood culture, sputa for microscopy and mycobacterial culture. Xpert MTB/RIF assay was introduced during the study. Study children were followed for 12 weeks following their discharge from the hospital. Results 405 eligible children were enrolled, with a median age of 10 months. Bacterial pathogens were isolated from blood culture in 18 (4.4%) children, of which 72% were Gram negatives. Tuberculosis was confirmed microbiologically in 7% (27/396) of children that provided sputum - 10 by culture, 21 by Xpert MTB/RIF assay, and 4 by both tests. The diagnostic yield from induced sputum was 6% compared to 3.5% from gastric aspirate. Sixty (16%) additional children had tuberculosis diagnosed clinically that was not microbiologically confirmed. Most confirmed tuberculosis cases did not have a positive contact history or positive tuberculin test. The sensitivity and specificity of Xpert MTB/RIF assay compared to culture was 67% (95% CI: 24–94) and 92% (95% CI: 87–95) respectively. Overall case-fatality rate was 17% and half of the deaths occurred in home following discharge from the hospital. Conclusion and Significance TB was common in severely malnourished Bangladeshi children with pneumonia. X-pert MTB/RIF assay provided higher case detection rate compared to sputum microscopy and culture. The high mortality among the study children underscores the need for further research aimed at improved case detection and management for better outcomes. PMID:24695758

  18. Multispectral VNIR Observations by the Opportunity Rover Pancam of Multiple Episodes of Aqueous Alteration in Marathon Valley, Endeavour Crater, Mars

    NASA Technical Reports Server (NTRS)

    Farrand, William H.; Bell, James F., III; Johnson, Jeffrey R.; Arvidson, Raymond E.; Mittlefehldt, David W.; Ruff, Steven W.; Rice, Melissa S.

    2016-01-01

    Since early 2015, the Mars Exploration Rover Opportunity has been exploring the break in the rim of Endeavour Crater dubbed Marathon Valley by the rover team. Marathon Valley was identified by orbital hyperspectral data from the MRO CRISM as having a relatively strong spectral feature in the 2.3 micrometer region indicative of an Mg or Fe-OH combination overtone absorption band indicative of smectite clay. Earlier in its mission, Opportunity examined the Matijevic Hill region on the more northerly Cape York crater rim segment and found evidence for smectite clays in a stratigraphically lower, pre-impact formed unit dubbed the Matijevic formation. However, the smectite exposures in Marathon Valley appear to be associated with the stratigraphically higher Shoemaker formation impact breccia. Evidence for alteration in this unit in Marathon Valley is provided by Pancam multispectral observations in the 430 to 1010 nm visible/near infrared (VNIR) spectral range. Sinuous troughs ("red zones") contain fragmented cobbles and pebbles displaying higher blue-to-red slopes, moderately higher 535 nm band depths, elevated 754 to 934 nm, and negative 934 to 1009 nm slopes. The lack of an absorption at 864 to 904 nm indicates the lack of crystalline red hematite in these red zones, but likely an enrichment in nanophase ferric oxides. The negative 934 to 1009 nm slope is potentially indicative of the presence of adsorbed or structurally bound water. A scuff in a red zone near the southern wall of Marathon Valley uncovered light-toned soils and a pebble with an 803 to 864 nm absorption resembling that of light-toned Fe-sulfate bearing soils uncovered by the Spirit rover in the Columbia Hills of Gusev crater. APXS chemical measurements indicated enrichments of Mg and S in the scuff soils and the pebble, Joseph Field, with the strongest 803 nm band- consistent with Mg and Fe sulfates. The presence of Fe and Mg sulfates can be interpreted as evidence of a potentially later episode of

  19. The Application of GeneXpert MTB/RIF for Smear-Negative TB Diagnosis as a Fee-Paying Service at a South Asian General Hospital

    PubMed Central

    Arjyal, Amit; Caws, Maxine; Prajapati, Krishna Govinda; Karkey, Abhilasha; Dongol, Sabina; Pathak, Saruna; Prajapati, Shanti; Basnyat, Buddha

    2015-01-01

    The GeneXpert MTB/RIF assay (Xpert) is a novel automated diagnostic tool for tuberculosis but its optimal placement in the healthcare system has not been determined. The objective of this study was to determine the possibility of additional case detection for pulmonary tuberculosis (PTB) by offering Xpert to smear-negative patients in a low-HIV burden setting with no Mycobacterium tuberculosis (M.tb.) culture facilities. Patients routinely presenting with symptoms suggestive of PTB with negative smears were offered single Xpert test on a fee-paying basis. Data were retrospectively reviewed to determine case detection in patients tested from February to December 2013. Symptoms associated with a positive test were analysed to determine if refinement of clinical criteria would reduce unnecessary testing. 258 smear-negative patients were included and M.tb. was detected in 55 (21.32%, n = 55/258). Using standard clinical assessment for selection, testing 5 patients detected one case of smear-negative PTB. These results demonstrate that fee-paying Xpert service in low-income setting can increase TB case confirmation substantially and further systematic studies of health economic implications should be conducted to determine optimal implementation models to increase access to Xpert in low- and middle-income countries. PMID:25949825

  20. Alterations of Neuromuscular Function after the World's Most Challenging Mountain Ultra-Marathon.

    PubMed

    Saugy, Jonas; Place, Nicolas; Millet, Guillaume Y; Degache, Francis; Schena, Federico; Millet, Grégoire P

    2013-01-01

    We investigated the physiological consequences of the most challenging mountain ultra-marathon (MUM) in the world: a 330-km trail run with 24000 m of positive and negative elevation change. Neuromuscular fatigue (NMF) was assessed before (Pre-), during (Mid-) and after (Post-) the MUM in experienced ultra-marathon runners (n = 15; finish time  = 122.43 hours ±17.21 hours) and in Pre- and Post- in a control group with a similar level of sleep deprivation (n = 8). Blood markers of muscle inflammation and damage were analyzed at Pre- and Post-. Mean ± SD maximal voluntary contraction force declined significantly at Mid- (-13±17% and -10±16%, P<0.05 for knee extensor, KE, and plantar flexor muscles, PF, respectively), and further decreased at Post- (-24±13% and -26±19%, P<0.01) with alteration of the central activation ratio (-24±24% and -28±34% between Pre- and Post-, P<0.05) in runners whereas these parameters did not change in the control group. Peripheral NMF markers such as 100 Hz doublet (KE: -18±18% and PF: -20±15%, P<0.01) and peak twitch (KE: -33±12%, P<0.001 and PF: -19±14%, P<0.01) were also altered in runners but not in controls. Post-MUM blood concentrations of creatine kinase (3719±3045 Ul·(1)), lactate dehydrogenase (1145±511 UI·L(-1)), C-Reactive Protein (13.1±7.5 mg·L(-1)) and myoglobin (449.3±338.2 µg·L(-1)) were higher (P<0.001) than at Pre- in runners but not in controls. Our findings revealed less neuromuscular fatigue, muscle damage and inflammation than in shorter MUMs. In conclusion, paradoxically, such extreme exercise seems to induce a relative muscle preservation process due likely to a protective anticipatory pacing strategy during the first half of MUM and sleep deprivation in the second half. PMID:23840345

  1. Alterations in Postural Control during the World's Most Challenging Mountain Ultra-Marathon

    PubMed Central

    Degache, Francis; Van Zaen, Jérôme; Oehen, Lukas; Guex, Kenny; Trabucchi, Pietro; Millet, Gégoire

    2014-01-01

    We investigated postural control (PC) effects of a mountain ultra-marathon (MUM): a 330-km trail run with 24000 m of positive and negative change in elevation. PC was assessed prior to (PRE), during (MID) and after (POST) the MUM in experienced ultra-marathon runners (n = 18; finish time = 126±16 h) and in a control group (n = 8) with a similar level of sleep deprivation. Subjects were instructed to stand upright on a posturographic platform over a period of 51.2 seconds using a double-leg stance under two test conditions: eyes open (EO) and eyes closed (EC). Traditional measures of postural stability (center of pressure trajectory analysis) and stabilogram-diffusion analysis (SDA) parameters were analysed. For the SDA, a significantly greater short-term effective diffusion was found at POST compared with PRE in the medio-lateral (ML; Dxs) and antero-posterior (AP) directions (Dys) in runners (p<0.05) The critical time interval (Ctx) in the ML direction was significantly higher at MID (p<0.001) and POST (p<0.05) than at PRE in runners. At MID (p<0.001) and POST (p<0.05), there was a significant difference between the two groups. The critical displacement (Cdx) in the ML was significantly higher at MID and at POST (p<0.001) compared with PRE for runners. A significant difference in Cdx was observed between groups in EO at MID (p<0.05) and POST (p<0.005) in the ML direction and in EC at POST in the ML and AP directions (p<0.05). Our findings revealed significant effects of fatigue on PC in runners, including, a significant increase in Ctx (critical time in ML plan) in EO and EC conditions. Thus, runners take longer to stabilise their body at POST than at MID. It is likely that the mountainous characteristics of MUM (unstable ground, primarily uphill/downhill running, and altitude) increase this fatigue, leading to difficulty in maintaining balance. PMID:24465417

  2. Alterations of Neuromuscular Function after the World's Most Challenging Mountain Ultra-Marathon

    PubMed Central

    Saugy, Jonas; Place, Nicolas; Millet, Guillaume Y.; Degache, Francis; Schena, Federico; Millet, Grégoire P.

    2013-01-01

    We investigated the physiological consequences of the most challenging mountain ultra-marathon (MUM) in the world: a 330-km trail run with 24000 m of positive and negative elevation change. Neuromuscular fatigue (NMF) was assessed before (Pre-), during (Mid-) and after (Post-) the MUM in experienced ultra-marathon runners (n = 15; finish time  = 122.43 hours ±17.21 hours) and in Pre- and Post- in a control group with a similar level of sleep deprivation (n = 8). Blood markers of muscle inflammation and damage were analyzed at Pre- and Post-. Mean ± SD maximal voluntary contraction force declined significantly at Mid- (−13±17% and −10±16%, P<0.05 for knee extensor, KE, and plantar flexor muscles, PF, respectively), and further decreased at Post- (−24±13% and −26±19%, P<0.01) with alteration of the central activation ratio (−24±24% and −28±34% between Pre- and Post-, P<0.05) in runners whereas these parameters did not change in the control group. Peripheral NMF markers such as 100 Hz doublet (KE: −18±18% and PF: −20±15%, P<0.01) and peak twitch (KE: −33±12%, P<0.001 and PF: −19±14%, P<0.01) were also altered in runners but not in controls. Post-MUM blood concentrations of creatine kinase (3719±3045 Ul·1), lactate dehydrogenase (1145±511 UI·L−1), C-Reactive Protein (13.1±7.5 mg·L−1) and myoglobin (449.3±338.2 µg·L−1) were higher (P<0.001) than at Pre- in runners but not in controls. Our findings revealed less neuromuscular fatigue, muscle damage and inflammation than in shorter MUMs. In conclusion, paradoxically, such extreme exercise seems to induce a relative muscle preservation process due likely to a protective anticipatory pacing strategy during the first half of MUM and sleep deprivation in the second half. PMID:23840345

  3. Piloting Upfront Xpert MTB/RIF Testing on Various Specimens under Programmatic Conditions for Diagnosis of TB & DR-TB in Paediatric Population

    PubMed Central

    Raizada, Neeraj; Sachdeva, Kuldeep Singh; Swaminathan, Soumya; Kulsange, Shubhangi; Khaparde, Sunil D.; Nair, Sreenivas Achuthan; Khanna, Ashwani; Chopra, Kamal Kishore; Hanif, Mahmud; Sethi, Gulshan Rai; Umadevi, K. R.; Keshav Chander, G.; Saha, Brojakishore; Shah, Amar; Parmar, Malik; Ghediya, Mayank; Jaju, Jyoti; Boehme, Catharina; Paramasivan, Chinnambedu Nainarappan

    2015-01-01

    Background India accounts for one-fifth of the global TB incidence. While the exact burden of childhood TB is not known, TB remains one of the leading causes of childhood mortality in India. Bacteriological confirmation of TB in children is challenging due to difficulty in obtaining quality specimens, in the absence of which diagnosis is largely based on clinical judgement. While testing multiple specimens can potentially contribute to higher proportion of laboratory confirmed paediatric TB cases, lack of high sensitivity tests adds to the diagnostic challenge. We describe here our experiences in piloting upfront Xpert MTB/RIF testing, for diagnosis of TB in paediatric population in respiratory and extra pulmonary specimens, as recently recommended by WHO. Method Xpert MTB/RIF testing was offered to all paediatric (0–14 years) presumptive TB cases (both pulmonary and extra-pulmonary) seeking care at public and private health facilities in the project areas covering 4 cities of India. Results Under this pilot project, 8,370 paediatric presumptive TB & presumptive DR-TB cases were tested between April and–November 2014. Overall, 9,149 specimens were tested, of which 4,445 (48.6%) were non-sputum specimens. Xpert MTB/RIF gave 9,083 (99.2%, CI 99.0–99.4) valid results. Of the 8,143 presumptive TB cases enrolled, 517 (6.3%, CI 5.8–6.9) were bacteriologically confirmed. TB detection rates were two fold higher with Xpert MTB/RIF as compared to smear microscopy. Further, a total of 60 rifampicin resistant TB cases were detected, of which 38 were detected among 512 presumptive TB cases while 22 were detected amongst 227 presumptive DR-TB cases tested under the project. Conclusion Xpert MTB/RIF with advantages of quick turnaround testing-time, high proportion of interpretable results and feasibility of rapid rollout, substantially improved the diagnosis of bacteriologically confirmed TB in children, while simultaneously detecting rifampicin resistance. PMID:26469691

  4. Xpert MTB/RIF assay for the diagnosis of extrapulmonary tuberculosis: a systematic review and meta-analysis.

    PubMed

    Denkinger, Claudia M; Schumacher, Samuel G; Boehme, Catharina C; Dendukuri, Nandini; Pai, Madhukar; Steingart, Karen R

    2014-08-01

    Xpert MTB/RIF (Cepheid, Sunnyvale, CA, USA) is endorsed for the detection of pulmonary tuberculosis (TB). We performed a systematic review and meta-analysis to assess the accuracy of Xpert for the detection of extrapulmonary TB. We searched multiple databases to October 15, 2013. We determined the accuracy of Xpert compared with culture and a composite reference standard (CRS). We grouped data by sample type and performed meta-analyses using a bivariate random-effects model. We assessed sources of heterogeneity using meta-regression for predefined covariates. We identified 18 studies involving 4461 samples. Sample processing varied greatly among the studies. Xpert sensitivity differed substantially between sample types. In lymph node tissues or aspirates, Xpert pooled sensitivity was 83.1% (95% CI 71.4-90.7%) versus culture and 81.2% (95% CI 72.4-87.7%) versus CRS. In cerebrospinal fluid, Xpert pooled sensitivity was 80.5% (95% CI 59.0-92.2%) against culture and 62.8% (95% CI 47.7-75.8%) against CRS. In pleural fluid, pooled sensitivity was 46.4% (95% CI 26.3-67.8%) against culture and 21.4% (95% CI 8.8-33.9%) against CRS. Xpert pooled specificity was consistently >98.7% against CRS across different sample types. Based on this systematic review, the World Health Organization now recommends Xpert over conventional tests for diagnosis of TB in lymph nodes and other tissues, and as the preferred initial test for diagnosis of TB meningitis. PMID:24696113

  5. Heat and cold : what does the environment do to the marathon runner?

    PubMed

    Maughan, Ron J; Watson, Phil; Shirreffs, Susan M

    2007-01-01

    The marathon poses a considerable physical challenge for athletes of all levels. When combined with high heat and humidity, not only is performance potentially compromised, but health and well-being are also at risk. There are well recognised effects of heat and hydration status on the cardiovascular and thermoregulatory systems that can account for the decreased performance and increased sensation of effort that are experienced when competing in the heat. Elevated exercise heart rate and core temperature at the same absolute exercise intensity are commonly reported. Dehydration occurring during exercise in the heat and results in reductions in stroke volume, cardiac output and blood pressure, as well as a marked decline in blood flow to the working muscles. Recent work suggests that hyperthermia may have a direct affect on the CNS and the brain may contribute to fatigue during prolonged exercise in a warm environment. At present, evidence supports a significant role of catecholaminergic neurotransmission, but there are a number of metabolic and circulatory perturbations occurring within the brain that may also be important in the fatigue process. PMID:17465618

  6. Kinetics of lipids, apolipoproteins, and cholesteryl ester transfer protein in plasma after a bicycle marathon.

    PubMed

    Föger, B; Wohlfarter, T; Ritsch, A; Lechleitner, M; Miller, C H; Dienstl, A; Patsch, J R

    1994-05-01

    The short-term effects of prolonged intense exercise on plasma lipid transport parameters including cholesterol, triglycerides (TGs), low-density lipoprotein (LD) cholesterol, high-density lipoprotein (HDL) cholesterol, and its subfractions HDL2 cholesterol and HDL3 cholesterol, on apolipoproteins (apos) A-I, A-II, and B, and on mass and activity of cholesteryl ester transfer protein (CETP) were studied in eight male endurance-trained athletes over the first week after a bicycle marathon. CETP mass concentration in plasma was quantified by a newly developed immunoradiometric assay (IRMA). Plasma concentrations of cholesterol, TGs, LDL cholesterol, apo B, CETP, and cholesteryl ester transfer activity (CETA) were significantly reduced in the recovery period compared with pre-exercise values (cholesterol by 20%, P < .05; TGs by 63%, P < .05; LDL cholesterol by 32%, P < .05; apo B by 18%, P < .05; CETP mass by 29%, P < .05; and CETA by 14%, P < .05). HDL cholesterol and HDL2 cholesterol, in contrast, were significantly increased in the post-exercise period (HDL cholesterol by 12%, P < .05, and HDL2 cholesterol by 96%, P < .05), whereas HDL3 cholesterol showed a tendency to decrease in the late recovery period (by 8%, NS). Although changes in cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, apo B, and CETP mass and activity were already evident in the early recovery period, HDL2 cholesterol showed a delayed response, reaching its maximum 72 hours after initiation of exercise.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8177053

  7. Blast Injuries: From Improvised Explosive Device Blasts to the Boston Marathon Bombing.

    PubMed

    Singh, Ajay K; Ditkofsky, Noah G; York, John D; Abujudeh, Hani H; Avery, Laura A; Brunner, John F; Sodickson, Aaron D; Lev, Michael H

    2016-01-01

    Although most trauma centers have experience with the imaging and management of gunshot wounds, in most regions blast wounds such as the ones encountered in terrorist attacks with the use of improvised explosive devices (IEDs) are infrequently encountered outside the battlefield. As global terrorism becomes a greater concern, it is important that radiologists, particularly those working in urban trauma centers, be aware of the mechanisms of injury and the spectrum of primary, secondary, tertiary, and quaternary blast injury patterns. Primary blast injuries are caused by barotrauma from the initial increased pressure of the explosive detonation and the rarefaction of the atmosphere immediately afterward. Secondary blast injuries are caused by debris carried by the blast wind and most often result in penetrating trauma from small shrapnel. Tertiary blast injuries are caused by the physical displacement of the victim and the wide variety of blunt or penetrating trauma sustained as a result of the patient impacting immovable objects such as surrounding cars, walls, or fences. Quaternary blast injuries include all other injuries, such as burns, crush injuries, and inhalational injuries. Radiography is considered the initial imaging modality for assessment of shrapnel and fractures. Computed tomography is the optimal test to assess penetrating chest, abdominal, and head trauma. The mechanism of blast injuries and the imaging experience of the victims of the Boston Marathon bombing are detailed, as well as musculoskeletal, neurologic, gastrointestinal, and pulmonary injury patterns from blast injuries. PMID:26761543

  8. The Boston Marathon Bombings Mass Casualty Incident: One Emergency Department's Information Systems Challenges and Opportunities.

    PubMed

    Landman, Adam; Teich, Jonathan M; Pruitt, Peter; Moore, Samantha E; Theriault, Jennifer; Dorisca, Elizabeth; Harris, Sheila; Crim, Heidi; Lurie, Nicole; Goralnick, Eric

    2015-07-01

    Emergency department (ED) information systems are designed to support efficient and safe emergency care. These same systems often play a critical role in disasters to facilitate real-time situation awareness, information management, and communication. In this article, we describe one ED's experiences with ED information systems during the April 2013 Boston Marathon bombings. During postevent debriefings, staff shared that our ED information systems and workflow did not optimally support this incident; we found challenges with our unidentified patient naming convention, real-time situational awareness of patient location, and documentation of assessments, orders, and procedures. As a result, before our next mass gathering event, we changed our unidentified patient naming convention to more clearly distinguish multiple, simultaneous, unidentified patients. We also made changes to the disaster registration workflow and enhanced roles and responsibilities for updating electronic systems. Health systems should conduct disaster drills using their ED information systems to identify inefficiencies before an actual incident. ED information systems may require enhancements to better support disasters. Newer technologies, such as radiofrequency identification, could further improve disaster information management and communication but require careful evaluation and implementation into daily ED workflow. PMID:24997562

  9. Airborne and ground reconnaissance of part of the syenite complex near Wausau, Marathon county, Wisconsin

    USGS Publications Warehouse

    Vickers, R.C.

    1955-01-01

    Airborne and ground reconnaissance for radioactive minerals in part of the syenite complex near Wausau, Marathon county, Wis., found 12 radioactive mineral localities. The rocks in the area are of Precambrian age and consist of syenite and nepheline syenite, which have intruded older granite, greenstone, quartzite, and argillite. There are very few outcrops, and much of the bedrock is deeply weathered and covered by residual soil. Thorium-bearing zircon pegatite float was found within the area of syenite and nepheline syenite at four localities. Reddish-brown euhedral to subeuhedral crystals of well-zoned zircon (variety cyrtolite) comprise more than 40 percent of some of the specimens. The radioactive mineral at four localities outside the area of syneites was identified as thorogummite, which occurred in nodular masses in residual soil. Alinement of the thorogummite float and associated radioactivity suggests that the thorogummite has resulted from weathering of narrow veins or pegmatites containing thorium-bearing minerals. Unidentified thorium-bearing minerals were found at three localities, and a specimen of allanite weighing about 2 pounds was found at one locality. Shallow trenches at two of the largest radioactivity anomalies showed that the radioactive material extended down into weathered bedrock. The occurrences might warrant additional physical exploration should there be sufficient demand for thorium. Further reconnaissance in the area would probably result in the discovery of additional occurrences.

  10. Using BigBite to Detect DIS Electrons for the MARATHON Experiment

    NASA Astrophysics Data System (ADS)

    Hague, Tyler

    2015-04-01

    The MARATHON experiment will use the BigBite Spectrometer to extract F2n /F2p from the inelastic cross section ratio of 12 GeV electrons on the mirror nuclei 3 He and 3 H. The BigBite Spectrometer consists of a series of detectors to detect electrons and an array of electronics (the ``Front End'') to create triggers in the Data Acquisition System (DAQ). BigBite uses two multi-wire drift chambers to determine the track of particles passing through it, a scintillator array for timing, and two lead-glass detectors for particle identification and a measurement of energy deposition. The Front End uses a series of logic units to create triggers for the DAQ when certain combinations of detectors fire. In this talk an overview of the detectors of the BigBite spectrometer and its Front End electronics setup will be presented. This work is supported by Kent State University, NSF Grant PHY-1405814, and DOE Contract DE-AC05-06OR23177.

  11. Influence of a 100-km ultra-marathon on hepatitis B carrier runners.

    PubMed

    Chiu, Y-H; Hou, S-K; How, C-K; Li, L-H; Kao, W-F; Yang, C-C; Chou, S-L; Shiau, Y-T S; Lam, C; Chen, R-J

    2013-09-01

    This study compares the serological markers between runners who are hepatitis B virus carries (HBVc) and runners who are non-HBVc in a 100-km ultra-marathon race. Blood samples of 8 HBVc and 18 non-HBVc runners were drawn 1 week before, immediately following, and 24 h after the race. Samples were analyzed and compared between the 2 groups for liver function tests, muscle damage markers and oxidative stress cytokines. For HBVc runners, HBV-DNA (hepatitis B virus-deoxyribonucleic acid) levels were also evaluated for virus reactivation. The results demonstrate a statistically significant increase in both immediate and 24-h post-race values for alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), compared with pre-race values. No statistically significant difference was observed between the 2 groups for the values of AST, LDH, CK, hs-CRP, IL-6 and TNF-α either before or after the race. There was also no statistically significant change in the levels of HBV-DNA in HBVc runners. These findings suggest that HBVc runners do not have higher risks of liver function impairment, muscle breakdown and inflammatory response compared to non-HBVc runners in such endurance races. PMID:23444084

  12. Self-selecting fluid intake while maintaining high carbohydrate availability does not impair half-marathon performance.

    PubMed

    Lee, M J C; Hammond, K M; Vasdev, A; Poole, K L; Impey, S G; Close, G L; Morton, J P

    2014-12-01

    We aimed to test the hypothesis that self-selecting fluid intake but maintaining high exogenous CHO availability (60 g/h) does not compromise half-marathon performance. 15 participants completed 3 half-marathons while drinking a 6% CHO solution to guidelines (DRINK) or a non-caloric solution in self-selected volumes when consuming 3×glucose (20 g) gels (G-GEL) or glucose-fructose (13 g glucose+7 g fructose) gels (GF-GEL) per hour. Fluid intake (DRINK: 1 557±182, G-GEL: 473±234, GF-GEL: 404±144 ml) and percent body mass loss (DRINK: - 0.8±0.9, G-GEL: - 2.0±0.6, GF-GEL: -2.3±1.1) were different (P<0.05) between conditions, though race time did not differ (DRINK: 110.6±14.4, G-GEL: 110.3±14.6, GF-GEL: 113.7±12.8 min). In G-GEL, there was a positive correlation (P<0.05) between body mass loss and race time. Plasma glucose was lower (P<0.05) in GF-GEL compared with other conditions, and total CHO oxidation (DRINK: 3.2±0.5, G-GEL: 3.0±0.4, GF-GEL: 2.6±0.4 g/min) was lower (P=0.06) in this trial. Self-selecting fluid intake but maintaining high CHO availability does not impair half-marathon performance. Additionally, consuming glucose-fructose mixtures in sub-optimal amounts reduces plasma glucose and total rates of CHO oxidation. PMID:25144431

  13. Energy balance, macronutrient intake, and hydration status during a 1,230 km ultra-endurance bike marathon.

    PubMed

    Geesmann, Bjoern; Mester, Joachim; Koehler, Karsten

    2014-10-01

    Athletes competing in ultra-endurance events are advised to meet energy requirements, to supply appropriate amounts of carbohydrates (CHO), and to be adequately hydrated before and during exercise. In practice, these recommendations may not be followed because of satiety, gastrointestinal discomfort, and fatigue. The purpose of the study was to assess energy balance, macronutrient intake and hydration status before and during a 1,230-km bike marathon. A group of 14 well-trained participants (VO2max: 63.2 ± 3.3 ml/kg/min) completed the marathon after 42:47 hr. Ad libitum food and fluid intake were monitored throughout the event. Energy expenditure (EE) was derived from power output and urine and blood markers were collected before the start, after 310, 618, and 921 km, after the finish, and 12 hr after the finish. Energy intake (EI; 19,749 ± 4,502 kcal) was lower than EE (25,303 ± 2,436 kcal) in 12 of 14 athletes. EI and CHO intake (average: 57.1 ± 17.7 g/hr) decreased significantly after km 618 (p < .05). Participants ingested on average 392 ± 85 ml/hr of fluid, but fluid intake decreased after km 618 (p < .05). Hydration appeared suboptimal before the start (urine specific gravity: 1.022 ± 0.010 g/ml) but did not change significantly throughout the event. The results show that participants failed to maintain in energy balance and that CHO and fluid intake dropped below recommended values during the second half of the bike marathon. Individual strategies to overcome satiety and fatigue may be necessary to improve eating and drinking behavior during prolonged ultra-endurance exercise. PMID:24668685

  14. Why we are here: early reflections on the role of reconstructive plastic surgery in the 2013 Boston marathon bombings.

    PubMed

    Carty, Matthew J; Caterson, Edward J; Caterson, Stephanie A; Chun, Yoon S; Erdmann-Sager, Jessica; Hadad, Ivan; Halvorson, Eric G; Orgill, Dennis P; Sampson, Christian E; Talbot, Simon G; Theman, Todd; Eriksson, Elof

    2013-12-01

    The 2013 Boston Marathon bombings resulted in a large and unexpected influx of patients requiring acute multidisciplinary surgical care. The authors describe the surgical management experience of these patients at Brigham & Women's Hospital and Brigham & Women's Faulkner Hospital, with a particular focus on the important role played by reconstructive plastic surgery. The authors suggest that this experience illustrates the value of reconstructive plastic surgery in the treatment of these patients specifically and of trauma patients in general, and argue for the increasing importance of promoting our identity as a specialty. PMID:24281588

  15. Performance of the new automated Abbott RealTime MTB assay for rapid detection of Mycobacterium tuberculosis complex in respiratory specimens.

    PubMed

    Chen, J H K; She, K K K; Kwong, T-C; Wong, O-Y; Siu, G K H; Leung, C-C; Chang, K-C; Tam, C-M; Ho, P-L; Cheng, V C C; Yuen, K-Y; Yam, W-C

    2015-09-01

    The automated high-throughput Abbott RealTime MTB real-time PCR assay has been recently launched for Mycobacterium tuberculosis complex (MTBC) clinical diagnosis. This study would like to evaluate its performance. We first compared its diagnostic performance with the Roche Cobas TaqMan MTB assay on 214 clinical respiratory specimens. Prospective analysis of a total 520 specimens was then performed to further evaluate the Abbott assay. The Abbott assay showed a lower limit of detection at 22.5 AFB/ml, which was more sensitive than the Cobas assay (167.5 AFB/ml). The two assays demonstrated a significant difference in diagnostic performance (McNemar's test; P = 0.0034), in which the Abbott assay presented significantly higher area under curve (AUC) than the Cobas assay (1.000 vs 0.880; P = 0.0002). The Abbott assay demonstrated extremely low PCR inhibition on clinical respiratory specimens. The automated Abbott assay required only very short manual handling time (0.5 h), which could help to improve the laboratory management. In the prospective analysis, the overall estimates for sensitivity and specificity of the Abbott assay were both 100 % among smear-positive specimens, whereas the smear-negative specimens were 96.7 and 96.1 %, respectively. No cross-reactivity with non-tuberculosis mycobacterial species was observed. The superiority in sensitivity of the Abbott assay for detecting MTBC in smear-negative specimens could further minimize the risk in MTBC false-negative detection. The new Abbott RealTime MTB assay has good diagnostic performance which can be a useful diagnostic tool for rapid MTBC detection in clinical laboratories. PMID:26071001

  16. MEDIA EXPOSURE AND SYMPATHETIC NERVOUS SYSTEM REACTIVITY PREDICT PTSD SYMPTOMS AFTER THE BOSTON MARATHON BOMBINGS

    PubMed Central

    Busso, Daniel S.; McLaughlin, Katie A.; Sheridan, Margaret A.

