Performance of Xpert® MTB/RIF among tuberculosis outpatients in Lilongwe, Malawi.

PubMed

Chikaonda, Tarsizio; Nguluwe, Nelson; Barnett, Brian; Gokhale, Runa H; Krysiak, Robert; Thengolose, Isaac; Rosenberg, Nora E; Stanley, Christopher; Mpunga, James; Hoffman, Irving F; Hosseinipour, Mina; Scott, Lesley; Stevens, Wendy

2017-01-01

Xpert ® MTB/RIF is a molecular test for the detection of Mycobacterium tuberculosis and rifampicin resistance. It is considered to be a great advance over smear microscopy and culture. However, there is very little information regarding the performance characteristics of Xpert MTB/RIF in Malawi. We aimed to evaluate the performance of Xpert MTB/RIF in a Malawian setting. Stored sputum pellets were processed on Xpert MTB/RIF between June 2012 and May 2014. Results were compared to mycobacteria growth indicator tube and Löwenstein-Jensen cultures, LED fluorescent microscopy and GenoType ® MTBDR plus assay. Rifampicin resistance was confirmed by DNA sequencing. Of the 348 specimens with valid Xpert MTB/RIF results, 129/348 (37%) were smear-positive and 198/348 (57%) were culture-positive. Xpert MTB/RIF demonstrated a sensitivity of 93.8% (95% CI 89.4% - 96.8%) and specificity of 97.4% (95% CI 93.5% - 99.3%), with a positive predictive value of 97.8% (95% CI 94.6% - 99.4%) and a negative predictive value of 92.6% (95% CI 87.4% - 96.1%). Xpert MTB/RIF correctly identified 185/186 (99.5%) rifampicin-sensitive and 2/2 (100%) rifampicin-resistant M. tuberculosis strains. Mutations were not detected by sequencing in one isolate which was rifampicin resistant on Xpert MTB/RIF but sensitive on MTBDR plus . Four non-tuberculous mycobacteria grew from four smear-negative specimens, namely, M. avium ( n = 1) and M. intracellulare ( n = 3). No cross-reactivity was observed with any of the non-tuberculous mycobacteria when using Xpert MTB/RIF. When fully implemented, Xpert MTB/RIF may have an impact on patient care in Malawi. The increased diagnostic yield of Xpert MTB/RIF over smear microscopy can increase laboratory-confirmed tuberculosis detection and ensure that treatment is given to appropriate individuals or groups.

Performance of Xpert® MTB/RIF among tuberculosis outpatients in Lilongwe, Malawi

PubMed Central

Nguluwe, Nelson; Gokhale, Runa H.; Krysiak, Robert; Thengolose, Isaac; Rosenberg, Nora E.; Stanley, Christopher; Mpunga, James; Hoffman, Irving F.; Hosseinipour, Mina; Scott, Lesley; Stevens, Wendy

2017-01-01

Background Xpert® MTB/RIF is a molecular test for the detection of Mycobacterium tuberculosis and rifampicin resistance. It is considered to be a great advance over smear microscopy and culture. However, there is very little information regarding the performance characteristics of Xpert MTB/RIF in Malawi. Objective We aimed to evaluate the performance of Xpert MTB/RIF in a Malawian setting. Methods Stored sputum pellets were processed on Xpert MTB/RIF between June 2012 and May 2014. Results were compared to mycobacteria growth indicator tube and Löwenstein-Jensen cultures, LED fluorescent microscopy and GenoType® MTBDRplus assay. Rifampicin resistance was confirmed by DNA sequencing. Results Of the 348 specimens with valid Xpert MTB/RIF results, 129/348 (37%) were smear-positive and 198/348 (57%) were culture-positive. Xpert MTB/RIF demonstrated a sensitivity of 93.8% (95% CI 89.4% – 96.8%) and specificity of 97.4% (95% CI 93.5% – 99.3%), with a positive predictive value of 97.8% (95% CI 94.6% – 99.4%) and a negative predictive value of 92.6% (95% CI 87.4% – 96.1%). Xpert MTB/RIF correctly identified 185/186 (99.5%) rifampicin-sensitive and 2/2 (100%) rifampicin-resistant M. tuberculosis strains. Mutations were not detected by sequencing in one isolate which was rifampicin resistant on Xpert MTB/RIF but sensitive on MTBDRplus. Four non-tuberculous mycobacteria grew from four smear-negative specimens, namely, M. avium (n = 1) and M. intracellulare (n = 3). No cross-reactivity was observed with any of the non-tuberculous mycobacteria when using Xpert MTB/RIF. Conclusion When fully implemented, Xpert MTB/RIF may have an impact on patient care in Malawi. The increased diagnostic yield of Xpert MTB/RIF over smear microscopy can increase laboratory-confirmed tuberculosis detection and ensure that treatment is given to appropriate individuals or groups. PMID:28879160

Half-marathon and full-marathon runners' hydration practices and perceptions.

PubMed

O'Neal, Eric K; Wingo, Jonathan E; Richardson, Mark T; Leeper, James D; Neggers, Yasmine H; Bishop, Phil A

2011-01-01

The behaviors and beliefs of recreational runners with regard to hydration maintenance are not well elucidated. To examine which beverages runners choose to drink and why, negative performance and health experiences related to dehydration, and methods used to assess hydration status. Cross-sectional study. Marathon registration site. Men (n = 146) and women (n = 130) (age = 38.3 ± 11.3 years) registered for the 2010 Little Rock Half-Marathon or Full Marathon. A 23-item questionnaire was administered to runners when they picked up their race timing chips. Runners were separated into tertiles (Low, Mod, High) based on z scores derived from training volume, expected performance, and running experience. We used a 100-mm visual analog scale with anchors of 0 (never) and 100 (always). Total sample responses and comparisons between tertile groups for questionnaire items are presented. The High group (58±31) reported greater consumption of sport beverages in exercise environments than the Low (42 ± 35 mm) and Mod (39 ± 32 mm) groups (P < .05) and perceived sport beverages to be superior to water in meeting hydration needs (P < .05) and improving performance during runs greater than 1 hour (P < .05). Seventy percent of runners experienced 1 or more incidents in which they believed dehydration resulted in a major performance decrement, and 45% perceived dehydration to have resulted in adverse health effects. Twenty percent of runners reported monitoring their hydration status. Urine color was the method most often reported (7%), whereas only 2% reported measuring changes in body weight. Greater attention should be paid to informing runners of valid techniques to monitor hydration status and developing an appropriate individualized hydration strategy.

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.

Evaluation of the GeneXpert MTB/RIF assay on extrapulmonary and respiratory samples other than sputum: a low burden country experience.

PubMed

Pandey, Sushil; Congdon, Jacob; McInnes, Bradley; Pop, Alina; Coulter, Christopher

2017-01-01

The aim of this study was to assess the performance of the GeneXpert MTB/RIF assay on extrapulmonary (EP) and respiratory (non-sputum) clinical samples of patients suspected of having tuberculosis (TB) from Queensland, Australia. A total of 269 EP and respiratory (non-sputum) clinical samples collected from Qld patients who were suspected of having TB were subjected to the GeneXpert MTB/RIF analysis, Ziehl-Neelsen (ZN) staining, Mycobacterium tuberculosis (MTB) culture and drug susceptibility testing. Phenotypic and genotypic data were compared. The overall performance analysis of the GeneXpert MTB/RIF assay for detection of MTB complex demonstrated sensitivity of 89%, specificity of 95%, PPV of 89% and NPV of 95% using culture as a reference standard. The GeneXpert MTB/RIF analysis of acid-fast bacilli (AFB) smear positive samples and AFB smear negative samples showed sensitivities of 100% and 77%, respectively. Looking at individual EP and respiratory (non-sputum) sample types, the sensitivity ranged from 60% to 100% although the specificity ranged from 33% to 100% with the specificity of lymph node tissue biopsy being the lowest. The GeneXpert MTB/RIF assay detected 11% more TB cases than culture and 27% more cases than ZN microscopy. Due to insufficient numbers of presenting rifampicin resistance cases, performance analysis of the GeneXpert MTB/RIF assay on rifampicin resistance could not be carried out. The GeneXpert MTB/RIF assay is potentially valuable for TB diagnosis in the majority of the EP and respiratory (other than sputum) samples in our setting. Although the GeneXpert MTB/RIF assay provides rapid diagnostic results, the overall sensitivity to rule out the disease is suboptimal for some specimen types. Performance varied according to specimen type and AFB smear status. The sensitivity and specificity of lymph node tissue was 63% and 33%. Care must be taken when using the GeneXpert MTB/RIF assay for detection of MTB in lymph node tissue samples. All

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

Half-Marathon and Full-Marathon Runners' Hydration Practices and Perceptions

PubMed Central

O'Neal, Eric K.; Wingo, Jonathan E.; Richardson, Mark T.; Leeper, James D.; Neggers, Yasmine H.; Bishop, Phil A.

2011-01-01

Context: The behaviors and beliefs of recreational runners with regard to hydration maintenance are not well elucidated. Objective: To examine which beverages runners choose to drink and why, negative performance and health experiences related to dehydration, and methods used to assess hydration status. Design: Cross-sectional study. Setting: Marathon registration site. Patients or Other Participants: Men (n = 146) and women (n = 130) (age = 38.3 ± 11.3 years) registered for the 2010 Little Rock Half-Marathon or Full Marathon. Intervention(s): A 23-item questionnaire was administered to runners when they picked up their race timing chips. Main Outcome Measure(s): Runners were separated into tertiles (Low, Mod, High) based on z scores derived from training volume, expected performance, and running experience. We used a 100-mm visual analog scale with anchors of 0 (never) and 100 (always). Total sample responses and comparisons between tertile groups for questionnaire items are presented. Results: The High group (58±31) reported greater consumption of sport beverages in exercise environments than the Low (42 ± 35 mm) and Mod (39 ± 32 mm) groups (P < .05) and perceived sport beverages to be superior to water in meeting hydration needs (P < .05) and improving performance during runs greater than 1 hour (P < .05). Seventy percent of runners experienced 1 or more incidents in which they believed dehydration resulted in a major performance decrement, and 45% perceived dehydration to have resulted in adverse health effects. Twenty percent of runners reported monitoring their hydration status. Urine color was the method most often reported (7%), whereas only 2% reported measuring changes in body weight. Conclusions: Greater attention should be paid to informing runners of valid techniques to monitor hydration status and developing an appropriate individualized hydration strategy. PMID:22488182

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.

The Middle-Aged Marathon Runner

PubMed Central

Valentine, Anthony S.

1982-01-01

Middle-aged runners form an appreciable number of those engaged in marathon running. They tend to have above average intelligence, high socioeconomic status, and better levels of aerobic fitness than sedentary members of the same age group. “Too much too soon” is the commonest cause of injury. Training before a marathon should last 18 months to two years. Middle-aged runners tend to experience fewer injuries than other marathoners. However, relatively minor complaints will be disastrous to them if they have to stop running. Injuries can occur from lack of warm up exercises, environmental factors such as weather, poor street lighting, carbon monoxide from car exhausts, etc. Some contraindications to marathon running are: poorly controlled diabetes, recent acute pulmonary disease, active rheumatoid arthritis, and recent cardiac conditions. Finishing a marathon involves both agony and ecstasy. PMID:21286102

[Comparison of the efficacies of cross priming amplification and RealAmp with XpertMTB/RIF for the diagnosis of pulmonary tuberculosis at peripheral microscopic center].

PubMed

Wang, S H; Zheng, D W; Zhu, Y K; Ma, X G; Shi, J; Ou, X C; Li, H; Xing, J; Zhao, Y L

2018-02-12

Objective: To compare the efficacies of cross priming amplification (CPA) and RealAmp with XpertMTB/RIF for the diagnosis of pulmonary tuberculosis(TB) at peripheral microscopic centers. Methods: From December of 2014 to December of 2015, 3 193 patients suspected with TB were enrolled consecutively at 3 county level TB clinical clinics in Zhongmu, Xinmi and Dengzhou of Henan province. Totally 3 193 collected sputum samples were detected by smear microscopy, L-J media culture, CPA, RealAmp and Xpert MTB/RIF. The culture positive samples were tested by MPB64 for strain identification. The sensitivity and specificity of CPA, RealAmp and Xpert MTB/RIF were calculated according to L-J solid culture results and clinical diagnosis results. Results: The sensitivity of CPA, RealAmp and Xpert MTB/RIF were 85.5%(413/483), 85.5%(413/483) and 87.9%(422/480), respectively, compared with L-J solid culture, the difference among the 3 methods being not significant(χ(2)=1.6, P >0.05). The specificity of CPA, RealAmp and Xpert MTB/RIF were 96.8%(2 624/2 170), 93.2%(2 527/2 170) and 95.3%(2 567/2 170) compared with culture; and there was a significantly statistic difference among the 3 methods(χ(2)=37.8, P <0.001). The sensitivity of smear microscopy, culture, CPA, RealAmp and Xpert MTB/RIF was 21.7%(300/1 383), 34.9%(483/1 383), 34.6%(478/1 383), 39.2%(542/1 383) and 38.1%(526/1 381) compared with clinical diagnosis. The sensitivity of CPA, RealAmp and Xpert MTB/RIF was higher than that of smear (χ(2) =31.9, P <0.01), but there was no significantly statistic difference between the 3 molecular methods(χ(2)=2.9, P >0.05). The specificity of smear microscopy, L-J solid culture, CPA, RealAmp and Xpert MTB/RIF was 100%(1 810/1 810), 100%(1 810/1 810), 98.8%(1 789/1 810), 98.8%(1 756/1 810) and 97.0%(1 788/1 810), and there was no significantly statistic difference among the 3 molecular methods(χ(2)=0.16, P >0.05). Conclusion: The capability of CPA and RealAmp for diagnosing pulmonary

Applied physiology of marathon running.

PubMed

Sjödin, B; Svedenhag, J

1985-01-01

Performance in marathon running is influenced by a variety of factors, most of which are of a physiological nature. Accordingly, the marathon runner must rely to a large extent on a high aerobic capacity. But great variations in maximal oxygen uptake (VO2 max) have been observed among runners with a similar performance capacity, indicating complementary factors are of importance for performance. The oxygen cost of running or the running economy (expressed, e.g. as VO2 15 at 15 km/h) as well as the fractional utilisation of VO2 max at marathon race pace (%VO2 Ma X VO2 max-1) [where Ma = mean marathon velocity] are additional factors which are known to affect the performance capacity. Together VO2 max, VO2 15 and %VO2 Ma X VO2 max-1 can almost entirely explain the variation in marathon performance. To a similar degree, these variables have also been found to explain the variations in the 'anaerobic threshold'. This factor, which is closely related to the metabolic response to increasing exercise intensities, is the single variable that has the highest predictive power for marathon performance. But a major limiting factor to marathon performance is probably the choice of fuels for the exercising muscles, which factor is related to the %VO2 Ma X VO2 max-1. Present indications are that marathon runners, compared with normal individuals, have a higher turnover rate in fat metabolism at given high exercise intensities expressed both in absolute (m/sec) and relative (%VO2 max) terms. The selection of fat for oxidation by the muscles is important since the stores of the most efficient fuel, the carbohydrates, are limited. The large amount of endurance training done by marathon runners is probably responsible for similar metabolic adaptations, which contribute to a delayed onset of fatigue and raise the VO2 Ma X VO2max-1. There is probably an upper limit in training kilometrage above which there are no improvements in the fractional utilisation of VO2 max at the marathon

Xpert® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults.

PubMed

Steingart, Karen R; Schiller, Ian; Horne, David J; Pai, Madhukar; Boehme, Catharina C; Dendukuri, Nandini

2014-01-21

Accurate, rapid detection of tuberculosis (TB) and TB drug resistance is critical for improving patient care and decreasing TB transmission. Xpert® MTB/RIF assay is an automated test that can detect both TB and rifampicin resistance, generally within two hours after starting the test, with minimal hands-on technical time. The World Health Organization (WHO) issued initial recommendations on Xpert® MTB/RIF in early 2011. A Cochrane Review on the diagnostic accuracy of Xpert® MTB/RIF for pulmonary TB and rifampicin resistance was published January 2013. We performed this updated Cochrane Review as part of a WHO process to develop updated guidelines on the use of the test. To assess the diagnostic accuracy of Xpert® MTB/RIF for pulmonary TB (TB detection), where Xpert® MTB/RIF was used as both an initial test replacing microscopy and an add-on test following a negative smear microscopy result.To assess the diagnostic accuracy of Xpert® MTB/RIF for rifampicin resistance detection, where Xpert® MTB/RIF was used as the initial test replacing culture-based drug susceptibility testing (DST).The populations of interest were adults presumed to have pulmonary, rifampicin-resistant or multidrug-resistant TB (MDR-TB), with or without HIV infection. The settings of interest were intermediate- and peripheral-level laboratories. The latter may be associated with primary health care facilities. We searched for publications in any language up to 7 February 2013 in the following databases: Cochrane Infectious Diseases Group Specialized Register; MEDLINE; EMBASE; ISI Web of Knowledge; MEDION; LILACS; BIOSIS; and SCOPUS. We also searched the metaRegister of Controlled Trials (mRCT) and the search portal of the WHO International Clinical Trials Registry Platform to identify ongoing trials. We included randomized controlled trials, cross-sectional studies, and cohort studies using respiratory specimens that allowed for extraction of data evaluating Xpert® MTB/RIF against the

Cardiac troponin increases among marathon runners in the Perth Marathon: the Troponin in Marathons (TRIM) study.

PubMed

Hubble, Kelley M; Fatovich, Daniel M; Grasko, Jonathon M; Vasikaran, Samuel D

2009-01-19

To determine the prevalence of elevated troponin levels after a marathon, and test for an association with reduced renal clearance. Prospective observational study of entrants running the full (42 km) 2007 Perth Marathon, Western Australia. Elevated troponin levels (> or = 0.1 microg/L) after the race; pre- and post-race survey data, and biochemical parameters. 27% of runners (92/346) enrolled in the study, of whom 88 (96%) completed it. Most were men (71%; 65/92); mean age was 43.1 years (SD, 9.8 years; range, 25-64 years) and mean body mass index (BMI) was 24.1 kg/m(2). Raised troponin levels were seen in 32% of participants (28/88), the highest being 1.4 microg/L. The strongest predictor for developing elevated troponin levels was a decrease in weight (odds ratio [OR], 2.15; 95% CI, 1.27-3.65). Creatinine increase was also associated with elevated troponin levels (OR, 1.03; 95% CI, 1.01-1.06), but pre-race estimated glomerular filtration rate, age, sex, BMI, training factors, marathon experience and race time were not. Most runners (99%; 87/88) had elevated levels of ischaemia-modified albumin after the race. Troponin level increases were common among marathon finishers. The strongest predictors were weight loss and an increase in creatinine levels, suggesting that reduced renal clearance is an associated factor. Further study is needed to determine the clinical significance of these findings, and to understand the mechanism.

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.

Evaluation of GeneXpert MTB/RIF for detecting Mycobacterium tuberculosis in a hospital in China.

PubMed

Tang, Tingyu; Liu, Fang; Lu, Xiaoling; Huang, Qingdong

2017-04-01

Objective To evaluate the performance of GeneXpert MTB/RIF in diagnosing pulmonary tuberculosis (TB) in China. Methods This cross-sectional study included sputum specimens of 240 suspected TB cases. Specimens were examined by light microscopy for the presence of acid-fast bacilli, which were cultured by the BACTEC MGIT 960 (M960) system and detected by the GeneXpert MTB/RIF assay. The positive rate, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and average turnaround time of methods were evaluated. Results The positive rate was 36.6% (87/238) for the GeneXpert MTB/RIF assay and 34.0% (81/238) by M960 culture, with no significant difference between methods (χ 2  = 0.33, p > 0.05). According to culture results, sensitivity of the GeneXpert MTB/RIF assay was 84.0% (68/81), specificity was 87.8% (129/147), the PPV was 78.2% (68/87), and the NPV was 87.2% (129/148). The agreement for results between Gene Xpert MTB/RIF and the M960 system was 82.8% and the Kappa value was 0.73. Conclusion The GeneXpert MTB/RIF assay is a simple, rapid, and accurate test for detecting Mycobacterium tuberculosis in sputum specimens.

Cognitive function in elderly marathon runners: cross-sectional data from the marathon trial (APSOEM).

PubMed

Winker, Robert; Lukas, Ina; Perkmann, Thomas; Haslacher, Helmut; Ponocny, Elisabeth; Lehrner, Johann; Tscholakoff, Dimiter; Dal-Bianco, Peter

2010-12-01

Cognitive impairment of the elderly contributes to morbidity, loss of quality of life, and impairment of work ability in aging western societies. Thus strategies to maintain cognitive function at an advanced age imply a great challenge to Occupational Medicine. To study whether intensive endurance exercise training is associated with better cognitive performance and increases brain-derived neurotrophic factor (BDNF) and insulin-like growth factor (IGF). Active elderly marathon runners or bicyclists older than 60 years were recruited and matched with an inactive control group according to age, sex, and education years. After exclusion of various diseases according to the study protocol 56 athletes and 58 controls could be selected for follow-up studies. The influence of endurance training on cognitive function was assessed by the use of the Vienna Neuropsychological Test Battery and the CERAD test battery. Other relevant outcomes were the levels of BDNF, IGF-1, Apo e4 carrier state, and self-ratings. The elderly marathon group performed better only in one specific cognitive task (the Five Point Test, p = 0.04) and almost significantly better in one additional test (the NAI Stroop Test, p = 0.08). Neither BDNF nor IGF-1 was related to the duration of daily exercise and no differences in the basal levels of these humoral growth factors in the exercise and the control cohort were found. Interestingly, we also found significantly decreased BDNF levels in subjects with Alzheimer's disease in the family in spite of the maintained normal cognitive performance (p = 0.01). These results suggest that extensive endurance exercise training might be beneficial for maintaining cognitive function in elderly persons. Our data demonstrate that beneficial endurance training effects are not linked to the upregulation of the examined neurotrophins. Since we found reduced BDNF-levels in subjects with a positive family history of Alzheimer's disease, we speculate that BDNF

Aging, Fitness, and Marathon Times in a 91 Year-old Man Who Competed in 627 Marathons.

PubMed

Addison, Odessa; Steinbrenner, Gregory; Goldberg, Andrew P; Katzel, Leslie I

Aging is associated with a decline in maximal aerobic capacity (VO 2max ) that may be attenuated by chronic endurance exercise. This case study chronicles the changes in marathon times in a 91 year old man who completed 627 marathons and 117 ultramarathons over 42 years. He began running marathons at age 48. His yearly best times remained fairly constant at ~240 minutes from age 50 - 64 years and then gradually rose to about 260 minutes in his early seventies followed by a curvilinear deterioration as he approached his ninth decade. His times plateaued at ~ 600 minutes in his late eighties. Between ages 68 and 89 his VO 2max declined from 43 to 20 ml/kg/min. His marathon times were highly correlated with his VO 2max (r 2 =0.87). The decline in marathons times and VO 2max may reflect the contributions of biological aging, changes in exercise training volume and intensity, injuries, and comorbid disease.

Xpert® Mtb/Rif assay for pulmonary tuberculosis and rifampicin resistance in adults

PubMed Central

Steingart, Karen R; Schiller, Ian; Horne, David J; Pai, Madhukar; Boehme, Catharina C; Dendukuri, Nandini

2014-01-01

Background Accurate, rapid detection of tuberculosis (TB) and TB drug resistance is critical for improving patient care and decreasing TB transmission. Xpert® MTB/RIF assay is an automated test that can detect both TB and rifampicin resistance, generally within two hours after starting the test, with minimal hands-on technical time. The World Health Organization (WHO) issued initial recommendations on Xpert® MTB/RIF in early 2011. A Cochrane Review on the diagnostic accuracy of Xpert® MTB/RIF for pulmonary TB and rifampicin resistance was published January 2013. We performed this updated Cochrane Review as part of a WHO process to develop updated guidelines on the use of the test. Objectives To assess the diagnostic accuracy of Xpert® MTB/RIF for pulmonary TB (TB detection), where Xpert® MTB/RIF was used as both an initial test replacing microscopy and an add-on test following a negative smear microscopy result. To assess the diagnostic accuracy of Xpert® MTB/RIF for rifampicin resistance detection, where Xpert® MTB/RIF was used as the initial test replacing culture-based drug susceptibility testing (DST). The populations of interest were adults presumed to have pulmonary, rifampicin-resistant or multidrug-resistant TB (MDR-TB), with or without HIV infection. The settings of interest were intermediate- and peripheral-level laboratories. The latter may be associated with primary health care facilities. Search methods We searched for publications in any language up to 7 February 2013 in the following databases: Cochrane Infectious Diseases Group Specialized Register; MEDLINE; EMBASE; ISI Web of Knowledge; MEDION; LILACS; BIOSIS; and SCOPUS. We also searched the metaRegister of Controlled Trials (mRCT) and the search portal of the WHO International Clinical Trials Registry Platform to identify ongoing trials. Selection criteria We included randomized controlled trials, cross-sectional studies, and cohort studies using respiratory specimens that allowed for

Three year evaluation of Xpert MTB/RIF in a low prevalence tuberculosis setting: A Scottish perspective.

PubMed

Parcell, Benjamin J; Jarchow-MacDonald, Anna A; Seagar, Amie-Louise; Laurenson, Ian F; Prescott, Gordon J; Lockhart, Michael

2017-05-01

Xpert MTB/RIF (Cepheid) is a rapid molecular assay shown to be sensitive and specific for pulmonary tuberculosis (TB) diagnosis in highly endemic countries. We evaluated its diagnostic performance in a low TB prevalence setting, examined rifampicin resistance detection and quantitative capabilities predicting graded auramine microscopy and time to positivity (TTP) of culture. Xpert MTB/RIF was used to test respiratory samples over a 3 year period. Samples underwent graded auramine microscopy, solid/liquid culture, in-house IS6110 real-time PCR, and GenoType MTBDRplus (HAIN Lifescience) to determine rifampicin and/or isoniazid resistance. A total of 2103 Xpert MTB/RIF tests were performed. Compared to culture sensitivity was 95.8%, specificity 99.5%, positive predictive value (PPV) 82.1%, and negative predictive value (NPV) 99.9%. A positive correlation was found between auramine microscopy grade and Xpert MTB/RIF assay load. We found a clear reduction in the median TTP as Xpert MTB/RIF assay load increased. Rifampicin resistance was detected. Xpert MTB/RIF was rapid and accurate in diagnosing pulmonary TB in a low prevalence area. Rapid results will influence infection prevention and control and treatment measures. The excellent NPV obtained suggests further work should be carried out to assess its role in replacing microscopy. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Single muscle fiber adaptations with marathon training.

PubMed

Trappe, Scott; Harber, Matthew; Creer, Andrew; Gallagher, Philip; Slivka, Dustin; Minchev, Kiril; Whitsett, David

2006-09-01

The purpose of this investigation was to characterize the effects of marathon training on single muscle fiber contractile function in a group of recreational runners. Muscle biopsies were obtained from the gastrocnemius muscle of seven individuals (22 +/- 1 yr, 177 +/- 3 cm, and 68 +/- 2 kg) before, after 13 wk of run training, and after 3 wk of taper. Slow-twitch myosin heavy chain [(MHC) I] and fast-twitch (MHC IIa) muscle fibers were analyzed for size, strength (P(o)), speed (V(o)), and power. The run training program led to the successful completion of a marathon (range 3 h 56 min to 5 h 35 min). Oxygen uptake during submaximal running and citrate synthase activity were improved (P < 0.05) with the training program. Muscle fiber size declined (P < 0.05) by approximately 20% in both fiber types after training. P(o) was maintained in both fiber types with training and increased (P < 0.05) by 18% in the MHC IIa fibers after taper. This resulted in >60% increase (P < 0.05) in force per cross-sectional area in both fiber types. Fiber V(o) increased (P < 0.05) by 28% in MHC I fibers with training and was unchanged in MHC IIa fibers. Peak power increased (P < 0.05) in MHC I and IIa fibers after training with a further increase (P < 0.05) in MHC IIa fiber power after taper. These data show that marathon training decreased slow-twitch and fast-twitch muscle fiber size but that it maintained or improved the functional profile of these fibers. A taper period before the marathon further improved the functional profile of the muscle, which was targeted to the fast-twitch muscle fibers.

The SPLASH/ICPC integrity marathon in Ibadan, Nigeria: incidence and management of injuries and marathon-related health problems.

PubMed

Ogwumike, Omoyemi O; Adeniyi, Ade F

2013-04-15

The growing interest in marathon runners and marathons in Nigeria has not been reflected in reports of injuries and other health problems associated with these events. This study therefore outlines the incidence of injuries, marathon-related health problems and delivery of physiotherapy at the maiden and second editions of the Splash 105.5 FM/ICPC Integrity Marathon in Ibadan city, south-west Nigeria in 2009 and 2010. Using a data entry sheet, demographics and information on running experience, past and present injuries and other health problems reported en route and at the finish line by the runners were documented. The prevalence of injuries and other health problems reported by previous and first-time runners were compared. In both events, 16.3% and 17.2% of the runners respectively reported injuries with significant occurrence in first-time runners (p = 0.003 for 2009; p = 0.002 for 2010) mostly at the finish line. The reported injury type and site were muscle cramps and the thigh (39.7% and 76.4% respectively). Heat exhaustion was reported by 42.8% of runners in 2009 and 56.3% in 2010. Cryotherapy was mostly used in combination with other physiotherapy modalities in both years. Most of the injuries and other health problems were reported by first-time marathon runners mainly at the finish line. The most reported site of injury was the thigh while muscle cramps and heat exhaustions were the most reported types of injuries and health problems. First-time marathon runners should be adequately informed of the predisposition to injury during marathons and adequate body conditioning should be emphasized. Ample preparation and effective involvement of the physiotherapy team is essential for management of injured runners en route and at the finish line in a marathon.

The SPLASH/ICPC integrity marathon in Ibadan, Nigeria: incidence and management of injuries and marathon-related health problems

PubMed Central

2013-01-01

Background The growing interest in marathon runners and marathons in Nigeria has not been reflected in reports of injuries and other health problems associated with these events. This study therefore outlines the incidence of injuries, marathon-related health problems and delivery of physiotherapy at the maiden and second editions of the Splash 105.5 FM/ICPC Integrity Marathon in Ibadan city, south-west Nigeria in 2009 and 2010. Methods Using a data entry sheet, demographics and information on running experience, past and present injuries and other health problems reported en route and at the finish line by the runners were documented. The prevalence of injuries and other health problems reported by previous and first-time runners were compared. Results In both events, 16.3% and 17.2% of the runners respectively reported injuries with significant occurrence in first-time runners (p = 0.003 for 2009; p = 0.002 for 2010) mostly at the finish line. The reported injury type and site were muscle cramps and the thigh (39.7% and 76.4% respectively). Heat exhaustion was reported by 42.8% of runners in 2009 and 56.3% in 2010. Cryotherapy was mostly used in combination with other physiotherapy modalities in both years. Conclusion Most of the injuries and other health problems were reported by first-time marathon runners mainly at the finish line. The most reported site of injury was the thigh while muscle cramps and heat exhaustions were the most reported types of injuries and health problems. First-time marathon runners should be adequately informed of the predisposition to injury during marathons and adequate body conditioning should be emphasized. Ample preparation and effective involvement of the physiotherapy team is essential for management of injured runners en route and at the finish line in a marathon. PMID:24499546

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. © 2015 The American Society of Photobiology.

Comparison of Xpert MTB/RIF with line probe assay for detection of rifampin-monoresistant Mycobacterium tuberculosis.

PubMed

Rufai, Syed Beenish; Kumar, Parveen; Singh, Amit; Prajapati, Suneel; Balooni, Veena; Singh, Sarman

2014-06-01

The MTBDRplus line probe assay (LPA) and Xpert MTB/RIF have been endorsed by the World Health Organization for the rapid diagnosis of drug-resistant tuberculosis. However, there is no clarity regarding the superiority of one over the other. In a double-blinded prospective study, we evaluated the efficacy of the Xpert MTB/RIF on samples that were first tested by LPA under the revised national tuberculosis control program of India. A total of 405 sputum samples from suspected drug-resistant tuberculosis patients were included. Of these, 285 smear-positive samples were subjected to LPA. Seventy-two (25.8%) samples showed multidrug resistance, 62 (22.2%) showed rifampin monoresistance, 29 (10.3%) showed isoniazid monoresistance, and 116 (41.5%) were pan-susceptible. Six (2.1%) of the samples gave invalid results. Of the 62 rifampin-monoresistant samples by LPA, 38 (61.4%) showed rifampin resistance, while 21 (33.8%) were found susceptible to rifampin by Xpert MTB/RIF using cartridge version G4. Three (4.8%) samples gave an error. Of the 116 pan-susceptible samples, only 83 were available for Xpert MTB/RIF testing; 4 (5.1%) were rifampin resistant, 74 (94.8%) were susceptible, and 5 (6.0%) showed an error. The 25 discrepant samples were further subjected to MGIT960 drug susceptibility testing. The MGIT960 results showed 100% agreement with LPA results but only 64.4% agreement with Xpert MTB/RIF results. Sequencing analysis of discrepant samples showed 91.3% concordance with LPA but only 8.7% concordance with the Xpert MTB/RIF assay. These findings indicate that by using Xpert MTB/RIF testing we might be underestimating the burden of drug-resistant tuberculosis and indicate that country-specific probes need to be designed to increase the sensitivity of the Xpert MTB/RIF. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Comparison of Xpert MTB/RIF with Line Probe Assay for Detection of Rifampin-Monoresistant Mycobacterium tuberculosis

PubMed Central

Rufai, Syed Beenish; Kumar, Parveen; Singh, Amit; Prajapati, Suneel; Balooni, Veena

2014-01-01

The MTBDRplus line probe assay (LPA) and Xpert MTB/RIF have been endorsed by the World Health Organization for the rapid diagnosis of drug-resistant tuberculosis. However, there is no clarity regarding the superiority of one over the other. In a double-blinded prospective study, we evaluated the efficacy of the Xpert MTB/RIF on samples that were first tested by LPA under the revised national tuberculosis control program of India. A total of 405 sputum samples from suspected drug-resistant tuberculosis patients were included. Of these, 285 smear-positive samples were subjected to LPA. Seventy-two (25.8%) samples showed multidrug resistance, 62 (22.2%) showed rifampin monoresistance, 29 (10.3%) showed isoniazid monoresistance, and 116 (41.5%) were pan-susceptible. Six (2.1%) of the samples gave invalid results. Of the 62 rifampin-monoresistant samples by LPA, 38 (61.4%) showed rifampin resistance, while 21 (33.8%) were found susceptible to rifampin by Xpert MTB/RIF using cartridge version G4. Three (4.8%) samples gave an error. Of the 116 pan-susceptible samples, only 83 were available for Xpert MTB/RIF testing; 4 (5.1%) were rifampin resistant, 74 (94.8%) were susceptible, and 5 (6.0%) showed an error. The 25 discrepant samples were further subjected to MGIT960 drug susceptibility testing. The MGIT960 results showed 100% agreement with LPA results but only 64.4% agreement with Xpert MTB/RIF results. Sequencing analysis of discrepant samples showed 91.3% concordance with LPA but only 8.7% concordance with the Xpert MTB/RIF assay. These findings indicate that by using Xpert MTB/RIF testing we might be underestimating the burden of drug-resistant tuberculosis and indicate that country-specific probes need to be designed to increase the sensitivity of the Xpert MTB/RIF. PMID:24648554

Advances in tuberculosis diagnostics: the Xpert MTB/RIF assay and future prospects for a point-of-care test

PubMed Central

Lawn, Stephen D; Mwaba, Peter; Bates, Matthew; Piatek, Amy; Alexander, Heather; Marais, Ben J; Cuevas, Luis E; McHugh, Timothy D; Zijenah, Lynn; Kapata, Nathan; Abubakar, Ibrahim; McNerney, Ruth; Hoelscher, Michael; Memish, Ziad A; Migliori, Giovanni Battista; Kim, Peter; Maeurer, Markus; Schito, Marco; Zumla, Alimuddin

2015-01-01

Rapid progress has been made in the development of new diagnostic assays for tuberculosis in recent years. New technologies have been developed and assessed, and are now being implemented. The Xpert MTB/RIF assay, which enables simultaneous detection of Mycobacterium tuberculosis (MTB) and rifampicin (RIF) resistance, was endorsed by WHO in December, 2010. This assay was specifically recommended for use as the initial diagnostic test for suspected drug-resistant or HIV-associated pulmonary tuberculosis. By June, 2012, two-thirds of countries with a high tuberculosis burden and half of countries with a high multidrug-resistant tuberculosis burden had incorporated the assay into their national tuberculosis programme guidelines. Although the development of the Xpert MTB/RIF assay is undoubtedly a landmark event, clinical and programmatic effects and cost-effectiveness remain to be defined. We review the rapidly growing body of scientific literature and discuss the advantages and challenges of using the Xpert MTB/RIF assay in areas where tuberculosis is endemic. We also review other prospects within the developmental pipeline. A rapid, accurate point-of-care diagnostic test that is affordable and can be readily implemented is urgently needed. Investment in the tuberculosis diagnostics pipeline should remain a major priority for funders and researchers. PMID:23531388

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. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Contribution of the Xpert MTB/RIF to the etiological diagnosis of tuberculous pleurisy].

PubMed

Touré, N O; Wayzani, M; Thiam, K; Cissé, M F; Mbaye, F B

2017-09-01

Performance of the Xpert MTB/RIF for the detection of Mycobacterium tuberculosis in pleural liquid is poorly described. The aim of this study was to determine its usefulness for the etiological diagnosis of a tuberculous pleurisy. We performed a descriptive cross-sectional study, with analytical design, including all the patients having a unilateral serofibrinous pleurisy, exudative, lymphocytic, and sterile. The diagnosis of pleural tuberculosis was considered based on epidemiological, clinical, paraclinical and therapeutic arguments. The Xpert MTB/RIF of the pleural fluid was carried out among all patients. Pleural tuberculosis was confirmed in 301 patients. The median age was 32years. Our study has included 217 men (72.1%) with a final sex ratio of 2.6. The cost of the pleural biopsy coupled with histology made it practicable in only 90 patients (29.9%) with a yield of 80%. The Xpert MTB/RIF of the pleural liquid was positive in only 10 patients (3.3% of the cases). Gene amplification by Xpert MTB/RIF of the pleural liquid is much less effective in establishing the diagnosis of tuberculous pleurisy than pleural biopsy, which remains the gold standard. Copyright © 2017 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Comparison between recreational male Ironman triathletes and marathon runners.

PubMed

Gianoli, Daniele; Knechtle, Beat; Knechtle, Patrizia; Barandun, Ursula; Rüst, Christoph Alexander; Rosemann, Thomas

2012-08-01

Recent investigations described a personal best marathon time as a predictor variable for an Ironman race time in recreational male Ironman triathletes. Similarities and differences in anthropometry and training were investigated between 83 recreational male Ironman triathletes and 81 recreational male marathoners. Ironman triathletes were significantly taller and had a higher body mass and a higher skin-fold thickness of the calf compared to the marathoners. Weekly training volume in hours was higher in Ironman triathletes. In the Ironman triathletes, percent body fat was related to overall race time and both the split time in cycling and running. The weekly swim kilometres were related to the split time in swimming, and the speed in cycling was related to the bike split time. For the marathoners, the calf skin-fold thickness and running speed during training were related to marathon race time. Although personal best marathon time was a predictor of Ironman race time in male triathletes, anthropometric and training characteristics of male marathoners were different from those of male Ironman triathletes, probably due to training of different muscle groups and metabolic endurance beyond marathon running, as the triathletes are also training for high-level performance in swimming and cycling. Future studies should compare Olympic distance triathletes and road cyclists with Ironman triathletes.

Mini-marathon groups: psychological "first aid" following disasters.

PubMed

Terr, L C

1992-01-01

Large group counseling sessions for soldiers following battle have been commonly used since World War II. The author conceptualizes and demonstrates how these mini-marathon sessions can be adapted to support all ages and types of civilians involved in disasters. Mini-marathons take about 3 hours and are divided into three sections: story sharing, symptom sharing, and suggestions for self-help, including sharing tales of heroism and survival. After an initial mini-marathon session, a second session may be held emphasizing creativity. The author also describes how mini-marathons can be adapted for therapists who will lead their own sessions.

Predictor Variables for Marathon Race Time in Recreational Female Runners

PubMed Central

Schmid, Wiebke; Knechtle, Beat; Knechtle, Patrizia; Barandun, Ursula; Rüst, Christoph Alexander; Rosemann, Thomas; Lepers, Romuald

2012-01-01

Purpose We intended to determine predictor variables of anthropometry and training for marathon race time in recreational female runners in order to predict marathon race time for future novice female runners. Methods Anthropometric characteristics such as body mass, body height, body mass index, circumferences of limbs, thicknesses of skin-folds and body fat as well as training variables such as volume and speed in running training were related to marathon race time using bi- and multi-variate analysis in 29 female runners. Results The marathoners completed the marathon distance within 251 (26) min, running at a speed of 10.2 (1.1) km/h. Body mass (r=0.37), body mass index (r=0.46), the circumferences of thigh (r=0.51) and calf (r=0.41), the skin-fold thicknesses of front thigh (r=0.38) and of medial calf (r=0.40), the sum of eight skin-folds (r=0.44) and body fat percentage (r=0.41) were related to marathon race time. For the variables of training, maximal distance ran per week (r=− 0.38), number of running training sessions per week (r=− 0.46) and the speed of the training sessions (r= − 0.60) were related to marathon race time. In the multi-variate analysis, the circumference of calf (P=0.02) and the speed of the training sessions (P=0.0014) were related to marathon race time. Marathon race time might be partially (r 2=0.50) predicted by the following equation: Race time (min)=184.4 + 5.0 x (circumference calf, cm) –11.9 x (speed in running during training, km/h) for recreational female marathoners. Conclusions Variables of both anthropometry and training were related to marathon race time in recreational female marathoners and cannot be reduced to one single predictor variable. For practical applications, a low circumference of calf and a high running speed in training are associated with a fast marathon race time in recreational female runners. PMID:22942994

Predictor variables for marathon race time in recreational female runners.

PubMed

Schmid, Wiebke; Knechtle, Beat; Knechtle, Patrizia; Barandun, Ursula; Rüst, Christoph Alexander; Rosemann, Thomas; Lepers, Romuald

2012-06-01

We intended to determine predictor variables of anthropometry and training for marathon race time in recreational female runners in order to predict marathon race time for future novice female runners. Anthropometric characteristics such as body mass, body height, body mass index, circumferences of limbs, thicknesses of skin-folds and body fat as well as training variables such as volume and speed in running training were related to marathon race time using bi- and multi-variate analysis in 29 female runners. The marathoners completed the marathon distance within 251 (26) min, running at a speed of 10.2 (1.1) km/h. Body mass (r=0.37), body mass index (r=0.46), the circumferences of thigh (r=0.51) and calf (r=0.41), the skin-fold thicknesses of front thigh (r=0.38) and of medial calf (r=0.40), the sum of eight skin-folds (r=0.44) and body fat percentage (r=0.41) were related to marathon race time. For the variables of training, maximal distance ran per week (r=- 0.38), number of running training sessions per week (r=- 0.46) and the speed of the training sessions (r= - 0.60) were related to marathon race time. In the multi-variate analysis, the circumference of calf (P=0.02) and the speed of the training sessions (P=0.0014) were related to marathon race time. Marathon race time might be partially (r(2)=0.50) predicted by the following equation: Race time (min)=184.4 + 5.0 x (circumference calf, cm) -11.9 x (speed in running during training, km/h) for recreational female marathoners. Variables of both anthropometry and training were related to marathon race time in recreational female marathoners and cannot be reduced to one single predictor variable. For practical applications, a low circumference of calf and a high running speed in training are associated with a fast marathon race time in recreational female runners.

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

Marathon Month Promotes Healthful Lifestyles for Extension Employees

ERIC Educational Resources Information Center

Donaldson, Joseph L.; Bell, Beth A.; Toman, John J.; Hastings, Shirley

2016-01-01

This article describes Marathon Month, a workplace wellness program for Extension employees. The program promoted physical activity by challenging employees to walk or run the length of a marathon (26.2 mi) or half marathon (13.1 mi) over the course of 1 month. Of the 317 participants, 90% achieved a self-set goal of completing a full or half…

Time Evolution of Sublingual Microcirculatory Changes in Recreational Marathon Runners

PubMed Central

Arstikyte, Justina; Vaitkaitiene, Egle; Vaitkaitis, Dinas

2017-01-01

We aimed to evaluate changes in sublingual microcirculation induced by a marathon race. Thirteen healthy male controls and 13 male marathon runners volunteered for the study. We performed sublingual microcirculation, using a Cytocam-IDF device (Braedius Medical, Huizen, Netherlands), and systemic hemodynamic measurements four times: 24 hours prior to their participation in the Kaunas Marathon (distance: 41.2 km), directly after finishing the marathon, 24 hours after the marathon, and one week after the marathon. The marathon runners exhibited a higher functional capillary density (FCD) and total vascular density of small vessels at the first visit compared with the controls. Overall, we did not find any changes in sublingual microcirculation of the marathon runners at any of the other visits. However, in a subgroup of marathon runners with a decreased FCD compared to the subgroup with increased FCD, the subgroup with decreased FCD had shorter running time (190.37 ± 30.2 versus 221.80 ± 23.4 min, p = 0.045), ingested less fluids (907 ± 615 versus 1950 ± 488 mL, p = 0.007) during the race, and lost much more weight (−2.4 ± 1.3 versus −1.0 ± 0.8 kg, p = 0.041). Recreational marathon running is not associated with an alteration of sublingual microcirculation. However, faster running and dehydration may be crucial for further impairing microcirculation. PMID:28828386

Energy expenditure and influence of physiologic factors during marathon running.

PubMed

Loftin, Mark; Sothern, Melinda; Koss, Cathie; Tuuri, Georgianna; Vanvrancken, Connie; Kontos, Anthony; Bonis, Marc

2007-11-01

This study examined energy expenditure and physiologic determinants for marathon performance in recreational runners. Twenty recreational marathon runners participated (10 males aged 41 +/- 11.3 years, 10 females aged 42.7 +/- 11.7 years). Each subject completed a V(.-)O2max and a 1-hour treadmill run at recent marathon pace, and body composition was indirectly determined via dual energy X-ray absorptiometry. The male runners exhibited higher V(.-)O2max (ml x kg(-1) x min(-1)) values (52.6 +/- 5.5) than their female counterparts (41.9 +/- 6.6), although ventilatory threshold (T-vent) values were similar between groups (males: 76.2 +/- 6.1 % of V(.-)O2max, females: 75.1 +/- 5.1%). The male runners expended more energy (2,792 +/- 235 kcal) for their most recent marathon as calculated from the 1-hour treadmill run at marathon pace than the female runners (2,436 +/- 297 kcal). Body composition parameters correlated moderately to highly (r ranging from 0.50 to 0.87) with marathon run time. Also, V(.-)O2max (r = -0.73) and ventilatory threshold (r = -0.73) moderately correlated with marathon run time. As a group, the participants ran near their ventilatory threshold for their most recent marathon (r = 0.74). These results indicate the influence of body size on marathon run performance. In general, the larger male and female runners ran slower and expended more kilocalories than smaller runners. Regardless of marathon finishing time, the runners maintained a pace near their T-vent, and as T-vent or V(.-)O2max increased, marathon performance time decreased.

Compression Socks Worn During Flight and Hemostatic Balance in Boston Marathon Runners on Oral Contraceptives.

PubMed

Taylor, Beth A; Zaleski, Amanda L; Ballard, Kevin D; Panza, Gregory A; Fernandez, Antonio B; Corso, Lauren; Pescatello, Linda S; Baggish, Aaron L; Troyanos, Christopher; Thompson, Paul D

2018-05-01

To investigate the effect of oral contraceptive (OC) use and compression socks on hemostatic activation in women flying cross-country to and from a marathon. Prospective study. 2015 Boston Marathon. Women were divided into non-OC using (CONTROL; n = 12), OC-using (OC; n = 15), and OC-using plus compression sock (OC + SOCK; n = 14) groups. Women in OC + SOCK wore compression socks during flights to and from the marathon. Venous blood samples were collected within 24 hours of arriving in Boston (EXPO), immediately after the marathon (RUN), and within 24 hours after a return flight home (Post-Flight) for analysis of thrombin-antithrombin complex (TAT), d-dimer, and tissue plasminogen activator (t-PA). TAT did not increase with exercise (P = 0.48) and was not affected by group (P = 0.08) or the interaction between these 2 factors (P = 0.80). Group, time, and their interaction were significant for d-dimer (all P < 0.05) such that d-dimer increased with acute exercise to a greater extent (Δ d-dimer from expo to postrace = 909.5 ± 1021.9 ng/mL) in the OC + SOCK group relative to OC (Δ d-dimer = 240.0 ± 178.5 ng/mL; P = 0.02) and CONTROL (Δ d-dimer = 230.3 ± 120.3 ng/mL; P = 0.02). There was a significant effect of time, group, and the interaction on t-PA (all P < 0.01) such that t-PA increased with acute exercise to a greater extent (Δ t-PA from expo to postrace = 19.6 ± 10.0 ng/mL) in the CONTROL group relative to OC (Δ t-PA = 4.0 ± 1.8 ng/mL; P < 0.01) and OC + SOCK (Δ t-PA = 3.3 ± 1.2 ng/mL; P < 0.01). Female runners using OCs did not exhibit disproportionately increased coagulation. The use of compression socks in women on OCs, surprisingly, resulted in a greater increase in d-dimer after exercise.

Delays in Emergency Care and Mortality during Major U.S. Marathons

PubMed Central

Jena, Anupam B.; Mann, N. Clay; Wedlund, Leia N.; Olenski, Andrew

2017-01-01

BACKGROUND Large marathons frequently involve widespread road closures and infrastructure disruptions, which may create delays in emergency care for nonparticipants with acute medical conditions who live in proximity to marathon routes. METHODS We analyzed Medicare data on hospitalizations for acute myocardial infarction or cardiac arrest among Medicare beneficiaries (≥65 years of age) in 11 U.S. cities that were hosting major marathons during the period from 2002 through 2012 and compared 30-day mortality among the beneficiaries who were hospitalized on the date of a marathon, those who were hospitalized on the same day of the week as the day of the marathon in the 5 weeks before or the 5 weeks after the marathon, and those who were hospitalized on the same day as the marathon but in surrounding ZIP Code areas unaffected by the marathon. We also analyzed data from a national registry of ambulance transports and investigated whether ambulance transports occurring before noon in marathon-affected areas (when road closures are likely) had longer scene-to-hospital transport times than on nonmarathon dates. We also compared transport times on marathon dates with those on nonmarathon dates in these same areas during evenings (when roads were reopened) and in areas unaffected by the marathon. RESULTS The daily frequency of hospitalizations was similar on marathon and nonmarathon dates (mean number of hospitalizations per city, 10.6 and 10.5, respectively; P=0.71); the characteristics of the beneficiaries hospitalized on marathon and nonmarathon dates were also similar. Unadjusted 30-day mortality in marathon-affected areas on marathon dates was 28.2% (323 deaths in 1145 hospitalizations) as compared with 24.9% (2757 deaths in 11,074 hospitalizations) on nonmarathon dates (absolute risk difference, 3.3 percentage points; 95% confidence interval, 0.7 to 6.0; P=0.01; relative risk difference, 13.3%). This pattern persisted after adjustment for covariates and in an

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…

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…

Evaluation of the Abbott RealTime MTB and RealTime MTB INH/RIF Assays for Direct Detection of Mycobacterium tuberculosis Complex and Resistance Markers in Respiratory and Extrapulmonary Specimens.

PubMed

Hofmann-Thiel, Sabine; Molodtsov, Nikolay; Antonenka, Uladzimir; Hoffmann, Harald

2016-12-01

The Abbott RealTime MTB (RT MTB) assay is a new automated nucleic acid amplification test for the detection of Mycobacterium tuberculosis complex (MTBC) in clinical specimens. In combination with the RealTime MTB INH/RIF (RT MTB INH/RIF) resistance assay, which can be applied to RT MTB-positive specimens as an add-on assay, the tests also indicate the genetic markers of resistance to isoniazid (INH) and rifampin (RIF). We aimed to evaluate the diagnostic sensitivity and specificity of RT MTB using different types of respiratory and extrapulmonary specimens and to compare performance characteristics directly with those of the FluoroType MTB assay. The resistance results obtained by RT MTB INH/RIF were compared to those from the GenoType MTBDRplus and from phenotypic drug susceptibility testing. A total of 715 clinical specimens were analyzed. Compared to culture, the overall sensitivity of RT MTB was 92.1%; the sensitivity rates for smear-positive and smear-negative samples were 100% and 76.2%, respectively. The sensitivities of smear-negative specimens were almost identical for respiratory (76.3%) and extrapulmonary (76%) specimens. Specificity rates were 100% and 95.8% for culture-negative specimens and those that grew nontuberculous mycobacteria, respectively. RT MTB INH/RIF was applied to 233 RT MTB-positive samples and identified resistance markers in 7.7% of samples. Agreement with phenotypic and genotypic drug susceptibility testing was 99.5%. In conclusion, RT MTB and RT MTB INH/RIF allow for the rapid and accurate diagnosis of tuberculosis (TB) in different types of specimens and reliably indicate resistance markers. The strengths of this system are the comparably high sensitivity with paucibacillary specimens, its ability to detect INH and RIF resistance, and its high-throughput capacities. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Evaluation of the Xpert® MTB/RIF assay and microscopy for the diagnosis of Mycobacterium tuberculosis in Namibia.

PubMed

Mavenyengwa, Rooyen T; Shaduka, Emma; Maposa, Innocent

2017-01-11

Tuberculosis (TB) kills approximately two million people and infects around nine million worldwide annually. Its proper management, especially in resource-limited settings, has been hindered by the lack of rapid and easy-to-use diagnostic tests. Sputum smear microscopy remains the cheapest, readily available diagnostic method but it only identifies less than half of the patients with a HIV/TB co-infection because the bacilli would have disseminated from the lungs to other areas of the body. The fully automated Xpert® MTB/RIF assay is a promising innovation for diagnosing TB and detecting resistance to rifampicin. This study aimed to evaluate the use of Xpert® MTB/RIF assay and microscopy in the diagnosis of Mycobacterium tuberculosis in Namibia, by determining the disease's epidemiology and calculating the proportion of cases infected just with TB and those with a resistance to rifampicin among the total suspected cases of TB in the country. This retrospective study analysed TB cases that were diagnosed using both the Xpert® MTB/RIF assay and microscopy. Data were collected from patient records from the Meditech laboratory information system of the Namibia Institute of Pathology for the time period of July 2012-April 2013. Data from 13 regions were collected. The total number of specimens collected from patients with symptoms of pulmonary TB was 1 842. Of these, 594 (32.20%) were found to be positive for MTB by Xpert® MTB/RIF assay, out of which 443 (24.05%) were also found to be positive by microscopy. The remainder was negative. The male patients were more resistant to rifampicin when compared to the female patients. Tuberculosis is widely distributed throughout Namibia, with slightly more males infected than females. Most TB patients are also co-infected with HIV. Both microscopy and Xpert® MTB/RIF assay are crucial for the diagnosis of TB in the country. Screening diagnostic efforts should focus on the sexually active HIV positive male population who could

What is associated with race performance in male 100-km ultra-marathoners--anthropometry, training or marathon best time?

PubMed

Knechtle, Beat; Knechtle, Patrizia; Rosemann, Thomas; Senn, Oliver

2011-03-01

We investigated the associations of anthropometry, training, and pre-race experience with race time in 93 recreational male ultra-marathoners (mean age 44.6 years, s = 10.0; body mass 74.0 kg, s = 9.0; height 1.77 m, s = 0.06; body mass index 23.4 kg · m(-2), s = 2.0) in a 100-km ultra-marathon using bivariate and multivariate analysis. In the bivariate analysis, body mass index (r = 0.24), the sum of eight skinfolds (r = 0.55), percent body fat (r = 0.57), weekly running hours (r = -0.29), weekly running kilometres (r = -0.49), running speed during training (r = -0.50), and personal best time in a marathon (r = 0.72) were associated with race time. Results of the multiple regression analysis revealed an independent and negative association of weekly running kilometres and average speed in training with race time, as well as a significant positive association between the sum of eight skinfold thicknesses and race time. There was a significant positive association between 100-km race time and personal best time in a marathon. We conclude that both training and anthropometry were independently associated with race performance. These characteristics remained relevant even when controlling for personal best time in a marathon.

Transient myocardial tissue and function changes during a marathon in less fit marathon runners.