    2014-01-01

    Background Terrorist attacks have been shown to precipitate posttraumatic stress disorder (PTSD) symptomatology in children and adolescents, particularly among youths with high exposure to media coverage surrounding such events. Media exposure may be particularly likely to trigger PTSD symptoms in youths with high physiological reactivity to stress or with prior psychopathology or exposure to violence. We examined the interplay between media exposure, preattack psychopathology, autonomic nervous system (ANS) reactivity, and prior violence exposure in predicting PTSD symptom onset following the terrorist attack at the 2013 Boston Marathon. Methods A community sample of 78 adolescents (mean age = 16.7 years, 65% female) completed a survey about the bombings, including media exposure to the event and PTSD symptoms. All respondents participated in a study assessing psychopathology prior to the attack, and sympathetic and parasympathetic reactivity to a laboratory-based stressor was assessed in a subset (N = 44) of this sample. We examined the associations of media exposure, ANS reactivity, preattack psychopathology, and prior violence exposure with onset of PTSD symptoms related to the bombings. Results Media exposure, preattack psychopathology, and prior violence exposure were associated with PTSD symptoms. Moreover, media exposure interacted with sympathetic reactivity to predict PTSD symptom onset, such that adolescents with lower levels of sympathetic reactivity developed PTSD symptoms only following high exposure to media coverage of the attack. Conclusions We provide novel evidence that physiological reactivity prior to exposure to an unpredictable traumatic stressor predicts PTSD symptom onset. These findings have implications for identifying youths most vulnerable to PTSD following wide-scale trauma. PMID:24995832

  17. Adjustment Among Area Youth After the Boston Marathon Bombing and Subsequent Manhunt

    PubMed Central

    Dantowitz, Annie; Chou, Tommy; Edson, Aubrey L.; Elkins, R. Meredith; Kerns, Caroline; Brown, Bonnie; Green, Jennifer Greif

    2014-01-01

    BACKGROUND: The majority of research on terrorism-exposed youth has examined large-scale terrorism with mass casualties. Limited research has examined children’s reactions to terrorism of the scope of the Boston Marathon bombing. Furthermore, the extraordinary postattack interagency manhunt and shelter-in-place warning made for a truly unprecedented experience in its own right for families. Understanding the psychological adjustment of Boston-area youth in the aftermath of these events is critical for informing clinical efforts. METHODS: Survey of Boston-area parents/caretakers (N = 460) reporting on their child’s experiences during the attack week, as well as psychosocial functioning in the first 6 attack months. RESULTS: There was heterogeneity across youth in attack- and manhunt-related experiences and clinical outcomes. The proportion of youth with likely attack/manhunt-related posttraumatic stress disorder (PTSD) was roughly 6 times higher among Boston Marathon–attending youth than nonattending youth. Attack and manhunt experiences each uniquely predicted 9% of PTSD symptom variance, with manhunt exposures more robustly associated than attack-related exposures with a range of psychosocial outcomes, including emotional symptoms, conduct problems, hyperactivity/inattention, and peer problems. One-fifth of youth watched >3 hours of televised coverage on the attack day, which was linked to PTSD symptoms, conduct problems, and total difficulties. Prosocial behavior and positive peer functioning buffered the impact of exposure. CONCLUSIONS: Clinical efforts must maintain a broadened focus beyond simply youth present at the blasts and must also include youth highly exposed to the intense interagency pursuit and manhunt. Continued research is needed to understand the adjustment of youth after mass traumas and large-scale manhunts in residential communities. PMID:24918223

  18. Media's role in broadcasting acute stress following the Boston Marathon bombings.

    PubMed

    Holman, E Alison; Garfin, Dana Rose; Silver, Roxane Cohen

    2014-01-01

    We compared the impact of media vs. direct exposure on acute stress response to collective trauma. We conducted an Internet-based survey following the Boston Marathon bombings between April 29 and May 13, 2013, with representative samples of residents from Boston (n = 846), New York City (n = 941), and the remainder of the United States (n = 2,888). Acute stress symptom scores were comparable in Boston and New York [regression coefficient (b) = 0.43; SE = 1.42; 95% confidence interval (CI), -2.36, 3.23], but lower nationwide when compared with Boston (b = -2.21; SE = 1.07; 95% CI, -4.31, -0.12). Adjusting for prebombing mental health (collected prospectively), demographics, and prior collective stress exposure, six or more daily hours of bombing-related media exposure in the week after the bombings was associated with higher acute stress than direct exposure to the bombings (continuous acute stress symptom total: media exposure b = 15.61 vs. direct exposure b = 5.69). Controlling for prospectively collected prebombing television-watching habits did not change the findings. In adjusted models, direct exposure to the 9/11 terrorist attacks and the Sandy Hook School shootings were both significantly associated with bombing-related acute stress; Superstorm Sandy exposure wasn't. Prior exposure to similar and/or violent events may render some individuals vulnerable to the negative effects of collective traumas. Repeatedly engaging with trauma-related media content for several hours daily shortly after collective trauma may prolong acute stress experiences and promote substantial stress-related symptomatology. Mass media may become a conduit that spreads negative consequences of community trauma beyond directly affected communities. PMID:24324161

  19. Detecting Outliers in Marathon Data by Means of the Andrews Plot

    NASA Astrophysics Data System (ADS)

    Stehlík, Milan; Wald, Helmut; Bielik, Viktor; Petrovič, Juraj

    2011-09-01

    For an optimal race performance, it is important, that the runner keeps steady pace during most of the time of the competition. First time runners or athletes without many competitions often experience an "blow out" after a few kilometers of the race. This could happen, because of strong emotional experiences or low control of running intensity. Competition pace of half marathon of the middle level recreational athletes is approximately 10 sec quicker than their training pace. If an athlete runs the first third of race (7 km) at a pace that is 20 sec quicker than is his capacity (trainability), he would experience an "blow out" in the last third of the race. This would be reflected by reducing the running intensity and inability to keep steady pace in the last kilometers of the race and in the final time as well. In sports science, there are many diagnostic methods ([3], [2], [6]) that are used for prediction of optimal race pace tempo and final time. Otherwise there is lacking practical evidence of diagnostics methods and its use in the field (competition, race). One of the conditions that needs to be carried out is that athletes have not only similar final times, but it is important that they keep constant pace as much as possible during whole race. For this reason it is very important to find outliers. Our experimental group consisted of 20 recreational trained athletes (mean age 32,6 years±8,9). Before the race the athletes were instructed to run on the basis of their subjective feeling and previous experience. The data (running pace of each kilometer, average and maximal heart rate of each kilometer) were collected by GPS-enabled personal trainer Forerunner 305.

  20. Hydration assessment among marathoners using urine specific gravity and bioelectrical impedance analysis.

    PubMed

    Cutrufello, Paul T; Dixon, Curt B; Zavorsky, Gerald S

    2016-01-01

    The present study examined the relationship between urine specific gravity (Usg), body mass (BM) and bioelectrical impedance determined variables [total body water (TBW), per cent TBW and impedance values] before and after a marathon (n = 25 men; 10 women). A significant reduction in BM (pre: 71.2 ± 12.4 kg; post: 69.6 ± 12.0 kg; p < 0.001) and an increase in Usg (pre: 1.009 ± 0.007; post: 1.018 ± 0.009; p < 0.001) was observed post-race. TBW was not significantly decreased (pre: 42.7 ± 8.0 kg; post: 42.4 ± 7.7 kg) while per cent TBW significantly increased post-race (pre: 60.0 ± 3.9%; post: 60.8 ± 3.8%; p < 0.001). Impedance values were significantly greater post-race (pre: 3288 ± 482; post: 3416 ± 492 Ω; p < 0.001). There was no correlation between the change in Usg and the change in BM or any of the bioelectrical impedance determined variables. On average, BM, Usg and impedance values appear to express changes in hydration; however, the observed changes among these variables for a given individual appear to be inconsistent with one another. PMID:27373703

  1. Effect of statins on creatine kinase levels before and after a marathon run.

    PubMed

    Parker, Beth A; Augeri, Amanda L; Capizzi, Jeffrey A; Ballard, Kevin D; Troyanos, Christopher; Baggish, Aaron L; D'Hemecourt, Pierre A; Thompson, Paul D

    2012-01-15

    We measured the serum levels of myoglobin, total creatine kinase (CK), and the CK myocardial (CK-MB), muscle (CK-MM), and brain (CK-BB) isoenzymes in 37 subjects treated with statins and 43 nonstatin-treated controls running the 2011 Boston Marathon. Venous blood samples were obtained the day before (PRE) and within 1 hour (FINISH) and 24 hours after (POST) the race. The hematocrit and hemoglobin values were used to adjust for changes in the plasma volume. The CK distribution was normalized using log transformation before analysis. The exercise-related increase in CK 24 hours after exercise, adjusted for changes in plasma volume, was greater in the statin users (PRE to POST 133 ± 15 to 1,104 ± 150 U/L) than in the controls (PRE to POST 125 ± 12 to 813 ± 137 U/L; p = 0.03 for comparison). The increase in CK-MB 24 hours after exercise was also greater in the statin users (PRE to POST 1.1 ± 3.9 to 8.9 ± 7.0 U/L) than in the controls (PRE to POST 0.0 ± 0.0 to 4.2 ± 5.0 U/L; p <0.05 for comparison). However, the increases in muscle myoglobin did not differ at any point between the 2 groups. Increases in CK at both FINISH and POST race measurements were directly related to age in the statin users (r(2) = 0.13 and r(2) = 0.14, respectively; p <0.05) but not in the controls (r(2) = 0.02 and r(2) = 0.00, respectively; p >0.42), suggesting that susceptibility to exercise-induced muscle injury with statins increases with age. In conclusion, our results show that statins increase exercise-related muscle injury. PMID:22036108

  2. Marathon Running, Accreditation of Study Programmes and Professional Development in Consultancies: Are They All about the Same? A Cognitive Perspective on Transfer of Training

    ERIC Educational Resources Information Center

    Gruber, Hans

    2013-01-01

    Three challenges are presented which address problems of transfer of training: running marathon, accreditation of study programmes, professional development in consultancies. It is discussed in-how-far and why different approaches to transfer of training stress commonalities or differences between these challenges. The results are used to analyse…

  3. Shaken but prepared: Analysis of disaster response at an academic medical centre following the Boston Marathon bombings.

    PubMed

    Osgood, Robert; Scanlon, Courtney; Jotwani, Rohan; Rodkey, Daniel; Arshanskiy, Maria; Salem, Deeb

    Over the last decade, there has been a rise in the number of mass casualty incidences (MCIs) and their subsequent effect on hospital systems. While there has been much discussion over improving procedures to treat victims of MCIs, there has not been a thorough, systems-based analysis concerning the costs incurred by hospitals during such events. Here the authors examine the history of the Hospital Incident Command Center and how its evolution at Tufts Medical Center helped mitigate the damage following the Boston Marathon Bombings. Tufts' unique variations to the Hospital Incident Command Center include strategic communication hierarchies and a 'zero cost centre' financial system which both provided for a quick and adaptive response. Operating in collaboration with the Conference of Boston Teaching Hospitals encouraged coordination and preparation during emergency situations such as mass casualty events. The direct and indirect effects on Tufts Medical Center stemming from the Boston Marathon Bombings were analysed. Tufts MC treated 36 victims immediately following the MCI. The estimated total cost during the week of April 15 to April 19, 2013 was $776,051. The cost was primarily comprised of lost revenue from cancelled outpatient and inpatient hospital services, as well as expenses incurred due to overtime pay, salary expenses, PPE kits and hospitality services. Finally, the authors examine ways to reduce the future costs during emergency situations through increasing communication with employees, understanding the source of all direct expenses, and mitigating excess risk by developing partnerships with other hospital systems. PMID:26642175

  4. Low prevalence of exercise-associated hyponatremia in male 100 km ultra-marathon runners in Switzerland.

    PubMed

    Knechtle, Beat; Knechtle, Patrizia; Rosemann, Thomas

    2011-06-01

    We investigated the prevalence of exercise-associated hyponatremia (EAH) in 145 male ultra-marathoners at the '100-km ultra-run' in Biel, Switzerland. Changes in body mass, urinary specific gravity, haemoglobin, haematocrit, plasma [Na(+)], and plasma volume were determined. Seven runners (4.8%) developed asymptomatic EAH. Body mass, haematocrit and haemoglobin decreased, plasma [Na(+)] remained unchanged and plasma volume increased. Δ body mass correlated with both post race plasma [Na(+)] and Δ plasma [Na(+)]. Δ plasma volume was associated with post race plasma [Na(+)]. The athletes consumed 0.65 (0.30) L/h; fluid intake correlated significantly and negatively (r = -0.50, p < 0.0001) to race time. Fluid intake was neither associated with post race plasma [Na(+)] nor with Δ plasma [Na(+)], but was related to Δ body mass. To conclude, the prevalence of EAH was low at ~5% in these male 100 km ultra-marathoners. EAH was asymptomatic and would not have been detected without the measurement of plasma [Na(+)]. PMID:21082192

  5. Epidemiology of Rifampicin Resistant Tuberculosis and Common Mutations in rpoB Gene of Mycobacterium tuberculosis: A Retrospective Study from Six Districts of Punjab (India) Using Xpert MTB/RIF Assay

    PubMed Central

    Kaur, Ramandeep; Jindal, Neerja; Arora, Shilpa; Kataria, Shajla

    2016-01-01

    Background: Xpert MTB/RIF assay has revolutionized the diagnosis of tuberculosis (TB) by simultaneously detecting the bacteria and resistance to rifampicin (RIF), a surrogate marker for multidrug-resistant TB (MDR-TB) in <2 h. The RIF resistance pattern in Malwa region of Punjab, India, is not documented. Here, we report the epidemiology of RIF-resistant TB and mutations in rpoB gene of Mycobacterium tuberculosis (MTB). Materials and Methods: A total of 1612 specimens received between October 2013 and February 2015 were tested by Xpert MTB/RIF assay following manufacturer's instructions. The results thus obtained were analyzed using SPSS version 20.0.0 (SPSS Inc., Chicago, IL, USA) statistical software. Result: RIF resistance was statistically higher in previously treated patients in comparison to the new patients (P = 0.006) and in patients with acid fast-Bacilli (AFB) positive smears to AFB-negative smears (P = 0.048). RIF resistance mutations in 130 specimens revealed frequency of E 73/130 (56%), B 28/130 (21.5%), D 18/130 (13.8%), A 11/130 (8.4%), and C 1/130 (0.7%) while in one specimen, mutation combination, i.e., mutations associated with more than one probe (A and B both) was present. Conclusion: Xpert MTB/RIF assay is a user-friendly screening tool for detection of MTB and RIF resistance from suspected TB/MDR cases in a shorter period of time. It could also serve as a useful technique to have simultaneous preliminary information regarding the mutation pattern of RIF resistance in MTB isolates. PMID:27365918

  6. Comparison of the Xpert MTB/RIF Test with an IS6110-TaqMan Real-Time PCR Assay for Direct Detection of Mycobacterium tuberculosis in Respiratory and Nonrespiratory Specimens▿

    PubMed Central

    Armand, Sylvie; Vanhuls, Pascale; Delcroix, Guy; Courcol, René; Lemaître, Nadine

    2011-01-01

    The sensitivities of the Xpert MTB/RIF test and an in-house IS6110-based real-time PCR using TaqMan probes (IS6110-TaqMan assay) for the detection of Mycobacterium tuberculosis complex (MTBC) DNA were compared by use of 117 clinical specimens (97 culture positive and 20 culture negative for MTBC) that were frozen in sediment. The 97 clinical specimens included 60 respiratory and 37 nonrespiratory specimens distributed into 36 smear-positive and 61 smear-negative specimens. Among the 97 culture-positive specimens, 4 had rifampin-resistant isolates. Both methods were highly specific and exhibited excellent sensitivity (100%) with smear-positive specimens. The sensitivity of the Xpert MTB/RIF test with the whole smear-negative specimens was more reduced than that of the IS6110-TaqMan assay (48 versus 69%, P = 0.005). Both methods exhibited similar sensitivities with smear-negative respiratory specimens, but the Xpert MTB/RIF test had lower sensitivity with smear-negative nonrespiratory specimens than the IS6110-TaqMan assay (37 versus 71%, P = 0.013). Finally, the sensitivities of the Xpert MTB/RIF test and the IS6110-TaqMan assay were 79% and 84%, respectively, with respiratory specimens and 53% and 78%, respectively (P = 0.013), with nonrespiratory specimens. The Xpert MTB/RIF test correctly detected the rifampin resistance in smear-positive specimens but not in the one smear-negative specimen. The Xpert MTB/RIF test is a simple rapid method well adapted to a routine laboratory that appeared to be as sensitive as the IS6110-TaqMan assay with respiratory specimens but less sensitive with paucibacillary specimens, such as smear-negative nonrespiratory specimens. PMID:21411592

  7. Runners in their forties dominate ultra-marathons from 50 to 3,100 miles

    PubMed Central

    Zingg, Matthias Alexander; Rüst, Christoph Alexander; Rosemann, Thomas; Lepers, Romuald; Knechtle, Beat

    2014-01-01

    OBJECTIVES: This study investigated performance trends and the age of peak running speed in ultra-marathons from 50 to 3,100 miles. METHODS: The running speed and age of the fastest competitors in 50-, 100-, 200-, 1,000- and 3,100-mile events held worldwide from 1971 to 2012 were analyzed using single- and multi-level regression analyses. RESULTS: The number of events and competitors increased exponentially in 50- and 100-mile events. For the annual fastest runners, women improved in 50-mile events, but not men. In 100-mile events, both women and men improved their performance. In 1,000-mile events, men became slower. For the annual top ten runners, women improved in 50- and 100-mile events, whereas the performance of men remained unchanged in 50- and 3,100-mile events but improved in 100-mile events. The age of the annual fastest runners was approximately 35 years for both women and men in 50-mile events and approximately 35 years for women in 100-mile events. For men, the age of the annual fastest runners in 100-mile events was higher at 38 years. For the annual fastest runners of 1,000-mile events, the women were approximately 43 years of age, whereas for men, the age increased to 48 years of age. For the annual fastest runners of 3,100-mile events, the age in women decreased to 35 years and was approximately 39 years in men. CONCLUSION: The running speed of the fastest competitors increased for both women and men in 100-mile events but only for women in 50-mile events. The age of peak running speed increased in men with increasing race distance to approximately 45 years in 1,000-mile events, whereas it decreased to approximately 39 years in 3,100-mile events. In women, the upper age of peak running speed increased to approximately 51 years in 3,100-mile events. PMID:24626948

  8. Alterations of Vertical Jump Mechanics after a Half-Marathon Mountain Running Race.

    PubMed

    Rousanoglou, Elissavet N; Noutsos, Konstantinos; Pappas, Achilleas; Bogdanis, Gregory; Vagenas, Georgios; Bayios, Ioannis A; Boudolos, Konstantinos D

    2016-06-01

    The fatiguing effect of long-distance running has been examined in the context of a variety of parameters. However, there is scarcity of data regarding its effect on the vertical jump mechanics. The purpose of this study was to investigate the alterations of countermovement jump (CMJ) mechanics after a half-marathon mountain race. Twenty-seven runners performed CMJs before the race (Pre), immediately after the race (Post 1) and five minutes after Post 1 (Post 2). Instantaneous and ensemble-average analysis focused on jump height and, the maximum peaks and time-to-maximum peaks of: Displacement, vertical force (Fz), anterior-posterior force (Fx), Velocity and Power, in the eccentric (tECC) and concentric (tCON) phase of the jump, respectively. Repeated measures ANOVAs were used for statistical analysis (p ≤ 0.05). The jump height decrease was significant in Post 2 (-7.9%) but not in Post 1 (-4.1%). Fx and Velocity decreased significantly in both Post 1 (only in tECC) and Post 2 (both tECC and tCON). Α timing shift of the Fz peaks (earlier during tECC and later during tCON) and altered relative peak times (only in tECC) were also observed. Ensemble-average analysis revealed several time intervals of significant post-race alterations and a timing shift in the Fz-Velocity loop. An overall trend of lowered post-race jump output and mechanics was characterised by altered jump timing, restricted anterior-posterior movement and altered force-velocity relations. The specificity of mountain running fatigue to eccentric muscle work, appears to be reflected in the different time order of the post-race reductions, with the eccentric phase reductions preceding those of the concentric one. Thus, those who engage in mountain running should particularly consider downhill training to optimise eccentric muscular action. Key pointsThe 4.1% reduction of jump height immediately after the race is not statistically significantThe eccentric phase alterations of jump mechanics precede

  9. Alterations of Vertical Jump Mechanics after a Half-Marathon Mountain Running Race

    PubMed Central

    Rousanoglou, Elissavet N.; Noutsos, Konstantinos; Pappas, Achilleas; Bogdanis, Gregory; Vagenas, Georgios; Bayios, Ioannis A.; Boudolos, Konstantinos D.

    2016-01-01

    The fatiguing effect of long-distance running has been examined in the context of a variety of parameters. However, there is scarcity of data regarding its effect on the vertical jump mechanics. The purpose of this study was to investigate the alterations of countermovement jump (CMJ) mechanics after a half-marathon mountain race. Twenty-seven runners performed CMJs before the race (Pre), immediately after the race (Post 1) and five minutes after Post 1 (Post 2). Instantaneous and ensemble-average analysis focused on jump height and, the maximum peaks and time-to-maximum peaks of: Displacement, vertical force (Fz), anterior-posterior force (Fx), Velocity and Power, in the eccentric (tECC) and concentric (tCON) phase of the jump, respectively. Repeated measures ANOVAs were used for statistical analysis (p ≤ 0.05). The jump height decrease was significant in Post 2 (-7.9%) but not in Post 1 (-4.1%). Fx and Velocity decreased significantly in both Post 1 (only in tECC) and Post 2 (both tECC and tCON). Α timing shift of the Fz peaks (earlier during tECC and later during tCON) and altered relative peak times (only in tECC) were also observed. Ensemble-average analysis revealed several time intervals of significant post-race alterations and a timing shift in the Fz-Velocity loop. An overall trend of lowered post-race jump output and mechanics was characterised by altered jump timing, restricted anterior-posterior movement and altered force-velocity relations. The specificity of mountain running fatigue to eccentric muscle work, appears to be reflected in the different time order of the post-race reductions, with the eccentric phase reductions preceding those of the concentric one. Thus, those who engage in mountain running should particularly consider downhill training to optimise eccentric muscular action. Key points The 4.1% reduction of jump height immediately after the race is not statistically significant The eccentric phase alterations of jump mechanics precede

  10. Evaluation of Xpert® MTB/RIF Assay in Induced Sputum and Gastric Lavage Samples from Young Children with Suspected Tuberculosis from the MVA85A TB Vaccine Trial

    PubMed Central

    Geldenhuys, Hennie; Schmidt, Bey-Marrie; Luabeya, Angelique Kany Kany; Mulenga, Humphrey; Scriba, Thomas J.; Hanekom, Willem A.; Mahomed, Hassan; McShane, Helen; Hatherill, Mark

    2015-01-01

    Objective Diagnosis of childhood tuberculosis is limited by the paucibacillary respiratory samples obtained from young children with pulmonary disease. We aimed to compare accuracy of the Xpert® MTB/RIF assay, an automated nucleic acid amplification test, between induced sputum and gastric lavage samples from young children in a tuberculosis endemic setting. Methods We analyzed standardized diagnostic data from HIV negative children younger than four years of age who were investigated for tuberculosis disease near Cape Town, South Africa [2009–2012]. Two paired, consecutive induced sputa and early morning gastric lavage samples were obtained from children with suspected tuberculosis. Samples underwent Mycobacterial Growth Indicator Tube [MGIT] culture and Xpert MTB/RIF assay. We compared diagnostic yield across samples using the two-sample test of proportions and McNemar’s χ2 test; and Wilson’s score method to calculate sensitivity and specificity. Results 1,020 children were evaluated for tuberculosis during 1,214 admission episodes. Not all children had 4 samples collected. 57 of 4,463[1.3%] and 26 of 4,606[0.6%] samples tested positive for Mycobacterium tuberculosis on MGIT culture and Xpert MTB/RIF assay respectively. 27 of 2,198[1.2%] and 40 of 2,183[1.8%] samples tested positive [on either Xpert MTB/RIF assay or MGIT culture] on induced sputum and gastric lavage samples, respectively. 19/1,028[1.8%] and 33/1,017[3.2%] admission episodes yielded a positive MGIT culture or Xpert MTB/RIF assay from induced sputum and gastric lavage, respectively. Sensitivity of Xpert MTB/RIF assay was 8/30[26.7%; 95% CI: 14.2–44.4] for two induced sputum samples and 7/31[22.6%; 11.4–39.8] [p = 0.711] for two gastric lavage samples. Corresponding specificity was 893/893[100%;99.6–100] and 885/890[99.4%;98.7–99.8] respectively [p = 0.025]. Conclusion Sensitivity of Xpert MTB/RIF assay was low, compared to MGIT culture, but diagnostic performance of Xpert MTB

  11. Regionally accentuated reversible brain grey matter reduction in ultra marathon runners detected by voxel-based morphometry

    PubMed Central

    2014-01-01

    Background During the 4,487 km ultra marathon TransEurope-FootRace 2009 (TEFR09), runners showed catabolism with considerable reduction of body weight as well as reversible brain volume reduction. We hypothesized that ultra marathon athletes might have developed changes to grey matter (GM) brain morphology due to the burden of extreme physical training. Using voxel-based morphometry (VBM) we undertook a cross sectional study and two longitudinal studies. Methods Prior to the start of the race 13 runners volunteered to participate in this study of planned brain scans before, twice during, and 8 months after the race. A group of matched controls was recruited for comparison. Twelve runners were able to participate in the scan before the start of the race and were taken into account for comparison with control persons. Because of drop-outs during the race, VBM could be performed in 10 runners covering the first 3 time points, and in 7 runners who also had the follow-up scan after 8 months. Volumetric 3D datasets were acquired using an MPRAGE sequence. A level of p < 0.05, family-wise corrected for multiple comparisons was the a priori set statistical threshold to infer significant effects from VBM. Results Baseline comparison of TEFR09 participants and controls revealed no significant differences regarding GM brain volume. During the race however, VBM revealed GM volume decreases in regionally distributed brain regions. These included the bilateral posterior temporal and occipitoparietal cortices as well as the anterior cingulate and caudate nucleus. After eight months, GM normalized. Conclusion Contrary to our hypothesis, we did not observe significant differences between TEFR09 athletes and controls at baseline. If this missing difference is not due to small sample size, extreme physical training obviously does not chronically alter GM. However, during the race GM volume decreased in brain regions normally associated with visuospatial and language tasks. The

  12. A chronotype comparison of South African and Dutch marathon runners: The role of scheduled race start times and effects on performance.

    PubMed

    Henst, Rob H P; Jaspers, Richard T; Roden, Laura C; Rae, Dale E

    2015-01-01

    Recently, a high prevalence of morning-types was reported among trained South African endurance athletes. Proposed explanations for this observation were that either the chronotype of these athletes is better suited to coping with the early-morning start times of endurance events in South Africa; or habitual early waking for training or endurance events may have conditioned the athletes to adapt and become morning-types. The South African endurance athletes also had earlier chronotypes compared to a control population of less active individuals, suggesting that individuals who are more physically active may have earlier chronotypes. However, since both the South African athlete and control groups showed an overrepresentation of morning-types compared to European and American populations, the South African climate may in part have explained this bias towards morningness. Given the latitude and climate differences between South Africa and the Netherlands, and that South African marathons typically start at about 06:30 while those in the Netherlands start later (±11:00), comparison of South African and Dutch marathon runners and active controls would allow for simultaneous assessment of the effects of marathon start time, degree of physical activity and climate on chronotype. Therefore, the primary aims of this study were: (i) to assess the effect of marathon start time on chronotype in marathon runners and (ii) to determine the extent to which either degree of physical activity or climate might explain the bias towards morningness observed in South African athletes and controls. A secondary aim was to determine whether any relationships exist between chronotype, PERIOD3 (PER3) variable number tandem repeat (VNTR) polymorphism genotype, habitual training habits and marathon performance. Trained male marathon runners from South Africa (n = 95) and the Netherlands (n = 90), and active but non-competitive male controls from South Africa (n = 97) and the

  13. Direct Detection by the Xpert MTB/RIF Assay and Characterization of Multi and Poly Drug-Resistant Tuberculosis in Guinea-Bissau, West Africa

    PubMed Central

    Ponce, Gema; Sanca, Lilica; Mané, Morto; Armada, Ana; Machado, Diana; Vieira, Fina; Gomes, Victor F.; Martins, Elisabete; Colombatti, Raffaella; Riccardi, Fabio; Perdigão, João; Sotero, Joana; Portugal, Isabel; Couto, Isabel; Atouguia, Jorge; Rodrigues, Amabélia; Viveiros, Miguel

    2015-01-01

    Background This study aimed to evaluate the usefulness of the Xpert MTB/RIF assay for the rapid direct detection of M. tuberculosis complex (MTBC) strains and rifampicin resistance associated mutations in a resource-limited setting such as Guinea-Bissau and its implications in the management of tuberculosis (TB) and drug resistant tuberculosis, complementing the scarce information on resistance and genotypic diversity of MTBC strains in this West African country. Methods and Results This cross-sectional prospective study included 100 consecutive TB patients with positive acid-fast smears at two months of anti-tuberculosis treatment or in a re-treatment situation, between May and December 2012. Resistance to rifampicin was detected using the GeneXpert system and the Xpert MTB/RIF assay. MTBC isolates obtained with the BACTEC MGIT 960 system were tested for susceptibility to first- and second-line anti-tuberculosis drugs. Overall, the prevalence of multidrug-resistant tuberculosis (MDR-TB) was found to be 9 cases. Of these, 67% (6 patients) of confirmed MDR-TB cases had no past history of TB treatment and 33% (3 patients) were previously treated cases. Extensively drug-resistant TB was not found. Molecular typing of the MDR-TB strains revealed recent transmission patterns of imported MDR strains. Conclusions The Xpert MTB/RIF assay was reliable for the detection of rifampicin resistant MTBC strains directly from sputum samples of patients undergoing first-line treatment for two months, being more trustworthy than the simple presence of acid-fast bacilli in the smear. Its implementation is technically simple, does not require specialized laboratory infrastructures and is suitable for resource-limited settings when a regular source of electricity and maintenance is available as well as financial and operation sustainability is guaranteed by the health authorities. A high prevalence of MDR-TB among patients at risk of MDR-TB after two months of first-line treatment was

  14. Health assessment for Marathon Battery, Cold Springs, New York, Region 2. CERCLIS No. NYD001959757. Preliminary report

    SciTech Connect

    Not Available

    1987-07-16

    The 11-acre Marathon Battery Site (MBS) Plant is located in Putnam County, Cold Springs, New York. The site is bordered to the east by a wooded area and to the south by a junkyard and Foundary Cove. Foundary Cove is a wetland marsh connected by several channels to the Hudson River. Various heavy metals have been identified on-site. They include arsenic, cadmium, cobalt, lead, nickel, and zinc. In addition, a previous ATSDR memorandum reports the results of a ground-water sample containing high concentrations of trichloroethylene. Based on the preliminary information reviewed concerning on-site and off-site contamination, MBS represents a potential public health threat to area residents.