PubMed

Gaudreault, Valerie; Tizon-Marcos, Helena; Poirier, Paul; Pibarot, Philippe; Gilbert, Philippe; Amyot, Marc; Rodés-Cabau, Josep; Després, Jean-Pierre; Bertrand, Olivier; Larose, Eric

2013-10-01

Although regular physical activity improves health, strenuous exercise might transiently increase cardiac risk. Training and fitness might provide protection. We prospectively studied 20 recreational marathon runners without known cardiovascular disease or symptoms: at peak training before, immediately after, and 3 months after a 42.2-km marathon. Changes in global/segmental myocardial function, edema, resting perfusion, and fibrosis were measured. At peak training, runners exercised 8.1 ± 2.3 hours and 62 ± 18 km per week with mean maximal oxygen consumption (VO2max) of 53.2 ± 8.3 mL/kg/min. In response to the marathon, global left ventricular and right ventricular ejection fraction decreased in half of the runners; these runners had poorer peak training distance, training time, and fitness level. Change in global left ventricular ejection fraction was associated with VO2max. Overall, 36% of segments developed edema, 53% decreased function, and 59% decreased perfusion. Significant agreement was observed between segment decreasing function, decreasing perfusion, and developing edema. Myocardial changes were reversible at 3 months. Completing a marathon leads to localized myocardial edema, diminished perfusion, and decreased function occurring more extensively in less trained and fit runners. Although reversible, these changes might contribute to the transient increase in cardiac risk reported during sustained vigorous exercise. Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Prevalence of Hyponatremia, Renal Dysfunction, and Other Electrolyte Abnormalities Among Runners Before and After Completing a Marathon or Half Marathon

PubMed Central

Mohseni, Michael; Silvers, Scott; McNeil, Rebecca; Diehl, Nancy; Vadeboncoeur, Tyler; Taylor, Walt; Shapiro, Shane; Roth, Jennifer; Mahoney, Sherry

2011-01-01

Background: Prior reports on metabolic derangements observed in distance running frequently have small sample sizes, lack prerace laboratory measures, and report sodium as the sole measure. Hypothesis: Metabolic abnormalities—hyponatremia, hypokalemia, renal dysfunction, hemoconcentration—are frequent after completing a full or half marathon. Clinically significant changes occur in these laboratory values after race completion. Study Design: Observational, cross-sectional study. Methods: Consenting marathon and half marathon racers completed a survey as well as finger stick blood sampling on race day of the National Marathon to Fight Breast Cancer (Jacksonville, Florida, February 2008). Parallel blood measures were obtained before and after race completion (prerace, n = 161; postrace, n = 195). Results: The prevalence of prerace and postrace hyponatremia was 8 of 161 (5.0%) and 16 of 195 (8.2%), respectively. Hypokalemia was not present prerace but was present in 1 runner postrace (1 of 195). Renal dysfunction occurred prerace in 14 of 161 (8.7%) and postrace in 83 of 195 (42.6%). Among those with postrace renal dysfunction, 45.8% (38 of 83) were classified as moderate or severe. Hemoconcentration was present in 2 of 161 (1.2%) prerace and 6 of 195 (3.1%) postrace. The mean changes in laboratory values were (postrace minus prerace): sodium, 1.6 mmol/L; potassium, −0.2 mmol/L; blood urea nitrogen, 2.8 mg/dL; creatinine, 0.2 mg/dL; and hemoglobin, 0.3 g/dL for 149 pairs (except blood urea nitrogen, n = 147 pairs). Changes were significant for all comparisons (P < 0.01) except potassium (P = 0.08) and hemoglobin (P = 0.01). Conclusions: Metabolic abnormalities are common among endurance racers, and they may be present prerace, including hyponatremia. The clinical significance of these findings is unknown. Clinical relevance: It is unclear which runners are at risk for developing clinically important metabolic derangements. Participating in prolonged endurance

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…

[Immunogenicity of chimeric gene vaccine Mtb8.4/hIL12].

PubMed

Li, Hui; Li, Rong; Zhong, Sen; Luo, Yue-bei; Ren, Hong; Deng, Cun-liang

2006-09-01

To construct chimeric gene vaccine Mtb8.4/hIL-12, express it in COS-7 cells and study its immunogenicity. Chimeric gene Mtb8.4/hIL-12 was amplified by PCR and cloned into the eukaryotic vector pCI-neo to construct the recombinant plasmid pCI-neo-Mtb8.4/hIL12. After the recombinant plasmid was identified by restriction enzyme digestion analysis, PCR and DNA sequencing, COS-7 cells were transfected with pCI-neo-Mtb8.4/hIL12 through cationic liposome. 48 hours later, the expression of mRNA was detected by RT-PCR and the level of hIL-12 in culture supernatant and cell lysates were detected by Western blot. C57BL/6N mice were vaccinated with chimeric gene vaccine Mtb8.4/hIL-12 three times at the interval of 3 weeks each time. Four weeks after the final inoculation, three mice were sacrificed to assess the cytotoxicity of CTLs and response to cytokine. The recombinant plasmid pCI-neo-Mtb8.4/hIL12 was constructed successfully. After COS-7 cells were transfected with pCI-neo-Mtb8.4/hIL12, chimeric gene Mtb8.4/hIL12 was expressed in COS-7 cells. The chimeric gene vaccine could induce strong antigen-specific immune response. With the increase of IFN-gamma and IL-2 secretion and the decrease of IL-4 secretion, the cytotoxicity of specific CTLs was heightened. Recombinant plasmid pCI-neo-Mtb8.4/hIL12 has been successfully constructed and expressed in COS-7 cells. The constructed chimeric gene vaccine Mtb8.4/hIL12 is of strong immunogenicity and can obviously induce the cytotoxicity of CTLs.

Increased Circulating Anti-inflammatory Cells in Marathon-trained Runners.

PubMed

Rehm, K; Sunesara, I; Marshall, G D

2015-10-01

Exercise training can alter immune function. Marathon training has been associated with an increased susceptibility to infectious diseases and an increased activity of inflammatory-based diseases, but the precise mechanisms are unknown. The purpose of this study was to compare levels of circulating CD4+  T cell subsets in the periphery of marathon-trained runners and matched non-marathon controls. 19 recreational marathoners that were 4 weeks from running a marathon and 19 demographically-matched healthy control subjects had the percentage of CD4+ T cell subpopulations (T helper 1, T helper 2, T helper 1/T helper 2 ratio, regulatory T cells, CD4+ IL10+, and CD4+ TGFβ+ (Transforming Growth Factor-beta) measured by flow cytometry. Marathon-trained runners had significantly less T helper 1 and regulatory T cells and significantly more T helper 2, CD4+ IL10+, and TGFβ+ cells than the control subjects. The alterations in the percentage of T helper 1 and T helper 2 cells led to a significantly lower T helper 1/T helper 2 ratio in the marathon-trained runners. These data suggest that endurance-based training can increase the number of anti-inflammatory cells. This may be a potential mechanism for the increased incidence of both infectious and inflammatory diseases observed in endurance athletes. © Georg Thieme Verlag KG Stuttgart · New York.

[Determination of in vitro synergy by a checkerboard method when 3 core antimicrobial agents of the retreatment new scheme combined against MDR-MTB and XDR-MTB].

PubMed

Zhang, L L; Yang, H; Xiao, H P; Lu, J M; Sha, W; Zhang, Q

2016-06-01

In order to detect the in vitro synergistic effect of 4 drugs-pasiniazid (PA), moxifloxacin, rifabutin and rifapentini on multidrug-resistant mycobacterium tuberculosis (MDR-MTB) and extensively drug-resistant mycobacterium tuberculosis(XDR-MTB), which were core drugs of"The program of retreatment research of tuberculosis". The checkerboard method was used to detect the minimum inhibitory concentration (MIC) of antituberculosis drug combination schemes (moxifloxacin-PA, moxifloxacin-PA-rifabutin and moxifloxacin-PA-rifapentini) to 40 strains of clinical drug resistant MTB(20 strains of MDR-MTB and 20 XDR-MTB) and the standard strain H37Rv, by calculating the fractional inhibitory concentration index of joint action in vitro to judge the combined effect, with fractional inhibitory concentration index(FICI)≤0.5 and FICI≤0.75 as the basis of 2 drugs and 3 drugs showing synergy. The FICI of moxifloxacin-PA scheme for DR-MTB was 0.125 to 1.000, only 5 strains with a FICI ≤0.5, showing synergistic effect. The FICI of moxifloxacin-Pa-rifabutin scheme with 20 strains of MDR-MTB ranged from 0.310 to 1.260, 10 strains with a FICI≤0.75, showing synergistic effect. The FICI of moxifloxacin-PA-rifabutin scheme with 20 strains of XDR-MTB ranged from 0.215 to 1.250, 11 strains with a FICI≤0.75, showing synergistic effect. The FICI of moxifloxacin-PA-rifapentini scheme with 20 strains of MDR-MTB ranged from 0.150 to 0.780, 19 strains with a FICI≤0.75, showing synergistic effect. The FICI of moxifloxacin-PA-rifapentini scheme with 20 strains of XDR-MTB ranged from 0.200 to 1.280, 16 strains with a FICI≤0.75, showing synergistic effect. The synergistic effect of moxifloxacin-PA scheme was poor, but showing better synergy when further combined with rifabutin or rifapentini. Rifabutin showed better effect than rifapentini, but the synergistic effect of moxifloxacin-PA-rifabutin combination scheme was poor than that of moxifloxacin-PA-rifapentini combination scheme.

Impact of Laboratory Practice Changes on the Diagnosis of Tuberculosis with the Introduction of Xpert MTB/RIF in Kiribati.

PubMed

Tonganibeia, Alfred; Harries, Anthony D; Merilles, Onofre Edwin A; Tarataake, Tekaibeti; Tiira, Teatao; Kienene, Takeieta

2018-02-01

The Republic of Kiribati, Central Pacific, has the largest tuberculosis epidemic in the region. There is a national tuberculosis control program, which has used smear microscopy for acid-fast bacilli as the main diagnostic tool for many years. In 2015, an Xpert MTB/RIF machine was procured and became functional within the tuberculosis hospital. The aim of this cross-sectional study, using routinely collected data, was to determine the effects of introducing Xpert MTB/RIF on laboratory smear microscopy practices and the pattern of registered tuberculosis cases. Between February 2015 and January 2016, there were 220 Xpert MTB/RIF assays performed with 6.4% errors and 15% detection of Mycobacterium tuberculosis: one patient showed rifampicin-resistance. One year before and after introducing Xpert MTB/RIF, the number of presumptive tuberculosis patients increased by 9% from 2,138 to 2,322. There were no changes in demographic characteristics, smear-positive results, or acid-fast bacilli grade between the two periods. The number of specimens cultured for Mycobacterium tuberculosis significantly declined from 638 to zero, with 76 positive MTB cultures before and none after introducing Xpert MTB/RIF. There was a significant change in the profile of registered tuberculosis cases with more children (34% versus 21%) and fewer bacteriologically-confirmed cases (29% versus 43%) - P < .001. Since the deployment of Xpert MTB/RIF in Kiribati, there have been a small number of assays performed and this has been associated with no adverse effects on smear microscopy, a stoppage in mycobacterial cultures, and a change in the types and categories of diagnosed tuberculosis.

Sex- and age-related differences in half-marathon performance and competitiveness in the world's largest half-marathon - the GöteborgsVarvet.

PubMed

Knechtle, B; Nikolaidis, P T

2018-01-01

In road runners, the age-related performance decline has been well investigated for marathoners, but little is known for half-marathoners. We analysed data from 138,616 runners (48,148 women and 90,469 men) competing between 2014 and 2016 in GöteborgsVarvet, the world's largest half-marathon. The men-to-women ratio in participants increased with age, the fastest race times were observed in age groups ˂35 and 35-39 years in women and in age group 35-39 years in men, the main effect of sex and the sex × age group interaction on race time were trivial, and the competitiveness was denser in men and in the younger age groups. In summary, in half-marathon running in the largest half-marathon in the world, the GöteborgsVarvet, women achieved the fastest race time at an earlier age compared to men where the fastest race times were observed in women in age groups ˂35 and 35-39 years and in men in age group 35-39 years.

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

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. Copyright © 2015 Elsevier Ltd. All rights reserved.

Implementation of the Xpert MTB/RIF assay for tuberculosis in Mongolia: a qualitative exploration of barriers and enablers.

PubMed

Rendell, Nicole L; Bekhbat, Solongo; Ganbaatar, Gantungalag; Dorjravdan, Munkhjargal; Pai, Madhukar; Dobler, Claudia C

2017-01-01

The aim of our study was to identify barriers and enablers to implementation of the Xpert MTB/RIF test within Mongolia's National Tuberculosis Program. Twenty-foursemi-structured interviews were conducted between June and September 2015 with laboratory staff and tuberculosis physicians in Mongolia's capital Ulaanbaatar and regional towns where Xpert MTB/RIF testing had been implemented. Interviews were recorded, transcribed, translated and analysed thematically using NVIVO qualitative analysis software. Eight laboratory staff (five from the National Tuberculosis Reference Laboratory in Ulaanbaatar and three from provincial laboratories) and sixteen tuberculosis physicians (five from the Mongolian National Center for Communicable Diseases in Ulaanbaatar, four from district tuberculosis clinics in Ulaanbaatar and seven from provincial tuberculosis clinics) were interviewed. Major barriers to Xpert MTB/RIF implementation identified were: lack of awareness of program guidelines; inadequate staffing arrangements; problems with cartridge supply management; lack of local repair options for the Xpert machines; lack of regular formal training; paper based system; delayed treatment initiation due to consensus meeting and poor sample quality. Enablers to Xpert MTB/RIF implementation included availability of guidelines in the local language; provision of extra laboratory staff, shift working arrangements and additional modules; capacity for troubleshooting internally; access to experts; opportunities for peer learning; common understanding of diagnostic algorithms and decentralised testing. Our study identified a number of barriers and enablers to implementation of Xpert MTB/RIF in the Mongolian National Tuberculosis Program. Lessons learned from this study can help to facilitate implementation of Xpert MTB/RIF in other Mongolian locations as well as other low-and middle-income countries.

Marathon Race Affects Neutrophil Surface Molecules: Role of Inflammatory Mediators

PubMed Central

2016-01-01

The fatigue induced by marathon races was observed in terms of inflammatory and immunological outcomes. Neutrophil survival and activation are essential for inflammation resolution and contributes directly to the pathogenesis of many infectious and inflammatory conditions. The aim of this study was to investigate the effect of marathon races on surface molecules related to neutrophil adhesion and extrinsic apoptosis pathway and its association with inflammatory markers. We evaluated 23 trained male runners at the São Paulo International Marathon 2013. The following components were measured: hematological and inflammatory mediators, muscle damage markers, and neutrophil function. The marathon race induced an increased leukocyte and neutrophil counts; creatine kinase (CK), lactate dehydrogenase (LDH), CK-MB, interleukin (IL)-6, IL-10, and IL-8 levels. C-reactive protein (CRP), IL-12, and tumor necrosis factor (TNF)-α plasma concentrations were significantly higher 24 h and 72 h after the marathon race. Hemoglobin and hematocrit levels decreased 72 h after the marathon race. We also observed an increased intercellular adhesion molecule-1 (ICAM-1) expression and decreasedTNF receptor-1 (TNFR1) expression immediately after and 24 h after the marathon race. We observed an increased DNA fragmentation and L-selectin and Fas receptor expressions in the recovery period, indicating a possible slow rolling phase and delayed neutrophil activation and apoptosis. Marathon racing affects neutrophils adhesion and survival in the course of inflammation, supporting the “open-window” post-exercise hypothesis. PMID:27911915

Nutrition behaviors, perceptions, and beliefs of recent marathon finishers.

PubMed

Wilson, Patrick B

2016-09-01

To describe the nutrition behaviors, perceptions, and beliefs of marathoners. A survey-based study was conducted with 422 recent marathon finishers (199 men, 223 women). Participants reported their running background, demographics, diets followed, supplements used, and food/fluid intake during their most recent marathon (median 7 days prior), as well as beliefs about hydration, fueling, and sources of nutrition information. Median finishing times were 3:53 (3:26-4:35) and 4:25 (3:50-4:59) h:min for men and women during their most recent marathon. Most participants (66.1%) reported typically following a moderate-carbohydrate, moderate-fat diet, while 66.4% carbohydrate-loaded prior to their most recent marathon. Among 139 participants following a specific diet over the past year, the most common were vegetarian/vegan/pescatarian (n = 39), Paleolithic (n = 16), gluten-free (n = 15), and low-carbohydrate (n = 12). Roughly 35% of participants took a supplement intended to improve running performance over the past month. Women were more likely to follow specific diets (39.0% vs. 26.1%), while men were more likely to recently use performance-enhancing supplements (40.2% vs. 30.0%). Most participants (68.3%) indicated they were likely or very likely to rely on a structured plan to determine fluid intake, and 75% were confident in their ability to hydrate. At least 35.6% of participants thought they could improve marathon performance by 8% or more with nutrition interventions. Scientific journals ranked as the most reliable source of nutrition information, while running coaches ranked as the most likely source to be utilized. Findings from this investigation, such as diets and supplements utilized by marathoners, can be used by practitioners and researchers alike to improve the dissemination of scientifically-based information on nutrition and marathon running.

Predictive Variables of Half-Marathon Performance for Male Runners

PubMed Central

Gómez-Molina, Josué; Ogueta-Alday, Ana; Camara, Jesus; Stickley, Christoper; Rodríguez-Marroyo, José A.; García-López, Juan

2017-01-01

The aims of this study were to establish and validate various predictive equations of half-marathon performance. Seventy-eight half-marathon male runners participated in two different phases. Phase 1 (n = 48) was used to establish the equations for estimating half-marathon performance, and Phase 2 (n = 30) to validate these equations. Apart from half-marathon performance, training-related and anthropometric variables were recorded, and an incremental test on a treadmill was performed, in which physiological (VO2max, speed at the anaerobic threshold, peak speed) and biomechanical variables (contact and flight times, step length and step rate) were registered. In Phase 1, half-marathon performance could be predicted to 90.3% by variables related to training and anthropometry (Equation 1), 94.9% by physiological variables (Equation 2), 93.7% by biomechanical parameters (Equation 3) and 96.2% by a general equation (Equation 4). Using these equations, in Phase 2 the predicted time was significantly correlated with performance (r = 0.78, 0.92, 0.90 and 0.95, respectively). The proposed equations and their validation showed a high prediction of half-marathon performance in long distance male runners, considered from different approaches. Furthermore, they improved the prediction performance of previous studies, which makes them a highly practical application in the field of training and performance. Key points The present study obtained four equations involving anthropometric, training, physiological and biomechanical variables to estimate half-marathon performance. These equations were validated in a different population, demonstrating narrows ranges of prediction than previous studies and also their consistency. As a novelty, some biomechanical variables (i.e. step length and step rate at RCT, and maximal step length) have been related to half-marathon performance. PMID:28630571

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…

Predictive Variables of Half-Marathon Performance for Male Runners.

PubMed

Gómez-Molina, Josué; Ogueta-Alday, Ana; Camara, Jesus; Stickley, Christoper; Rodríguez-Marroyo, José A; García-López, Juan

2017-06-01

The aims of this study were to establish and validate various predictive equations of half-marathon performance. Seventy-eight half-marathon male runners participated in two different phases. Phase 1 (n = 48) was used to establish the equations for estimating half-marathon performance, and Phase 2 (n = 30) to validate these equations. Apart from half-marathon performance, training-related and anthropometric variables were recorded, and an incremental test on a treadmill was performed, in which physiological (VO 2max , speed at the anaerobic threshold, peak speed) and biomechanical variables (contact and flight times, step length and step rate) were registered. In Phase 1, half-marathon performance could be predicted to 90.3% by variables related to training and anthropometry (Equation 1), 94.9% by physiological variables (Equation 2), 93.7% by biomechanical parameters (Equation 3) and 96.2% by a general equation (Equation 4). Using these equations, in Phase 2 the predicted time was significantly correlated with performance (r = 0.78, 0.92, 0.90 and 0.95, respectively). The proposed equations and their validation showed a high prediction of half-marathon performance in long distance male runners, considered from different approaches. Furthermore, they improved the prediction performance of previous studies, which makes them a highly practical application in the field of training and performance.

Diagnostic accuracy of Xpert MTB/RIF for tuberculosis detection in different regions with different endemic burden: A systematic review and meta-analysis.

PubMed

Li, Shiying; Liu, Bin; Peng, Mingli; Chen, Min; Yin, Wenwei; Tang, Hui; Luo, Yuxuan; Hu, Peng; Ren, Hong

2017-01-01

To estimate the diagnostic accuracy of Xpert MTB/RIF, a systematic review and meta-analysis were carried out. Up to June 20, 2015, multiple databases were screened for relevant studies. Accordingly, 106 studies included 52,410 samples were selected. Diagnostic accuracy of Xpert MTB/RIF for TB detection was validated against either culture or a composite reference standard (CRS). Additionally, selected studies were further subgrouped in four groups based on sample's type, subject's age, status of HIV co-infection and smear-positivity. The overall pooled sensitivity and specificity of Xpert MTB/RIF was 0.85 (95% confidence interval [CI] 0.82-0.88) and 0.98 (95% CI 0.96-0.98), respectively, compared to culture; while it was 0.59 (95% CI 0.44-0.72) and 0.99 (95% CI 0.97-1.00) compared to CRS. The overall sensitivity was lower in countries with high TB prevalence than countries with middle/low prevalence (0.84, 95% CI: 0.80-0.88 versus 0.89, 95% CI: 0.84-0.93). Furthermore, Xpert MTB/RIF has higher sensitivity in patients with positive smears (0.99, 95% CI 0.97-0.99), in patients with pulmonary TB samples (0.87, 95% CI 0.83-0.90), in adults (0.82, 95% CI 0.76-0.86) and in HIV-positive patients (0.81, 95% CI 0.73-0.87). Taken together, Xpert MTB/RIF is a quick and accurate diagnostic assay for TB which will significantly help the physicians to make their clinical decisions.

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)…

Predictor variables for half marathon race time in recreational female runners.

PubMed

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

2011-01-01

The relationship between skin-fold thickness and running performance has been investigated from 100 m to the marathon distance, except the half marathon distance. To investigate whether anthropometry characteristics or training practices were related to race time in 42 recreational female half marathoners to determine the predictor variables of half-marathon race time and to inform future novice female half marathoners. Observational field study at the 'Half Marathon Basel' in Switzerland. In the bivariate analysis, body mass (r = 0.60), body mass index (r = 0.48), body fat (r = 0.56), skin-fold at pectoral (r = 0.61), mid-axilla (r = 0.69), triceps (r = 0.49), subscapular (r = 0.61), abdominal (r = 0.59), suprailiac (r = 0.55) medial calf (r = 0.53) site, and speed of the training sessions (r = -0.68) correlated to race time. Mid-axilla skin-fold (p = 0.04) and speed of the training sessions (p = 0.0001) remained significant after multi-variate analysis. Race time in a half marathon might be predicted by the following equation (r² = 0.71): Race time (min) = 166.7 + 1.7x (mid-axilla skin-fold, mm) - 6.4x (speed in training, km/h). Running speed during training was related to skinfold thickness at mid-axilla (r = -0.31), subscapular (r = -0.38), abdominal (r = -0.44), suprailiacal (r = -0.41), the sum of eight skin-folds (r = -0.36) and percent body fat (r = -0.31). Anthropometric and training variables were related to half-marathon race time in recreational female runners. Skin-fold thicknesses at various upper body locations were related to training intensity. High running speed in training appears to be important for fast half-marathon race times and may reduce upper body skin-fold thicknesses in recreational female half marathoners.

Differences in IgG responses against infection phase related Mycobacterium tuberculosis (Mtb) specific antigens in individuals exposed or not to Mtb correlate with control of TB infection and progression.

PubMed

Coppola, Mariateresa; Arroyo, Leonar; van Meijgaarden, Krista E; Franken, Kees Lmc; Geluk, Annemieke; Barrera, Luis F; Ottenhoff, Tom H M

2017-09-01

Tuberculosis (TB) occurs in only 3-10% of Mycobacterium tuberculosis (Mtb) infected individuals, suggesting that natural immunity can contain Mtb infection, although this remains poorly understood. Next to T-cells, a potentially protective role for B-cells and antibodies has emerged recently. However, the Mtb antigens involved remain ill-defined. Here, we investigated in a TB-endemic setting IgG levels against 15 Mtb antigens, representing various phases of Mtb infection and known to be potent human T-cell antigens. IgG levels against ESAT6/CFP10, Rv0440, Rv0867c, Rv1737c, Rv2029c, Rv2215, Rv2389c, Rv3616c and Mtb purified protein derivative (PPD) were higher in TB patients than in endemic and non-endemic controls. The only exception was Rv1733c that was preferentially recognized by antibodies from endemic controls compared to TB patients and non-endemic controls, suggesting a potential correlation with control of TB infection and progression. In patients, IgG levels against Ag85B and Rv2029c correlated with Mtb loads, while immunoglobulins against Rv0440 differed between genders. Our results support the potential role of certain Mtb antigen-(Rv1733c) specific antibodies in the control of TB infection and progression, while other Mtb antigen-specific antibodies correlate with TB disease activity and bacillary loads. The findings for Rv1733c agree with previous T-cell results and have implications for including antibody-mediated immunity in designing new strategies to control TB. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Implementation of the Xpert MTB/RIF assay for tuberculosis in Mongolia: a qualitative exploration of barriers and enablers

PubMed Central

Bekhbat, Solongo; Ganbaatar, Gantungalag; Dorjravdan, Munkhjargal; Pai, Madhukar; Dobler, Claudia C.

2017-01-01

Objective The aim of our study was to identify barriers and enablers to implementation of the Xpert MTB/RIF test within Mongolia’s National Tuberculosis Program. Methods Twenty-foursemi-structured interviews were conducted between June and September 2015 with laboratory staff and tuberculosis physicians in Mongolia’s capital Ulaanbaatar and regional towns where Xpert MTB/RIF testing had been implemented. Interviews were recorded, transcribed, translated and analysed thematically using NVIVO qualitative analysis software. Results Eight laboratory staff (five from the National Tuberculosis Reference Laboratory in Ulaanbaatar and three from provincial laboratories) and sixteen tuberculosis physicians (five from the Mongolian National Center for Communicable Diseases in Ulaanbaatar, four from district tuberculosis clinics in Ulaanbaatar and seven from provincial tuberculosis clinics) were interviewed. Major barriers to Xpert MTB/RIF implementation identified were: lack of awareness of program guidelines; inadequate staffing arrangements; problems with cartridge supply management; lack of local repair options for the Xpert machines; lack of regular formal training; paper based system; delayed treatment initiation due to consensus meeting and poor sample quality. Enablers to Xpert MTB/RIF implementation included availability of guidelines in the local language; provision of extra laboratory staff, shift working arrangements and additional modules; capacity for troubleshooting internally; access to experts; opportunities for peer learning; common understanding of diagnostic algorithms and decentralised testing. Conclusion Our study identified a number of barriers and enablers to implementation of Xpert MTB/RIF in the Mongolian National Tuberculosis Program. Lessons learned from this study can help to facilitate implementation of Xpert MTB/RIF in other Mongolian locations as well as other low-and middle-income countries. PMID:28717600

Xpert MTB/RIF diagnosis of childhood tuberculosis from sputum and stool samples in a high TB-HIV-prevalent setting.

PubMed

Orikiriza, Patrick; Nansumba, Margaret; Nyehangane, Dan; Bastard, Mathieu; Mugisha, Ivan Taremwa; Nansera, Denis; Mwanga-Amumpaire, Juliet; Boum, Yap; Kumbakumba, Elias; Bonnet, Maryline

2018-05-08

The Xpert MTB/RIF assay is a major advance for diagnosis of tuberculosis (TB) in high-burden countries but is limited in children by their difficulty to produce sputum. We investigated TB in sputum and stool from children with the aim of improving paediatric TB diagnosis. A prospective cohort of children with presumptive TB, provided two sputum or induced sputum at enrolment in a regional referral hospital in Uganda. Stool was collected from those started on TB treatment. All specimen were tested for Xpert MTB/RIF, mycobacteria growth indicator tube (MGIT), Lowenstein Jensen cultures and microscopy (except stool). We compared TB detection between age categories and assessed the performance of Xpert MTB/RIF in sputum and stool. Of the 392 children enrolled, 357 (91.1%) produced at least one sputum sample. Sputum culture yield was 13/357 (3.6%): 3/109 (2.6%), 3/89 (3.2%), 3/101 (2.6%) and 4/44 (8.2%) among children of < 2, 2-5, ≥ 5-10 and > 10 years, respectively (p = 0.599). Xpert MTB/RIF yield was 14/350 (4.0%): 3/104 (2.9%), 4/92 (4.3%), 3/88 (2.9%) and 4/50 (.0%), respectively (p = 0.283). Sensitivity and specificity of Xpert MTB/RIF in sputum against sputum culture were 90.9% (95% CI 58.7-99.8) and 99.1% (99.1-99.8). In stool, it was 55.6% (21.2-86.3) and 98.2% (98.2-100) against Xpert MTB/RIF and culture in sputum. Only a minority of children had microbiologically confirmed TB with a higher proportion in children above 10 years. Although sensitivity of Xpert MTB/RIF in stool was low, with good optimization, it might be a good alternative to sputum in children.

COMPARISON OF GeneXpert MTB/RIF ASSAY WITH CONVENTIONAL AFB SMEAR FOR DIAGNOSIS OF PULMONARY TUBERCULOSIS IN NORTHEASTERN THAILAND.

PubMed

Reechaipichitkul, Wipa; Suleesathira, Tanapong; Chaimanee, Prajaub

2017-03-01

Among infectious agents, Mycobacterium tuberculosis remains one of the most significant causes of death worldwide. Rapid and accurate diagnosis of pulmonary tuberculosis (TB) remains a great challenge. GeneXpert MTB/RIF assay is a novel integrated diagnostic system for rapid diagnosis of TB and particularly of rifampicin-resistant strains. A study was conducted between January 2010 and December 2014 to compare the performance of the sputum GeneXpert MTB/RIF assay with the conventional sputum AFB smear for diagnosis of active pulmonary TB in Thailand, a country with a high burden of this disease. Of the 125 patients who had cough and/or prolonged fever together with abnormal chest radiograph, 63 were diagnosed as having pulmonary TB by mycobacterium culture assay, while the remaining subjects were considered of having TB-like conditions, viz non-tuberculous mycobacterium infection (NTM), bacterial pneumonia or bronchogenic carcinoma. Two-thirds of the patients had underlying diseases, eg, diabetes mellitus (19 patients), autoimmune diseases (14), and HIV (6). Among patients with positive diagnosis of M. tuberculosis infection, 30 were AFB smear positive and 53 by sputum GeneXpert MTB/RIF method; among patients negative for M. tuberculosis infection, 4 were AFB smear positive and 5 by GeneXpert MTB/ RIF assay. Sensitivity and specificity of the sputum AFB smear and GeneXpertMTB/ RIF assay test were 48% (95% CI: 35-61) and 84% (95% CI: 73-92), and 94% (95% CI: 84-98) and 92% (95% CI: 82-97), respectively. Diagnostic performance of the GeneXpert MTB/RIF assay among AFB smear positive patients was higher than among AFB smear negative patients (adjusted OR 6.7; 95% CI: 2.3-19.9). Earlier diagnosis of pulmonary TB using GeneXpert MTB/RIF assay will lead to earlier appropriate treatment and provide opportunities to interrupt TB transmission.

Epidemiology of tinea pedis in marathon runners: prevalence of occult athlete's foot.

PubMed

Auger, P; Marquis, G; Joly, J; Attye, A

1993-01-01

Studies on the prevalence of tinea pedis, a frequently encountered dermatophytic infection, have been conducted mostly in swimmers although people who regularly practise other types of physical activities may also have a high rate of clinical or subclinical infection. This investigation was undertaken to establish the rate of infection in marathon runners, and to determine the incidence of occult athlete's foot disease in this population. Among samples obtained from 405 individuals, 22% were positive. The rate of infection was highest in the older age groups. The prevalence of infection was 24.2% in men and 6.1% in women. Trichophyton rubrum and Trichophyton mentagrophytes were the two species of dermatophytes most commonly isolated on culture. Occult athlete's foot disease represented 48% of cases with a positive culture. Finally, routine sampling of both feet was confirmed necessary to adequately establish the rate of infection: 26.9% of cases with a positive culture would have been missed by unilateral sampling. Other epidemiological factors were not clearly linked to the prevalence of disease in marathon runners: weight; presence of pet animals; practice of other sports; race and country of origin. In conclusion, we establish that marathon runners represent a population at risk for the occurrence of both clinical and subclinical tinea pedis infection.

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)

Predictor variables for half marathon race time in recreational female runners

PubMed Central

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

2011-01-01

INTRODUCTION: The relationship between skin-fold thickness and running performance has been investigated from 100 m to the marathon distance, except the half marathon distance. OBJECTIVE: To investigate whether anthropometry characteristics or training practices were related to race time in 42 recreational female half marathoners to determine the predictor variables of half-marathon race time and to inform future novice female half marathoners. METHODS: Observational field study at the ‘Half Marathon Basel’ in Switzerland. RESULTS: In the bivariate analysis, body mass (r = 0.60), body mass index (r = 0.48), body fat (r = 0.56), skin-fold at pectoral (r = 0.61), mid-axilla (r = 0.69), triceps (r = 0.49), subscapular (r = 0.61), abdominal (r = 0.59), suprailiac (r = 0.55) medial calf (r = 0.53) site, and speed of the training sessions (r = -0.68) correlated to race time. Mid-axilla skin-fold (p = 0.04) and speed of the training sessions (p = 0.0001) remained significant after multi-variate analysis. Race time in a half marathon might be predicted by the following equation (r2 = 0.71): Race time (min)  =  166.7 + 1.7x (mid-axilla skin-fold, mm) - 6.4x (speed in training, km/h). Running speed during training was related to skin-fold thickness at mid-axilla (r = -0.31), subscapular (r = -0.38), abdominal (r = -0.44), suprailiacal (r = -0.41), the sum of eight skin-folds (r = -0.36) and percent body fat (r = -0.31). CONCLUSION: Anthropometric and training variables were related to half-marathon race time in recreational female runners. Skin-fold thicknesses at various upper body locations were related to training intensity. High running speed in training appears to be important for fast half-marathon race times and may reduce upper body skin-fold thicknesses in recreational female half marathoners. PMID:21484048

Diagnostic accuracy of Xpert MTB/RIF for tuberculosis detection in different regions with different endemic burden: A systematic review and meta-analysis

PubMed Central

Li, Shiying; Liu, Bin; Peng, Mingli; Chen, Min; Yin, Wenwei; Tang, Hui; Luo, Yuxuan; Ren, Hong

2017-01-01

Purpose To estimate the diagnostic accuracy of Xpert MTB/RIF, a systematic review and meta-analysis were carried out. Methods Up to June 20, 2015, multiple databases were screened for relevant studies. Results Accordingly, 106 studies included 52,410 samples were selected. Diagnostic accuracy of Xpert MTB/RIF for TB detection was validated against either culture or a composite reference standard (CRS). Additionally, selected studies were further subgrouped in four groups based on sample’s type, subject’s age, status of HIV co-infection and smear-positivity. The overall pooled sensitivity and specificity of Xpert MTB/RIF was 0.85 (95% confidence interval [CI] 0.82–0.88) and 0.98 (95% CI 0.96–0.98), respectively, compared to culture; while it was 0.59 (95% CI 0.44–0.72) and 0.99 (95% CI 0.97–1.00) compared to CRS. The overall sensitivity was lower in countries with high TB prevalence than countries with middle/low prevalence (0.84, 95% CI: 0.80–0.88 versus 0.89, 95% CI: 0.84–0.93). Furthermore, Xpert MTB/RIF has higher sensitivity in patients with positive smears (0.99, 95% CI 0.97–0.99), in patients with pulmonary TB samples (0.87, 95% CI 0.83–0.90), in adults (0.82, 95% CI 0.76–0.86) and in HIV-positive patients (0.81, 95% CI 0.73–0.87). Conclusions Taken together, Xpert MTB/RIF is a quick and accurate diagnostic assay for TB which will significantly help the physicians to make their clinical decisions. PMID:28708844

NT-proBNP concentrations in mountain marathoners.

PubMed

Banfi, Giuseppe; Lippi, Giuseppe; Susta, Daniele; Barassi, Alessandra; D'Eril, Gianvico Melzi; Dogliotti, Giada; Corsi, Massimiliano M

2010-05-01

The 76 amino acid N-terminal proB-type natriuretic peptide (NT-proBNP) is proposed for evaluating and monitoring heart pathologies characterized by myocardial wall stress. Strenuous exercise might generate transitory ischemia, myocardial stress, and diastolic left ventricular dysfunction, possibly inducing an increase of some biochemical parameter concentrations. An alert has been claimed owing to biochemical and instrumental signs of heart dysfunction in recreational athletes during marathon races. We studied the behaviour of NT-proBNP in 15 mountain marathoners before and after a race. The concentrations of the parameter were lower than that observed in controls at rest and were similar to that observed in professional soccer and rugby players. The concentrations significantly increased after the race. NT-proBNP is low at rest in professional athletes, and the increase after physical exercise is physiological. The marathoners, even when performing races in a high-altitude environment, show NT-proBNP concentrations similar to those of athletes from other sports disciplines, characterized by low levels of effort and by a mix of aerobic and anaerobic metabolism. The increase of NT-proBNP is linked to strenuous physical exercise and to heavy heart effort, testified also by an increase of troponin I. However, the role of the NT-proBNP could be important to screen recreational and professional marathoners to avoid possible heart problems and sudden cardiac death in subjects with occult heart disease. The results of the present study are relevant to the design and evaluation of training programs for improving strength and function of professional marathoners.

Alveolar-Membrane Diffusing Capacity Limits Performance in Boston Marathon Qualifiers

PubMed Central

Lavin, Kaleen M.; Straub, Allison M.; Uhranowsky, Kathleen A.; Smoliga, James M.; Zavorsky, Gerald S.

2012-01-01

Purpose (1) to examine the relation between pulmonary diffusing capacity and marathon finishing time, and (2), to evaluate the accuracy of pulmonary diffusing capacity for nitric oxide (DLNO) in predicting marathon finishing time relative to that of pulmonary diffusing capacity for carbon monoxide (DLCO). Methods 28 runners [18 males, age = 37 (SD 9) years, body mass = 70 (13) kg, height = 173 (9) cm, percent body fat = 17 (7) %] completed a test battery consisting of measurement of DLNO and DLCO at rest, and a graded exercise test to determine running economy and aerobic capacity prior to the 2011 Steamtown Marathon (Scranton, PA). One to three weeks later, all runners completed the marathon (range: 2∶22:38 to 4∶48:55). Linear regressions determined the relation between finishing time and a variety of anthropometric characteristics, resting lung function variables, and exercise parameters. Results In runners meeting Boston Marathon qualification standards, 74% of the variance in marathon finishing time was accounted for by differences in DLNO relative to body surface area (BSA) (SEE = 11.8 min, p<0.01); however, the relation between DLNO or DLCO to finishing time was non-significant in the non-qualifiers (p = 0.14 to 0.46). Whereas both DLCO and DLNO were predictive of finishing time for all finishers, DLNO showed a stronger relation (r2 = 0.30, SEE = 33.4 min, p<0.01) compared to DLCO when considering BSA. Conclusion DLNO is a performance-limiting factor in only Boston qualifiers. This suggests that alveolar-capillary membrane conductance is a limitation to performance in faster marathoners. Additionally, DLNO/BSA predicts marathon finishing time and aerobic capacity more accurately than DLCO. PMID:22984520

Evaluation of the Cepheid Xpert MTB/RIF assay

PubMed Central

Shinnick, Thomas M; Starks, Angela M; Alexander, Heather L; Castro, Kenneth G

2018-01-01

The lack of capacity to provide laboratory confirmation of a diagnosis of tuberculosis disease (TB) is contributing to enormous gaps in the ability to find, treat and follow TB patients. WHO estimates that globally only about 57% of the notified new cases of pulmonary TB in 2012 and about 19% of rifampicin-resistant TB cases were laboratory confirmed. The Cepheid Xpert® MTB/RIF assay has been credited with revolutionizing laboratory testing to aid in the diagnosis of TB and rifampicin-resistant TB. This semi-automated test can detect both the causative agent of TB and mutations that confer rifampicin resistance from clinical specimens within 2 h after starting the test. In this article, we review the performance of the test, its pathway to regulatory approval and endorsement, guidelines for its use and lessons learned from the implementation of the test in low-burden, high-resource countries and in high-burden, low-resource countries. PMID:25373876

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)

A feasibility study of the Xpert MTB/RIF test at the peripheral level laboratory in China.

PubMed

Ou, Xichao; Xia, Hui; Li, Qiang; Pang, Yu; Wang, Shengfen; Zhao, Bing; Song, Yuanyuan; Zhou, Yang; Zheng, Yang; Zhang, Zhijian; Zhang, Zhiying; Li, Junchen; Dong, Haiyan; Chi, Junying; Zhang, Jack; Kam, Kai Man; Huan, Shitong; Jun, Yue; Chin, Daniel P; Zhao, Yanlin

2015-02-01

To evaluate the performance of Xpert MTB/RIF (MTB/RIF) in the county-level tuberculosis (TB) laboratory in China. From April 2011 to January 2012, patients with suspected multidrug-resistant tuberculosis (MDR-TB) and non-MDR-TB were enrolled consecutively from four county-level TB laboratories. The detection of Mycobacterium tuberculosis (MTB) by MTB/RIF was compared to detection by Löwenstein-Jensen culture. The detection of rifampin resistance was compared to detection by conventional drug-susceptibility testing. The impact of multiple specimens on the performance of MTB/RIF was also evaluated. A total of 2142 suspected non-MDR-TB cases and 312 suspected MDR-TB cases were enrolled. For MTB detection in suspected non-MDR-TB cases, the sensitivity and specificity of MTB/RIF were 94.4% and 90.2%, respectively. The sensitivity in smear-negative patients was 88.8%. For the detection of rifampin resistance in suspected non-MDR-TB cases, the sensitivity and specificity of MTB/RIF were 87.1% and 97.9%, respectively. For the detection of rifampin resistance in suspected MDR-TB cases, the sensitivity and specificity of MTB/RIF were 87.1% and 91.0%, respectively. Using multiple sputum specimens had no significant influence on the performance of MTB/RIF for MTB detection. The introduction of MTB/RIF could increase the accuracy of detection of MTB and rifampin resistance in peripheral-level TB laboratories in China. One single specimen is adequate for TB diagnosis by MTB/RIF. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Evaluating the diagnostic accuracy of the Xpert MTB/RIF assay on bronchoalveolar lavage fluid: A retrospective study.

PubMed

Lu, Yanjun; Zhu, Yaowu; Shen, Na; Tian, Lei; Sun, Ziyong

2018-02-08

Limited data on the diagnostic accuracy of the Xpert MTB/RIF assay using bronchoalveolar lavage fluid from patients with suspected pulmonary tuberculosis (PTB) have been reported in China. Therefore, a retrospective study was designed to evaluate the diagnostic accuracy of this assay. Clinical, radiological, and microbiological characteristics of 238 patients with suspected PTB were reviewed retrospectively. The sensitivity, specificity, positive predictive value, and negative predictive value for the diagnosis of active PTB were calculated for the Xpert MTB/RIF assay using TB culture or final diagnosis based on clinical and radiological evaluation as the reference standard. The sensitivity and specificity of the Xpert MTB/RIF assay were 84.5% and 98.9%, respectively, and those for smear microscopy were 36.2% and 100%, respectively, when compared to the culture method. However, compared with the sensitivity and specificity of final diagnosis based on clinical and radiological evaluation, the sensitivity and specificity of the assay were 72.9% and 98.7%, respectively, which were significantly higher than those for smear microscopy. The Xpert MTB/RIF assay on bronchoalveolar lavage fluid could serve as an additional rapid diagnostic tool for PTB in a high TB-burden country and improve the time to TB treatment initiation in patients with PTB. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Mass Spectrometric Identification of Mtb81, a Novel Serological Marker for Tuberculosis

PubMed Central

Hendrickson, Ronald C.; Douglass, John F.; Reynolds, Lisa D.; McNeill, Patricia D.; Carter, Darrick; Reed, Steven G.; Houghton, Raymond L.

2000-01-01

We have used serological proteome analysis in conjunction with tandem mass spectrometry to identify and sequence a novel protein, Mtb81, which may be useful for the diagnosis of tuberculosis (TB), especially for patients coinfected with human immunodeficiency virus (HIV). Recombinant Mtb81 was tested by an enzyme-linked immunosorbent assay to detect antibodies in 25 of 27 TB patients (92%) seropositive for HIV as well as in 38 of 67 individuals (57%) who were TB positive alone. No reactivity was observed in 11 of 11 individuals (100%) who were HIV seropositive alone. In addition, neither sera from purified protein derivative (PPD)-negative (0 of 29) nor sera from healthy (0 of 45) blood donors tested positive with Mtb81. Only 2 of 57 of PPD-positive individuals tested positive with Mtb81. Sera from individuals with smear-positive TB and seropositive for HIV but who had tested negative for TB in the 38-kDa antigen immunodiagnostic assay were also tested for reactivity against Mtb81, as were sera from individuals with lung cancer and pneumonia. Mtb81 reacted with 26 of 37 HIV+ TB+ sera (70%) in this group, compared to 2 of 37 (5%) that reacted with the 38-kDa antigen. Together, these results demonstrate that Mtb81 may be a promising complementary antigen for the serodiagnosis of TB. PMID:10835002

Shoulder pathoanatomy in marathon kayakers

PubMed Central

Hagemann, G; Rijke, A; Mars, M

2004-01-01

Objectives: To determine the prevalence of soft and hard tissue abnormalities and their interrelations in the shoulders of marathon kayakers and to examine the pathoanatomical factors that predispose these athletes to injury. Methods: Fifty two long distance kayakers completed a questionnaire. Their shoulders were examined for range of motion, pain, and stability using a standard set of 10 clinical tests. The shoulder was subsequently scanned by magnetic resonance imaging (MRI) in three planes and evaluated for evidence of injury or other abnormality. The relation of clinical symptoms and MRI findings was investigated with respect to kayaker's age, number of years kayaking, and number of marathon races completed. Results: Thirty subjects were asymptomatic at the time of scanning, and twenty two showed symptoms of pain and/or instability. MRI showed acromioclavicular hypertrophy, acromial or clavicular spur, supraspinatus tendinitis, and partial tear of the supraspinatus as the most common abnormalities. Kayaker's age, number of years kayaking, and number of races completed did not relate significantly to symptoms or to the presence of an abnormality on MRI scan. Of all the pathoanatomical findings that are reported to predispose to rotator cuff injury, only acromial and clavicular spurs were found to correlate highly with supraspinatus muscle pathology. Conclusions: Rotator cuff injuries make up a large portion of the injuries seen in marathon kayakers, about twice the number reported for sprint kayakers. These injuries are the result of secondary impingement factors associated with overuse, possibly specific to kayakers, and not the result of bony restrictions around the shoulder joint. Acromioclavicular hypertrophy is a common finding in marathon kayakers, but is possibly the result of portaging or a previous injury. PMID:15273173

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

Long-Term Marathon Running Is Associated with Low Coronary Plaque Formation in Women.

PubMed

Roberts, William O; Schwartz, Robert S; Kraus, Stacia Merkel; Schwartz, Jonathan G; Peichel, Gretchen; Garberich, Ross F; Lesser, John R; Oesterle, Stephen N; Wickstrom, Kelly K; Knickelbine, Thomas; Harris, Kevin M

2017-04-01

Marathon running is presumed to improve cardiovascular risk, but health benefits of high volume running are unknown. High-resolution coronary computed tomography angiography and cardiac risk factor assessment were completed in women with long-term marathon running histories to compare to sedentary women with similar risk factors. Women who had run at least one marathon per year for 10-25 yr underwent coronary computed tomography angiography, 12-lead ECG, blood pressure and heart rate measurement, lipid panel, and a demographic/health risk factor survey. Sedentary matched controls were derived from a contemporaneous clinical study database. CT scans were analyzed for calcified and noncalcified plaque prevalence, volume, stenosis severity, and calcium score. Women marathon runners (n = 26), age 42-82 yr, with combined 1217 marathons (average 47) exhibited significantly lower coronary plaque prevalence and less calcific plaque volume. The marathon runners also had less risk factors (smoking, hypertension, and hyperlipidemia); significantly lower resting heart rate, body weight, body mass index, and triglyceride levels; and higher high-density lipoprotein cholesterol levels compared with controls (n = 28). The five women runners with coronary plaque had run marathons for more years and were on average 12 yr older (65 vs 53) than the runners without plaque. Women marathon runners had minimal coronary artery calcium counts, lower coronary artery plaque prevalence, and less calcified plaque volume compared with sedentary women. Developing coronary artery plaque in long-term women marathon runners appears related to older age and more cardiac risk factors, although the runners with coronary artery plaque had accumulated significantly more years running marathons.

Mouse Tumor Biology (MTB): a database of mouse models for human cancer.

PubMed

Bult, Carol J; Krupke, Debra M; Begley, Dale A; Richardson, Joel E; Neuhauser, Steven B; Sundberg, John P; Eppig, Janan T

2015-01-01

The Mouse Tumor Biology (MTB; http://tumor.informatics.jax.org) database is a unique online compendium of mouse models for human cancer. MTB provides online access to expertly curated information on diverse mouse models for human cancer and interfaces for searching and visualizing data associated with these models. The information in MTB is designed to facilitate the selection of strains for cancer research and is a platform for mining data on tumor development and patterns of metastases. MTB curators acquire data through manual curation of peer-reviewed scientific literature and from direct submissions by researchers. Data in MTB are also obtained from other bioinformatics resources including PathBase, the Gene Expression Omnibus and ArrayExpress. Recent enhancements to MTB improve the association between mouse models and human genes commonly mutated in a variety of cancers as identified in large-scale cancer genomics studies, provide new interfaces for exploring regions of the mouse genome associated with cancer phenotypes and incorporate data and information related to Patient-Derived Xenograft models of human cancers. © The Author(s) 2014. Published by Oxford University Press on behalf of Nucleic Acids Research.

Sex differences in performance-matched marathon runners.

PubMed

Helgerud, J; Ingjer, F; Strømme, S B

1990-01-01

Six male and six female runners were chosen on the basis of age (20-30 years) and their performance over the marathon distance (mean time = 199.4, SEM 2.3 min for men and 201.8, SEM 1.8 min for women). The purpose was to find possible sex differences in maximal aerobic power (VO2max), anaerobic threshold, running economy, degree and utilization of VO2max (when running a marathon) and amount of training. The results showed that performance-matched male and female marathon runners had approximately the same VO2max (about 60 ml.kg-1.min-1). For both sexes the anaerobic threshold was reached at an exercise intensity of about 83% of VO2max, or 88%-90% of maximal heart rate. The females' running economy was poorer, i.e. their oxygen uptake during running at a standard submaximal speed was higher (P less than 0.05). The heart rate, respiratory exchange ratio and blood lactate concentration also confirmed that a given running speed resulted in higher physiological strain for the females. The percentage utilization of VO2max at the average marathon running speed was somewhat higher for the females, but the difference was not significant. For both sexes the oxygen uptake at average speed was 93%-94% of the oxygen uptake corresponding to the anaerobic threshold. Answers to a questionnaire showed that the females' training programme over the last 2 months prior to running the actual marathon comprised almost twice as many kilometers of running per week compared to the males (60 and 33 km, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

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. Copyright ©ERS 2016.

Sex Differences in the Age of Peak Marathon Race Time.

PubMed

Nikolaidis, Pantelis T.; Rosemann, Thomas; Knechtle, Beat

2018-04-30

Recent studies showed that women were older than men when achieving their fastest marathon race time. These studies, however, investigated a limited sample of athletes. We investigated the age of peak marathon performance in a large sample of female and male marathon finishers by using data from all finishers. We analyzed the age of peak marathon performance in 1-year and 5-year age intervals of 451,637 runners (i.e. 168,702 women and 282,935 men) who finished the ‘New York City Marathon’ between 2006 and 2016, using analysis of variance and non-linear regression analysis. During these 11 years, men were faster and older than women, the participation of women increased disproportionately to that of men resulting in a decrease of the male-to-female ratio, and relatively more women participated in the younger age groups. Most women were in the age group 30-34 years and most men in the age group 40-44 years. The fastest race time was shown at 29.7 years in women and 34.8 years in men in the 1-year age intervals, and in age group 30-34 years in women and 35-39 years in men in the 5-year age intervals. In contrast to existing findings reporting a higher age of peak marathon performance in women compared to men, we found that women achieved their best marathon race time ~5 years earlier in life than men in both 1-year and 5-year age intervals. Female athletes and their coaches should plan to achieve their fastest marathon race time at the age of ~30 years.

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

Rapid detection of Mycobacterium tuberculosis and rifampicin resistance in extrapulmonary tuberculosis and sputum smear-negative pulmonary suspects using Xpert MTB/RIF.

PubMed

Ullah, Irfan; Javaid, Arshad; Masud, Haleema; Ali, Mazhar; Basit, Anila; Ahmad, Waqas; Younis, Faisal; Yasmin, Rehana; Khan, Afsar; Jabbar, Abdul; Husain, Masroor; Butt, Zahid Ahmad

2017-04-01

Tuberculosis (TB) is a serious public health problem in developing countries such as Pakistan. Rapid diagnosis of TB and detection of drug resistance are very important for timely and appropriate management of multidrug-resistant TB (MDR-TB). The purpose of this study was to determine the diagnostic efficacy of the Xpert MTB/RIF assay for rapid diagnosis of TB and detection of rifampicin (RIF) resistance in extrapulmonary and smear-negative pulmonary TB suspects. A total of 98 bronchoalveolar lavage fluid (BALF) and 168 extrapulmonary specimens were processed by Xpert MTB/RIF. Culture results are considered as the gold standard for diagnosis of TB, and drug susceptibility testing for detection of RIF resistance. Diagnostic efficacy was measured in terms of sensitivity, specificity and positive and negative predictive values. The Xpert MTB/RIF assay detected 40 (40.8 %) of 98 BALF of presumptive pulmonary TB and 60 (35.7 %) of 168 extrapulmonary specimens. Sensitivity and specificity of the Xpert MTB/RIF assay for detection of TB was 86 and 88.4 %, respectively. The positive predictive value was 71.5 % while negative predictive value was 95.1 %. The Xpert MTB/RIF assay is a rapid and simple technique with high sensitivity and specificity for diagnosing TB and detecting drug resistance in extrapulmonary and smear-negative TB cases.

Novel Trisubstituted Benzimidazoles, Targeting Mtb FtsZ, As A New Class of Antitubercular Agents

PubMed Central

Kumar, Kunal; Awasthi, Divya; Lee, Seung-Yub; Zanardi, Ilaria; Ruzsicska, Bela; Knudson, Susan; Tonge, Peter J.; Slayden, Richard A.; Ojima, Iwao

2010-01-01

Libraries of novel trisubstituted benzimidazoles were created through rational drug design. A good number of these benzimidazoles exhibited promising MIC values in the range of 0.5-6 μg/mL (2-15 μM) for their antibacterial activity against Mtb H37Rv strain. Moreover, five of the lead compounds also exhibited excellent activity against clinical Mtb strains with different drug-resistance profiles. All lead compounds do not show appreciable cytotoxicity (IC50 >200 μM) against Vero cells, which inhibit Mtb FtsZ assembly in a dose dependent manner. The two lead compounds unexpectedly showed enhancement of the GTPase activity of Mtb FtsZ. The result strongly suggests that the increased GTPase activity destabilizes FtsZ assembly leading to efficient inhibition of FtsZ polymerization and filament formation. The TEM and SEM analyses of Mtb FtsZ and Mtb cells, respectively, treated with a lead compound strongly suggest that lead benzimidazoles have a novel mechanism of action on the inhibition of Mtb FtsZ assembly and Z-ring formation. PMID:21126020

Novel trisubstituted benzimidazoles, targeting Mtb FtsZ, as a new class of antitubercular agents.

PubMed

Kumar, Kunal; Awasthi, Divya; Lee, Seung-Yub; Zanardi, Ilaria; Ruzsicska, Bela; Knudson, Susan; Tonge, Peter J; Slayden, Richard A; Ojima, Iwao

2011-01-13

Libraries of novel trisubstituted benzimidazoles were created through rational drug design. A good number of these benzimidazoles exhibited promising MIC values in the range of 0.5-6 μg/mL (2-15 μM) for their antibacterial activity against Mtb H37Rv strain. Moreover, five of the lead compounds also exhibited excellent activity against clinical Mtb strains with different drug-resistance profiles. All lead compounds did not show appreciable cytotoxicity (IC(50) > 200 μM) against Vero cells, which inhibited Mtb FtsZ assembly in a dose dependent manner. The two lead compounds unexpectedly showed enhancement of the GTPase activity of Mtb FtsZ. The result strongly suggests that the increased GTPase activity destabilizes FtsZ assembly, leading to efficient inhibition of FtsZ polymerization and filament formation. The TEM and SEM analyses of Mtb FtsZ and Mtb cells, respectively, treated with a lead compound strongly suggest that lead benzimidazoles have a novel mechanism of action on the inhibition of Mtb FtsZ assembly and Z-ring formation.

Prevalence, Severity and Potential Nutritional Causes of Gastrointestinal Symptoms during a Marathon in Recreational Runners.

PubMed

Pugh, Jamie N; Kirk, Ben; Fearn, Robert; Morton, James P; Close, Graeme L

2018-06-24

The purpose of the present study was to investigate the prevalence of gastrointestinal symptoms (GIS) amongst recreational runners during a marathon race, and potential nutritional factors that may contribute. Recreational runners of the 2017 Liverpool ( n = 66) and Dublin ( n = 30) marathons were recruited. GIS were reported post-marathon and we considered GIS in the 7 days prior to the marathon and during the marathon using the Gastrointestinal Symptom Rating Scale (GSRS). Nutritional intake was recorded using food diaries for the day before the race, morning of the race, and during the race; 43% of participants reported moderate (≥4) GIS in the 7 days prior to the marathon and 27% reported moderate symptoms during the marathon with most common symptoms being flatulence (16%) during training, and nausea (8%) during the marathon race. Correlations between all nutritional intake and GIS were not statistically significant ( p > 0.05). There were significant correlations between total GIS score ( r = 0.510, p < 0.001), upper GIS score ( r = 0.346, p = 0.001) and lower GIS score ( r = 0.483, p < 0.001) in training and during the marathon. There appears to be a modest prevalence of GIS in recreational runners, in the week prior to a marathon and during marathon running, although there was no association with nutritional intake before or during the race.

Identification of Mycobacterium tuberculosis and rifampin resistance in clinical specimens using the Xpert MTB/RIF assay.

PubMed

Kim, Cheol-Hong; Hyun, In Gyu; Hwang, Yong Il; Kim, Dong-Gyu; Lee, Chang Youl; Lee, Myung Goo; Jung, Ki-Suck; Woo, Heungjeong; Hyun, Jeongwon; Kim, Hyun Soo; Park, Myung Jae

2015-01-01

The Xpert MTB/RIF assay is a novel real-time polymerase chain reaction technique for the detection of the Mycobacterium tuberculosis (MTB) complex and rifampin (RIF) resistance. We evaluated the performance of this assay in identifying MTB and resistance to RIF in clinical specimens. We analyzed clinical specimens from 383 patients with suspected TB who were hospitalized at a secondary hospital in Korea. Specimens were processed using the Xpert MTB/RIF assay, acid-fast bacilli smear and culture, and drug susceptibility test (DST). Among the 444 clinical samples analyzed, the Xpert MTB/RIF assay identified MTB in 56 (13.8%) of 405 respiratory specimens, but did not detect MTB in the remaining 39 non-respiratory specimens. Of the 65 pulmonary TB patients, 52 (80.0%) were confirmed by using mycobacterial culture as a reference standard. The sensitivity, specificity, PPV, and NPV of the Xpert MTB/RIF assay were 73.85%, 99.03%, 94.12%, and 94.72%, respectively. Among five patients with RIF resistance determined by the Xpert MTB/RIF assay, four (80%) were confirmed as suffering from multidrug-resistant (MDR) TB by DST. The Xpert MTB/RIF assay appears to be an accurate, simple, and useful technique for detecting MTB, especially in respiratory specimens. However, RIF resistance, if detected, should be verified with DST. © 2015 by the Association of Clinical Scientists, Inc.

Real-Life Clinical Practice of Using the Xpert MTB/RIF Assay in Thailand.

PubMed

Kawkitinarong, Kamon; Suwanpimolkul, Gompol; Kateruttanakul, Pairaj; Manosuthi, Weerawat; Ubolyam, Sasiwimol; Sophonphan, Jiratchaya; Avihingsanon, Anchalee; Ruxrungtham, Kiat

2017-05-15

Delayed diagnosis of tuberculosis (TB) and drug-resistant TB are major challenges of TB control in Thailand. This study assessed the practicality of the Xpert MTB/RIF assay in a real-life setting with high prevalence of human immunodeficiency virus (HIV) infection and pulmonary tuberculosis (PTB). This prospective study was conducted at 3 large tertiary care hospitals. Patients who had suspected PTB were enrolled into the study. Expectorated sputum samples were sent for staining, mycobacterial culture, and Xpert MTB/RIF. Four hundred ninety-four patients were enrolled. From 355 cases with final diagnosis of PTB, 263 (71.8%) had definite diagnosis and 92 cases had probable diagnosis. Among TB culture-positive cases, Xpert MTB/RIF had 100% and 81% sensitivity in sputum smear-positive and smear-negative groups, respectively. The specificity was 95.7%. The sensitivity and positive predictive value of Xpert MTB/RIF in culture-negative but clinically diagnosed PTB was 37.8% and 83.8%, respectively. Centrifugation was required in 59% cases with scanty sputum. Five cases were false-positive by Xpert MTB/RIF in patients with nontuberculous mycobacteria, old PTB scar, and immune reconstitution syndrome. Discordant rifampicin susceptibility results of Xpert MTB/RIF and mycobacteria growth indicator tube (MGIT) were confirmed by using rpoB gene sequencing, which raised the sensitivity of Xpert MTB/RIF in detecting rifampicin resistance to 93.8%. Xpert MTB/RIF is an effective tool in diagnosing PTB but will be more cost-effective for sputum-negative patients and in settings with high prevalence of rifampicin resistance. Early diagnosis of TB results in early treatment and implementation of strategies to limit spreading of TB. Sputum centrifugation may increase the yield of Xpert MTB/RIF. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Marathon running increases circulating endothelial- and thrombocyte-derived microparticles.

PubMed

Schwarz, Viktoria; Düsing, Philip; Liman, Thomas; Werner, Christian; Herm, Juliane; Bachelier, Katrin; Krüll, Matthias; Brechtel, Lars; Jungehulsing, Gerhard J; Haverkamp, Wilhelm; Böhm, Michael; Endres, Matthias; Haeusler, Karl Georg; Laufs, Ulrich

2018-02-01

Background Acute vascular effects of high intensity physical activity are incompletely characterized. Circulating microparticles are cellular markers for vascular activation and damage. Methods Microparticles were analysed in 99 marathon runners (49 ± 6 years, 22% female) of the prospective Berlin Beat of Running study. Blood samples were taken within three days before, immediately after and within two days after the marathon run. Endothelial-derived microparticles were labelled with CD144, CD31 and CD62E, platelet-derived microparticles with CD62P and CD42b, leukocyte-derived microparticles with CD45 and monocyte-derived microparticles with CD14. Results Marathon running induced leukocytosis (5.9 ± 0.1 to 14.8 ± 0.3 10 9 /l, p < 0.0001) and increased platelet counts (239 ± 4.6 to 281 ± 5.9 10 9 /l, p < 0.0001) immediately after the marathon. Blood monocytes increased and lymphocytes decreased after the run ( p < 0.0001). Endothelial-derived microparticles were acutely increased ( p = 0.008) due to a 23% increase of apoptotic endothelial-derived microparticles ( p = 0.007) and returned to baseline within two days after the marathon. Thrombocyte-derived microparticles acutely increased by 38% accompanied by an increase in activated and apoptotic thrombocyte-derived microparticles ( p ≤ 0.0001) each. Both monocyte- and leukocyte-derived microparticles were decreased immediately after marathon run ( p < 0.0001) and remained below baseline until day 2. Troponin T increased from 12 to 32 ng/l ( p < 0.0001) immediately after the run and returned to baseline after two days. Conclusion Circulating apoptotic endothelial- and thrombocyte-derived microparticles increased after marathon running consistent with an acute pro-thrombotic and pro-inflammatory state. Exercise-induced vascular damage reflected by microparticles could indicate potential mechanisms of post-exertional cardiovascular complications. Further

Does a run/walk strategy decrease cardiac stress during a marathon in non-elite runners?

PubMed

Hottenrott, Kuno; Ludyga, Sebastian; Schulze, Stephan; Gronwald, Thomas; Jäger, Frank-Stephan

2016-01-01

Although alternating run/walk-periods are often recommended to novice runners, it is unclear, if this particular pacing strategy reduces the cardiovascular stress during prolonged exercise. Therefore, the aim of the study was to compare the effects of two different running strategies on selected cardiac biomarkers as well as marathon performance. Randomized experimental trial in a repeated measure design. Male (n=22) and female subjects (n=20) completed a marathon either with a run/walk strategy or running only. Immediately after crossing the finishing line cardiac biomarkers were assessed in blood taken from the cubital vein. Before (-7 days) and after the marathon (+4 days) subjects also completed an incremental treadmill test. Despite different pacing strategies, run/walk strategy and running only finished the marathon with similar times (04:14:25±00:19:51 vs 04:07:40±00:27:15 [hh:mm:ss]; p=0.377). In both groups, prolonged exercise led to increased B-type natriuretic peptide, creatine kinase MB isoenzyme and myoglobin levels (p<0.001), which returned to baseline 4 days after the marathon. Elevated cTnI concentrations were observable in only two subjects. B-type natriuretic peptide (r=-0.363; p=0.041) and myoglobin levels (r=-0.456; p=0.009) were inversely correlated with the velocity at the individual anaerobic threshold. Run/walk strategy compared to running only reported less muscle pain and fatigue (p=0.006) after the running event. In conclusion, the increase in cardiac biomarkers is a reversible, physiological response to strenuous exercise, indicating temporary stress on the myocyte and skeletal muscle. Although a combined run/walk strategy does not reduce the load on the cardiovascular system, it allows non-elite runners to achieve similar finish times with less (muscle) discomfort. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

An evaluation of false-positive rifampicin resistance on the Xpert MTB/RIF.

PubMed

Cayci, Yeliz Tanriverdi; Bilgin, Kemal; Coban, Ahmet Yilmaz; Birinci, Asuman; Durupınar, Belma

2017-11-01

Mycobacterium tuberculosis (MTB) is one of the most significant causes of mortality and morbidity. Early diagnose is important especially in multiple drug resistant tuberculosis to avoid transmission. Traditional techniques requires at least one to three weeks for diagnosis of tuberculosis. Diagnostic delays with multiple drug resistant tuberculosis are associated with worse clinical outcomes and increased transmission The Xpert MTB/RIF assay is one of the new diagnostic device for the diagnosis of tuberculosis and rapid detection of rifampicin resistance. We assessed the performance of Xpert MTB/RIF assay for detecting rifampicin resistance using phenotypic drug susceptibility tests as automated BD MGIT 960. Total of 2136 specimens were included in the study. Xpert MTB/RIF testing was performed on samples, using version 4 cartridges, according to the manufacturer's recommendations. The MTBC culture and first-line phenotypic DST were performed in automated BD MGIT 960 (Becton & Dickinson, USA) according to the recommendations of the manufacturer. Agar proportion was used in the case of inconsistency for rifampicin resistance. Thirty-four samples (19 respiratory and 15 nonrespiratory samples) were determined as positive for M. tuberculosis complex by Xpert MTB/RIF (Cepheid GeneXpert® System, USA). Xpert MTB/RIF assay detected 4/34 (11.7%) specimens as rifampicin resistant. One of the rifampicin resistant isolates was determined susceptible in MGIT 960 automated system. This isolate was also tested with agar proportion method and found susceptible to rifampicin. The Xpert MTB/RIF assay can be used as first-line assay for the detection of M. tuberculosis. However, microbiologists must be aware of the limitations of the assay.

GeneXpert MTB/RIF for rapid diagnosis and rifampin resistance detection of endobronchial tuberculosis.

PubMed

Zhang, Qin; Zhang, Qing; Sun, Bing-Qi; Liu, Chang; Su, An-Na; Wang, Xiao-Han; Liu, Na; Zhang, Juan; Kang, Jian; Hou, Gang

2018-04-24

Delayed diagnosis and treatment of tuberculosis (TB) contribute to poor outcomes, especially for endobronchial TB (EBTB), which typically leads to tracheobronchial stenosis. Finding rapid and accurate diagnostic tools for EBTB is crucial. GeneXpert Mycobacterium tuberculosis (MTB)/rifampin (RIF) was recommended by the World Health Organization (WHO) as a standard molecular biological diagnostic technique for MTB. The aim of this study was to evaluate the efficacy of GeneXpert MTB/RIF for diagnosing EBTB and for evaluating RIF resistance. Biopsy tissue and bronchial brushings from EBTB patients were prospectively assessed with GeneXpert MTB/RIF. The diagnostic yields of auramine O-stained sputum smears and bronchial brush smears were obtained, and the results were compared with the cultures of sputum and biopsy tissues for MTB. In 61 confirmed cases of EBTB, the sensitivities of sputum smear, bronchial brush smear, sputum culture and tissue culture to diagnose EBTB were 13.1%, 32.8%, 36.1% and 68.9%, respectively. For bronchial brushings and biopsies, our data showed sensitivities of 57.4% and 63.9%, respectively, and a specificity of 100% for GeneXpert MTB/RIF, and these results were superior to those of sputum smears, bronchial brush smears and sputum culture. GeneXpert MTB/RIF for bronchial brushings and biopsies showed complementarity in its diagnostic performance. Resistance to RIF was identified in 17.4% (8/46) of GeneXpert MTB-positive cases. GeneXpert MTB/RIF may enable more rapid EBTB diagnosis and determination of RIF resistance, which are crucial for timely treatment. © 2018 Asian Pacific Society of Respirology.

Running speed during training and percent body fat predict race time in recreational male marathoners

PubMed Central

Barandun, Ursula; Knechtle, Beat; Knechtle, Patrizia; Klipstein, Andreas; Rüst, Christoph Alexander; Rosemann, Thomas; Lepers, Romuald

2012-01-01

Background Recent studies have shown that personal best marathon time is a strong predictor of race time in male ultramarathoners. We aimed to determine variables predictive of marathon race time in recreational male marathoners by using the same characteristics of anthropometry and training as used for ultramarathoners. Methods Anthropometric and training characteristics of 126 recreational male marathoners were bivariately and multivariately related to marathon race times. Results After multivariate regression, running speed of the training units (β = −0.52, P < 0.0001) and percent body fat (β = 0.27, P < 0.0001) were the two variables most strongly correlated with marathon race times. Marathon race time for recreational male runners may be estimated to some extent by using the following equation (r2 = 0.44): race time ( minutes) = 326.3 + 2.394 × (percent body fat, %) − 12.06 × (speed in training, km/hours). Running speed during training sessions correlated with prerace percent body fat (r = 0.33, P = 0.0002). The model including anthropometric and training variables explained 44% of the variance of marathon race times, whereas running speed during training sessions alone explained 40%. Thus, training speed was more predictive of marathon performance times than anthropometric characteristics. Conclusion The present results suggest that low body fat and running speed during training close to race pace (about 11 km/hour) are two key factors for a fast marathon race time in recreational male marathoner runners. PMID:24198587

Running speed during training and percent body fat predict race time in recreational male marathoners.

PubMed

Barandun, Ursula; Knechtle, Beat; Knechtle, Patrizia; Klipstein, Andreas; Rüst, Christoph Alexander; Rosemann, Thomas; Lepers, Romuald

2012-01-01

Recent studies have shown that personal best marathon time is a strong predictor of race time in male ultramarathoners. We aimed to determine variables predictive of marathon race time in recreational male marathoners by using the same characteristics of anthropometry and training as used for ultramarathoners. Anthropometric and training characteristics of 126 recreational male marathoners were bivariately and multivariately related to marathon race times. After multivariate regression, running speed of the training units (β = -0.52, P < 0.0001) and percent body fat (β = 0.27, P < 0.0001) were the two variables most strongly correlated with marathon race times. Marathon race time for recreational male runners may be estimated to some extent by using the following equation (r (2) = 0.44): race time ( minutes) = 326.3 + 2.394 × (percent body fat, %) - 12.06 × (speed in training, km/hours). Running speed during training sessions correlated with prerace percent body fat (r = 0.33, P = 0.0002). The model including anthropometric and training variables explained 44% of the variance of marathon race times, whereas running speed during training sessions alone explained 40%. Thus, training speed was more predictive of marathon performance times than anthropometric characteristics. The present results suggest that low body fat and running speed during training close to race pace (about 11 km/hour) are two key factors for a fast marathon race time in recreational male marathoner runners.

Cardiac and renal function in a large cohort of amateur marathon runners.

PubMed

Hewing, Bernd; Schattke, Sebastian; Spethmann, Sebastian; Sanad, Wasiem; Schroeckh, Sabrina; Schimke, Ingolf; Halleck, Fabian; Peters, Harm; Brechtel, Lars; Lock, Jürgen; Baumann, Gert; Dreger, Henryk; Borges, Adrian C; Knebel, Fabian

2015-03-21

Participation of amateur runners in endurance races continues to increase. Previous studies of marathon runners have raised concerns about exercise-induced myocardial and renal dysfunction and damage. In our pooled analysis, we aimed to characterize changes of cardiac and renal function after marathon running in a large cohort of mostly elderly amateur marathon runners. A total of 167 participants of the Berlin-Marathon (female n = 89, male n = 78; age = 50.3 ± 11.4 years) were included and cardiac and renal function was analyzed prior to, immediately after and 2 weeks following the race by echocardiography and blood tests (including cardiac troponin T, NT-proBNP and cystatin C). Among the runners, 58% exhibited a significant increase in cardiac biomarkers after completion of the marathon. Overall, the changes in echocardiographic parameters for systolic or diastolic left and right ventricular function did not indicate relevant myocardial dysfunction. Notably, 30% of all participants showed >25% decrease in cystatin C-estimated glomerular filtration rate (GFR) from baseline directly after the marathon; in 8%, we observed a decline of more than 50%. All cardiac and renal parameters returned to baseline ranges within 2 weeks after the marathon. The increase in cardiac biomarkers after completing a marathon was not accompanied by relevant cardiac dysfunction as assessed by echocardiography. After the race, a high proportion of runners experienced a decrease in cystatin C-estimated GFR, which is suggestive of transient, exercise-related alteration of renal function. However, we did not observe persistent detrimental effects on renal function.

Age-Predicted Maximal Heart Rate in Recreational Marathon Runners: A Cross-Sectional Study on Fox's and Tanaka's Equations

PubMed Central

Nikolaidis, Pantelis T.; Rosemann, Thomas; Knechtle, Beat

2018-01-01

Age-based prediction equations of maximal heart rate (HRmax), such as the popular formulas Fox's 220-age, or Tanaka's 208-0.7 × age, have been widely used in various populations. Surprisingly, so far these equations have not been validated in marathon runners, despite the importance of the role of HRmax for training purposes in endurance running. The aim of the present study was to examine the validity of Fox and Tanaka equations in a large sample of women and men recreational marathon runners. Participants (n = 180, age 43.2 ± 8.5 years, VO2max 46.8 mL/min/kg, finishers in at least one marathon during the last year) performed a graded exercise test on a treadmill, where HRmax was measured. Measured HRmax correlated largely with age in the total sample (r = −0.50, p < 0.001), women (r = −0.60, p < 0.001) and men (r = −0.53, p < 0.001). In women, a large main effect of method on HRmax (p = 0.001, η2 = 0.294) was shown with measured HRmax lower than Fox-HRmax (−4.8 bpm; −8.4, −1.3) and Tanaka-HRmax (−4.9 bpm; −8.1, −1.8). In men, a moderate effect of assessment method on HRmax was found (p = 0.001, η2 = 0.066) with measured HRmax higher than Fox-HRmax (+2.8; 1.0, 4.6), Tanaka-HRmax higher than Fox-HRmax (+1.2; 0.7, 1.7). Based on these findings, it was concluded that Fox and Tanaka' formulas overestimated HRmax by ~5 bpm in women, whereas Fox underestimated HRmax in men by ~3 bpm. Thus, we recommend the further use of Tanaka's formula in men marathon runners. In addition, exercise physiologists and sport scientists should consider the observed differences among various assessment methods when performing exercise testing or prescribing training program relying on HR. PMID:29599724

Age-Predicted Maximal Heart Rate in Recreational Marathon Runners: A Cross-Sectional Study on Fox's and Tanaka's Equations.

PubMed

Nikolaidis, Pantelis T; Rosemann, Thomas; Knechtle, Beat

2018-01-01

Age-based prediction equations of maximal heart rate (HR max ), such as the popular formulas Fox's 220-age, or Tanaka's 208-0.7 × age, have been widely used in various populations. Surprisingly, so far these equations have not been validated in marathon runners, despite the importance of the role of HR max for training purposes in endurance running. The aim of the present study was to examine the validity of Fox and Tanaka equations in a large sample of women and men recreational marathon runners. Participants ( n = 180, age 43.2 ± 8.5 years, VO 2max 46.8 mL/min/kg, finishers in at least one marathon during the last year) performed a graded exercise test on a treadmill, where HR max was measured. Measured HR max correlated largely with age in the total sample ( r = -0.50, p < 0.001), women ( r = -0.60, p < 0.001) and men ( r = -0.53, p < 0.001). In women, a large main effect of method on HR max ( p = 0.001, η 2 = 0.294) was shown with measured HR max lower than Fox-HR max (-4.8 bpm; -8.4, -1.3) and Tanaka-HR max (-4.9 bpm; -8.1, -1.8). In men, a moderate effect of assessment method on HR max was found ( p = 0.001, η 2 = 0.066) with measured HR max higher than Fox-HR max (+2.8; 1.0, 4.6), Tanaka-HR max higher than Fox-HR max (+1.2; 0.7, 1.7). Based on these findings, it was concluded that Fox and Tanaka' formulas overestimated HR max by ~5 bpm in women, whereas Fox underestimated HR max in men by ~3 bpm. Thus, we recommend the further use of Tanaka's formula in men marathon runners. In addition, exercise physiologists and sport scientists should consider the observed differences among various assessment methods when performing exercise testing or prescribing training program relying on HR.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-18

...-AA00 Safety Zone; Marathon Oil Refinery Construction, Rouge River, Detroit, MI AGENCY: Coast Guard, DHS... River during the Marathon Oil Refinery Construction project. This temporary safety zone is necessary to... personnel during the setup and offloading of equipment in conjunction with the Marathon Oil Refinery...

Evaluation of the Xpert MTB/RIF assay for diagnosis of tuberculosis and rifampin resistance in county-level laboratories in Hunan province, China.

PubMed

Hu, Peilei; Bai, Liqiong; Liu, Fengping; Ou, Xichao; Zhang, Zhiying; Yi, Songlin; Chen, Zhongnan; Gong, Daofang; Liu, Binbin; Guo, Jingwei; Tan, Yunhong

2014-01-01

The Xpert MTB/RIF showed high sensitivity and specificity in previous studies carried out in different epidemiological and geographical settings and patient populations in high-burden tuberculosis (TB) countries. However, there were little data obtained by validation or demonstration study of the assay in China. In this study, the performance of Xpert MTB/RIF was investigated in two county-level laboratories in Hunan Province, China. Consecutive patients with suspected pulmonary tuberculosis (PTB) and suspicion for multidrug-resistant tuberculosis (MDR-TB) were enrolled. For each patient suspected to have PTB, three sputum specimens (one spot sputum, one night sputum, and one morning sputum) were collected and each sputum was tested with smear microscopy, Löwenstein-Jensen (LJ) culture, and Xpert MTB/RIF test. For comparison across subgroups and testing methods, 95% confidence intervals were calculated. All analyses were done with SPSS 16.0, and P < 0.05 was regarded as significant. For case detection, the sensitivity of Xpert MTB/RIF was 100% for smear- and culture-positive TB and 88.6% for smear-negative and culture-positive TB; the overall sensitivity was 94.5% for all culture-positive patients. The specificity was 99.8%. The sensitivity of Xpert MTB/RIF assay was 22.0% in clinical TB patients and the specificity reached 100.0% in the group of patients who are infected with nontuberculous mycobacteria. For the detection of rifampin resistance, the sensitivity of MTB/RIF RIF-resistance detection was 92.9%, and the specificity was 98.7%. Of the 26 Xpert MTB/RIF-positive and RIF-resistant patients confirmed by LJ proportion tests, 20 (76.9%) patients were infected by MDR-TB. The Xpert MTB/RIF assay is a highly sensitive and specific method for diagnosis of TB and RIF resistance, which will enable it to have the potential to be used in county-level laboratories and lead to the reduction of the infectious pool and improvements in TB control in China. Further

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.

Marathon performance in relation to body fat percentage and training indices in recreational male runners.

PubMed

Tanda, Giovanni; Knechtle, Beat

2013-01-01

The purpose of this study was to investigate the effect of anthropometric characteristics and training indices on marathon race times in recreational male marathoners. Training and anthropometric characteristics were collected for a large cohort of recreational male runners (n = 126) participating in the Basel marathon in Switzerland between 2010 and 2011. Among the parameters investigated, marathon performance time was found to be affected by mean running speed and the mean weekly distance run during the training period prior to the race and by body fat percentage. The effect of body fat percentage became significant as it exceeded a certain limiting value; for a relatively low body fat percentage, marathon performance time correlated only with training indices. Marathon race time may be predicted (r = 0.81) for recreational male runners by the following equation: marathon race time (minutes) = 11.03 + 98.46 exp(-0.0053 mean weekly training distance [km/week]) + 0.387 mean training pace (sec/km) + 0.1 exp(0.23 body fat percentage [%]). The marathon race time results were valid over a range of 165-266 minutes.

Empirical analysis on the runners' velocity distribution in city marathons

NASA Astrophysics Data System (ADS)

Lin, Zhenquan; Meng, Fan

2018-01-01

In recent decades, much researches have been performed on human temporal activity and mobility patterns, while few investigations have been made to examine the features of the velocity distributions of human mobility patterns. In this paper, we investigated empirically the velocity distributions of finishers in New York City marathon, American Chicago marathon, Berlin marathon and London marathon. By statistical analyses on the datasets of the finish time records, we captured some statistical features of human behaviors in marathons: (1) The velocity distributions of all finishers and of partial finishers in the fastest age group both follow log-normal distribution; (2) In the New York City marathon, the velocity distribution of all male runners in eight 5-kilometer internal timing courses undergoes two transitions: from log-normal distribution at the initial stage (several initial courses) to the Gaussian distribution at the middle stage (several middle courses), and to log-normal distribution at the last stage (several last courses); (3) The intensity of the competition, which is described by the root-mean-square value of the rank changes of all runners, goes weaker from initial stage to the middle stage corresponding to the transition of the velocity distribution from log-normal distribution to Gaussian distribution, and when the competition gets stronger in the last course of the middle stage, there will come a transition from Gaussian distribution to log-normal one at last stage. This study may enrich the researches on human mobility patterns and attract attentions on the velocity features of human mobility.

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…

Group training programs and self-reported injury risk in female marathoners.

PubMed

Parker, Daniel T; Weitzenberg, Todd W; Amey, Annette L; Nied, Robert J

2011-11-01

To investigate the association of group training program (GTP) participation and other known risk factors with training and intrarace injury rates in female marathoners. Multivariate analysis of a self-reported questionnaire. Nike Women's Marathon, San Francisco, CA. Three hundred seventy-eight female marathoners. Training and intrarace injury rates, severity of these injuries, and satisfaction rates. Participants of GTPs were 2.36 times more likely to experience intrarace injury than non-GTP participants (P = 0.02). Runners with mild and severe injuries in the past 12 months preceding training were 3.54 and 5.08 times more likely to be injured during training (P < 0.0001 and P < 0.0001), respectively, and those with previous severe injury were 6.43 times more likely to experience severe training injury (P < 0.0001). Similarly, the risk for intrarace marathon injury was 3.79 and 7.09 times greater among those with mild and severe injuries during training (P = 0.003 and P < 0.0001), and the risk of severe intrarace injury was 5.63 times greater for those reporting a severe training injury (P < 0.001). Runners with previous marathon experience had a 0.53 risk of severe training injury compared with inexperienced runners (P = 0.04). Participants of GTPs were more likely to be injured during the marathon in multivariate analysis but were also more satisfied with training in bivariate analysis. Female runners with previous injury had a greater risk of future training and race injury, and severe previous injury was associated with severe training and intrarace injury. Previous marathon experience was protective of severe training injury.

Risk factors for lower extremity injuries among male marathon runners.

PubMed

Van Middelkoop, M; Kolkman, J; Van Ochten, J; Bierma-Zeinstra, S M A; Koes, B W

2008-12-01

The aim of this study is to identify risk factors for lower extremity injuries in male marathon runners. A random sample of 1500 recreational male marathon runners was drawn. Possible risk factors were obtained from a baseline questionnaire 1 month before the start of the marathon. Information on injuries sustained shortly before or during the marathon was obtained using a post-race questionnaire. Of the 694 male runners who responded to the baseline and post-race questionnaire, 28% suffered a self-reported running injury on the lower extremities in the month before or during the marathon run. More than six times race participation in the previous 12 months [odds ratio (OR) 1.66; confidence interval (CI) 1.08-2.56], a history of running injuries (OR 2.62; CI 1.82-3.78), high education level (OR 0.73; CI 0.51-1.04) and daily smoking (OR 0.23; CI 0.05-1.01) were associated with the occurrence of lower extremity injuries. Among the modifiable risk factor studies, a training distance <40 km a week is a strong protective factor of future calf injuries, and regular interval training is a strong protective factor for knee injuries. Other training characteristics appear to have little or no effect on future injuries.

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)

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…

MTB-DR-RIF 9G test: Detection and discrimination of tuberculosis and multi-drug resistant tuberculosis strains.

PubMed

Song, Keum-Soo; Nimse, Satish Balasaheb; Cho, Nam Hoon; Sung, Nackmoon; Kim, Hee-Jin; Yang, Jeongseong; Kim, Taisun

2015-12-01

This report describes the evaluation of the novel MTB-DR-RIF 9G test for the accurate detection and discrimination of Mycobacterium tuberculosis (MTB) and rifampicin-resistant M. tuberculosis (MTB-DR-RIF) in the clinical samples. The procedure included the amplification of a nucleotide fragment of the rpoB gene of the MTB and MTB-DR-RIF strains and their hybridization with the immobilized probes. The MTB-DR-RIF 9G test was evaluated for its ability to detect and discriminate MTB and MTB-DR-RIF strains in 113 known clinical samples. The accuracy of the MTB-DR-RIF 9G test was determined by comparing its results with sequencing analysis and drug susceptibility testing. The sensitivity and specificity of the MTB-DR-RIF 9G test at 95% confidence interval were found to be 95.4% (89.5-98.5) and 100% (69.2-100), respectively. The positive predictive value and negative predictive value of the MTB-DR-RIF 9G test at 95% confidence interval were found to be 100% (85.0-95.9) and 66.7% (38.4-88.18), respectively. Sequencing analysis of all samples indicated that the mutations present in the regions identified with the MTB-DR-RIF 9G assay can be detected accurately. Copyright © 2015 Elsevier Ltd. All rights reserved.

Diagnostic accuracy and turnaround time of the Xpert MTB/RIF assay in routine clinical practice.

PubMed

Kwak, Nakwon; Choi, Sun Mi; Lee, Jinwoo; Park, Young Sik; Lee, Chang-Hoon; Lee, Sang-Min; Yoo, Chul-Gyu; Kim, Young Whan; Han, Sung Koo; Yim, Jae-Joon

2013-01-01

The Xpert MTB/RIF assay was introduced for timely and accurate detection of tuberculosis (TB). The aim of this study was to determine the diagnostic accuracy and turnaround time (TAT) of Xpert MTB/RIF assay in clinical practice in South Korea. We retrospectively reviewed the medical records of patients in whom Xpert MTB/RIF assay using sputum were requested. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of pulmonary tuberculosis (PTB) and detection of rifampicin resistance were calculated. In addition, TAT of Xpert MTB/RIF assay was compared with those of other tests. Total 681 patients in whom Xpert MTB/RIF assay was requested were included in the analysis. The sensitivity, specificity, PPV and NPV of Xpert MTB/RIF assay for diagnosis of PTB were 79.5% (124/156), 100.0% (505/505), 100.0% (124/124) and 94.0% (505/537), respectively. Those for the detection of rifampicin resistance were 57.1% (8/14), 100.0% (113/113), 100.0% (8/8) and 94.9% (113/119), respectively. The median TAT of Xpert MTB/RIF assay to the report of results and results confirmed by physicians in outpatient settings were 0 (0-1) and 6 (3-7) days, respectively. Median time to treatment after initial evaluation was 7 (4-9) days in patients with Xpert MTB/RIF assay, but was 21 (7-33.5) days in patients without Xpert MTB/RIF assay. Xpert MTB/RIF assay showed acceptable sensitivity and excellent specificity for the diagnosis of PTB and detection of rifampicin resistance in areas with intermediate TB burden. Additionally, the assay decreased time to the initiation of anti-TB drugs through shorter TAT.

Diagnostic Accuracy and Turnaround Time of the Xpert MTB/RIF Assay in Routine Clinical Practice

PubMed Central

Kwak, Nakwon; Choi, Sun Mi; Lee, Jinwoo; Park, Young Sik; Lee, Chang-Hoon; Lee, Sang-Min; Yoo, Chul-Gyu; Kim, Young Whan; Han, Sung Koo; Yim, Jae-Joon

2013-01-01

The Xpert MTB/RIF assay was introduced for timely and accurate detection of tuberculosis (TB). The aim of this study was to determine the diagnostic accuracy and turnaround time (TAT) of Xpert MTB/RIF assay in clinical practice in South Korea. We retrospectively reviewed the medical records of patients in whom Xpert MTB/RIF assay using sputum were requested. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of pulmonary tuberculosis (PTB) and detection of rifampicin resistance were calculated. In addition, TAT of Xpert MTB/RIF assay was compared with those of other tests. Total 681 patients in whom Xpert MTB/RIF assay was requested were included in the analysis. The sensitivity, specificity, PPV and NPV of Xpert MTB/RIF assay for diagnosis of PTB were 79.5% (124/156), 100.0% (505/505), 100.0% (124/124) and 94.0% (505/537), respectively. Those for the detection of rifampicin resistance were 57.1% (8/14), 100.0% (113/113), 100.0% (8/8) and 94.9% (113/119), respectively. The median TAT of Xpert MTB/RIF assay to the report of results and results confirmed by physicians in outpatient settings were 0 (0–1) and 6 (3–7) days, respectively. Median time to treatment after initial evaluation was 7 (4–9) days in patients with Xpert MTB/RIF assay, but was 21 (7–33.5) days in patients without Xpert MTB/RIF assay. Xpert MTB/RIF assay showed acceptable sensitivity and excellent specificity for the diagnosis of PTB and detection of rifampicin resistance in areas with intermediate TB burden. Additionally, the assay decreased time to the initiation of anti-TB drugs through shorter TAT. PMID:24204834

Marathon performance in relation to body fat percentage and training indices in recreational male runners

PubMed Central

Tanda, Giovanni; Knechtle, Beat

2013-01-01

Background The purpose of this study was to investigate the effect of anthropometric characteristics and training indices on marathon race times in recreational male marathoners. Methods Training and anthropometric characteristics were collected for a large cohort of recreational male runners (n = 126) participating in the Basel marathon in Switzerland between 2010 and 2011. Results Among the parameters investigated, marathon performance time was found to be affected by mean running speed and the mean weekly distance run during the training period prior to the race and by body fat percentage. The effect of body fat percentage became significant as it exceeded a certain limiting value; for a relatively low body fat percentage, marathon performance time correlated only with training indices. Conclusion Marathon race time may be predicted (r = 0.81) for recreational male runners by the following equation: marathon race time (minutes) = 11.03 + 98.46 exp(−0.0053 mean weekly training distance [km/week]) + 0.387 mean training pace (sec/km) + 0.1 exp(0.23 body fat percentage [%]). The marathon race time results were valid over a range of 165–266 minutes. PMID:24379719

Evaluation of Xpert MTB/RIF assay performance in the diagnosis of abdominal tuberculosis.

PubMed

Kumar, Suraj; Bopanna, Sawan; Kedia, Saurabh; Mouli, Pratap; Dhingra, Rajan; Padhan, Rajesh; Kohli, Mikashmi; Chaubey, Jigyasa; Sharma, Rohini; Das, Prasenjit; Dattagupta, S; Makharia, Govind; Sharma, S K; Ahuja, Vineet

2017-04-01

The use of genetic probes for the diagnosis of pulmonary tuberculosis (TB) has been well described. However, the role of these assays in the diagnosis of intestinal tuberculosis is unclear. We therefore assessed the diagnostic utility of the Xpert Mycobacterium tuberculosis /rifampicin (MTB/RIF) assay, and estimated the prevalence of multidrug-resistant (MDR) TB in the Indian population. Of 99 patients recruited, 37 had intestinal TB; two control groups comprised 43 with Crohn's disease (CD) and 19 with irritable bowel syndrome. Colonoscopy was performed before starting any therapy; mucosal biopsies were subjected to histopathology, acid-fast bacilli staining, Lowenstein-Jensen culture, and nucleic acid amplification testing using the Xpert MTB/RIF assay. Patients were followed up for 6 months to confirm the diagnosis and response to therapy. A composite reference standard was used for diagnosis of TB and assessment of the diagnostic utility of the Xpert MTB/RIF assay. Of 37 intestinal TB patients, the Xpert MTB/RIF assay was positive in three of 37 (8.1%), but none had MDR-TB. The sensitivity, specificity, positive predictive value, and negative predictive value of the Xpert MTB/RIF assay was 8.1%, 100%, 100%, and, 64.2%, respectively. The Xpert MTB/RIF assay has low sensitivity but high specificity for intestinal TB, and may be helpful in endemic tuberculosis areas, when clinicians are faced with difficulty differentiating TB and CD. Based on the Xpert MTB/RIF assay, the prevalence of intestinal MDR-TB is low in the Indian population.

[Application value of Xpert MTB/RIF in diagnosis of spinal tuberculosis and detection of rifampin resistance].

PubMed

Jin, Yang-Hui; Shi, Shi-Yuan; Zheng, Qi; Shen, Jian; Ying, Xiao-Zhang; Wang, Yi-Fan

2017-09-25

To investigate the application value of Xpert MTB/RIF in diagnosis of spinal tuberculosis and detection of rifampin resistance. The 109 pus specimens were obtained from patients who were primaryly diagnosed as spinal tuberculosis. All of the pus specimens were detected by acid-fast stain, liquid fast culturing by BACTEC MGIT 960 and Xpert MTB/RIF assay to definite the differences in sensitivity and specificity of mycobacterium tuberculosis among detecting methods. Pus specimens obtained by different methods were deteceded by MTB/RIF test to analyze the self-influence on Xpert MTB/RIF test. The result of liquid fast culturing by BACTEC MGIT 960 was used as the gold standard; and the value of Xpert MTB/RIF assay in detecting rifampin resistance was analyzed. The sensitivity of acid-fast stain, liquid fast culturing by BACTEC MGIT 960 and Xpert MTB/RIF assay were 25.92%, 48.15%, 77.78%, respectively. The sensitivity of pus specimens obtained from open surgery, ultrasound positioning puncture and biopsy the sensitivity were 83.78%, 76.47%, 44.68% respectively deteceded by MTB/RIF test. According to the gold standard of the results of liquid fast culturing by BACTEC MGIT 960 assay, the sensitivity and specificity of Xpert MTB/RIF assay in detecting rifampin resistance were 80%(4/5) and 90.70%(39/43), respectively. Xpert MTB/RIF assay has higher value in diagnosis of spinal tuberculosi, and also can detect rifampin resistance. The number of mycobacterium tuberculosis in pus specimens has a great influence in the sensitivity of Xpert MTB/RIF assay.

Declines in marathon performance: Sex differences in elite and recreational athletes.

PubMed

Zavorsky, Gerald S; Tomko, Kelly A; Smoliga, James M

2017-01-01

The first aim of this study was to determine the age group at which marathon performance declines in top male and female runners and to compare that to the runners of average ability. Another aim of this of this study was to examine the age-related yearly decline in marathon performance between age group winners and the average marathon finisher. Data from the New York (NYC), Boston, and Chicago marathons from 2001-2016 were analyzed. Age, sex, and location were used in multiple linear regression models to determine the rate of decline in marathon times. Winners of each age group were assessed in 5-year increments from 16 through 74 years old (n = 47 per age group). The fastest times were between 25-34 years old, with overall champion males at 28.3 years old, and overall champion females at 30.8 years old (p = 0.004). At 35 years of age up to 74 years of age, female age group winners had a faster yearly decline in marathon finishing times compared to male age group winners, irrespective of marathon location [women = (min:sec) 2:33 per year, n = 336; men = 2:06 per year, n = 373, p < 0.01]. The median times between each age group only slowed beginning at 50 years old, thereafter the decline was similar between both men and women (women = 2:36, n = 140; men = 2:57, n = 150, p = 0.11). The median times were fastest at Boston and similar between Chicago and NYC. In conclusion, the rate of decline at 35 years old up to 74 years old is roughly linear (adjusted r2 = 0.88, p < 0.001) with female age group winners demonstrating 27 s per year greater decline per year compared to male age group winners.

Declines in marathon performance: Sex differences in elite and recreational athletes

PubMed Central

Tomko, Kelly A.; Smoliga, James M.

2017-01-01

The first aim of this study was to determine the age group at which marathon performance declines in top male and female runners and to compare that to the runners of average ability. Another aim of this of this study was to examine the age-related yearly decline in marathon performance between age group winners and the average marathon finisher. Data from the New York (NYC), Boston, and Chicago marathons from 2001–2016 were analyzed. Age, sex, and location were used in multiple linear regression models to determine the rate of decline in marathon times. Winners of each age group were assessed in 5-year increments from 16 through 74 years old (n = 47 per age group). The fastest times were between 25–34 years old, with overall champion males at 28.3 years old, and overall champion females at 30.8 years old (p = 0.004). At 35 years of age up to 74 years of age, female age group winners had a faster yearly decline in marathon finishing times compared to male age group winners, irrespective of marathon location [women = (min:sec) 2:33 per year, n = 336; men = 2:06 per year, n = 373, p < 0.01]. The median times between each age group only slowed beginning at 50 years old, thereafter the decline was similar between both men and women (women = 2:36, n = 140; men = 2:57, n = 150, p = 0.11). The median times were fastest at Boston and similar between Chicago and NYC. In conclusion, the rate of decline at 35 years old up to 74 years old is roughly linear (adjusted r2 = 0.88, p < 0.001) with female age group winners demonstrating 27 s per year greater decline per year compared to male age group winners. PMID:28187185

Running a Research Marathon

ERIC Educational Resources Information Center

Maaravi, Yossi

2018-01-01

In the current article, I describe a case of experiential learning that can be used to enhance learning, students' research skills and motivation in academic institutions. We used the already existing process of hackathons--intense computer programming events--and conducted a social science research marathon. Fifty-two graduate students…

Cardiac output and performance during a marathon race in middle-aged recreational runners.

PubMed

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

2012-01-01

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). 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). 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). 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.

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.

Prediction of half-marathon race time in recreational female and male runners.

PubMed

Knechtle, Beat; Barandun, Ursula; Knechtle, Patrizia; Zingg, Matthias A; Rosemann, Thomas; Rüst, Christoph A

2014-01-01

Half-marathon running is of high popularity. Recent studies tried to find predictor variables for half-marathon race time for recreational female and male runners and to present equations to predict race time. The actual equations included running speed during training for both women and men as training variable but midaxillary skinfold for women and body mass index for men as anthropometric variable. An actual study found that percent body fat and running speed during training sessions were the best predictor variables for half-marathon race times in both women and men. The aim of the present study was to improve the existing equations to predict half-marathon race time in a larger sample of male and female half-marathoners by using percent body fat and running speed during training sessions as predictor variables. In a sample of 147 men and 83 women, multiple linear regression analysis including percent body fat and running speed during training units as independent variables and race time as dependent variable were performed and an equation was evolved to predict half-marathon race time. For men, half-marathon race time might be predicted by the equation (r(2) = 0.42, adjusted r(2) = 0.41, SE = 13.3) half-marathon race time (min) = 142.7 + 1.158 × percent body fat (%) - 5.223 × running speed during training (km/h). The predicted race time correlated highly significantly (r = 0.71, p < 0.0001) to the achieved race time. For women, half-marathon race time might be predicted by the equation (r(2) = 0.68, adjusted r(2) = 0.68, SE = 9.8) race time (min) = 168.7 + 1.077 × percent body fat (%) - 7.556 × running speed during training (km/h). The predicted race time correlated highly significantly (r = 0.89, p < 0.0001) to the achieved race time. The coefficients of determination of the models were slightly higher than for the existing equations. Future studies might include physiological

A comparison of anthropometric and training characteristics between recreational female marathoners and recreational female Ironman triathletes.

PubMed

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

2013-02-28

A personal best marathon time has been reported as a strong predictor variable for an Ironman race time in recreational female Ironman triathletes. This raises the question whether recreational female Ironman triathletes are similar to recreational female marathoners. We investigated similarities and differences in anthropometry and training between 53 recreational female Ironman triathletes and 46 recreational female marathoners. The association of anthropometric variables and training characteristics with race time was investigated using bi- and multi-variate analysis. The Ironman triathletes were younger (P < 0.01), had a lower skin-fold thickness at pectoral (P < 0.001), axillar (P < 0.01), and subscapular (P < 0.05) site, but a thicker skin-fold thickness at the calf site (P < 0.01) compared to the marathoners. Overall weekly training hours were higher in the Ironman triathletes (P < 0.001). The triathletes were running faster during training than the marathoners (P < 0.05). For the triathletes, neither an anthropometric nor a training variable showed an association with overall Ironman race time after bi-variate analysis. In the multi-variate analysis, running speed during training was related to marathon split time for the Ironman triathletes (P = 0.01) and to marathon race time for the marathoners (P = 0.01). To conclude, although personal best marathon time is a strong predictor variable for performance in recreational female Ironman triathletes, there are differences in both anthropometry and training between recreational female Ironman triathletes and recreational female marathoners and different predictor variables for race performance in these two groups of athletes. These findings suggest that recreational female Ironman triathletes are not comparable to recreational female marathoners regarding the association between anthropometric and training characteristics with race time.

Predictor variables for a half marathon race time in recreational male runners

PubMed Central

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

2011-01-01

The aim of this study was to investigate predictor variables of anthropometry, training, and previous experience in order to predict a half marathon race time for future novice recreational male half marathoners. Eighty-four male finishers in the ‘Half Marathon Basel’ completed the race distance within (mean and standard deviation, SD) 103.9 (16.5) min, running at a speed of 12.7 (1.9) km/h. After multivariate analysis of the anthropometric characteristics, body mass index (r = 0.56), suprailiacal (r = 0.36) and medial calf skin fold (r = 0.53) were related to race time. For the variables of training and previous experience, speed in running of the training sessions (r = −0.54) were associated with race time. After multivariate analysis of both the significant anthropometric and training variables, body mass index (P = 0.0150) and speed in running during training (P = 0.0045) were related to race time. Race time in a half marathon might be partially predicted by the following equation (r2 = 0.44): Race time (min) = 72.91 + 3.045 * (body mass index, kg/m2) −3.884 * (speed in running during training, km/h) for recreational male runners. To conclude, variables of both anthropometry and training were related to half marathon race time in recreational male half marathoners and cannot be reduced to one single predictor variable. PMID:24198577

Predictor variables for a half marathon race time in recreational male runners.

PubMed

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

2011-01-01

The aim of this study was to investigate predictor variables of anthropometry, training, and previous experience in order to predict a half marathon race time for future novice recreational male half marathoners. Eighty-four male finishers in the 'Half Marathon Basel' completed the race distance within (mean and standard deviation, SD) 103.9 (16.5) min, running at a speed of 12.7 (1.9) km/h. After multivariate analysis of the anthropometric characteristics, body mass index (r = 0.56), suprailiacal (r = 0.36) and medial calf skin fold (r = 0.53) were related to race time. For the variables of training and previous experience, speed in running of the training sessions (r = -0.54) were associated with race time. After multivariate analysis of both the significant anthropometric and training variables, body mass index (P = 0.0150) and speed in running during training (P = 0.0045) were related to race time. Race time in a half marathon might be partially predicted by the following equation (r(2) = 0.44): Race time (min) = 72.91 + 3.045 * (body mass index, kg/m(2)) -3.884 * (speed in running during training, km/h) for recreational male runners. To conclude, variables of both anthropometry and training were related to half marathon race time in recreational male half marathoners and cannot be reduced to one single predictor variable.

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

Impact of Xpert MTB/RIF rollout on management of tuberculosis in a South African community.

PubMed

Schmidt, B-M; Geldenhuys, H; Tameris, M; Luabeya, A; Mulenga, H; Bunyasi, E; Scriba, T; Hatherill, M

2017-11-27

The Xpert MTB/RIF test shortens the time to microbiological confirmation of pulmonary tuberculosis (TB) under research conditions. To evaluate the field impact of Xpert MTB/RIF rollout on TB diagnostic yield and time to treatment in a South African (SA) community. We compared TB investigation outcomes for 6-month calendar periods before and after Xpert MTB/RIF rollout in a semi-rural area of SA. The proportion of adult patients who tested positive by sputum smear microscopy, liquid culture or Xpert MTB/RIF and the proportion of positive sputum smear, liquid culture or Xpert MTB/RIF tests were compared. Secondary outcomes included time to laboratory diagnosis and treatment initiation. Data were collected from the National Health Laboratory Service database and from the Western Cape Provincial Department of Health TB register. Regional rollout of Xpert MTB/RIF testing occurred in 2013. Of the 15 629 patients investigated in the post-rollout period, 7.9% tested positive on GeneXpert, compared with 6.4% of the 10 741 investigated in the pre-rollout period who tested positive by sputum smear microscopy (p<0.001). Median laboratory processing time was <1 day for Xpert MTB/RIF (interquartile range (IQR) 0 - 1) compared with 1 day (IQR 0 - 16) for sputum smear microscopy (p=0.001). The median time to TB treatment initiation was 4 days (IQR 2 - 8) after rollout compared with 5 days (IQR 2 - 14) before (p=0.001). Patients investigated for suspected pulmonary TB were more likely to be diagnosed after rollout of Xpert MTB/RIF testing, although the benefit to diagnostic yield was modest, and Xpert MTB/RIF testing was associated with a marginal improvement in time to treatment initiation.

Glasgow marathons 1982-1987. A review of medical problems.

PubMed

Ridley, S A; Rogers, P N; Wright, I H

1990-02-01

The race statistics, whether conditions and incidence of medical problems for the six consecutive years of the Glasgow Marathon are reviewed. The results suggest that the popularity of marathon running is declining but that the competitors are becoming more experienced, seeking medical assistance earlier and, as a result, experiencing fewer and less serious problems at the finish. The effect of weather conditions on the runners' performance is discussed.

Athletes with higher VO2max present reduced oxLDL after a marathon race

PubMed Central

Bachi, André L L; Sierra, Ana Paula R; Rios, Francisco J O; Gonçalves, Danieli A; Ghorayeb, Nabil; Abud, Ronaldo L; Victorino, Angélica B; dos Santos, Juliana M B; Kiss, Maria Augusta D P; Pithon-Curi, Tania C; Vaisberg, Mauro

2015-01-01

Background During a session of prolonged and exhaustive exercise, such as a marathon race, large quantities of free radicals are produced and can oxidise (ox) several molecules, such as low-density lipoprotein (LDL). To prevent oxidative damage, athletes present higher antioxidant levels. However, the effect of marathon running on the natural IgM or IgG anti-oxLDL autoantibodies is not understood. Thus, we investigated the effect of a marathon race on oxidative stress and the mechanisms of control of this stress. Methods Blood samples of 20 marathon runners were collected 24 hours before, immediately and 72 hours after a marathon race to evaluate: plasma lipid profile; serum levels of oxLDL and anti-oxLDL autoantibodies (IgM and IgG isotype) and total antioxidant capacity (TAC). Maximum oxygen uptake (VO2max) was also determined. Results Immediately after the race, oxLDL and TAC levels decreased in comparison to the basal levels; however, the IgM or IgG anti-oxLDL levels remain unchanged. Whereas no differences were observed in the IgM or IgG anti-oxLDL levels 72h after the marathon, the oxLDL and TAC levels returned to the basal values. Significant positive correlations were observed between oxLDL and LDL-cholesterol before, and 72h after the marathon. Significant negative correlations were observed between oxLDL and VO2max immediately after the marathon and 72 h later, as well as between oxLDL and TAC 72 h after the race. Conclusions Athletes with a higher VO2max and total antioxidant activity presented reduced LDL oxidation. The levels of IgM or IgG anti-oxLDL autoantibodies were not affected by running the marathon. PMID:27900109

Determining a "do not start" temperature for a marathon on the basis of adverse outcomes.

PubMed

Roberts, William O

2010-02-01

Marathon races faced with unexpectedly hot conditions must make a decision to start or not to start. The current race cancellation parameters may not reflect the safety profile of an individual race, and a universal temperature may not work an individual race. A retrospective review of the number of starters, finishers, and finish line medical encounters was used to calculate the rate of "unsuccessful" marathon starters from race records, where unsuccessful is defined as medical encounters seen for any reason in the finish medical area plus marathon starters who did not finish. Unsuccessful marathon starters were plotted against the race start wet bulb globe temperature (WBGT), and the WBGT level at which a mass casualty incident (MCI) occurred was used to calculate a "do not start" WBGT. A start WBGT of >21 degrees C resulted in MCI or midrace cancellation in several races. Twin Cities Marathon data show a rapid increase in the rate of unsuccessful marathoner starters above a start WBGT of 13 degrees C. The event experienced an area-wide MCI at a start WBGT of 22 degrees C with an unsuccessful starter rate of 160 per 1000 finishers. Marathons in northern latitudes (>40 degrees) held in "unexpectedly" hot conditions when the participants are not acclimatized and the start WBGT is >21 degrees C often end in either race cancellation or an MCI. It would seem prudent not to start these races in similar conditions. The rate of unsuccessful marathon starters per 1000 marathon finishers plotted against start WBGT generates a curve that can be used to estimate a do not start level. The do not start WBGT for Twin Cities Marathon is 20.5 degrees C on the basis of this model.

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

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

PubMed

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

2016-02-01

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. To verify if there are changes in the cardiopulmonary capacity, and cardiac inotropy and lusitropy in amateur marathoners after running a marathon. 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. 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). 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.

Feasibility, accuracy, and clinical effect of point-of-care Xpert MTB/RIF testing for tuberculosis in primary-care settings in Africa: a multicentre, randomised, controlled trial.

PubMed

Theron, Grant; Zijenah, Lynn; Chanda, Duncan; Clowes, Petra; Rachow, Andrea; Lesosky, Maia; Bara, Wilbert; Mungofa, Stanley; Pai, Madhukar; Hoelscher, Michael; Dowdy, David; Pym, Alex; Mwaba, Peter; Mason, Peter; Peter, Jonny; Dheda, Keertan

2014-02-01

The Xpert MTB/RIF test for tuberculosis is being rolled out in many countries, but evidence is lacking regarding its implementation outside laboratories, ability to inform same-day treatment decisions at the point of care, and clinical effect on tuberculosis-related morbidity. We aimed to assess the feasibility, accuracy, and clinical effect of point-of-care Xpert MTB/RIF testing at primary-care health-care facilities in southern Africa. In this pragmatic, randomised, parallel-group, multicentre trial, we recruited adults with symptoms suggestive of active tuberculosis from five primary-care health-care facilities in South Africa, Zimbabwe, Zambia, and Tanzania. Eligible patients were randomly assigned using pregenerated tables to nurse-performed Xpert MTB/RIF at the clinic or sputum smear microscopy. Participants with a negative test result were empirically managed according to local WHO-compliant guidelines. Our primary outcome was tuberculosis-related morbidity (measured with the TBscore and Karnofsky performance score [KPS]) in culture-positive patients who had begun anti-tuberculosis treatment, measured at 2 months and 6 months after randomisation, analysed by intention to treat. This trial is registered with Clinicaltrials.gov, number NCT01554384. Between April 12, 2011, and March 30, 2012, we randomly assigned 758 patients to smear microscopy (182 culture positive) and 744 to Xpert MTB/RIF (185 culture positive). Median TBscore in culture-positive patients did not differ between groups at 2 months (2 [IQR 0-3] in the smear microscopy group vs 2 [0·25-3] in the MTB/RIF group; p=0·85) or 6 months (1 [0-3] vs 1 [0-3]; p=0·35), nor did median KPS at 2 months (80 [70-90] vs 90 [80-90]; p=0·23) or 6 months (100 [90-100] vs 100 [90-100]; p=0·85). Point-of-care MTB/RIF had higher sensitivity than microscopy (154 [83%] of 185 vs 91 [50%] of 182; p=0·0001) but similar specificity (517 [95%] 544 vs 540 [96%] of 560; p=0·25), and had similar sensitivity to

WEEKLY RUNNING VOLUME AND RISK OF RUNNING‐RELATED INJURIES AMONG MARATHON RUNNERS

PubMed Central

Nielsen, Rasmus Oestergaard; Juul, Martin Serup; Rasmussen, Sten

2013-01-01

Purpose/Background: The purpose of this study was to investigate if the risk of injury declines with increasing weekly running volume before a marathon race. Methods: The study was a retrospective cohort study on marathon finishers. Following a marathon, participants completed a web‐based questionnaire. The outcome of interest was a self‐reported running‐related injury. The injury had to be severe enough to cause a reduction in distance, speed, duration or frequency of running for at least 14 days. Primary exposure was self‐reported average weekly volume of running before the marathon categorized into below 30 km/week, 30 to 60 km/week, and above 60 km/week. Results: A total of 68 of the 662 respondents sustained an injury. When adjusting for previous injury and previous marathons, the relative risk (RR) of suffering an injury rose by 2.02 [95% CI: 1.26; 3.24], p < 0.01, among runners with an average weekly training volume below 30 km/week compared with runners with an average weekly training volume of 30‐60 km/week. No significant differences were found between runners exceeding 60 km/week and runners running 30‐60 km/week (RR=1.13 [0.5;2.8], p=0.80). Conclusions: Runners may be advised to run a minimum of 30 km/week before a marathon to reduce their risk of running‐related injury. Level of Evidence: 2b PMID:23593549

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. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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)

Running a marathon induces changes in adipokine levels and in markers of cartilage degradation--novel role for resistin.

PubMed

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.

Rapid diagnosis of pulmonary tuberculosis in African children in a primary care setting by use of Xpert MTB/RIF on respiratory specimens: a prospective study.