  15. The role of technical assistance in expanding access to Xpert(®) MTB/RIF: experience in sub-Saharan Africa.

    PubMed

    Umubyeyi, A N; Bonsu, F; Chimzizi, R; Jemal, S; Melese, M; Ruttoh, E; Mundy, C

    2016-03-21

    To improve tuberculosis (TB) diagnosis, many national TB programmes have committed to deploying Xpert(®) MTB/RIF. Implementation of this relatively new technology has suffered from a lack of comprehensive technical assistance, however, including the formulation of policies and plans to address operational issues. While providing technical assistance, we observed numerous operational challenges in the implementation and scale-up of Xpert in five sub-Saharan African countries: low coverage, poor laboratory infrastructure, limited access, poor linkages to treatment, inadequate data on outcomes, problems with specimen transport, diagnostic algorithms that are not aligned with updated World Health Organization recommendations on target patient groups and financing challenges. We recommend better country preparedness and training, laboratory information and quality systems, supply management and referral mechanisms. PMID:27051609

  16. Source identification of VOCs at an urban site of western India: Effect of marathon events and anthropogenic emissions

    NASA Astrophysics Data System (ADS)

    Sahu, L. K.; Yadav, Ravi; Pal, Devendra

    2016-03-01

    Ambient volatile organic compounds (VOCs) were measured using a high-resolution proton transfer reaction-time of flight-mass spectrometer at an urban site of Ahmedabad in India during the winter season in 2014. Mixing ratios of VOCs show large diurnal and day-to-day variations. Although strongly influenced by local emissions, periods of higher VOCs were observed during transport from the polluted Indo-Gangetic Plains than those from the cleaner Thar Desert. However with different rates, VOCs decreased exponentially with increasing wind speed. Relative abundance of methanol varied with weather conditions contributing highest and lowest under fog and clear-sky conditions, respectively. Among the compounds reported here, oxygenated VOCs (OVOCs) contribute to a large fraction (67-85%) with methanol being most abundant (40-58%). In spite of predominant vehicular emissions, diurnal distribution and emission ratios (ERs) of several VOCs indicate the role of biogenic and secondary sources. The ratios of isoprene/benzene and OVOCs/benzene show significant enhancements during daytime suggesting their contributions from biogenic and secondary sources. During marathon and cyclothon events, mixing ratios of VOCs were 2-10 times higher compared to a normal Sunday. The ERs of VOCs estimated using the nighttime data on marathon day are well within the range of values reported for several megacities of the world. The average contributions of primary anthropogenic sources to acetaldehyde, acetone, and isoprene were 44 ± 06%, 45 ± 07%, and 63 ± 12%, respectively. During cloudy condition, the increase in anthropogenic contribution to acetaldehyde (~10%), acetone (9%) and isoprene (30%) is due to reduction in biogenic emissions and secondary formation of these VOCs.

  17. Containment of Bioaerosol Infection Risk by the Xpert MTB/RIF Assay and Its Applicability to Point-of-Care Settings ▿

    PubMed Central

    Banada, Padmapriya P.; Sivasubramani, Satheesh K.; Blakemore, Robert; Boehme, Catharina; Perkins, Mark D.; Fennelly, Kevin; Alland, David

    2010-01-01

    The recently introduced Xpert MTB/RIF assay (Xpert) has point-of-care potential, but its capacity for biohazard containment remained to be studied. We compared the bioaerosols generated by the Xpert assay to acid-fast bacillus (AFB) microscope slide smear preparation. The Xpert assay sample treatment reagent (SR) was also studied for its sterilizing capacity, stability, and effect on assay sensitivity after prolonged treatment. During the preparation of AFB smears, sputum samples spiked with Mycobacterium bovis BCG at 5 × 108 CFU/ml produced 16 and 325 CFU/m3 air measured with an Andersen impactor or BioSampler, respectively. In contrast, neither the sample preparation steps for the Xpert assay nor its automated processing produced any culturable bioaerosols. In testing of SR sterilizing capacity, clinical sputum samples from strongly smear-positive tuberculosis patients treated with SR at a 2:1 ratio eliminated Mycobacterium tuberculosis growth in all but 1/39 or 3/45 samples cultured on solid or liquid medium, respectively. These few unsterilized samples had a mean 13.1-day delay in the time to positive culture. SR treatment at a 3:1 ratio eliminated growth in all samples. SR retained a greater than 6-log-unit killing capacity despite storage at temperatures spanning 4 to 45°C for at least 3 months. The effect of prolonged SR sample treatment was also studied. Spiked sputum samples could be incubated in SR for up to 3 days without affecting Xpert sensitivity for M. tuberculosis detection and up to 8 h without affecting specificity for rifampin resistance detection. These results suggest that benchtop use of the Xpert MTB/RIF assay limits infection risk to the user. PMID:20720033

  18. Running a marathon from −45°C to +55°C in a climate chamber: a case study

    PubMed Central

    Kälin, Kaspar; Knechtle, Beat; Rüst, Christoph Alexander; Mydlak, Karsten; Rosemann, Thomas

    2012-01-01

    Background We describe a runner who completed a self-paced marathon (42.195 km) in a climate chamber with a temperature difference of 100°C, starting at an ambient temperature (Tambient) of −45°C and finishing at an Tambient of +55°C. Methods Tambient was set at −45°C at the start, and was steadily increased at a rate of 1°C at 4.5-minute intervals to +55°C. Before the start, after every 10.5 km, and at the end of the marathon, body mass, urine, and sweat production were measured and samples of venous blood and urine were collected. The runner’s temperature was recorded every 10 seconds at four sites, ie, the rectum for body core temperature (Tcore), and at the forehead, right wrist, and right ankle for surface temperatures (Tskin). Results The subject took 6.5 hours to complete the marathon, during which Tcore varied by 0.9°C (start 37.5°C, peak 38.4°C). The largest difference (∆) of Tskin was recorded at the ankle (∆16°C). The calculated amount of sweat produced increased by 888% from baseline. In the blood samples, myoglobin (+250%) showed the highest change. Of the pituitary hormones, somatotropic hormone (+391%) and prolactin (+221%) increased the most. Regarding fluid regulation hormones, renin (+1145%) and aldosterone (+313%) showed the greatest increase. Conclusion These results show that running a marathon in a climate chamber with a total ∆Tambient of 100°C is possible, and that the Tambient to Tcore relationship is maintained. These results may offer insight into regulatory mechanisms to avoid hypothermia and hyperthermia. The same study is to be performed using more subjects with the same characteristics to validate the present findings. PMID:24198596

  19. Multispectral Evidence of Alteration from Murray Ridge to Marathon Valley Observed by the Opportunity Pancam on the Rim of Endeavour Crater, Mars

    NASA Technical Reports Server (NTRS)

    Farrand, W. H.; Mittlefehldt, D. W.; Bell, J. F.; Johnson, J. R.

    2015-01-01

    The Mars Exploration Rover Opportunity has been traversing the rim of the Noachian-aged, 22 km diameter Endeavour crater. Circa sol 3390 of its mission, Opportunity reached the northern tip of the rim segment known as Solander Point and has since been traversing the rim to the south to its current location at the break in the rim known as Marathon Valley. The rocks making up the rim are dominated by impact breccias consisting of clasts and a finer-grained matrix. Several segments of the rim are transected by fractures as observed from orbital HiRISE imagery. Pancam multispectral observations of outcrop in these fracture regions, including part of the rim crest dubbed Murray Ridge, the Hueytown fracture, and Marathon Valley have been made. Over the range of 430 to 1010 nm there are changes in the multispectral reflectance signature of the breccia matrix with an increase in 535 nm and 904 nm band depth. This is attributed to oxidation and an increase in ferric oxides in these areas. In situ observations by the rover's APXS also indicate chemical differences associated with the matrix along these fractures, including increasing Fe/Mn southward from Solander Point to a region having an Al-OH signature in CRISM spectra, and generally higher SO3 in the Hueytown fracture region and the area around Spirit of St. Louis. Overturned rocks observed on Murray Ridge were determined by the APXS to have elevated Mn and Pancam spectra of the high Mn spots have a characteristic red, featureless slope. This spectrum was also observed in association with some coatings on blocks of the sulfate-rich Grasberg formation. Spectra resembling red hematite are observed in some zones in association with the craterform feature Spirit of St. Louis outside the mouth (to the west) of Marathon Valley. Marathon Valley itself has been observed from orbital hyperspectral observations by the CRISM sensor to host occurrences of Fe/Mg smectite minerals- indicating extensive aqueous alteration in this

  20. Structure, Dynamics, and Interaction of Mycobacterium tuberculosis (Mtb) DprE1 and DprE2 Examined by Molecular Modeling, Simulation, and Electrostatic Studies

    PubMed Central

    Bhutani, Isha; Loharch, Saurabh; Gupta, Pawan; Madathil, Rethi; Parkesh, Raman

    2015-01-01

    The enzymes decaprenylphosphoryl-β-D-ribose oxidase (DprE1) and decaprenylphosphoryl-β-D-ribose-2-epimerase (DprE2) catalyze epimerization of decaprenylphosporyl ribose (DPR) todecaprenylphosporyl arabinose (DPA) and are critical for the survival of Mtb. Crystal structures of DprE1 so far reported display significant disordered regions and no structural information is known for DprE2. We used homology modeling, protein threading, molecular docking and dynamics studies to investigate the structural and dynamic features of Mtb DprE1 and DprE2 and DprE1-DprE2 complex. A three-dimensional model for DprE2 was generated using the threading approach coupled with ab initio modeling. A 50 ns simulation of DprE1 and DprE2 revealed the overall stability of the structures. Principal Component Analysis (PCA) demonstrated the convergence of sampling in both DprE1 and DprE2. In DprE1, residues in the 269–330 area showed considerable fluctuation in agreement with the regions of disorder observed in the reported crystal structures. In DprE2, large fluctuations were detected in residues 95–113, 146–157, and 197–226. The study combined docking and MD simulation studies to map and characterize the key residues involved in DprE1-DprE2 interaction. A 60 ns MD simulation for DprE1-DprE2 complex was also performed. Analysis of data revealed that the docked complex is stabilized by H-bonding, hydrophobic and ionic interactions. The key residues of DprE1 involved in DprE1-DprE2 interactions belong to the disordered region. We also examined the docked complex of DprE1-BTZ043 to investigate the binding pocket of DprE1 and its interactions with the inhibitor BTZ043. In summary, we hypothesize that DprE1-DprE2 interaction is crucial for the synthesis of DPA and DprE1-DprE2 complex may be a new therapeutic target amenable to pharmacological validation. The findings have important implications in tuberculosis (TB) drug discovery and will facilitate drug development efforts against TB

  1. Structure, dynamics, and interaction of Mycobacterium tuberculosis (Mtb) DprE1 and DprE2 examined by molecular modeling, simulation, and electrostatic studies.

    PubMed

    Bhutani, Isha; Loharch, Saurabh; Gupta, Pawan; Madathil, Rethi; Parkesh, Raman

    2015-01-01

    The enzymes decaprenylphosphoryl-β-D-ribose oxidase (DprE1) and decaprenylphosphoryl-β-D-ribose-2-epimerase (DprE2) catalyze epimerization of decaprenylphosporyl ribose (DPR) todecaprenylphosporyl arabinose (DPA) and are critical for the survival of Mtb. Crystal structures of DprE1 so far reported display significant disordered regions and no structural information is known for DprE2. We used homology modeling, protein threading, molecular docking and dynamics studies to investigate the structural and dynamic features of Mtb DprE1 and DprE2 and DprE1-DprE2 complex. A three-dimensional model for DprE2 was generated using the threading approach coupled with ab initio modeling. A 50 ns simulation of DprE1 and DprE2 revealed the overall stability of the structures. Principal Component Analysis (PCA) demonstrated the convergence of sampling in both DprE1 and DprE2. In DprE1, residues in the 269-330 area showed considerable fluctuation in agreement with the regions of disorder observed in the reported crystal structures. In DprE2, large fluctuations were detected in residues 95-113, 146-157, and 197-226. The study combined docking and MD simulation studies to map and characterize the key residues involved in DprE1-DprE2 interaction. A 60 ns MD simulation for DprE1-DprE2 complex was also performed. Analysis of data revealed that the docked complex is stabilized by H-bonding, hydrophobic and ionic interactions. The key residues of DprE1 involved in DprE1-DprE2 interactions belong to the disordered region. We also examined the docked complex of DprE1-BTZ043 to investigate the binding pocket of DprE1 and its interactions with the inhibitor BTZ043. In summary, we hypothesize that DprE1-DprE2 interaction is crucial for the synthesis of DPA and DprE1-DprE2 complex may be a new therapeutic target amenable to pharmacological validation. The findings have important implications in tuberculosis (TB) drug discovery and will facilitate drug development efforts against TB. PMID

  2. Implementing the Xpert® MTB/RIF Diagnostic Test for Tuberculosis and Rifampicin Resistance: Outcomes and Lessons Learned in 18 Countries

    PubMed Central

    Ardizzoni, Elisa; Fajardo, Emmanuel; Saranchuk, Peter; Casenghi, Martina; Page, Anne-Laure; Varaine, Francis; Kosack, Cara S.; Hepple, Pamela

    2015-01-01

    Background The Xpert® MTB/RIF (Xpert) is an automated molecular test for simultaneous detection of tuberculosis (TB) and rifampicin resistance, recommended by the World Health Organization as the preferred diagnostic method for individuals presumed to have multi-drug resistant TB (MDR-TB) or HIV-associated TB. We describe the performance of Xpert and key lessons learned during two years of implementation under routine conditions in 33 projects located in 18 countries supported by Médecins Sans Frontières across varied geographic, epidemiological and clinical settings. Methods Xpert was used following three strategies: the first being as the initial test, with microscopy in parallel, for all presumptive TB cases; the second being only for patients at risk of MDR-TB, or with HIV- associated TB, or presumptive paediatric TB; and the third being as the initial test for these high-risk patients plus as an add-on test to microscopy in others. Routine laboratory data were collected, using laboratory registers. Qualitative data such as logistic aspects, human resources, and tool acceptance were collected using a questionnaire. Findings In total, 52,863 samples underwent Xpert testing from April 2011 to December 2012. The average MTB detection rate was 18.5%, 22.3%, and 11.6% for the three different strategies respectively. Analysis of the results on samples tested in parallel showed that using Xpert as add-on test to microscopy would have increased laboratory TB confirmation by 49.7%, versus 42.3% for Xpert replacing microscopy. The main limitation of the test was the high rate of inconclusive results, which correlated with factors such as defective modules, cartridge version (G3 vs. G4) and staff experience. Operational and logistical hurdles included infrastructure renovation, basic computer training, regular instrument troubleshooting and maintenance, all of which required substantial and continuous support. Conclusion The implementation of Xpert was feasible and

  3. Static and Dynamic Postural Changes after a Mountain Ultra-Marathon of 80 km and 5500 D.

    PubMed

    Marcolin, Giuseppe; Grainer, Alessandro; Reggiani, Carlo; Bisiacchi, Patrizia; Cona, Giorgia; Petrone, Nicola; Paoli, Antonio

    2016-01-01

    The study aimed to investigate the effect of fatigue on static and dynamic postural stability after completing a mountain ultra-marathon. Twelve male athletes participated in the study. Postural stability was assessed before and immediately after the race. Static postural stability was evaluated on a dynamometric platform with eyes opened (OE) and closed (CE). Dynamic postural stability was assessed with OE on an instrumented plate which allowed medio-lateral oscillations. Stabilometric data were affected by fatigue in the OE condition, concerning sway path velocity (p = 0.0006), sway area velocity (p = 0.0006), area of the confidence ellipse (p = 0.0016), maximal anterior-posterior (AP) (p = 0.0017) and medio-lateral (ML) (p = 0.0039) oscillations. In the CE condition the sway path velocity (p = 0.0334), the maximal ML oscillations (p = 0.0161) and the area of the confident ellipse (p = 0.0180) were also negatively influenced. Stabilogram diffusion analysis showed in the OE condition an increase of short-term diffusion coefficients considering the anterior-posterior direction (Dfys; p = 0.0023) and the combination of the two (Dfr2s; p = 0.0032). Equally, long term diffusion coefficients increased considering the anterior-posterior direction (Dfyl; p = 0.0093) and the combination of the two (Dfr2l; p = 0.0086). In CE condition greater values were detected for medio-lateral direction (Dfxl; p = 0.033), anterior-posterior direction (Dfyl; p = 0.0459) and the combination of the two (Dfr2l; p = 0.0048). The dynamic postural stability test showed an increase of the time spent with the edges of the plate on the floor (p = 0.0152). Our results showed that mountain ultra-marathon altered static stability more than dynamic stability. An involvement of cognitive resources to monitor postural stability after fatiguing could be the explanation of the worsening in the automatic task (quiet standing) and of the positive compensation in the less automatic task (dynamic standing

  4. Static and Dynamic Postural Changes after a Mountain Ultra-Marathon of 80 km and 5500 D+

    PubMed Central

    Marcolin, Giuseppe; Grainer, Alessandro; Reggiani, Carlo; Bisiacchi, Patrizia; Cona, Giorgia; Petrone, Nicola

    2016-01-01

    The study aimed to investigate the effect of fatigue on static and dynamic postural stability after completing a mountain ultra-marathon. Twelve male athletes participated in the study. Postural stability was assessed before and immediately after the race. Static postural stability was evaluated on a dynamometric platform with eyes opened (OE) and closed (CE). Dynamic postural stability was assessed with OE on an instrumented plate which allowed medio-lateral oscillations. Stabilometric data were affected by fatigue in the OE condition, concerning sway path velocity (p = 0.0006), sway area velocity (p = 0.0006), area of the confidence ellipse (p = 0.0016), maximal anterior-posterior (AP) (p = 0.0017) and medio-lateral (ML) (p = 0.0039) oscillations. In the CE condition the sway path velocity (p = 0.0334), the maximal ML oscillations (p = 0.0161) and the area of the confident ellipse (p = 0.0180) were also negatively influenced. Stabilogram diffusion analysis showed in the OE condition an increase of short-term diffusion coefficients considering the anterior-posterior direction (Dfys; p = 0.0023) and the combination of the two (Dfr2s; p = 0.0032). Equally, long term diffusion coefficients increased considering the anterior-posterior direction (Dfyl; p = 0.0093) and the combination of the two (Dfr2l; p = 0.0086). In CE condition greater values were detected for medio-lateral direction (Dfxl; p = 0.033), anterior-posterior direction (Dfyl; p = 0.0459) and the combination of the two (Dfr2l; p = 0.0048). The dynamic postural stability test showed an increase of the time spent with the edges of the plate on the floor (p = 0.0152). Our results showed that mountain ultra-marathon altered static stability more than dynamic stability. An involvement of cognitive resources to monitor postural stability after fatiguing could be the explanation of the worsening in the automatic task (quiet standing) and of the positive compensation in the less automatic task (dynamic standing

  5. Effects of Mountain Ultra-Marathon Running on ROS Production and Oxidative Damage by Micro-Invasive Analytic Techniques

    PubMed Central

    Mrakic-Sposta, Simona; Gussoni, Maristella; Moretti, Sarah; Pratali, Lorenza; Giardini, Guido; Tacchini, Philippe; Dellanoce, Cinzia; Tonacci, Alessandro; Mastorci, Francesca; Borghini, Andrea; Montorsi, Michela; Vezzoli, Alessandra

    2015-01-01

    Purpose Aiming to gain a detailed insight into the physiological mechanisms involved under extreme conditions, a group of experienced ultra-marathon runners, performing the mountain Tor des Géants® ultra-marathon: 330 km trail-run in Valle d’Aosta, 24000 m of positive and negative elevation changes, was monitored. ROS production rate, antioxidant capacity, oxidative damage and inflammation markers were assessed, adopting micro-invasive analytic techniques. Methods Forty-six male athletes (45.04±8.75 yr, 72.6±8.4 kg, 1.76±0.05 m) were tested. Capillary blood and urine were collected before (Pre-), in the middle (Middle-) and immediately after (Post-) Race. Samples were analyzed for: Reactive Oxygen Species (ROS) production by Electron Paramagnetic Resonance; Antioxidant Capacity by Electrochemistry; oxidative damage (8-hydroxy-2-deoxy Guanosine: 8-OH-dG; 8-isoprostane: 8-isoPGF2α) and nitric oxide metabolites by enzymatic assays; inflammatory biomarkers (plasma and urine interleukin-6: IL-6-P and IL-6-U) by enzyme-linked immunosorbent assays (ELISA); Creatinine and Neopterin by HPLC, hematologic (lactate, glucose and hematocrit) and urine parameters by standard analyses. Results Twenty-five athletes finished the race, while twenty-one dropped out of it. A significant increase (Post-Race vs Pre) of the ROS production rate (2.20±0.27 vs 1.65±0.22 μmol.min-1), oxidative damage biomarkers (8-OH-dG: 6.32±2.38 vs 4.16±1.25 ng.mg-1 Creatinine and 8-isoPGF2α: 1404.0±518.30 vs 822.51±448.91 pg.mg-1Creatinine), inflammatory state (IL-6-P: 66.42±36.92 vs 1.29±0.54 pg.mL-1 and IL-6-U: 1.33±0.56 vs 0.71±0.17 pg.mL1) and lactate production (+190%), associated with a decrease of both antioxidant capacity (-7%) and renal function (i.e. Creatinine level +76%) was found. Conclusions The used micro-invasive analytic methods allowed us to perform most of them before, during and immediately after the race directly in the field, by passing the need of storing and

  6. Assessing the utility of Xpert® MTB/RIF as a screening tool for patients admitted to medical wards in South Africa

    PubMed Central

    Heidebrecht, Christine L.; Podewils, Laura J.; Pym, Alexander S.; Cohen, Ted; Mthiyane, Thuli; Wilson, Douglas

    2016-01-01

    Many hospital inpatients in South Africa have undiagnosed active and drug-resistant tuberculosis (TB). Early detection of TB is essential to inform immediate infection control actions to minimize transmission risk. We assessed the utility of Xpert® MTB/RIF (GeneXpert) as a screening tool for medical admissions at a large public hospital in South Africa. Consecutive adult patients admitted to medical wards between March-June 2013 were enrolled; sputum specimens were collected and tested by GeneXpert, smear microscopy, and culture. Chest X-rays (CXRs) were conducted as standard care for all patients admitted. We evaluated the proportion of patients identified with TB disease through each diagnostic method. Among enrolled patients whose medical charts were available for review post-discharge, 61 (27%) were diagnosed with TB; 34 (56% of diagnosed TB cases) were GeneXpert positive. When patients in whom TB was identified by other means were excluded, GeneXpert yielded only four additional TB cases. However, GeneXpert identified rifampicin-resistant TB in one patient, who was initially diagnosed based on CXR. The utility of GeneXpert for TB screening was limited in an institution where CXR is conducted routinely and which serves a population in which TB and TB/HIV co-infection are highly prevalent, but it allowed for rapid detection of rifampicin resistance. PMID:26786396

  7. Development, roll-out and impact of Xpert MTB/RIF for tuberculosis: what lessons have we learnt and how can we do better?

    PubMed Central

    Isaacs, Chris; Pai, Madhukar; Denkinger, Claudia M.; Boehme, Catharina C.

    2016-01-01

    The global roll-out of Xpert MTB/RIF (Cepheid Inc., Sunnyvale, CA, USA) has changed the diagnostic landscape of tuberculosis (TB). More than 16 million tests have been performed in 122 countries since 2011, and detection of multidrug-resistant TB has increased three- to eight-fold compared to conventional testing. The roll-out has galvanised stakeholders, from donors to civil society, and paved the way for universal drug susceptibility testing. It has attracted new product developers to TB, resulting in a robust molecular diagnostics pipeline. However, the roll-out has also highlighted gaps that have constrained scale-up and limited impact on patient outcomes. The roll-out has been hampered by high costs for under-funded programmes, unavailability of a complete solution package (notably comprehensive training, quality assurance, implementation plans, inadequate service and maintenance support) and lack of impact assessment. Insufficient focus has been afforded to effective linkage to care of diagnosed patients, and clinical impact has been blunted by weak health systems. In many countries the private sector plays a dominant role in TB control, yet this sector has limited access to subsidised pricing. In light of these lessons, we advocate for a comprehensive diagnostics implementation approach, including increased engagement of in-country stakeholders for product launch and roll-out, broader systems strengthening in preparation for new technologies, as well as quality impact data from programmatic settings. PMID:27418550

  8. Development, roll-out and impact of Xpert MTB/RIF for tuberculosis: what lessons have we learnt and how can we do better?

    PubMed

    Albert, Heidi; Nathavitharana, Ruvandhi R; Isaacs, Chris; Pai, Madhukar; Denkinger, Claudia M; Boehme, Catharina C

    2016-08-01

    The global roll-out of Xpert MTB/RIF (Cepheid Inc., Sunnyvale, CA, USA) has changed the diagnostic landscape of tuberculosis (TB). More than 16 million tests have been performed in 122 countries since 2011, and detection of multidrug-resistant TB has increased three- to eight-fold compared to conventional testing. The roll-out has galvanised stakeholders, from donors to civil society, and paved the way for universal drug susceptibility testing. It has attracted new product developers to TB, resulting in a robust molecular diagnostics pipeline. However, the roll-out has also highlighted gaps that have constrained scale-up and limited impact on patient outcomes. The roll-out has been hampered by high costs for under-funded programmes, unavailability of a complete solution package (notably comprehensive training, quality assurance, implementation plans, inadequate service and maintenance support) and lack of impact assessment. Insufficient focus has been afforded to effective linkage to care of diagnosed patients, and clinical impact has been blunted by weak health systems. In many countries the private sector plays a dominant role in TB control, yet this sector has limited access to subsidised pricing. In light of these lessons, we advocate for a comprehensive diagnostics implementation approach, including increased engagement of in-country stakeholders for product launch and roll-out, broader systems strengthening in preparation for new technologies, as well as quality impact data from programmatic settings. PMID:27418550

  9. Xpert® MTB/RIF assay: development, evaluation and implementation of a new rapid molecular diagnostic for tuberculosis and rifampicin resistance

    PubMed Central

    Lawn, Stephen D; Nicol, Mark P

    2011-01-01

    Global TB control efforts have been severely hampered by the lack of diagnostic tests that are accurate, simple to use and can be applied at the point of clinical care. This has been further compounded by the widespread inability to test for drug resistance. The Xpert® MTB/RIF assay is a rapid molecular assay that can be used close to the point of care by operators with minimal technical expertise, enabling diagnosis of TB and simultaneous assessment of rifampicin resistance to be completed within 2 h. Moreover, this can be accomplished using unprocessed sputum samples as well as clinical specimens from extrapulmonary sites. We review in detail the development of this assay, its evaluation within the laboratory, its utility among adult and pediatric TB suspects, its use as a screening tool for HIV-associated TB and studies of its implementation at the district and sub-district levels in resource-limited settings. Following endorsement by the WHO in 2010, we consider the next steps in the implementation of the assay and its potential impact in high burden settings. PMID:21958145

  10. Gender Differences in Sport Injury Risk and Types of Inju-Ries: A Retrospective Twelve-Month Study on Cross-Country Skiers, Swimmers, Long-Distance Runners and Soccer Players

    PubMed Central

    Ristolainen, Leena; Heinonen, Ari; Waller, Benjamin; Kujala, Urho M.; Kettunen, Jyrki A.

    2009-01-01

    This twelve months survey compared injury risk and injury types by genders (312 females, 262 males) in 15- to 35-year-old cross-country skiers, swimmers, long- distance runners and soccer players. More male than female athletes reported at least one acute injury (44% vs. 35%, p < 0.05), and more male than female runners reported at least one overuse injury (69% vs. 51%, p < 0.05). When the incidence of acute and overuse injuries both separately and combined was calculated per 1000 training hours, per 1000 competition hours and all exposure hours combined we found no gender differences in either of these comparisons. After adjustment for sport event males were at increased risk for posterior thigh overuse injuries compared to females (relative risk (RR) 5.8, 95% confidence interval (CI) 1.3 to 26.4, p < 0.05) while females were at increased risk for overuse injuries in the ankle compared to males (RR 3.1, 95% CI 1.0 to 9.3, p < 0.05). After adjustment for exposure time (injuries/1000 exposure hours) significance of the difference between the sexes in overuse injury to the ankle persisted (female 0.11 vs. male 0.02 injuries/1000 exposure hours, p < 0.05). Six athletes had an anterior cruciate ligament (ACL) injury, of whom four were female soccer players. After combining all reported acute and overuse ankle and knee injuries, the proportion of athletes with such injury was higher in the female compared to male soccer players (75% and 54% respectively; p < 0.05), but no difference was found in such injuries when calculated per 1000 exposure hours. In conclusion, we found some gender differences in sport-related injuries, but most of these differences seemed to be explained at least in part by differences in the amount of training. Key points Only a few sport injury studies have compared in-jury rates between the sexes Overall gender-related risk for acute and overuse injuries in top-level athletes between the sexes was small Some gender differences in the specific

  11. Fluid intake and changes in limb volumes in male ultra-marathoners: does fluid overload lead to peripheral oedema?

    PubMed

    Bracher, Alexia; Knechtle, Beat; Gnädinger, Markus; Bürge, Jolanda; Rüst, Christoph Alexander; Knechtle, Patrizia; Rosemann, Thomas

    2012-03-01

    An increase in body mass due to oedema has been previously described. The aim of this study was to investigate a potential association between both fluid and electrolyte intake and the formation of peripheral oedemas. Fluid and electrolyte intakes and the changes in limb volumes in 50 male 100-km ultra-marathoners were measured. Pre- and post-race serum sodium concentration ([Na(+)]), serum aldosterone concentration, serum copeptin concentration, serum and urine osmolality and body mass were determined. Fluid intake, renal function parameters and urinary output, as well as the changes of volume in the extremities, were measured. The changes of volume in the limbs were measured using plethysmography. Serum [Na(+)] increased by 1.6%; body mass decreased by 1.9 kg. Serum copeptin and aldosterone concentrations were increased. The change in serum copeptin concentration and the change in serum [Na(+)] correlated positively; the change in serum [Na(+)] and body mass correlated negatively. A mean fluid intake of 0.58 L/h was positively related to running speed and negatively to post-race serum [Na(+)]. Total fluid intake was positively related to the changes in both arm and lower leg volumes. Running speed was positively associated with the changes in arm and lower leg volumes; race time was related to the changes in serum copeptin or aldosterone concentrations. To conclude, fluid intake was related to the changes in limb volumes, where athletes with an increased fluid intake developed an increase in limb volumes. PMID:21720884

  12. Superfund Record of Decision (EPA Region 2): Marathon Battery, Cold Spring, NY. (Third remedial action), September 1989. Final report

    SciTech Connect

    Not Available

    1989-09-29

    The Marathon Battery site is a former battery-manufacturing plant in Cold Spring, Putnam County, New York. The site is composed of three study areas: Area I, which consists of East Foundry Cove Marsh and Constitution Marsh; Area II, which encompasses the former plant, presently a book-storage warehouse, the surrounding grounds, and a vault with cadmium contaminated sediment dredged from East Foundry Cove; and Area III, which includes East Foundry Cove (48 acres), West Foundry Cove and the Hudson River in the vicinity of Cold Spring pier and a sewer outfall. Contamination in Area III emanates from plant waste water that was discharged via the city sewer system into the Hudson River at Cold Spring Pier or, in some instances, through a storm sewer into East Foundry Cove. A Record of Decision (ROD) was signed for Area I in September 1986 with cleanup activities to include dredging the East Foundry Cove Marsh. The second ROD for the site was signed in September 1988 and included decontamination of the battery plant and soil excavation in Area II. The 1989 ROD represents the third and final operable unit for the site and addresses sediment contamination in Area III. The primary contaminants of concern affecting sediment at the site are metals, including cadmium and nickel.

  13. Superfund Record of Decision (EPA Region 2): Marathon Battery, NY (second remedial action), September 1988 (re-announced)

    SciTech Connect

    Not Available

    1988-09-30

    The Marathon Battery Company (MBC) site, a former battery manufacturing plant, is located in the Village of Cold Spring in Putnam, New York, approximately 40 miles north of New York City. The site operated from 1952 to 1979 producing military and commercial batteries. During this time the site changed ownership several times, finally operating as the MBC from 1969 to 1979. Before 1965, the plant's waste-water treatment system discharged into the Hudson River at the Cold Spring pier via the Cold Spring sewer system, except during periods of overload or system shutdown during which time the process effluent was discharged directly into East Foundry Cove Marsh (EFCM) to the southeast. Between November 1972 and July 1973, a limited cleanup was conducted by MBC and other responsible parties, to remove sediment from parts of Foundry Cove and surrounding areas contaminated with cadmium and nickel in excess of 900 mg/kg. The selected remedial action for Area II at this site includes: decontamination of the former battery facility; excavation; and offsite disposal.

  14. Caregiver distress, shared traumatic exposure, and child adjustment among area youth following the 2013 Boston Marathon bombing

    PubMed Central

    Kerns, Caroline E.; Elkins, R. Meredith; Carpenter, Aubrey L.; Chou, Tommy; Green, Jennifer Greif; Comer, Jonathan S.

    2014-01-01

    Background Disasters are associated with myriad negative outcomes in youth, including posttraumatic stress disorder and related psychopathology. Prior work suggests links between caregiver distress and child mental health outcomes following community traumas, but the extent to which caregiver distress is directly linked to post-disaster child functioning, or whether such associations may simply be due to shared traumatic exposure, remains unclear. Methods The current study examined relationships among caregiver distress, caregiver-child shared traumatic exposure, and child outcomes in Boston-area families (N=460) during the six months following the 2013 Boston Marathon bombing. Parents completed surveys about their and their child’s potentially traumatic experiences during the bombing and subsequent manhunt. Post-attack caregiver distress and child psychological functioning were also assessed. Results After accounting for caregiver-child shared traumatic exposure, significant associations were retained between caregiver distress and child functioning across several domains. Furthermore, after accounting for caregiver traumatic exposure, caregiver distress moderated relationships between child traumatic exposure and child posttraumatic stress and conduct problems, such that associations between child traumatic exposure and child posttraumatic stress and conduct problems were particularly strong among children of highly distressed caregivers. Limitations The cross-sectional design did not permit evaluations across time, and population-based methods were not applied. Conclusions Findings clarify links between caregiver distress and child psychopathology in the aftermath of disaster and can inform optimal allocation of clinical resources targeting disaster-affected youth and their families. PMID:25082114

  15. Circulatory endotoxin concentration and cytokine profile in response to exertional-heat stress during a multi-stage ultra-marathon competition.

    PubMed

    Gill, Samantha K; Teixeira, Ana; Rama, Luis; Prestes, Jonato; Rosado, Fatima; Hankey, Joanne; Scheer, Volker; Hemmings, Krystal; Ansley-Robson, Paula; Costa, Ricardo J S

    2015-01-01

    Exertional-heat stress has the potential to disturb intestinal integrity, leading to enhanced permeability of enteric pathogenic micro-organisms and associated clinical manifestations. The study aimed to determine the circulatory endotoxin concentration and cytokine profile of ultra-endurance runners (UER, n=19) and a control group (CON, n=12) during a five stage 230km ultra-marathon (mean ± SD: 27h38min ± 3h55min) conducted in hot and dry environmental conditions (30ºC to 40ºC and 31% to 40% relative humidity). Body mass and tympanic temperature were measured, and venous blood samples were taken before (pre-stage) and immediately after (post-stage) each stage of the ultra-marathon for the analysis of gram-negative bacterial endotoxin, C-reactive protein, cytokine profile (IL-6, IL-1β, TNF-α, IFN-γ, IL-10, and IL- 1ra), and plasma osmolality. Gastrointestinal symptoms and perceptive thermal tolerance rating were also monitored throughout competition. Mean exercise-induced body mass loss over the five stages ranged 1.0% to 2.5%. Pre- and poststage plasma osmolality in UER ranged277 to 282mOsmol/kg and 286 to 297 mOsmol/kg, respectively. Pre-stage concentrations of endotoxin (peak: 21% at Stage 5), C-reactive protein (889% at Stage 3), IL-6 (152% at Stage 2), IL-1β (95% at Stage 5), TNF-α (168% at Stage 5), IFN-γ (102% at Stage 5),IL-10 (1271% at Stage 3), and IL-1ra (106% at Stage 5) increased as the ultra-marathon progressed in UER; while no changes in CON were observed (except for IL-1β, 71% at Stage 5). Pre- to post-stage increases were observed for endotoxin (peak: 22% at Stage 3), C-reactive protein (25% at Stage 1), IL-6 (238% at Stage 1), IL-1β (64% at Stage 1), TNF-α (101% at Stage 1), IFN-γ (39% at Stage 1), IL-10 (1100% at Stage 1), and IL-1ra(207% at Stage 1) concentrations in UER. Multi-stage ultra-marathon competition in the heat resulted in a modest circulatory endotoxaemia accompanied by a pronounced pro-inflammatory cytokinaemia by post

  16. Testing Pooled Sputum with Xpert MTB/RIF for Diagnosis of Pulmonary Tuberculosis To Increase Affordability in Low-Income Countries

    PubMed Central

    Abdurrahman, Saddiq T.; Mbanaso, Omezikam; Lawson, Lovett; Oladimeji, Olanrewaju; Blakiston, Matthew; Obasanya, Joshua; Dacombe, Russell; Adams, Emily R.; Emenyonu, Nnamdi; Sahu, Suvanand; Creswell, Jacob

    2015-01-01

    Tuberculosis (TB) is a global public health problem, with the highest burden occurring in low-income countries. In these countries, the use of more sensitive diagnostics, such as Xpert MTB/RIF (Xpert), is still limited by costs. A cost-saving strategy to diagnose other diseases is to pool samples from various individuals and test them with single tests. The samples in positive pool samples are then retested individually to identify the patients with the disease. We assessed a pooled testing strategy to optimize the affordability of Xpert for the diagnosis of TB. Adults with presumptive TB attending hospitals or identified by canvassing of households in Abuja, Nigeria, were asked to provide sputum for individual and pooled (4 per pool) testing. The agreement of the results of testing of individual and pooled samples and costs were assessed. A total of 738 individuals submitted samples, with 115 (16%) being Mycobacterium tuberculosis positive. Valid Xpert results for individual and pooled samples were available for 718 specimens. Of these, testing of pooled samples detected 109 (96%) of 114 individual M. tuberculosis-positive samples, with the overall agreement being 99%. Xpert semiquantitative M. tuberculosis levels had a positive correlation with the smear grades, and the individual sample-positive/pooled sample-negative results were likely due to the M. tuberculosis concentration being below the detection limit. The strategy reduced cartridge costs by 31%. Savings were higher with samples from individuals recruited in the community, where the proportion of positive specimens was low. The results of testing of pooled samples had a high level of agreement with the results of testing of individual samples, and use of the pooled testing strategy reduced costs and has the potential to increase the affordability of Xpert in countries with limited resources. PMID:26019204

  17. Bacterial Loads Measured by the Xpert MTB/RIF Assay as Markers of Culture Conversion and Bacteriological Cure in Pulmonary TB

    PubMed Central

    Shenai, Shubhada; Ronacher, Katharina; Malherbe, Stefanus; Stanley, Kim; Kriel, Magdalena; Winter, Jill; Peppard, Thomas; Barry, Charles E.; Wang, Jing; Dodd, Lori E.; Via, Laura E.; Barry, Clifton E.; Walzl, Gerhard; Alland, David

    2016-01-01

    Introduction Biomarkers are needed to monitor tuberculosis (TB) treatment and predict treatment outcomes. We evaluated the Xpert MTB/RIF (Xpert) assay as a biomarker for TB treatment during and at the end of the 24 weeks therapy. Methods Sputum from 108 HIV-negative, culture-positive pulmonary TB patients was analyzed using Xpert at time points before and during anti-TB therapy. Results were compared against culture. Direct Xpert cycle-threshold (Ct), a change in the Ct (delta Ct), or a novel “percent closing of baseline Ct deficit” (percent closing) were evaluated as classifiers of same-day and end-of-treatment culture and therapeutic outcomes. Results Xpert was positive in 29/95 (30.5%) of subjects at week 24; and positive one year after treatment in 8/64 (12.5%) successfully-treated patients who remained free of tuberculosis. We identified a relationship between initial bacterial load measured by baseline Xpert Ct and time to culture conversion (hazard ratio 1.06, p = 0.0023), and to the likelihood of being among the 8 treatment failures at week 24 (AUC = 72.8%). Xpert Ct was even more strongly associated with culture conversion on the day the test was performed with AUCs 96.7%, 99.2%, 86.0% and 90.2%, at Day 7, Week 4, 8 and 24, respectively. Compared to baseline Ct measures alone, a combined measure of baseline Ct plus either Delta Ct or percent closing improved the classification of treatment failure status to a 75% sensitivity and 88.9% specificity. Conclusions Genome loads measured by Xpert provide a potentially-useful biomarker for classifying same day culture status and predicting response to therapy. PMID:27508390

  18. Intensified tuberculosis case finding among HIV-infected persons using a WHO symptom screen and Xpert® MTB/RIF

    PubMed Central

    Adelman, M. W.; Tsegaye, M.; Kempker, R. R.; Alebachew, T.; Haile, K.; Tesfaye, A.; Aseffa, A.; Blumberg, H. M.

    2015-01-01

    SUMMARY SETTING Human immunodeficiency virus (HIV) clinic in Addis Ababa, Ethiopia. The World Health Organization (WHO) recommends active tuberculosis (TB) case-finding among people living with HIV (PLHIV) in high-burden settings. OBJECTIVE To evaluate the effectiveness of combining a WHO-recommended symptom screen and the Xpert® MTB/RIF test to enhance TB case finding. DESIGN In this cross-sectional study, PLHIV were screened for TB using a WHO-recommended symptom-based algorithm (cough, fever, night sweats, weight loss). Those with a positive symptom screen (≥1 symptom) underwent diagnostic testing with smear microscopy, culture, and Xpert. RESULTS Of 828 PLHIV (89% on antiretroviral therapy), 321 (39%) had a positive symptom screen. In multivariate analysis, an unscheduled clinic visit (aOR 3.78, 95%CI 2.69–5.32), CD4 count <100 cells/µl (aOR 2.62, 95%CI 1.23–5.59) and previous history of TB (aOR 1.62, 95%CI 1.12–2.31) were predictors of a positive symptom screen. Among those with a positive symptom screen, 6% had active pulmonary TB. Smear microscopy sensitivity for TB was poor (30%) compared to culture and Xpert. CONCLUSIONS A positive symptom screen was common among PLHIV, creating a substantial laboratory burden. Smear microscopy had poor sensitivity for active TB disease. Given the high rate of positive symptom screen, substantial additional resources are needed to implement intensified TB case finding among PLHIV in high-burden areas. PMID:26459533

  19. Comparison of Xpert MTB/RIF Assay and GenoType MTBDRplus DNA Probes for Detection of Mutations Associated with Rifampicin Resistance in Mycobacterium tuberculosis

    PubMed Central

    Rahman, Arfatur; Sahrin, Mahfuza; Afrin, Sadia; Earley, Keith; Ahmed, Shahriar; Rahman, S. M. Mazidur; Banu, Sayera

    2016-01-01

    Background GeneXpert MTB/RIF (Xpert) and Genotype MTBDRplus (DRplus) are two World Health Organization (WHO) endorsed probe based molecular drug susceptibility testing (DST) methods for rapid diagnosis of drug resistant tuberculosis. Both methods target the same 81 bp Rifampicin Resistance Determining Region (RRDR) of bacterial RNA polymerase β subunit (rpoB) for detection of Rifampicin (RIF) resistance associated mutations using DNA probes. So there is a correspondence of the probes of each other and expected similarity of probe binding. Methods We analyzed 92 sputum specimens by Xpert, DRplus and LJ proportion method (LJ-DST). We compared molecular DSTs with gold standard LJ-DST. We wanted to see the agreement level of two molecular methods for detection of RIF resistance associated mutations. The 81bp RRDR region of rpoB gene of discrepant cases between the two molecular methods was sequenced by Sanger sequencing. Results The agreement of Xpert and DRplus with LJ-DST for detection of RIF susceptibility was found to be 93.5% and 92.4%, respectively. We also found 92.4% overall agreement of two molecular methods for the detection of RIF susceptibility. A total of 84 out of 92 samples (91.3%) had agreement on the molecular locus of RRDR mutation by DRplus and Xpert. Sanger sequencing of 81bp RRDR revealed that Xpert probes detected seven of eight discrepant cases correctly and DRplus was erroneous in all the eight cases. Conclusion Although the overall concordance with LJ-DST was similar for both Xpert and DRplus assay, Xpert demonstrated more accuracy in the detection of RIF susceptibility for discrepant isolates compared with DRplus. This observation would be helpful for the improvement of probe based detection of drug resistance associated mutations especially rpoB mutation in M. tuberculosis. PMID:27054344

  20. A Novel Sample Processing Method for Rapid Detection of Tuberculosis in the Stool of Pediatric Patients Using the Xpert MTB/RIF Assay

    PubMed Central

    Deshpande, Srinidhi; Karim, Farina; Flynn, JoAnne L.; O’Malley, Melanie; Jones, Martin; Nanassy, Oliver; Jeena, Prakash; Alland, David

    2016-01-01

    Background Tuberculosis (TB) is difficult to diagnose in children using molecular tests, because children have difficulty providing respiratory samples. Stool could replace sputum for diagnostic TB testing if adequate sample processing techniques were available. Methods We developed a rapid method to process large volumes of stool for downstream testing by the Xpert MTB/RIF (Xpert) TB-detection assay. The method was tested and optimized on stool samples spiked with known numbers of M. tuberculosis colony forming units (CFU), and stools from M. tuberculosis-infected cynomolgus macaques (Macaca fascicularis). Performance was scored on number of positive Xpert tests, the cycle thresholds (Cts) of the Xpert sample-processing control (SPC), and the Cts of the M. tuberculosis-specific rpoB probes. The method was then validated on 20 confirmed TB cases and 20 controls in Durban, South Africa. Results The assay’s analytical limit of detection was 1,000 CFU/g of stool. As much as one gram of spiked stool could be tested without showing increased PCR inhibition. In analytical spiking experiments using human stool, 1g samples provided the best sensitivity compared to smaller amounts of sample. However, in Macaques with TB, 0.6g stool samples performed better than either 0.2g or 1.2g samples. Testing the stool of pediatric TB suspects and controls suggested an assay sensitivity of 85% (95% CI 0.6–0.9) and 84% (95% CI 0.6–0.96) for 0.6g and 1.2g stool samples, respectively, and a specificity of 100% (95% CI 0.77–1) and 94% (95% CI 0.7–0.99), respectively. Conclusion This novel approach may permit simple and rapid detection of TB using pediatric stool samples. PMID:27007974

  1. A faster running speed is associated with a greater body weight loss in 100-km ultra-marathoners.

    PubMed

    Knechtle, Beat; Knechtle, Patrizia; Wirth, Andrea; Alexander Rüst, Christoph; Rosemann, Thomas

    2012-01-01

    In 219 recreational male runners, we investigated changes in body mass, total body water, haematocrit, plasma sodium concentration ([Na(+)]), and urine specific gravity as well as fluid intake during a 100-km ultra-marathon. The athletes lost 1.9 kg (s = 1.4) of body mass, equal to 2.5% (s = 1.8) of body mass (P < 0.001), 0.7 kg (s = 1.0) of predicted skeletal muscle mass (P < 0.001), 0.2 kg (s = 1.3) of predicted fat mass (P < 0.05), and 0.9 L (s = 1.6) of predicted total body water (P < 0.001). Haematocrit decreased (P < 0.001), urine specific gravity (P < 0.001), plasma volume (P < 0.05), and plasma [Na(+)] (P < 0.05) all increased. Change in body mass was related to running speed (r = -0.16, P < 0.05), change in plasma volume was associated with change in plasma [Na(+)] (r = -0.28, P < 0.0001), and change in body mass was related to both change in plasma [Na(+)] (r = -0.36) and change in plasma volume (r = 0.31) (P < 0.0001). The athletes consumed 0.65 L (s = 0.27) fluid per hour. Fluid intake was related to both running speed (r = 0.42, P < 0.0001) and change in body mass (r = 0.23, P = 0.0006), but not post-race plasma [Na(+)] or change in plasma [Na(+)] (P > 0.05). In conclusion, faster runners lost more body mass, runners lost more body mass when they drank less fluid, and faster runners drank more fluid than slower runners. PMID:22668199

  2. Methods and Technologies Branch (MTB)

    Cancer.gov

    The Methods and Technologies Branch focuses on methods to address epidemiologic data collection, study design and analysis, and to modify technological approaches to better understand cancer susceptibility.

  3. What it Takes to Get Passed On: Message Content, Style, and Structure as Predictors of Retransmission in the Boston Marathon Bombing Response

    PubMed Central

    Sutton, Jeannette; Gibson, C. Ben; Spiro, Emma S.; League, Cedar; Fitzhugh, Sean M.; Butts, Carter T.

    2015-01-01

    Message retransmission is a central aspect of information diffusion. In a disaster context, the passing on of official warning messages by members of the public also serves as a behavioral indicator of message salience, suggesting that particular messages are (or are not) perceived by the public to be both noteworthy and valuable enough to share with others. This study provides the first examination of terse message retransmission of official warning messages in response to a domestic terrorist attack, the Boston Marathon Bombing in 2013. Using messages posted from public officials’ Twitter accounts that were active during the period of the Boston Marathon bombing and manhunt, we examine the features of messages that are associated with their retransmission. We focus on message content, style, and structure, as well as the networked relationships of message senders to answer the question: what characteristics of a terse message sent under conditions of imminent threat predict its retransmission among members of the public? We employ a negative binomial model to examine how message characteristics affect message retransmission. We find that, rather than any single effect dominating the process, retransmission of official Tweets during the Boston bombing response was jointly influenced by various message content, style, and sender characteristics. These findings suggest the need for more work that investigates impact of multiple factors on the allocation of attention and on message retransmission during hazard events. PMID:26295584

  4. What it Takes to Get Passed On: Message Content, Style, and Structure as Predictors of Retransmission in the Boston Marathon Bombing Response.

    PubMed

    Sutton, Jeannette; Gibson, C Ben; Spiro, Emma S; League, Cedar; Fitzhugh, Sean M; Butts, Carter T

    2015-01-01

    Message retransmission is a central aspect of information diffusion. In a disaster context, the passing on of official warning messages by members of the public also serves as a behavioral indicator of message salience, suggesting that particular messages are (or are not) perceived by the public to be both noteworthy and valuable enough to share with others. This study provides the first examination of terse message retransmission of official warning messages in response to a domestic terrorist attack, the Boston Marathon Bombing in 2013. Using messages posted from public officials' Twitter accounts that were active during the period of the Boston Marathon bombing and manhunt, we examine the features of messages that are associated with their retransmission. We focus on message content, style, and structure, as well as the networked relationships of message senders to answer the question: what characteristics of a terse message sent under conditions of imminent threat predict its retransmission among members of the public? We employ a negative binomial model to examine how message characteristics affect message retransmission. We find that, rather than any single effect dominating the process, retransmission of official Tweets during the Boston bombing response was jointly influenced by various message content, style, and sender characteristics. These findings suggest the need for more work that investigates impact of multiple factors on the allocation of attention and on message retransmission during hazard events. PMID:26295584

  5. Lessons From the Boston Marathon Bombing: An Orthopaedic Perspective on Preparing for High-Volume Trauma in an Urban Academic Center.

    PubMed

    Tobert, Daniel; von Keudell, Arvind; Rodriguez, Edward K

    2015-10-01

    The 2013 Boston Marathon bombing resulted in a mass casualty event that tested the limits of Boston-area trauma centers. The explosions, 12 seconds apart, led to the rapid influx of 124 patients with primarily lower extremity injuries in 5 different adult level 1 trauma centers. This study aimed to examine the existing hospital systems in place for disaster scenarios at the time of the event and identify areas for improvement. Preparation before the Boston Marathon bombing included coordinating the delivery of patients to area facilities and creating a framework for response at an institutional level. These simulations, coupled with the fact that the explosions occurred at a nexus of medical facilities, helped provide impactful care preventing any fatalities in patients who arrived at a Boston hospital that day. The experience at our institution led to the implementation of a more robust communication infrastructure and reinforced the value of preparatory drills. Within the Orthopaedic Surgery Department, we developed a more robust organizational hierarchy for mass casualty events and implemented a multitrauma follow-up clinic. We believe that it is the responsibility of every hospital to have systems in place to handle the rapid arrival of patients with multiple-trauma, and we hope that others can learn from our experience. PMID:26356215

  6. Effect of Introducing Xpert MTB/RIF to Test and Treat Individuals at Risk of Multidrug-Resistant Tuberculosis in Kazakhstan: A Prospective Cohort Study

    PubMed Central

    van Kampen, Sanne Christine; Tursynbayeva, Aigul; Koptleuova, Aliya; Murzabekova, Zauresh; Bigalieva, Lyazzat; Aubakirova, Moldir; Pak, Svetlana; van den Hof, Susan

    2015-01-01

    Background Xpert MTB/RIF (Xpert) was piloted in Kazakhstan to detect tuberculosis (TB) and rifampicin resistance (RR-)TB among individuals at risk of multidrug-resistant (MDR-) TB. This study assessed the performance of Xpert compared to conventional diagnostic methods, RR-TB case detection among various risk groups, treatment initiation and time to diagnosis and treatment. Methods Eligible individuals were tested with Xpert, smear microscopy, culture and drug-susceptibility testing (DST) at the national TB reference laboratory and three provincial laboratories. Data was collected prospectively from August 2012 to May 2013 from routine laboratory and treatment registers. Results A total of 5,611 Xpert tests were performed mostly targeting contacts of MDR-TB patients, ‘other’ presumptive MDR-TB patients, and retreatment cases (26%, 24% and 22%, respectively). Compared to phenotypic DST, the positive predictive value of Xpert to detect RR-TB was 93.1% and 96.4% and the negative predictive value was 94.6% and 92.7% using solid and liquid culture media, respectively. RR-TB detection was highest among (former) prisoners, retreatment cases, people living with HIV/AIDS (PLWHA), and TB patients with positive smears after intensive phase of treatment (59%, 58%, 54% and 53% among TB positives, respectively). 88.9% of RR-TB patients were registered to have started second-line TB treatment. Median time to diagnosis with Xpert was 0.0 days (IQR 0.0-1.0), time from diagnosis to start of first-line treatment 3.0 days (IQR 1.0-7.0), and to start of second-line treatment 7.0 days (IQR 4.0-16). Conclusions Compared to conventional culture and DST, Xpert had a shorter result turn-around-time and excellent concordance to detect RR-TB. Time from sputum collection to start of second-line treatment was reduced to one week. The yield of Xpert could be maximized by increasing referrals from penitentiary and HIV centers to TB centers. PMID:26181578

  7. Implementation Research to Inform the Use of Xpert MTB/RIF in Primary Health Care Facilities in High TB and HIV Settings in Resource Constrained Settings

    PubMed Central

    Muyoyeta, Monde; Moyo, Maureen; Kasese, Nkatya; Ndhlovu, Mapopa; Milimo, Deborah; Mwanza, Winfridah; Kapata, Nathan; Schaap, Albertus; Godfrey Faussett, Peter; Ayles, Helen

    2015-01-01

    Background The current cost of Xpert MTB RIF (Xpert) consumables is such that algorithms are needed to select which patients to prioritise for testing with Xpert. Objective To evaluate two algorithms for prioritisation of Xpert in primary health care settings in a high TB and HIV burden setting. Method Consecutive, presumptive TB patients with a cough of any duration were offered either Xpert or Fluorescence microscopy (FM) test depending on their CXR score or HIV status. In one facility, sputa from patients with an abnormal CXR were tested with Xpert and those with a normal CXR were tested with FM (“CXR algorithm”). CXR was scored automatically using a Computer Aided Diagnosis (CAD) program. In the other facility, patients who were HIV positive were tested using Xpert and those who were HIV negative were tested with FM (“HIV algorithm”). Results Of 9482 individuals pre-screened with CXR, Xpert detected TB in 2090/6568 (31.8%) with an abnormal CXR, and FM was AFB positive in 8/2455 (0.3%) with a normal CXR. Of 4444 pre-screened with HIV, Xpert detected TB in 508/2265 (22.4%) HIV positive and FM was AFB positive in 212/1920 (11.0%) in HIV negative individuals. The notification rate of new bacteriologically confirmed TB increased; from 366 to 620/ 100,000/yr and from 145 to 261/100,000/yr at the CXR and HIV algorithm sites respectively. The median time to starting TB treatment at the CXR site compared to the HIV algorithm site was; 1(IQR 1-3 days) and 3 (2-5 days) (p<0.0001) respectively. Conclusion Use of Xpert in a resource-limited setting at primary care level in conjunction with pre-screening tests reduced the number of Xpert tests performed. The routine use of Xpert resulted in additional cases of confirmed TB patients starting treatment. However, there was no increase in absolute numbers of patients starting TB treatment. Same day diagnosis and treatment commencement was achieved for both bacteriologically confirmed and empirically diagnosed patients

  8. Comparing Tuberculosis Diagnostic Yield in Smear/Culture and Xpert® MTB/RIF-Based Algorithms Using a Non-Randomised Stepped-Wedge Design

    PubMed Central

    Naidoo, Pren; Dunbar, Rory; Lombard, Carl; du Toit, Elizabeth; Caldwell, Judy; Detjen, Anne; Squire, S. Bertel; Enarson, Donald A.; Beyers, Nulda

    2016-01-01

    Setting Primary health services in Cape Town, South Africa. Study Aim To compare tuberculosis (TB) diagnostic yield in an existing smear/culture-based and a newly introduced Xpert® MTB/RIF-based algorithm. Methods TB diagnostic yield (the proportion of presumptive TB cases with a laboratory diagnosis of TB) was assessed using a non-randomised stepped-wedge design as sites transitioned to the Xpert® based algorithm. We identified the full sequence of sputum tests recorded in the electronic laboratory database for presumptive TB cases from 60 primary health sites during seven one-month time-points, six months apart. Differences in TB yield and temporal trends were estimated using a binomial regression model. Results TB yield was 20.9% (95% CI 19.9% to 22.0%) in the smear/culture-based algorithm compared to 17.9% (95%CI 16.4% to 19.5%) in the Xpert® based algorithm. There was a decline in TB yield over time with a mean risk difference of -0.9% (95% CI -1.2% to -0.6%) (p<0.001) per time-point. When estimates were adjusted for the temporal trend, TB yield was 19.1% (95% CI 17.6% to 20.5%) in the smear/culture-based algorithm compared to 19.3% (95% CI 17.7% to 20.9%) in the Xpert® based algorithm with a risk difference of 0.3% (95% CI -1.8% to 2.3%) (p = 0.796). Culture tests were undertaken for 35.5% of smear-negative compared to 17.9% of Xpert® negative low MDR-TB risk cases and for 82.6% of smear-negative compared to 40.5% of Xpert® negative high MDR-TB risk cases in respective algorithms. Conclusion Introduction of an Xpert® based algorithm did not produce the expected increase in TB diagnostic yield. Studies are required to assess whether improving adherence to the Xpert® negative algorithm for HIV-infected individuals will increase yield. In light of the high cost of Xpert®, a review of its role as a screening test for all presumptive TB cases may be warranted. PMID:26930400