PubMed

Zar, Heather J; Workman, Lesley; Isaacs, Washiefa; Dheda, Keertan; Zemanay, Widaad; Nicol, Mark P

2013-08-01

In children admitted to hospital, rapid, accurate diagnosis of pulmonary tuberculosis with the Xpert MTB/RIF assay is possible, but no paediatric studies have been done in the primary care setting, where most children are given care, and where microbiological diagnosis is rarely available. We assessed the diagnostic accuracy of Xpert MTB/RIF in children in primary care. For this prospective study, we obtained repeat induced sputum and nasopharyngeal aspirate specimens from children (<15 years) with suspected pulmonary tuberculosis at a clinic in Khayeliwtsha, Cape Town, South Africa. We compared the diagnostic accuracy of Xpert MTB/RIF with a reference standard of culture and smear microscopy on induced sputum specimens. For the main analysis, specificity of Xpert MTB/RIF versus liquid culture, we included only children with two interpretable Xpert MTB/RIF and induced sputum culture results. Between Aug 1, 2010, and July 30, 2012, we enrolled 384 children (median age 38·3 months, IQR 21·2-56·5) who had one paired induced sputum and nasopharyngeal specimen, 309 (81%) of whom had two paired specimens. Five children (1%) tested positive for tuberculosis by smear microscopy, 26 (7%) tested positive by Xpert MTB/RIF, and 30 (8%) tested positive by culture. Xpert MTB/RIF on two induced sputum specimens detected 16 of 28 culture-confirmed cases (sensitivity of 57·1%, 95% CI 39·1-73·5) and on two nasopharyngeal aspirates detected 11 of 28 culture-confirmed cases (sensitivity of 39·3, 23·6-57·6; p=0·18). The specificity of Xpert MTB/RIF on induced sputum was 98·9% (95% CI 96·9-99·6) and on nasopharyngeal aspirates was 99·3% (97·4-99·8). Our findings suggest that Xpert MTB/RIF on respiratory secretions is a useful test for rapid diagnosis of paediatric pulmonary tuberculosis in primary care. National Institutes of Health, National Health Laboratory Services Research Trust, the Medical Research Council of South Africa, the National Research Foundation South

Detection of Mycobacterium tuberculosis Complex in Paraffin-Embedded Tissues by the New Automated Abbott RealTime MTB Assay.

PubMed

Fu, Yung-Chieh; Liao, I-Chuang; Chen, Hung-Mo; Yan, Jing-Jou

2016-07-01

The Abbott RealTime MTB assay, launched in June 2014, has been shown to have a competitive performance in the detection of the Mycobacterium tuberculosis (MTB) complex in respiratory specimens. The present study was conducted to investigate the usefulness of the Abbott MTB Realtime assay in the detection of MTB in formalin-fixed paraffin-embedded (FFPE) tissues. A total of 96 FFPE specimens obtained from microbiologically proven MTB cases (N=60) and nontuberculous Mycobacterium cases (N=36) were analyzed. The performance of the Abbott MTB Realtime assay was compared with that of the Roche Cobas TaqMan MTB assay. The overall sensitivity and specificity of the Abbott assay were 63.3% and 97.2%, respectively, compared with 11.7% and 100% for the Cobas assay. The detection rate of the Abbott assay was much higher among 37 acid-fast-positive specimens than among 23 acid-fast-negative specimens (89.3% versus 21.7%, respectively). The detection rate of the assay was higher among 29 resection specimens than among 31 small biopsy specimens (86.2% versus 41.9%, respectively). Our results suggest that the Abbott RealTime MTB assay can be used to differentiate MTB from nontuberculous mycobacterial infections in acid-fast-positive FFPE tissues. © 2016 by the Association of Clinical Scientists, Inc.

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…

Comparison of anthropometric and training characteristics between recreational male marathoners and 24-hour ultramarathoners.

PubMed

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

2012-01-01

Of the anthropometry and training variables used to predict race performance in a 24-hour ultrarun, the personal best marathon time is the strongest predictor in recreational male 24-hour ultramarathoners. This finding raises the question of whether similarities exist between male recreational 24-hour ultramarathoners and male recreational marathoners. The association between age, anthropometric variables (ie, body mass, body height, body mass index, percent body fat, skeletal muscle mass, limb circumference, and skinfold thickness at the pectoral, mid axillary, triceps, subscapular, abdominal, suprailiac, front thigh, and medial calf sites), previous experience and training characteristics (ie, volume, speed, and personal best time), and race time for 79 male recreational 24-hour ultramarathoners and 126 male recreational marathoners was investigated using bivariate and multivariate analysis. The 24-hour ultramarathoners were older (P < 0.05), had a lower circumference at both the upper arm (P < 0.05) and thigh (P < 0.01), and a lower skinfold thickness at the pectoral, axillary, and suprailiac sites (P < 0.05) compared with the marathoners. During training, the 24-hour ultramarathoners were running for more hours per week (P < 0.001) and completed more kilometers (P < 0.001), but were running slower (P < 0.01) compared with the marathoners. In the 24-hour ultramarathoners, neither anthropometric nor training variables were associated with kilometers completed in the race (P > 0.05). In the marathoners, percent body fat (P < 0.001) and running speed during training (P < 0.0001) were related to marathon race times. In summary, differences in anthropometric and training predictor variables do exist between male recreational 24-hour ultramarathoners and male recreational marathoners for race performance.

Comparison of anthropometric and training characteristics between recreational male marathoners and 24-hour ultramarathoners

PubMed Central

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

2012-01-01

Background Of the anthropometry and training variables used to predict race performance in a 24-hour ultrarun, the personal best marathon time is the strongest predictor in recreational male 24-hour ultramarathoners. This finding raises the question of whether similarities exist between male recreational 24-hour ultramarathoners and male recreational marathoners. Methods The association between age, anthropometric variables (ie, body mass, body height, body mass index, percent body fat, skeletal muscle mass, limb circumference, and skinfold thickness at the pectoral, mid axillary, triceps, subscapular, abdominal, suprailiac, front thigh, and medial calf sites), previous experience and training characteristics (ie, volume, speed, and personal best time), and race time for 79 male recreational 24-hour ultramarathoners and 126 male recreational marathoners was investigated using bivariate and multivariate analysis. Results The 24-hour ultramarathoners were older (P < 0.05), had a lower circumference at both the upper arm (P < 0.05) and thigh (P < 0.01), and a lower skinfold thickness at the pectoral, axillary, and suprailiac sites (P < 0.05) compared with the marathoners. During training, the 24-hour ultramarathoners were running for more hours per week (P < 0.001) and completed more kilometers (P < 0.001), but were running slower (P < 0.01) compared with the marathoners. In the 24-hour ultramarathoners, neither anthropometric nor training variables were associated with kilometers completed in the race (P > 0.05). In the marathoners, percent body fat (P < 0.001) and running speed during training (P < 0.0001) were related to marathon race times. Conclusion In summary, differences in anthropometric and training predictor variables do exist between male recreational 24-hour ultramarathoners and male recreational marathoners for race performance. PMID:24198595

The wear and tear of 26.2: dermatological injuries reported on marathon day.

PubMed

Mailler, E A; Adams, B B

2004-08-01

Whether it is to take on the challenge, to get in shape and lose weight, to relieve stress, or to enjoy the outdoors, people have increasingly turned to the marathon as their sporting event of choice. Although there are many health benefits, beginners should be aware that injuries are quite common in marathon runners. Among these are the wear and tear injuries to the skin. This is a review of the most commonly reported dermatological injuries on marathon day.

Effect of Arnica D30 in marathon runners. Pooled results from two double-blind placebo controlled studies.

PubMed

Tveiten, D; Bruset, S

2003-10-01

To examine whether the homeopathic medicine Arnica D30 has an effect on muscle soreness and cell damage after marathon running. The subjects were 82 marathon runners from two separate randomised double-blind placebo controlled trials participating in the Oslo Marathon in 1990 and 1995. Five pills of Arnica D30 or placebo were given morning and evening. Treatment started on the evening before the marathon and continued on day of the race and the three following days. The runners assessed muscular soreness on a visual analogue scale. Muscle enzymes, electrolytes and creatinine were measured before and after the marathon. Muscle soreness immediately after the marathon run was lower in the Arnica group than in the placebo group (P = 0.04). Cell damage measured by enzymes was similar in the Arnica and the placebo group. These pooled results suggest that Arnica D30 has a positive effect on muscle soreness after marathon running, but not on cell damage measured by enzymes.

Running Pace Decrease during a Marathon Is Positively Related to Blood Markers of Muscle Damage

PubMed Central

Del Coso, Juan; Fernández, David; Abián-Vicen, Javier; Salinero, Juan José; González-Millán, Cristina; Areces, Francisco; Ruiz, Diana; Gallo, César; Calleja-González, Julio; Pérez-González, Benito

2013-01-01

Background Completing a marathon is one of the most challenging sports activities, yet the source of running fatigue during this event is not completely understood. The aim of this investigation was to determine the cause(s) of running fatigue during a marathon in warm weather. Methodology/Principal Findings We recruited 40 amateur runners (34 men and 6 women) for the study. Before the race, body core temperature, body mass, leg muscle power output during a countermovement jump, and blood samples were obtained. During the marathon (27 °C; 27% relative humidity) running fatigue was measured as the pace reduction from the first 5-km to the end of the race. Within 3 min after the marathon, the same pre-exercise variables were obtained. Results Marathoners reduced their running pace from 3.5 ± 0.4 m/s after 5-km to 2.9 ± 0.6 m/s at the end of the race (P<0.05), although the running fatigue experienced by the marathoners was uneven. Marathoners with greater running fatigue (> 15% pace reduction) had elevated post-race myoglobin (1318 ± 1411 v 623 ± 391 µg L−1; P<0.05), lactate dehydrogenase (687 ± 151 v 583 ± 117 U L−1; P<0.05), and creatine kinase (564 ± 469 v 363 ± 158 U L−1; P = 0.07) in comparison with marathoners that preserved their running pace reasonably well throughout the race. However, they did not differ in their body mass change (−3.1 ± 1.0 v −3.0 ± 1.0%; P = 0.60) or post-race body temperature (38.7 ± 0.7 v 38.9 ± 0.9 °C; P = 0.35). Conclusions/Significance Running pace decline during a marathon was positively related with muscle breakdown blood markers. To elucidate if muscle damage during a marathon is related to mechanistic or metabolic factors requires further investigation. PMID:23460881

The role of Xpert MTB/RIF assay in the diagnosis of tubercular spondylodiscitis.

PubMed

Arockiaraj, Justin; Michael, Joy S; Amritanand, Rohit; David, Kenny Samuel; Krishnan, Venkatesh

2017-12-01

This study aims to assess the accuracy of the Xpert MTB/RIF assay in the diagnosis of tubercular spondylodiscitis and to identify its role in detecting Rifampicin resistance in patients with infective spondylodiscitis. A retrospective study including 348 patients suspected to have infective spondylodiscitis was done. Tissue/pus samples obtained were sent for culture, histopathology and Xpert MTB/RIF assay. All patients who were confirmed to have tubercular spondylodiscitis and those patients who were suspected on clinico-radiological basis were also treated with anti-tuberculous chemotherapy for a period of 9 months. The efficacy of the Xpert MTB/RIF assay was assessed in terms of sensitivity and specificity when compared to culture, histopathology, and Composite reference standard (CRS). During this study period of 24 months, a total of 348 patients were treated for infective spondylodiscitis. 254 patients were treated for tuberculosis following a smear positivity, culture positivity, and histopathology report or empirically based on clinico-radiological findings. The sensitivity and specificity of the Xpert MTB/RIF assay when compared to culture were 88.4 and 63.7%, respectively. When compared to both culture and histopathology reports it was 80.9 and 80.6%. The sensitivity and specificity of the Xpert MTB/RIF assay when compared to composite reference standard were 71.2 and 100%, respectively. The sensitivity of the assay to detect Rifampicin resistance was 100%. The prevalence of Rifampicin resistance was 5.1%. This study recommends Xpert MTB/RIF assay for early detection of Mycobacterium tubercular spondylodiscitis and Rifampicin resistance.

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.;

Running multiple marathons is not a risk factor for premature subclinical vascular impairment.

PubMed

Pressler, Axel; Suchy, Christiane; Friedrichs, Tasja; Dallinger, Sophia; Grabs, Viola; Haller, Bernhard; Halle, Martin; Scherr, Johannes

2017-08-01

Background In contrast to the well-accepted benefits of moderate exercise, recent research has suggested potential deleterious effects of repeated marathon running on the cardiovascular system. We thus performed a comprehensive analysis of markers of subclinical vascular damage in a cohort of runners having finished multiple marathon races successfully. Design This was a prospective, observational study. Methods A total of 97 healthy male Munich marathon participants (mean age 44 ± 10 years) underwent detailed training history, cardiopulmonary exercise testing for assessment of peak oxygen uptake, ultrasound for assessment of intima-media-thickness as well as non-invasive assessments of ankle-brachial index, augmentation index, pulse wave velocity and reactive hyperaemia index. Results Runners had previously completed a median of eight (range 1-500) half marathons, six (1-100) full marathons and three (1-40) ultramarathons; mean weekly and annual training volumes were 59 ± 23 and 1639 ± 979 km. Mean peak oxygen uptake was 50 ± 8 ml/min/kg, and the Munich marathon was finished in 3:45 ± 0:32 h. Runners showed normal mean values for intima-media-thickness (0.60 ± 0.14 mm), ankle-brachial index (1.2 ± 0.1), augmentation index (17 ± 13%), pulse wave velocity (8.7 ± 1.4 cm/s) and reactive hyperaemia index (1.96 ± 0.50). Age was significantly and independently associated with intima-media-thickness ( r = 0.531; p < 0.001), augmentation index ( r = 0.593; p < 0.001) and pulse wave velocity ( r = 0.357; p < 0.001). However, no independent associations of peak oxygen uptake, marathon finishing time, number of completed races or weekly and annual training km with any of the vascular parameters were observed. Conclusions In this cohort of healthy male runners, running multiple marathon races did not pose an additional risk factor for premature subclinical vascular impairment beyond age.

Is Xpert MTB/RIF appropriate for diagnosing tuberculous pleurisy with pleural fluid samples? A systematic review.

PubMed

Huo, Zhen-Yu; Peng, Li

2018-06-25

Tuberculous pleurisy (TP) presents a diagnostic problem due to the limitations of traditional diagnostic methods. Different studies with the Xpert MTB/RIF assay have drawn variable conclusions about its values in TP diagnosis. We conducted a meta-analysis to assess whether the Xpert MTB/RIF assay is appropriate for the diagnosis of TP using pleural fluid samples. A systematic search of four literature databases in English and Chinese language was performed to identify studies involving the use of Xpert MTB/RIF in patients with TP confirmed by plural biopsy and/or mycobacterial culture. Pooled sensitivity, specificity and accordance proportion were calculated, and the forest plots were generated to assess the accuracy of Xpert MTB/RIF for TP diagnosis. We identified 23 studies meeting our inclusion criteria. The pooled sensitivity and specificity of Xpert MTB/RIF were 30% (95% CI: 21-42%, I 2  = 87.93%) and 99% (95% CI: 97-100%, I 2  = 96.20%), respectively, and the area under the SROC curve (AUC) of Xpert MTB/RIF was 0.86 (95% CI: 0.83-0.89). Compared with drug susceptibility testing (DST), the pooled accordance rate of Xpert MTB/RIF in detecting rifampicin-susceptible cases and rifampicin-resistant cases was 99% (95% CI: 95-104%, I 2  = 8.7%) and 94% (95% CI: 86-102%), respectively. Our analysis suggests that the Xpert MTB/RIF assay is of limited value as a screening test for TP but has a high potential for confirming TP diagnosis and differentiating TP from non-TB diseases using pleural fluid samples.

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

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

[Evaluation of Xpert® MTB/RIF technique for Mycobacterium tuberculosis complex detection in extra-respiratory specimens].

PubMed

García, Patricia; Balcells, M Elvira; Castillo, Claudia; Miranda, Carolina; Geoffroy, Enrique; Román, Juan C; Wozniak, Aniela

2017-08-01

Extra-pulmonary tuberculosis (TB) represents the 26.2% of total TB cases in Chile. Culture is the gold standard method, but the process is extremely slow. Xpert®MTB/RIF technique detects Mycobacterium tuberculosis complex (MTBc) through real time PCR in less than 3 h. However, it has been validated only for respiratory specimens. We aimed to determine the performance of Xpert®MTB/RIF test in detecting MTBc in extra-respiratory specimens compared with a combined gold standard consisting in a positive (liquid and solid) mycobacterial culture and/or a positive validated molecular method (q-RPC, Cobas®TaqMan®-MTB). Fifty extra-respiratory specimens were analyzed, from which 25 were positive and 25 negative for MTBc based on the combined gold standard. The 25 positive specimens had a positive result by Xpert®MTB/RIF; from the 25 negative specimens, 24 had a negative result and one had a positive result. We obtained an overall concordance of 98% between Xpert®MTB/RIF and the combined gold standard. Xpert®MTB/RIF test was able to detect 12 smear-negative specimens and 3 culture-negative specimens, all of them corresponding to extra-pulmonary TB cases. Xpert®MTB/RIF showed similar sensitivity to q-RPC in detecting MTBc in extra-respiratory specimens. This procedure allowed a substantial reduction in the time of diagnosis.

The additional role of Xpert MTB/RIF in the diagnosis of intrathoracic tuberculous lymphadenitis.

PubMed

Lee, Jinwoo; Choi, Sun Mi; Lee, Chang-Hoon; Lee, Sang-Min; Yim, Jae-Joon; Yoo, Chul-Gyu; Kim, Young Whan; Han, Sung Koo; Park, Young Sik

2017-06-01

Diagnosis of intrathoracic tuberculosis (TB) lymphadenitis remains a challenge because of difficulties in obtaining adequate tissue and the lack of a sensitive test. Recently, Xpert MTB/RIF assay is being used for rapid diagnosis of pulmonary TB, but it has not yet been widely validated in intrathoracic TB lymphadenitis. The aim of this study was to assess the additional role of Xpert MTB/RIF in diagnosing intrathoracic TB lymphadenitis using endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) specimen. Consecutive patients who underwent Xpert MTB/RIF assay using EBUS-TBNA specimen from January 2012 and November 2013 at a tertiary referral hospital were recruited. Among them, the cases with malignant lymph nodes were excluded. Among 73 patients, 13 (17.8%) cases were diagnosed with intrathoracic TB lymphadenitis. In detail, 10 patients were diagnosed using conventional methods only (histology or AFB culture) and 3 patients were additionally diagnosed when adding Xpert MTB/RIF assay. The median time to diagnosis using Xpert MTB/RIF (1 day) was shorter than conventional methods (3 days for histology, 14 days for AFB culture). Rifampin resistance was not detected in any patients. In patients with enlarged intrathoracic lymph nodes and low suspicion of malignancy, combination of conventional diagnostic methods with Xpert MTB/RIF could lead to additional and rapid diagnosis of intrathoracic TB lymphadenitis. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

A multisite assessment of the quantitative capabilities of the Xpert MTB/RIF assay.

PubMed

Blakemore, Robert; Nabeta, Pamela; Davidow, Amy L; Vadwai, Viral; Tahirli, Rasim; Munsamy, Vanisha; Nicol, Mark; Jones, Martin; Persing, David H; Hillemann, Doris; Ruesch-Gerdes, Sabine; Leisegang, Felicity; Zamudio, Carlos; Rodrigues, Camilla; Boehme, Catharina C; Perkins, Mark D; Alland, David

2011-11-01

The Xpert MTB/RIF is an automated molecular test for Mycobacterium tuberculosis that estimates bacterial burden by measuring the threshold-cycle (Ct) of its M. tuberculosis-specific real-time polymerase chain reaction. Bacterial burden is an important biomarker for disease severity, infection control risk, and response to therapy. Evaluate bacterial load quantitation by Xpert MTB/RIF compared with conventional quantitative methods. Xpert MTB/RIF results were compared with smear-microscopy, semiquantiative solid culture, and time-to-detection in liquid culture for 741 patients and 2,008 samples tested in a multisite clinical trial. An internal control real-time polymerase chain reaction was evaluated for its ability to identify inaccurate quantitative Xpert MTB/RIF results. Assays with an internal control Ct greater than 34 were likely to be inaccurately quantitated; this represented 15% of M. tuberculosis-positive tests. Excluding these, decreasing M. tuberculosis Ct was associated with increasing smear microscopy grade for smears of concentrated sputum pellets (r(s) = -0.77) and directly from sputum (r(s) =-0.71). A Ct cutoff of approximately 27.7 best predicted smear-positive status. The association between M. tuberculosis Ct and time-to-detection in liquid culture (r(s) = 0.68) and semiquantitative colony counts (r(s) = -0.56) was weaker than smear. Tests of paired same-patient sputum showed that high viscosity sputum samples contained ×32 more M. tuberculosis than nonviscous samples. Comparisons between the grade of the acid-fast bacilli smear and Xpert MTB/RIF quantitative data across study sites enabled us to identify a site outlier in microscopy. Xpert MTB/RIF quantitation offers a new, standardized approach to measuring bacterial burden in the sputum of patients with tuberculosis.

Opportunity Rover Nears Mars Marathon Feat

NASA Image and Video Library

2015-02-10

In February 2015, NASA Mars Exploration Rover Opportunity is approaching a cumulative driving distance on Mars equal to the length of a marathon race. This map shows the rover position relative to where it could surpass that distance.

Hepcidin deficiency and iron deficiency do not alter tuberculosis susceptibility in a murine M.tb infection model

PubMed Central

Harrington-Kandt, Rachel; Stylianou, Elena; Eddowes, Lucy A.; Lim, Pei Jin; Stockdale, Lisa; Pinpathomrat, Nawamin; Bull, Naomi; Pasricha, Janet; Ulaszewska, Marta; Beglov, Yulia; Vaulont, Sophie

2018-01-01

Tuberculosis (TB), caused by the macrophage-tropic pathogen Mycobacterium tuberculosis (M.tb) is a highly prevalent infectious disease. Since an immune correlate of protection or effective vaccine have yet to be found, continued research into host-pathogen interactions is important. Previous literature reports links between host iron status and disease outcome for many infections, including TB. For some extracellular bacteria, the iron regulatory hormone hepcidin is essential for protection against infection. Here, we investigated hepcidin (encoded by Hamp1) in the context of murine M.tb infection. Female C57BL/6 mice were infected with M.tb Erdman via aerosol. Hepatic expression of iron-responsive genes was measured by qRT-PCR and bacterial burden determined in organ homogenates. We found that hepatic Hamp1 mRNA levels decreased post-infection, and correlated with a marker of BMP/SMAD signalling pathways. Next, we tested the effect of Hamp1 deletion, and low iron diets, on M.tb infection. Hamp1 knockout mice did not have a significantly altered M.tb mycobacterial load in either the lungs or spleen. Up to 10 weeks of dietary iron restriction did not robustly affect disease outcome despite causing iron deficiency anaemia. Taken together, our data indicate that unlike with many other infections, hepcidin is decreased following M.tb infection, and show that hepcidin ablation does not influence M.tb growth in vivo. Furthermore, because even severe iron deficiency did not affect M.tb mycobacterial load, we suggest that the mechanisms M.tb uses to scavenge iron from the host must be extremely efficient, and may therefore represent potential targets for drugs and vaccines. PMID:29324800

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…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-04

... DEPARTMENT OF TRANSPORTATION Surface Transportation Board [Docket No. AB 303 (Sub-No. 37X)] Wisconsin Central, Ltd.--Abandonment Exemption--in Marathon County, WI Wisconsin Central, Ltd. (WCL), filed... to abandon 1.14 miles of rail line between mileposts 17.50 and 18.64, in Weston, Marathon County, Wis...

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)

Quantitative T2(*) assessment of knee joint cartilage after running a marathon.

PubMed

Hesper, Tobias; Miese, Falk R; Hosalkar, Harish S; Behringer, Michael; Zilkens, Christoph; Antoch, Gerald; Krauspe, Rüdiger; Bittersohl, Bernd

2015-02-01

To study the effect of repetitive joint loading on the T2(*) assessment of knee joint cartilage. T2(*) mapping was performed in 10 non-professional marathon runners (mean age: 28.7±3.97 years) with no morphologically evident cartilage damage within 48h prior to and following the marathon and after a period of approximately four weeks. Bulk and zonal T2(*) values at the medial and lateral tibiofemoral compartment and the patellofemoral compartment were assessed by means of region of interest analysis. Pre- and post-marathon values were compared. There was a small increase in the T2(*) after running the marathon (30.47±5.16ms versus 29.84±4.97ms, P<0.05) while the T2(*) values before the marathon and those after the period of convalescence were similar (29.84±4.97ms versus 29.81±5.17ms, P=0.855). Regional analyses revealed lower T2(*) values in the medial tibial plateau (P<0.001). It appears that repetitive joint loading has a transient influence on the T2(*) values. However, this effect is small and probably not clinically relevant. The low T2(*) values in the medial tibial plateau may be related to functional demand or early cartilage degeneration. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Performance of Xpert MTB/RIF on Ascitic Fluid Samples for Detection of Abdominal Tuberculosis.

PubMed

Rufai, Syed Beenish; Singh, Sarman; Singh, Amit; Kumar, Parveen; Singh, Jitendra; Vishal, Anand

2017-01-01

Diagnosis of abdominal tuberculosis (TB) from ascitic fluid samples using routinely available diagnostic methods is challenging due to its paucibacillary nature. Although performance of Xpert MTB/RIF assay has been evaluated extensively on pulmonary samples, its performance on extrapulmonary samples is still under evaluation. The objective of this study was to find out the performance of Xpert MTB/RIF on ascitic fluid samples obtained from suspected cases of abdominal TB. Performance was compared with Mycobacterium growth indicator tube-960 (MGIT-960) culture and in-house multiplex polymerase chain reaction (PCR). The latter detects and differentiates Mycobacterium tuberculosis and nontuberculous mycobacteria simultaneously. Sixty-seven patients suspected of probable/possible abdominal TB were included in this observational, prospective study. All samples were tested by Ziehl-Neelsen staining, MGIT-960 culture, in-house multiplex PCR, and Xpert MTB/RIF assay. All 67 samples were smear negative. Seventeen (25.4%) were MGIT-960 culture positive while 12 (17.9%) were detected positive by the Xpert MTB/RIF assay and 9 (13.4%) by in-house multiplex PCR. Sensitivity and specificity of the Xpert MTB/RIF assay compared with the MGIT-960 culture were 70.6% (95%, confidence interval [CI]: 44.1-89.7) and 100% (95%, CI: 92.8-100) and that of in-house multiplex PCR were 52.9% (95%, CI: 30.9-73.8) and 100% (95%, CI: 92.8-100), respectively. Diagnostic yield of Xpert MTB/RIF assay on ascitic fluid samples was lower than MGIT-960 culture. We thus emphasize on the need for urgent discovery of new biomarkers for paucibacillary TB.

Excessive Exercise Habits in Marathoners as Novel Indicators of Masked Hypertension.

PubMed

Kim, Young-Joo; Park, Yongbum; Kang, Duk-Ho; Kim, Chul-Hyun

2017-01-01

Background . Excessive exercise such as marathon running increases the risk of cardiovascular events that may be related to myocardial infarction and sudden death. We aimed to investigate that the exercise characteristics can be used as a novel indicator of masked hypertension. Methods . A total of 571 middle-aged recreational male marathoners were assigned to a high blood pressure group (HBPG; n = 214) or a normal blood pressure group (NBPG; n = 357). A graded exercise test was used to examine the hemodynamic response and cardiac events, and the personal exercise characteristics were recorded. Results . Systolic blood pressure and diastolic blood pressure were higher in the HBPG than in the NBPG ( p < 0.05, all). The marathon history, exercise intensity, and time were longer and higher, whereas the marathon completion duration was shorter in the HBPG than in NBPG ( p < 0.05, all). HBPG showed a higher frequency of alcohol consumption than NBPG ( p < 0.05). Conclusion . More excessive exercise characteristics than the normative individuals. If the individuals exhibit high blood pressure during rest as well as exercise, the exercise characteristics could be used as a novel indicator for masked hypertension.

Excessive Exercise Habits in Marathoners as Novel Indicators of Masked Hypertension

PubMed Central

Kim, Young-Joo; Kang, Duk-Ho

2017-01-01

Background. Excessive exercise such as marathon running increases the risk of cardiovascular events that may be related to myocardial infarction and sudden death. We aimed to investigate that the exercise characteristics can be used as a novel indicator of masked hypertension. Methods. A total of 571 middle-aged recreational male marathoners were assigned to a high blood pressure group (HBPG; n = 214) or a normal blood pressure group (NBPG; n = 357). A graded exercise test was used to examine the hemodynamic response and cardiac events, and the personal exercise characteristics were recorded. Results. Systolic blood pressure and diastolic blood pressure were higher in the HBPG than in the NBPG (p < 0.05, all). The marathon history, exercise intensity, and time were longer and higher, whereas the marathon completion duration was shorter in the HBPG than in NBPG (p < 0.05, all). HBPG showed a higher frequency of alcohol consumption than NBPG (p < 0.05). Conclusion. More excessive exercise characteristics than the normative individuals. If the individuals exhibit high blood pressure during rest as well as exercise, the exercise characteristics could be used as a novel indicator for masked hypertension. PMID:28293624

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

PubMed

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

2014-06-01

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. 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). 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. 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.

Regulation of substrate use during the marathon.

PubMed

Spriet, Lawrence L

2007-01-01

The energy required to run a marathon is mainly provided through oxidative phosphorylation in the mitochondria of the active muscles. Small amounts of energy from substrate phosphorylation are also required during transitions and short periods when running speed is increased. The three inputs for adenosine triphosphate production in the mitochondria include oxygen, free adenosine diphosphate and inorganic phosphate, and reducing equivalents. The reducing equivalents are derived from the metabolism of fat and carbohydrate (CHO), which are mobilised from intramuscular stores and also delivered from adipose tissue and liver, respectively. The metabolism of fat and CHO is tightly controlled at several regulatory sites during marathon running. Slower, recreational runners run at 60-65% maximal oxygen uptake (VO(2max)) for approximately 3:45:00 and faster athletes run at 70-75% for approximately 2:45:00. Both groups rely heavily on fat and CHO fuels. However, elite athletes run marathons at speeds requiring between 80% and 90% VO(2max), and finish in times between 2:05:00 and 2:20:00. They are highly adapted to oxidise fat and must do so during training. However, they compete at such high running speeds, that CHO oxidation (also highly adapted) may be the exclusive source of energy while racing. Further work with elite athletes is needed to examine this possibility.

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…

Reassessment of the positive predictive value and specificity of Xpert MTB/RIF: a diagnostic accuracy study in the context of community-wide screening for tuberculosis.

PubMed

Ho, Jennifer; Nguyen, Phuong Thi Bich; Nguyen, Thu Anh; Tran, Khoa Hien; Van Nguyen, Son; Nguyen, Nhung Viet; Nguyen, Hoa Binh; Luu, Khanh Boi; Fox, Greg J; Marks, Guy B

2016-09-01

Community-wide screening for tuberculosis with Xpert MTB/RIF as a primary screening tool overcomes some of the limitations of conventional screening. However, concerns exist about the low positive predictive value of this test in screening settings. We did a cross-sectional assessment of this diagnostic test to directly estimate the actual positive predictive value of Xpert MTB/RIF when used in the setting of community-wide screening for tuberculosis, and to draw an inference about the specificity of the test for tuberculosis detection. Field staff visited households in 60 randomly selected villages in Ca Mau province, Vietnam. We included people aged 15 years or older who provided written informed consent and were able to produce 0·5 mL or more of sputum, irrespective of reported symptoms. Participants were tested with Xpert MTB/RIF, then those with positive results had two further sputum samples tested for smear microscopy and culture, and underwent chest radiography at the provincial TB Health Center. The positive predictive value of Xpert MTB/RIF was compared against two reference standards for tuberculosis diagnosis-a positive sputum culture for Mycobacterium tuberculosis, and a positive sputum culture or a chest radiograph consistent with active pulmonary tuberculosis. We then calculated the specificity of Xpert MTB/RIF for tuberculosis detection on the basis of these positive predictive values and disease prevalence in this setting. 43 435 adults consented to screening with Xpert MTB/RIF. Sputum samples of 0·5 mL or greater were collected from 23 202 participants, producing 22 673 valid results. 169 participants had positive Xpert MTB/RIF results (0·39% of those screened and 0·75% of those with valid sputum results). The positive predictive value of Xpert MTB/RIF was 61·0% (95% CI 52·8-68·7) when compared against a positive sputum culture and 83·9% (76·8-89·2) when compared against a positive sputum culture or chest radiograph consistent with

Initial experience with GeneXpert MTB/RIF assay in the Arkansas Tuberculosis Control Program.

PubMed

Patil, Naveen; Saba, Hamida; Marco, Asween; Samant, Rohan; Mukasa, Leonard

2014-01-01

Mycobacterium tuberculosis remains one of the most significant causes of death from an infectious agent. Rapid and accurate diagnosis of pulmonary and extra-pulmonary tuberculosis (TB) is still a great challenge. The GeneXpert MTB/RIF assay is a novel integrated diagnostic system for the diagnosis of tuberculosis and rapid detection of Rifampin (RIF) resistance in clinical specimens. In 2012, the Arkansas Tuberculosis Control Program introduced GeneXpert MTB/RIF assay to replace the labour-intensive Mycobacterium Tuberculosis Direct (MTD) assay. To rapidly diagnose TB within two hours and to simultaneously detect RIF resistance. Describe the procedure used to introduce GeneXpert MTB/RIF assay in the Arkansas Tuberculosis Control Program.Characterise the current gap in rapid M. tuberculosis diagnosis in Arkansas.Assess factors that predict acid fast bacilli (AFB) smearnegative but culture-positive cases in Arkansas.Illustrate, with two case reports, the role of GeneXpert MTB/RIF assay in reduction of time to confirmation of M. tuberculosis diagnosis in the first year of implementation. Between June 2012 and June 2013, all AFB sputum smearpositive cases and any others, on request by the physician, had GeneXpert MTB/RIF assay performed as well as traditional M. tuberculosis culture and susceptibilities using Mycobacteria Growth Indicator Tube (MGIT) 960 and Löwenstein-Jensen (LJ) slants. Surveillance data for January 2009-June 2013 was analysed to characterise sputum smear-negative but culture-positive cases. Seventy-one TB cases were reported from June 2012- June 2013. GeneXpert MTB/RIF assay identified all culture-positive cases as well as three cases that were negative on culture. Also, this rapid assay identified all six smear-negative but M. tuberculosis culture-positive cases; two of these cases are described as case reports. GeneXpert MTB/RIF assay has made rapid TB diagnosis possible, with tremendous potential in determining isolation of TB suspects on one

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

Implementation and Operational Research: Clinical Impact of the Xpert MTB/RIF Assay in Patients With Multidrug-Resistant Tuberculosis.

PubMed

Padayatchi, Nesri; Naidu, Naressa; Yende-Zuma, Nonhlanhla; OʼDonnell, Max Roe; Naidoo, Kogieleum; Augustine, Stanton; Zumla, Alimuddin; Loveday, Marian

2016-09-01

The Xpert MTB/RIF assay has been widely implemented in South Africa for rapid tuberculosis (TB) screening. However, its usefulness in management and improving treatment outcomes in patients with multidrug-resistant TB (MDR-TB) remains undefined. The aim of this study was to evaluate the clinical impact of introduction of the Xpert MTB/RIF assay in patients with MDR-TB. We enrolled 921 patients with MDR-TB, who presented to a specialist drug-resistant TB facility in KwaZulu-Natal, South Africa, pre- and post-rollout and implementation of the Xpert MTB/RIF assay. Clinical, laboratory, chest radiograph, and follow-up data from 108 patients with MDR-TB, post-introduction of the Xpert MTB/RIF assay (Xpert group) in November 2010, were analyzed and compared with data from 813 MDR-TB patients from the pre-MTB/RIF assay period (Conventional group), July 2008-2010. Primary impact measure was "treatment success" (World Health Organization definition) at 24 months. Secondary outcomes were time to treatment initiation and disease morbidity. There were no significant differences in treatment success rates between the pre-Xpert MTB/RIF and post-Xpert MTB/RIF groups (54% versus 56.5%, P = 0.681). Median time to treatment initiation was 20 days (interquartile range, 13-31) in the Xpert group versus 92 days (interquartile range, 69-120) in the Conventional group (P < 0.001). Although use of Xpert MTB/RIF assay significantly reduces the time to initiation of MDR-TB treatment, it had no significant impact on treatment outcomes of patients with MDR-TB. Studies on the impact of the Xpert MTB/RIF assay usage on transmission of MDR-TB are required.

Clinical evaluation of the Abbott RealTime MTB Assay for direct detection of Mycobacterium tuberculosis-complex from respiratory and non-respiratory samples.

PubMed

Hinić, Vladimira; Feuz, Kinga; Turan, Selda; Berini, Andrea; Frei, Reno; Pfeifer, Karin; Goldenberger, Daniel

2017-05-01

Rapid and reliable diagnosis is crucial for correct management of tuberculosis. The Abbott RealTime MTB Assay represents a novel qualitative real-time PCR assay for direct detection of M. tuberculosis-complex (MTB) DNA from respiratory samples. The test targets two highly conserved sequences, the multi-copy insertion element IS6110 and the protein antigen B (PAB) gene of MTB, allowing even the detection of IS6610-deficient strains. We evaluated this commercial diagnostic test by analyzing 200 respiratory and, for the first time, 87 non-respiratory clinical specimens from our tertiary care institution and compared its results to our IS6110-based in-house real-time PCR for MTB as well as MTB culture. Overall sensitivity for Abbott RealTime MTB was 100% (19/19) in smear positive and 87.5% (7/8) in smear negative specimens, while the specificity of the assay was 100% (260/260). For both non-respiratory smear positive and smear negative specimens Abbott RealTime MTB tests showed 100% (8/8) sensitivity and 100% (8/8) specificity. Cycle threshold (Ct) value analysis of 16 MTB positive samples showed a slightly higher Ct value of the Abbott RealTime MTB test compared to our in-house MTB assay (mean delta Ct = 2.55). In conclusion, the performance of the new Abbott RealTime MTB Assay was highly similar to culture and in-house MTB PCR. We document successful analysis of 87 non-respiratory samples with the highly automated Abbott RealTime MTB test with no inhibition observed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Is motivation for marathon a protective factor or a risk factor of injury?

PubMed

Chalabaev, A; Radel, R; Ben Mahmoud, I; Massiera, B; Deroche, T; d'Arripe-Longueville, F

2017-12-01

This research investigated whether and how self-determined motivation predicts perceived susceptibility to injury during competition (marathon). Two correlational studies including 378 (Study 1) and 339 (Study 2) marathon runners were conducted. Participants filled out a questionnaire the day before the race measuring self-determined motivation, perceived susceptibilities to marathon-related injury and to keep running through pain, and control variables. Study 1 showed that self-determined motivation was negatively related to perceived susceptibility to marathon-related injury. Study 2 replicated this finding and showed that this relationship was partially mediated by perceived susceptibility to keep running through pain during the race. Moreover, results indicated that the predictive role of self-determination was mostly driven by controlled forms of motivation, and more particularly external regulation. These results suggest that self-determined motivation for sport is a protective factor of injury. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

An update on the Boston Marathon as a research laboratory.

PubMed

Panza, Gregory A; Taylor, Beth A; Zaleski, Amanda L; Thompson, Paul D

2015-07-01

The Boston Athletic Association's annual marathon, also referred to as BAA in this article, continues to be a source of subjects for exercise and endurance performance research. We performed a systematic literature review of BAA studies published in the 7 years since our prior report. We identified 20 articles published from January 2008 to February 2015. Nine were related to cardiology; six were related to exercise physiology; four were related to metabolism; and one was related to marathon qualifying times. As in our prior, report cardiovascular studies remained the dominant topic, but with risk factors for atherosclerosis and thrombosis as the present focus. Cardiac issues remain the largest subject area for BAA studies, but with more emphasis on the effect of prolonged exercise on atherosclerotic and thrombotic risk factors. This shift is associated with an increase in marathon participation by older, recreational runners at increased risk of cardiac complications due to exercise.

Performance of the Abbott RealTime MTB RIF/INH resistance assay when used to test Mycobacterium tuberculosis specimens from Bangladesh.

PubMed

Kostera, Joshua; Leckie, Gregor; Abravaya, Klara; Wang, Hong

2018-01-01

The Abbott RealTime MTB RIF/INH Resistance Assay (RT MTB RIF/INH) is an assay for the detection of rifampicin (RIF)- and/or isoniazid (INH)-resistant Mycobacterium tuberculosis (MTB). The assay can be used to test sputum, bronchial alveolar lavage, and N-Acetyl-L-Cysteine (NALC)/NaOH pellets prepared from these samples. The assay can be used in direct testing mode, or in reflex mode following a MTB positive result produced by its companion assay, Abbott RT MTB. In this study, the direct testing mode was used to test paired sputum and NALC/NaOH pellets prepared from sputum collected from Bangladesh TB patients. One hundred and thirty two paired samples were tested. The RT MTB RIF/INH inhibition rate was 0%. One hundred and twenty-two paired samples had results above the assay limit of detection and were analyzed by comparing with results from phenotypic drug sensitivity testing, GeneXpert MTB/RIF (Xpert), and MTBDR plus (Hain). RT MTB RIF/INH results were in good agreement with those of GeneXpert and Hain. The ability of this assay to detect RIF and INH resistance may contribute to the global control of multidrug resistant tuberculosis.

Sedentary and active: self-reported sitting time among marathon and half-marathon participants.

PubMed

Whitfield, Geoffrey; Pettee Gabriel, Kelley K; Kohl, Harold William

2014-01-01

Emerging evidence suggests that combined physical activity (PA) and inactivity may be more important for chronic disease risk than PA alone. A highly active yet highly sedentary population is needed to study this interaction. The present purpose is to describe the sitting habits of a group of recreational runners and determine if sitting varies with reported training duration or anticipated running velocity. Marathon and half-marathon participants completed the Multicontext Sitting Time Questionnaire and reported peak training duration, anticipated finishing time, and demographic information. Sitting time was described across 5 contexts for workdays and nonworkdays. Total sitting time was analyzed by tertiles of training duration and anticipated event running velocity. 218 participants took part in this study. Median reported training time was 6.5 hours per week. Median total sitting time was higher on workdays than nonworkdays (645 and 480 minutes, respectively, P < .0001). Total sitting time was not associated with training duration or anticipated event running velocity. These results suggest that recreational distance runners are simultaneously highly sedentary and highly active, supporting independence of sedentary behaviors and moderate- to vigorous-intensity PA. This population may provide the characteristics needed to study the joint effects of active and sedentary behaviors on health outcomes.

Xpert MTB/RIF assay for diagnosis of pulmonary tuberculosis in sputum specimens in remote health care facility.

PubMed

Geleta, Dereje Assefa; Megerssa, Yoseph Cherinet; Gudeta, Adugna Negussie; Akalu, Gizachew Taddesse; Debele, Melaku Tesfaye; Tulu, Kassu Desta

2015-10-19

Xpert MTB/RIF assay is considered as a great advance over conventional smear and culture in the diagnosis of TB and MDR-TB by simultaneously detecting M.tuberculosis and rifampicin resistance bacilli. However, very little information regarding the performance characteristics of Xpert MTB/RIF assay is available in Ethiopia. Therefore, the purpose of this study was to evaluate the performance of Xpert MTB/RIF assay compared to conventional sputum smear and culture methods for the diagnosis of pulmonary tuberculosis in remote health care facility. A paired expectorated sputum samples were obtained from 227 consecutively recruited patients with signs and symptoms suggestive of tuberculosis at Karamara hospital during December 2013 to May 2014. One of the sputum specimen was tested directly by Ziehl-Neelsen staining and Xpert MTB/RIF assay without NALC-NaOH decontamination. The other of pair of sputa specimen was cultured for isolation of TB bacilli by conventional methods. Diagnostic performance of Xpert MTB/RIF assay and AFB smear microscopy were calculated against culture as the gold standard. Overall 25.5% (58/227) samples were positive for Mycobacterium tuberculosis complex (MTBC) by MGIT and/or LJ media of which 36.2% (21/58) and 65.5% (35/58) were positive by AFB smear microscopy and Xpert MTB/RIF respectively. The sensitivity, specificity, as well as the positive and negative predictive value of Xpert MTB/RIF assay were 65.5% (95% CI: 53.3-77.7%), 96.3% (95% CI: 93.4-99.2%), 86.4% (95% CI: 76.2-96.5%), and 88.6% (95% CI: 83.9-93.3%) respectively. Eighteen of 58 (31%) cases that were smear microscopy negative, were positive by Xpert MTB/RIF assay. Although Xpert MTB/RIF assay demonstrated high sensitivity in detecting MTBC in sputum specimens compared with conventional AFB smear microscopy, it demonstrated suboptimal sensitivity in smear negative patients compared to conventional culture.

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.…

Evaluation of GeneXpert MTB/RIF for detection of pulmonary tuberculosis at peripheral tuberculosis clinics.

PubMed

Shao, Yan; Peng, Hong; Chen, Cheng; Zhu, Tao; Ji, Ming; Jiang, Wei; Zhu, Wei; Zhai, Xiang Jun; Lu, Wei

2017-04-01

Tuberculosis is one of the most common infectious diseases in China, while delayed patient finding obstructed disease control, especially for smear-negative patients. The current study was undertaken to evaluate the diagnostic accuracy of GeneXpert MTB/RIF compared with conventional methods in the detection of pulmonary tuberculosis patients. A total of 295 spot sputum samples from confirmed pulmonary tuberculosis patients were evaluated from September 2014 to June 2015. Each sample was examined by acid-fast bacillus smear microscopy, culture and GeneXpert MTB/RIF. The sputum culture on Löwenstein-Jensen (L-J) was considered as the gold-standard. After testing by smear, 68.81% (203/295) was negative and 31.19% (92/295) was positive. As the gold-standard, L-J culture detected 37.97% (112/295) positive of all specimens, while the positivity for GeneXpert MTB/RIF was 46.44% (137/295). Compared with L-J culture, the combined sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for GeneXpert MTB/RIF were 94.64%, 82.97%, 77.37% and 96.18% respectively. For smear-negative specimens, the sensitivity, specificity, PPV and NPV for GeneXpert MTB/RIF were 96.00%, 83.05%, 44.44% and 99.32%; while for smear-positive specimens, the corresponding accuracy values were 94.25%, 80.00%, 98.80% and 44.44%. The findings of study indicated that GeneXpert MTB/RIF assay demonstrated a high sensitivity in detecting Mycobacterium tuberculosis compared to smear method and a high NPV among smear negative patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

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)

Is marathon running toxic? An observational study of cardiovascular disease prevalence and longevity in 54 male marathon runners.

PubMed

Rosin, Benjamin

2017-05-01

Recent literature suggests reduced benefits associated with high intensity (HIT) and or sustained intensity exercise training (SIT). While important, they tend to contrast with other studies of HIT and SIT and may not be representative of all individuals wishing to participate in activities such as marathon running. The purpose of this observational report is to describe a 45-year history of 54 long distance runners, their incidence of death from cardiovascular disease and their ages at death compared to the normal population. Data were collected longitudinally on all 54 members of a Southern California mens running club by the author, a cardiologist with 45 years of experience, member of the running club, and personal physician for most of the men for over 40 years. Retrospective and observational data were collected from direct professional and personal contact with the 54 men in the running club. Closely monitored group of marathon runners with extreme HIT and SIT revealed a low incidence of cardiovascular disease (CVD) with an extended longevity relative to the general population. The benefits of exercise for reducing risk of chronic disease, including CVD, are well known. Whether these benefits extend to the more intense and prolonged exercise associated with marathon running is unclear. However, as evidenced in the observational data presented here, at least in some populations, years of high-intensity, prolonged exercise may not be as toxic as suggested by others. Whether this is due to self-selection or predisposition is not well understood but merits further study.

Diagnostic usefulness of Xpert MTB/RIF assay for detection of tuberculous meningitis using cerebrospinal fluid.

PubMed

Rufai, Syed Beenish; Singh, Amit; Singh, Jitendra; Kumar, Parveen; Sankar, Manimuthu Mani; Singh, Sarman

2017-08-01

Tuberculous meningitis (TBM) is the most severe form of extra-pulmonary tuberculosis (TB) due to association of diseases with high rates of mortality and morbidity. Diagnosis continues to be a clinical challenge as microbiological confirmation is rare and time consuming resulting in delayed treatment. Xpert MTB/RIF assay is a rapid and simple test, which has been endorsed by World Health Organization as an initial diagnostic test for the diagnosis of TBM. However, evidence still lacks for its performance on cerebrospinal fluid (CSF) for the diagnosis of TBM especially from India. A total of 267 CSF samples from patients with high clinico-radiological suspicion of TBM were included in this study. Ziehl-Neelsen (ZN) staining, BACTEC Mycobacterial Growth Indicator Tube (MGIT-960) culture system, and Xpert MTB/RIF assay (using cartridge version G4) were tested on all samples. Of total 267 samples, all were negative for smear AFB and 52 (19.5%) were culture positive by MGIT-960 culture system. However, out of 52 (19.5%) cultures detected positive by MGIT-960, 5 (9.6%) were detected as resistant to rifampicin. Xpert MTB/RIF assay was positive in 38 (14.2%) samples and negative in 223 (83.5%) samples. Cartridge error was detected in 6 (2.2%) samples, which could not be repeated due to insufficient sample volume. The sensitivity and specificity of Xpert MTB/RIF assay in comparison to MGIT-960 was 55.1% (95%, CI: 40.2-69.3) and 94.8% (95%, CI: 90.9-97.4) respectively. Overall, Xpert MTB/RIF assay detected 38 (14.2%) as positive for MTB of which 4 (10.5%), 31 (81.6%) and 3 (7.9%) were found to be rifampicin resistant, sensitive and indeterminate respectively. Xpert MTB/RIF assay showed lower sensitivity as compared to MGIT 960 culture for the diagnosis of TBM from CSF samples. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

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)

Use of the Xpert(®) MTB/RIF assay for diagnosing pulmonary tuberculosis comorbidity and multidrug-resistant TB in obstetrics and gynaecology inpatient wards at the University Teaching Hospital, Lusaka, Zambia.

PubMed

Bates, Matthew; Ahmed, Yusuf; Chilukutu, Lophina; Tembo, John; Cheelo, Busiku; Sinyangwe, Sylvester; Kapata, Nathan; Maeurer, Markus; O'Grady, Justin; Mwaba, Peter; Zumla, Alimuddin

2013-09-01

In high-tuberculosis (TB)-endemic countries, comorbidity of pulmonary TB in hospitalised patients with non-communicable diseases is well documented. In this study, we evaluated the use of the Xpert(®) MTB/RIF assay for the detection of concomitant pulmonary TB in patients admitted to the University Teaching Hospital, Lusaka, Zambia, with a primary obstetric or gynaecological condition. The Study population were inpatients admitted with a primary obstetric or gynaecological problem who had a concomitant cough and were able to expectorate a sputum sample. Sputum samples from 94 patients were analysed for the presence of Mycobacterium tuberculosis (M.tb) by standard smear microscopy, MGIT culture, MGIT drug-susceptibility testing (DST) and the Xpert(®) MTB/RIF assay. The sensitivity and specificity of the Xpert(®) MTB/RIF assay were evaluated against the culture gold standard. Twenty-six of 94 (27.7%) patients had culture-confirmed pulmonary TB. The Xpert(®) MTB/RIF assay had a sensitivity of 80.8% [95% CI: 60.0-92.7%]) compared against MGIT culture. The Xpert(®) MTB/RIF assay was more sensitive than sputum smear microscopy (21/26 (80.8%) vs. 13/26 (50.0%), P = 0.02) and detected an additional eight culture-confirmed cases. Culture DST analysis identified two monoresistant M.tb strains: one resistant to rifampicin (rifampicin sensitive by the Xpert(®) MTB/RIF assay) and one to ethambutol. HIV infection was linked with a 3-fold increase in risk of TB, accounting for 87.5% (21/24) of TB cases. 50% of cases presented as comorbidities with other communicable diseases (CDs) and non-communicable diseases (NCDs). As an alternative to sputum microscopy, the Xpert(®) MTB/RIF assay provides a sensitive, specific and rapid method for the diagnosis of pulmonary TB in obstetric or gynaecological inpatients. Pulmonary TB is an important cause of concomitant comorbidity to the obstetric or gynaecological condition necessitating admission. TB and HIV comorbidities with other

Limited value of whole blood Xpert(®) MTB/RIF for diagnosing tuberculosis in children.

PubMed

Pohl, Christian; Rutaihwa, Liliana K; Haraka, Frederick; Nsubuga, Martin; Aloi, Francesco; Ntinginya, Nyanda E; Mapamba, Daniel; Heinrich, Norbert; Hoelscher, Michael; Marais, Ben J; Jugheli, Levan; Reither, Klaus

2016-10-01

We evaluated the ability of the Xpert(®) MTB/RIF assay to detect Mycobacterium tuberculosis in whole blood of children with tuberculosis in tuberculosis endemic settings with high rates of HIV infection. From June 2011 to September 2012 we prospectively enrolled children with symptoms or signs suggestive of tuberculosis at three research centres in Tanzania and Uganda. After clinical assessment, respiratory specimens were collected for microscopy and culture, as well as whole blood for Xpert(®) MTB/RIF. Children were classified according to standardised case definitions. A total of 232 children were evaluated; 14 (6.0%) had culture-confirmed tuberculosis. The Xpert(®) MTB/RIF assay detected M. tuberculosis in 5/232 (2.2%) blood samples with 1 (0.4%) error reading and presumably 1 (0.4%) false-positive result. The sensitivity of the assay in children with culture-confirmed (1/14) versus no tuberculosis (1/117) was 7.1% (95% CI, 1.3-31.5). Three of the five Xpert(®) MTB/RIF positive patients had negative cultures, but were classified as probable tuberculosis cases. Assay sensitivity against a composite reference standard (culture-confirmed, highly probable or probable tuberculosis) was 5.4% (95% CI, 2.1-13.1). Whole blood Xpert(®) MTB/RIF demonstrated very poor sensitivity, although it may enhance the diagnostic yield in select cases, with culture-negative tuberculosis. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Xpert MTB/RIF assay for diagnosis of pulmonary tuberculosis in children: a prospective, multi-centre evaluation.

PubMed

Reither, Klaus; Manyama, Christina; Clowes, Petra; Rachow, Andrea; Mapamba, Daniel; Steiner, Andreas; Ross, Amanda; Mfinanga, Elirehema; Sasamalo, Mohamed; Nsubuga, Martin; Aloi, Francesco; Cirillo, Daniela; Jugheli, Levan; Lwilla, Fred

2015-04-01

Following endorsement by the World Health Organisation, the Xpert MTB/RIF assay has been widely incorporated into algorithms for the diagnosis of adult tuberculosis (TB). However, data on its performance in children remain scarce. This prospective, multi-centre study evaluated the performance of Xpert MTB/RIF to diagnose pulmonary tuberculosis in children. Children older than eight weeks and younger than 16 years with suspected pulmonary tuberculosis were enrolled at three TB endemic settings in Tanzania and Uganda, and assigned to five well-defined case definition categories: culture-confirmed TB, highly probable TB, probable TB, not TB, or indeterminate. The diagnostic accuracy of Xpert MTB/RIF was assessed using culture-confirmed TB cases as reference standard. In total, 451 children were enrolled. 37 (8%) had culture-confirmed TB, 48 (11%) highly probably TB and 62 probable TB (13%). The Xpert MTB/RIF assay had a sensitivity of 68% (95% CI, 50%-82%) and specificity of 100% (95% CI, 97%-100%); detecting 1.7 times more culture-confirmed cases than smear microscopy with a similar time to detection. Xpert MTB/RIF was positive in 2% (1/48) of highly probable and in 3% (2/62) of probable TB cases. Xpert MTB/RIF provided timely results with moderate sensitivity and excellent specificity compared to culture. Low yields in children with highly probable and probable TB remain problematic. Copyright © 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Cardiovascular adaptations to marathon running : the marathoner's heart.

PubMed

Thompson, Paul D

2007-01-01

Endurance exercise training produces a series of cardiac adaptations including resting bradycardia, first and second degree atrioventricular block, increased intolerance to orthostatic stress, and enlargement of the left ventricular walls and of all cardiac chambers. Cardiac dimensions may be increased beyond the upper limits of normal and some endurance athletes demonstrate mild reductions in estimated left ventricular ejection fraction. Among athletes, such adaptations occur primarily in well trained endurance athletes. Clinicians should be aware of the cardiac changes accompanying endurance training to avoid unnecessary evaluation of physiological changes. On the other hand, the presence of conduction abnormalities or cardiac enlargement in low level or recreational athletes should prompt a search for pathological causes. Many of these findings were presented in the 1977 report on the marathon and have simply been better defined with subsequent studies.

The Diagnostic Accuracy of Urine-Based Xpert MTB/RIF in HIV-Infected Hospitalized Patients Who Are Smear-Negative or Sputum Scarce

PubMed Central

Peter, Jonathan G.; Theron, Grant; Muchinga, Tapuwa E.; Govender, Ureshnie; Dheda, Keertan

2012-01-01

Background Hospitals in sub-Saharan Africa are inundated with HIV-infected patients and tuberculosis (TB) is the commonest opportunistic infection in this sub-group. Up to one third of TB-HIV co-infected patients fail to produce a sputum sample (sputum scarce) and diagnosis is thus often delayed or missed. We investigated the sensitivity of urine-based methods (Xpert MTB/RIF, LAM strip test and LAM ELISA) in such patients. Methodology/Principal Findings 281 HIV-infected hospitalised patients with clinically suspected TB provided a spot urine sample. The reference standard was culture positivity for Mycobacterium tuberculosis on ≥1 sputum or extra-pulmonary sample. MTB/RIF was performed using 1 ml of both unprocessed and, when possible, concentrated urine. Each unconcentrated urine sample was also tested using the Clearview LAM ELISA and Alere LAM strip test. 42% (116/242) of patients had culture-proven TB. 18% (20/54) were sputum scarce. In sputum-scarce patients, the sensitivity of urine MTB/RIF and LAM ELISA was 40% (95%CI: 22–61) and 60% (95%CI: 39–78), respectively. Urine MTB/RIF specificity was 98% (95%CI: 95–100). Combined sensitivity of urine LAM ELISA and MTB/RIF was better than MTB/RIF alone [MTB/RIF and LAM: 70% (95%CI: 48–85) vs. MTB/RIF: 40% (95%CI: 22–61), p = 0.03]. Significant predictors of urine MTB/RIF positivity were CD4<50 cells/ml (p = 0.001), elevated protein-to-creatinine ratio (p<0.001) and LAM ELISA positivity (p<0.001). Urine centrifugation and pelleting significantly increased the sensitivity of MTB/RIF over unprocessed urine in paired samples [42% (95%CI: 26–58) vs. 8% (95%CI: 0–16), p<0.001]. Urine MTB/RIF-generated CT values correlated poorly with markers of bacillary burden (smear grade and time-to-positivity). Conclusions/Significance This preliminary study indicates that urine-based MTB/RIF, alone or in combination with LAM antigen detection, may potentially aid the diagnosis of TB in HIV-infected patients

Anthropometric and training variables related to half-marathon running performance in recreational female runners.

PubMed

Knechtle, Beat; Knechtle, Patrizia; Barandun, Ursula; Rosemann, Thomas

2011-05-01

The relationship between skin-fold thickness and running has been investigated in distances ranging from 100 m to the marathon distance (42.195 km), with the exclusion of the half-marathon distance (21.0975 km). We investigated the association between anthropometric variables, prerace experience, and training variables with race time in 42 recreational, nonprofessional, female half-marathon runners using bi- and multivariate analysis. Body weight (r, 0.60); body mass index (r, 0.48); body fat percentage (r, 0.56); pectoral (r, 0.61), mid-axilla (r, 0.69), triceps (r, 0.49), subscapular (r, 0.61), abdominal (r, 0.59), suprailiac (r, 0.55), and medial calf (r, 0.53) skin-fold thickness; mean speed of the training sessions (r, -0.68); and personal best time in a half-marathon (r, 0.69) correlated with race time after bivariate analysis. Body weight (P = 0.0054), pectoral skin-fold thickness (P = 0.0068), and mean speed of the training sessions (P = 0.0041) remained significant after multivariate analysis. Mean running speed during training was related to mid-axilla (r, -0.31), subscapular (r, -0.38), abdominal (r, -0.44), and suprailiac (r, -0.41) skin-fold thickness, the sum of 8 skin-fold thicknesses (r, -0.36); and percent body fat (r, -0.31). It was determined that variables of both anthropometry and training were related to half-marathon race time, and that skin-fold thicknesses were associated with running speed during training. For practical applications, high running speed during training (as opposed to extensive training) may both reduce upper-body skin-fold thicknesses and improve race performance in recreational female half-marathon runners.

How to prevent the next Marathon Pharmaceuticals.

PubMed

David, Frank S; Dixit, Richa

2018-01-01

In recent years, several drug companies have exploited U.S. regulatory policies to acquire exclusive rights to cheap therapies and substantially raise their prices, and Federal agencies and state governments are exploring various ways to prevent or punish such behavior in the future. Among these cases, however, Marathon Pharmaceuticals' handling of Emflaza (deflazacort) is unique, because the drug was previously only available abroad, and was never previously sold in the U.S. before the company obtained FDA approval for it. Thus, laws and policies designed to address price hikes on already-marketed drugs are unlikely to prevent additional Marathon-like scenarios. In this article, we describe in more detail the unique features of Emflaza compared with these other recent cases of drug price increases, determine the likelihood that similar situations will arise in the future, and explore legislative and administrative options to specifically prevent such behavior.

Physiological and training characteristics of recreational marathon runners.

PubMed

Gordon, Dan; Wightman, Sarah; Basevitch, Itay; Johnstone, James; Espejo-Sanchez, Carolina; Beckford, Chelsea; Boal, Mariette; Scruton, Adrian; Ferrandino, Mike; Merzbach, Viviane

2017-01-01

The aim of this study was to examine the physical and training characteristics of recreational marathon runners within finish time bandings (2.5-3 h, 3-3.5 h, 3.5-4 h, 4-4.5 h and >4.5 h). A total of 97 recreational marathon runners (age 42.4 ± 9.9 years; mass 69.2 ± 11.3 kg; stature 172.8 ± 9.1 cm), with a marathon finish time of 229.1 ± 48.7 min, of whom n = 34 were female and n = 63 were male, completed an incremental treadmill test for the determination of lactate threshold (LT1), lactate turn point (LT2) and running economy (RE). Following a 7-min recovery, they completed a test to volitional exhaustion starting at LT2 for the assessment of [Formula: see text]. In addition, all participants completed a questionnaire gathering information on their current training regimes exploring weekly distances, training frequencies, types of sessions, longest run in a week, with estimations of training speed, and load and volume derived from these data. Training frequency was shown to be significantly greater for the 2.5-3 h group compared to the 3.5-4 h runners ( P < 0.001) and >4.5 h group ( P = 0.004), while distance per session (km·session -1 ) was significantly greater for the 2.5-3 h group (16.1 ± 4.2) compared to the 3.5-4 h group (15.5 ± 5.2; P = 0.01) and >4.5 h group (10.3 ± 2.6; P = 0.001). Race speed correlated with LT1 ( r = 0.791), LT2 ( r = 0.721) and distance per session ( r = 0.563). The data highlight profound differences for key components of marathon running ([Formula: see text], LT1, LT2, RE and % [Formula: see text]) within a group of recreational runners with the discriminating training variables being training frequency and the absolute training speed.

Course and predicting factors of lower-extremity injuries after running a marathon.

PubMed

van Middelkoop, Marienke; Kolkman, Jelle; van Ochten, John; Bierma-Zeinstra, Sita M A; Koes, Bart W

2007-01-01

To investigate in recreational runners the 3 month prognosis of and medical consumption caused by running injuries occurring shortly before or during a marathon. Possible prognostic factors for persistent complaints were also evaluated. Prospective cohort study. Rotterdam, the Netherlands. One hundred sixty-five recreational marathon runners who reported a new running injury in the month before or during the Rotterdam Marathon 2005 and who were available for follow-up. ASSESSMENT OF DETERMINANTS: Demographic, running (training distance, frequency and duration, experience, etc), lifestyle (other sports, smoking), and injury-related factors were collected at baseline. Persistent complaints of running injuries occurring in the month before or during the Rotterdam marathon at 3 month follow-up. Potential prognostic factors for persistent complaints were analyzed by multivariate logistic regression. At 3 month follow-up, 25.5% of the 165 injured runners reported persistent complaints; they had little pain during exercise and almost no pain in rest. Of all 165 male runners, 27 (16.4%) visited a general practitioner because of their running injury and 40 (24.2%) visited a physiotherapist (218 times in total). Persistent complaints at 3 month follow-up were associated with non-musculoskeletal comorbidities [odds ratio (OR), 3.23; confidence interval (CI), 1.24-8.43], and calf injuries (OR, 0.37; CI, 0.13-1.05). One quarter of the runners had persistent complaints of their marathon-related running injury at 3 month follow-up. However, the clinical and social consequences of the injuries seem to be relatively mild. Non-musculoskeletal comorbidities at baseline are related to poor recovery, whereas recovery is also location specific.

Protein Supplementation During or Following a Marathon Run Influences Post-Exercise Recovery

PubMed Central

Saunders, Michael J.; Luden, Nicholas D.; DeWitt, Cash R.; Gross, Melinda C.; Dillon Rios, Amanda

2018-01-01

The effects of protein supplementation on the ratings of energy/fatigue, muscle soreness [ascending (A) and descending (D) stairs], and serum creatine kinase levels following a marathon run were examined. Variables were compared between recreational male and female runners ingesting carbohydrate + protein (CP) during the run (CPDuring, n = 8) versus those that were consuming carbohydrate (CHODuring, n = 8). In a second study, outcomes were compared between subjects who consumed CP or CHO immediately following exercise [CPPost (n = 4) versus CHOPost (n = 4)]. Magnitude-based inferences revealed no meaningful differences between treatments 24 h post-marathon. At 72 h, recovery [Δ(72 hr-Pre)] was likely improved with CPDuring versus CHODuring, respectively, for Physical Energy (+14 ± 64 vs −74 ± 70 mm), Mental Fatigue (−52 ± 59 vs +1 ± 11 mm), and Soreness-D (+15 ± 9 vs +21 ± 70 mm). In addition, recovery at 72 h was likely-very likely improved with CPPost versus CHOPost for Physical Fatigue, Mental Energy, and Soreness-A. Thus, protein supplementation did not meaningfully alter recovery during the initial 24 h following a marathon. However, ratings of energy/fatigue and muscle soreness were improved over 72 h when CP was consumed during exercise, or immediately following the marathon. PMID:29534444

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

Diagnostic accuracy of quantitative PCR (Xpert MTB/RIF) for tuberculous meningitis in a high burden setting: a prospective study.

PubMed

Patel, Vinod B; Theron, Grant; Lenders, Laura; Matinyena, Brian; Connolly, Cathy; Singh, Ravesh; Coovadia, Yacoob; Ndung'u, Thumbi; Dheda, Keertan

2013-10-01

Tuberculous meningitis (TBM) is difficult to diagnose promptly. The utility of the Xpert MTB/RIF test for the diagnosis of TBM remains unclear, and the effect of host- and sample-related factors on test performance is unknown. This study sought to evaluate the sensitivity and specificity of Xpert MTB/RIF for the diagnosis of TBM. 235 South-African patients with a meningeal-like illness were categorised as having definite (culture or Amplicor PCR positive), probable (anti-TBM treatment initiated but microbiological confirmation lacking), or non-TBM. Xpert MTB/RIF accuracy was evaluated using 1 ml of uncentrifuged and, when available, 3 ml of centrifuged cerebrospinal fluid (CSF). To evaluate the incremental value of MTB/RIF over a clinically based diagnosis, test accuracy was compared to a clinical score (CS) derived using basic clinical and laboratory information. Of 204 evaluable patients (of whom 87% were HIV-infected), 59 had definite TBM, 64 probable TBM, and 81 non-TBM. Overall sensitivity and specificity (95% CI) were 62% (48%-75%) and 95% (87%-99%), respectively. The sensitivity of Xpert MTB/RIF was significantly better than that of smear microscopy (62% versus 12%; p = 0.001) and significantly better than that of the CS (62% versus 30%; p = 0.001; C statistic 85% [79%-92%]). Xpert MTB/RIF sensitivity was higher when centrifuged versus uncentrifuged samples were used (82% [62%-94%] versus 47% [31%-61%]; p = 0.004). The combination of CS and Xpert MTB/RIF (Xpert MTB/RIF performed if CS<8) performed as well as Xpert MTB/RIF alone but with a ∼10% reduction in test usage. This overall pattern of results remained unchanged when the definite and probable TBM groups were combined. Xpert MTB/RIF was not useful in identifying TBM among HIV-uninfected individuals, although the sample was small. There was no evidence of PCR inhibition, and the limit of detection was ∼80 colony forming units per millilitre. Study limitations included a predominantly HIV

Diagnostic Accuracy of Quantitative PCR (Xpert MTB/RIF) for Tuberculous Meningitis in a High Burden Setting: A Prospective Study

PubMed Central

Patel, Vinod B.; Theron, Grant; Lenders, Laura; Matinyena, Brian; Connolly, Cathy; Singh, Ravesh; Coovadia, Yacoob; Ndung'u, Thumbi; Dheda, Keertan

2013-01-01

Background Tuberculous meningitis (TBM) is difficult to diagnose promptly. The utility of the Xpert MTB/RIF test for the diagnosis of TBM remains unclear, and the effect of host- and sample-related factors on test performance is unknown. This study sought to evaluate the sensitivity and specificity of Xpert MTB/RIF for the diagnosis of TBM. Methods and Findings 235 South-African patients with a meningeal-like illness were categorised as having definite (culture or Amplicor PCR positive), probable (anti-TBM treatment initiated but microbiological confirmation lacking), or non-TBM. Xpert MTB/RIF accuracy was evaluated using 1 ml of uncentrifuged and, when available, 3 ml of centrifuged cerebrospinal fluid (CSF). To evaluate the incremental value of MTB/RIF over a clinically based diagnosis, test accuracy was compared to a clinical score (CS) derived using basic clinical and laboratory information. Of 204 evaluable patients (of whom 87% were HIV-infected), 59 had definite TBM, 64 probable TBM, and 81 non-TBM. Overall sensitivity and specificity (95% CI) were 62% (48%–75%) and 95% (87%–99%), respectively. The sensitivity of Xpert MTB/RIF was significantly better than that of smear microscopy (62% versus 12%; p = 0.001) and significantly better than that of the CS (62% versus 30%; p = 0.001; C statistic 85% [79%–92%]). Xpert MTB/RIF sensitivity was higher when centrifuged versus uncentrifuged samples were used (82% [62%–94%] versus 47% [31%–61%]; p = 0.004). The combination of CS and Xpert MTB/RIF (Xpert MTB/RIF performed if CS<8) performed as well as Xpert MTB/RIF alone but with a ∼10% reduction in test usage. This overall pattern of results remained unchanged when the definite and probable TBM groups were combined. Xpert MTB/RIF was not useful in identifying TBM among HIV-uninfected individuals, although the sample was small. There was no evidence of PCR inhibition, and the limit of detection was ∼80 colony forming units per millilitre. Study

Nonlytic Fc-fused IL-7 synergizes with Mtb32 DNA vaccine to enhance antigen-specific T cell responses in a therapeutic model of tuberculosis.

PubMed

Ahn, So-Shin; Jeon, Bo-Young; Park, Seong-Jeong; Choi, Dong-Hoon; Ku, Sun-Hwa; Cho, Sang-Nae; Sung, Young-Chul

2013-06-12

Improvement to the immunogenicity of DNA vaccines was evaluated in a Mycobacterium tuberculosis (MTB) infection mouse model examining the combined effects of nonlytic Fc-fused IL-7 DNA (IL-7-nFc) and Flt3-ligand fused Mtb32 (F-Mtb32) DNA. Mice were treated with conventional chemotherapy for 6 weeks from 4 weeks after aerosol infection of MTB. Following the start of chemotherapy, DNA immunizations were administered five times with 2-week intervals. Coadministration of IL-7-nFc and F-Mtb32 DNA given during chemotherapy synergistically enhanced the magnitude of Mtb32-specific T cell responses and sustained for one-year after the last immunization assessed by IFN-γ ELISPOT assay. After dexamethasone treatment, a significantly reduced MTB reactivation was observed in mice received both IL-7-nFc and F-Mtb32 DNA, compared with F-MTb32 DNA alone or with control mice. In addition, mice treated with IL-7-nFc and F-Mtb32 DNA together showed improved lung pathology and reduced pulmonary inflammation values relative to F-Mtb32 DNA or saline injected mice. Intracellular cytokine staining revealed that the protection levels induced by combination therapy with IL-7-nFc and F-Mtb32 DNA was associated with enhanced Mtb32-specific IFN-γ secreting CD4(+) T cell responses and CD8(+) T cell responses stimulated with CTL epitope peptide in the lungs and spleens. These data suggest that IL-7-nFc as a novel TB adjuvant may facilitate therapeutic TB DNA vaccine to the clinics through significant enhancement of codelivered DNA vaccine-induced T cell immunity. Copyright © 2013 Elsevier Ltd. All rights reserved.

Rifampicin resistance mutations in the 81 bp RRDR of rpoB gene in Mycobacterium tuberculosis clinical isolates using Xpert MTB/RIF in Khyber Pakhtunkhwa, Pakistan: a retrospective study.

PubMed

Ullah, Irfan; Shah, Aamer Ali; Basit, Anila; Ali, Mazhar; Khan, Afsar; Ullah, Ubaid; Ihtesham, Muhammad; Mehreen, Sumaira; Mughal, Anita; Javaid, Arshad

2016-08-12

Multi-drug resistant tuberculosis (MDR-TB) is a major public health problem especially in developing countries. World Health Organization (WHO) recommends use of Xpert MTB/RIF assay to simultaneously detecting Mycobacterium tuberculosis (MTB) and rifampicin (RIF) resistance. The primary objective of this study was to determine the frequency of MDR-TB in patients suspected to have drug resistance in Khyber Pakhtunkhwa. The frequency of probes for various rpoB gene mutations using Xpert MTB/RIF assay within 81 bp RRDR (Rifampicin Resistance Determining Region) was the secondary objective. A total of 2391 specimens, received at Programmatic Management of Drug Resistant TB (PMDT) Unit, Lady Reading Hospital (LRH) Peshawar, Pakistan, between October 2011 and December 2014, were analyzed by Xpert MTB/RIF test. MTB positive with rifampicin resistance were further analyzed to first line anti-mycobacterial drug susceptibility testing (DST) using middle brook 7H10 medium. The data was analyzed using statistical software; SPSS version 18. Out of 2391 specimens, 1408 (59 %) were found positive for MTB and among them, 408 (29 %) showed rifampicin-resistance with four different rpoB gene mutations within 81 bp RRDR. The frequency of various probes among RIF-resistant isolates was observed as: probe E, in 314 out of 408 isolates; B, 44 out of 408; A, 5 out of 408; D, 34 out of 408; and probe C was observed among 6 out of 408 RIF-resistant isolates. The probe A&B and E&D mutation combination was found in only 1 isolate in each case, while B&D mutation combination was detected among 3 out of 408 RIF-resistant isolates. Hence, it is concluded from our study on a selected population, 29 % of patients had MDR-TB. Probe E related mutations (also known as codon 531and 533) were the most common rpoB genetic mutation [314 (77 %)], acknowledged by Xpert MTB/RIF assay. Least mutation was detected within the sequence 511 (1.2 %).

Diagnostic accuracy of GeneXpert MTB/RIF in musculoskeletal tuberculosis: High sensitivity in tissue samples of HIV-infected and HIV-uninfected patients.

PubMed

Held, M; Laubscher, M; Workman, L; Zar, H J; Dunn, R

2017-09-22

GeneXpert MTB/RIF is useful for the diagnosis of pulmonary TB in adults, but there is limited evidence on its usefulness in extrapulmonary TB. To investigate the diagnostic accuracy of GeneXpert MTB/RIF in HIV-infected and HIV-uninfected patients with suspected musculoskeletal TB. A prospective study of patients with suspected musculoskeletal (bone and joint) TB was undertaken. The diagnostic accuracy of GeneXpert MTB/RIF was compared with the reference standards of culture and histopathology. A total of 206 biopsies from 201 patients (23% HIV-infected) were evaluated. The sensitivity and specificity of GeneXpert MTB/RIF was 92.3% (84/91) and 99.1% (114/115), respectively. GeneXpert MTB/RIF detected 8.8% more cases than culture (84/91 (92.3%) v. 76/91 (83.5%), respectively; p=0.069). GeneXpert MTB/RIF also detected all 4 multidrug-resistant TB cases and an additional 2 rifampicin-resistant cases in culture-negative samples. The sensitivity of GeneXpert MTB/RIF in HIV-infected patients was 96.9% (31/32) v. 89.6% (43/48) in HIV-uninfected patients (p=0.225). GeneXpert MTB/RIF is an accurate test for the detection of TB in tissue samples of HIV-infected and HIV-uninfected patients with suspected musculoskeletal TB. A positive GeneXpert MTB/RIF result should be regarded as microbiological confirmation of TB.

Do adjunct tuberculosis tests, when combined with Xpert MTB/RIF, improve accuracy and the cost of diagnosis in a resource-poor setting?

PubMed Central

Theron, Grant; Pooran, Anil; Peter, Jonny; van Zyl-Smit, Richard; Mishra, Hridesh Kumar; Meldau, Richard; Calligaro, Greg; Allwood, Brian; Sharma, Surendra Kumar; Dawson, Rod; Dheda, Keertan

2017-01-01

Information regarding the utility of adjunct diagnostic tests in combination with Xpert MTB/RIF (Cepheid, Sunnyvale, CA, USA) is limited. We hypothesised adjunct tests could enhance accuracy and/or reduce the cost of tuberculosis (TB) diagnosis prior to MTB/RIF testing, and rule-in or rule-out TB in MTB/RIF-negative individuals. We assessed the accuracy and/or laboratory-associated cost of diagnosis of smear microscopy, chest radiography (CXR) and interferon-γ release assays (IGRAs; T-SPOT-TB (Oxford Immunotec, Oxford, UK) and QuantiFERON-TB Gold In-Tube (Cellestis, Chadstone, Australia)) combined with MTB/RIF for TB in 480 patients in South Africa. When conducted prior to MTB/RIF: 1) smear microscopy followed by MTB/RIF (if smear negative) had the lowest cost of diagnosis of any strategy investigated; 2) a combination of smear microscopy, CXR (if smear negative) and MTB/RIF (if imaging compatible with active TB) did not further reduce the cost per TB case diagnosed; and 3) a normal CXR ruled out TB in 18% of patients (57 out of 324; negative predictive value (NPV) 100%). When downstream adjunct tests were applied to MTB/RIF-negative individuals, radiology ruled out TB in 24% (56 out of 234; NPV 100%), smear microscopy ruled in TB in 21% (seven out of 24) of culture-positive individuals and IGRAs were not useful in either context. In resource-poor settings, smear microscopy combined with MTB/RIF had the highest accuracy and lowest cost of diagnosis compared to either technique alone. In MTB/RIF-negative individuals, CXR has poor rule-in value but can reliably rule out TB in approximately one in four cases. These data inform upon the programmatic utility of MTB/RIF in high-burden settings. PMID:22075479

Unstable rocker shoes promote recovery from marathon-induced muscle damage in novice runners.

PubMed

Nakagawa, K; Inami, T; Yonezu, T; Kenmotsu, Y; Narita, T; Kawakami, Y; Kanosue, K

2018-02-01

We recently reported that wearing unstable rocker shoes (Masai Barefoot Technology: MBT) may enhance recovery from marathon race-induced fatigue. However, this earlier study only utilized a questionnaire. In this study, we evaluated MBT utilizing objective physiological measures of recovery from marathon-induced muscle damages. Twenty-five university student novice runners were divided into two groups. After running a full marathon, one group wore MBT shoes (MBT group), and the control group (CON) wore ordinary shoes daily for 1 week following the race. We measured maximal isometric joint torque, muscle hardness (real time tissue elastography of the strain ratio) in the lower limb muscles before, immediately after, and 1, 3, and 8 days following the marathon. We calculated the magnitude of recovery by observing the difference in each value between the first measurement and the latter measurements. Results showed that isometric torques in knee flexion recovered at the first day after the race in the MBT group while it did not recover even at the eighth day in the CON group. Muscle hardness in the gastrocnemius and vastus lateralis showed enhanced recovery in the MBT group in comparison with the CON group. Also for muscle hardness in the tibialis anterior and biceps femoris, the timing of recovery was delayed in the CON group. In conclusion, wearing MBT shoes enhanced recovery in lower leg and thigh muscles from muscle damage induced by marathon running. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The influence of training and mental skills preparation on injury incidence and performance in marathon runners.

PubMed

Hamstra-Wright, Karrie L; Coumbe-Lilley, John E; Kim, Hajwa; McFarland, Jose A; Huxel Bliven, Kellie C

2013-10-01

There has been a considerable increase in the number of participants running marathons over the past several years. The 26.2-mile race requires physical and mental stamina to successfully complete it. However, studies have not investigated how running and mental skills preparation influence injury and performance. The purpose of our study was to describe the training and mental skills preparation of a typical group of runners as they began a marathon training program, assess the influence of training and mental skills preparation on injury incidence, and examine how training and mental skills preparation influence marathon performance. Healthy adults (N = 1,957) participating in an 18-week training program for a fall 2011 marathon were recruited for the study. One hundred twenty-five runners enrolled and received 4 surveys: pretraining, 6 weeks, 12 weeks, posttraining. The pretraining survey asked training and mental skills preparation questions. The 6- and 12-week surveys asked about injury incidence. The posttraining survey asked about injury incidence and marathon performance. Tempo runs during training preparation had a significant positive relationship to injury incidence in the 6-week survey (ρ[93] = 0.26, p = 0.01). The runners who reported incorporating tempo and interval runs, running more miles per week, and running more days per week in their training preparation ran significantly faster than did those reporting less tempo and interval runs, miles per week, and days per week (p ≤ 0.05). Mental skills preparation did not influence injury incidence or marathon performance. To prevent injury, and maximize performance, while marathon training, it is important that coaches and runners ensure that a solid foundation of running fitness and experience exists, followed by gradually building volume, and then strategically incorporating runs of various speeds and distances.

Online pre-race education improves test scores for volunteers at a marathon.

PubMed

Maxwell, Shane; Renier, Colleen; Sikka, Robby; Widstrom, Luke; Paulson, William; Christensen, Trent; Olson, David; Nelson, Benjamin

2017-09-01

This study examined whether an online course would lead to increased knowledge about the medical issues volunteers encounter during a marathon. Health care professionals who volunteered to provide medical coverage for an annual marathon were eligible for the study. Demographic information about medical volunteers including profession, specialty, education level and number of marathons they had volunteered for was collected. A 15-question test about the most commonly encountered medical issues was created by the authors and administered before and after the volunteers took the online educational course and compared to a pilot study the previous year. Seventy-four subjects completed the pre-test. Those who participated in the pilot study last year (N = 15) had pre-test scores that were an average of 2.4 points higher than those who did not (mean ranks: pilot study = 51.6 vs. non-pilot = 33.9, p = 0.004). Of the 74 subjects who completed the pre-test, 54 also completed the post-test. The overall post-pre mean score difference was 3.8 ± 2.7 (t = 10.5 df = 53 p < 0.001). While subjects with all levels of volunteer experience demonstrated improvement, only change among first time marathon volunteers was significantly different from the others. Subjects reporting all degree/certification levels demonstrated improvement, but no difference in improvement was found between degree/certification levels. In this follow-up to the previous year's pilot study, online education demonstrated a long-term (one-year) increase in test scores. Testing also continued to show short-term improvement in post-course test scores, compared to pre-course test scores. In general, marathon medical volunteers who had no volunteer experience demonstrated greater improvement than those who had prior volunteer experience.

Exercise-associated hyponatraemia after a marathon: case series

PubMed Central

Goudie, A M; Tunstall-Pedoe, D S; Kerins, M; Terris, J

2006-01-01

Objectives To review the presentation, treatment and response of those runners from the London Marathon who presented to St Thomas' Hospital with exercise induced hyponatraemia. Design Observational case series. Setting St Thomas' Hospital, a tertiary hospital situated near the finish line of the 2003 London Marathon. Participants All runners who presented to St Thomas' Hospital on the day of the 2003 London Marathon with altered mental state whose serum sodium concentration was less than 135 mmol/L. Main outcome measures Presenting symptoms, volume and type of fluids administered and response to treatment (biochemical and clinical). Results Fourteen patients were diagnosed with exercise associated hyponatraemia with serum sodium concentrations ranging from 116 to 133 mmol/L. Eleven presented with confusion. There were long delays between the finish time and presentation time for some runners. Anecdotal descriptions suggested some runners finished the race with normal mental state then became confused. There was no correlation between running time and serum sodium level. All patients received 0.9% saline and six received 1.8% saline. Despite this, some patients demonstrated falls in serum sodium concentrations. Thirteen to fourteen patients were symptomatically well the following morning, with the remaining patient significantly improved. Conclusion Presentation of exercise associated hyponatraemia may be delayed. Optimal treatment is controversial, but the use of isotonic saline may not result in rises of serum sodium and we would suggest the early use of hypertonic fluids in symptomatic patients. PMID:16816267

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)

14 CFR 61.93 - Solo cross-country flight requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... preflight planning and preparation is correct and that the student is prepared to make the flight safely... instructor has: (1) Determined that the student's cross-country planning is correct for the flight; (2... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Solo cross-country flight requirements. 61...

14 CFR 61.93 - Solo cross-country flight requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... preflight planning and preparation is correct and that the student is prepared to make the flight safely... instructor has: (1) Determined that the student's cross-country planning is correct for the flight; (2... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Solo cross-country flight requirements. 61...

14 CFR 61.93 - Solo cross-country flight requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... preflight planning and preparation is correct and that the student is prepared to make the flight safely... instructor has: (1) Determined that the student's cross-country planning is correct for the flight; (2... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Solo cross-country flight requirements. 61...

14 CFR 61.93 - Solo cross-country flight requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... preflight planning and preparation is correct and that the student is prepared to make the flight safely... instructor has: (1) Determined that the student's cross-country planning is correct for the flight; (2... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Solo cross-country flight requirements. 61...

14 CFR 61.93 - Solo cross-country flight requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... preflight planning and preparation is correct and that the student is prepared to make the flight safely... instructor has: (1) Determined that the student's cross-country planning is correct for the flight; (2... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Solo cross-country flight requirements. 61...

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…

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…

The modified turning bands (MTB) model for space-time rainfall. I. Model definition and properties

NASA Astrophysics Data System (ADS)

Mellor, Dale

1996-02-01

A new stochastic model of space-time rainfall, the Modified Turning Bands (MTB) model, is proposed which reproduces, in particular, the movements and developments of rainbands, cluster potential regions and raincells, as well as their respective interactions. The ensemble correlation structure is unsuitable for practical estimation of the model parameters because the model is not ergodic in this statistic, and hence it cannot easily be measured from a single real storm. Thus, some general theory on the internal covariance structure of a class of stochastic models is presented, of which the MTB model is an example. It is noted that, for the MTB model, the internal covariance structure may be measured from a single storm, and can thus be used for model identification.

Age and ultra-marathon performance - 50 to 1,000 km distances from 1969 - 2012.

PubMed

Romer, Tobias; Rüst, Christoph Alexander; Zingg, Matthias Alexander; Rosemann, Thomas; Knechtle, Beat

2014-01-01

We investigated age and performance in distance-limited ultra-marathons held from 50 km to 1,000 km. Age of peak running speed and running speed of the fastest competitors from 1969 to 2012 in 50 km, 100 km, 200 km and 1,000 km ultra-marathons were analyzed using analysis of variance and multi-level regression analyses. The ages of the ten fastest women ever were 40 ± 4 yrs (50 km), 34 ± 7 yrs (100 km), 42 ± 6 yrs (200 km), and 41 ± 5 yrs (1,000 km). The ages were significantly different between 100 km and 200 km and between 100 km and 1,000 km. For men, the ages of the ten fastest ever were 34 ± 6 yrs (50 km), 32 ± 4 yrs (100 km), 44 ± 4 yrs (200 km), and 47 ± 9 yrs (1,000 km). The ages were significantly younger in 50 km compared to 100 km and 200 km and also significantly younger in 100 km compared to 200 km and 1,000 km. The age of the annual ten fastest women decreased in 50 km from 39 ± 8 yrs (1988) to 32 ± 4 yrs (2012) and in men from 35 ± 5 yrs (1977) to 33 ± 5 yrs (2012). In 100 km events, the age of peak running speed of the annual ten fastest women and men remained stable at 34.9 ± 3.2 and 34.5 ± 2.5 yrs, respectively. Peak running speed of top ten runners increased in 50 km and 100 km in women (10.6 ± 1.0 to 15.3 ± 0.7 km/h and 7.3 ± 1.5 to 13.0 ± 0.2 km/h, respectively) and men (14.3 ± 1.2 to 17.5 ± 0.6 km/h and 10.2 ± 1.2 to 15.1 ± 0.2 km/h, respectively). In 200 km and 1,000 km, running speed remained unchanged. In summary, the best male 1,000 km ultra-marathoners were ~15 yrs older than the best male 100 km ultra-marathoners and the best female 1,000 km ultra-marathoners were ~7 yrs older than the best female 100 km ultra-marathoners. The age of the fastest 50 km ultra-marathoners decreased across years whereas it remained unchanged in 100 km ultra-marathoners. These findings may help

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

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.…

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)

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

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. ER11-4357-000] Marathon Power LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes Request for Blanket Section 204 Authorization This is a supplemental notice in the above-referenced proceeding of Marathon...

Warming up with an ice vest: core body temperature before and after cross-country racing.

PubMed

Hunter, Iain; Hopkins, J Ty; Casa, Douglas J

2006-01-01

Athletes running in a hot, humid environment may have an increased risk of heat illness. In the 2004 Olympic Games, American and Australian athletes were provided with ice vests designed to cool their bodies before performance. The vest appeared to be effective in keeping body temperatures down and improving the performance of the marathoners. However, body temperatures have not been reported when the vest was used before an actual competition. To determine if wearing the Nike Ice-Vest decreased core temperature (Tc) before and during athletic performance in warm (26 degrees C to 27 degrees C), humid (relative humidity = 50% to 75%) conditions. A 2 x 3 mixed-model design was used to compare groups (ice vest, no ice vest) across changes in temperature from baseline (10 minutes and 1 minute before the race and immediately after the race). 2005 Big Wave Invitational 4-km race in Hawaii and 2005 Great American 5-km race in North Carolina. Eighteen women from a National Collegiate Athletic Association Division I cross-country team who participated in either the Big Wave Invitational or the Great American Race. Four hours before the start of the race, the athletes ingested radiotelemetry temperature sensors. One hour before the start of the race, Tc was recorded, and half of the athletes donned a Nike Ice-Vest, which was removed immediately before the race. Additional Tc readings were taken at 10 minutes and 1 minute before the start of the race and immediately after the race. Ten minutes before the start of the race, Tc was elevated by 0.84 degrees C +/- 0.37 degrees C in the no-vest group, compared with 0.29 degrees C +/- 0.56 degrees C in the ice-vest group ( P < .01). This difference in Tc persisted at 1 minute before the start. Immediately after the finish, the increase in Tc averaged 2.75 degrees C +/- 0.62 degrees C in the no-vest group and 2.12 degrees C +/- 0.62 degrees C in the ice-vest group ( P < .01). Wearing an ice vest before cross-country performance in

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,…

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…

Skeletal muscle plasticity with marathon training in novice runners.

PubMed

Luden, N; Hayes, E; Minchev, K; Louis, E; Raue, U; Conley, T; Trappe, S

2012-10-01

The purpose of this study was to investigate leg muscle adaptation in runners preparing for their first marathon. Soleus and vastus lateralis (VL) biopsies were obtained from six recreational runners (23 ± 1 years, 61 ± 3 kg) before (T1), after 13 weeks of run training (T2), and after 3 weeks of taper and marathon (T3). Single muscle fiber size, contractile function (strength, speed, and power) and oxidative enzyme activity [citrate synthase (CS)] were measured at all three time points, and fiber type distribution was determined before and after the 16-week intervention. Training increased VO(2max) ∼9% (P<0.05). All soleus parameters were unchanged. VL MHC I fiber diameter increased (+8%; P<0.05) from T1 to T2. VL MHC I V(o) (-12%), MHC I power (-22%) and MHC IIa power (-29%) were reduced from T1 to T2 (P<0.05). No changes in VL single fiber contractile properties were observed from T2 to T3. No change was observed in soleus CS activity, whereas VL CS activity increased 66% (P<0.05). Our observations indicate that modest marathon training elicits very specific skeletal muscle adaptations that likely support the ability to perform 42.2 km of continuous running - further strengthening the existing body of evidence for skeletal muscle specificity. © 2011 John Wiley & Sons A/S.

Physiological and training characteristics of recreational marathon runners

PubMed Central

Gordon, Dan; Wightman, Sarah; Basevitch, Itay; Johnstone, James; Espejo-Sanchez, Carolina; Beckford, Chelsea; Boal, Mariette; Scruton, Adrian; Ferrandino, Mike; Merzbach, Viviane

2017-01-01

Purpose The aim of this study was to examine the physical and training characteristics of recreational marathon runners within finish time bandings (2.5–3 h, 3–3.5 h, 3.5–4 h, 4–4.5 h and >4.5 h). Materials and methods A total of 97 recreational marathon runners (age 42.4 ± 9.9 years; mass 69.2 ± 11.3 kg; stature 172.8 ± 9.1 cm), with a marathon finish time of 229.1 ± 48.7 min, of whom n = 34 were female and n = 63 were male, completed an incremental treadmill test for the determination of lactate threshold (LT1), lactate turn point (LT2) and running economy (RE). Following a 7-min recovery, they completed a test to volitional exhaustion starting at LT2 for the assessment of V˙O2max. In addition, all participants completed a questionnaire gathering information on their current training regimes exploring weekly distances, training frequencies, types of sessions, longest run in a week, with estimations of training speed, and load and volume derived from these data. Results Training frequency was shown to be significantly greater for the 2.5–3 h group compared to the 3.5–4 h runners (P < 0.001) and >4.5 h group (P = 0.004), while distance per session (km·session−1) was significantly greater for the 2.5–3 h group (16.1 ± 4.2) compared to the 3.5–4 h group (15.5 ± 5.2; P = 0.01) and >4.5 h group (10.3 ± 2.6; P = 0.001). Race speed correlated with LT1 (r = 0.791), LT2 (r = 0.721) and distance per session (r = 0.563). Conclusion The data highlight profound differences for key components of marathon running (V˙O2max, LT1, LT2, RE and % V˙O2max) within a group of recreational runners with the discriminating training variables being training frequency and the absolute training speed. PMID:29200895

Diagnostic Accuracy of Xpert MTB/RIF for Extrapulmonary Tuberculosis Specimens: Establishing a Laboratory Testing Algorithm for South Africa

PubMed Central

Beylis, Natalie; Nicol, Mark; Nkuna, Gloria; Molapo, Sebaka; Berrie, Leigh; Duse, Adriano; Stevens, Wendy Susan

2014-01-01

South Africa implemented Xpert MTB/RIF as the initial diagnostic test for pulmonary tuberculosis (TB). Xpert MTB/RIF's accuracy for diagnosing extrapulmonary tuberculosis (EPTB) was investigated. EPTB specimens (n = 7,916) from hospitalized patients received over a 6-month period at a high-throughput TB referral laboratory in Johannesburg were investigated. Large-volume specimens were centrifuged, tissue biopsy specimens homogenized, and all specimens checked for growth of contaminating bacteria on blood agar. Contaminated samples received NALC-NaOH (N-acetyl-l-cysteine–sodium hydroxide) decontamination prior to liquid culture. Residual specimens (volumes > 1 ml) after inoculation of culture (n = 1,175) were tested using the Xpert MTB/RIF sputum protocol. Using culture as the reference, Xpert MTB/RIF's overall sensitivity was 59% (95% confidence interval [95% CI], 53% to 65%) and specificity was 92% (CI, 90% to 94%), with the highest sensitivities of 91% (95% CI, 78% to 97%) for pus, 80% (95% CI, 56% to 94%) for lymph node aspirates, and 51% (95% CI, 44% to 58%) for fluids (ascitic, 59%; pleural, 47%). A difference in sensitivities was noticed between specimens classified as having a thick (87% [95% CI, 76% to 94%]) versus clear (watery) (48% [95% CI, 36% to 61%]) appearance. This was unchanged with traces of blood (52% [95% CI, 44% to 60%]) or precentrifugation (57% [95% CI, 28% to 82%]) among clear specimens. Xpert MTB/RIF generated an additional 124 specimen results that were contaminated by Mycobacterial Growth Indicator Tubes (MGIT; 10.5%) and diagnosed rifampin (RIF) resistance earlier (9.6% [25/260]). Xpert MTB/RIF's performance on EPTB specimens provides very promising results and should be considered for incorporation into national TB guidelines. Xpert MTB/RIF is less affected by contaminating bacteria and reduces laboratory labor and diagnostic delay compared to traditional methods. PMID:24622091

Developing a Data Visualization System for the Bank of America Chicago Marathon (Chicago, Illinois USA).

PubMed

Hanken, Taylor; Young, Sam; Smilowitz, Karen; Chiampas, George; Waskowski, David

2016-10-01

As one of the largest marathons worldwide, the Bank of America Chicago Marathon (BACCM; Chicago, Illinois USA) accumulates high volumes of data. Race organizers and engaged agencies need the ability to access specific data in real-time. This report details a data visualization system designed for the Chicago Marathon and establishes key principles for event management data visualization. The data visualization system allows for efficient data communication among the organizing agencies of Chicago endurance events. Agencies can observe the progress of the race throughout the day and obtain needed information, such as the number and location of runners on the course and current weather conditions. Implementation of the system can reduce time-consuming, face-to-face interactions between involved agencies by having key data streams in one location, streamlining communications with the purpose of improving race logistics, as well as medical preparedness and response. Hanken T , Young S , Smilowitz K , Chiampas G , Waskowski D . Developing a data visualization system for the Bank of America Chicago Marathon (Chicago, Illinois USA). Prehosp Disaster Med. 2016;31(5):572-577.

Women show similar central and peripheral fatigue to men after half-marathon.

PubMed

Boccia, Gennaro; Dardanello, Davide; Tarperi, Cantor; Festa, Luca; La Torre, Antonio; Pellegrini, Barbara; Schena, Federico; Rainoldi, Alberto

2018-06-01

Women are known to be less fatigable than men in single-joint exercises, but fatigue induced by running has not been well understood. Here we investigated sex differences in central and peripheral fatigue and in rate of force development (RFD) in the knee extensors after a half-marathon run. Ten male and eight female amateur runners (aged 25-50 years) were evaluated before and immediately after a half-marathon race. Knee extensors forces were obtained under voluntary and electrically evoked isometric contractions. Maximal voluntary isometric contraction (MVC) force and peak RFD were recorded. Electrically doublet stimuli were delivered during the MVC and at rest to calculate the level of voluntary activation and the resting doublet twitch. After the race, decreases in MVC force (males: -11%, effect size [ES] 0.52; females: -11% ES 0.33), voluntary activation (males: -6%, ES 0.87; females: -4%, ES 0.72), and resting doublet twitch (males: -6%, ES 0.34; females: -8%, ES 0.30) were found to be similar between males and females. The decrease in peak RFD was found to be similar between males and females (males: -14%, ES 0.43; females: -15%, ES 0.14). Half-marathon run induced both central and peripheral fatigue, without any difference between men and women. The maximal and explosive strength loss was found similar between sexes. Together, these findings do not support the need of sex-specific training interventions to increase the tolerance to neuromuscular fatigue in half-marathoners.

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...

Performance of the Xpert MTB/RIF assay in the diagnosis of tuberculosis in formalin-fixed, paraffin-embedded tissues.

PubMed

Polepole, Pascal; Kabwe, Mwila; Kasonde, Mpanga; Tembo, John; Shibemba, Aaron; O'Grady, Justin; Kapata, Nathan; Zumla, Alimuddin; Bates, Matthew

2017-01-01

Extrapulmonary tuberculosis (EPTB), which accounts for 10%-40% of the global burden of TB, with the highest incidence in Sub-Saharan Africa, is strongly associated with human immunodeficiency virus infection. Diagnosing EPTB is challenging, and recently, there has been a concerted effort to evaluate the latest molecular diagnostics for diagnosing TB in a range of specimen types. The Xpert MTB/RIF assay (Cepheid, Sunnyvale, CA, USA) is one such technology, which simultaneously detects Mycobacterium tuberculosis and rifampicin resistance. Our objective was to evaluate the accuracy of the Xpert MTB/RIF assay for the diagnosis of EPTB and detection of rifampicin resistance in routinely processed formalin-fixed, paraffin-embedded (FFPE) tissues, compared with histological detection of TB as the gold standard. A convenience set of 100 biobanked FFPE tissues, including lymph nodes (n = 64), male genital tract tissue (n = 10), abdominal tissue (n = 8), female genital tissue (n = 5), breast tissue (n = 5), synovial tissue (n = 4), skin (n = 2), tongue tissue (n = 1), and thyroid (n = 1), from routine cases of clinically suspected EPTB admitted to the University Teaching Hospital, Lusaka, Zambia, were analyzed using the Xpert MTB/RIF assay and in-house polymerase chain reaction (PCR) assay targeting IS6110, in parallel with Ziehl-Neelsen (ZN) staining, against histology as the gold standard. Some 66% of specimens had histological evidence of TB infection. ZN staining was positive for TB in 8% of cases, and Xpert MTB/RIF was positive for TB in 25% of cases. Taking histology as the gold standard, the sensitivity and specificity were as follows: In lymph tissue the accuracy of the Xpert MTB/RIF assay was 41% (95%CI 27-57), not significantly better than ZN or the in-house PCR assay. In non-lymph tissue the sensitivity of the in-house PCR assay was 82% (95%CI: 56%-95%), significantly higher than the Xpert MTB/RIF assay (P = 0.004). The Xpert MTB/RIF assay indicated rifampicin

Rifampicin Resistance and Multidrug-Resistant Tuberculosis Detection Using Xpert MTB/RIF in Wuhan, China: A Retrospective Study.

PubMed

Huang, Hai; Zhang, Yanlin; Li, Sheng; Wang, Jun; Chen, Jun; Pan, Zhiyun; Gan, Hui

2018-06-01

The Xpert MTB/RIF test (Cepheid, Sunnyvale, CA) can simultaneously detect the Mycobacterium tuberculosis (MTB) complex DNA and rifampicin (RFP) resistance and can rapidly determine RFP resistance and predict multidrug-resistant tuberculosis (MDR-TB). In this study, we analyzed clinical examination results of a hospital specializing in TB treatment in Wuhan, Hubei, China, and examined the use of traditional culture and drug-sensitive test (DST) results as a gold standard to assess the diagnosis value of the Xpert MTB/RIF test in RFP resistance and MDR-TB. A total of 2,910 specimens were received in the Mycobacteriology Laboratory, Wuhan Pulmonary Hospital, for Xpert MTB/RIF testing between December 2013 and December 2014. After the results were reviewed by exclusion criteria, 1,066 Xpert test results were eligible for our study. We then compared the Xpert test results with sputum acid-fast bacilli staining, cultures, and DST results. In total, Xpert correctly identified 96.71% (147/152) RFP-resistant TB and 98.25% (898/914) RFP-sensitive TB specimens. Of the 147 RFP-resistant TB specimens detected by Xpert, 122 MDR-TB (82.99%) were identified by traditional culture and DST techniques. Xpert can simultaneously detect MTB and RFP resistance with high sensitivity and specificity. Thus, Xpert testing aids in saving a considerable amount of time in the diagnosis and treatment of MDR-TB.

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

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Safety zone; Marathon Oil Refinery construction, Rouge River, Detroit, MI. 165.T09-0333 Section 165.T09-0333 Navigation and Navigable... Coast Guard District § 165.T09-0333 Safety zone; Marathon Oil Refinery construction, Rouge River...

Risk factors associated with cluster size of Mycobacterium tuberculosis (Mtb) of different RFLP lineages in Brazil.

PubMed

Peres, Renata Lyrio; Vinhas, Solange Alves; Ribeiro, Fabíola Karla Correa; Palaci, Moisés; do Prado, Thiago Nascimento; Reis-Santos, Bárbara; Zandonade, Eliana; Suffys, Philip Noel; Golub, Jonathan E; Riley, Lee W; Maciel, Ethel Leonor

2018-02-08

Tuberculosis (TB) transmission is influenced by patient-related risk, environment and bacteriological factors. We determined the risk factors associated with cluster size of IS6110 RFLP based genotypes of Mycobacterium tuberculosis (Mtb) isolates from Vitoria, Espirito Santo, Brazil. Cross-sectional study of new TB cases identified in the metropolitan area of Vitoria, Brazil between 2000 and 2010. Mtb isolates were genotyped by the IS6110 RFLP, spoligotyping and RD Rio . The isolates were classified according to genotype cluster sizes by three genotyping methods and associated patient epidemiologic characteristics. Regression Model was performed to identify factors associated with cluster size. Among 959 Mtb isolates, 461 (48%) cases had an isolate that belonged to an RFLP cluster, and six clusters with ten or more isolates were identified. Of the isolates spoligotyped, 448 (52%) were classified as LAM and 412 (48%) as non-LAM. Our regression model found that 6-9 isolates/RFLP cluster were more likely belong to the LAM family, having the RD Rio genotype and to be smear-positive (adjusted OR = 1.17, 95% CI 1.08-1.26; adjusted OR = 1.25, 95% CI 1.14-1.37; crude OR = 2.68, 95% IC 1.13-6.34; respectively) and living in a Serra city neighborhood decrease the risk of being in the 6-9 isolates/RFLP cluster (adjusted OR = 0.29, 95% CI, 0.10-0.84), than in the others groups. Individuals aged 21 to 30, 31 to 40 and > 50 years were less likely of belonging the 2-5 isolates/RFLP cluster than unique patterns compared to individuals < 20 years of age (adjusted OR = 0.49, 95% CI 0.28-0.85, OR = 0.43 95% CI 0.24-0.77and OR = 0. 49, 95% CI 0.26-0.91), respectively. The extrapulmonary disease was less likely to occur in those infected with strains in the 2-5 isolates/cluster group (adjustment OR = 0.45, 95% CI 0.24-0.85) than unique patterns. We found that a large proportion of new TB infections in Vitoria is caused by prevalent Mtb genotypes

GeneXpert MTB/RIF Testing in the Management of Patients with Active Tuberculosis; A Real Life Experience from Saudi Arabia.

PubMed

Omrani, Ali S; Al-Otaibi, Mohammed F; Al-Ateah, Souad M; Al-Onazi, Fahad M; Baig, Kamran; El-Khizzi, Noura A; Albarrak, Ali M

2014-03-01

GeneXpert MTB/RIF is a real-time PCR assay with established diagnostic performance in pulmonary and extra-pulmonary forms of tuberculosis. The aim of this study was to assess the contribution of GeneXpert MTB/RIF assay to the management of patients with any form of active tuberculosis in a single large tertiary center in Saudi Arabia, with a special focus on the impact on time to start of antituberculous therapy compared with Ziehl-Neelsen (ZN) smears and mycobacterial cultures. Clinical, radiological and laboratory records for all patients who were commenced on antituberculous therapy between March 2011 and February 2013 were retrospectively reviewed. A total of 140 patients were included, 38.6% of which had pulmonary tuberculosis. GeneXpert MTB/RIF was requested for only 39.2% of patients and was the only reason for starting antituberculous therapy for only 12.1%. The median time to a positive GeneXpert MTB/RIF result was 0 days (IQR 3) compared with 0 day (IQR 1) for smear microscopy (P > 0.999) and 22 days (IQR 21) for mycobacterial cultures (P < 0.001). No patients discontinued antituberculous therapy because of a negative GeneXpert MTB/RIF result. In a setting wherein physicians are highly experienced in the diagnosis and treatment of tuberculosis, GeneXpert MTB/RIF was remarkably under-utilized and had only a limited impact on decisions related to starting or stopping antituberculous therapy. Cost-effectiveness and clinical utility of routine testing of all smear-negative clinical samples submitted for tuberculosis investigations by GeneXpert MTB/RIF warrant further study.

Recovery following a marathon: a comparison of cold water immersion, whole body cryotherapy and a placebo control.

PubMed

Wilson, Laura J; Cockburn, Emma; Paice, Katherine; Sinclair, Scott; Faki, Tanwir; Hills, Frank A; Gondek, Marcela B; Wood, Alyssa; Dimitriou, Lygeri

2018-01-01

Cryotherapy is an increasingly popular recovery strategy used in an attempt to attenuate the negative impact of strenuous physical activity on subsequent exercise. Therefore, this study aimed to assess the effects of whole body cryotherapy (WBC) and cold water immersion (CWI) on markers of recovery following a marathon. Thirty-one endurance trained males completed a marathon. Participants were randomly assigned to a CWI, WBC or placebo group. Perceptions of muscle soreness, training stress and markers of muscle function were recorded before the marathon and at 24 and 48 h post exercise. Blood samples were taken at baseline, post intervention and 24 and 48 h post intervention to assess inflammation and muscle damage. WBC had a harmful effect on muscle function compared to CWI post marathon. WBC positively influenced perceptions of training stress compared to CWI. With the exception of C-reactive protein (CRP) at 24 and 48 h, neither cryotherapy intervention positively influenced blood borne markers of inflammation or structural damage compared to placebo. The findings show WBC has a negative impact on muscle function, perceptions of soreness and a number of blood parameters compared to CWI, contradicting the suggestion that WBC may be a superior recovery strategy. Further, cryotherapy is no more effective than a placebo intervention at improving functional recovery or perceptions of training stress following a marathon. These findings lend further evidence to suggest that treatment belief and the placebo effect may be largely responsible for the beneficial effects of cryotherapy on recovery following a marathon.

The utility of Xpert MTB/RIF performed on bronchial washings obtained in patients with suspected pulmonary tuberculosis in a high prevalence setting.

PubMed

Barnard, Dewald A; Irusen, Elvis M; Bruwer, Johannes W; Plekker, Danté; Whitelaw, Andrew C; Deetlefs, Jacobus D; Koegelenberg, Coenraad F N

2015-09-16

Xpert MTB/RIF has been shown to have a superior sensitivity to microscopy for acid fast bacilli (AFB) in sputum and has been recommended as a standard first line investigation for pulmonary tuberculosis (PTB). Bronchoscopy is a valuable tool in diagnosing PTB in sputum negative patients. There is limited data on the utility of Xpert MTB/RIF performed on bronchial lavage specimens. Our aim was to evaluate the diagnostic efficiency of Xpert MTB/RIF performed on bronchial washings in sputum scarce/negative patients with suspected PTB. All patients with a clinical and radiological suspicion of PTB who underwent bronchoscopy between January 2013 and April 2014 were included. The diagnostic efficiencies of Xpert MTB/RIF and microscopy for AFB were compared to culture for Mycobacterium tuberculosis. Thirty nine of 112 patients were diagnosed with culture-positive PTB. Xpert MTB/RIF was positive in 36/39 with a sensitivity of 92.3% (95% CI 78-98%) for PTB, which was superior to that of smear microscopy (41%; 95% CI 26.0-57.8%, p = 0.005). The specificities of Xpert MTB/RIF and smear microscopy were 87.7% (95% CI 77.4-93.9%) and 98.6% (95% CI 91.6%-99.9%) respectively. Xpert MTB/RIF had a positive predictive value of 80% (95% CI; 65-89.9%) and negative predictive value of 95.5% (95% CI 86.6-98.8%). 3/9 patients with Xpert MTB/RIF positive culture negative results were treated for PTB based on clinical and radiological findings. Xpert MTB/RIF has a higher sensitivity than smear microscopy and similar specificity for the immediate confirmation of PTB in specimens obtained by bronchial washing, and should be utilised in patients with a high suspicion of pulmonary tuberculosis.

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…

Evaluation of the Xpert MTB/RIF Performance on Tissues: Potential Impact on Airborne Infection Isolation at a Tertiary Cancer Care Center.

PubMed

McMillen, Tracy; Usiak, Shauna C; Chen, Liang Hua; Gomez, Luz; Ntiamoah, Peter; Hameed, Meera R; Budvytiene, Indre; Banaei, Niaz; Kamboj, Mini; Babady, N Esther

2018-04-01

OBJECTIVES In this study, we sought to evaluate the performance of the Xpert MTB/RIF (Cepheid) assay for the detection of Mycobacterium tuberculosis (MTB) complex DNA on fresh and formalin-fixed, paraffin-embedded (FFPE) tissue specimens from oncology patients in an area with a low prevalence of tuberculosis. We also aimed to retrospectively assess the potential impact of Xpert MTB/RIF on the duration of airborne infection isolation (AII). SETTING A 473-bed, tertiary-care cancer center in New York City. DESIGN A total of 203 tissue samples (101 FFPE and 102 fresh) were tested using Xpert MTB/RIF, including 133 pulmonary tissue samples (65.5%) and 70 extrapulmonary tissue samples (34.5%). Acid-fast bacilli (AFB) culture was used as the diagnostic gold standard. The limit of detection (LOD) and reproducibility were also evaluated for both samples types using contrived specimens. The potential impact of the Xpert MTB PCR assay on tissue samples from AII patients on AII duration was retrospectively assessed. RESULTS Using the Xpert MTB/RIF for fresh tissue specimens, the sensitivity was 50% (95% CI, 1.3%-98.7%) and the specificity was 99% (95% CI, 94.5%-99.9%). For FFPE tissue specimens, the sensitivity was 100% (95% CI, 63.1%-100%) and the specificity was 98.3% (95% CI, 95.5%-100%. The LOD was 103 colony-forming units (CFU)/mL for both fresh and FFPE tissue specimens, and the Xpert MTB/RIF was 100% reproducible at concentrations 10 times that of the LOD. With an expected turnaround time of 24 hours, the Xpert MTB PCR could decrease the duration of AII from a median of 8 days to a median of 1 day. CONCLUSIONS The Xpert MTB/RIF assay offers a valid option for ruling out Mycobacterium tuberculosis complex (MTBC) on tissue samples from oncology patients and for minimizing AII resource utilization. Infect Control Hosp Epidemiol 2018;39:462-466.

A Comparative Study on the Role of Xpert MTB/RIF in Testing Different Types of Spinal Tuberculosis Tissue Specimens.