  9. The Diagnostic Performance of a Single GeneXpert MTB/RIF Assay in an Intensified Tuberculosis Case Finding Survey among HIV-Infected Prisoners in Malaysia

    PubMed Central

    Al-Darraji, Haider Abdulrazzaq Abed; Razak, Humaira Abd; Ng, Kee Peng; Altice, Frederick L.; Kamarulzaman, Adeeba

    2013-01-01

    Background Delays in tuberculosis (TB) diagnosis, particularly in prisons, is associated with detrimental outcomes. The new GeneXpert MTB/RIF assay (Xpert) offers accurate and rapid diagnosis of active TB, but its performance in improving case detection in high-transmission congregate settings has yet to be evaluated. We assessed the diagnostic accuracy of a single Xpert assay in an intensified case finding survey among HIV-infected prisoners in Malaysia. Methods HIV-infected prisoners at a single site provided two early-morning sputum specimens to be examined using fluorescence smear microscopy, BACTEC MGIT 960 liquid culture and a single Xpert. The sensitivity, specificity, negative and positive predictive values of Xpert were calculated relative to gold-standard results using MGIT 960 liquid culture. Relevant clinical and demographic data were used to examine correlates of active TB disease. Results The majority of enrolled subjects with complete data (N=125) were men (90.4%), age <40 years (61.6%) and had injected drugs (75.2%). Median CD4 lymphocyte count was 337 cells/µL (IQR 149-492); only 19 (15.2%) were receiving antiretroviral therapy. Of 15 culture-positive TB cases, single Xpert assay accurately detected only eight previously undiagnosed TB cases, resulting in a sensitivity, specificity, positive predictive value and negative predictive value of 53.3% (95% CI 30.12-75.2%), 100% (95% CI 96.6-100%), 100% (95% CI 67.56-100%) and 94.0% (95% CI 88.2-97.1%), respectively. Only 1 of 15 (6.7%) active TB cases was smear-positive. The prevalence (12%) of undiagnosed active pulmonary TB (15 of 125 prisoners) was high and associated with longer duration of drug use (AOR 1.14, 95% CI 1.03-1.26, for each year of drug use). Conclusions Single Xpert assay improved TB case detection and outperformed AFB smear microscopy, but yielded low screening sensitivity. Further examination of the impact of HIV infection on the diagnostic performance of the new assay alongside

  10. Perturbed energy balance and hydration status in ultra-endurance runners during a 24 h ultra-marathon.

    PubMed

    Costa, Ricardo J S; Gill, Samantha K; Hankey, Joanne; Wright, Alice; Marczak, Slawomir

    2014-08-14

    The present study aimed to assess the adequacy of energy, macronutrients and water intakes of ultra-endurance runners (UER) competing in a 24 h ultra-marathon (distance range: 122-208 km). The ad libitum food and fluid intakes of the UER (n 25) were recorded throughout the competition and analysed using dietary analysis software. Body mass (BM), urinary ketone presence, plasma osmolality (POsmol) and volume change were determined at pre- and post-competition time points. Data were analysed using appropriate t tests, with significance set at P <0·05. The total energy intake and expenditure of the UER were 20 (sd 12) and 55 (sd 11) MJ, respectively (control (CON) (n 17): 12 (sd 1) and 14 (sd 5) MJ, respectively). The protein, carbohydrate and fat intakes of the UER were 1·1 (sd 0·4), 11·3 (sd 7·0) and 1·5 (sd 0·7) g/kg BM, respectively. The rate of carbohydrate intake during the competition was 37 (sd 24) g/h. The total water intake of the UER was 9·1 (sd 4·0) litres (CON: 2·1 (sd 1·0) litres), while the rate of water intake was 378 (sd 164) ml/h. Significant BM loss occurred at pre- to post-competition time points (P =0·001) in the UER (1·6 (sd 2·0) %). No significant changes in POsmol values were observed at pre- (285 (sd 11) mOsmol/kg) to post-competition (287 (sd 10) mOsmol/kg) time points in the UER and were lower than those recorded in the CON group (P <0·05). However, plasma volume (PV) increased at post-competition time points in the UER (10·2 (sd 9·7) %; P <0·001). Urinary ketones were evident in the post-competition samples of 90 % of the UER. Energy deficit was observed in all the UER, with only one UER achieving the benchmark recommendations for carbohydrate intake during endurance exercise. Despite the relatively low water intake rates recorded in the UER, hypohydration does not appear to be an issue, considering increases in PV values observed in the majority (80 %) of the UER. Population-specific dietary recommendations may be

  11. Petrogenesis of orbicular ijolites from the Prairie Lake complex, Marathon, Ontario: Textural evidence from rare processes of carbonatitic magmatism

    NASA Astrophysics Data System (ADS)

    Zurevinski, Shannon E.; Mitchell, Roger H.

    2015-12-01

    A unique occurrence of orbicular ijolite is hosted in a matrix of contemporaneous holocrystalline ijolite at the 1.1 Ga Prairie Lake Carbonatite Complex (Marathon, Ontario, Canada), and is the only known occurrence of this textural type in a rock of ijolitic composition. This mineralogical and petrological study of this orbicular ijolite highlights many of the differences from other rare occurrences of orbicular rocks described from carbonatites, granites, diorites and lamprophyres. The orbicules occur along distinct, densely packed bands in equigranular nepheline-rich ijolite and range up to 6 cm in diameter. Macroscopically, the orbicules show variability in the mineralogy of their cores. Detailed imaging of the cores shows evidence of quench textures. Radial outward zoning is common near the cores with concentric banding occurring toward the margins of the orbicules. The mineralogy of the orbicules consists of: nepheline; diopside; calcite; apatite; andradite-melanite garnet; titanite; Fe-rich phlogopite; titaniferous magnetite; perovskite; with secondary natrolite, calcite and cancrinite. The mineralogy of the host ijolite is similar to that of the orbicules. Mineral compositions from the orbicular ijolite and the host ijolite are similar. Within the orbicules, anhedral minerals are found occurring in a 'matrix' of garnet throughout the distinct concentric bands. The textures within the concentric bands of the orbicules are best described as annealing recrystallization textures. The rims of the orbicules form interlocking crystals with the host ijolite resulting in near-indistinguishable boundaries. The orbicules are interpreted to represent interaction of a partially-crystallized quenched ijolitic melt, which was in contact with a second pulse of consanguineous ijolite magma. Immersion in the latter resulted in sub-solidus diffusion and annealing recrystallization. Orbicular textures were produced from previously formed quenched ijolite, which was

  12. Population Health Impact and Cost-Effectiveness of Tuberculosis Diagnosis with Xpert MTB/RIF: A Dynamic Simulation and Economic Evaluation

    PubMed Central

    Menzies, Nicolas A.; Cohen, Ted; Lin, Hsien-Ho; Murray, Megan; Salomon, Joshua A.

    2012-01-01

    Background The Xpert MTB/RIF test enables rapid detection of tuberculosis (TB) and rifampicin resistance. The World Health Organization recommends Xpert for initial diagnosis in individuals suspected of having multidrug-resistant TB (MDR-TB) or HIV-associated TB, and many countries are moving quickly toward adopting Xpert. As roll-out proceeds, it is essential to understand the potential health impact and cost-effectiveness of diagnostic strategies based on Xpert. Methods and Findings We evaluated potential health and economic consequences of implementing Xpert in five southern African countries—Botswana, Lesotho, Namibia, South Africa, and Swaziland—where drug resistance and TB-HIV coinfection are prevalent. Using a calibrated, dynamic mathematical model, we compared the status quo diagnostic algorithm, emphasizing sputum smear, against an algorithm incorporating Xpert for initial diagnosis. Results were projected over 10- and 20-y time periods starting from 2012. Compared to status quo, implementation of Xpert would avert 132,000 (95% CI: 55,000–284,000) TB cases and 182,000 (97,000–302,000) TB deaths in southern Africa over the 10 y following introduction, and would reduce prevalence by 28% (14%–40%) by 2022, with more modest reductions in incidence. Health system costs are projected to increase substantially with Xpert, by US$460 million (294–699 million) over 10 y. Antiretroviral therapy for HIV represents a substantial fraction of these additional costs, because of improved survival in TB/HIV-infected populations through better TB case-finding and treatment. Costs for treating MDR-TB are also expected to rise significantly with Xpert scale-up. Relative to status quo, Xpert has an estimated cost-effectiveness of US$959 (633–1,485) per disability-adjusted life-year averted over 10 y. Across countries, cost-effectiveness ratios ranged from US$792 (482–1,785) in Swaziland to US$1,257 (767–2,276) in Botswana. Assessing outcomes over a 10-y period

  13. Comparison of the Predicted Population Coverage of Tuberculosis Vaccine Candidates Ag85B-ESAT-6, Ag85B-TB10.4, and Mtb72f via a Bioinformatics Approach

    PubMed Central

    Davila, Jose; McNamara, Lucy A.; Yang, Zhenhua

    2012-01-01

    The Bacille-Calmette Guérin (BCG) vaccine does not provide consistent protection against adult pulmonary tuberculosis (TB) worldwide. As novel TB vaccine candidates advance in studies and clinical trials, it will be critically important to evaluate their global coverage by assessing the impact of host and pathogen variability on vaccine efficacy. In this study, we focus on the impact that host genetic variability may have on the protective effect of TB vaccine candidates Ag85B-ESAT-6, Ag85B-TB10.4, and Mtb72f. We use open-source epitope binding prediction programs to evaluate the binding of vaccine epitopes to Class I HLA (A, B, and C) and Class II HLA (DRB1) alleles. Our findings suggest that Mtb72f may be less consistently protective than either Ag85B-ESAT-6 or Ag85B-TB10.4 in populations with a high TB burden, while Ag85B-TB10.4 may provide the most consistent protection. The findings of this study highlight the utility of bioinformatics as a tool for evaluating vaccine candidates before the costly stages of clinical trials and informing the development of new vaccines with the broadest possible population coverage. PMID:22815851

  14. Simulation of ground-water flow in an unconfined sand and gravel aquifer at Marathon, Cortland County, New York

    USGS Publications Warehouse

    Miller, Todd S.

    2000-01-01

    The Village of Marathon, in Cortland County, N.Y., has three municipal wells that tap a relatively thin (25 to 40 feet thick) and narrow (less than 0.25 mile wide) unconfined sand and gravel aquifer in the Tioughnioga River valley. Only one of the wells is in use because water from one well has been contaminated by petroleum chemicals from a leaking storage tank, and water from the other well contains high concentrations of manganese. The operating well pumps about 0.1 million gallons per day and supplies about 1,000 people. A three-dimensional, finite-difference ground-water-flow model was used to (1) compute hydraulic heads in the aquifer under steady-state conditions, (2) develop a water budget, and (3) delineate the areas contributing recharge to two simulated wells that represent two of the municipal wells: one 57 feet east of the Tioughnioga River, the other 4,000 feet to the south and 75 feet from a man-made pond. The water budget for simulated long-term average, steady-state conditions with two simulated pumping wells indicates that the principal sources of recharge to the unconfined aquifer are unchanneled runoff and ground-water inflow from the uplands (41 percent of total recharge), precipitation that falls directly on the aquifer (34 percent), and stream leakage (23 percent). Only 2 percent of the recharge to the aquifer is from ground-water underflow into the northern end of the modeled area. Most of the simulated groundwater discharge from the modeled area (78 percent of total discharge) is to the Tioughnioga River; the rest discharges to the two simulated wells (19 percent) and as underflow at the southern end of the modeled area (3 percent). Results of a particle-tracking analysis indicate that the aquifer contributing area of the northern (simulated) well is 0.10 mile wide and 0.15 mile long and encompasses 0.015 square miles; the contributing area of the southern (simulated) well is 0.20 mile wide and 0.11 mile long and encompasses 0.022 square

  15. 3-(Benzodioxan-2-ylmethoxy)-2,6-difluorobenzamides bearing hydrophobic substituents at the 7-position of the benzodioxane nucleus potently inhibit methicillin-resistant Sa and Mtb cell division.

    PubMed

    Straniero, Valentina; Pallavicini, Marco; Chiodini, Giuseppe; Zanotto, Carlo; Volontè, Luca; Radaelli, Antonia; Bolchi, Cristiano; Fumagalli, Laura; Sanguinetti, Maurizio; Menchinelli, Giulia; Delogu, Giovanni; Battah, Basem; De Giuli Morghen, Carlo; Valoti, Ermanno

    2016-09-14

    Lipophilic substituents at benzodioxane C (7) of 3-(benzodioxan-2-ylmethoxy)-2,6-difluorobenzamide improve the antibacterial activity against methicillin-resistant Staphylococcus aureus strains to MIC values in the range of 0.2-2.5 μg/mL, whereas hydrophilic substituents at the same position and modifications at the benzodioxane substructure, excepting for replacement with 2-cromanyl, are deleterious. Some of the lead compounds also exhibit good activity against Mtb. Parallel SARs to those of 3-(2-benzothiazol-2-ylmethoxy)-2,6-difluorobenzamide, well known FtsZ inhibitor, and cells alterations typical of FtsZ inhibition indicate such a protein as the target of these potent antibacterial benzodioxane-benzamides. PMID:27191617

  16. Multicenter Evaluation of Anyplex Plus MTB/NTM MDR-TB Assay for Rapid Detection of Mycobacterium tuberculosis Complex and Multidrug-Resistant Isolates in Pulmonary and Extrapulmonary Specimens

    PubMed Central

    De Maio, Flavio; Caccuri, Francesca; Campilongo, Federica; Sanguinetti, Maurizio; Fiorentini, Simona; Giagulli, Cinzia

    2015-01-01

    The rapid diagnosis of tuberculosis (TB) and the detection of drug-resistant Mycobacterium tuberculosis strains are critical for successful public health interventions. Therefore, TB diagnosis requires the availability of diagnostic tools that allow the rapid detection of M. tuberculosis and drug resistance in clinical samples. Here, we performed a multicenter study to evaluate the performance of the Seegene Anyplex MTB/NTM MDR-TB assay, a new molecular method based on a multiplex real-time PCR system, for detection of Mycobacterium tuberculosis complex (MTBC), nontuberculous mycobacteria (NTM), and genetic determinants of drug resistance. In total, the results for 755 samples (534 pulmonary and 221 extrapulmonary samples) were compared with the results of smears and cultures. For pulmonary specimens, the sensitivities of the Anyplex assay and acid-fast bacillus smear testing were 86.4% and 75.0%, respectively, and the specificities were 99% and 99.4%. For extrapulmonary specimens, the sensitivities of the Anyplex assay and acid-fast bacillus smear testing were 83.3% and 50.0%, respectively, and the specificities of both were 100%. The negative and positive predictive values of the Anyplex assay for pulmonary specimens were 97% and 100%, respectively, and those for extrapulmonary specimens were 84.6% and 100%. The sensitivities of the Anyplex assay for detecting isoniazid resistance in MTBC strains from pulmonary and extrapulmonary specimens were 83.3% and 50%, respectively, while the specificities were 100% for both specimen types. These results demonstrate that the Anyplex MTB/NTM MDR-TB assay is an efficient and rapid method for the diagnosis of pulmonary and extrapulmonary TB and the detection of isoniazid resistance. PMID:26491178

  17. Shear-Wave Elastography Assessments of Quadriceps Stiffness Changes prior to, during and after Prolonged Exercise: A Longitudinal Study during an Extreme Mountain Ultra-Marathon.

    PubMed

    Andonian, Pierre; Viallon, Magalie; Le Goff, Caroline; de Bourguignon, Charles; Tourel, Charline; Morel, Jérome; Giardini, Guido; Gergelé, Laurent; Millet, Grégoire P; Croisille, Pierre

    2016-01-01

    In sports medicine, there is increasing interest in quantifying the elastic properties of skeletal muscle, especially during extreme muscular stimulation, to improve our understanding of the impact of alterations in skeletal muscle stiffness on resulting pain or injuries, as well as the mechanisms underlying the relationships between these parameters. Our main objective was to determine whether real-time shear-wave elastography (SWE) can monitor changes in quadriceps muscle elasticity during an extreme mountain ultra-marathon, a powerful mechanical stress model. Our study involved 50 volunteers participating in an extreme mountain marathon (distance: 330 km, elevation: +24,000 m). Quantitative SWE velocity and shear modulus measurements were performed in most superficial quadriceps muscle heads at the following 4 time points: before the race, halfway through the race, upon finishing the race and after recovery (+48 h). Blood biomarker levels were also measured. A significant decrease in the quadriceps shear modulus was observed upon finishing the race (3.31±0.61 kPa) (p<0.001) compared to baseline (3.56±0.63 kPa), followed by a partial recovery +48 h after the race (3.45±0.6 kPa) (p = 0.002) across all muscle heads, as well as for each of the following three muscle heads: the rectus femoris (p = 0.003), the vastus medialis (p = 0.033) and the vastus lateralis (p = 0.001). Our study is the first to assess changes in muscle stiffness during prolonged extreme physical endurance exercises based on shear modulus measurements using non-invasive SWE. We concluded that decreases in stiffness, which may have resulted from quadriceps overuse in the setting of supra-physiological stress caused by the extreme distance and unique elevation of the race, may have been responsible for the development of inflammation and muscle swelling. SWE may hence represent a promising tool for monitoring physiologic or pathological variations in muscle stiffness and may be useful for

  18. Higher prevalence of exercise-associated hyponatremia in female than in male open-water ultra-endurance swimmers: the 'Marathon-Swim' in Lake Zurich.

    PubMed

    Wagner, Sandra; Knechtle, Beat; Knechtle, Patrizia; Rüst, Christoph Alexander; Rosemann, Thomas

    2012-03-01

    We investigated the prevalence of exercise-associated hyponatremia (EAH) in 25 male and 11 female open-water ultra-endurance swimmers participating in the 'Marathon-Swim' in Lake Zurich, Switzerland, covering a distance of 26.4 km. Changes in body mass, fat mass, skeletal muscle mass, total body water, urine specific gravity, plasma sodium concentration [Na(+)] and haematocrit were determined. Two males (8%) and four females (36%) developed EAH where one female was symptomatic with plasma sodium [Na(+)] of 127 mmol/L. Body mass and plasma [Na(+)] decreased (p < 0.05). The changes in body mass correlated in both male and female swimmers to post-race plasma [Na(+)] (r = -0.67, p = 0.0002 and r = -0.80, p = 0.0034, respectively) and changes in plasma [Na(+)] (r = -0.68, p = 0.0002 and r = -0.79, p = 0.0039, respectively). Fluid intake was neither associated with changes in body mass, post-race plasma [Na(+)] or the change in plasma [Na(+)]. Sodium intake showed no association with either the changes in plasma [Na(+)] or post-race plasma [Na(+)]. We concluded that the prevalence of EAH was greater in female than in male open-water ultra-endurance swimmers. PMID:21748367

  19. [Behavioral risk factors and readiness in amateur marathon runners 18-64 years of age in Bogotá, Colombia, 2014].

    PubMed

    Ramírez-Góngora, María Del Pilar; Prieto-Alvarado, Franklyn Edwin

    2016-01-01

    Participation in amateur street marathons has become increasingly popular and requires prior individual health risk assessment. The objective was to identify risk factors and readiness in registered runners. This was a cross-sectional study in a random sample (n = 510) of registered amateur runners 18-64 years of age, using a digital survey with IPAQ, Par-Q+, and STEPwise, with an expected physical inactivity rate of 35% (±5%). The study explored physical activity, (binge) alcohol consumption, fruit, vegetable, and salt intake, smoking, and readiness. Self-reported rates were: 97.4% recommended level of physical activity, 2.4% optimal fruit and vegetable intake, 3.7% smoking, and 44.1% binge drinking. 19.8% were Par-Q+ positive and 5.7% practiced supervised exercise. The analysis showed differences by age, sex, and socioeconomic status. Recreational runners followed the recommended levels of physical activity but did not score well on other risk factors. Prior evaluation of lifestyle-related risk factors and readiness provides a safer athletic strategy. PMID:27143307

  20. Political Regime and Human Capital: A Cross-Country Analysis

    ERIC Educational Resources Information Center

    Klomp, Jeroen; de Haan, Jakob

    2013-01-01

    We examine the relationship between different dimensions of the political regime in place and human capital using a two-step structural equation model. In the first step, we employ factor analysis on 16 human capital indicators to construct two new human capital measures (basic and advanced human capital). In the second step, we estimate the…

  1. Understanding Quality Assurance: A Cross Country Case Study

    ERIC Educational Resources Information Center

    Choon Boey Lim, Fion

    2008-01-01

    Purpose: The purpose of this paper is to examine the level of understanding between an Australian university and its offshore partner institution, on quality assurance. It attempts to highlight the dynamics of quality assurance policy implementation within and across institutions for an offshore degree. Design/methodology/approach: The study used…

  2. ScrapbookUSA: Writing 'Cross Grade, 'Cross Curriculum, 'Cross Country.

    ERIC Educational Resources Information Center

    Roth, Emery, II

    1993-01-01

    Describes the ScrapBookUSA Writing Project, a computer telecommunications project linking classrooms across the country, and its educational opportunities for the writing and multicultural studies curricula. Examples of Hello letters, student essays, and ScrapBook Chronicles are given to demonstrate the impact a wide audience and immediate…

  3. A novel vaccine p846 encoding Rv3615c, Mtb10.4, and Rv2660c elicits robust immune response and alleviates lung injury induced by Mycobacterium infection.

    PubMed

    Kong, Hongmei; Dong, Chunsheng; Xiong, Sidong

    2014-01-01

    Development of effective anti-tuberculosis (TB) vaccines is one of the important steps to improve control of TB. Cell-mediated immune response significantly affects the control of M. tuberculosis infection. Thus, vaccines able to elicit strong cellular immune response hold special advantages against TB. In this study, three well-defined mycobacterial antigens (Rv3615c, Mtb10.4 [Rv0228], and Rv2660c) were engineered as a novel triple-antigen fusion DNA vaccine p846. The p846 vaccine consists of a high density of CD4(+) and CD8(+) T-cell epitopes. Intramuscular immunization of p846 induced robust T cells mediated immune response comparable to that of bacillus Calmette-Guérin (BCG) vaccination but more effective than that of individual antigen vaccination. After mycobacterial challenge, p846 immunization decreased bacterial burden at least 15-fold compared with individual antigen-based vaccination. Notably, the lungs of mice immunized with p846 exhibited fewer inflammatory cell infiltrates and less damage than those of control group mice. Our data demonstrate that the potential of p846 vaccine to protect against TB and the feasibility of this design strategy for further TB vaccine development. PMID:24280763

  4. Sensitivity and specificity of Cobas TaqMan MTB real-time polymerase chain reaction for culture-proven Mycobacterium tuberculosis: meta-analysis of 26999 specimens from 17 Studies.

    PubMed

    Horita, Nobuyuki; Yamamoto, Masaki; Sato, Takashi; Tsukahara, Toshinori; Nagakura, Hideyuki; Tashiro, Ken; Shibata, Yuji; Watanabe, Hiroki; Nagai, Kenjiro; Nakashima, Kentaro; Ushio, Ryota; Ikeda, Misako; Sakamaki, Kentaro; Yoshiyama, Takashi; Kaneko, Takeshi

    2015-01-01

    Since 2010, studies on the diagnostic accuracy of COBAS TaqMan MTB (CTM) have been frequently reported with an unignorable discrepancy. The key inclusion criterion for this systematic review was original studies that could provide sufficient data for calculating the sensitivity and the specificity of CTM for M tuberculosis (TB) or M tuberculosis complex. The reference test was Mycobacterium culture. We used bivariate model for meta-analyses. Of the 201 candidate articles, we finally identified 17 eligible articles.Concerning the respiratory specimens, 1900 culture positive specimens and 20983 culture negative specimens from 15 studies were assessed. This provided the summary estimate sensitivity of 0.808 (95% CI 0.758-0.850) and the summary estimate specificity of 0.990 (95% CI 0.981-0.994). The area under curve was 0.956. The diagnostic odds ratio was 459 (95% CI 261-805, I(2) 26%). For the smear positive respiratory specimens, the sensitivity was 0.952 (95% CI 0.926-0.969) and the specificity was 0.916 (95% CI 0.797-0.968). For the smear negative respiratory specimens, the sensitivity and the specificity were 0.600 (95% CI 0.459-0.726) and 0.989 (95% CI 0.981-0.993), respectively. The diagnostic accuracy was poorer for the non-respiratory specimens, than for the respiratory specimens, but was acceptable. We believe that the information obtained from this study will aid physicians' decision making. PMID:26648113

  5. Can Pacing Be Regulated by Post-Activation Potentiation? Insights from a Self-Paced 30 km Trial in Half-Marathon Runners

    PubMed Central

    Del Rosso, Sebastián; Barros, Edilberto; Tonello, Laís; Oliveira-Silva, Iransé; Behm, David G.; Foster, Carl; Boullosa, Daniel A.

    2016-01-01

    Purpose Given the co-existence of post-activation potentiation (PAP) and fatigue within muscle, it is not known whether PAP could influence performance and pacing during distance running by moderating fatigue. The aim of this study was to assess the influence of PAP on pacing, jumping and other physiological measures during a self-paced 30 km trial. Methods Eleven male endurance-trained runners (half-marathon runners) volunteered to participate in this study. Runners participated in a multi-stage 30 km trial. Before the trial started, determination of baseline blood lactate (bLa) and countermovement jump (CMJ) height was performed. The self-paced 30 km trial consisted of 6 × 5 km splits. At the end of each 5 km split (60 s break), data on time to complete the split, CMJ height, Rating of Perceived Exertion (RPE) and blood lactate were collected while heart rate was continuously monitored. Results There was a significant decrease in speed (e.g. positive pacing strategy after the 4th split, p<0.05) with a progressive increase in RPE throughout the trial. Compared with baseline, CMJ height was significantly (p<0.05) greater than baseline and was maintained until the end of the trial with an increase after the 5th split, concomitant with a significant reduction in speed and an increase in RPE. Significant correlations were found between ΔCMJ and ΔSPEED (r = 0.77 to 0.87, p<0.05) at different time points as well as between RPE and speed (r = -0.61 to -0.82, p<0.05). Conclusion Our results indicates that fatigue and potentiation co-exist during long lasting endurance events, and that the observed increase in jump performance towards the end of the trial could be reflecting a greater potentiation potentially perhaps counteracting the effects of fatigue and preventing further reductions in speed. PMID:26934357

  6. Outcomes of a clinical diagnostic algorithm for management of ambulatory smear and Xpert MTB/Rif negative HIV infected patients with presumptive pulmonary TB in Uganda: a prospective study

    PubMed Central

    Walusimbi, Simon; Semitala, Fred; Bwanga, Freddie; Haile, Melles; De Costa, Ayesha; Davis, Lucian; Joloba, Moses; Hoffner, Sven; Kamya, Moses

    2016-01-01

    Introduction Diagnostic guidelines for Tuberculosis (TB) in HIV infected patients previously relied on microscopy where the value of initial antibiotic treatment for exclusion of pulmonary TB (PTB) was limited. New guidelines rely on the Xpert MTB Rif test (Xpert). However, the value of the antibiotic treatment remains unclear particularly in individuals who are smear-negative and Xpert-negative-given Xpert has only moderate sensitivity for smear-negative PTB. We assessed an algorithm involving initial treatment with antibiotics prior empiric TB treatment in HIV patients with presumptive PTB who were both smear and Xpert negative. Methods We performed a prospective study with six month follow-up to establish patient response to a course of broad spectrum antibiotics prior empiric TB treatment between March 2012 and June 2013. We calculated the proportion of patients who responded to the antibiotic treatment and those who did not. We computed the crude and adjusted odds ratios with their 95% confidence intervals, for response to the antibiotic treatment on various patient characteristics. We report treatment outcomes for patients who received broad spectrum antibiotics only or who were initiated empiric TB treatment. Results Our cohort comprised 162 smear-negative and Xpert-negative patients, of whom 59% (96 of 162) were female, 81% (131 of 162) were on antiretroviral therapy (ART) for a median of 8.7 months. Overall, 88% (141 of 160) responded to the antibiotic treatment, 8% (12 of 160) got empiric TB treatment and 4% (7 out of 160) were treated for other respiratory disease. The odds of improvement on antibiotics were lower in patients with advanced HIV disease than in patients with early HIV disease. Adjusted odds ratios were significant for HIV clinical stage (AOR; 0.038,) and duration on ART (AOR; 1.038,). Conclusion The majority of HIV patients with presumptive PTB with smear-negative and Xpert negative results improved on the antibiotic treatment and did not

  7. Performance of Cepheid ® Xpert MTB/RIF ® and TB-Biochip ® MDR in two regions of Russia with a high prevalence of drug-resistant tuberculosis.

    PubMed

    Kurbatova, E V; Kaminski, D A; Erokhin, V V; Volchenkov, G V; Andreevskaya, S N; Chernousova, L N; Demikhova, O V; Ershova, J V; Kaunetis, N V; Kuznetsova, T A; Larionova, E E; Smirnova, T G; Somova, T R; Vasilieva, I A; Vorobieva, A V; Zolkina, S S; Cegielski, J P

    2013-06-01

    The purpose of this study was to assess the performance of Cepheid® Xpert MTB/RIF® ("Xpert") and TB-Biochip® MDR ("TB-Biochip"). Sputum specimens from adults with presumptive tuberculosis (TB) were homogenized and split for: (1) direct Xpert and microscopy, and (2) concentration for Xpert, microscopy, culture [Lowenstein-Jensen (LJ) solid media and Mycobacteria Growth Indicator Tube® (MGIT)], indirect drug susceptibility testing (DST) using the absolute concentration method and MGIT, and TB-Biochip. In total, 109 of 238 (45.8 %) specimens were culture-positive for Mycobacterium tuberculosis complex (MTBC), and, of these, 67 isolates were rifampicin resistant (RIF-R) by phenotypic DST and 64/67 (95.5 %) were isoniazid resistant (INH-R). Compared to culture of the same specimen, a single direct Xpert was more sensitive for detecting MTBC [95.3 %, 95 % confidence interval (CI), 90.0-98.3 %] than direct (59.6 %, 95 % CI, 50.2-68.5 %) or concentrated smear (85.3 %, 95 % CI, 77.7-91.1 %) or LJ culture (80.8 %, 95 % CI, 72.4-87.5 %); the specificity was 86.0 % (95 % CI, 78.9-91.3 %). Compared with MGIT DST, Xpert correctly identified 98.2 % (95 % CI, 91.5-99.9 %) of RIF-R and 95.5 % (95 % CI, 85.8-99.2 %) of RIF-susceptible (RIF-S) specimens. In a subset of 104 specimens, the sensitivity of TB-Biochip for MTBC detection compared to culture was 97.3 % (95 % CI, 91.0-99.5 %); the specificity was 78.1 % (95 % CI, 61.5-89.9 %). TB-Biochip correctly identified 100 % (95 % CI, 94.2-100 %) of RIF-R, 94.7 % (95 % CI, 76.7-99.7 %) of RIF-S, 98.2 % (95 % CI, 91.4-99.9 %) of INH-R, and 78.6 % (95 % CI, 52.1-94.2 %) of INH-S specimens compared to MGIT DST. Xpert and Biochip were similar in accuracy for detecting MTBC and RIF resistance compared to conventional culture methods. PMID:23263819

  8. Performance of Cepheid® Xpert MTB/RIF® and TB Biochip® MDR in two regions of Russia with a high prevalence of drug-resistant tuberculosis

    PubMed Central

    Kurbatova, Ekaterina V.; Kaminski, Dorothy A.; Erokhin, Vladislav V.; Volchenkov, Grigory V.; Andreevskaya, Sofia N.; Chernousova, Larisa N.; Demikhova, Olga V.; Ershova, Julia V.; Kaunetis, Natalia V.; Kuznetsova, Tatiana A.; Larionova, Elena E.; Smirnova, Tatiana G.; Somova, Tatiana R.; Vasilieva, Irina A.; Vorobieva, Alena V.; Zolkina, Svetlana S.; Cegielski, J. Peter

    2015-01-01

    Purpose To assess the performance of Cepheid® Xpert MTB/RIF® (“Xpert”) and TB Biochip® MDR (“TB-Biochip”). Methods Sputum specimens from adults with presumptive tuberculosis (TB) were homogenized and split for (1) direct Xpert and microscopy, and (2) concentration for Xpert, microscopy, culture (Lowenstein-Jensen [LJ] solid media and Mycobacteria Growth Indicator Tube® [MGIT]), indirect drug susceptibility testing (DST) using the absolute concentration method and MGIT, and TB-Biochip. Results In total, 109 of 238 (45.8%) specimens were culture-positive for M. tuberculosis complex (MTBC), and of these, 67 isolates were rifampicin resistant (RIF-R) by phenotypic DST, and 64/67 (95.5%) were isoniazid resistant (INH-R). Compared to culture of the same specimen, a single direct Xpert was more sensitive for detecting MTBC (95.3%, 95% confidence interval [CI], 90.0–98.3%) than direct (59.6%, 95% CI, 50.2–68.5%) or concentrated smear (85.3%, 95% CI, 77.7–91.1%) or LJ culture (80.8%, 95% CI, 72.4–87.5%); specificity was 86.0% (95% CI 78.9–91.3%). Compared with MGIT DST, Xpert correctly identified 98.2% (95% CI, 91.5–99.9%) of RIF-R and 95.5% (95% CI, 85.8–99.2%) of RIF-susceptible (RIF-S) specimens. In a subset of 104 specimens, the sensitivity of TB-Biochip for MTBC detection compared to culture was 97.3% (95% CI, 91.0–99.5%); specificity was 78.1% (95% CI, 61.5– 89.9%). TB-Biochip correctly identified 100% (95% CI, 94.2–100%) of RIF-R, 94.7% (95% CI, 76.7–99.7%) of RIF-S, 98.2% (95% CI, 91.4–99.9%) of INH-R, and 78.6% (95% CI, 52.1–94.2%) of INH-S specimens, compared to MGIT DST. Conclusions Xpert and Biochip were similar in accuracy for detecting MTBC and RIF resistance compared to conventional culture methods. PMID:23263819

  9. Zuschauer beim Berlin-Marathon

    NASA Astrophysics Data System (ADS)

    Hougardy, Stefan; Kirchner, Stefan; Zelke, Mariano

    Jedes Computerprogramm, sei es ein Betriebssystem, eine Textverarbeitung oder ein Computerspiel, ist aus einer Vielzahl von Algorithmen zusammen gesetzt. Ein Algorithmus ist eine Art Rechenvorschrift, die Daten als Eingabe entgegennimmt und daraus ein Ergebnis berechnet. Um beispielsweise die Anzeige desMauszeigers auf dem Bildschirm zu steuern, erhält der dafür zuständige Algorithmus die letzte Position des Mauszeigers und die Bewegung der Maus auf dem Schreibtisch als Eingabe. Daraus wird die neue Position des Mauszeigers berechnet, sie bildet die Ausgabe des Algorithmus.

  10. Stolen twin: fascination and curiosity/twin research reports: evolution of sleep length; dental treatment of craniopagus twins; cryopreserved double embryo transfer; gender options in multiple pregnancy/current events: appendectomy in one twin; autistic twin marathon runners; 3D facial recognition; twin biathletes.

    PubMed

    Segal, Nancy L

    2014-02-01

    The story of her allegedly stolen twin brother in Armenia is recounted by a 'singleton twin' living in the United States. The behavioral consequences and societal implications of this loss are considered. This case is followed by twin research reports on the evolution of sleep length, dental treatment of craniopagus conjoined twins, cryopreserved double embryo transfer (DET), and gender options in multiple pregnancy. Current events include the diagnosis of appendectomy in one identical twin, the accomplishments of autistic twin marathon runners, the power of three-dimensional (3D) facial recognition, and the goals of twin biathletes heading to the 2014 Sochi Olympics in Russia. PMID:24418634

  11. Advanced Running Performance by Genetic Predisposition in Male Dummerstorf Marathon Mice (DUhTP) Reveals Higher Sterol Regulatory Element-Binding Protein (SREBP) Related mRNA Expression in the Liver and Higher Serum Levels of Progesterone

    PubMed Central

    Brenmoehl, Julia; Walz, Christina; Ponsuksili, Siriluck; Schwerin, Manfred; Fuellen, Georg; Hoeflich, Andreas

    2016-01-01

    Long-term-selected DUhTP mice represent a non-inbred model for inborn physical high-performance without previous training. Abundance of hepatic mRNA in 70-day male DUhTP and control mice was analyzed using the Affymetrix mouse array 430A 2.0. Differential expression analysis with PLIER corrected data was performed using AltAnalyze. Searching for over-representation in biochemical pathways revealed cholesterol metabolism being most prominently affected in DUhTP compared to unselected control mice. Furthermore, pathway analysis by AltAnalyze plus PathVisio indicated significant induction of glycolysis, fatty acid synthesis and cholesterol biosynthesis in the liver of DUhTP mice versus unselected control mice. In contrast, gluconeogenesis was partially inactivated as judged from the analysis of hepatic mRNA transcript abundance in DUhTP mice. Analysis of mRNA transcripts related to steroid hormone metabolism inferred elevated synthesis of progesterone and reduced levels of sex steroids. Abundance of steroid delta isomerase-5 mRNA (Hsd3b5, FC 4.97) was increased and steroid 17-alpha-monooxygenase mRNA (Cyp17a1, FC -11.6) was massively diminished in the liver of DUhTP mice. Assessment of steroid profiles by LC-MS revealed increased levels of progesterone and decreased levels of sex steroids in serum from DUhTP mice versus controls. Analysis of hepatic mRNA transcript abundance indicates that sterol regulatory element-binding protein-1 (SREBP-1) may play a major role in metabolic pathway activation in the marathon mouse model DUhTP. Thus, results from bioinformatics modeling of hepatic mRNA transcript abundance correlated with direct steroid analysis by mass spectrometry and further indicated functions of SREBP-1 and steroid hormones for endurance performance in DUhTP mice. PMID:26799318

  12. Advanced Running Performance by Genetic Predisposition in Male Dummerstorf Marathon Mice (DUhTP) Reveals Higher Sterol Regulatory Element-Binding Protein (SREBP) Related mRNA Expression in the Liver and Higher Serum Levels of Progesterone.

    PubMed

    Ohde, Daniela; Moeller, Mark; Brenmoehl, Julia; Walz, Christina; Ponsuksili, Siriluck; Schwerin, Manfred; Fuellen, Georg; Hoeflich, Andreas

    2016-01-01

    Long-term-selected DUhTP mice represent a non-inbred model for inborn physical high-performance without previous training. Abundance of hepatic mRNA in 70-day male DUhTP and control mice was analyzed using the Affymetrix mouse array 430A 2.0. Differential expression analysis with PLIER corrected data was performed using AltAnalyze. Searching for over-representation in biochemical pathways revealed cholesterol metabolism being most prominently affected in DUhTP compared to unselected control mice. Furthermore, pathway analysis by AltAnalyze plus PathVisio indicated significant induction of glycolysis, fatty acid synthesis and cholesterol biosynthesis in the liver of DUhTP mice versus unselected control mice. In contrast, gluconeogenesis was partially inactivated as judged from the analysis of hepatic mRNA transcript abundance in DUhTP mice. Analysis of mRNA transcripts related to steroid hormone metabolism inferred elevated synthesis of progesterone and reduced levels of sex steroids. Abundance of steroid delta isomerase-5 mRNA (Hsd3b5, FC 4.97) was increased and steroid 17-alpha-monooxygenase mRNA (Cyp17a1, FC -11.6) was massively diminished in the liver of DUhTP mice. Assessment of steroid profiles by LC-MS revealed increased levels of progesterone and decreased levels of sex steroids in serum from DUhTP mice versus controls. Analysis of hepatic mRNA transcript abundance indicates that sterol regulatory element-binding protein-1 (SREBP-1) may play a major role in metabolic pathway activation in the marathon mouse model DUhTP. Thus, results from bioinformatics modeling of hepatic mRNA transcript abundance correlated with direct steroid analysis by mass spectrometry and further indicated functions of SREBP-1 and steroid hormones for endurance performance in DUhTP mice. PMID:26799318

  13. Application of a new version of GA-RBF neural network for simultaneous spectrophotometric determination of Zn(II), Fe(II), Co(II) and Cu(II) in real samples: An exploratory study of their complexation abilities toward MTB.

    PubMed

    Rasouli, Zolaikha; Hassanzadeh, Zeinabe; Ghavami, Raouf

    2016-11-01

    The current study for the first time is devoted to the application of whole space genetic algorithm-radial basis function network (wsGA-RBFN) method to determine the content micro minerals of Zn(2+), Fe(2+), Co(2+) and Cu(2+) based on their complexes formation with methylthymol blue (MTB) spectrophotometrically in various pharmaceutical products and vegetable samples. Advantage of wsGA-RBFN compared to GA-RBFN is that centers can be located in any point of the samples spaces. Initially, the parameters controlling behavior of the system were investigated and optimum conditions were selected. Then, an exploratory analysis of complex systems was carried out by chemometrics approaches such as SVD, EFA, MCR-ALS and RAFA. The optimal parameters and conditions for constructing the proposed model of wsGA-RBFN were obtained from processing the data set of synthetic samples. Finally, wsGA-RBFN was successfully applied to the simultaneous determination of Zn(2+), Fe(2+), Co(2+) and Cu(2+) in tomato, white cabbage, red cabbage and lettuce and pharmaceutical products included iron, zinc, multi complete and B12 ampoule. PMID:27591591

  14. The Impact of Skills Development on Competitiveness: Empirical Evidence from a Cross-Country Analysis

    ERIC Educational Resources Information Center

    Onsomu, Eldah N.; Ngware, Moses W.; Manda, Damiano K.

    2010-01-01

    In the past half-century, most countries have emphasized the development of human capital as an instrument for economic growth, sustainable development, and improved global competitiveness. However, limited evidence exists on the link between skills development and a country's competitiveness. This paper examines the contribution and association…

  15. Explaining Cross-Country Differences in Attitudes towards Immigration in the EU-15

    ERIC Educational Resources Information Center

    Malchow-Moller, Nikolaj; Munch, Jakob Roland; Schroll, Sanne; Skaksen, Jan Rose

    2009-01-01

    In this paper, we use data from the first two rounds of the European Social Survey to analyze the extent to which differences in average attitudes towards immigration across the EU-15 countries may be explained by differences in socioeconomic characteristics and individually perceived consequences of immigration, using an extension of a…

  16. Propagation of economic shocks in input-output networks: a cross-country analysis.

    PubMed

    Contreras, Martha G Alatriste; Fagiolo, Giorgio

    2014-12-01

    This paper investigates how economic shocks propagate and amplify through the input-output network connecting industrial sectors in developed economies. We study alternative models of diffusion on networks and we calibrate them using input-output data on real-world inter-sectoral dependencies for several European countries before the Great Depression. We show that the impact of economic shocks strongly depends on the nature of the shock and country size. Shocks that impact on final demand without changing production and the technological relationships between sectors have on average a large but very homogeneous impact on the economy. Conversely, when shocks change also the magnitudes of input-output across-sector interdependencies (and possibly sector production), the economy is subject to predominantly large but more heterogeneous avalanche sizes. In this case, we also find that (i) the more a sector is globally central in the country network, the larger its impact; (ii) the largest European countries, such as those constituting the core of the European Union's economy, typically experience the largest avalanches, signaling their intrinsic higher vulnerability to economic shocks. PMID:25615153

  17. Determinants of Participation in Global Volunteer Grids: A Cross-Country Analysis

    NASA Astrophysics Data System (ADS)

    Hwang, Junseok; Altmann, Jörn; Mohammed, Ashraf Bany

    Volunteer Grids, in which users share computing resources altruistically, play a critical role in fostering research. Sharing and collaboration in Volunteer Grids is determined by many factors. These determinants define the participation in Grids and the amount of contribution to such Grids. Whereas previous studies focused on explaining researchers’ and countries’ willingness to share resources in Volunteer Grids based on social sharing theory, this research argues that without the appropriate technological capabilities, countries or researcher cannot implement their willingness. Based on the literature review, this paper defines the influential determinants for participating in global Volunteer Grids. Besides, this research employs a multiple regression analysis of these determinants, using a total of 130 observations collected from international data repositories. Our results show that R&D and Internet connection type (broadband or dial-up) are significant determinates for participating in Volunteer Grids. This result explains why developed countries are active and enjoy the benefits from Volunteer Grids, while developing countries still lag behind. Therefore, an increased participation in Grids cannot be solely achieved by interconnecting with developing countries through high-speed Internet backbones.

  18. A cross-country comparison of tobacco consumption among youths from selected South-Asian countries

    PubMed Central

    2013-01-01

    Background Tobacco consumption (TC) among youths poses significant public health problem in developing countries. This study utilized the data of Global Youth Tobacco Survey (GYTS), 2007 to examine and compare youth TC behavior in Bangladesh, Nepal and Sri Lanka. Methods The GYTS covered a total of 2,242 Bangladeshi, 1,444 Nepalese and 1,377 Sri-Lankan youths aged 13–15 years. They represented response rates of 88.9%, 94.6%, and 85.0% for the three countries, respectively. Socioeconomic, environmental, motivating, and programmatic predictors of TC were examined using cross tabulations and logistic regressions. Results Prevalence of TC was 6.9% (9.1% in males, 5.1% in females) in Bangladesh, 9.4% (13.2% in males, 5.3% in females) in Nepal and 9.1% (12.4% in males, 5.8% in females) in Sri Lanka. The average tobacco initiation age was 9.6, 10.24 and 8.61 years, respectively. Cross tabulations showed that gender, smoking among parents and friends, exposure to smoking at home and public places, availability of free tobacco were significantly (P < 0.001) associated with TC in all three countries. The multivariable analysis [odds ratio (95% confidence interval)] indicated that the common significant predictors for TC in the three countries were TC among friends [1.9 (1.30-2.89) for Bangladesh, 4.10 (2.64-6.38) for Nepal, 2.34 (1.36-4.02) for Sri Lanka], exposure to smoking at home [1.7 (1.02-2.81) for Bangladesh, 1.81 (1.08-2.79) for Nepal, 3.96 (1.82-8.62) for Sri Lanka], exposure to smoking at other places [2.67 (1.59-4.47) for Bangladesh, 5.22 (2.76-9.85) for Nepal, 1.76 (1.05-2.88) for Sri Lanka], and the teaching of smoking hazards in schools [0.56 (0.38-0.84) for Bangladesh, 0.60 (0.41-0.89) for Nepal, 0.58 (0.35-0.94) for Sri Lanka]. Conclusions An understanding of the influencing factors of youth TC provides helpful insights for the formulation of tobacco control policies in the South-Asian region. PMID:23617464

  19. Children's involvement in care order decision-making: A cross-country analysis.

    PubMed

    Berrick, Jill Duerr; Dickens, Jonathan; Pösö, Tarja; Skivenes, Marit

    2015-11-01

    This international comparative paper examines how child protection workers in four countries, England, Finland, Norway, USA (CA), involve children in decision making regarding involuntary child removal. The analysis is based on 772 workers' responses to a vignette describing preparations for care order proceedings. We examine children's involvement along three dimensions including information given to the child, information gathered from the child, and opportunities for their perspectives and interests to be considered. Results show that child protection workers weigh children's involvement differently based upon age. Staff in the four countries were more likely to talk with an older child, to provide information, to gather information, and to include in relevant decision making if the child were 11 compared to five in our vignette. Although the Nordic countries and England provide policy guidance regarding children's role in child protection decision making, we did not see consistently higher indicators of children's involvement from the respondents in these countries. Using child protection system frames to analyze the findings did not produce consistent differences between the family service systems and child protection systems included in this study. Findings highlight the wide range in practices concerning children's involvement in decision making, and the wide space for professional discretion in implementing practice with children at the local level. PMID:26232058

  20. Attitudes toward Wife Beating: A Cross-Country Study in Asia

    ERIC Educational Resources Information Center

    Rani, Manju; Bonu, Sekhar

    2009-01-01

    Using demographic and health surveys conducted between 1998 and 2001 from seven countries (Armenia, Bangladesh, Cambodia, India, Kazakhstan, Nepal, and Turkey), the study found that acceptance of wife beating ranged from 29% in Nepal, to 57% in India (women only), and from 26% in Kazakhstan, to 56% in Turkey (men only). Increasing wealth predicted…

  1. Climate change in the Baltic sea region: a cross-country analysis of institutional stakeholder perceptions.

    PubMed

    Piwowarczyk, Joanna; Hansson, Anders; Hjerpe, Mattias; Chubarenko, Boris; Karmanov, Konstantin

    2012-09-01

    Before climate change is considered in long-term coastal management, it is necessary to investigate how institutional stakeholders in coastal management conceptualize climate change, as their awareness will ultimately affect their actions. Using questionnaires in eight Baltic Sea riparian countries, this study examines environmental managers' awareness of climate change. Our results indicate that problems related to global warming are deemed secondary to short-term social and economic issues. Respondents agree that problems caused by global warming will become increasingly important, but pay little attention to adaptation and mitigation strategies. Current environmental problems are expected to continue to be urgent in the future. We conclude that an apparent gap exists between decision making, public concerns, and scientific consensus, resulting in a situation in which the latest evidence rarely influences commonly held opinions. PMID:22926886

  2. Health Systems' Responsiveness and Its Characteristics: A Cross-Country Comparative Analysis

    PubMed Central

    Robone, Silvana; Rice, Nigel; Smith, Peter C

    2011-01-01

    Objectives Responsiveness has been identified as one of the intrinsic goals of health care systems. Little is known, however, about its determinants. Our objective is to investigate the potential country-level drivers of health system responsiveness. Data Source Data on responsiveness are taken from the World Health Survey. Information on country-level characteristics is obtained from a variety of sources including the United Nations Development Program (UNDP). Study Design A two-step procedure. First, using survey data we derive a country-level measure of system responsiveness purged of differences in individual reporting behavior. Secondly, we run cross-sectional country-level regressions of responsiveness on potential drivers. Principal Findings Health care expenditures per capita are positively associated with responsiveness, after controlling for the influence of potential confounding factors. Aspects of responsiveness are also associated with public sector spending (negatively) and educational development (positively). Conclusions From a policy perspective, improvements in responsiveness may require higher spending levels. The expansion of nonpublic sector provision, perhaps in the form of increased patient choice, may also serve to improve responsiveness. However, these inferences are tentative and require further study. PMID:21762144

  3. Designing Online Interaction to Address Disciplinary Competencies: A Cross-Country Comparison of Faculty Perspectives

    ERIC Educational Resources Information Center

    Barberà, Elena; Layne, Ludmila; Gunawardena, Charlotte N.

    2014-01-01

    This study was conducted at colleges in three countries (United States, Venezuela, and Spain) and across three academic disciplines (engineering, education, and business), to examine how experienced faculty define competencies for their discipline, and design instructional interaction for online courses. A qualitative research design employing…

  4. The Benefits of Creating a Cross-Country Data Framework for Energy Efficiency

    SciTech Connect

    Katzman, Alex; McNeil, Michael; Pantano, Stephen

    2013-09-11

    As manufacturers now sell a similar range of consumer electronics and home appliances to major markets around the world, the task of identifying a product?s energy efficiency rating has usually been the responsibility of each country and its respective government agency. This has led to a multitude of energy efficiency testing procedures, ratings, and certifications, resulting in disparate data being captured on identical products. Furthermore, lack of consistent product identification criteria means product energy performance is not easily connected to relevant information about the product such as market availability, price or real world energy consumption. This paper presents a new data standard for reporting energy performance and related product information that can be adopted internationally. To inform the development of this standard, we explore the existing energy efficiency market data for the two example products of TVs and Room Air Conditioners. This paper discusses current/future use cases of appliance level energy efficiency data across all stakeholders, including consumers, retailers/manufacturers, global standards organizations, third party service providers, and regulatory agencies. It also explains the key benefits of moving to a common international data framework for energy efficiency, such as: 1) a centralized product information repository for comparing energy use, ratings/certifications, and pricing data 2) improved access to relevant consumer electronics and appliance data to facilitate new policy development and harmonization across markets 3) enablement of retailers and other third parties to embed actionable energy efficiency information as part of the consumer experience.

  5. Benefits of creating a cross-country data framework for energy efficiency

    SciTech Connect

    Katzman, Alex; McNeil, Michael; Pantano, Stephen

    2013-10-15

    As manufacturers now sell a similar range of consumer electronics and home appliances to major markets around the world, the task of identifying a product’s energy efficiency rating has usually been the responsibility of each country and its respective government agency. This has led to a multitude of energy efficiency testing procedures, ratings, and certifications, resulting in disparate data being captured on identical products. Furthermore, lack of consistent product identification criteria means product energy performance is not easily connected to relevant information about the product such as market availability, price or real world energy consumption. This paper presents a new data standard for reporting energy performance and related product information that can be adopted internationally. To inform the development of this standard, we explore the existing energy efficiency market data for the two example products of TVs and Room Air Conditioners. This paper discusses current/future use cases of appliance level energy efficiency data across all stakeholders, including consumers, retailers/manufacturers, global standards organizations, third party service providers, and regulatory agencies. It also explains the key benefits of moving to a common international data framework for energy efficiency, such as: 1) a centralized product information repository for comparing energy use, ratings/certifications, and pricing data 2) improved access to relevant consumer electronics and appliance data to facilitate new policy development and harmonization across markets 3) enablement of retailers and other third parties to embed actionable energy efficiency information as part of the consumer experience.

  6. 14 CFR 61.111 - Cross-country flights: Pilots based on small islands.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... flight training required in § 61.109 of this part cannot be accomplished without flying over water for... without flying over water for more than 10 nautical miles from the nearest shoreline, the applicant...

  7. Who cares about health inequalities? Cross-country evidence from the World Health Survey

    PubMed Central

    King, Nicholas B; Harper, Sam; Young, Meredith E

    2013-01-01

    Reduction of health inequalities within and between countries is a global health priority, but little is known about the determinants of popular support for this goal. We used data from the World Health Survey to assess individual preferences for prioritizing reductions in health and health care inequalities. We used descriptive tables and regression analysis to study the determinants of preferences for reducing health inequalities as the primary health system goal. Determinants included individual socio-demographic characteristics (age, sex, urban residence, education, marital status, household income, self-rated health, health care use, satisfaction with health care system) and country-level characteristics [gross domestic product (GDP) per capita, disability-free life expectancy, equality in child mortality, income inequality, health and public health expenditures]. We used logistic regression to assess the likelihood that individuals ranked minimizing inequalities first, and rank-ordered logistic regression to compare the ranking of other priorities against minimizing health inequalities. Individuals tended to prioritize health system goals related to overall improvement (improving population health and health care responsiveness) over those related to equality and fairness (minimizing inequalities in health and responsiveness, and promoting fairness of financial contribution). Individuals in countries with higher GDP per capita, life expectancy, and equality in child mortality were more likely to prioritize minimizing health inequalities. PMID:23059735

  8. Depression screening via a smartphone app: cross-country user characteristics and feasibility

    PubMed Central

    BinDhim, Nasser F; Shaman, Ahmed M; Trevena, Lyndal; Basyouni, Mada H; Pont, Lisa G; Alhawassi, Tariq M

    2015-01-01

    Background and objective Smartphone applications (apps) have the potential to be valuable self-help interventions for depression screening. However, information about their feasibility and effectiveness and the characteristics of app users is limited. The aim of this study is to explore the uptake, utilization, and characteristics of voluntary users of an app for depression screening. Methods This was a cross-sectional study of a free depression screening smartphone app that contains the demographics, patient health questionnaire (PHQ-9), brief anxiety test, personalized recommendation based on the participant's results, and links to depression-relevant websites. The free app was released globally via Apple's App Store. Participants aged 18 and older downloaded the study app and were recruited passively between September 2012 and January 2013. Findings 8241 participants from 66 countries had downloaded the app, with a response rate of 73.9%. While one quarter of the participants had a previous diagnosis of depression, the prevalence of participants with a higher risk of depression was 82.5% and 66.8% at PHQ-9 cut-off 11 and cut-off 15, respectively. Many of the participants had one or more physical comorbid conditions and suicidal ideation. The cut-off 11 (OR: 1.4; 95% CI 1.2 to 1.6), previous depression diagnosis (OR: 1.3; 95% CI1.2 to 1.5), and postgraduate educational level (OR: 1.2; 95% CI 1.0 to 1.5) were associated with completing the PHQ-9 questionnaire more than once. Conclusions Smartphone apps can be used to deliver a screening tool for depression across a large number of countries. Apps have the potential to play a significant role in disease screening, self-management, monitoring, and health education, particularly among younger adults. PMID:25326599

  9. Cross-country transferability of flood damage models for residential buildings

    NASA Astrophysics Data System (ADS)

    Kreibich, H.; Neuhold, C.

    2012-04-01

    The estimation of flood damage is an important component for risk-oriented flood design, risk mapping, financial appraisals and comparative risk analyses. However, existing damage models are hardly validated and inherent to substantial uncertainty. Many damage models are currently transferred in space and time, e.g. from region to region or from one flood event to another. Though, it is still unknown to what extent and under which conditions this transfer is possible and reliable. Model validations in different countries could provide valuable insights into the transferability of damage models. Therefore, the German flood damage model FLEMOps has been applied and validated in Austria and an Austrian flood damage model has been applied and validated in Germany. The Austrian municipality of Gleisdorf and the German city of Eilenburg are analysed as test cases. Flood damage data collected after the flood in 2005 in Tyrol, Austria and Bavaria, Germany are used for validation purposes. Results of model validations and comparisons in both countries as well as model sensitivities with respect to flood and resistance characteristics are discussed.

  10. Predictors of Difficulty in Medication Intake in Europe: a Cross-country Analysis Based on SHARE

    PubMed Central

    Figueiredo, Daniela; Teixeira, Laetitia; Poveda, Veronica; Paúl, Constança; Santos-Silva, Alice; Costa, Elísio

    2016-01-01

    The aim of this study is to evaluate the prevalence and the predictors of difficulty in medication intake across Europe, using a cross-sectional design. We used data from all participants in the wave 4 of the SHARE (Survey of Health, Ageing, and Retirement in Europe) database, which is a cross national European survey. The difficulty in take medication was evaluated using an item from the “Limitations with activities of daily living”. Clinical and sociodemographic variables were evaluated as potential predictors. A total of 58 124 individual have been included in this work (mean age=64.9 ± 10.4 years; 43.3% male). The rate of difficulty in taking medication across the 16 European evaluated countries was 2.1%, presenting Spain the highest rate (5.7%) and Switzerland the lowest (0.6%). Increasing age, physical inactivity, physical limitations (mobility, arms function and fine motor limitations, and difficulties in picking up a small coin from a table), a poor sense of meaning in life, and losses in memory and concentration are independent and significant variables associated with difficulty in medication intake across Europe. Predictors of difficulties in medication intake are multicausal, including factors related to physical, cognitive and psychological conditions. Interventions aiming to optimize adherence to medication, particularly in elderly population, need to consider this diversity of determinants. PMID:27330839

  11. 14 CFR 61.111 - Cross-country flights: Pilots based on small islands.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... flight training required in § 61.109 of this part cannot be accomplished without flying over water for... without flying over water for more than 10 nautical miles from the nearest shoreline, the applicant must..., including a landing at each airport on both flights. (c) An applicant who complies with paragraph (a)...

  12. 14 CFR 61.111 - Cross-country flights: Pilots based on small islands.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... flight training required in § 61.109 of this part cannot be accomplished without flying over water for... without flying over water for more than 10 nautical miles from the nearest shoreline, the applicant must..., including a landing at each airport on both flights. (c) An applicant who complies with paragraph (a)...

  13. Worksheet Usage, Reading Achievement, Classes' Lack of Readiness, and Science Achievement: A Cross-Country Comparison

    ERIC Educational Resources Information Center

    Lee, Che-Di

    2014-01-01

    Instructional written materials play important roles as teachers' agents in effective teaching practices. Worksheets are one of the most frequently used materials. In this exploratory study, the relationships between worksheet usage and science achievement in 32 countries were examined through the use of TIMSS and PIRLS data and multiple…

  14. Inconsistencies among European Union Pharmaceutical Regulator Safety Communications: A Cross-Country Comparison

    PubMed Central

    Zeitoun, Jean-David; Lefèvre, Jérémie H.; Downing, Nicholas; Bergeron, Henri; Ross, Joseph S.