PubMed

Tang, Liang; Feng, Shiqing; Gao, Ruixiao; Han, Chenfu; Sun, Xiaochen; Bao, Yucheng; Zhang, Wenlong

2017-12-01

The aim of the present study was to compare the efficacy of the commercial Xpert Mycobacterium tuberculosis/rifampin (MTB/RIF) test for evaluating different types of spinal tuberculosis (TB) tissue specimens. Pus, granulation tissue, and caseous necrotic tissue specimens from 223 patients who were diagnosed with spinal TB and who underwent curettage were collected for bacterial culture and the Xpert MTB/RIF assay to calculate the positive rate. Bacterial culture and phenotypic drug sensitivity testing (pDST) were adopted as the gold standards to calculate the sensitivity and specificity of the Xpert bacterial detection and drug resistance (DR) test. The positive rate (68.61% ± 7.35%) from the Xpert MTB/RIF assays of spinal TB patients' tissue specimens was higher compared with bacterial culture (44.39% ± 6.51%, Z = 5.1642, p < 0.01), and the positive rates from Xpert MTB/RIF assays on the three types of specimens were all higher than those of bacterial culture, with statistically significant results for pus and granulation tissue specimens. The positive rates for pus using the two bacteriological tests were higher than those for granulation tissue but were not statistically significant. However, the positive rates obtained from granulation tissue were statistically significantly higher than those obtained from caseous necrotic tissue. With bacterial culture and pDST as the gold standards, the sensitivity of Xpert MTB/RIF assays for MTB was 96.97%, while the sensitivity and specificity of the DR test also remained relatively high. For efficient and accurate diagnosis of spinal TB and DR and timely provision of effective treatment, multiple specimens, especially the pus of spinal TB patients, should be collected for Xpert MTB/RIF assays.

Relationship between age and elite marathon race time in world single age records from 5 to 93 years

PubMed Central

2014-01-01

Background The aims of the study were (i) to investigate the relationship between elite marathon race times and age in 1-year intervals by using the world single age records in marathon running from 5 to 93 years and (ii) to evaluate the sex difference in elite marathon running performance with advancing age. Methods World single age records in marathon running in 1-year intervals for women and men were analysed regarding changes across age for both men and women using linear and non-linear regression analyses for each age for women and men. Results The relationship between elite marathon race time and age was non-linear (i.e. polynomial regression 4th degree) for women and men. The curve was U-shaped where performance improved from 5 to ~20 years. From 5 years to ~15 years, boys and girls performed very similar. Between ~20 and ~35 years, performance was quite linear, but started to decrease at the age of ~35 years in a curvilinear manner with increasing age in both women and men. The sex difference increased non-linearly (i.e. polynomial regression 7th degree) from 5 to ~20 years, remained unchanged at ~20 min from ~20 to ~50 years and increased thereafter. The sex difference was lowest (7.5%, 10.5 min) at the age of 49 years. Conclusion Elite marathon race times improved from 5 to ~20 years, remained linear between ~20 and ~35 years, and started to increase at the age of ~35 years in a curvilinear manner with increasing age in both women and men. The sex difference in elite marathon race time increased non-linearly and was lowest at the age of ~49 years. PMID:25120915

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)

Effects of strenuous exercise on Th1/Th2 gene expression from human peripheral blood mononuclear cells of marathon participants.

PubMed

Xiang, Lianbin; Rehm, Kristina E; Marshall, Gailen D

2014-08-01

Physical stressors, such as strenuous exercise, can have numerous effects on the human body including the immune system. The aim of this study was to evaluate the gene expression profile of Th1/Th2 cytokines and related transcription factor genes in order to investigate possible immune imbalances before and after a marathon. Blood samples were collected from 16 normal volunteers 24-48 h before and one week after completing a marathon race. Gene expression of Th1 and Th2 related cytokines from human peripheral blood mononuclear cells (PBMC) was analyzed using Human Th1-Th2-Th3 RT(2) Profiler PCR Array and qRT-PCR that measured the transcript levels of 84 genes related to T cell activation. We found that PBMC express a characteristic Th2-like gene profile one week post-marathon compared to pre-marathon. The majority of genes up-regulated one week post-marathon such as IL-4, GATA3, and CCR4 were Th2 associated. For Th1-related genes, CXCR3 and IRF1 were up-regulated one week post-marathon. There was a trend of down-regulation of two Th1 related genes, T-bet and STAT1. Th3-related gene expression patterns did not change in the study. The ratios of both IFN-γ/IL-4 and T-bet/GATA3 gene expressions were significantly lower one week after marathon. These findings suggest that a Th1/Th2 immune imbalance persisted at least 1 week after completion of a marathon which offers a mechanistic rationale for the increased risk of upper respiratory tract infections often reported after strenuous exercise. Copyright © 2014 Elsevier Ltd. All rights reserved.

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)

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)

Evaluating the Diagnostic Accuracy of Xpert MTB/RIF Assay in Pulmonary Tuberculosis

PubMed Central

Sharma, Surendra K; Kohli, Mikashmi; Yadav, Raj Narayan; Chaubey, Jigyasa; Bhasin, Dinkar; Sreenivas, Vishnubhatla; Sharma, Rohini; Singh, Binit K

2015-01-01

Pulmonary tuberculosis still remains a major communicable disease worldwide. In 2013, 9 million people developed TB and 1.5 million people died from the disease. India constitutes 24% of the total TB burden. Early detection of TB cases is the key to successful treatment and reduction of disease transmission. Xpert MTB/RIF, an automated cartridge-based molecular technique detects Mycobacterium tuberculosis and rifampicin resistance within two hours has been endorsed by WHO for rapid diagnosis of TB. Our study is the first study from India with a large sample size to evaluate the performance of Xpert MTB/RIF assay in PTB samples. The test showed an overall sensitivity and specificity of 95.7% (430/449) and 99.3% (984/990) respectively. In smear negative-culture positive cases, the test had a sensitivity of 77.7%. The sensitivity and specificity for detecting rifampicin resistance was 94.5% and 97.7% respectively with respect to culture as reference standard. However, after resolving the discrepant samples with gene sequencing, the sensitivity and specificity rose to 99.0% and 99.3% respectively. Hence, while solid culture still forms the foundation of TB diagnosis, Xpert MTB/RIF proposes to be a strong first line diagnostic tool for pulmonary TB cases. PMID:26496123

CD4+ T Cells Recognizing PE/PPE Antigens Directly or via Cross Reactivity Are Protective against Pulmonary Mycobacterium tuberculosis Infection

PubMed Central

Sayes, Fadel; Pawlik, Alexandre; Frigui, Wafa; Gröschel, Matthias I.; Crommelynck, Samuel; Fayolle, Catherine; Cia, Felipe; Bancroft, Gregory J.; Bottai, Daria; Leclerc, Claude; Brosch, Roland; Majlessi, Laleh

2016-01-01

Mycobacterium tuberculosis (Mtb), possesses at least three type VII secretion systems, ESX-1, -3 and -5 that are actively involved in pathogenesis and host-pathogen interaction. We recently showed that an attenuated Mtb vaccine candidate (Mtb Δppe25-pe19), which lacks the characteristic ESX-5-associated pe/ppe genes, but harbors all other components of the ESX-5 system, induces CD4+ T-cell immune responses against non-esx-5-associated PE/PPE protein homologs. These T cells strongly cross-recognize the missing esx-5-associated PE/PPE proteins. Here, we characterized the fine composition of the functional cross-reactive Th1 effector subsets specific to the shared PE/PPE epitopes in mice immunized with the Mtb Δppe25-pe19 vaccine candidate. We provide evidence that the Mtb Δppe25-pe19 strain, despite its significant attenuation, is comparable to the WT Mtb strain with regard to: (i) its antigenic repertoire related to the different ESX systems, (ii) the induced Th1 effector subset composition, (iii) the differentiation status of the Th1 cells induced, and (iv) its particular features at stimulating the innate immune response. Indeed, we found significant contribution of PE/PPE-specific Th1 effector cells in the protective immunity against pulmonary Mtb infection. These results offer detailed insights into the immune mechanisms underlying the remarkable protective efficacy of the live attenuated Mtb Δppe25-pe19 vaccine candidate, as well as the specific potential of PE/PPE proteins as protective immunogens. PMID:27467705

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.

Accuracy and impact of Xpert MTB/RIF for the diagnosis of smear-negative or sputum-scarce tuberculosis using bronchoalveolar lavage fluid.

PubMed

Theron, Grant; Peter, Jonny; Meldau, Richard; Khalfey, Hoosain; Gina, Phindile; Matinyena, Brian; Lenders, Laura; Calligaro, Gregory; Allwood, Brian; Symons, Gregory; Govender, Ureshnie; Setshedi, Mashiko; Dheda, Keertan

2013-11-01

The accuracy and impact of new tuberculosis (TB) tests, such as Xpert MTB/RIF, when performed on bronchoalveolar lavage fluid (BALF) obtained from patients with sputum-scarce or smear-negative TB is unclear. South African patients with suspected pulmonary TB (n=160) who were sputum-scarce or smear-negative underwent bronchoscopy. MTB/RIF was performed on uncentrifuged BALF (1 ml) and/or a resuspended pellet of centrifuged BALF (∼10 ml). Time to TB detection and anti-TB treatment initiation were compared between phase one, when MTB/RIF was performed as a research tool, and phase two, when it was used for patient management. 27 of 154 patients with complete data had culture-confirmed TB. Of these, a significantly lower proportion were detected by smear microscopy compared with MTB/RIF (58%, 95% CI 39% to 75% versus 93%, 77% to 98%; p<0.001). Of the 127 patients who were culture negative, 96% (91% to 98%) were MTB/RIF negative. When phase two was compared with phase one, MTB/RIF reduced the median days to TB detection (29 (18-41) to 0 (0-0); p<0.001). However, more patients initiated empirical therapy (absence of a positive test in those commencing treatment) in phase one versus phase two (79% (11/14) versus 28% (10/25); p=0.026). Consequently, there was no detectable difference in the overall proportion of patients initiating treatment (26% (17/67; 17% to 37%) versus 36% (26/73; 26% to 47%); p=0.196) or the days to treatment initiation (10 (1-49) versus 7 (0-21); p=0.330). BALF centrifugation, HIV coinfection and a second MTB/RIF did not result in detectable changes in accuracy. MTB/RIF detected TB cases more accurately and more rapidly than smear microscopy and significantly reduced the rate of empirical treatment.

Accuracy and impact of Xpert MTB/RIF for the diagnosis of smear-negative or sputum-scarce tuberculosis using bronchoalveolar lavage fluid

PubMed Central

Theron, Grant; Peter, Jonny; Meldau, Richard; Khalfey, Hoosain; Gina, Phindile; Matinyena, Brian; Lenders, Laura; Calligaro, Gregory; Allwood, Brian; Symons, Gregory; Govender, Ureshnie; Setshedi, Mashiko; Dheda, Keertan

2017-01-01

Rationale The accuracy and impact of new tuberculosis (TB) tests, such as Xpert MTB/RIF, when performed on bronchoalveolar lavage fluid (BALF) obtained from patients with sputum-scarce or smear-negative TB is unclear. Methods South African patients with suspected pulmonary TB (n=160) who were sputum-scarce or smear-negative underwent bronchoscopy. MTB/RIF was performed on uncentrifuged BALF (1 ml) and/or a resuspended pellet of centrifuged BALF (~10 ml). Time to TB detection and anti-TB treatment initiation were compared between phase one, when MTB/RIF was performed as a research tool, and phase two, when it was used for patient management. Results 27 of 154 patients with complete data had culture-confirmed TB. Of these, a significantly lower proportion were detected by smear microscopy compared with MTB/RIF (58%, 95% CI 39% to 75% versus 93%, 77% to 98%; p<0.001). Of the 127 patients who were culture negative, 96% (91% to 98%) were MTB/RIF negative. When phase two was compared with phase one, MTB/RIF reduced the median days to TB detection (29 (18–41) to 0 (0–0); p<0.001). However, more patients initiated empirical therapy (absence of a positive test in those commencing treatment) in phase one versus phase two (79% (11/14) versus 28% (10/25); p=0.026). Consequently, there was no detectable difference in the overall proportion of patients initiating treatment (26% (17/67; 17% to 37%) versus 36% (26/73; 26% to 47%); p=0.196) or the days to treatment initiation (10 (1–49) versus 7 (0–21); p=0.330). BALF centrifugation, HIV coinfection and a second MTB/RIF did not result in detectable changes in accuracy. Conclusions MTB/RIF detected TB cases more accurately and more rapidly than smear microscopy and significantly reduced the rate of empirical treatment. PMID:23811536

Xpert MTB/RIF Assay for Pulmonary Tuberculosis and Rifampicin Resistance in Children: a Meta-Analysis.

PubMed

Wang, X W; Pappoe, F; Huang, Y; Cheng, X W; Xu, D F; Wang, H; Xu, Y H

2015-01-01

The Xpert MTB/RIF assay has been recommended by WHO to replace conventional microscopy, culture, and drug resistance tests. It simultaneously detects both Mycobacterium tuberculosis infection (TB) and resistance to rifampicin (RIF) within two hours. The objective was to review the available research studies on the accuracy of the Xpert MTB/RIF assay for diagnosing pulmonary TB and RIF-resistance in children. A comprehensive search of Pubmed and Embase was performed up to October 28, 2014. We identified published articles estimating the diagnostic accuracy of the Xpert MTB/RIF assay in children with or without HIV using culture or culture plus clinical TB as standard reference. QUADAS-2 tool was used to evaluate the quality of the studies. A summary estimation for sensitivity, specificity, diagnostic odds ratios (DOR), and the area under the summary ROC curve (AUC) was performed. Meta-analysis was used to establish the overall accuracy. 11 diagnostic studies with 3801 patients were included in the systematic review. The overall analysis revealed a moderate sensitivity and high specificity of 65% (95% CI: 61 - 69%) and 99% (95% CI: 98 - 99%), respectively, and a pooled diagnostic odds ratio of 164.09 (95% CI: 111.89 - 240.64). The AUC value was found to be 0.94. The pooled sensitivity and specificity for paediatric rifampicin resistance were 94.0% (95% CI: 80.0 - 93.0%) and 99.0% (95% CI: 95.0 - 98.0%), respectively. Hence, the Xpert MTB/RIF assay has good diagnostic and rifampicin performance for paediatric pulmonary tuberculosis. The Xpert MTB/RIF is sensitive and specific for diagnosing paediatric pulmonary TB. It is also effective in detecting rifamnicin resistance. It can, therefore, be used as an initial diagnostic tool.

Interindividual variability in sweat electrolyte concentration in marathoners.

PubMed

Lara, Beatriz; Gallo-Salazar, César; Puente, Carlos; Areces, Francisco; Salinero, Juan José; Del Coso, Juan

2016-01-01

Sodium (Na(+)) intake during exercise aims to replace the Na(+) lost by sweat to avoid electrolyte imbalances, especially in endurance disciplines. However, Na(+) needs can be very different among individuals because of the great inter-individual variability in sweat electrolyte concentration. The aim of this investigation was to determine sweat electrolyte concentration in a large group of marathoners. A total of 157 experienced runners (141 men and 16 women) completed a marathon race (24.4 ± 3.6 °C and 27.7 ± 4.8 % of humidity). During the race, sweat samples were collected by using sweat patches placed on the runners' forearms. Sweat electrolyte concentration was measured by using photoelectric flame photometry. As a group, sweat Na(+) concentration was 42.9 ± 18.7 mmol·L(-1) (minimal-maximal value = 7.0-95.5 mmol·L(-1)), sweat Cl(-) concentration was 32.2 ± 15.6 mmol·L(-1) (7.3-90.6 mmol·L(-1)) and sweat K(+) concentration was 6.0 ± 0.9 mmol·L(-1) (3.1-8.0 mmol·L(-1)). Women presented lower sweat Na(+) (33.9 ± 12.1 vs 44.0 ± 19.1 mmol·L(-1); P = 0.04) and sweat Cl(-) concentrations (22.9 ± 10.5 vs 33.2 ± 15.8 mmol·L(-1); P = 0.01) than men. A 20 % of individuals presented a sweat Na(+) concentration higher than 60 mmol·L(-1) while this threshold was not surpassed by any female marathoner. Sweat electrolyte concentration did not correlate to sweat rate, age, body characteristics, experience or training. Although there was a significant correlation between sweat Na(+) concentration and running pace (r = 0.18; P = 0.03), this association was weak to interpret that sweat Na(+) concentration increased with running pace. The inter-individual variability in sweat electrolyte concentration was not explained by any individual characteristics except for individual running pace and sex. An important portion (20 %) of marathoners might need special sodium intake recommendations due to

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.…

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.

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

... DEPARTMENT OF COMMERCE Foreign-Trade Zones Board [Order No. 1881] Expansion/Reorganization of Foreign-Trade Subzone 70T; Marathon Petroleum Company LP; Detroit, MI Pursuant to its authority under the... Subzone 70T and remove Site 3 of the subzone at the Marathon Petroleum Company LP refinery in Detroit...

Evaluation of Xpert MTB/RIF assay in children with presumed pulmonary tuberculosis in Papua New Guinea.

PubMed

Kasa Tom, Sharon; Welch, Henry; Kilalang, Cornelia; Tefuarani, Nakapi; Vince, John; Lavu, Evelyn; Johnson, Karen; Magaye, Ruth; Duke, Trevor

2018-05-01

The Gene Xpert MTB/ RIF assay (Xpert) is used for rapid, simultaneous detection of Mycobacterium tuberculosis (MTB) and rifampicin resistance. This study examined the accuracy of Xpert in children with suspected pulmonary tuberculosis (PTB). Children admitted to Port Moresby General Hospital with suspected PTB were prospectively enrolled between September 2014 and March 2015. They were classified into probable, possible and TB-unlikely groups. Sputum or gastric aspirates were tested by Xpert and smear microscopy; mycobacterial culture was undertaken on a subset. Children were diagnosed with TB on the basis of standard criteria which were used as the primary reference standard. Xpert, smear for acid-fast bacilli (AFB) and the Edwards TB score were compared with the primary reference standard. A total of 93 children ≤14 years with suspected PTB were enrolled; 67 (72%) were classified as probable, 21 (22%) possible and 5 (5.4%) TB-unlikely. Eighty were treated for TB based on the primary reference standard. Xpert was positive in 26/93 (28%) MTB cases overall, including 22/67 (33%) with probable TB and 4/21 (19%) with possible TB. Three (13%) samples identified rifampicin resistance. Xpert confirmed more cases of TB than AFB smear (26 vs 13, p = 0.019). The sensitivity of Xpert, AFB smear and an Edwards TB score of ≥7 was 31% (25/80), 16% (13/80) and 90% (72/80), respectively, and the specificity was 92% (12/13), 100% (13/13) and 31% (4/13), respectively, when compared with the primary reference standard. Xpert sensitivity is sub-optimal and cannot be relied upon for diagnosing TB, although a positive result is confirmatory. A detailed history and examination, standardised clinical criteria, radiographs and available tests remain the most appropriate way of diagnosing TB in children in resource-limited countries. Xpert helps confirm PTB better than AFB smear, and identifies rifampicin resistance. Practical guidelines should be used to identify children who

Tuberculous spondylitis diagnosed through Xpert MTB/RIF assay in urine: a case report.

PubMed

Sikalengo, George; Ramirez, Adria; Faini, Diana; Mwamelo, Kim; Battegay, Manuel; Jugheli, Levan; Hatz, Christoph; Reither, Klaus; Letang, Emilio

2016-09-26

Extrapulmonary tuberculosis (EPTB) is associated with high rates of morbidity and mortality. Diagnosis of EPTB is challenging in resource-limited settings due to difficulties in obtaining samples, as well as the paucibacillarity of the specimens. Skeletal tuberculosis accounts for 10-35 % of EPTB cases, with vertebral osteomyelitis (Pott's disease) representing 50 % of the cases. We present two cases of suspected Pott's disease, diagnosed through GeneXpert MTB/RIF assay in urine at a rural Tanzanian hospital. Case I A 49-year old male, HIV-1 positive, on co-formulated tenofovir disoproxil fumarate/lamivudine/efavirenz since 2009 and CD4 counts of 205 cells/μL (13 %). He presented with lower back pain and progressive lower limb weakness for two weeks prior to admission. The physical examination revealed bilateral flaccid paraplegia with reduced reflexes, but otherwise unremarkable findings. A lateral lumbar X-ray showed noticeable reduction of intervertebral space between L4 and L5, and a small calcification in the anterior longitudinal ligament between L4 and L5, being compatible with focal spondylosis deformans but inconclusive with regard to tuberculous spondylitis. An abdominal ultrasound showed normal kidneys, bladder and prostate gland. The urinalysis and complete blood counts (CBC) were normal. M. Tuberculosis was detected through GeneXpert MTB/RIF in centrifuged urine, with no resistance to rifampicin. Case II A 76-year old female, HIV-1 negative, presented with lower back pain and progressive weakness and numbness of the lower limbs for two months prior to admission. The physical examination revealed paraplegia, but otherwise unremarkable findings. The lumbosacral X-ray findings were compatible with spondylosis deformans of the lumbar spine and possible tuberculous spondylitis in L3-L4. The abdominal and renal ultrasound showed normal kidneys and bladder. The urinalysis and CBC were normal. M. Tuberculosis was detected through GeneXpert MTB/RIF in

Performance and age of African and non-African runners in half- and full marathons held in Switzerland, 2000–2010

PubMed Central

Aschmann, André; Knechtle, Beat; Cribari, Marco; Rüst, Christoph Alexander; Onywera, Vincent; Rosemann, Thomas; Lepers, Romuald

2013-01-01

Background Endurance running performance of African (AF) and non-African (NAF) athletes is investigated, with better performances seen for Africans. To date, no study has compared the age of peak performance between AF and NAF runners. The present research is an analysis of the age and running performance of top AF and NAF athletes, using the hypothesis that AF athletes were younger and faster than NAF athletes. Methods Age and performance of male and female AF and NAF athletes in half-marathons and marathons held in Switzerland in 2000–2010 were investigated using single and multilevel hierarchical regression analyses. Results For half-marathons, male NAF runners were older than male AF runners (P = 0.02; NAF, 31.1 years ± 6.4 years versus AF, 26.2 years ± 4.9 years), and their running time was longer (P = 0.02; NAF, 65.3 minutes ± 1.7 minutes versus AF, 64.1 minutes ± 0.9 minutes). In marathons, differences between NAF and AF male runners in age (NAF, 33.0 years ± 4.8 years versus AF, 28.6 years ± 3.8 years; P < 0.01) and running time (NAF, 139.5 minutes ± 5.6 minutes versus AF, 133.3 minutes ± 2.7 minutes; P < 0.01) were more pronounced. There was no difference in age (NAF, 31.0 years ± 7.0 years versus AF, 26.7 years ± 6.0 years; P > 0.05) or running time (NAF, 75.0 minutes ± 3.7 minutes versus AF, 75.6 minutes ± 5.3 minutes; P > 0.05) between NAF and AF female half-marathoners. For marathoners, NAF women were older than AF female runners (P = 0.03; NAF, 31.6 years ± 4.8 years versus AF, 27.8 years ± 5.3 years), but their running times were similar (NAF, 162.4 minutes ± 7.2 minutes versus AF, 163.0 minutes ± 7.0 minutes; P > 0.05). Conclusion In Switzerland, the best AF male half-marathoners and marathoners were younger and faster than the NAF counterpart runners. In contrast to the results seen in men, AF and NAF female runners had similar performances. Future studies need to investigate performance and age of AF and NAF marathoners in the

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.

Optimum polygenic profile to resist exertional rhabdomyolysis during a marathon

PubMed Central

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

2017-01-01

Purpose Exertional rhabdomyolysis can occur in individuals performing various types of exercise but it is unclear why some individuals develop this condition while others do not. Previous investigations have determined the role of several single nucleotide polymorphisms (SNPs) to explain inter-individual variability of serum creatine kinase (CK) concentrations after exertional muscle damage. However, there has been no research about the interrelationship among these SNPs. The purpose of this investigation was to analyze seven SNPs that are candidates for explaining individual variations of CK response after a marathon competition (ACE = 287bp Ins/Del, ACTN3 = p.R577X, CKMM = NcoI, IGF2 = C13790G, IL6 = 174G>C, MLCK = C37885A, TNFα = 308G>A). Methods Using Williams and Folland’s model, we determined the total genotype score from the accumulated combination of these seven SNPs for marathoners with a low CK response (n = 36; serum CK <400 U·L-1) vs. marathoners with a high CK response (n = 31; serum CK ≥400 U·L-1). Results At the end of the race, low CK responders had lower serum CK (290±65 vs. 733±405 U·L-1; P<0.01) and myoglobin concentrations (443±328 vs. 1009±971 ng·mL-1, P<0.01) than high CK responders. Although the groups were similar in age, anthropometric characteristics, running experience and training habits, total genotype score was higher in low CK responders than in high CK responders (5.2±1.4 vs. 4.4±1.7 point, P = 0.02). Conclusion Marathoners with a lower CK response after the race had a more favorable polygenic profile than runners with high serum CK concentrations. This might suggest a significant role of genetic polymorphisms in the levels of exertional muscle damage and rhabdomyolysis. Yet other SNPs, in addition to exercise training, might also play a role in the values of CK after damaging exercise. PMID:28257486

Optimum polygenic profile to resist exertional rhabdomyolysis during a marathon.

PubMed

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

2017-01-01

Exertional rhabdomyolysis can occur in individuals performing various types of exercise but it is unclear why some individuals develop this condition while others do not. Previous investigations have determined the role of several single nucleotide polymorphisms (SNPs) to explain inter-individual variability of serum creatine kinase (CK) concentrations after exertional muscle damage. However, there has been no research about the interrelationship among these SNPs. The purpose of this investigation was to analyze seven SNPs that are candidates for explaining individual variations of CK response after a marathon competition (ACE = 287bp Ins/Del, ACTN3 = p.R577X, CKMM = NcoI, IGF2 = C13790G, IL6 = 174G>C, MLCK = C37885A, TNFα = 308G>A). Using Williams and Folland's model, we determined the total genotype score from the accumulated combination of these seven SNPs for marathoners with a low CK response (n = 36; serum CK <400 U·L-1) vs. marathoners with a high CK response (n = 31; serum CK ≥400 U·L-1). At the end of the race, low CK responders had lower serum CK (290±65 vs. 733±405 U·L-1; P<0.01) and myoglobin concentrations (443±328 vs. 1009±971 ng·mL-1, P<0.01) than high CK responders. Although the groups were similar in age, anthropometric characteristics, running experience and training habits, total genotype score was higher in low CK responders than in high CK responders (5.2±1.4 vs. 4.4±1.7 point, P = 0.02). Marathoners with a lower CK response after the race had a more favorable polygenic profile than runners with high serum CK concentrations. This might suggest a significant role of genetic polymorphisms in the levels of exertional muscle damage and rhabdomyolysis. Yet other SNPs, in addition to exercise training, might also play a role in the values of CK after damaging exercise.

77 FR 33716 - Foreign-Trade Zone 70-Detroit, MI; Expansion of Subzone; Marathon Petroleum Company LP, (Oil...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-07

... DEPARTMENT OF COMMERCE Foreign-Trade Zones Board [B-42-2012] Foreign-Trade Zone 70--Detroit, MI; Expansion of Subzone; Marathon Petroleum Company LP, (Oil Refinery) Detroit, MI An application has been...., grantee of FTZ 70, requesting an expansion of Subzone 70T, on behalf of Marathon Petroleum Company LP in...

Evaluation of Cepheid's Xpert MTB/Rif test on pleural fluid in the diagnosis of pleural tuberculosis in a high prevalence HIV/TB setting.

PubMed

Lusiba, John K; Nakiyingi, Lydia; Kirenga, Bruce J; Kiragga, Agnes; Lukande, Robert; Nsereko, Maria; Ssengooba, Willy; Katamba, Achilles; Worodria, William; Joloba, Moses L; Mayanja-Kizza, Harriet

2014-01-01

Diagnosis of pleural tuberculosis (TB) using routinely available diagnostic methods is challenging due to the paucibacillary nature of the disease. Histopathology and pleural tissue TB culture involves an invasive procedure which requires expertise and appropriate equipment, both often unavailable in many health units. Xpert MTB/Rif test has been widely evaluated in sputum specimens but data on its performance in pleural TB is scarce. We evaluated the accuracy of Cepheid's Xpert MTB/Rif test on pleural fluid in the diagnosis of pleural TB in Uganda. Consenting adult patients with exudative pleural effusions underwent pleural biopsy and the tissue obtained subjected to Lowenstein-Jensen and mycobacterial growth indicator tube MTB cultures and histopathology. Pleural fluid for Xpert MTB/Rif testing was also collected. Data on socio-demographic characteristics, clinical symptoms, HIV status and CD4 count were also collected. Sensitivity, specificity, positive and negative predictive values of Xpert MTB/Rif test on pleural fluid in pleural TB diagnosis were calculated using pleural tissue MTB culture and/or histopathology as the reference standard. Of the 116 participants [female 50%, mean age 34 (SD ±13], 87/116 (75%) had pleural TB confirmed on pleural tissue culture and/or histopathology. The Xpert MTB/Rif test identified 25 (28.7%) of the 87 confirmed pleural TB cases. The sensitivity and specificity of Xpert MTB/Rif test were 28.7% and 96.6% respectively while the positive and negative predictive values were 96.1% and 31.1% respectively. Xpert MTB/Rif test on pleural fluid does not accurately diagnose pleural TB and therefore cannot be used as an initial evaluation test in patients with suspected pleural TB. New, rapid and accurate tests for the diagnosis of pleural TB are still warranted.

Evaluation of Cepheid's Xpert MTB/RIF Test on Pleural Fluid in the Diagnosis of Pleural Tuberculosis in a High Prevalence HIV/TB Setting

PubMed Central

Kirenga, Bruce J.; Kiragga, Agnes; Lukande, Robert; Nsereko, Maria; Ssengooba, Willy; Katamba, Achilles; Worodria, William; Joloba, Moses L.; Mayanja-Kizza, Harriet

2014-01-01

Background Diagnosis of pleural tuberculosis (TB) using routinely available diagnostic methods is challenging due to the paucibacillary nature of the disease. Histopathology and pleural tissue TB culture involves an invasive procedure which requires expertise and appropriate equipment, both often unavailable in many health units. Xpert MTB/Rif test has been widely evaluated in sputum specimens but data on its performance in pleural TB is scarce. We evaluated the accuracy of Cepheid's Xpert MTB/Rif test on pleural fluid in the diagnosis of pleural TB in Uganda. Methods Consenting adult patients with exudative pleural effusions underwent pleural biopsy and the tissue obtained subjected to Lowenstein-Jensen and mycobacterial growth indicator tube MTB cultures and histopathology. Pleural fluid for Xpert MTB/Rif testing was also collected. Data on socio-demographic characteristics, clinical symptoms, HIV status and CD4 count were also collected. Sensitivity, specificity, positive and negative predictive values of Xpert MTB/Rif test on pleural fluid in pleural TB diagnosis were calculated using pleural tissue MTB culture and/or histopathology as the reference standard. Results Of the 116 participants [female 50%, mean age 34 (SD ±13], 87/116 (75%) had pleural TB confirmed on pleural tissue culture and/or histopathology. The Xpert MTB/Rif test identified 25 (28.7%) of the 87 confirmed pleural TB cases. The sensitivity and specificity of Xpert MTB/Rif test were 28.7% and 96.6% respectively while the positive and negative predictive values were 96.1% and 31.1% respectively. Conclusion Xpert MTB/Rif test on pleural fluid does not accurately diagnose pleural TB and therefore cannot be used as an initial evaluation test in patients with suspected pleural TB. New, rapid and accurate tests for the diagnosis of pleural TB are still warranted. PMID:25051491

A Comparison of Anthropometric and Training Characteristics between Female and Male Half-Marathoners and the Relationship to Race Time

PubMed Central

Friedrich, Miriam; Rüst, Christoph A.; Rosemann, Thomas; Knechtle, Patrizia; Barandun, Ursula; Lepers, Romuald; Knechtle, Beat

2013-01-01

Purpose Lower limb skin-fold thicknesses have been differentially associated with sex in elite runners. Front thigh and medial calf skin-fold appear to be related to 1,500m and 10,000m time in men but 400m time in women. The aim of the present study was to compare anthropometric and training characteristics in recreational female and male half-marathoners. Methods The association between both anthropometry and training characteristics and race time was investigated in 83 female and 147 male recreational half marathoners using bi- and multi-variate analyses. Results In men, body fat percentage (β=0.6), running speed during training (β=-3.7), and body mass index (β=1.9) were related to half-marathon race time after multi-variate analysis. After exclusion of body mass index, r2 decreased from 0.51 to 0.49, but body fat percentage (β=0.8) and running speed during training (β=-4.1) remained predictive. In women, body fat percentage (β=0.75) and speed during training (β=-6.5) were related to race time (r2=0.73). For women, the exclusion of body mass index had no consequence on the predictive variables for half-marathon race time. Conclusion To summarize, in both female and male recreational half-marathoners, both body fat percentage and running speed during training sessions were related to half-marathon race times when corrected with co-variates after multi-variate regression analyses. PMID:24868427

A Comparison of Anthropometric and Training Characteristics between Female and Male Half-Marathoners and the Relationship to Race Time.

PubMed

Friedrich, Miriam; Rüst, Christoph A; Rosemann, Thomas; Knechtle, Patrizia; Barandun, Ursula; Lepers, Romuald; Knechtle, Beat

2014-03-01

Lower limb skin-fold thicknesses have been differentially associated with sex in elite runners. Front thigh and medial calf skin-fold appear to be related to 1,500m and 10,000m time in men but 400m time in women. The aim of the present study was to compare anthropometric and training characteristics in recreational female and male half-marathoners. The association between both anthropometry and training characteristics and race time was investigated in 83 female and 147 male recreational half marathoners using bi- and multi-variate analyses. In men, body fat percentage (β=0.6), running speed during training (β=-3.7), and body mass index (β=1.9) were related to half-marathon race time after multi-variate analysis. After exclusion of body mass index, r (2) decreased from 0.51 to 0.49, but body fat percentage (β=0.8) and running speed during training (β=-4.1) remained predictive. In women, body fat percentage (β=0.75) and speed during training (β=-6.5) were related to race time (r (2) =0.73). For women, the exclusion of body mass index had no consequence on the predictive variables for half-marathon race time. To summarize, in both female and male recreational half-marathoners, both body fat percentage and running speed during training sessions were related to half-marathon race times when corrected with co-variates after multi-variate regression analyses.

Tissue Xpert™ MTB/Rif assay is of limited use in diagnosing peritoneal tuberculosis in patients with exudative ascites.

PubMed

Bera, Chinmay; Michael, Joy Sarojini; Burad, Deepak; Shirly, Suzana B; Gibikote, Sridhar; Ramakrishna, Banumathi; Goel, Ashish; Eapen, C E

2015-09-01

Xpert™ MTB/Rif is a multiplex hemi-nested real-time PCR-based assay to detect presence of M. tuberculosis within 2 hours of sample collection. The present study aimed at assessing efficacy of Xpert™ MTB/Rif assay for diagnosing peritoneal tuberculosis. Patients with exudative ascites, fluid negative for acid-fast bacilli on auramine O fluorescence staining and unyielding fluid cytology for malignant cells, were included. Ultrasound-guided omental biopsy samples were obtained in all. Xpert™ MTB/Rif assay on tissue samples was assessed against a composite "reference" standard for diagnosis of peritoneal tuberculosis, defined as presence of any of the three-culture showing M tuberculosis, granulomatous inflammation on histology or resolution of ascites with 2 months of antitubercular therapy. During January 2012-July 2013, 28 patients (age:43 ± 15 years; mean ± SD; male:20) were recruited. Serum ascitic albumin gradient was <1.1 in all except in four patients with underlying cirrhosis. Twenty-one of the 28 patients had peritoneal TB as diagnosed by composite reference standard (histology:18; culture:4; treatment response:3). Seven patients (25%) had an alternative diagnosis (metastatic carcinoma 2, adenocarcinoma 2, mesothelioma 2, and systemic lupus erythematous 1). Xpert™ MTB/Rif assay was positive in 4/21 patients with peritoneal tuberculosis and in none of the 7 patients with alternative diagnosis. Thus, sensitivity, specificity, positive, and negative predictive values for tissue Xpert™ MTB/Rif assay in diagnosing peritoneal tuberculosis were 19% (95% C.I: 6% to 42%), 100% (95% C.I: 59% to 100%), 100% (40% to 100%), and 29% (95% C.I: 13% to 51%), respectively. Tissue Xpert™ MTB/Rif assay was of limited use in diagnosing peritoneal tuberculosis.

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

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.

Cost-effectiveness of the Xpert® MTB/RIF assay for tuberculosis diagnosis in Brazil.

PubMed

Pinto, M; Steffen, R E; Cobelens, F; van den Hof, S; Entringer, A; Trajman, A

2016-05-01

The Xpert® MTB/RIF assay is being implemented as a substitute for sputum smear microscopy (SSM) in many low and high tuberculosis (TB) burden countries, including Brazil, a country with low multidrug resistance and moderate human immunodeficiency virus co-infection rates. Brazilian National TB Programme (NTP). We estimated the incremental cost-effectiveness ratio (ICER) of Xpert as a substitute for two SSM tests in the diagnosis of drug-susceptible TB. The costs for confirming each additional case and for avoiding treatment due to false-positive empirical diagnoses were estimated. The ICER was US$943 for each additional TB diagnosis and US$356 for each additional TB diagnosis with bacteriological confirmation, assuming 80% specificity of clinical diagnosis using both strategies. For every 100 000 patients with suspected TB, the NTP would spend an additional US$1.2 million per year to confirm 3344 more TB patients. The model was highly sensitive to specificity of clinical diagnosis after a negative test. Although the NTP has no threshold for cost-effectiveness, our model can provide support for decision makers in Brazil and other countries with a low prevalence of drug resistance among TB patients. Financial benefit can potentially be expected if physicians rely more on a negative Xpert result and empirical treatment is reduced.

Case report of a false positive result of the Xpert® MTB/RIF assay for rifampicin resistance in Mycobacterium tuberculosis complex.

PubMed

Claessens, Jolien; Mathys, Vanessa; Derdelinckx, Inge; Saegeman, Veroniek

2017-06-01

In the present case, we report a false positive result for the detection of rifampicin (RIF) resistance by the Xpert ® MTB/RIF assay, version G4.Miliary Mycobacterium tuberculosis infection (miliary TB) was suspected in a 50-year old Angolan woman. Imaging of the thorax and abdomen displayed diffuse lesions. The Xpert ® MTB/RIF assay conducted on the broncho-alveolar lavage (BAL) fluid was positive for TB and positive for RIF resistance. Confirmatory molecular tests and the phenotypic drug susceptibility determination supported the diagnosis of TB but not RIF resistance. The patient was treated successfully with a conventional therapeutic scheme. Because, the Xpert ® MTB/RIF assay allows the simultaneous detection of TB and RIF resistance, the World Health Organisation (WHO) recommends its use as initial diagnostic test, over microscopy, culture and phenotypic drug susceptibility testing. Even though specificity of the Xpert ® MTB/RIF assay version G4 is high, false positive test results remain possible and have to be considered for the interpretation of the RIF resistance detection by Xpert ® MTB/RIF assay.

Skiing economy and efficiency in recreational and elite cross-country skiers.

PubMed

Ainegren, Mats; Carlsson, Peter; Tinnsten, Mats; Laaksonen, Marko S

2013-05-01

The purpose of this study was to investigate and compare skiing economy and gross efficiency in cross-country skiers of different performance levels, ages and genders; male recreational skiers and elite senior and junior cross-country skiers of both genders. The skiers performed tests involving roller skiing on a treadmill using the gear 3 and diagonal stride techniques. The elite cross-country skiers were found to have better skiing economy and higher gross efficiency (5-18%) compared with the recreational skiers (p < 0.05) and the senior elite had better economy and higher efficiency (4-5%) than their junior counterparts (p < 0.05), whereas no differences could be found between the genders. Also, large ranges in economy and gross efficiency were found in all groups. It was concluded that, in addition to V[Combining Dot Above]O2peak, skiing economy and gross efficiency have a great influence on the differences in performance times between recreational and junior and senior elite cross-country skiers, as well as between individual skiers within the different categories. Thus, we recommend cross-country skiers at all performance levels to test not only V[Combining Dot Above]O2peak, but also skiing economy and efficiency.

How Biomechanical Improvements in Running Economy Could Break the 2-hour Marathon Barrier.

PubMed

Hoogkamer, Wouter; Kram, Rodger; Arellano, Christopher J

2017-09-01

A sub-2-hour marathon requires an average velocity (5.86 m/s) that is 2.5% faster than the current world record of 02:02:57 (5.72 m/s) and could be accomplished with a 2.7% reduction in the metabolic cost of running. Although supporting body weight comprises the majority of the metabolic cost of running, targeting the costs of forward propulsion and leg swing are the most promising strategies for reducing the metabolic cost of running and thus improving marathon running performance. Here, we calculate how much time could be saved by taking advantage of unconventional drafting strategies, a consistent tailwind, a downhill course, and specific running shoe design features while staying within the current International Association of Athletic Federations regulations for record purposes. Specifically, running in shoes that are 100 g lighter along with second-half scenarios of four runners alternately leading and drafting, or a tailwind of 6.0 m/s, combined with a 42-m elevation drop could result in a time well below the 2-hour marathon barrier.

Warming Up With an Ice Vest: Core Body Temperature Before and After Cross-Country Racing

PubMed Central

Hunter, Iain; Hopkins, J. Ty; Casa, Douglas J

2006-01-01

Context: Athletes running in a hot, humid environment may have an increased risk of heat illness. In the 2004 Olympic Games, American and Australian athletes were provided with ice vests designed to cool their bodies before performance. The vest appeared to be effective in keeping body temperatures down and improving the performance of the marathoners. However, body temperatures have not been reported when the vest was used before an actual competition. Objective: To determine if wearing the Nike Ice-Vest decreased core temperature (Tc) before and during athletic performance in warm (26°C to 27°C), humid (relative humidity = 50% to 75%) conditions. Design: A 2 × 3 mixed-model design was used to compare groups (ice vest, no ice vest) across changes in temperature from baseline (10 minutes and 1 minute before the race and immediately after the race). Setting: 2005 Big Wave Invitational 4-km race in Hawaii and 2005 Great American 5-km race in North Carolina. Patients or Other Participants: Eighteen women from a National Collegiate Athletic Association Division I cross-country team who participated in either the Big Wave Invitational or the Great American Race. Intervention(s): Four hours before the start of the race, the athletes ingested radiotelemetry temperature sensors. One hour before the start of the race, Tc was recorded, and half of the athletes donned a Nike Ice-Vest, which was removed immediately before the race. Main Outcome Measure(s): Additional Tc readings were taken at 10 minutes and 1 minute before the start of the race and immediately after the race. Results: Ten minutes before the start of the race, Tc was elevated by 0.84°C ± 0.37°C in the no-vest group, compared with 0.29°C ± 0.56°C in the ice-vest group ( P < .01). This difference in Tc persisted at 1 minute before the start. Immediately after the finish, the increase in Tc averaged 2.75°C ± 0.62°C in the no-vest group and 2.12°C ± 0.62°C in the ice-vest group ( P < .01

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

PubMed

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

2013-05-01

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. 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. 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. 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.

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

PubMed

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

2016-01-01

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). 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. 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. 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. ClinicalTrials.gov NCT01944865.

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

International health IT benchmarking: learning from cross-country comparisons.

PubMed

Zelmer, Jennifer; Ronchi, Elettra; Hyppönen, Hannele; Lupiáñez-Villanueva, Francisco; Codagnone, Cristiano; Nøhr, Christian; Huebner, Ursula; Fazzalari, Anne; Adler-Milstein, Julia

2017-03-01

To pilot benchmark measures of health information and communication technology (ICT) availability and use to facilitate cross-country learning. A prior Organization for Economic Cooperation and Development-led effort involving 30 countries selected and defined functionality-based measures for availability and use of electronic health records, health information exchange, personal health records, and telehealth. In this pilot, an Organization for Economic Cooperation and Development Working Group compiled results for 38 countries for a subset of measures with broad coverage using new and/or adapted country-specific or multinational surveys and other sources from 2012 to 2015. We also synthesized country learnings to inform future benchmarking. While electronic records are widely used to store and manage patient information at the point of care-all but 2 pilot countries reported use by at least half of primary care physicians; many had rates above 75%-patient information exchange across organizations/settings is less common. Large variations in the availability and use of telehealth and personal health records also exist. Pilot participation demonstrated interest in cross-national benchmarking. Using the most comparable measures available to date, it showed substantial diversity in health ICT availability and use in all domains. The project also identified methodological considerations (e.g., structural and health systems issues that can affect measurement) important for future comparisons. While health policies and priorities differ, many nations aim to increase access, quality, and/or efficiency of care through effective ICT use. By identifying variations and describing key contextual factors, benchmarking offers the potential to facilitate cross-national learning and accelerate the progress of individual countries. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.

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

Xpert MTB/Rif for the diagnosis of extrapulmonary tuberculosis--an experience from a tertiary care centre in South India.

PubMed

Suzana, Shirly; Ninan, Marilyn M; Gowri, Mahasampath; Venkatesh, Krishnan; Rupali, Priscilla; Michael, Joy S

2016-03-01

The Xpert MTB/Rif, with a detection limit of 131 CFU/ml, plays a valuable role in the diagnosis of extrapulmonary tuberculosis, both susceptible and resistant. This study aims at evaluating the Xpert MTB/Rif for the same, at a tertiary care centre in south India, assessing it against both culture and a composite gold standard (CGS). We tested consecutive samples from patients suspected of extrapulmonary tuberculosis with Xpert MTB/Rif, evaluated its sensitivity and specificity against solid and/or liquid culture and CGS. An individual analysis of different sample types (tissue biopsies, fluids, pus, lymph node biopsies and CSF) given an adequate sample size, against both culture and CGS, was also performed. In total, 494 samples were analysed against culture. Compared to culture, the sensitivity of Xpert MTB/Rif was 89% (95% CI 0.81-0.94) and its specificity was 74% (95% CI 0.70-0.78). When Xpert MTB/Rif was compared to the CGS, pooled sensitivity was 62% (95% CI 0.56-0.67) and specificity was 100% (95% CI 0.91-1.00). This assay performs better than the currently available conventional laboratory methods. The rapidity with which results are obtained is an added advantage, and its integration into a routine diagnostic protocol must be considered. © 2015 John Wiley & Sons Ltd.

NPDES Permit for Marathon Oil Company – Circle Ridge in Wyoming

EPA Pesticide Factsheets

Under NPDES permit WY-0000949, the Marathon Oil Company – Circle Ridge is authorized to discharge from its wastewater treatment facility located in Fremont County, Wyoming to a tributary to Coal Draw.

A Comparison of the Energetic Cost of Running in Marathon Racing Shoes.

PubMed

Hoogkamer, Wouter; Kipp, Shalaya; Frank, Jesse H; Farina, Emily M; Luo, Geng; Kram, Rodger

2018-04-01

Reducing the energetic cost of running seems the most feasible path to a sub-2-hour marathon. Footwear mass, cushioning, and bending stiffness each affect the energetic cost of running. Recently, prototype running shoes were developed that combine a new highly compliant and resilient midsole material with a stiff embedded plate. The aim of this study was to determine if, and to what extent, these newly developed running shoes reduce the energetic cost of running compared with established marathon racing shoes. 18 high-caliber athletes ran six 5-min trials (three shoes × two replicates) in prototype shoes (NP), and two established marathon shoes (NS and AB) during three separate sessions: 14, 16, and 18 km/h. We measured submaximal oxygen uptake and carbon dioxide production during minutes 3-5 and averaged energetic cost (W/kg) for the two trials in each shoe model. Compared with the established racing shoes, the new shoes reduced the energetic cost of running in all 18 subjects tested. Averaged across all three velocities, the energetic cost for running in the NP shoes (16.45 ± 0.89 W/kg; mean ± SD) was 4.16 and 4.01% lower than in the NS and AB shoes, when shoe mass was matched (17.16 ± 0.92 and 17.14 ± 0.97 W/kg, respectively, both p < 0.001). The observed percent changes were independent of running velocity (14-18 km/h). The prototype shoes lowered the energetic cost of running by 4% on average. We predict that with these shoes, top athletes could run substantially faster and achieve the first sub-2-hour marathon.

Biochemical and hematological changes following the 120-km open-water marathon swim.

PubMed

Drygas, Wojciech; Rębowska, Ewa; Stępień, Ewa; Golański, Jacek; Kwaśniewska, Magdalena

2014-09-01

Data on physiological effects and potential risks of a ultraendurance swimming are scarce. This report presents the unique case of a 61-year old athlete who completed a non-stop open-water 120-km ultramarathon swim on the Warta River, Poland. Pre-swimming examinations revealed favorable conditions (blood pressure, 110/70 mmHg; rest heart rate, 54 beats/minute, ejection fraction, 60%, 20.2 metabolic equivalents in a maximal exercise test). The swimming time and distance covered were 27 h 33 min and 120 km, respectively. Blood samples for hematological and biochemical parameters were collected 30 min, 4 hrs, 10 hrs and 8 days after the swim. The body temperature of the swimmer was 36.7°C before and 35.1°C after the swim. The hematological parameters remained within the reference range in the postexercise period except for leucocytes (17.5 and 10.6 x G/l noted 30 minutes and 4 hours after the swim, respectively). Serum urea, aspartate aminotransferase and C-reactive protein increased above the reference range reaching 11.3 mmol/l, 1054 nmol/l/s and 25.9 mg/l, respectively. Symptomatic hyponatremia was not observed. Although the results demonstrate that an experienced athlete is able to complete an ultra-marathon swim without negative health consequences, further studies addressing the potential risks of marathon swimming are required. Key pointsData on biochemical changes due to long-distance swimming are scarce.This report presents the unique case of a 61-year old athlete who completed a non-stop open-water 120-km ultramarathon swim.An experienced athlete is able to complete an ultra-marathon swim without serious health consequences.Regarding the growing popularity of marathon swimming further studies addressing the potential risks of such exhaustive exercise are required.

Determinants of PCR performance (Xpert MTB/RIF), including bacterial load and inhibition, for TB diagnosis using specimens from different body compartments

PubMed Central

Theron, Grant; Peter, Jonny; Calligaro, Greg; Meldau, Richard; Hanrahan, Colleen; Khalfey, Hoosain; Matinyenya, Brian; Muchinga, Tapuwa; Smith, Liezel; Pandie, Shaheen; Lenders, Laura; Patel, Vinod; Mayosi, Bongani M.; Dheda, Keertan

2014-01-01

The determinants of Xpert MTB/RIF sensitivity, a widely used PCR test for the diagnosis of tuberculosis (TB) are poorly understood. We compared culture time-to-positivity (TTP; a surrogate of bacterial load), MTB/RIF TB-specific and internal positive control (IPC)-specific CT values, and clinical characteristics in patients with suspected TB who provided expectorated (n = 438) or induced sputum (n = 128), tracheal aspirates (n = 71), bronchoalveolar lavage fluid (n = 152), pleural fluid (n = 76), cerebral spinal fluid (CSF; n = 152), pericardial fluid (n = 131), or urine (n = 173) specimens. Median bacterial load (TTP in days) was the strongest associate of MTB/RIF positivity in each fluid. TTP correlated with CT values in pulmonary specimens but not extrapulmonary specimens (Spearman's coefficient 0.5043 versus 0.1437; p = 0.030). Inhibition affected a greater proportion of pulmonary specimens than extrapulmonary specimens (IPC CT > 34: 6% (47/731) versus 1% (4/381; p < 0.0001). Pulmonary specimens had greater load than extrapulmonary specimens [TTPs (interquartile range) of 11 (7–16) versus 22 (18–33.5) days; p < 0.0001]. HIV-infection was associated with a decreased likelihood of MTB/RIF-positivity in pulmonary specimens but an increased likelihood in extrapulmonary specimens. Mycobacterial load, which displays significant variation across different body compartments, is the main determinant of MTB/RIF-positivity rather than PCR inhibition. MTB/RIF CT is a poor surrogate of load in extrapulmonary specimens. PMID:25014250

NPDES Permit for Marathon Oil Company – Maverick Springs in Wyoming

EPA Pesticide Factsheets

Under NPDES permit WY-0000779, the Marathon Oil Company – Maverick Springs is authorized to discharge from its wastewater treatment facility located in Fremont County, Wyoming to a tributary to Five Mile Creek.

NPDES Permit for Marathon Oil Company – Chatterton Battery in Wyoming

EPA Pesticide Factsheets

Under NPDES permit WY-0000922, the Marathon Oil Company – Chatterton Battery is authorized to discharge from its wastewater treatment facility located in Fremont County, Wyoming to a tributary to Five Mile Creek.

Revised device labeling for the Cepheid Xpert MTB/RIF assay for detecting Mycobacterium tuberculosis.

PubMed

2015-02-27

The Food and Drug Administration (FDA) has cleared the Xpert MTB/RIF Assay (Cepheid; Sunnyvale, California) with an expanded intended use that includes testing of either one or two sputum specimens as an alternative to examination of serial acid-fast stained sputum smears to aid in the decision of whether continued airborne infection isolation (AII) is warranted for patients with suspected pulmonary tuberculosis. This change reflects the outcome of a recent multicenter international study demonstrating that negative Xpert MTB/RIF Assay results from either one or two sputum specimens are highly predictive of the results of two or three negative acid-fast sputum smears.

Performance of the Xpert MTB/RIF assay for the diagnosis of pulmonary tuberculosis and rifampin resistance in a low-incidence, high-resource setting.

PubMed

Rice, Jason P; Seifert, Marva; Moser, Kathleen S; Rodwell, Timothy C

2017-01-01

Performance of the Xpert MTB/RIF assay, designed to simultaneously detect Mycobacterium tuberculosis complex (MTBC) and rifampin (RIF) resistance, has been well documented in low-resource settings with high TB-incidence. However, few studies have assessed its accuracy in low TB incidence settings. We evaluated the performance of Xpert MTB/RIF using clinical sputum specimens routinely collected from suspect pulmonary TB patients over a 4-year time period in San Diego County, California. Xpert MTB/RIF results were compared to acid-fast bacilli (AFB) smear microscopy, mycobacterial culture, and phenotypic drug susceptibility testing (DST). Of 751 sputum specimens, 134 (17.8%) were MTBC culture-positive and 2 (1.5%) were multidrug-resistant (MDR). For the detection of MTBC, Xpert MTB/RIF sensitivity was 89.6% (97.7% and 74.5% in smear-positive and -negative sputa, respectively) and specificity was 97.2%; while AFB smear sensitivity and specificity were 64.9% and 77.8%, respectively. Xpert MTB/RIF detected 35 of 47 smear-negative culture-positive specimens, and excluded 124 of 137 smear-positive culture-negative specimens. Xpert MTB/RIF also correctly excluded 99.2% (121/122) of nontuberculous mycobacteria (NTM) specimens, including all 33 NTM false-positives by smear microscopy. For the detection of RIF resistance, Xpert MTB/RIF sensitivity and specificity were 100% and 98.3%, respectively. Our findings demonstrate that Xpert MTB/RIF is able to accurately detect MTBC and RIF resistance in routinely collected respiratory specimens in a low TB-incidence setting, with comparable performance to that achieved in high-incidence settings; and suggest that under these conditions the assay has particular utility in detecting smear-negative TB cases, excluding smear-positive patients without MTBC disease, and differentiating MTBC from NTM.

Performance of the Xpert MTB/RIF assay for the diagnosis of pulmonary tuberculosis and rifampin resistance in a low-incidence, high-resource setting

PubMed Central

Rice, Jason P.; Moser, Kathleen S.; Rodwell, Timothy C.

2017-01-01

Performance of the Xpert MTB/RIF assay, designed to simultaneously detect Mycobacterium tuberculosis complex (MTBC) and rifampin (RIF) resistance, has been well documented in low-resource settings with high TB-incidence. However, few studies have assessed its accuracy in low TB incidence settings. We evaluated the performance of Xpert MTB/RIF using clinical sputum specimens routinely collected from suspect pulmonary TB patients over a 4-year time period in San Diego County, California. Xpert MTB/RIF results were compared to acid-fast bacilli (AFB) smear microscopy, mycobacterial culture, and phenotypic drug susceptibility testing (DST). Of 751 sputum specimens, 134 (17.8%) were MTBC culture-positive and 2 (1.5%) were multidrug-resistant (MDR). For the detection of MTBC, Xpert MTB/RIF sensitivity was 89.6% (97.7% and 74.5% in smear-positive and -negative sputa, respectively) and specificity was 97.2%; while AFB smear sensitivity and specificity were 64.9% and 77.8%, respectively. Xpert MTB/RIF detected 35 of 47 smear-negative culture-positive specimens, and excluded 124 of 137 smear-positive culture-negative specimens. Xpert MTB/RIF also correctly excluded 99.2% (121/122) of nontuberculous mycobacteria (NTM) specimens, including all 33 NTM false-positives by smear microscopy. For the detection of RIF resistance, Xpert MTB/RIF sensitivity and specificity were 100% and 98.3%, respectively. Our findings demonstrate that Xpert MTB/RIF is able to accurately detect MTBC and RIF resistance in routinely collected respiratory specimens in a low TB-incidence setting, with comparable performance to that achieved in high-incidence settings; and suggest that under these conditions the assay has particular utility in detecting smear-negative TB cases, excluding smear-positive patients without MTBC disease, and differentiating MTBC from NTM. PMID:29016684

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)

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…

Myocardial adaptations to recreational marathon training among middle-aged men.

PubMed

Zilinski, Jodi L; Contursi, Miranda E; Isaacs, Stephanie K; Deluca, James R; Lewis, Gregory D; Weiner, Rory B; Hutter, Adolph M; d'Hemecourt, Pierre A; Troyanos, Christopher; Dyer, K Sophia; Baggish, Aaron L

2015-02-01

Myocardial adaptations to exercise have been well documented among competitive athletes. To what degree cardiac remodeling occurs among recreational exercisers is unknown. We sought to evaluate the effect of recreational marathon training on myocardial structure and function comprehensively. Male runners (n=45; age, 48±7 years; 64% with ≥1 cardiovascular risk factor) participated in a structured marathon-training program. Echocardiography, cardiopulmonary exercise testing, and laboratory evaluation were performed pre and post training to quantify changes in myocardial structure and function, cardiorespiratory fitness, and traditional cardiac risk parameters. Completion of an 18-week running program (25±9 miles/wk) led to increased cardiorespiratory fitness (peak oxygen consumption, 44.6±5.2 versus 46.3±5.4 mL/kg per minute; P<0.001). In this setting, there was a significant structural cardiac remodeling characterized by dilation of the left ventricle (end-diastolic volume, 156±26 versus 172±28 mL, P<0.001), right ventricle (end-diastolic area=27.0±4.8 versus 28.6±4.3 cm(2); P=0.02), and left atrium (end-diastolic volume, 65±19 versus 72±19; P=0.02). Functional adaptations included increases in both early (E'=12.4±2.5 versus 13.2±2.0 cm/s; P=0.007) and late (A'=11.5±1.9 versus 12.2±2.1 cm/s; P=0.02) left ventricular diastolic velocities. Myocardial remodeling was accompanied by beneficial changes in cardiovascular risk factors, including body mass index (27.0±2.7 versus 26.7±2.6 kg/m(2); P<0.001), total cholesterol (199±33 versus 192±29 mg/dL; P=0.01), low-density lipoprotein (120±29 versus 114±26 mg/dL; P=0.01), and triglycerides (100±52 versus 85±36 mg/dL; P=0.02). Among middle-aged men, recreational marathon training is associated with biventricular dilation, enhanced left ventricular diastolic function, and favorable changes in nonmyocardial determinants of cardiovascular risk. Recreational marathon training may, therefore, serve as an

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)

Rehabilitation of a marathon runner with Guillain-Barré syndrome.

PubMed

Fisher, Tara Beth; Stevens, Jennifer E

2008-12-01

Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyradiculoneuropathy that affects nerve roots and peripheral nerves leading to motor neuropathy and flaccid paralysis. This case report describes the physical therapy examination, intervention, and outcomes for a marathon runner with GBS. The patient was a 30-year-old male marathon runner who presented with acutely evolving motor and sensory deficits that initially stabilized and then worsened. Both GBS and chronic inflammatory demyelinating polyradiculoneuropathy were considered as diagnoses, and medical treatment included a combination of intravenous administration of immunoglobulins, plasmapheresis, and corticosteroids. During his stay in an acute inpatient rehabilitation facility, the intervention was focused on regaining functional independence and strength with care not to induce fatigue or relapse. After three weeks in an acute inpatient rehabilitation facility, the patient showed marked gains in Functional Independence Measure scores and muscle performance as measured by manual muscle testing.

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

Xpert MTB/RIF for rapid detection of rifampicin-resistant Mycobacterium tuberculosis from pulmonary tuberculosis patients in Southwest Ethiopia.

PubMed

Tadesse, Mulualem; Aragaw, Dossegnaw; Dimah, Belayneh; Efa, Feyisa; Abebe, Gemeda

2016-12-01

Accurate and rapid detection of drug-resistant strains of tuberculosis (TB) is critical for early initiation of treatment and for limiting the transmission of drug-resistant TB. Here, we investigated the accuracy of Xpert MTB/RIF for detection of rifampicin (RIF) resistance, and whether this detection predicts the presence of multidrug resistant (MDR) TB in Southwest Ethiopia. Smear- or culture-positive sputa obtained from TB patients with increased suspicion of drug resistance were included in this study. GenoType MTBDRplus line-probe assays (LPAs) and Xpert MTB/RIF tests were performed on smear-positive sputum specimens and on cultured isolates for smear-negative specimens. We performed routine drug-susceptibility testing using LPA as the reference standard for confirmation of RIF and isoniazid (INH) resistance. First-line drug-susceptibility results were available for 67 Mycobacterium tuberculosis complex-positive sputum specimens using the LPA test, with our preliminary results indicating that 30% (20/67) were MDR-TB, 3% (2/67) were RIF monoresistant, 6% (4/67) were INH monoresistant, and 61% (41/67) were susceptible to both RIF and INH. Relative to routine RIF-susceptibility testing (LPA), Xpert MTB/RIF detected all RIF resistance correctly, with 100% sensitivity and 97.8% specificity and a positive-predictive value of 95.7%. Of the 23 RIF-resistant strains according to Xpert MTB/RIF, 87% (20/23) were resistant to both RIF and INH (MDR), 8.7% (2/23) were RIF monoresistant, and 4.3% (1/23) were sensitive to RIF according to the LPA test. A high proportion of RIF resistance was documented among patients previously categorized as failure cases (50%, 10/20), followed by relapse cases (31.6%, 6/19) and defaulters (28.6%, 2/7). Xpert MTB/RIF was highly effective at identifying RIF-resistant strains in smear- or culture-positive samples. RIF resistance based on Xpert MTB/RIF results could be used to estimate MDR and allow rapid initiation of MDR-TB treatment in

Effects of running a marathon on irisin concentration in men aged over 50.

PubMed

Jóźków, Paweł; Koźlenia, Dawid; Zawadzka, Katarzyna; Konefał, Marek; Chmura, Paweł; Młynarska, Katarzyna; Kosowski, Michał; Mędraś, Marek; Chmura, Jan; Ponikowski, Piotr; Daroszewski, Jacek

2018-05-14

Our aim was to verify whether running a marathon is associated with changes in irisin concentration in healthy, endurance-trained men. In an observational study, we assessed baseline biochemical and fitness parameters of 28 middle-aged runners (mean ± SD age, BMI, VO 2max : 58 ± 8 years; 24.5 ± 3 kg/m 2 ; 51.1 ± 1.7 ml/kg/min). We evaluated irisin before, immediately after, and 7 days after the marathon. Irisin concentration decreased from a baseline value of 639 ± 427 to 461 ± 255 ng/ml immediately after the marathon (p < 0.05). After 7 days, it was still significantly lower than before the race, at 432 ± 146 ng/ml (p < 0.05). We found no correlations between irisin concentration and the training history of the studied subjects. We conclude that a long-distance run may have a negative impact on irisin release in men. This effect was not correlated with the training history of runners.

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…

Role of Xpert MTB/RIF in differentiating tuberculosis from sarcoidosis in patients with mediastinal lymphadenopathy undergoing EBUS-TBNA: a study of 147 patients.

PubMed

Dhooria, Sahajal; Gupta, Nalini; Bal, Amanjit; Sehgal, Inderpaul Singh; Aggarwal, Ashutosh Nath; Sethi, Sunil; Behera, Digambar; Agarwal, Ritesh

2016-10-07

In patients with intrathoracic lymphadenopathy, differentiating tuberculosis from sarcoidosis is often difficult. We hypothesized that Xpert MTB/RIF assay, a semi-automated hemi-nested PCR would help in this regard. To evaluate the performance of Xpert MTB/RIF in the differential diagnosis of tuberculosis and sarcoidosis. This was a retrospective analysis of patients with intrathoracic lymphadenopathy who underwent endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA), and were diagnosed as either tuberculosis or sarcoidosis. The results of Xpert MTB/RIF assay, tuberculin skin test and endosonographic characteristics (heterogeneous echotexture and coagulation necrosis sign) of the lymph nodes were compared between the two groups. During the study period, 465 EBUS procedures were performed and a diagnosis of sarcoidosis (n=94) or tuberculosis (n=53) was made in 147 patients. Xpert MTB/RIF was positive in 26 (49.1%) and two (2.1%) patients with tuberculosis and sarcoidosis, respectively. The sensitivity, specificity, positive and negative predictive values of Xpert MTB/RIF in the diagnosis of tuberculosis were 49.1 %, 97.9%, 92.9% and 77.3%, respectively. The presence of any of the four features namely positive Xpert MTB/RIF, positive tuberculin skin test, heterogeneous echotexture of the lymph nodes, or the presence of endosonographic coagulation necrosis sign yielded a sensitivity and negative predictive value of 83.0% and 88.0%, respectively in the diagnosis of tuberculosis versus sarcoidosis. Xpert MTB/RIF has good specificity and positive predictive value in the diagnosis of tuberculosis, and is a useful investigation in separating tuberculosis from sarcoidosis.

Evaluation of the safety and immunogenicity of two antigen concentrations of the Mtb72F/AS02(A) candidate tuberculosis vaccine in purified protein derivative-negative adults.

PubMed

Leroux-Roels, Isabel; Leroux-Roels, Geert; Ofori-Anyinam, Opokua; Moris, Philippe; De Kock, Els; Clement, Frédéric; Dubois, Marie-Claude; Koutsoukos, Marguerite; Demoitié, Marie-Ange; Cohen, Joe; Ballou, W Ripley

2010-11-01

Tuberculosis (TB) remains a major cause of illness and death worldwide, making a new TB vaccine an urgent public health priority. Purified protein derivative (PPD)-negative adults (n = 50) were equally randomized to receive 3 doses at 1-month intervals (at 0, 1, and 2 months) of one of the following vaccines: Mtb72F/AS02(A) (10 or 40 μg antigen), Mtb72F/saline (10 or 40 μg antigen), or AS02(A). Mtb72F/AS02(A) recipients received an additional dose 1 year after the first dose to evaluate if the elicited immune response could be boosted. Mtb72F/AS02(A) vaccines were locally reactogenic but clinically well tolerated, with transient adverse events (usually lasting between 1 and 4 days) that resolved without sequelae being observed. No vaccine-related serious adverse events were reported. Vaccination with Mtb72F/AS02(A) induced a strong Mtb72F-specific humoral response and a robust Mtb72F-specific CD4(+) T-cell response, both of which persisted at 9 months after primary immunization and for 1 year after the booster immunization. There was no significant difference between the magnitude of the CD4(+) T-cell response induced by the 10-μg and 40-μg Mtb72F/AS02(A) vaccines. The Mtb72F-specific CD4(+) T cells predominantly expressed CD40L; CD40L and interleukin-2 (IL-2); CD40L and tumor necrosis factor alpha (TNF-α); CD40L, IL-2, and TNF-α; and CD40L, IL-2, TNF-α, and gamma interferon (IFN-γ). Serum IFN-γ, but not TNF-α, was detected 1 day after doses 2 and 3 for the Mtb72F/AS02(A) vaccine but did not persist. Vaccine-induced CD8(+) T-cell responses were not detected, and no immune responses were elicited with AS02(A) alone. In conclusion, Mtb72F/AS02(A) is clinically well tolerated and is highly immunogenic in TB-naïve adults. The 10- and 40-μg Mtb72F/AS02(A) vaccines show comparable safety and immunogenicity profiles.

The experience of breast pain (mastalgia) in female runners of the 2012 London Marathon and its effect on exercise behaviour.

PubMed

Brown, Nicola; White, Jennifer; Brasher, Amanda; Scurr, Joanna

2014-02-01

For female marathon runners, breast pain (mastalgia) may be an important issue which has yet to be considered. This study aimed to determine the prevalence and severity of mastalgia in female marathon runners, identify factors that increase mastalgia and methods used to overcome mastalgia, and explore the impact that mastalgia may have on marathon training. 1397 female marathon runners were surveyed at the 2012 London Marathon Registration. All participants who completed the four-part, 30-question survey in its entirety have been included in the analysis (n=1285). 32% of participants experienced mastalgia. This was significantly related to cup size and was greater during vigorous compared with moderate physical activity. Exercise-related factors were the primary factors reported to increase mastalgia participation. Seventeen per cent of symptomatic participants reported that mastalgia affected their exercise behaviour. Methods reportedly used to overcome mastalgia included pain medication and firm breast support; however, 44% of participants took no measures to relieve symptoms despite over half describing their mastalgia as discomforting. Mastalgia was experienced by a third of marathon runners and was found to be related to breast size which has previously been unreported. The link between exercise and mastalgia has yet to be established; however, this study identified that exercise was the most prevalent factor in mastalgia occurrence which may have implications for its management. The number of participants who took no measures to relieve their mastalgia, or resorted to pain medication, highlights the importance and significance of research into exercise-related mastalgia.

Cross-Country Skiing Injuries and Training Methods.

PubMed

Nagle, Kyle B

2015-01-01

Cross-country skiing is a low injury-risk sport that has many health benefits and few long-term health risks. Some concern exists that cross-country skiing may be associated with a higher incidence of atrial fibrillation; however, mortality rates among skiers are lower than those among the general population. While continuing to emphasize aerobic and anaerobic training, training methods also should promote ski-specific strength training to increase maximum force and its rate of delivery and to build muscular endurance to maintain that power through a race. Multiple tests are available to monitor training progress. Which tests are most appropriate depends on the specific events targeted. In addition to laboratory-based tests, there also are many simpler, more cost-effective tests, such as short time trials, that can be used to monitor training progress and predict performance particularly at the junior skier level where access and cost may be more prohibitive.

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…

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

PubMed

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

2016-01-01

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. 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. 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. 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.

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

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…

Evaluation of cytokine responses against novel Mtb antigens as diagnostic markers for TB disease.

PubMed

Awoniyi, Dolapo O; Teuchert, Andrea; Sutherland, Jayne S; Mayanja-Kizza, Harriet; Howe, Rawleigh; Mihret, Adane; Loxton, Andre G; Sheehama, Jacob; Kassa, Desta; Crampin, Amelia C; Dockrell, Hazel M; Kidd, Martin; Rosenkrands, Ida; Geluk, Annemieke; Ottenhoff, Tom H M; Corstjens, P L A M; Chegou, Novel N; Walzl, Gerhard

2016-09-01

We investigated the accuracy of host markers detected in Mtb antigen-stimulated whole blood culture supernatant in the diagnosis of TB. Prospectively, blood from 322 individuals with presumed TB disease from six African sites was stimulated with four different Mtb antigens (Rv0081, Rv1284, ESAT-6/CFP-10, and Rv2034) in a 24 h whole blood stimulation assay (WBA). The concentrations of 42 host markers in the supernatants were measured using the Luminex multiplex platform. Diagnostic biosignatures were investigated through the use of multivariate analysis techniques. 17% of the participants were HIV infected, 106 had active TB disease and in 216 TB was excluded. Unstimulated concentrations of CRP, SAA, ferritin and IP-10 had better discriminating ability than markers from stimulated samples. Accuracy of marker combinations by general discriminant analysis (GDA) identified a six analyte model with 77% accuracy for TB cases and 84% for non TB cases, with a better performance in HIV uninfected patients. A biosignature of 6 cytokines obtained after stimulation with four Mtb antigens has moderate potential as a diagnostic tool for pulmonary TB disease individuals and stimulated marker expression had no added value to unstimulated marker performance. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

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.

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)

Defined tuberculosis vaccine, Mtb72F/AS02A, evidence of protection in cynomolgus monkeys

PubMed Central

Reed, Steven G.; Coler, Rhea N.; Dalemans, Wilfried; Tan, Esterlina V.; DeLa Cruz, Eduardo C.; Basaraba, Randall J.; Orme, Ian M.; Skeiky, Yasir A. W.; Alderson, Mark R.; Cowgill, Karen D.; Prieels, Jean-Paul; Abalos, Rodolfo M.; Dubois, Marie-Claude; Cohen, Joe; Mettens, Pascal; Lobet, Yves

2009-01-01

The development of a vaccine for tuberculosis requires a combination of antigens and adjuvants capable of inducing appropriate and long-lasting T cell immunity. We evaluated Mtb72F formulated in AS02A in the cynomolgus monkey model. The vaccine was immunogenic and caused no adverse reactions. When monkeys were immunized with bacillus Calmette–Guérin (BCG) and then boosted with Mtb72F in AS02A, protection superior to that afforded by using BCG alone was achieved, as measured by clinical parameters, pathology, and survival. We observed long-term survival and evidence of reversal of disease progression in monkeys immunized with the prime-boost regimen. Antigen-specific responses from protected monkeys receiving BCG and Mtb72F/AS02A had a distinctive cytokine profile characterized by an increased ratio between 3 Th1 cytokines, IFN-γ, TNF, and IL-2 and an innate cytokine, IL-6. To our knowledge, this is an initial report of a vaccine capable of inducing long-term protection against tuberculosis in a nonhuman primate model, as determined by protection against severe disease and death, and by other clinical and histopathological parameters. PMID:19188599

Microscopic observation drug-susceptibility assay vs. Xpert® MTB/RIF for the diagnosis of tuberculosis in a rural African setting: a cost-utility analysis.

PubMed

Wikman-Jorgensen, Philip E; Llenas-García, Jara; Pérez-Porcuna, Tomàs M; Hobbins, Michael; Ehmer, Jochen; Mussa, Manuel A; Ascaso, Carlos

2017-06-01

To compare the cost-utility of microscopic observation drug-susceptibility assay (MODS) and Xpert ® MTB/RIF implementation for tuberculosis (TB) diagnosis in rural northern Mozambique. Stochastic transmission compartmental TB model from the healthcare provider perspective with parameter input from direct measurements, systematic literature reviews and expert opinion. MODS and Xpert ® MTB/RIF were evaluated as replacement test of smear microscopy (SM) or as an add-on test after a negative SM. Costs were calculated in 2013 USD, effects in disability-adjusted life years (DALY). Willingness to pay threshold (WPT) was established at once the per capita Gross National Income of Mozambique. MODS as an add-on test to negative SM produced an incremental cost-effectiveness ratio (ICER) of 5647.89USD/DALY averted. MODS as a substitute for SM yielded an ICER of 5374.58USD/DALY averted. Xpert ® MTB/RIF as an add-on test to negative SM yielded ICER of 345.71USD/DALY averted. Xpert ® MTB/RIF as a substitute for SM obtained an ICER of 122.13USD/DALY averted. TB prevalence and risk of infection were the main factors impacting MODS and Xpert ® MTB/RIF ICER in the one-way sensitivity analysis. In the probabilistic sensitivity analysis, Xpert ® MTB/RIF was most likely to have an ICER below the WPT, whereas MODS was not. Our cost-utility analysis favours the implementation of Xpert ® MTB/RIF as a replacement of SM for all TB suspects in this rural high TB/HIV prevalence African setting. © 2017 John Wiley & Sons Ltd.

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.

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)

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)

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

The Dynamics of Cardiovascular Biomarkers in non-Elite Marathon Runners.

PubMed

Roca, Emma; Nescolarde, Lexa; Lupón, Josep; Barallat, Jaume; Januzzi, James L; Liu, Peter; Cruz Pastor, M; Bayes-Genis, Antoni

2017-04-01

The number of recreational/non-elite athletes participating in marathons is increasing, but data regarding impact of endurance exercise on cardiovascular health are conflicting. This study evaluated 79 recreational athletes of the 2016 Barcelona Marathon (72% men; mean age 39 ± 6 years; 71% ≥35 years). Blood samples were collected at baseline (24-48 h before the race), immediately after the race (1-2 h after the race), and 48-h post-race. Amino-terminal pro-B type natriuretic peptide (NT-proBNP, a marker of myocardial strain), ST2 (a marker of extracellular matrix remodeling and fibrosis, inflammation, and myocardial strain), and high-sensitivity troponin T (hs-TnT, a marker of myocyte stress/injury) were assayed. The median (interquartile range, IQR) years of training was 7 (5-11) years and median (IQR) weekly training hours was 6 (5-8) h/week, respectively. The median (IQR) race time (h:min:s) was 3:32:44 (3:18:50-3:51:46). Echocardiographic indices were within normal ranges. Immediately after the race, blood concentration of the three cardiac biomarkers increased significantly, with 1.3-, 1.6-, and 16-fold increases in NT-proBNP, ST2, and hs-TnT, respectively. We found an inverse relationship between weekly training hours and increased ST2 (p = 0.007), and a direct relationship between race time and increased hs-TnT (p < 0.001) and ST2 (p = 0.05). Our findings indicate that preparation for and participation in marathon running may affect multiple pathways affecting the cardiovascular system. More data and long-term follow-up studies in non-elite and elite athletes are needed.

Perceptions of perioperative nursing competence: a cross-country comparison.

PubMed

Gillespie, Brigid M; Harbeck, Emma B; Falk-Brynhildsen, Karin; Nilsson, Ulrica; Jaensson, Maria

2018-01-01

Throughout many countries, professional bodies rely on yearly self-assessment of competence for ongoing registration; therefore, nursing competence is pivotal to safe clinical practice. Our aim was to describe and compare perioperative nurses' perceptions of competence in four countries, while examining the effect of specialist education and years of experience in the operating room. We conducted a secondary analysis of cross-sectional surveys from four countries including; Australia, Canada, Scotland, and Sweden. The 40-item Perceived Perioperative Competence Scale-Revised (PPCS-R), was used with a total sample of 768 respondents. We used a factorial design to examine the influence of country, years of experience in the operating room and specialist education on nurses' reported perceived perioperative competence. Regardless of country origin, nurses with specialist qualifications reported higher perceived perioperative competence when compared to nurses without specialist education. However, cross-country differences were dependent on nurses' number of years of experience in the operating room. Nurses from Sweden with 6-10 years of experience in the operating room reported lower perceived perioperative competence when compared to Australian nurses. In comparing nurses with > 10 years of experience, Swedish nurses reported significantly lower perceived perioperative competence when compared to nurses from Australia, Canada and Scotland. Researchers need to consider educational level and years of experience in the perioperative context when examining constructs such as competence.

Marathon works

PubMed Central

Orrantia, Eliseo

2005-01-01

PROBLEM BEING ADDRESSED Medical care in rural Canada has long been hampered by insufficient numbers of physicians. How can a rural community’s physicians change the local medical culture and create a new approach to sustaining their practice? OBJECTIVE OF PROGRAM To create a sustainable, collegial family practice group and address one rural community’s chronically underserviced health care needs. PROGRAM DESCRIPTION Elements important to physicians’ well-being were incorporated into the health care group’s functioning to enhance retention and recruitment. The intentional development of a consensus-based approach to decision making has created a supportive team of physicians. Ongoing communication is kept up through regular meetings, retreats, and a Web-based discussion board. Individual physicians retain control of their hours worked each year and their schedules. A novel obstetric call system was introduced to help make schedules more predictable. An internal governance agreement on an alternative payment plan supports varied work schedules, recognizes and funds non-clinical medical work, and pays group members for undertaking health-related projects. CONCLUSION This approach has helped maintain a stable number of physicians in Marathon, Ont, and has increased the number of health care services delivered to the community. PMID:16190174

Increased pediatric functional neurological symptom disorders after the Boston marathon bombings: a case series.

PubMed

Guerriero, Réjean M; Pier, Danielle B; de Gusmão, Claudio M; Bernson-Leung, Miya E; Maski, Kiran P; Urion, David K; Waugh, Jeff L

2014-11-01

Functional neurological symptom disorders are frequently the basis for acute neurological consultation. In children, they are often precipitated by high-frequency everyday stressors. The extent to which a severe traumatic experience may also precipitate functional neurological abnormalities is unknown. For the 2-week period after the Boston Marathon bombings, we prospectively collected data on patients whose presentation suggested a functional neurological symptom disorder. We assessed clinical and demographic variables, duration of symptoms, extent of educational impact, and degree of connection to the Marathon bombing. We contacted all patients at 6 months after presentation to determine the outcome and accuracy of the diagnosis. In a parallel study, we reported a baseline of 2.6 functional neurological presentations per week in our emergency room. In the week after the Marathon bombings, this frequency tripled. Ninety-one percent of presentations were delayed by 1 week, with onset around the first school day after a city-wide lockdown. Seventy-three percent had a history of a prior psychiatric diagnosis. At the 6 months follow-up, no functional neurological symptom disorder diagnoses were overturned and no new organic diagnosis was made. Pediatric functional neurological symptom disorder may be precipitated by both casual and high-intensity stressors. The 3.4-fold increase in incidence after the Boston Marathon bombings and city-wide lockdown demonstrates the marked effect that a community-wide tragedy can have on the mental health of children. Care providers must be aware of functional neurological symptom disorders after stressful community events in vulnerable patient populations, particularly those with prior psychiatric diagnoses. Copyright © 2014 Elsevier Inc. All rights reserved.

Structure of the Mtb CarD/RNAP β-lobes complex reveals the molecular basis of interaction and presents a distinct DNA-binding domain for Mtb CarD.

PubMed

Gulten, Gulcin; Sacchettini, James C

2013-10-08

CarD from Mycobacterium tuberculosis (Mtb) is an essential protein shown to be involved in stringent response through downregulation of rRNA and ribosomal protein genes. CarD interacts with the β-subunit of RNAP and this interaction is vital for Mtb's survival during the persistent infection state. We have determined the crystal structure of CarD in complex with the RNAP β-subunit β1 and β2 domains at 2.1 Å resolution. The structure reveals the molecular basis of CarD/RNAP interaction, providing a basis to further our understanding of RNAP regulation by CarD. The structural fold of the CarD N-terminal domain is conserved in RNAP interacting proteins such as TRCF-RID and CdnL, and displays similar interactions to the predicted homology model based on the TRCF/RNAP β1 structure. Interestingly, the structure of the C-terminal domain, which is required for complete CarD function in vivo, represents a distinct DNA-binding fold. Copyright © 2013 Elsevier Ltd. All rights reserved.

Foot-strike pattern and performance in a marathon.

PubMed

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

2013-05-01

To determine prevalence of heel strike in a midsize city marathon, if there is an association between foot-strike classification and race performance, and if there is an association between foot-strike classification and gender. Foot-strike classification (forefoot, midfoot, heel, or split strike), gender, and rank (position in race) were recorded at the 8.1-km mark for 2112 runners at the 2011 Milwaukee Lakefront Marathon. 1991 runners were classified by foot-strike pattern, revealing a heel-strike prevalence of 93.67% (n = 1865). A significant difference between foot-strike classification and performance was found using a Kruskal-Wallis test (P < .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 exact test. In addition, subgroup analysis of the 126 non-heel strikers found no significant difference between shoe wear and performance using a Kruskal-Wallis test. The high prevalence of heel striking observed in this study reflects the foot-strike pattern of most mid-distance to long-distance runners and, more important, may predict their injury profile based on the biomechanics of a heel-strike running pattern. This knowledge can help clinicians appropriately diagnose, manage, and train modifications of injured runners.

Evaluation of GeneXpert MTB/RIF for detection of Mycobacterium tuberculosis complex and rpo B gene in respiratory and non-respiratory clinical specimens at a tertiary care teaching hospital in Saudi Arabia.

PubMed

Somily, Ali M; Barry, Mazin A; Habib, Hanan A; Alotaibi, Fawzia E; Al-Zamil, Fahad A; Khan, Mohammed A; Sarwar, Mohammed S; Bakhash, Nawab D; Alrabiaah, Abdulkarim A; Shakoor, Zahid A; Senok, Abiola C

2016-12-01

To assess the performance of Xpert MTB/RIF, an automated molecular test for Mycobacterium tuberculosis (MTB) and resistance to rifampin (RIF), against smear microscopy and culture method for diagnosis of MTB infection. Methods: This is a retrospective analysis of 103 respiratory and 137 non-respiratory patient specimens suspected of tuberculosis at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia performed between April 2014 and March 2015. Each sample underwent smear microscopy, mycobacterial culture, and GeneXpert MTB/RIF test. Results: Fifteen out of 103 respiratory samples were smear and culture positive, whereas 9 out of 137 non-respiratory samples were smear positive. Out of 9 smear positive specimens, 8 were also culture positive. All 15 culture positive respiratory samples were detected by Xpert MTB/RIF (sensitivity  and positive predictive value [PPV]=100%). Similarly, all 8 culture positive non-respiratory specimens were identified by Xpert MTB/RIF (sensitivity 100%; PPV 88.8%). The Xpert MTB/RIF detected only one false positive result in 88 smear negative respiratory specimens (specificity 98.9%; negative predictive value [NPV]= 100%). All 125 smear negative non-respiratory specimens tested negative by culture and Xpert MTB/RIF (sensitivity, specificity, PPV, NPV= 100%). Conclusion: The performance of Xpert MTB/RIF was comparable to the gold standard culture method for identification of MTB in both respiratory and non-respiratory clinical specimens.

Evaluation of GeneXpert MTB/RIF for detection of Mycobacterium tuberculosis complex and rpo B gene in respiratory and non-respiratory clinical specimens at a tertiary care teaching hospital in Saudi Arabia

PubMed Central

Somily, Ali M.; Barry, Mazin A.; Habib, Hanan A.; Alotaibi, Fawzia E.; Al-Zamil, Fahad A.; Khan, Mohammed A.; Sarwar, Mohammed S.; Bakhash, Nawab D.; Alrabiaah, Abdulkarim A.; Shakoor, Zahid A.; Senok, Abiola C.

2016-01-01

Objectives To assess the performance of Xpert MTB/RIF, an automated molecular test for Mycobacterium tuberculosis (MTB) and resistance to rifampin (RIF), against smear microscopy and culture method for diagnosis of MTB infection. Methods This is a retrospective analysis of 103 respiratory and 137 non-respiratory patient specimens suspected of tuberculosis at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia performed between April 2014 and March 2015. Each sample underwent smear microscopy, mycobacterial culture, and GeneXpert MTB/RIF test. Results Fifteen out of 103 respiratory samples were smear and culture positive, whereas 9 out of 137 non-respiratory samples were smear positive. Out of 9 smear positive specimens, 8 were also culture positive. All 15 culture positive respiratory samples were detected by Xpert MTB/RIF (sensitivity and positive predictive value [PPV]=100%). Similarly, all 8 culture positive non-respiratory specimens were identified by Xpert MTB/RIF (sensitivity 100%; PPV 88.8%). The Xpert MTB/RIF detected only one false positive result in 88 smear negative respiratory specimens (specificity 98.9%; negative predictive value [NPV]= 100%). All 125 smear negative non-respiratory specimens tested negative by culture and Xpert MTB/RIF (sensitivity, specificity, PPV, NPV= 100%). Conclusion The performance of Xpert MTB/RIF was comparable to the gold standard culture method for identification of MTB in both respiratory and non-respiratory clinical specimens. PMID:27874159

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.

Discordance between MTB/RIF and Real-Time Tuberculosis-Specific Polymerase Chain Reaction Assay in Bronchial Washing Specimen and Its Clinical Implications.

PubMed

Jo, Yong Suk; Park, Ju-Hee; Lee, Jung Kyu; Heo, Eun Young; Chung, Hee Soon; Kim, Deog Kyeom

2016-01-01

The prevalence and clinical implications of discordance between Xpert MTB/RIF assays and the AdvanSure TB/NTM real-time polymerase chain reaction (PCR) for bronchial washing specimens have not been studied in pulmonary TB (PTB) patients. The discordant proportion and its clinical impact were evaluated in 320 patients from the bronchoscopy registry whose bronchial washing specimens were tested simultaneously with Xpert MTB/RIF and the TB/NTM PCR assay for three years, and the accuracy of the assays, including the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were studied. The clinical risk factors for discordance and false positivity of assays were also studied. Among 130 patients who were clinically diagnosed with PTB, 64 patients showed positive acid-fast bacilli culture results, 56 patients showed positive results in molecular methods and clinician diagnosed PTB without results of microbiology in 10 patients. The sensitivity, specificity, PPV, and NPV were 80.0%, 98.95%, 98.1%, and 87.9%, respectively, for Xpert MTB/RIF and 81.5%, 92.6%, 88.3%, and 88.0%, respectively, for TB/NTM PCR. The discordant proportion was 16.9% and was higher in culture-negative PTB compared to culture-confirmed PTB (24.3% vs. 9.4%, p = 0.024). However, there were no significant differences in the clinical characteristics, regardless of the discordance. The diagnostic yield increased with an additional assay (7.7% for Xpert MTB/RIF and 9.2% for TB/NTM PCR). False positivity was less common in patients tested with Xpert MTB/RIF (1.05% vs. 7.37%, p = 0.0035). No host-related risk factor for false positivity was identified. The Xpert MTB/RIF and TB/NTM PCR assay in bronchial washing specimens can improve the diagnostic yields for PTB, although there were considerable discordant results without any patient-related risk factors.

Skeletal muscle architectural adaptations to marathon run training.

PubMed

Murach, Kevin; Greever, Cory; Luden, Nicholas D

2015-01-01

We assessed lateral gastrocnemius (LG) and vastus lateralis (VL) architecture in 16 recreational runners before and after 12 weeks of marathon training. LG fascicle length decreased 10% while pennation angle increased 17% (p < 0.05). There was a significant correlation between diminished blood lactate levels and LG pennation angle change (r = 0.90). No changes were observed in VL. This is the first evidence that run training can modify skeletal muscle architectural features.

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)

Analytical and clinical performance characteristics of the Abbott RealTime MTB RIF/INH Resistance, an assay for the detection of rifampicin and isoniazid resistant Mycobacterium tuberculosis in pulmonary specimens.

PubMed

Kostera, Joshua; Leckie, Gregor; Tang, Ning; Lampinen, John; Szostak, Magdalena; Abravaya, Klara; Wang, Hong

2016-12-01

Clinical management of drug-resistant tuberculosis patients continues to present significant challenges to global health. To tackle these challenges, the Abbott RealTime MTB RIF/INH Resistance assay was developed to accelerate the diagnosis of rifampicin and/or isoniazid resistant tuberculosis to within a day. This article summarizes the performance of the Abbott RealTime MTB RIF/INH Resistance assay; including reliability, analytical sensitivity, and clinical sensitivity/specificity as compared to Cepheid GeneXpert MTB/RIF version 1.0 and Hain MTBDRplus version 2.0. The limit of detection (LOD) of the Abbott RealTime MTB RIF/INH Resistance assay was determined to be 32 colony forming units/milliliter (cfu/mL) using the Mycobacterium tuberculosis (MTB) strain H37Rv cell line. For rifampicin resistance detection, the Abbott RealTime MTB RIF/INH Resistance assay demonstrated statistically equivalent clinical sensitivity and specificity as compared to Cepheid GeneXpert MTB/RIF. For isoniazid resistance detection, the assay demonstrated statistically equivalent clinical sensitivity and specificity as compared to Hain MTBDRplus. The performance data presented herein demonstrate that the Abbott RealTime MTB RIF/INH Resistance assay is a sensitive, robust, and reliable test for realtime simultaneous detection of first line anti-tuberculosis antibiotics rifampicin and isoniazid in patient specimens. Copyright © 2016 The Author. Published by Elsevier Ltd.. All rights reserved.

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

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

2016-02-05

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.

[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

SAR Studies on Trisubstituted Benzimidazoles as Inhibitors of Mtb FtsZ for the Development of Novel Antitubercular Agents

PubMed Central

Awasthi, Divya; Kumar, Kunal; Knudson, Susan E.; Slayden, Richard A.; Ojima, Iwao

2014-01-01

FtsZ, an essential protein for bacterial cell division, is a highly promising therapeutic target, especially for the discovery and development of new-generation anti-TB agents. Following up the identification of two lead 2,5,6-trisubstituted benzimidazoles, 1 and 2, targeting Mtb-FtsZ in our previous study, an extensive SAR study for optimization of these lead compounds was performed through systematic modification of the 5 and 6 positions. This study has successfully led to the discovery of a highly potent advanced lead 5f (MIC 0.06 µg/mL) and several other compounds with comparable potencies. These advanced lead compounds possess a dimethylamino group at the 6 position. The functional groups at the 5 position exhibit substantial effects on the antibacterial activity as well. In vitro experiments such as the FtsZ polymerization inhibitory assay and TEM analysis of Mtb-FtsZ treated with 5f and others indicate that Mtb-FtsZ is the molecular target for their antibacterial activity. PMID:24266862

SAR studies on trisubstituted benzimidazoles as inhibitors of Mtb FtsZ for the development of novel antitubercular agents.

PubMed

Awasthi, Divya; Kumar, Kunal; Knudson, Susan E; Slayden, Richard A; Ojima, Iwao

2013-12-12

FtsZ, an essential protein for bacterial cell division, is a highly promising therapeutic target, especially for the discovery and development of new-generation anti-TB agents. Following up the identification of two lead 2,5,6-trisubstituted benzimidazoles, 1 and 2, targeting Mtb-FtsZ in our previous study, an extensive SAR study for optimization of these lead compounds was performed through systematic modification of the 5 and 6 positions. This study has successfully led to the discovery of a highly potent advanced lead 5f (MIC = 0.06 μg/mL) and several other compounds with comparable potencies. These advanced lead compounds possess a dimethylamino group at the 6 position. The functional groups at the 5 position exhibit substantial effects on the antibacterial activity as well. In vitro experiments such as the FtsZ polymerization inhibitory assay and TEM analysis of Mtb-FtsZ treated with 5f and others indicate that Mtb-FtsZ is the molecular target for their antibacterial activity.

Melanoma markers in marathon runners: increase with sun exposure and physical strain.

PubMed

Richtig, Erika; Ambros-Rudolph, Christina M; Trapp, Michael; Lackner, Helmut K; Hofmann-Wellenhof, Rainer; Kerl, Helmut; Schwaberger, Guenther

2008-01-01

Marathon runners seem to have an increased melanoma risk. To identify potential melanoma markers. 150 marathon runners volunteered to take part in the skin cancer screening campaign. After the runners completed a questionnaire about melanoma risk factors, types of sportswear and training programs, they received a total skin examination. The number of lentigines and nevi on the left shoulder and the left buttock were counted in each participant using templates in standardized positions. The potential association of training sportswear and training parameters with the number of lentigines and nevi on the left shoulder was evaluated. The mean number of lentigines on the left shoulder was 19.6 +/- 18.2 (SD), whereas no lentigines were found on the left buttock (p = 0.000). The number of nevi also differed significantly between the 2 localizations with higher numbers on the left shoulder (p = 0.000). While lifetime sunburn history and type of sportswear correlated with the number of lentigines, training parameters had an impact on the number of nevi. Independent of their mean weekly running time, runners with higher heart rates while training, higher training velocities and higher physical strain indexes showed more nevi on the shoulder than the other runners (p = 0.029, 0.046, 0.038, respectively). Sun exposure and high physical strain lead to an increase in melanoma markers such as lentigines and nevi in marathon runners. Copyright 2008 S. Karger AG, Basel.

Evaluation of a new automated Abbott RealTime MTB RIF/INH assay for qualitative detection of rifampicin/isoniazid resistance in pulmonary and extra-pulmonary clinical samples of Mycobacterium tuberculosis.

PubMed

Ruiz, Pilar; Causse, Manuel; Vaquero, Manuel; Gutierrez, Juan Bautista; Casal, Manuel

2017-01-01

A new automated real-time PCR assay for the detection of rifampicin (RIF) and isoniazid (INH) resistance in Mycobacterium tuberculosis (MTB) was evaluated. A total of 163 clinical samples (128 pulmonary and 35 extra-pulmonary) were processed using four PCR assay kits: Abbott RealTime MTB RIF/INH, Genotype MTBDRplus, Xpert/MTB RIF, and Anyplex MTB/MDR. The results of phenotypic drug-susceptibility testing using BACTECMGIT 960 were used as reference. The sensitivity and specificity of the new Abbott RealTime MTB RIF/INH assay in comparison with phenotypic testing was 96.3% (95%CI 87.32%-100%) for RIF and 100% (95%CI 99.3%-100%) for INH; the sensitivity was 78.8% (95%CI 66.8%-90.9%) and the specificity was 100% (95%CI 98.9%-100%). The Abbott RealTime MTB RIF/INH test could be a valid method for detecting the most common mutations in strains resistant to RIF and INH.

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

Prevalence of allergy and upper respiratory tract symptoms in runners of the London marathon.

PubMed

Robson-Ansley, Paula; Howatson, Glyn; Tallent, Jamie; Mitcheson, Kelly; Walshe, Ian; Toms, Chris; DU Toit, George; Smith, Matt; Ansley, Les

2012-06-01

The prevalence of self-reported upper respiratory tract (URT) symptoms in athletes has been traditionally associated with opportunistic infection during the temporal suppression of immune function after prolonged exercise. There is little evidence for this, and a competing noninfectious hypothesis has been proposed, whereby the exercise-induced immune system modulations favor the development of atopy and allergic disease, which manifests as URT symptoms. The aim of this study was to examine the association between allergy and URT symptoms in runners after an endurance running event. Two hundred eight runners from the 2010 London Marathon completed the validated Allergy Questionnaire for Athletes (AQUA) and had serum analyzed for total and specific immunoglobulin E response to common inhalant allergens. Participants who completed the marathon and nonrunning controls who lived in the same household were asked to complete a diary on URT symptoms. Forty percent of runners had allergy as defined by both a positive AQUA and elevated specific immunoglobulin E. Forty-seven percent of runners experienced URT symptoms after the marathon. A positive AQUA was a significant predictor of postmarathon URT symptoms in runners. Only 19% of nonrunning controls reported symptoms. The prevalence of allergy in recreational marathon runners was similar to that in elite athletes and higher than that in the general population. There was a strong association between a positive AQUA and URT symptoms. The low proportion of households in which both runners and nonrunners were symptomatic suggests that the nature of symptoms may be allergic or inflammatory based rather than infectious. Allergy is a treatable condition, and its potential effect on performance and health may be avoided by accurate clinical diagnosis and management. Both athletes' and coaches' awareness of the potential implications of poorly managed allergy needs to be raised.

Rate of cardiac arrhythmias and silent brain lesions in experienced marathon runners: rationale, design and baseline data of the Berlin Beat of Running study.

PubMed

Haeusler, Karl Georg; Herm, Juliane; Kunze, Claudia; Krüll, Matthias; Brechtel, Lars; Lock, Jürgen; Hohenhaus, Marc; Heuschmann, Peter U; Fiebach, Jochen B; Haverkamp, Wilhelm; Endres, Matthias; Jungehulsing, Gerhard Jan

2012-08-31

Regular exercise is beneficial for cardiovascular health but a recent meta-analysis indicated a relationship between extensive endurance sport and a higher risk of atrial fibrillation, an independent risk factor for stroke. However, data on the frequency of cardiac arrhythmias or (clinically silent) brain lesions during and after marathon running are missing. In the prospective observational "Berlin Beat of Running" study experienced endurance athletes underwent clinical examination (CE), 3 Tesla brain magnetic resonance imaging (MRI), carotid ultrasound imaging (CUI) and serial blood sampling (BS) within 2-3 days prior (CE, MRI, CUI, BS), directly after (CE, BS) and within 2 days after (CE, MRI, BS) the 38th BMW BERLIN-MARATHON 2011. All participants wore a portable electrocardiogram (ECG)-recorder throughout the 4 to 5 days baseline study period. Participants with pathological MRI findings after the marathon, troponin elevations or detected cardiac arrhythmias will be asked to undergo cardiac MRI to rule out structural abnormalities. A follow-up is scheduled after one year. Here we report the baseline data of the enrolled 110 athletes aged 36-61 years. Their mean age was 48.8 ± 6.0 years, 24.5% were female, 8.2% had hypertension and 2.7% had hyperlipidaemia. Participants have attended a mean of 7.5 ± 6.6 marathon races within the last 5 years and a mean of 16 ± 36 marathon races in total. Their weekly running distance prior to the 38th BMW BERLIN-MARATHON was 65 ± 17 km. Finally, 108 (98.2%) Berlin Beat-Study participants successfully completed the 38th BMW BERLIN-MARATHON 2011. Findings from the "Berlin Beats of Running" study will help to balance the benefits and risks of extensive endurance sport. ECG-recording during the marathon might contribute to identify athletes at risk for cardiovascular events. MRI results will give new insights into the link between physical stress and brain damage. clinicaltrials.gov NCT01428778.

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.

The Xpert® MTB/RIF assay in routine diagnosis of pulmonary tuberculosis: A multicentre study in Lithuania.

PubMed

Pimkina, Edita; Zablockis, Rolandas; Nikolayevskyy, Vladyslav; Danila, Edvardas; Davidaviciene, Edita

2015-11-01

Drug-resistant tuberculosis (TB) is an important public health problem in Lithuania with MDR rates in new cases reaching 11% in 2012. Currently available diagnostic tools are not fully adequate for an accurate and rapid result for diagnosis of TB and MDR-TB. To evaluate the performance of Xpert(®) MTB/RIF assay for an early diagnosis of TB and detection of rifampicin (RIF) resistance in routine settings in Lithuania. A total of 833 individual respiratory samples obtained from patients previously treated for TB and MDR-TB contacts were tested using the Xpert MTB/RIF assay. Performance characteristics of the assay for TB and RIF resistance detection were calculated using culture and phenotypical DST results as a gold standard. The overall sensitivity and specificity of the Xpert MTB/RIF assay for TB detection were 93.7% and 91.7%, respectively with the sensitivity for smear-negative specimens reaching 82.5%. Resistance to RIF was detected in 81 (20.7%) primary specimens with no false negative results; there were 4/225 (1.8%) false-positives among strains sensitive to rifampicin. Overall sensitivity and specificity of the molecular assay for detection of RIF resistance calculated against phenotypic DST results were 100% and 98.2%, respectively. Our results demonstrate very good performance of the Xpert MTB/RIF assay for the detection of TB and RIF resistance on primary respiratory specimens. It provides strong evidence that implementation of the assay for routine laboratory diagnosis in high drug-resistance settings may improve and facilitate TB diagnosis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Rifampicin resistance mutations in the 81 bp RRDR of rpoB gene in Mycobacterium tuberculosis clinical isolates using Xpert® MTB/RIF in Kampala, Uganda: a retrospective study.

PubMed

Mboowa, Gerald; Namaganda, Carolyn; Ssengooba, Willy

2014-09-04

Introduction of Xpert® MTB/RIF assay has revolutionalised the diagnosis of tuberculosis (TB) by simultaneously detecting the bacteria and resistance to rifampicin (rif), a surrogate marker for multi-drug resistant TB (MDR-TB) as well as one of the principal first-line anti-tuberculosis drugs. In general, rpoB mutations can be found in 96.1% of rif-resistant Mycobacterium tuberculosis (MTB) strains worldwide and these mutations usually are located in a region at the 507-533rd amino acid residuals (81 bp) in the MTB rpoB gene, which is referred to as Rifampicin-resistance-determining region (RRDR). In this study, we determined the frequency of MDR-TB in Kampala using Xpert® MTB/RIF in comparison with the agar proportion method using Middlebrook 7H11and further determined the frequency of probes for different rpoB gene mutations using Xpert® MTB/RIF assay in the 81 bp RRDR. A total of 1501 specimens received at Mycobacteriology laboratory, Makerere University for Xpert testing between May 2011 and May 2014 were analysed by Xpert® MTB/RIF assay. Specimens that were positive for both MTB and rifampicin resistance were further subjected to a complete first line anti-mycobacterial drug susceptibility testing using Middlebrook 7H11 agar proportion method (APM). Xpert® MTB/RIF assay detected 313 MTB positive specimens and out of which 12 specimens had both MTB and rifampicin- resistance conferred by four different rpoB gene mutations in the 81 bp-RRDR of MTB, further one (1/12), specimen was found to be rifampicin mono-resistant on APM while the 11 were found to be MDR-TB. Probes associated with the observed rif- resistance were as follows: E (7/12), B (3/12), A (1/12), D (1/12) and no rif-resistance was associated with probe C. No specimen yielded rif-resistance associated with more than one probe failure (mutation combinations). Probe D was associated with rifampicin mono-resistant. MDR-TB was at 3.5% in the studied population. Mutations associated with Probe E

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…

Influence of the world's most challenging mountain ultra-marathon on energy cost and running mechanics.

PubMed

Vernillo, Gianluca; Savoldelli, Aldo; Zignoli, Andrea; Trabucchi, Pietro; Pellegrini, Barbara; Millet, Grégoire P; Schena, Federico

2014-05-01

To examine the effects of the world's most challenging mountain ultra-marathon (Tor des Géants(®) 2012) on the energy cost of three types of locomotion (cycling, level and uphill running) and running kinematics. Before (pre-) and immediately after (post-) the competition, a group of ten male experienced ultra-marathon runners performed in random order three submaximal 4-min exercise trials: cycling at a power of 1.5 W kg(-1) body mass; level running at 9 km h(-1) and uphill running at 6 km h(-1) at an inclination of +15 % on a motorized treadmill. Two video cameras recorded running mechanics at different sampling rates. Between pre- and post-, the uphill-running energy cost decreased by 13.8 % (P = 0.004); no change was noted in the energy cost of level running or cycling (NS). There was an increase in contact time (+10.3 %, P = 0.019) and duty factor (+8.1 %, P = 0.001) and a decrease in swing time (-6.4 %, P = 0.008) in the uphill-running condition. After this extreme mountain ultra-marathon, the subjects modified only their uphill-running patterns for a more economical step mechanics.

Use of Xpert MTB/RIF in Decentralized Public Health Settings and Its Effect on Pulmonary TB and DR-TB Case Finding in India.

PubMed

Sachdeva, Kuldeep Singh; Raizada, Neeraj; Sreenivas, Achuthan; Van't Hoog, Anna H; van den Hof, Susan; Dewan, Puneet K; Thakur, Rahul; Gupta, R S; Kulsange, Shubhangi; Vadera, Bhavin; Babre, Ameet; Gray, Christen; Parmar, Malik; Ghedia, Mayank; Ramachandran, Ranjani; Alavadi, Umesh; Arinaminpathy, Nimalan; Denkinger, Claudia; Boehme, Catharina; Paramasivan, C N

2015-01-01

Xpert MTB/RIF, the first automated molecular test for tuberculosis, is transforming the diagnostic landscape in high-burden settings. This study assessed the impact of up-front Xpert MTB/RIF testing on detection of pulmonary tuberculosis (PTB) and rifampicin-resistant PTB (DR-TB) cases in India. This demonstration study was implemented in 18 sub-district level TB programme units (TUs) in India in diverse geographic and demographic settings covering a population of 8.8 million. A baseline phase in 14 TUs captured programmatic baseline data, and an intervention phase in 18 TUs had Xpert MTB/RIF offered to all presumptive TB patients. We estimated changes in detection of TB and DR-TB, the former using binomial regression models to adjust for clustering and covariates. In the 14 study TUs, which participated in both phases, 10,675 and 70,556 presumptive TB patients were enrolled in the baseline and intervention phase, respectively, and 1,532 (14.4%) and 14,299 (20.3%) bacteriologically confirmed PTB cases were detected. The implementation of Xpert MTB/RIF was associated with increases in both notification rates of bacteriologically confirmed TB cases (adjusted incidence rate ratio [aIRR] 1.39; CI 1.18-1.64), and proportion of bacteriological confirmed TB cases among presumptive TB cases (adjusted risk ratio (aRR) 1.33; CI 1.6-1.52). Compared with the baseline strategy of selective drug-susceptibility testing only for PTB cases at high risk of drug-resistant TB, Xpert MTB/RIF implementation increased rifampicin resistant TB case detection by over fivefold. Among, 2765 rifampicin resistance cases detected, 1055 were retested with conventional drug susceptibility testing (DST). Positive predictive value (PPV) of rifampicin resistance detected by Xpert MTB/RIF was 94.7% (CI 91.3-98.1), in comparison to conventional DST. Introduction of Xpert MTB/RIF as initial diagnostic test for TB in public health facilities significantly increased case-notification rates of all

Use of Xpert MTB/RIF in Decentralized Public Health Settings and Its Effect on Pulmonary TB and DR-TB Case Finding in India

PubMed Central

Sachdeva, Kuldeep Singh; Raizada, Neeraj; Sreenivas, Achuthan; van't Hoog, Anna H.; van den Hof, Susan; Dewan, Puneet K.; Thakur, Rahul; Gupta, R. S.; Kulsange, Shubhangi; Vadera, Bhavin; Babre, Ameet; Gray, Christen; Parmar, Malik; Ghedia, Mayank; Ramachandran, Ranjani; Alavadi, Umesh; Arinaminpathy, Nimalan; Denkinger, Claudia; Boehme, Catharina; Paramasivan, C. N.

2015-01-01

Background Xpert MTB/RIF, the first automated molecular test for tuberculosis, is transforming the diagnostic landscape in high-burden settings. This study assessed the impact of up-front Xpert MTB/RIF testing on detection of pulmonary tuberculosis (PTB) and rifampicin-resistant PTB (DR-TB) cases in India. Methods This demonstration study was implemented in 18 sub-district level TB programme units (TUs) in India in diverse geographic and demographic settings covering a population of 8.8 million. A baseline phase in 14 TUs captured programmatic baseline data, and an intervention phase in 18 TUs had Xpert MTB/RIF offered to all presumptive TB patients. We estimated changes in detection of TB and DR-TB, the former using binomial regression models to adjust for clustering and covariates. Results In the 14 study TUs, which participated in both phases, 10,675 and 70,556 presumptive TB patients were enrolled in the baseline and intervention phase, respectively, and 1,532 (14.4%) and 14,299 (20.3%) bacteriologically confirmed PTB cases were detected. The implementation of Xpert MTB/RIF was associated with increases in both notification rates of bacteriologically confirmed TB cases (adjusted incidence rate ratio [aIRR] 1.39; CI 1.18-1.64), and proportion of bacteriological confirmed TB cases among presumptive TB cases (adjusted risk ratio (aRR) 1.33; CI 1.6-1.52). Compared with the baseline strategy of selective drug-susceptibility testing only for PTB cases at high risk of drug-resistant TB, Xpert MTB/RIF implementation increased rifampicin resistant TB case detection by over fivefold. Among, 2765 rifampicin resistance cases detected, 1055 were retested with conventional drug susceptibility testing (DST). Positive predictive value (PPV) of rifampicin resistance detected by Xpert MTB/RIF was 94.7% (CI 91.3-98.1), in comparison to conventional DST. Conclusion Introduction of Xpert MTB/RIF as initial diagnostic test for TB in public health facilities significantly increased

Marathon maternity oral history project: Exploring rural birthing through narrative methods.

PubMed

Orkin, Aaron; Newbery, Sarah

2014-01-01

To explore how birthing and maternity care are understood and valued in a rural community. Oral history research. The rural community of Marathon, Ont, with a population of approximately 3500. A purposive selection of mothers, grandmothers, nurses, physicians, and community leaders in the Marathon medical catchment area. 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. 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. 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 maternity services in rural Canada.

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

Xpert® MTB/RIF: Usefulness for the diagnosis of tuberculosis and resistance to rifampicin.

PubMed

Vergara Gómez, Andrea; González-Martín, Julià; García-Basteiro, Alberto L

2017-11-09

The advent of the Xpert® MTB/RIF technique was a revolution in the diagnosis of tuberculosis, especially in areas with high incidence and low resources. It allows the detection of Mycobacterium tuberculosis complex and simultaneously the most common resistance mutations to rifampicin in less than 2h. For respiratory samples the sensitivity is very high, but it decreases for extrapulmonary samples and children. Although it is faster and simpler than conventional methods, it presents some limitations and new and better techniques are needed to reduce the number of cases and deaths caused by tuberculosis. This review aims to assess the scientific evidence around the diagnostic performance of Xpert® MTB/RIF in different types of samples and populations, as well as analyse its strengths and limitations for TB diagnosis. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Reliability, Factor Structure, and Measurement Invariance of the Dominic Interactive Across European Countries: Cross-Country Utility of a Child Mental Health Self-Report

PubMed Central

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

2015-01-01

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. PMID:26237209

Effects of Marathon Running on Aerobic Fitness and Performance in Recreational Runners One Week after a Race.

PubMed

Takayama, Fuminori; Aoyagi, Atsushi; Shimazu, Wataru; Nabekura, Yoshiharu

2017-01-01

It is not clear whether or not recreational runners can recover aerobic fitness and performance within one week after marathon running. This study aimed to investigate the effects of running a marathon race on aerobic fitness and performance one week later. Eleven recreational runners (six men, five women) completed the race in 3 h 36 min 20 s ± 41 min 34 s (mean ± standard deviation). Before and 7 days after the race, they performed a treadmill running test. Perceived muscle soreness was assessed before the race and for the following 7 days. The magnitude of changes in the treadmill running test was considered possibly trivial for maximal oxygen uptake ([Formula: see text]O 2 max) (mean difference -1.2 ml/kg/min; ±90% confidence limits 2 ml/kg/min), unclear for %[Formula: see text]O 2 max at anaerobic threshold (AT) (-0.5; ±4.1%) and RE (0.2; ±3.5 ml/kg/km), and likely trivial for both velocity at AT and peak (-0.2; ±0.49 km/h and -0.3; ±0.28 km/h). Perceived muscle soreness increased until 3 days after the race, but there were no clear differences between the values before the race and 4-7 days after it. These results show that physiological capacity associated with marathon running performance is recovered within 7 days after a marathon run.