    2014-01-01

    Background The European Medicines Agency (EMA) and national regulators share the responsibility to communicate to healthcare providers postmarketing safety events but little is known about the consistency of this process. We aimed to compare public availability of safety-related communications and drug withdrawals from the EMA and European Union member countries for novel medicines. Methods and Findings We performed a cross-sectional analysis using public Dear Healthcare Professional Communications (DHPCs) for all novel medicines authorized between 2001 and 2010 by the EMA and available for use in France, Netherlands, Spain, and the United Kingdom. Between 2001 and 2010, the EMA approved 185 novel medicines. DHPCs could not be ascertained for the EMA. Among the 4 national regulators, as of April 30, 2013, at least one safety DHPC or withdrawal occurred for 53 (28.6%) medicines, totaling 90 DHPCs and 5 withdrawals. Among these 53 medicines, all 4 national agencies issued at least one communication for 17 (32.1%), three of the four for 25 (47.2%), two of the four for 6 (11.3%), and one of the four for 5 (9.4%). Five drugs were reported to be withdrawn, three by all four countries, one by three and one by two. Among the 95 DHPCs and withdrawals, 20 (21.1%) were issued by all 4 national regulators, 37 (38.9%) by 3 of the 4, 22 (23.2%) by 2 of the 4, and 16 (16.8%) by one. Consistency of making publicly available all identified safety DHPC or withdrawal across regulator pairs varied from 33% to 73% agreement. Conclusions Safety communications were not made publicly available by the EMA. Among the 4 European member countries with national regulators that make DHPCs publicly available since at least 2001, there were substantial inconsistencies in safety communications for novel medicines. The impact of those inconsistencies in terms of public health remains to be determined. PMID:25333986

  15. How Business Cycles Affect the Healthcare Sector: A Cross-country Investigation.

    PubMed

    Cleeren, Kathleen; Lamey, Lien; Meyer, Jan-Hinrich; De Ruyter, Ko

    2016-07-01

    The long-term relationship between the general economy and healthcare expenditures has been extensively researched, to explain differences in healthcare spending between countries, but the midterm (i.e., business cycle) perspective has been overlooked. This study explores business cycle sensitivity in both public and private parts of the healthcare sector across 32 countries. Responses to the business cycle vary notably, both across spending sources and across countries. Whereas in some countries, consumers and/or governments cut back, in others, private and/or public healthcare buyers tend to spend more. We also assess long-term consequences of business cycle sensitivity and show that public cost cutting during economic downturns deflates the mortality rates, whereas private cut backs increase the long-term growth in total healthcare expenditures. Finally, multiple factors help explain variability in cyclical sensitivity. Private cost cuts during economic downturns are smaller in countries with a predominantly publicly funded healthcare system and more preventive public activities. Public cut backs during contractions are smaller in countries that rely more on tax-based resources rather than social health insurances. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25916435

  16. Merging molecular data for evaluating cross country genetic diversity of pigs.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Integration of molecular data generated by microsatellite panels recommended by FAO around the world should be initiated in order to accomplish objectives stated in the Global Plan of Action for Animal Genetic Resources. To that end microsatellite datasets from U.S. (n=179, including imported Chines...

  17. Health in China and India: a cross-country comparison in a context of rapid globalisation.

    PubMed

    Dummer, Trevor J B; Cook, Ian G

    2008-08-01

    China and India are similarly huge nations currently experiencing rapid economic growth, urbanisation and widening inequalities between rich and poor. They are dissimilar in terms of their political regimes, policies for population growth and ethnic composition and heterogeneity. This review compares health and health care in China and India within the framework of the epidemiological transition model and against the backdrop of globalisation. We identify similarities and differences in health situation. In general, for both countries, infectious diseases of the past sit alongside emerging infectious diseases and chronic illnesses associated with ageing societies, although the burden of infectious diseases is much higher in India. Whilst globalisation contributes to widening inequalities in health and health care in both countries--particularly with respect to increasing disparities between urban and rural areas and between rich and poor--there is evidence that local circumstances are important, especially with respect to the structure and financing of health care and the implementation of health policy. For example, India has huge problems providing even rudimentary health care to its large population of urban slum dwellers whilst China is struggling to re-establish universal rural health insurance. In terms of funding access to health care, the Chinese state has traditionally supported most costs, whereas private insurance has always played a major role in India, although recent changes in China have seen the burgeoning of private health care payments. China has, arguably, had more success than India in improving population health, although recent reforms have severely impacted upon the ability of the Chinese health care system to operate effectively. Both countries are experiencing a decline in the amount of government funding for health care and this is a major issue that must be addressed. PMID:18554766

  18. Successful three-way kidney paired donation with cross-country live donor allograft transport.

    PubMed

    Montgomery, R A; Katznelson, S; Bry, W I; Zachary, A A; Houp, J; Hiller, J M; Shridharani, S; John, D; Singer, A L; Segev, D L

    2008-10-01

    Providing transplantation opportunities for patients with incompatible live donors through kidney paired donation (KPD) is seen as one of the important strategies for easing the crisis in organ availability. It has been estimated that an additional 1000-2000 transplants per year could be accomplished if a national KPD program were implemented in the United States. While most of these transplants could be arranged within the participants' local or regional area, patients with hard-to-match blood types or broad HLA sensitization would benefit from matching across larger geographic areas. In this case, either patients or organs would need to travel in order to obtain maximum benefit from a national program. In this study, we describe how a triple KPD enabled a highly sensitized patient (PRA 96%) to receive a well-matched kidney from a live donor on the opposite coast. The kidney was removed in San Francisco and transported to Baltimore where it was reperfused 8 h later. The patient had prompt function and 1 year later has a serum creatinine of 1.1 mg/dl. This case provides a blueprint for solving some of the complexities that are inherent in the implementation of a national KPD program in a large country like the United States. PMID:18828774

  19. The influence of tyre characteristics on measures of rolling performance during cross-country mountain biking.

    PubMed

    Macdermid, Paul William; Fink, Philip W; Stannard, Stephen R

    2015-01-01

    This investigation sets out to assess the effect of five different models of mountain bike tyre on rolling performance over hard-pack mud. Independent characteristics included total weight, volume, tread surface area and tread depth. One male cyclist performed multiple (30) trials of a deceleration field test to assess reliability. Further tests performed on a separate occasion included multiple (15) trials of the deceleration test and six fixed power output hill climb tests for each tyre. The deceleration test proved to be reliable as a means of assessing rolling performance via differences in initial and final speed (coefficient of variation (CV) = 4.52%). Overall differences between tyre performance for both deceleration test (P = 0.014) and hill climb (P = 0.032) were found, enabling significant (P < 0.0001 and P = 0.049) models to be generated, allowing tyre performance prediction based on tyre characteristics. The ideal tyre for rolling and climbing performance on hard-pack surfaces would be to decrease tyre weight by way of reductions in tread surface area and tread depth while keeping volume high. PMID:25073042

  20. Trade Liberalization and Women's Integration into National Labor Markets: A Cross-Country Analysis

    ERIC Educational Resources Information Center

    Meyer, Lisa B.

    2006-01-01

    This paper examines the effects of trade liberalization and the risks associated with participation in the global trading system on women's integration into national labor markets. Using data from 1970 to 1995, I identify two global determinants of the female share of national labor markets: trade openness and transnational corporate penetration.…

  1. Inequalities of Income and Inequalities of Longevity: A Cross-Country Study

    PubMed Central

    Plümper, Thomas

    2016-01-01

    Objectives. We examined the effects of market income inequality (income inequality before taxes and transfers) and income redistribution via taxes and transfers on inequality in longevity. Methods. We used life tables to compute Gini coefficients of longevity inequality for all individuals and for individuals who survived to at least 10 years of age. We regressed longevity inequality on market income inequality and income redistribution, and we controlled for potential confounders, in a cross-sectional time-series sample of up to 28 predominantly Western developed countries and up to 37 years (1974–2011). Results. Income inequality before taxes and transfers was positively associated with inequality in the number of years lived; income redistribution (the difference between market income inequality and income inequality after taxes and transfers were accounted for) was negatively associated with longevity inequality. Conclusions. To the extent that our estimated effects derived from observational data are causal, governments can reduce longevity inequality not only via public health policies, but also via their influence on market income inequality and the redistribution of incomes from the relatively rich to the relatively poor. PMID:26562120

  2. Does debt affect health? Cross country evidence on the debt-health nexus.

    PubMed

    Clayton, Maya; Liñares-Zegarra, José; Wilson, John O S

    2015-04-01

    We investigate the relationship between aggregate household debt and aggregate health outcomes across 17 European countries over the period 1995 to 2012. Using a dataset of country-level standardized and objective measures of household debt, health outcomes and a rich set of control variables, we estimate an instrumental variable (GMM) model to address possible reverse causality concerns. We find that aggregate household debt affects health outcomes, and that this varies by the maturity of debt. Both short and medium-term debt has a positive effect on health outcomes. Long-term unsecured debt and mortgage debt are associated with poorer health outcomes. These findings are robust after controlling for alternative measures of health and debt. Overall, the results suggest that aggregate household debt is an important determinant of aggregate health outcomes across countries. PMID:25681714

  3. Continuing Vocational Training [in Central and Eastern Europe]. Volume 1. Cross Country Analysis. Report.

    ERIC Educational Resources Information Center

    European Training Foundation, Turin (Italy).

    The current state of continuing vocational training in Central and Eastern European countries and its most important challenges were analyzed. The analysis found that the former continuing vocational training systems in these areas were characterized by generally low training levels and interdependence among the state-owned enterprises that…

  4. Effects of Female Education on Economic Growth: A Cross Country Empirical Study

    ERIC Educational Resources Information Center

    Oztunc, Hakan; Oo, Zar Chi; Serin, Zehra Vildan

    2015-01-01

    This study examines the extent to which women's education affects long-term economic growth in the Asia Pacific region. It focuses on the time period between 1990 and 2010, using data collected in randomly selected Asia Pacific countries: Bangladesh, Cambodia, China, India, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Thailand, and Vietnam.…

  5. Fertility, income distribution, and economic growth: theory and cross-country evidence.

    PubMed

    Galor, O; Zang, H

    1997-05-01

    The authors perform discriminatory, empirical tests of a theoretical model that predicts that family size adversely affects output per capita and nonsteady state growth rates. Neoclassical models posit that adverse output and nonsteady growth rates are affected by labor force growth (LFG) or population growth (PG). This study tests whether family size (FS) will be more significant than LFG or PG in explaining differences in economic growth (EG) rates across countries during 1960-88. A proxy variable for the public education system was used to separate government interventions on human capital formation from market forces. Data were obtained for 73 countries, which exclude centrally planned economies, oil-producing countries, and those with less than 1 million population. The empirical test is run with 58-country, 45-country, and 96-country samples to test for robustness and reliability. The empirical test supports the theoretical model. It demonstrates that equal distribution of income and smaller FS enhance EG. With income inequality, the effect of FS was significant, and the effect of the LFG rate or PG rate was insignificant. With a given FS, LFG was positively correlated with EG. A reduction of the net fertility rate by one point would increase the worker output growth rate by 0.25%, and the differences in growth rates between high- and low-fertility countries would be 1%. An increase in the income share of the bottom 60% would increase the growth rate of worker output by about 1%. Higher investments in public or private education would be conducive to growth. PMID:12321036

  6. An Analytical Framework for the Cross-Country Comparison of Higher Education Governance

    ERIC Educational Resources Information Center

    Dobbins, Michael; Knill, Christoph; Vogtle, Eva Maria

    2011-01-01

    In this article we provide an integrated framework for the analysis of higher education governance which allows us to more systematically trace the changes that European higher education systems are currently undergoing. We argue that, despite highly insightful previous analyses, there is a need for more specific empirically observable indicators…

  7. Congratulating North Central College on winning the 2009 NCAA Division III men's cross country championship.

    THOMAS, 111th Congress

    Rep. Biggert, Judy [R-IL-13

    2010-01-12

    02/23/2010 Referred to the Subcommittee on Higher Education, Lifelong Learning, and Competitiveness. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  8. Policy Innovation and Tertiary Education Graduation Rates: A Cross-Country Analysis

    ERIC Educational Resources Information Center

    Delaney, Jennifer A.; Yu, Patricia

    2013-01-01

    This study extends Trow's theory of higher education development to examine changes in national-level tertiary education graduation rates. Applying Trow's framework we arrive at three stages: (1) elite systems with gross tertiary graduation rates less than 15%, (2) massified systems with gross tertiary graduation rates between 15% and 50%, and (3)…

  9. Propagation of economic shocks in input-output networks: A cross-country analysis

    NASA Astrophysics Data System (ADS)

    Contreras, Martha G. Alatriste; Fagiolo, Giorgio

    2014-12-01

    This paper investigates how economic shocks propagate and amplify through the input-output network connecting industrial sectors in developed economies. We study alternative models of diffusion on networks and we calibrate them using input-output data on real-world inter-sectoral dependencies for several European countries before the Great Depression. We show that the impact of economic shocks strongly depends on the nature of the shock and country size. Shocks that impact on final demand without changing production and the technological relationships between sectors have on average a large but very homogeneous impact on the economy. Conversely, when shocks change also the magnitudes of input-output across-sector interdependencies (and possibly sector production), the economy is subject to predominantly large but more heterogeneous avalanche sizes. In this case, we also find that (i) the more a sector is globally central in the country network, the larger its impact; (ii) the largest European countries, such as those constituting the core of the European Union's economy, typically experience the largest avalanches, signaling their intrinsic higher vulnerability to economic shocks.

  10. Predictors of Difficulty in Medication Intake in Europe: a Cross-country Analysis Based on SHARE.

    PubMed

    Figueiredo, Daniela; Teixeira, Laetitia; Poveda, Veronica; Paúl, Constança; Santos-Silva, Alice; Costa, Elísio

    2016-05-01

    The aim of this study is to evaluate the prevalence and the predictors of difficulty in medication intake across Europe, using a cross-sectional design. We used data from all participants in the wave 4 of the SHARE (Survey of Health, Ageing, and Retirement in Europe) database, which is a cross national European survey. The difficulty in take medication was evaluated using an item from the "Limitations with activities of daily living". Clinical and sociodemographic variables were evaluated as potential predictors. A total of 58 124 individual have been included in this work (mean age=64.9 ± 10.4 years; 43.3% male). The rate of difficulty in taking medication across the 16 European evaluated countries was 2.1%, presenting Spain the highest rate (5.7%) and Switzerland the lowest (0.6%). Increasing age, physical inactivity, physical limitations (mobility, arms function and fine motor limitations, and difficulties in picking up a small coin from a table), a poor sense of meaning in life, and losses in memory and concentration are independent and significant variables associated with difficulty in medication intake across Europe. Predictors of difficulties in medication intake are multicausal, including factors related to physical, cognitive and psychological conditions. Interventions aiming to optimize adherence to medication, particularly in elderly population, need to consider this diversity of determinants. PMID:27330839

  11. The global economic and regulatory determinants of household food waste generation: A cross-country analysis.

    PubMed

    Chalak, Ali; Abou-Daher, Chaza; Chaaban, Jad; Abiad, Mohamad G

    2016-02-01

    Food is generally wasted all along the supply chain, with an estimated loss of 35percent generated at the consumer level. Consequently, household food waste constitutes a sizable proportion of the total waste generated throughout the food supply chain. Yet such wastes vary drastically between developed and developing countries. Using data collected from 44 countries with various income levels, this paper investigates the impact of legislation and economic incentives on household food waste generation. The obtained results indicate that well-defined regulations, policies and strategies are more effective than fiscal measures in mitigating household food waste generation. PMID:26680687

  12. Methodological and Conceptual Issues Confronting a Cross-Country Delphi Study of Educational Program Evaluation

    ERIC Educational Resources Information Center

    Hung, Hsin-Ling; Altschuld, James W.; Lee, Yi-Fang

    2008-01-01

    Although the Delphi is widely used, research on certain methodological issues is somewhat limited. After a brief introduction to the strengths, limitations, and methodological challenges of the technique, we share our experiences (as well as problems encountered) with an electronic Delphi of educational program evaluation (EPE) in the Asia-Pacific…

  13. Privatization in Higher Education: Cross-Country Analysis of Trends, Policies, Problems, and Solutions. Issue Brief

    ERIC Educational Resources Information Center

    Holzhacker, Denilde; Chornoivan, Olena; Yazilitas, Demet; Dayan-Ochir, Khishigbuyan

    2009-01-01

    Privatization is one of the main global trends in higher education. Aspects of privatization include the development and expansion of private institutions, increased reliance of public institutions on private funding, and the operation of the institutions in a businesslike manner. The rapid spread of privatization in higher education systems of…

  14. A cross country comparison of exposure to secondhand smoke among youth

    PubMed Central

    Group, The GTSS Collaborative

    2006-01-01

    Secondhand smoke or environmental tobacco smoke is a combination of smoke from a burning cigarette and exhaled smoke from a smoker. This substance is an involuntarily inhaled mix of compounds that causes or contributes to a wide range of adverse health effects, including cancer, cardiovascular diseases, respiratory infections, adverse reproductive effects, and asthma. This paper presents findings from Global Youth Tobacco Surveys (GYTS) conducted in 132 countries between 1999 and 2005. GYTS data indicate that a large proportion of students in every World Health Organization Region are exposed to secondhand smoke at home (43.9%) and in public places (55.8%), and many have parents (46.5%) or best friends who smoke (17.9%). GYTS data have shown widespread and strong support among students for bans on smoking in public areas all over the world (76.1%). Countries should engage this positive public health attitude among youth to promote and enforce policies for smoke‐free public places and workplaces, including restaurants and bars. PMID:16731523

  15. The Role of Eportfolios in Finance Studies: A Cross-Country Study

    ERIC Educational Resources Information Center

    Domínguez, Amparo S.; Morales, Lucía; Tarkovska, Valentina

    2014-01-01

    This study explores the use of ePortfolios as an efficient assessment tool to support students pursuing a Business degree, where Finance is a major component. We conducted an analysis on the role of ePortfolios in Higher Education at Dublin Institute of Technology (Republic of Ireland) and at Universitat Jaume I (Spain) for undergraduate studies.…

  16. Service innovation management practices in the telecommunications industry: what does cross country analysis reveal?

    PubMed

    Rahman, Syed Abidur; Taghizadeh, Seyedeh Khadijeh; Ramayah, T; Ahmad, Noor Hazlina

    2015-01-01

    Service innovation management practice is currently being widely scrutinized mainly in the developed countries, where it has been initiated. The current study attempts to propose a framework and empirically validate and explain the service innovation practices for successful performance in the telecommunications industry of two developing countries, Malaysia and Bangladesh. The research framework proposes relationships among organisational culture, operating core (innovation process, cross-functional organisation, and implementation of tools/technology), competition-informed pricing, and performance. A total of 176 usable data from both countries are analysed for the purpose of the research. The findings show that organisational culture tends to be more influential on innovation process and cross-functional organisation in Malaysian telecommunication industry. In contrast, implementation of tools/technology plays a more instrumental role in competition-informed pricing practices in Bangladesh. This study revealed few differences in the innovation management practices between two developing countries. The findings have strategic implications for the service sectors in both the developing countries regarding implementation of innovative enterprises, especially in Bangladesh where innovation is the basis for survival. Testing the innovation management practices in the developing countries perhaps contains uniqueness in the field of innovation management. PMID:26722630

  17. The "Dissertation Marathon" in Doctoral Distance Education

    ERIC Educational Resources Information Center

    Tweedie, M. Gregory; Clark, Sheila; Johnson, Robert C.; Kay, D. William

    2013-01-01

    Participation in "communities of practice" is often depicted as a central feature of various theoretical understandings of the social nature of learning. How are such communities of practice to be enacted in distance education, which, by definition, implies spatial detachment? This article reflects on the dimensions of communities of…

  18. For Head Start, a Marathon Run

    ERIC Educational Resources Information Center

    Jacobs, Linda

    2007-01-01

    This article talks about a pioneering federal preschool program, launched during the War on Poverty that faces reauthorization amid competition from state programs and perennial debates about its efficacy. The nutritional, social, and educational needs of disadvantaged children--combined with opportunities for parents to be involved--have been…

  19. Tuberculosis Incidence and Case Notification Rates in Kosovo and the Balkans in 2012: Cross-country Comparison

    PubMed Central

    Kurhasani, Xhevat; Hafizi, Hasan; Toci, Ervin; Burazeri, Genc

    2014-01-01

    Aim: Tuberculosis (TB) continues to be a considerable burden especially for millions of young adults and disadvantaged people worldwide. The TB incidence and notification rates are good indicators of TB situation in a country. Our aim was to compare TB incidence and notification rates in Kosovo and in seven other Balkan countries. Methods: Retrospective epidemiologic analysis of published data on TB incidence and notification rates in eight Balkan countries in 2012. Notification rates were expressed per 100,000 inhabitants and were calculated based on the number of TB cases reported divided by the population of each country under analysis. Results: The TB incidence in Kosovo (47/100,000) was considerably higher compared to its four neighboring countries: Albania (16/100,000), Macedonia, Montenegro (18/100,000) and Serbia (23/100,000). The TB notification rates in Kosovo and other countries closely mimicked the incidence rates in these countries. Conclusion: The exceptionally high TB incidence rate in Kosovo could be due to many factors including low health and medical-seeking behaviors of the local population, poverty and low education levels. Effective interventions should be adapted to the local context in order to increase the chances of success. PMID:24757405

  20. A Cross-Country Exploration: Dietetic Students' Knowledge, Attitudes, and Intentions to Provide Services to the Elderly

    ERIC Educational Resources Information Center

    Cha, Myeonghwa; Seo, Sunhee

    2009-01-01

    This study identified dietetic students' knowledge of aging, attitudes, and intentions to provide services to the elderly and compared the cross-cultural differences between the United States and South Korea. The results show that knowledge about aging and the elderly, coursework experiences, and internship experiences are much greater among…

  1. The Effect of Immigration on the School Performance of Natives: Cross Country Evidence Using PISA Test Scores

    ERIC Educational Resources Information Center

    Brunello, Giorgio; Rocco, Lorenzo

    2013-01-01

    We use aggregate PISA data for 19 countries over the period 2000-2009 to study whether a higher share of immigrant pupils affects the school performance of natives. We find evidence of a negative and statistically significant relationship. The size of the estimated effect is small: doubling the share of immigrant pupils in secondary schools from…

  2. The Influence of Classroom Disciplinary Climate of Schools on Reading Achievement: A Cross-Country Comparative Study

    ERIC Educational Resources Information Center

    Ning, Bo; Van Damme, Jan; Van Den Noortgate, Wim; Yang, Xiangdong; Gielen, Sarah

    2015-01-01

    Despite considerable interest in research and practice in the effect of classroom disciplinary climate of schools on academic achievement, little is known about the generalizability of this effect over countries. Using hierarchical linear analyses, the present study reveals that a better classroom disciplinary climate in a school is significantly…

  3. A Cross-Country Study on Research Students' Perceptions of the Role of Supervision and Cultural Knowledge in Thesis Development

    ERIC Educational Resources Information Center

    McGinty, Suzanne Claire; Koo, Yew Lie; Saeidi, Mahnaz

    2010-01-01

    This paper presents preliminary findings from a research study in Australia, Malaysia and Iran on students' perceptions of the roles of supervisor and student in the production of their thesis and the contribution of their cultural knowledge to thesis development. The 360 respondents who answered an online survey were studying for their Master's…

  4. Sensitivity Analysis for Multivalued Treatment Effects: An Example of a Cross-Country Study of Teacher Participation and Job Satisfaction

    ERIC Educational Resources Information Center

    Chang, Chi

    2015-01-01

    It is known that interventions are hard to assign randomly to subjects in social psychological studies, because randomized control is difficult to implement strictly and precisely. Thus, in nonexperimental studies and observational studies, controlling the impact of covariates on the dependent variables and addressing the robustness of the…

  5. A Standardized System of Training Intensity Guidelines for the Sports of Track and Field and Cross Country

    ERIC Educational Resources Information Center

    Belcher, Christopher P.; Pemberton, Cynthia Lee A.

    2012-01-01

    Accurate quantification of training intensity is an essential component of a training program (Rowbottom, 2000). A training program designed to optimize athlete performance abilities cannot be practically planned or implemented without a valid and reliable indication of training intensity and its effect on the physiological mechanisms of the human…

  6. Determinants of the lethality of climate-related disasters in the Caribbean Community (CARICOM): a cross-country analysis

    PubMed Central

    Andrewin, Aisha N.; Rodriguez-Llanes, Jose M.; Guha-Sapir, Debarati

    2015-01-01

    Floods and storms are climate-related hazards posing high mortality risk to Caribbean Community (CARICOM) nations. However risk factors for their lethality remain untested. We conducted an ecological study investigating risk factors for flood and storm lethality in CARICOM nations for the period 1980–2012. Lethality - deaths versus no deaths per disaster event- was the outcome. We examined biophysical and social vulnerability proxies and a decadal effect as predictors. We developed our regression model via multivariate analysis using a generalized logistic regression model with quasi-binomial distribution; removal of multi-collinear variables and backward elimination. Robustness was checked through subset analysis. We found significant positive associations between lethality, percentage of total land dedicated to agriculture (odds ratio [OR] 1.032; 95% CI: 1.013–1.053) and percentage urban population (OR 1.029, 95% CI 1.003–1.057). Deaths were more likely in the 2000–2012 period versus 1980–1989 (OR 3.708, 95% CI 1.615–8.737). Robustness checks revealed similar coefficients and directions of association. Population health in CARICOM nations is being increasingly impacted by climate-related disasters connected to increasing urbanization and land use patterns. Our findings support the evidence base for setting sustainable development goals (SDG). PMID:26153115

  7. Worksheet Usage, Reading Achievement, Classes' Lack of Readiness, and Science Achievement: A Cross-Country Comparison

    ERIC Educational Resources Information Center

    Lee, Che-Di

    2014-01-01

    Instructional written materials play important roles as teachers' agents in effective teaching practices. Worksheets are one of the most frequently used materials. In this exploratory study, the relationships between worksheet usage and science achievement in 32 countries were examined through the use of TIMSS and PIRLS data and multiple…

  8. How do output growth-rate distributions look like? Some cross-country, time-series evidence

    NASA Astrophysics Data System (ADS)

    Fagiolo, G.; Napoletano, M.; Roventini, A.

    2007-05-01

    This paper investigates the statistical properties of within-country gross domestic product (GDP) and industrial production (IP) growth-rate distributions. Many empirical contributions have recently pointed out that cross-section growth rates of firms, industries and countries all follow Laplace distributions. In this work, we test whether also within-country, time-series GDP and IP growth rates can be approximated by tent-shaped distributions. We fit output growth rates with the exponential-power (Subbotin) family of densities, which includes as particular cases both Gaussian and Laplace distributions. We find that, for a large number of OECD (Organization for Economic Cooperation and Development) countries including the US, both GDP and IP growth rates are Laplace distributed. Moreover, we show that fat-tailed distributions robustly emerge even after controlling for outliers, autocorrelation and heteroscedasticity.

  9. Cross-Country Generalizability of the Role of Metacognitive Knowledge in Students' Strategy Use and Reading Competence

    ERIC Educational Resources Information Center

    Artelt, Cordula; Schneider, Wolfgang

    2015-01-01

    Background/Context: Because metacognitive knowledge includes knowledge about adequate learning strategies, and because an effective use of learning strategies is associated with higher levels of performance, substantial relationships can be assumed between metacognitive knowledge, strategic behavior, and performance. However, such a pattern of…

  10. How does consumer knowledge affect environmentally sustainable choices? Evidence from a cross-country latent class analysis of food labels.

    PubMed

    Peschel, Anne O; Grebitus, Carola; Steiner, Bodo; Veeman, Michele

    2016-11-01

    This paper examines consumers' knowledge and lifestyle profiles and preferences regarding two environmentally labeled food staples, potatoes and ground beef. Data from online choice experiments conducted in Canada and Germany are analyzed through latent class choice modeling to identify the influence of consumer knowledge (subjective and objective knowledge as well as usage experience) on environmentally sustainable choices. We find that irrespective of product or country under investigation, high subjective and objective knowledge levels drive environmentally sustainable food choices. Subjective knowledge was found to be more important in this context. Usage experience had relatively little impact on environmentally sustainable choices. Our results suggest that about 20% of consumers in both countries are ready to adopt footprint labels in their food choices. Another 10-20% could be targeted by enhancing subjective knowledge, for example through targeted marketing campaigns. PMID:26944229

  11. Public views on principles for health care priority setting: findings of a European cross-country study using Q methodology.

    PubMed

    van Exel, Job; Baker, Rachel; Mason, Helen; Donaldson, Cam; Brouwer, Werner

    2015-02-01

    Resources available to the health care sector are finite and typically insufficient to fulfil all the demands for health care in the population. Decisions must be made about which treatments to provide. Relatively little is known about the views of the general public regarding the principles that should guide such decisions. We present the findings of a Q methodology study designed to elicit the shared views in the general public across ten countries regarding the appropriate principles for prioritising health care resources. In 2010, 294 respondents rank ordered a set of cards and the results of these were subject to by-person factor analysis to identify common patterns in sorting. Five distinct viewpoints were identified, (I) "Egalitarianism, entitlement and equality of access"; (II) "Severity and the magnitude of health gains"; (III) "Fair innings, young people and maximising health benefits"; (IV) "The intrinsic value of life and healthy living"; (V) "Quality of life is more important than simply staying alive". Given the plurality of views on the principles for health care priority setting, no single equity principle can be used to underpin health care priority setting. Hence, the process of decision making becomes more important, in which, arguably, these multiple perspectives in society should be somehow reflected. PMID:25550076

  12. Pictorial health warning label content and smokers' understanding of smoking-related risks-a cross-country comparison.

    PubMed

    Swayampakala, Kamala; Thrasher, James F; Hammond, David; Yong, Hua-Hie; Bansal-Travers, Maansi; Krugman, Dean; Brown, Abraham; Borland, Ron; Hardin, James

    2015-02-01

    The aim of the present study was to assess smokers' level of agreement with smoking-related risks and toxic tobacco constituents relative to inclusion of these topics on health warning labels (HWLs). 1000 adult smokers were interviewed between 2012 and 2013 from online consumer panels of adult smokers from each of the three countries: Australia (AU), Canada (CA) and Mexico (MX). Generalized estimating equation models were estimated to compare agreement with smoking-related risks and toxic tobacco constituents. For disease outcomes described on HWLs across all three countries, there were few statistical differences in agreement with health outcomes (e.g. emphysema and heart attack). By contrast, increases in agreement where the HWLs were revised or introduced on HWLs for the first time (e.g. blindness in AU and CA, bladder cancer in CA). Similarly, samples from countries that have specific health content or toxic constituents on HWLs showed higher agreement for that particular disease or toxin than countries without (e.g. higher agreement for gangrene and blindness in AU, higher agreement for bladder cancer and all toxic constituents except nitrosamines and radioactive polonium in CA). Pictorial HWL content is associated with greater awareness of smoking-related risks and toxic tobacco constituents. PMID:24848554

  13. Assessing the impact of cigarette package health warning labels: a cross-country comparison in Brazil, Uruguay, and Mexico

    PubMed Central

    Thrasher, James F; Villalobos, Victor; Szklo, André; Fong, Geoffrey T; Pérez, Cristina; Sebrié, Ernesto; Sansone, Natalie; Figueiredo, Valeska; Boado, Marcelo; Arillo-Santillán, Edna; Bianco, Eduardo

    2015-01-01

    Objective To assess the impact of different health warning labels (HWL). Material and Methods Data from the International Tobacco Control Survey (ITC Survey) were analyzed from adult smokers in Brazil, Uruguay and Mexico, each of which used a different HWL strategy (pictures of human suffering and diseased organs; abstract pictorial representations of risk; and text-only messages, respectively). Main outcomes were HWL salience and cognitive impact. Results HWLs in Uruguay (which was the only country with a HWL on the front of the package) had higher salience than either Brazilian or Mexican packs. People at higher levels of educational attainment in Mexico were more likely to read the text-only HWLs whereas education was unassociated with salience in Brazil or Uruguay. Brazilian HWLs had greater cognitive impacts than HWLs in either Uruguay or Mexico. HWLs in Uruguay generated lower cognitive impacts than the text-only HWLs in Mexico. In Brazil, cognitive impacts were strongest among smokers with low educational attainment. Conclusions This study suggests that HWLs have the most impact when they are prominent (i.e., front and back of the package) and include emotionally engaging imagery that illustrates negative bodily impacts or human suffering due to smoking. PMID:21243191

  14. Pictorial Health Warning Label Content and Smokers' Understanding of Smoking-Related Risks--A Cross-Country Comparison

    ERIC Educational Resources Information Center

    Swayampakala, Kamala; Thrasher, James F.; Hammond, David; Yong, Hua-Hie; Bansal-Travers, Maansi; Krugman, Dean; Brown, Abraham; Borland, Ron; Hardin, James

    2015-01-01

    The aim of the present study was to assess smokers' level of agreement with smoking-related risks and toxic tobacco constituents relative to inclusion of these topics on health warning labels (HWLs). 1000 adult smokers were interviewed between 2012 and 2013 from online consumer panels of adult smokers from each of the three countries: Australia…

  15. Determinants of the lethality of climate-related disasters in the Caribbean Community (CARICOM): a cross-country analysis

    NASA Astrophysics Data System (ADS)

    Andrewin, Aisha N.; Rodriguez-Llanes, Jose M.; Guha-Sapir, Debarati

    2015-07-01

    Floods and storms are climate-related hazards posing high mortality risk to Caribbean Community (CARICOM) nations. However risk factors for their lethality remain untested. We conducted an ecological study investigating risk factors for flood and storm lethality in CARICOM nations for the period 1980-2012. Lethality - deaths versus no deaths per disaster event- was the outcome. We examined biophysical and social vulnerability proxies and a decadal effect as predictors. We developed our regression model via multivariate analysis using a generalized logistic regression model with quasi-binomial distribution; removal of multi-collinear variables and backward elimination. Robustness was checked through subset analysis. We found significant positive associations between lethality, percentage of total land dedicated to agriculture (odds ratio [OR] 1.032; 95% CI: 1.013-1.053) and percentage urban population (OR 1.029, 95% CI 1.003-1.057). Deaths were more likely in the 2000-2012 period versus 1980-1989 (OR 3.708, 95% CI 1.615-8.737). Robustness checks revealed similar coefficients and directions of association. Population health in CARICOM nations is being increasingly impacted by climate-related disasters connected to increasing urbanization and land use patterns. Our findings support the evidence base for setting sustainable development goals (SDG).

  16. Household portfolio choices, health status and health care systems: A cross-country analysis based on SHARE

    PubMed Central

    Atella, Vincenzo; Brunetti, Marianna; Maestas, Nicole

    2013-01-01

    Health risk is increasingly viewed as an important form of background risk that affects household portfolio decisions. However, its role might be mediated by the presence of a protective full-coverage national health service that could reduce households’ probability of incurring current and future out-of-pocket medical expenditures. We use SHARE data to study the influence of current health status and future health risk on the decision to hold risky assets, across ten European countries with different health systems, each offering a different degree of protection against out-of-pocket medical expenditures. We find robust empirical evidence that perceived health status matters more than objective health status and, consistent with the theory of background risk, health risk affects portfolio choices only in countries with less protective health care systems. Furthermore, portfolio decisions consistent with background risk models are observed only with respect to middle-aged and highly-educated investors. PMID:23885134

  17. Determinants of the lethality of climate-related disasters in the Caribbean Community (CARICOM): a cross-country analysis.

    PubMed

    Andrewin, Aisha N; Rodriguez-Llanes, Jose M; Guha-Sapir, Debarati

    2015-01-01

    Floods and storms are climate-related hazards posing high mortality risk to Caribbean Community (CARICOM) nations. However risk factors for their lethality remain untested. We conducted an ecological study investigating risk factors for flood and storm lethality in CARICOM nations for the period 1980-2012. Lethality--deaths versus no deaths per disaster event- was the outcome. We examined biophysical and social vulnerability proxies and a decadal effect as predictors. We developed our regression model via multivariate analysis using a generalized logistic regression model with quasi-binomial distribution; removal of multi-collinear variables and backward elimination. Robustness was checked through subset analysis. We found significant positive associations between lethality, percentage of total land dedicated to agriculture (odds ratio [OR] 1.032; 95% CI: 1.013-1.053) and percentage urban population (OR 1.029, 95% CI 1.003-1.057). Deaths were more likely in the 2000-2012 period versus 1980-1989 (OR 3.708, 95% CI 1.615-8.737). Robustness checks revealed similar coefficients and directions of association. Population health in CARICOM nations is being increasingly impacted by climate-related disasters connected to increasing urbanization and land use patterns. Our findings support the evidence base for setting sustainable development goals (SDG). PMID:26153115

  18. A cross-country comparison of secondhand smoke exposure among adults: findings from the Global Adult Tobacco Survey (GATS)

    PubMed Central

    King, Brian A; Mirza, Sara A; Babb, Stephen D

    2015-01-01

    Objective Exposure to secondhand smoke (SHS) from burning tobacco products causes disease and premature death among non-smoking adults and children. The objective of this study was to determine the nature, extent and demographic correlates of SHS exposure among adults in low- and middle-income countries with a high burden of tobacco use. Methods Data were obtained from the Global Adult Tobacco Survey (GATS), a nationally representative household survey of individuals 15 years of age or older. Interviews were conducted during 2008–2010 in Bangladesh, Brazil, China, Egypt, India, Mexico, the Philippines, Poland, Russia, Thailand, Turkey, Ukraine, Uruguay and Vietnam. Descriptive statistics were used to determine the prevalence and correlates of SHS exposure in homes, workplaces, government buildings, restaurants, public transportation and healthcare facilities. Results Exposure to SHS in the home ranged from 17.3% (Mexico) to 73.1% (Vietnam). Among those who work in an indoor area outside the home, SHS exposure in the workplace ranged from 16.5% (Uruguay) to 63.3% (China). Exposure to SHS ranged from 6.9% (Uruguay) to 72.7% (Egypt) in government buildings, 4.4% (Uruguay) to 88.5% (China) in restaurants, 5.4% (Uruguay) to 79.6% (Egypt) on public transportation, and 3.8% (Uruguay) to 49.2% (Egypt) in healthcare facilities. Conclusions A large proportion of adults living in low-and middle-income countries are exposed to SHS in their homes, workplaces, and other public places. Countries can enact and enforce legislation requiring 100% smoke-free public places and workplaces, and can also conduct educational initiatives to reduce SHS exposure in homes. PMID:23019273

  19. Inequalities in Global Trade: A Cross-Country Comparison of Trade Network Position, Economic Wealth, Pollution and Mortality.

    PubMed

    Prell, Christina; Sun, Laixiang; Feng, Kuishuang; Myroniuk, Tyler W

    2015-01-01

    In this paper we investigate how structural patterns of international trade give rise to emissions inequalities across countries, and how such inequality in turn impact countries' mortality rates. We employ Multi-regional Input-Output analysis to distinguish between sulfur-dioxide (SO2) emissions produced within a country's boarders (production-based emissions) and emissions triggered by consumption in other countries (consumption-based emissions). We use social network analysis to capture countries' level of integration within the global trade network. We then apply the Prais-Winsten panel estimation technique to a panel data set across 172 countries over 20 years (1990-2010) to estimate the relationships between countries' level of integration and SO2 emissions, and the impact of trade integration and SO2 emission on mortality rates. Our findings suggest a positive, (log-) linear relationship between a country's level of integration and both kinds of emissions. In addition, although more integrated countries are mainly responsible for both forms of emissions, our findings indicate that they also tend to experience lower mortality rates. Our approach offers a unique combination of social network analysis with multiregional input-output analysis, which better operationalizes intuitive concepts about global trade and trade structure. PMID:26642202

  20. The Spread of Higher Education around the Globe: A Cross- Country Analysis of Gross Tertiary Education Enrollment, 1999-2005

    ERIC Educational Resources Information Center

    Yu, Patricia; Delaney, Jennifer A.

    2016-01-01

    Many nation-states have realized the importance of tertiary education and the world has seen a corollary increase in tertiary education enrollments. Using Berry and Berry's event history model as a framework, this study tests both the internal features of each country and the influence that nation-states have on each other with regard to setting…

  1. Is That Dog a Pit Bull? A Cross-Country Comparison of Perceptions of Shelter Workers Regarding Breed Identification

    PubMed Central

    Hoffman, Christy L.; Harrison, Natalie; Wolff, London; Westgarth, Carri

    2014-01-01

    Bull breeds are commonly kept as companion animals, but the pit bull terrier is restricted by breed-specific legislation (BSL) in parts of the United States and throughout the United Kingdom. Shelter workers must decide which breed(s) a dog is. This decision may influence the dog's fate, particularly in places with BSL. In this study, shelter workers in the United States and United Kingdom were shown pictures of 20 dogs and were asked what breed each dog was, how they determined each dog's breed, whether each dog was a pit bull, and what they expected the fate of each dog to be. There was much variation in responses both between and within the United States and United Kingdom. UK participants frequently labeled dogs commonly considered by U.S. participants to be pit bulls as Staffordshire bull terriers. UK participants were more likely to say their shelters would euthanize dogs deemed to be pit bulls. Most participants noted using dogs' physical features to determine breed, and 41% affected by BSL indicated they would knowingly mislabel a dog of a restricted breed, presumably to increase the dog's adoption chances. PMID:24673506

  2. The Relationship between English Language Adoption and Global Digital Inequality: A Cross-Country Analysis of ICT Readiness and Use

    ERIC Educational Resources Information Center

    Tang, Hui-Wen Vivian; Yin, Mu-Shang; Sheu, Ru-Shuo

    2011-01-01

    The aim of this study was to investigate whether differences in information and communication technology (ICT) readiness and access across countries were fundamentally related to the variable of English language adoption. A one-way multivariate analysis of variance (MANOVA) was utilized to comparatively examine the developments of ICT readiness…

  3. Problem Gambling Messages on College Counseling Center Websites: An Over-Time and Cross-Country Comparison.

    PubMed

    McKinley, Christopher J; Luo, Yi; Wright, Paul J; Kraus, Ashley

    2016-03-01

    Gambling problems remain more prevalent among college students than any other adult population. Among the different informational services available to students struggling with this issue, the convenience, anonymity, and accessibility of the college counseling center website (CCW) make this a particularly appealing resource. This updated assessment explored the nature and frequency of problem gambling messages on U.S. CCWs. and assessed whether differences existed between U.S. and U.K. sites. Results showed that problem gambling remains disproportionately underrepresented on U.S. CCWs compared to other mental health concerns. Furthermore, in only one instance-links to pamphlets-did findings indicate any over-time increase in website communications. Overall, <11 % of U.S. CCWs mentioned anything regarding this topic. When assessing U.K. CCWs, results were relatively consistent with U.S. CCWs. Specifically, while significantly more U.K. sites mentioned anything regarding problem gambling than U.S. CCWs, this was mostly limited to links to self-help groups and issue-specific websites. Given the substantial health, social, and financial consequences linked to problem gambling behaviors, universities must focus on incorporating more information about this issue on CCWs and pursue initiatives to promote this service. PMID:25677613

  4. Expanding the Field of Inquiry: A Cross-Country Study of Higher Education Institutions' Responses to HIV and AIDS

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific and Cultural Organization (UNESCO), 2006

    2006-01-01

    This report compares, analyses, and summarises findings from twelve case studies commissioned by the United Nations Education, Scientific, and Cultural Organization (UNESCO) in higher education institutions in Brazil, Burkina Faso, China, Democratic Republic of the Congo (DRC), Dominican Republic, Haiti, Jamaica, Lebanon, Lesotho, Suriname,…

  5. Dropping Out from School: A Cross Country Review of the Literature. Create Pathways to Access. Research Monograph, No. 16

    ERIC Educational Resources Information Center

    Hunt, Frances

    2008-01-01

    This paper provides an in-depth review and analysis of literature on dropping out from school, and focuses on children who have gained access, but fail to complete a basic education cycle. The main discussion is around why and how children drop out from school. Here drop out is not presented as a distinct event, but rather a process where a range…

  6. Cross-country differences in professionals' perceptions of effective parenting practices to promote fruit and vegetable consumption in preschool children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Fruit and vegetable (FV) intake may reduce the risk of some chronic diseases and obesity. Parents are considered an important influence on children's FV intake. However, the effectiveness of FV parenting practices (PP) are unknown, and differences may exist between countries. We compared health and ...

  7. Pictorial health warning label content and smokers’ understanding of smoking-related risks—a cross-country comparison

    PubMed Central

    Swayampakala, Kamala; Thrasher, James F.; Hammond, David; Yong, Hua-Hie; Bansal-Travers, Maansi; Krugman, Dean; Brown, Abraham; Borland, Ron; Hardin, James

    2015-01-01

    The aim of the present study was to assess smokers’ level of agreement with smoking-related risks and toxic tobacco constituents relative to inclusion of these topics on health warning labels (HWLs). 1000 adult smokers were interviewed between 2012 and 2013 from online consumer panels of adult smokers from each of the three countries: Australia (AU), Canada (CA) and Mexico (MX). Generalized estimating equation models were estimated to compare agreement with smoking-related risks and toxic tobacco constituents. For disease outcomes described on HWLs across all three countries, there were few statistical differences in agreement with health outcomes (e.g. emphysema and heart attack). By contrast, increases in agreement where the HWLs were revised or introduced on HWLs for the first time (e.g. blindness in AU and CA, bladder cancer in CA). Similarly, samples from countries that have specific health content or toxic constituents on HWLs showed higher agreement for that particular disease or toxin than countries without (e.g. higher agreement for gangrene and blindness in AU, higher agreement for bladder cancer and all toxic constituents except nitrosamines and radioactive polonium in CA). Pictorial HWL content is associated with greater awareness of smoking-related risks and toxic tobacco constituents. PMID:24848554

  8. The adoption of sustainable remediation behaviour in the US and UK: a cross country comparison and determinant analysis.

    PubMed

    Hou, Deyi; Al-Tabbaa, Abir; Guthrie, Peter

    2014-08-15

    The sustainable remediation concept, aimed at maximizing the net environmental, social, and economic benefits in contaminated site remediation, is being increasingly recognized by industry, governments, and academia. However, there is limited understanding of actual sustainable behaviour being adopted and the determinants of such sustainable behaviour. The present study identified 27 sustainable practices in remediation. An online questionnaire survey was used to rank and compare them in the US (n=112) and the UK (n=54). The study also rated ten promoting factors, nine barriers, and 17 types of stakeholders' influences. Subsequently, factor analysis and general linear models were used to determine the effects of internal characteristics (i.e. country, organizational characteristics, professional role, personal experience and belief) and external forces (i.e. promoting factors, barriers, and stakeholder influences). It was found that US and UK practitioners adopted many sustainable practices to similar extents. Both US and UK practitioners perceived the most effectively adopted sustainable practices to be reducing the risk to site workers, protecting groundwater and surface water, and reducing the risk to the local community. Comparing the two countries, we found that the US adopted innovative in-situ remediation more effectively; while the UK adopted reuse, recycling, and minimizing material usage more effectively. As for the overall determinants of sustainable remediation, the country of origin was found not to be a significant determinant. Instead, organizational policy was found to be the most important internal characteristic. It had a significant positive effect on reducing distant environmental impact, sustainable resource usage, and reducing remediation cost and time (p<0.01). Customer competitive pressure was found to be the most extensively significant external force. In comparison, perceived stakeholder influence, especially that of primary stakeholders (site owner, regulator, and primary consultant), did not appear to have as extensive a correlation with the adoption of sustainability as one would expect. PMID:24908650

  9. Understanding the Relationships among PISA Scores, Economic Growth and Employment in Different Sectors: A Cross-Country Study

    ERIC Educational Resources Information Center

    Cheung, Hoi Yan; Chan, Alex W. H.

    2008-01-01

    This study investigates the relationship between Program for International Student Assessment (PISA) scores in mathematics, science and reading and the employment rates in the following four economic activities: research and development, agriculture, industry, and service industries. Thirty-three countries were included in the study, and most…

  10. Quality of life of people living with HIV/AIDS: a cross-country comparison study of Finland and Portugal.

    PubMed

    Nobre, Nuno; Pereira, Marco; Sutinen, Jussi; Canavarro, Maria Cristina; Sintonen, Harri; Roine, Risto P

    2016-07-01

    The premises underlying the development of the World Health Organization Quality of Life (WHOQOL) instruments provide a convincing rationale for comparing quality of life (QoL) across countries. The aim of the present study was to compare the QoL of patients living with HIV infection in Finland and in Portugal, and to examine the contribution of the QoL domains to the overall QoL in these two countries. The sample comprised 453 patients from Finland (76.3% male; mean age = 46.50) and 975 from Portugal (69.2% male; mean age = 40.98), all living with HIV. QoL data were collected by use of the WHOQOL-HIV-Bref questionnaire. Significant country differences were found in QoL domains and specific facets. Patients from Finland reported markedly higher scores on all six QoL domains and general facet, than did their Portuguese counterparts. Regarding the specific facets of the WHOQOL-HIV-Bref, patients from Finland also reported significantly higher scores on 24 out of 29. The exceptions were dependence on medications and treatment, positive feelings, personal relationships, sexual activity, and on spirituality, religion and personal beliefs. Regression analyses showed that physical, psychological, and independence domains contributed to overall QoL among the Finnish patients (R(2) = 0.63), whereas among the Portuguese, the domains significantly associated with overall QoL were physical, psychological, independence, and environment (R(2) = 0.48). Country differences in QoL domains and specific facets may reflect sociocultural differences between southern and northern Europe. PMID:26883186

  11. Inequalities in Global Trade: A Cross-Country Comparison of Trade Network Position, Economic Wealth, Pollution and Mortality

    PubMed Central

    Prell, Christina; Sun, Laixiang; Feng, Kuishuang; Myroniuk, Tyler W.

    2015-01-01

    In this paper we investigate how structural patterns of international trade give rise to emissions inequalities across countries, and how such inequality in turn impact countries’ mortality rates. We employ Multi-regional Input-Output analysis to distinguish between sulfur-dioxide (SO2) emissions produced within a country’s boarders (production-based emissions) and emissions triggered by consumption in other countries (consumption-based emissions). We use social network analysis to capture countries’ level of integration within the global trade network. We then apply the Prais-Winsten panel estimation technique to a panel data set across 172 countries over 20 years (1990–2010) to estimate the relationships between countries’ level of integration and SO2 emissions, and the impact of trade integration and SO2 emission on mortality rates. Our findings suggest a positive, (log-) linear relationship between a country’s level of integration and both kinds of emissions. In addition, although more integrated countries are mainly responsible for both forms of emissions, our findings indicate that they also tend to experience lower mortality rates. Our approach offers a unique combination of social network analysis with multiregional input-output analysis, which better operationalizes intuitive concepts about global trade and trade structure. PMID:26642202

  12. Traditional Wisdom and Male Adolescent Development on Marathon Bicycle Rides.

    ERIC Educational Resources Information Center

    McClelland, Gary W.

    The challenge of the Australian lifestyle has historically led bushmen on journeys of arduous adventure which actively developed unfettered spirits and extraordinary endurance. These qualities have contributed to the development of the Australian psyche. As a way of passing on the qualities and values of Australian bushmen of years ago, an…

  13. Nutrition for endurance sports: marathon, triathlon, and road cycling.

    PubMed

    Jeukendrup, Asker E

    2011-01-01

    Endurance sports are increasing in popularity and athletes at all levels are looking for ways to optimize their performance by training and nutrition. For endurance exercise lasting 30 min or more, the most likely contributors to fatigue are dehydration and carbohydrate depletion, whereas gastrointestinal problems, hyperthermia, and hyponatraemia can reduce endurance exercise performance and are potentially health threatening, especially in longer events (>4 h). Although high muscle glycogen concentrations at the start may be beneficial for endurance exercise, this does not necessarily have to be achieved by the traditional supercompensation protocol. An individualized nutritional strategy can be developed that aims to deliver carbohydrate to the working muscle at a rate that is dependent on the absolute exercise intensity as well as the duration of the event. Endurance athletes should attempt to minimize dehydration and limit body mass losses through sweating to 2-3% of body mass. Gastrointestinal problems occur frequently, especially in long-distance races. Problems seem to be highly individual and perhaps genetically determined but may also be related to the intake of highly concentrated carbohydrate solutions, hyperosmotic drinks, as well as the intake of fibre, fat, and protein. Hyponatraemia has occasionally been reported, especially among slower competitors with very high intakes of water or other low sodium drinks. Here I provide a comprehensive overview of recent research findings and suggest several new guidelines for the endurance athlete on the basis of this. These guidelines are more detailed and allow a more individualized approach. PMID:21916794

  14. The evolution of marathon running : capabilities in humans.

    PubMed

    Lieberman, Daniel E; Bramble, Dennis M

    2007-01-01

    Humans have exceptional capabilities to run long distances in hot, arid conditions. These abilities, unique among primates and rare among mammals, derive from a suite of specialised features that permit running humans to store and release energy effectively in the lower limb, help keep the body's center of mass stable and overcome the thermoregulatory challenges of long distance running. Human endurance running performance capabilities compare favourably with those of other mammals and probably emerged sometime around 2 million years ago in order to help meat-eating hominids compete with other carnivores. PMID:17465590

  15. Cross-Country comparison of professionals' perceptions of the effectiveness of parenting practices to promote fruit and vegetable consumption in preschool children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Obesity prevention often includes promotion of fruit and vegetable (FV) intake. Parents may be an important influence on FV intake for preschool children. Which parenting practices (PP) are effective in getting children to eat FV throughout childhood is unclear. A national variations in professional...

  16. Do Basic Skills Predict Youth Unemployment (16- to 24-Year-Olds) Also when Controlled for Accomplished Upper-Secondary School? A Cross-Country Comparison

    ERIC Educational Resources Information Center

    Lundetrae, Kjersti; Gabrielsen, Egil; Mykletun, Reidar

    2010-01-01

    Basic skills and educational level are closely related, and both might affect employment. Data from the Adult Literacy and Life Skills Survey were used to examine whether basic skills in terms of literacy and numeracy predicted youth unemployment (16-24 years) while controlling for educational level. Stepwise logistic regression showed that in…

  17. The Association Analysis between ACE and ACTN3 Genes Polymorphisms and Endurance Capacity in Young Cross-Country Skiers: Longitudinal Study.

    PubMed

    Mägi, Agnes; Unt, Eve; Prans, Ele; Raus, Liina; Eha, Jaan; Veraksitš, Alar; Kingo, Külli; Kõks, Sulev

    2016-06-01

    Endurance performance depends on the integration of several phenotypic traits influenced by multiple environmental and genetic factors. Objectives of the study were: (1) to examine the genotypic frequencies of the ACE I/D, ACTN3 R577X polymorphisms and endurance performance-related phenotypes, (2) to evaluate the dynamics of endurance performance parameters during a 5-year period in relation to ACE I/D and ACTN3 R577X genotypes in Estonian young skiers. Determination of VO2peak was performed in 58 skiers aged 15-19 years (41 males, 17 females) during a 5-year period. The control group consisted of 322 healthy non-athletic subjects (145 males, 177 females). The study groups were genotyped for the ACE I/D and ACTN3 R577X variants. Frequencies of the ACE ID and ACTN3 RR genotypes were significantly higher (p = 0.047 and p = 0.003, respectively) and the RX genotype was lower (p = 0.008) in young male skiers compared with controls. A significant relationship was found between change (Δ) of training volume and ΔVO2peak (mL·kg(-1)·min(-1)) (r = 0.475, p = 0.002). No significant main effect was detected between VO2peak (mL·kg(-1)·min(-1)) dynamics (comparison with the previous age group data) and ACE I/D and ACTN3 R577X genotypes interactions (F = 0.571, p = 0.770 and F = 0.650 and p = 0.705, respectively) in all young skiers. Study results indicated a significantly higher frequency of the ACE ID and ACTN3 RR genotypes among Estonian young male skiers compared with the male control group. Significant genotype-related differences in dynamics of VO2peak during a 5-year period were not found. In the future, longitudinal research including different gene variants may contribute to a better understanding of the nature of endurance performance. Key pointsSignificantly higher prevalence of the ACE ID and the ACTN3 RR genotypes were found among Estonian young male skiers compared with the male control group, which may be an advantage for the explosive speed and power capacity in race skiing.A more remarkable trend of increase in VO2peak (mL·kg(-1)·min(-1)) during the 5-year period was observed among male skiers with the ACTN3 XX genotype and among female skiers with the ACE ID genotype.No significant genotype-related associations in the dynamics of VO2peak were found during the 5-year period. PMID:27274666

  18. The Association Analysis between ACE and ACTN3 Genes Polymorphisms and Endurance Capacity in Young Cross-Country Skiers: Longitudinal Study

    PubMed Central

    Mägi, Agnes; Unt, Eve; Prans, Ele; Raus, Liina; Eha, Jaan; Veraksitš, Alar; Kingo, Külli; Kõks, Sulev

    2016-01-01

    Endurance performance depends on the integration of several phenotypic traits influenced by multiple environmental and genetic factors. Objectives of the study were: (1) to examine the genotypic frequencies of the ACE I/D, ACTN3 R577X polymorphisms and endurance performance-related phenotypes, (2) to evaluate the dynamics of endurance performance parameters during a 5-year period in relation to ACE I/D and ACTN3 R577X genotypes in Estonian young skiers. Determination of VO2peak was performed in 58 skiers aged 15-19 years (41 males, 17 females) during a 5-year period. The control group consisted of 322 healthy non-athletic subjects (145 males, 177 females). The study groups were genotyped for the ACE I/D and ACTN3 R577X variants. Frequencies of the ACE ID and ACTN3 RR genotypes were significantly higher (p = 0.047 and p = 0.003, respectively) and the RX genotype was lower (p = 0.008) in young male skiers compared with controls. A significant relationship was found between change (Δ) of training volume and ΔVO2peak (mL·kg-1·min-1) (r = 0.475, p = 0.002). No significant main effect was detected between VO2peak (mL·kg-1·min-1) dynamics (comparison with the previous age group data) and ACE I/D and ACTN3 R577X genotypes interactions (F = 0.571, p = 0.770 and F = 0.650 and p = 0.705, respectively) in all young skiers. Study results indicated a significantly higher frequency of the ACE ID and ACTN3 RR genotypes among Estonian young male skiers compared with the male control group. Significant genotype-related differences in dynamics of VO2peak during a 5-year period were not found. In the future, longitudinal research including different gene variants may contribute to a better understanding of the nature of endurance performance. Key points Significantly higher prevalence of the ACE ID and the ACTN3 RR genotypes were found among Estonian young male skiers compared with the male control group, which may be an advantage for the explosive speed and power capacity in race skiing. A more remarkable trend of increase in VO2peak (mL·kg-1·min-1) during the 5-year period was observed among male skiers with the ACTN3 XX genotype and among female skiers with the ACE ID genotype. No significant genotype-related associations in the dynamics of VO2peak were found during the 5-year period. PMID:27274666

  19. No theory: an explanation of the lack of consistency in cross-country health care comparisons using non-parametric estimators.

    PubMed

    Gearhart, Richard

    2016-12-01

    Since 2000 several papers have examined the efficiency of healthcare delivery systems worldwide. These papers have extended the literature using drastically different input and output combinations from one another, with little theoretical or empirical support backing these specifications. Issues arise that many of these inputs and outputs are available for a subset of OECD countries each year. Using a common estimator and the different specifications proposed leads to the result that efficiency rankings across papers can diverge quite significantly, with several countries being highly efficient in one specification and highly inefficient in another. Broad input-output measures that are collected annually provide consistent efficiency rankings across specifications, compared to specifications that utilize specific measures collected infrequently. This paper also finds that broad output measures that are not quality-adjusted, such as life expectancy, seem to be a suitable alternative for infrequently collected quality-adjusted output measures, such as disability adjusted life years. PMID:27580726

  20. Impact of the removal of misleading terms on cigarette pack on smokers’ beliefs about Light/Mild cigarettes: Cross-country comparisons

    PubMed Central

    Yong, Hua-Hie; Borland, Ron; Cummings, K. Michael; Hammond, David; O’Connor, Richard J.; Hastings, Gerard; King, Bill

    2011-01-01

    Aim This paper examines how smokers’ beliefs about “light/ mild” cigarettes in Australia, Canada and the UK were affected by the removal of misleading “light/mild” terms from packs. Design, setting and participants The data come from the first 7 waves (2002–2009) of the International Tobacco Control Policy Evaluation (ITC) Four-Country Survey, an annual cohort telephone survey of adult smokers in Canada, United States, United Kingdom, and Australia (21,613 individual cases). “Light” and “mild” descriptors were removed in 2003 in the UK, in 2006 in Australia, and in 2007 in Canada. We compare beliefs about “light” cigarettes both before and after the bans, with those of smokers in the US serving as the control condition. Findings The proportions of respondents reporting misperceptions about light cigarettes declined between 2002 and 2009 in all four countries. There were marked temporary reductions in reported misperceptions in the UK and Australia but not in Canada following the removal of “light/mild” descriptors. Conclusions Removal of “light/mild” descriptors and tar, nicotine and carbon monoxide yield information from cigarette packs is insufficient to effectively eliminate false beliefs. The combination of alternative descriptors and design features that produce differences in taste strength and harshness, independent of actual intakes, are sufficient to produce or sustain the same misbeliefs. PMID:21658140