Effects of Marathon Running on Aerobic Fitness and Performance in Recreational Runners One Week after a Race

PubMed Central

Aoyagi, Atsushi; Shimazu, Wataru

2017-01-01

It is not clear whether or not recreational runners can recover aerobic fitness and performance within one week after marathon running. This study aimed to investigate the effects of running a marathon race on aerobic fitness and performance one week later. Eleven recreational runners (six men, five women) completed the race in 3 h 36 min 20 s ± 41 min 34 s (mean ± standard deviation). Before and 7 days after the race, they performed a treadmill running test. Perceived muscle soreness was assessed before the race and for the following 7 days. The magnitude of changes in the treadmill running test was considered possibly trivial for maximal oxygen uptake (V˙O2max) (mean difference −1.2 ml/kg/min; ±90% confidence limits 2 ml/kg/min), unclear for %V˙O2max at anaerobic threshold (AT) (−0.5; ±4.1%) and RE (0.2; ±3.5 ml/kg/km), and likely trivial for both velocity at AT and peak (−0.2; ±0.49 km/h and −0.3; ±0.28 km/h). Perceived muscle soreness increased until 3 days after the race, but there were no clear differences between the values before the race and 4–7 days after it. These results show that physiological capacity associated with marathon running performance is recovered within 7 days after a marathon run. PMID:29138757

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

Similarities and differences among half-marathon runners according to their performance level

PubMed Central

Morante, Juan Carlos; Gómez-Molina, Josué; García-López, Juan

2018-01-01

This study aimed to identify the similarities and differences among half-marathon runners in relation to their performance level. Forty-eight male runners were classified into 4 groups according to their performance level in a half-marathon (min): Group 1 (n = 11, < 70 min), Group 2 (n = 13, < 80 min), Group 3 (n = 13, < 90 min), Group 4 (n = 11, < 105 min). In two separate sessions, training-related, anthropometric, physiological, foot strike pattern and spatio-temporal variables were recorded. Significant differences (p<0.05) between groups (ES = 0.55–3.16) and correlations with performance were obtained (r = 0.34–0.92) in training-related (experience and running distance per week), anthropometric (mass, body mass index and sum of 6 skinfolds), physiological (VO2max, RCT and running economy), foot strike pattern and spatio-temporal variables (contact time, step rate and length). At standardized submaximal speeds (11, 13 and 15 km·h-1), no significant differences between groups were observed in step rate and length, neither in contact time when foot strike pattern was taken into account. In conclusion, apart from training-related, anthropometric and physiological variables, foot strike pattern and step length were the only biomechanical variables sensitive to half-marathon performance, which are essential to achieve high running speeds. However, when foot strike pattern and running speeds were controlled (submaximal test), the spatio-temporal variables were similar. This indicates that foot strike pattern and running speed are responsible for spatio-temporal differences among runners of different performance level. PMID:29364940

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

PubMed

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

2011-01-01

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. Age and anthropometry, training, and previous experience variables were related to Ironman race time using bivariate and multivariate analysis. 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: (r (2) = 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). 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.

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

Assessment of the sensitivity and specificity of Xpert MTB/RIF assay as an early sputum biomarker of response to tuberculosis treatment.

PubMed

Friedrich, Sven O; Rachow, Andrea; Saathoff, Elmar; Singh, Kasha; Mangu, Chacha D; Dawson, Rodney; Phillips, Patrick Pj; Venter, Amour; Bateson, Anna; Boehme, Catharina C; Heinrich, Norbert; Hunt, Robert D; Boeree, Martin J; Zumla, Alimuddin; McHugh, Timothy D; Gillespie, Stephen H; Diacon, Andreas H; Hoelscher, Michael

2013-08-01

An accurate biomarker is urgently needed to monitor the response to treatment in patients with pulmonary tuberculosis. The Xpert MTB/RIF assay is a commercially available real-time PCR that can be used to detect Mycobacterium-tuberculosis-specific DNA sequences in sputum samples. We therefore evaluated this assay with serial sputum samples obtained over 26 weeks from patients undergoing treatment for tuberculosis. We analysed sputum samples from 221 patients with smear-positive tuberculosis enrolled at two sites (Cape Town, South Africa, and Mbeya, Tanzania) of a multicentre randomised clinical trial REMoxTB of antituberculosis treatment on a weekly basis (weeks 0 to 8), then at weeks 12, 17, 22, and 26 after treatment initiation. The Xpert MTB/RIF results over time were compared with the results of standard smear microscopy and culture methods. We obtained and analysed 2741 sputum samples from 221 patients. The reduction in positivity rates with Xpert MTB/RIF were slower than those with the standard methods. At week 8, positive results were obtained for 62 (29%) of 212 sputum samples with smear microscopy, 46 (26%) of 175 with solid culture (Löwenstein-Jensen medium), 77 (42%) of 183 with liquid culture (Bactec MGIT960 system), and 174 (84%) of 207 with Xpert MTB/RIF; at 26 weeks, positive results were obtained for ten (5%) of 199, four (3%) of 157, seven (4%) of 169, and 22 (27%) of 83 sputum samples, respectively. The reduction in detection of quantitative M tuberculosis DNA with Xpert MTB/RIF correlated with smear grades (ρ=-0·74; p<0·0001), solid culture grades (ρ=-0·73; p<0·0001), and time to liquid culture positivity (ρ=0·73; p<0·0001). Compared with the combined binary smear and culture results as a reference standard, the Xpert MTB/RIF assay had high sensitivity (97·0%, 95% CI 95·8-97·9), but poor specificity (48·6%, 45·0-52·2). The poor specificity precludes the use of the Xpert MTB/RIF assay as a biomarker for monitoring tuberculosis

Immigrants' health in Europe: a cross-classified multilevel approach to examine origin country, destination country, and community effects.

PubMed

Huijts, Tim; Kraaykamp, Gerbert

2012-01-01

In this study, we examined origin, destination, and community effects on first- and second-generation immigrants' health in Europe. We used information from the European Social Surveys (2002–2008) on 19,210 immigrants from 123 countries of origin, living in 31 European countries. Cross-classified multilevel regression analyses reveal that political suppression in the origin country and living in countries with large numbers of immigrant peers have a detrimental influence on immigrants' health. Originating from predominantly Islamic countries and good average health among natives in the destination country appear to be beneficial. Additionally, the results point toward health selection mechanisms into migration.

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…

Iron excess in recreational marathon runners.

PubMed

Mettler, S; Zimmermann, M B

2010-05-01

Iron deficiency and anemia may impair athletic performance, and iron supplements are commonly consumed by athletes. However, iron overload should be avoided because of the possible long-term adverse health effects. We investigated the iron status of 170 male and female recreational runners participating in the Zürich marathon. Iron deficiency was defined either as a plasma ferritin (PF) concentration <15 microg/l (iron depletion) or as the ratio of the concentrations of transferrin receptor (sTfR) to PF (sTfR:log(PF) index) of > or =4.5 (functional iron deficiency). After excluding subjects with elevated C-reactive protein concentrations, iron overload was defined as PF >200 microg/l. Iron depletion was found in only 2 out of 127 men (1.6% of the male study population) and in 12 out of 43 (28.0%) women. Functional iron deficiency was found in 5 (3.9%) and 11 (25.5%) male and female athletes, respectively. Body iron stores, calculated from the sTfR/PF ratio, were significantly higher (P<0.001) among male compared with female marathon runners. Median PF among males was 104 microg/l, and the upper limit of the PF distribution in males was 628 microg/l. Iron overload was found in 19 out of 127 (15.0%) men but only 2 out of 43 in women (4.7%). Gender (male sex), but not age, was a predictor of higher PF (P<0.001). Iron depletion was present in 28% of female runners but in <2% of males, whereas one in six male runners had signs of iron overload. Although iron supplements are widely used by athletes in an effort to increase performance, our findings indicate excess body iron may be common in male recreational runners and suggest supplements should only be used if tests of iron status indicate deficiency.

Rate of cardiac arrhythmias and silent brain lesions in experienced marathon runners: rationale, design and baseline data of the Berlin Beat of Running study

PubMed Central

2012-01-01

Background Regular exercise is beneficial for cardiovascular health but a recent meta-analysis indicated a relationship between extensive endurance sport and a higher risk of atrial fibrillation, an independent risk factor for stroke. However, data on the frequency of cardiac arrhythmias or (clinically silent) brain lesions during and after marathon running are missing. Methods/ Design In the prospective observational “Berlin Beat of Running” study experienced endurance athletes underwent clinical examination (CE), 3 Tesla brain magnetic resonance imaging (MRI), carotid ultrasound imaging (CUI) and serial blood sampling (BS) within 2-3 days prior (CE, MRI, CUI, BS), directly after (CE, BS) and within 2 days after (CE, MRI, BS) the 38th BMW BERLIN-MARATHON 2011. All participants wore a portable electrocardiogram (ECG)-recorder throughout the 4 to 5 days baseline study period. Participants with pathological MRI findings after the marathon, troponin elevations or detected cardiac arrhythmias will be asked to undergo cardiac MRI to rule out structural abnormalities. A follow-up is scheduled after one year. Results Here we report the baseline data of the enrolled 110 athletes aged 36-61 years. Their mean age was 48.8 ± 6.0 years, 24.5% were female, 8.2% had hypertension and 2.7% had hyperlipidaemia. Participants have attended a mean of 7.5 ± 6.6 marathon races within the last 5 years and a mean of 16 ± 36 marathon races in total. Their weekly running distance prior to the 38th BMW BERLIN-MARATHON was 65 ± 17 km. Finally, 108 (98.2%) Berlin Beat-Study participants successfully completed the 38th BMW BERLIN-MARATHON 2011. Discussion Findings from the “Berlin Beats of Running” study will help to balance the benefits and risks of extensive endurance sport. ECG-recording during the marathon might contribute to identify athletes at risk for cardiovascular events. MRI results will give new insights into the link between physical stress

International Migration and Human Development in Destination Countries: A Cross-National Analysis of Less-Developed Countries, 1970-2005

ERIC Educational Resources Information Center

Sanderson, Matthew

2010-01-01

Contemporary levels of international migration in less-developed countries are raising new and important questions regarding the consequences of immigration for human welfare and well-being. However, there is little systematic cross-national evidence of how international migration affects human development levels in migrant-receiving countries in…

Rolling Out Xpert® MTB/RIF for TB Detection in HIV-Infected Populations:An Opportunity for Systems Strengthening.

PubMed

Pathmanathan, Ishani; Date, Anand; Coggin, William L; Nkengasong, John; Piatek, Amy S; Alexander, Heather

2017-03-31

To eliminate preventable deaths, disease and suffering due to tuberculosis (TB), improved diagnostic capacity is critical. The Cepheid Xpert ® MTB/RIF assay is recommended by the World Health Organization as the initial diagnostic test for people with suspected HIV-associated TB. However, despite high expectations, its scale-up in real-world settings has faced challenges, often due to the systems that support it. In this commentary we discuss needs and opportunities for systems strengthening to support widespread scale-up of Xpert ® MTB/RIF as they relate to each step within the TB diagnostic cascade, from finding presumptive patients, to collecting, transporting and testing sputum specimens, to reporting and receiving results, to initiating and monitoring treatment and, ultimately, to ensuring successful and timely treatment and cure. Investments in evidence-based interventions at each step along the cascade and within the system as a whole will augment not only the utility of Xpert ® MTB/RIF, but also the successful implementation of future diagnostic tests. Xpert ® MTB/RIF will only improve patient outcomes if optimally implemented within the context of strong TB programs and systems. Roll-out of this technology to people living with HIV and others in resource-limited settings offers the opportunity to leverage current TB and HIV laboratory, diagnostic and programmatic investments, while also addressing challenges and strengthening coordination between laboratory systems, laboratory-program interfaces, and TB-HIV program interfaces. If successful, the benefits of this tool could extend beyond progress towards global End TB Strategy goals, to improve system-wide capacity for global disease detection and control.

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. Copyright © 2014 Elsevier Inc. All rights reserved.

Cost efficiency of university hospitals in the Nordic countries: a cross-country analysis.

PubMed

Medin, Emma; Anthun, Kjartan S; Häkkinen, Unto; Kittelsen, Sverre A C; Linna, Miika; Magnussen, Jon; Olsen, Kim; Rehnberg, Clas

2011-12-01

This paper estimates cost efficiency scores using the bootstrap bias-corrected procedure, including variables for teaching and research, for the performance of university hospitals in the Nordic countries. Previous research has shown that hospital provision of research and education interferes with patient care routines and inflates the costs of health care services, turning university hospitals into outliers in comparative productivity and efficiency analyses. The organisation of patient care, medical education and clinical research as well as available data at the university hospital level are highly similar in the Nordic countries, creating a data set of comparable decision-making units suitable for a cross-country cost efficiency analysis. The results demonstrate significant differences in university hospital cost efficiency when variables for teaching and research are entered into the analysis, both between and within the Nordic countries. The results of a second-stage analysis show that the most important explanatory variables are geographical location of the hospital and the share of discharges with a high case weight. However, a substantial amount of the variation in cost efficiency at the university hospital level remains unexplained.

Analysis of Mycobacterium tuberculosis Genotypic Lineage Distribution in Chile and Neighboring Countries

PubMed Central

Lagos, Jaime; Couvin, David; Arata, Loredana; Tognarelli, Javier; Aguayo, Carolina; Leiva, Tamara; Arias, Fabiola; Hormazabal, Juan Carlos; Rastogi, Nalin; Fernández, Jorge

2016-01-01

Tuberculosis (TB), caused by the pathogen Mycobacterium tuberculosis (MTB), remains a disease of high importance to global public health. Studies into the population structure of MTB have become vital to monitoring possible outbreaks and also to develop strategies regarding disease control. Although Chile has a low incidence of MTB, the current rates of migration have the potential to change this scenario. We collected and analyzed a total of 458 M. tuberculosis isolates (1 isolate per patient) originating from all 15 regions of Chile. The isolates were genotyped using the spoligotyping method and the data obtained were analyzed and compared with the SITVIT2 database. A total of 169 different patterns were identified, of which, 119 patterns (408 strains) corresponded to Spoligotype International Types (SITs) and 50 patterns corresponded to orphan strains. The most abundantly represented SITs/lineages were: SIT53/T1 (11.57%), SIT33/LAM3 (9.6%), SIT42/LAM9 (9.39%), SIT50/H3 (5.9%), SIT37/T3 (5%); analysis of the spoligotyping minimum spanning tree as well as spoligoforest were suggestive of a recent expansion of SIT42, SIT50 and SIT37; all of which potentially evolved from SIT53. The most abundantly represented lineages were LAM (40.6%), T (34.1%) and Haarlem (13.5%). LAM was more prevalent in the Santiago (43.6%) and Concepción (44.1%) isolates, rather than the Iquique (29.4%) strains. The proportion of X lineage was appreciably higher in Iquique and Concepción (11.7% in both) as compared to Santiago (1.6%). Global analysis of MTB lineage distribution in Chile versus neighboring countries showed that evolutionary recent lineages (LAM, T and Haarlem) accounted together for 88.2% of isolates in Chile, a pattern which mirrored MTB lineage distribution in neighboring countries (n = 7378 isolates recorded in SITVIT2 database for Peru, Brazil, Paraguay, and Argentina; and published studies), highlighting epidemiological advantage of Euro-American lineages in this region

[Use of the Xpert® MTB/RIF test in routine screening of new cases of pulmonary tuberculosis in an endemic area].

PubMed

Horo, K; N'Guessan, R; Koffi, M-O; Kouamé-N'Takpé, N; Koné, A; Samaké, K; Koffi, L; Ahui, B J M; Brou-Gode, C V; N'Gom, A; Kouassi, B A; Koffi, N; Aka-Danguy, E

2017-09-01

Developed initially for the diagnosis of multidrug-resistant tuberculosis, the Xpert ® MTB/RIF test has shown to be useful for the diagnosis of tuberculosis, especially among HIV-infected subjects. The objective of the study was to determine the contribution of the Xpert ® MTB/RIF test for routine pulmonary tuberculosis diagnosis in an endemic area. We undertook a prospective study among patients presenting with cough and sputum. The sputum was submitted to microscopic examination, to the Xpert ® MTB/RIF test and cultured by the Mycobacteria growth indicator tube (MGIT) technique. The study compared cases of pulmonary tuberculosis confirmed by a positive sputum culture and cases with cough but negative sputum culture. In multivariate analysis, the factors associated with positive cultures were the following: male gender, cough for more than 2 weeks, loss of weight and fever. The estimated clinical suspicion score consisted of 4 signs each having a coefficient of 1. The sensitivity of each clinical sign varied between 79 and 94%. In 348 cases of negative microscopic examination (composed of 295 cases with score<4 and 53 cases with score=4), the predictive positive value of the Xpert ® MTB/RIF was 80% for a score equal to 4 and 40.9% for a score<4. In cases of negative microscopic examination of the sputum, the Xpert ® MRT/RIF test should be undertaken if the score=4. The diagnosis of tuberculosis in endemic zones could be improved by using the Xpert ® MTB/RIF. Copyright © 2017 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Evaluation of Xpert® MTB/RIF and Ustar EasyNAT™ TB IAD for diagnosis of tuberculous lymphadenitis of children in Tanzania: a prospective descriptive study.

PubMed

Bholla, Maira; Kapalata, Neema; Masika, Edward; Chande, Hassan; Jugheli, Levan; Sasamalo, Mohamed; Glass, Tracy R; Beck, Hans-Peter; Reither, Klaus

2016-06-06

Fine needle aspiration biopsy has become a standard approach for diagnosis of peripheral tuberculous lymphadenitis. The aim of this study was to compare the performance of Xpert MTB/RIF and Ustar EasyNAT TB IAD nucleic acid amplification assays, against acid-fast bacilli microscopy, cytology and mycobacterial culture for the diagnosis of TB lymphadenitis in children from a TB-endemic setting in Tanzania. Children of 8 weeks to 16 years of age, suspected of having TB lymphadenitis, were recruited at a district hospital in Tanzania. Fine needle aspirates of lymph nodes were analysed using acid-fast bacilli microscopy, liquid TB culture, cytology, Xpert MTB/RIF and EasyNAT. Latent class analysis and comparison against a composite reference standard comprising "culture and/or cytology" was done, to assess the performance of Xpert MTB/RIF and EasyNAT for the diagnosis of TB lymphadenitis. Seventy-nine children were recruited; 4 were excluded from analysis. Against a composite reference standard of culture and/or cytology, Xpert MTB/RIF and EasyNAT had a sensitivity and specificity of 58 % and 93 %; and 19 % and 100 % respectively. Relative to latent class definitions, cytology had a sensitivity of 100 % and specificity of 94.7 %. Combining clinical assessment, cytology and Xpert MTB/RIF may allow for a rapid and accurate diagnosis of childhood TB lymphadenitis. Larger diagnostic evaluation studies are recommended to validate these findings and on Xpert MTB/RIF to assess its use as a solitary initial test for TB lymphadenitis in children.

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

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.

Corruption costs lives: evidence from a cross-country study.

PubMed

Li, Qiang; An, Lian; Xu, Jing; Baliamoune-Lutz, Mina

2018-01-01

This paper investigates the effect of corruption on health outcomes by using cross-country panel data covering about 150 countries for the period of 1995 to 2012. We employ ordinary least squares (OLS), fixed-effects and two-stage least squares (2SLS) estimation methods, and find that corruption significantly increases mortality rates, and reduces life expectancy and immunization rates. The results are consistent across different regions, gender, and measures of corruption. The findings suggest that reducing corruption can be an effective method to improve health outcomes.

A Comprehensive Evaluation of Xpert MTB/RIF Assay With Bronchoalveolar Lavage Fluid as a Single Test or Combined With Conventional Assays for Diagnosis of Pulmonary Tuberculosis in China: A Two-Center Prospective Study

PubMed Central

Pan, Xiaofu; Yang, Shoufeng; Deighton, Margaret A.; Qu, Yue; Hong, Liang; Su, Feifei

2018-01-01

Introduction: The Xpert MTB/RIF is recommended by the World Health Organization as a first line rapid test for the diagnosis of pulmonary tuberculosis (TB); however, China does not routinely use this test, partially due to the lack of a sufficient number of systematic evaluations of this assay in local patients. The aims of this study were to comprehensively assess the diagnostic performance of Xpert MTB/RIF, either alone or in combination with conventional assays for the diagnosis of pulmonary TB in adult Chinese patients. Methods: Xpert MTB/RIF tests were performed in 190 adult patients with suspected pulmonary TB, using bronchoalveolar lavage fluid (BALF) as test specimens. In parallel, conventional tests were carried out using the same BALF samples. Using two different reference standards, the performance of Xpert MTB/RIF, conventional assays and their combinations were evaluated. Results: Using mycobacterial culture as the reference comparator, Xpert MTB/RIF was found to be superior to smear-microscopy in detecting Mycobacterium tuberculosis. When final diagnosis, based on clinical criteria, was employed as the reference standard, Xpert MTB/RIF showed an even higher accuracy of 72.1%, supported by a sensitivity of 61.1% and specificity of 96.6%. Xpert MTB/RIF also demonstrated a powerful capability to identify pulmonary TB cases undetected by culture or smear-microscopy. Combining smear-microscopy and Xpert MTB/RIF was found to be the most accurate early predictor for pulmonary TB. Rifampicin resistance reported by Xpert MTB/RIF slightly deviated from that by phenotypic antibiotic susceptibility testing and requires further study with a larger sample size. Conclusion: This two-center prospective study highlights the value of Xpert MTB/RIF with BALF in diagnosing pulmonary TB in adult Chinese patients. These findings might contribute to the optimization of current diagnostic algorithms for pulmonary TB in China. PMID:29593688

A Comprehensive Evaluation of Xpert MTB/RIF Assay With Bronchoalveolar Lavage Fluid as a Single Test or Combined With Conventional Assays for Diagnosis of Pulmonary Tuberculosis in China: A Two-Center Prospective Study.

PubMed

Pan, Xiaofu; Yang, Shoufeng; Deighton, Margaret A; Qu, Yue; Hong, Liang; Su, Feifei

2018-01-01

Introduction: The Xpert MTB/RIF is recommended by the World Health Organization as a first line rapid test for the diagnosis of pulmonary tuberculosis (TB); however, China does not routinely use this test, partially due to the lack of a sufficient number of systematic evaluations of this assay in local patients. The aims of this study were to comprehensively assess the diagnostic performance of Xpert MTB/RIF, either alone or in combination with conventional assays for the diagnosis of pulmonary TB in adult Chinese patients. Methods: Xpert MTB/RIF tests were performed in 190 adult patients with suspected pulmonary TB, using bronchoalveolar lavage fluid (BALF) as test specimens. In parallel, conventional tests were carried out using the same BALF samples. Using two different reference standards, the performance of Xpert MTB/RIF, conventional assays and their combinations were evaluated. Results: Using mycobacterial culture as the reference comparator, Xpert MTB/RIF was found to be superior to smear-microscopy in detecting Mycobacterium tuberculosis . When final diagnosis, based on clinical criteria, was employed as the reference standard, Xpert MTB/RIF showed an even higher accuracy of 72.1%, supported by a sensitivity of 61.1% and specificity of 96.6%. Xpert MTB/RIF also demonstrated a powerful capability to identify pulmonary TB cases undetected by culture or smear-microscopy. Combining smear-microscopy and Xpert MTB/RIF was found to be the most accurate early predictor for pulmonary TB. Rifampicin resistance reported by Xpert MTB/RIF slightly deviated from that by phenotypic antibiotic susceptibility testing and requires further study with a larger sample size. Conclusion: This two-center prospective study highlights the value of Xpert MTB/RIF with BALF in diagnosing pulmonary TB in adult Chinese patients. These findings might contribute to the optimization of current diagnostic algorithms for pulmonary TB in China.

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

Catching the missing million: experiences in enhancing TB & DR-TB detection by providing upfront Xpert MTB/RIF testing for people living with HIV in India.

PubMed

Raizada, Neeraj; Sachdeva, Kuldeep Singh; Sreenivas, Achuthan; Kulsange, Shubhangi; Gupta, Radhey Shyam; Thakur, Rahul; Dewan, Puneet; Boehme, Catharina; Paramsivan, Chinnambedu Nainarappan

2015-01-01

A critical challenge in providing TB care to People Living with HIV (PLHIV) is establishing an accurate bacteriological diagnosis. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents results from PLHIV taking part in a large demonstration study across India wherein upfront Xpert MTB/RIF testing was offered to all presumptive PTB cases in public health facilities. The study covered a population of 8.8 million across 18 sub-district level tuberculosis units (TU), with one Xpert MTB/RIF platform established at each TU. All HIV-infected patients suspected of TB (both TB and Drug Resistant TB (DR-TB)) accessing public health facilities in study area were prospectively enrolled and provided upfront Xpert MTB/RIF testing. 2,787 HIV-infected presumptive pulmonary TB cases were enrolled and 867 (31.1%, 95% Confidence Interval (CI) 29.4‒32.8) HIV-infected TB cases were diagnosed under the study. Overall 27.6% (CI 25.9-29.3) of HIV-infected presumptive PTB cases were positive by Xpert MTB/RIF, compared with 12.9% (CI 11.6-14.1) who had positive sputum smears. Upfront Xpert MTB/RIF testing of presumptive PTB and DR-TB cases resulted in diagnosis of 73 (9.5%, CI 7.6‒11.8) and 16 (11.2%, CI 6.7‒17.1) rifampicin resistance cases, respectively. Positive predictive value (PPV) for rifampicin resistance detection was high 97.7% (CI 89.3‒99.8), with no significant difference with or without prior history of TB treatment. The study results strongly demonstrate limitations of using smear microscopy for TB diagnosis in PLHIV, leading to low TB and DR-TB detection which can potentially lead to either delayed or sub-optimal TB treatment. Our findings demonstrate the usefulness and feasibility of addressing this diagnostic gap with upfront of Xpert MTB/RIF testing, leading to overall strengthening of care and support package for PLHIV.

Catching the Missing Million: Experiences in Enhancing TB & DR-TB Detection by Providing Upfront Xpert MTB/RIF Testing for People Living with HIV in India

PubMed Central

Raizada, Neeraj; Sachdeva, Kuldeep Singh; Sreenivas, Achuthan; Kulsange, Shubhangi; Gupta, Radhey Shyam; Thakur, Rahul; Dewan, Puneet; Boehme, Catharina; Paramsivan, Chinnambedu Nainarappan

2015-01-01

Background A critical challenge in providing TB care to People Living with HIV (PLHIV) is establishing an accurate bacteriological diagnosis. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents results from PLHIV taking part in a large demonstration study across India wherein upfront Xpert MTB/RIF testing was offered to all presumptive PTB cases in public health facilities. Method The study covered a population of 8.8 million across 18 sub-district level tuberculosis units (TU), with one Xpert MTB/RIF platform established at each TU. All HIV-infected patients suspected of TB (both TB and Drug Resistant TB (DR-TB)) accessing public health facilities in study area were prospectively enrolled and provided upfront Xpert MTB/RIF testing. Result 2,787 HIV-infected presumptive pulmonary TB cases were enrolled and 867 (31.1%, 95% Confidence Interval (CI) 29.4‒32.8) HIV-infected TB cases were diagnosed under the study. Overall 27.6% (CI 25.9–29.3) of HIV-infected presumptive PTB cases were positive by Xpert MTB/RIF, compared with 12.9% (CI 11.6–14.1) who had positive sputum smears. Upfront Xpert MTB/RIF testing of presumptive PTB and DR-TB cases resulted in diagnosis of 73 (9.5%, CI 7.6‒11.8) and 16 (11.2%, CI 6.7‒17.1) rifampicin resistance cases, respectively. Positive predictive value (PPV) for rifampicin resistance detection was high 97.7% (CI 89.3‒99.8), with no significant difference with or without prior history of TB treatment. Conclusion The study results strongly demonstrate limitations of using smear microscopy for TB diagnosis in PLHIV, leading to low TB and DR-TB detection which can potentially lead to either delayed or sub-optimal TB treatment. Our findings demonstrate the usefulness and feasibility of addressing this diagnostic gap with upfront of Xpert MTB/RIF testing, leading to overall strengthening of care and support package for PLHIV. PMID:25658091

[MRI changes of Achilles tendon and hindfoot in experienced runners and beginners during training and after a (half)-marathon competition].

PubMed

Freund, W; Billich, C; Brambs, H-J; Weber, F; Schütz, U H

2011-08-01

Marathon running is gaining in popularity. Its benefits regarding the cardiovascular system as well as the metabolism are beyond doubt. However, whether or not there are detrimental side effects to the musculoskeletal system such as wear and tear is an unsolved question. We therefore prospectively looked at beginners and experienced runners at a city marathon during training and after the competition for lesions to the Achilles tendon (AT) or hindfoot. 73 healthy subjects were prospectively included in our study. They were recruited from the applicants of the city marathon or half-marathon. They underwent an initial clinical orthopaedic as well as three magnetic resonance (MRI) examinations. The MRI were conducted at the time point of study enrolment, near the end of training and directly (up to 72 hours) after the run. MRI evaluation (fat saturated T (2)-weighted sagittal STIR sequence) was performed by two independent experienced radiologists blinded to the clinical context. The results were compared for subgroups of runners, also a factorial analysis was performed. Statistical results were deemed significant for p ≤ 0.05. 32 women and 41 men were included. In the end there were 53 finishers and 20 non-finishers; 28 seasoned runners and 25 novices. 57 runners had no foot complaints, while 14 had foot pain during training and 13 during the marathon. Mean body weight was 71.6 kg, height was 173 cm, age was 40.2 years. Mean AT diameter was 7.0 mm and showed no change during training or after the marathon. There was no significant influence of gender on other variables investigated. There was a significant and positive correlation between AT diameter and weight (r = 0.37), also AT and height (r = 0.34), while there was negative correlation between height and signal intensity of calcaneus (r = -0.50). The signal intensity of the AT decreased during training. The signal intensity of the calcaneus decreased from inclusion until after the marathon

Thermal comfort along the marathon course of the 2020 Tokyo Olympics.

PubMed

Honjo, Tsuyoshi; Seo, Yuhwan; Yamasaki, Yudai; Tsunematsu, Nobumitsu; Yokoyama, Hitoshi; Yamato, Hiroaki; Mikami, Takehiko

2018-04-17

The Olympic Games will be held in Tokyo in 2020 and the period will be the hottest period of the year in Japan. Marathon is a sport with a large heat load, and it is said that the risk of heat stroke rises more than other sports activities. The thermal environment of the 2020 Tokyo Olympic marathon course is analyzed by using wet-bulb globe temperature (WBGT) and Universal Thermal Climate Index (UTCI) map of the center area of Tokyo. The change due to the place, the effect of the shadow of the building, and the position on the course was analyzed from the distribution of WBGT and UTCI in the short-term analysis of sunny day from August 2 to August 6, 2014. To make the distribution map, we calculated distributions of sky view factor and mean radiant temperature of the 10 km × 7.5 km analyzed area in the center of Tokyo. Distributions of air temperature and humidity are calculated from Metropolitan Environmental Temperature and Rainfall Observation System data, which is a high-resolution measurement network. It was possible to incorporate the local variation of temperature and humidity of the analyzed area. In the result, the WBGT is about 1 °C lower and the UTCI is about 4-8 °C lower in the shadow of buildings from 9:00 to 10:00 than in the sunny side. As a cooling method, making a shadow is a relatively effective method. The variation along the course considering the distribution of meteorological data within the area is about 0.5 °C WBGT and 1 °C UTCI range. If we allow the error of this range, one-point meteorological data can be applied for the estimation along the course. Passing the right side (left side in the case of return) of the course could keep the accumulated value slightly lower along the course in the morning because the marathon course roughly runs from west to east and buildings' shadow is on the relatively right side (south side). But practically, the effect of changing the position on the course was small. The long-term analysis on

Thermal comfort along the marathon course of the 2020 Tokyo Olympics

NASA Astrophysics Data System (ADS)

Honjo, Tsuyoshi; Seo, Yuhwan; Yamasaki, Yudai; Tsunematsu, Nobumitsu; Yokoyama, Hitoshi; Yamato, Hiroaki; Mikami, Takehiko

2018-04-01

The Olympic Games will be held in Tokyo in 2020 and the period will be the hottest period of the year in Japan. Marathon is a sport with a large heat load, and it is said that the risk of heat stroke rises more than other sports activities. The thermal environment of the 2020 Tokyo Olympic marathon course is analyzed by using wet-bulb globe temperature (WBGT) and Universal Thermal Climate Index (UTCI) map of the center area of Tokyo. The change due to the place, the effect of the shadow of the building, and the position on the course was analyzed from the distribution of WBGT and UTCI in the short-term analysis of sunny day from August 2 to August 6, 2014. To make the distribution map, we calculated distributions of sky view factor and mean radiant temperature of the 10 km × 7.5 km analyzed area in the center of Tokyo. Distributions of air temperature and humidity are calculated from Metropolitan Environmental Temperature and Rainfall Observation System data, which is a high-resolution measurement network. It was possible to incorporate the local variation of temperature and humidity of the analyzed area. In the result, the WBGT is about 1 °C lower and the UTCI is about 4-8 °C lower in the shadow of buildings from 9:00 to 10:00 than in the sunny side. As a cooling method, making a shadow is a relatively effective method. The variation along the course considering the distribution of meteorological data within the area is about 0.5 °C WBGT and 1 °C UTCI range. If we allow the error of this range, one-point meteorological data can be applied for the estimation along the course. Passing the right side (left side in the case of return) of the course could keep the accumulated value slightly lower along the course in the morning because the marathon course roughly runs from west to east and buildings' shadow is on the relatively right side (south side). But practically, the effect of changing the position on the course was small. The long-term analysis on the

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

Continuous three dimensional analysis of running mechanics during a marathon by means of inertial magnetic measurement units to objectify changes in running mechanics.

PubMed

Reenalda, Jasper; Maartens, Erik; Homan, Lotte; Buurke, J H Jaap

2016-10-03

Recent developments in wearable and wireless sensor technology allow for a continuous three dimensional analysis of running mechanics in the sport specific setting. The present study is the first to demonstrate the possibility of analyzing three dimensional (3D) running mechanics continuously, by means of inertial magnetic measurement units, to objectify changes in mechanics over the course of a marathon. Three well trained male distance runners ran a marathon while equipped with inertial magnetic measurement units on trunk, pelvis, upper legs, lower legs and feet to obtain a 3D view of running mechanics and to asses changes in running mechanics over the course of a marathon. Data were continuously recorded during the entire 42.2km (26.2Miles) of the Marathon. Data from the individual sensors were transmitted wirelessly to a receiver, mounted on the handlebar of an accompanying cyclist. Anatomical calibration was performed using both static and dynamic procedures and sensor orientations were thus converted to body segment orientations by means of transformation matrices obtained from the segment calibration. Joint angle (hip, knee and ankle) trajectories as well as center of mass (COM) trajectory and acceleration were derived from the sensor data after segment calibration. Data were collected and repeated measures one way ANOVA׳s, with Tukey post-hoc test, were used to statistically analyze differences between the defined kinematic parameters (max hip angle, peak knee flexion at mid-stance and at mid-swing, ankle angle at initial contact and COM vertical displacement and acceleration), averaged over 100 strides, between the first and the last stages (8 and 40km) of the marathon. Significant changes in running mechanics were witnessed between the first and the last stage of the marathon. This study showed the possibility of performing a 3D kinematic analysis of the running technique, in the sport specific setting, by using inertial magnetic measurement units. For

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…

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.…

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…

Increased longitudinal contractility and diastolic function at rest in well-trained amateur Marathon runners: a speckle tracking echocardiography study

PubMed Central

2014-01-01

Background Regular physical activity reduces cardiovascular risk. There is concern that Marathon running might acutely damage the heart. It is unknown to what extent intensive physical endurance activity influences the cardiac mechanics at resting condition. Methods Eighty-four amateur marathon runners (43 women and 41 men) from Berlin-Brandenburg area who had completed at least one marathon previously underwent clinical examination and echocardiography at least 10 days before the Berlin Marathon at rest. Standard transthoracic echocardiography and 2D strain and strain rate analysis were performed. The 2D Strain and strain rate values were compared to previous published data of healthy untrained individuals. Results The average global longitudinal peak systolic strain of the left ventricle was -23 +/- 2% with peak systolic strain rate -1.39 +/- 0.21/s, early diastolic strain rate 2.0 +/- 0.40/s and late diastolic strain rate 1.21 +/- 0.31/s. These values are significantly higher compared to the previous published values of normal age-adjusted individuals. In addition, no age-related decline of longitudinal contractility in well-trained athletes was observed. Conclusions There is increased overall longitudinal myocardial contractility at rest in experienced endurance athletes compared to the published normal values in the literature indicating a preserved and even supra-normal contractility in the athletes. There is no age dependent decline of the longitudinal 2D Strain values. This underlines the beneficial effects of regular physical exercise even in advanced age. PMID:24571726

Decomposing cross-country differences in quality adjusted life expectancy: the impact of value sets.

PubMed

Heijink, Richard; van Baal, Pieter; Oppe, Mark; Koolman, Xander; Westert, Gert

2011-06-23

The validity, reliability and cross-country comparability of summary measures of population health (SMPH) have been persistently debated. In this debate, the measurement and valuation of nonfatal health outcomes have been defined as key issues. Our goal was to quantify and decompose international differences in health expectancy based on health-related quality of life (HRQoL). We focused on the impact of value set choice on cross-country variation. We calculated Quality Adjusted Life Expectancy (QALE) at age 20 for 15 countries in which EQ-5D population surveys had been conducted. We applied the Sullivan approach to combine the EQ-5D based HRQoL data with life tables from the Human Mortality Database. Mean HRQoL by country-gender-age was estimated using a parametric model. We used nonparametric bootstrap techniques to compute confidence intervals. QALE was then compared across the six country-specific time trade-off value sets that were available. Finally, three counterfactual estimates were generated in order to assess the contribution of mortality, health states and health-state values to cross-country differences in QALE. QALE at age 20 ranged from 33 years in Armenia to almost 61 years in Japan, using the UK value set. The value sets of the other five countries generated different estimates, up to seven years higher. The relative impact of choosing a different value set differed across country-gender strata between 2% and 20%. In 50% of the country-gender strata the ranking changed by two or more positions across value sets. The decomposition demonstrated a varying impact of health states, health-state values, and mortality on QALE differences across countries. The choice of the value set in SMPH may seriously affect cross-country comparisons of health expectancy, even across populations of similar levels of wealth and education. In our opinion, it is essential to get more insight into the drivers of differences in health-state values across populations. This

Running injuries and associated factors in participants of ING Taipei Marathon.

PubMed

Chang, Wei-Ling; Shih, Yi-Fen; Chen, Wen-Yin

2012-08-01

To investigate the distribution of lower extremity running injuries and their associated factors. Descriptive and exploratory study. 1004 participants of the 2005 ING Taipei International Marathon. We used a self-developed questionnaire to collect data of previous running injuries and applied multivariate logistic regression modeling to examine relationships between these injuries and associated factors. Of the 893 valid questionnaires, 396 (44.4%) reported having previous lower extremity pain related to running. Knee joint pain was the most common problem (32.5%). Hip pain was associated with the racing group, training duration, and medial arch support. Use of knee orthotics (P = 0.002) and ankle braces (P = 0.007) was related to a higher rate of knee and ankle pain. Participants of the full marathon group who practiced on a synthetic track had a higher incidence of ankle pain. A training duration of >60 min was linked to an increased rate of foot pain (P = 0.003). Our data indicated that running injuries were associated with training duration and use of orthotics. Clinicians can use this information in treating or preventing running associated injuries and pain. Copyright © 2011 Elsevier Ltd. All rights reserved.

A cross-country Exchange Market Pressure (EMP) dataset.

PubMed

Desai, Mohit; Patnaik, Ila; Felman, Joshua; Shah, Ajay

2017-06-01

The data presented in this article are related to the research article titled - "An exchange market pressure measure for cross country analysis" (Patnaik et al. [1]). In this article, we present the dataset for Exchange Market Pressure values (EMP) for 139 countries along with their conversion factors, ρ (rho). Exchange Market Pressure, expressed in percentage change in exchange rate, measures the change in exchange rate that would have taken place had the central bank not intervened. The conversion factor ρ can interpreted as the change in exchange rate associated with $1 billion of intervention. Estimates of conversion factor ρ allow us to calculate a monthly time series of EMP for 139 countries. Additionally, the dataset contains the 68% confidence interval (high and low values) for the point estimates of ρ 's. Using the standard errors of estimates of ρ 's, we obtain one sigma intervals around mean estimates of EMP values. These values are also reported in the dataset.

Prevalence of pathologic findings in asymptomatic knees of marathon runners before and after a competition in comparison with physically active subjects-a 3.0 T magnetic resonance imaging study.

PubMed

Stahl, Robert; Luke, Anthony; Ma, C Benjamin; Krug, Roland; Steinbach, Lynne; Majumdar, Sharmila; Link, Thomas M

2008-07-01

To determine the prevalence of pathologic findings in asymptomatic knees of marathon runners before and after a competition in comparison with physically active subjects. To compare the diagnostic performance of cartilage-dedicated magnetic resonance imaging (MRI) sequences at 3.0 T. Ten marathon runners underwent 3.0 T MRI 2-3 days before and after competition. Twelve physically active asymptomatic subjects not performing long-distance running were examined as controls. Pathologic condition was assessed with the whole-organ magnetic resonance imaging score (WORMS). Cartilage abnormalities and bone marrow edema pattern (BMEP) were quantified. Visualization of cartilage pathology was assessed with intermediate-weighted fast spin-echo (IM-w FSE), fast imaging employing steady-state acquisition (FIESTA) and T1-weighted three-dimensional (3D) high-spatial-resolution volumetric fat-suppressed spoiled gradient-echo (SPGR) MRI sequences. Eight of ten marathon runners and 7/12 controls showed knee abnormality. Slightly more and larger cartilage abnormalities, and BMEP, in marathon runners yielded higher but not significantly different WORMS (P > 0.05) than in controls. Running a single marathon did not alter MR findings substantially. Cartilage abnormalities were best visualized with IM-w FSE images (P < 0.05). A high prevalence of knee abnormalities was found in marathon runners and also in active subjects participating in other recreational sports. IM-w FSE sequences delineated more cartilage MR imaging abnormalities than did FIESTA and SPGR sequences.

The sportsman readjustment after transcontinental flight: a study on marathon runners.

PubMed

Montaruli, A; Roveda, E; Calogiuri, G; La Torre, A; Carandente, F

2009-12-01

The aim of the study was to evaluate the synchronizing effect of physical activity on the rest-activity cycle after a flight across different time zones, investigating the parameters linked to sleep. The purpose of this study is to evaluate the synchronizing effect of physical activity on the sleep-activity parameters after a flight across different time zones. Eighteen volunteers flew from Milan to New York for the 2007 New York City Marathon. A training program, that consisted of running sessions three times a week for one month, was planned for the twelve athletes that participated in the marathon. The athletes were divided in two groups: Morning Training Group (MTG), trained from 7:00 to 9:00; Evening Training Group (ETG) from 19:00 to 21:00. The Control Group (CG), of 6 non-athletes, did not train before the flight and did not participate in the marathon. In New York, both groups of athletes trained in the morning. Two Actigraph monitoring sessions were performed in all three groups, before the Milan-New York flight and during the stay in New York. The actigraphy made it possible to calculate sleep and activity-specific parameters; sleep and activity patterns were continuously monitored using an actometer on the wrist of the non-dominant hand. Sleep analysis done on the first night in New York showed a significant difference (P<0.05) in the Movement and Fragmentation Index (MFI) between MTG and ETG. In CG and MTG, the MFI increased after the flight, while in ETG, the MFI decreased. Activity analysis demonstrated that, in ETG, evening physical activity in Milan associated with morning activity in New York produced a shift in the Cosine Peak of the rhythm of activity. Physical activity can have a positive effect both on sleep, by improving quality, as well as on the circadian rhythm of activity, by encouraging re-synchronization after the flight.

Sweat sodium loss influences serum sodium concentration in a marathon.

PubMed

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

2017-02-01

The aim of this investigation was to determine the influence of sweat electrolyte concentration on body water and electrolyte homeostasis during a marathon. Fifty-one runners completed a marathon race in a warm and dry environment (24.4 ± 3.6 °C). Runners were classified as low-salt sweaters (n = 21; <30 mmol/L of sweat Na + concentration), typical sweaters (n = 20; ≥30 and <60 mmol/L of sweat Na + concentration), and salty sweaters (n = 10; ≥60 mmol/L of sweat Na + concentration). Before and after the race, body mass and a sample of venous blood were obtained. During the race, sweat samples were collected by using sweat patches, and fluid and electrolyte intake were recorded by using self-reported questionnaires. Low-salt, typical and salty sweaters presented similar sweat rates (0.93 ± 0.2, 0.92 ± 0.29, 0.99 ± 0.21 L/h, respectively), body mass changes (-3.0 ± 1.0, -3.3 ± 1.0, -3.2 ± 0.8%), total Na + intake (12.7 ± 8.1, 11.5 ± 9.7, 14.5 ± 16.6 mmol), and fluid intake (1.3 ± 0.8, 1.2 ± 0.8, 1.2 ± 0.6 L) during the race. However, salty sweaters presented lower post-race serum Na + concentration (140.8 ± 1.3 vs 142.5 ± 1.1, 142.4 ± 1.4 mmol/L; P < 0.01) and serum osmolality (297 ± 6 vs 299 ± 5, 301 ± 6 mOsm/kg; P < 0.05) than low-salt and typical sweaters. Sweat electrolyte concentration could influence post-race serum electrolyte concentration in the marathon. However, even the saltiest sweaters did not develop exercise-associated hyponatremia or associated symptoms. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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…

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

Bunyasi, Erick Wekesa; Tameris, Michele; 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

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. 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. 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]. Sensitivity of Xpert MTB/RIF assay was low, compared to MGIT culture, but diagnostic performance of Xpert MTB/RIF did not differ sufficiently between induced sputum

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.

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

Kaur, Ramandeep; Jindal, Neerja; Arora, Shilpa; Kataria, Shajla

2016-01-01

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). 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. 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. 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.

Zipf rank approach and cross-country convergence of incomes

NASA Astrophysics Data System (ADS)

Shao, Jia; Ivanov, Plamen Ch.; Urošević, Branko; Stanley, H. Eugene; Podobnik, Boris

2011-05-01

We employ a concept popular in physics —the Zipf rank approach— in order to estimate the number of years that EU members would need in order to achieve "convergence" of their per capita incomes. Assuming that trends in the past twenty years continue to hold in the future, we find that after t≈30 years both developing and developed EU countries indexed by i will have comparable values of their per capita gross domestic product {\\cal G}_{i,t} . Besides the traditional Zipf rank approach we also propose a weighted Zipf rank method. In contrast to the EU block, on the world level the Zipf rank approach shows that, between 1960 and 2009, cross-country income differences increased over time. For a brief period during the 2007-2008 global economic crisis, at world level the {\\cal G}_{i,t} of richer countries declined more rapidly than the {\\cal G}_{i,t} of poorer countries, in contrast to EU where the {\\cal G}_{i,t} of developing EU countries declined faster than the {\\cal G}_{i,t} of developed EU countries, indicating that the recession interrupted the convergence between EU members. We propose a simple model of GDP evolution that accounts for the scaling we observe in the data.

Marathon performance, anaerobic threshold, and onset of blood lactate accumulation.

PubMed

Tanaka, K; Matsuura, Y

1984-09-01

The study tested the hypothesis that running velocity corresponding to the anaerobic threshold (VAT) would more accurately approximate the actually measured marathon race velocity (VM) than would running velocity corresponding to the so-called onset of blood lactate (4 mM) accumulation (VOBLA). The VAT (4.57 m X s-1) well approximated the VM (4.49 m X s-1), whereas the VOBLA (5.30 m X s-1) differed significantly from the VM. In addition, the VAT (r = 0.781) correlated with VM to a greater extent than did the VOBLA (r = 0.682). When the VAT (X1) was combined with delta % maximum O2 consumption (VO2max) (%VO2max at the OBLA minus %VO2max at the AT; X2) and VO2max (ml X min-1 x kg-1; X3), variation in the VM accounted for increased profoundly from 61 to 88%. Thus one of the useful equations formulated with high predictive accuracy was VM (m X s-1) = 1.312X1 + 0.0346X2 - 0.00993X3 - 1.272. Our study demonstrates that the anaerobic threshold (AT) is more closely associated with marathon running performance and that the degree of the association is raised when delta %VO2max and/or VO2max are combined as additional information.

Jim Peters' collapse in the 1954 Vancouver Empire Games marathon.

PubMed

Noakes, Tim; Mekler, Jackie; Pedoe, Dan Tunstall

2008-08-01

On 7 August 1954, the world 42 km marathon record holder, Jim Peters, collapsed repeatedly during the final 385 metres of the British Empire and Commonwealth Games marathon held in Vancouver, Canada. It has been assumed that Peters collapsed from heatstroke because he ran too fast and did not drink during the race, which was held in windless, cloudless conditions with a dry-bulb temperature of 28 degrees C. Hospital records made available to us indicate that Peters might not have suffered from exertional heatstroke, which classically produces a rectal temperature > 42 degrees C, cerebral effects and, usually, a fatal outcome without vigorous active cooling. Although Peters was unconscious on admission to hospital approximately 60 minutes after he was removed from the race, his rectal temperature was 39.4 degrees C and he recovered fully, even though he was managed conservatively and not actively cooled. We propose that Peters' collapse was more likely due to a combination of hyperthermia-induced fatigue which caused him to stop running; exercise-associated postural hypotension as a result of a low peripheral vascular resistance immediately he stopped running; and combined cerebral effects of hyperthermia, hypertonic hypernatraemia associated with dehydration, and perhaps undiagnosed hypoglycaemia. But none of these conditions should cause prolonged unconsciousness, raising the possibility that Peters might have suffered from a transient encephalopathy, the exact nature of which is not understood.

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…

North Pole Marathon Laboratory Lessons and Field Success.

PubMed

Barwood, Martin J; Burrows, Holly; Cessford, Jessica

2016-05-01

This case study documents the training, laboratory preparation, and in-race performance data from Great Britain's top finisher in the 13(th) edition of the UVU North Pole Marathon. We report data from a preparatory laboratory test in simulated cold conditions (-15°C) with and without wind chill during high- and low-intensity expected 'race pace' running. These tests examined the adequacy of the selected clothing assembly and provided recommendations for the race. The tests established that there was no risk of hypothermia, as the clothing assembly provided too much insulation; terminal rectal temperature was 39.25°C. Skin temperature (Tsk) data revealed no impending risk of frostbite; nadir Tsk was 20.2°C at the hamstring. Oxygen consumption data revealed the self-selected high intensity was potentially not sustainable based on estimates of substrate utilization. We recommended: 1) a maximum running speed; 2) some of the clothing base layers could be removed pre-race; 3) vents and/or zips could be used to offload or retain heat; and 4) an even pacing profile should be adopted. The participant completed the race in 6:55:24 (h:mm:ss) in temperatures of -41°C. GPS data revealed a positive pacing template (i.e., marginally quicker in the first half). Neither hypothermia nor frostbite occurred. Peak pace from the laboratory tests was not consistently exceeded. Marathon performance can be undertaken in one of the world's most inhospitable environments when careful consideration is given to clothing insulation and exercise intensity by planning for the dynamic thermal changes that may occur as the race ensues.

Infectious episodes before and after a marathon race.

PubMed

Ekblom, B; Ekblom, O; Malm, C

2006-08-01

The aim of this study was to investigate the incidence of self-reported infectious episodes (IE) during 3 weeks before (pre-IE) and 3 weeks after (post-IE) a marathon race and relate these figures to training status, running time, socioeconomic and demographic factors. Two questionnaires, including questions about important factors for IE incidence, were given to a representative cohort of 1694 runners (17% of all finishers) in the Stockholm Marathon 2000. Pre-IE incidence in the cohort was 17% with no difference between women and men. Post-IE incidence in the whole cohort was 19% with no significant (P>0.05) difference between women and men. The post-IE incidence in runners without a pre-IE was 16% (P>0.05 to pre-IE incidence). In the group of runners with pre-IE, 33% experienced an IE after the race also (P<0.05 to Pre-IE incidence). A logistic regression analysis showed that younger age and pre race health status and, for men only, experienced nausea during and after the race were depended factors explaining post-IE incidence. Younger runners were more prone to experience IE both before and after the race. There was no relation between training volume 6 months before the race, finishing time and socioeconomic and demographic factors and pre-IE or post-IE. This study does not support the theory of increased infection rate after exhaustive long-distance running ("The Open Window Theory") in recreational runners, but suggests that the sometimes experienced increased rate of infections among athletes can be caused by strenuous exercise too soon after an infection.

Diagnosis of Concurrent Pulmonary Tuberculosis and Tuberculous Otitis Media Confirmed by Xpert MTB/RIF in the United States.

PubMed

Tompkins, Kathleen M; Reimers, Melissa A; White, Becky L; Herce, Michael E

2016-05-01

Tuberculosis (TB) remains an important cause of infectious morbidity in the United States (US), necessitating timely and accurate diagnosis. We report a case of concurrent pulmonary and extrapulmonary TB presenting as tuberculous otitis media in a hospitalized US patient admitted with cough, night sweats, and unilateral purulent otorrhea. Diagnosis was made by smear microscopy and rapidly confirmed by Xpert MTB/RIF-a novel, automated nucleic acid amplification test for the rapid detection of drug-susceptible and drug-resistant TB. This case adds to the growing body of evidence validating Xpert MTB/RIF as an effective tool for the rapid diagnosis of extrapulmonary TB, even in low TB-prevalence settings such as the US, when testing is performed on non-respiratory specimens.

Diagnosis of Concurrent Pulmonary Tuberculosis and Tuberculous Otitis Media Confirmed by Xpert MTB/RIF in the United States

PubMed Central

Tompkins, Kathleen M.; Reimers, Melissa A.; White, Becky L.; Herce, Michael E.

2015-01-01

Tuberculosis (TB) remains an important cause of infectious morbidity in the United States (US), necessitating timely and accurate diagnosis. We report a case of concurrent pulmonary and extrapulmonary TB presenting as tuberculous otitis media in a hospitalized US patient admitted with cough, night sweats, and unilateral purulent otorrhea. Diagnosis was made by smear microscopy and rapidly confirmed by Xpert MTB/RIF—a novel, automated nucleic acid amplification test for the rapid detection of drug-susceptible and drug-resistant TB. This case adds to the growing body of evidence validating Xpert MTB/RIF as an effective tool for the rapid diagnosis of extrapulmonary TB, even in low TB-prevalence settings such as the US, when testing is performed on non-respiratory specimens. PMID:27346926

A Cross-Cultural Test of the Work-Family Interface in 48 Countries

ERIC Educational Resources Information Center

Jeffrey Hill, E.; Yang, Chongming; Hawkins, Alan J.; Ferris, Maria

2004-01-01

This study tests a cross-cultural model of the work-family interface. Using multigroup structural equation modeling with IBM survey responses from 48 countries (N= 25,380), results show that the same work-family interface model that fits the data globally also fits the data in a four-group model composed of culturally related groups of countries,…

Xpert MTB/RIF assay can be used on archived gastric aspirate and induced sputum samples for sensitive diagnosis of paediatric tuberculosis.

PubMed

Singh, Sarman; Singh, Amit; Prajapati, Suneel; Kabra, Sushil K; Lodha, Rakesh; Mukherjee, Aparna; Singh, Varinder; Hesseling, Anneke C; Grewal, Harleen M S

2015-09-29

Tuberculosis (TB) in children is neglected, mainly due to lack of sensitive diagnostic tools. Recently Xpert MTB/RIF assay has revolutionized the diagnostic field, but its usefulness in pediatric TB has not been reported from India and no report is available on its use on long term archived samples. We recruited 130 pediatric patients with probable intrathoracic tuberculosis and their gastric aspirate (GA) and induced sputum (IS) samples on 2 consecutive days were collected between January 2009 and December 2012. All samples (n = 520) were subjected to smear examination, BACTEC-MGIT culture and in-house multiplex PCR. An aliquot of each sample was stored at -80 °C and tested in Xpert MTB/RIF assay in 2013. Sample wise and patient wise detection rate of smear microscopy was 4.4 % and 10 %, while for BACTEC-MGIT culture this rate was 24.4 % and 46.9 %, respectively. Of the 130 day 1 GA samples, 31.5 % and 27.7 % day 2 GA samples were culture positive. Only 17.7 % GA samples were positive on both days. Of the 130 IS samples collected on day 1 and day 2, 15.4 % and 23.1 % samples were culture positive. A combination of GA and IS yielded best results. Combining both GA and IS, the overall sensitivity of Xpert MTB/RIF on smear and culture positive samples was 95.6 %. In smear negative and culture positive samples its sensitivity was 62.5 %. The duration of sample storage impacted the Xpert MTB/RIF test performance (p = 0.0001). In smear positive samples stored for 650-849 days, its sensitivity was 85.7 % and 77.1 % for IS and GA samples which dropped to 33.3 % and 50 %, respectively, if stored for more than 1050 days. Confirmatory diagnosis of tuberculosis particularly in children is a medical challenge. No laboratory or radiological test can reach to a satisfactory level of diagnostic sensitivity. However, in this study we found that combination of multiple samples and multiple diagnostic tests can give much better yield, though not optimum. In present study

Stress fractures in elite cross-country athletes.

PubMed

Laker, Scott R; Saint-Phard, Deborah; Tyburski, Mark; Van Dorsten, Brent

2007-04-01

This retrospective and comparative survey investigates an unusual number of stress fractures seen within a Division I college cross-country team. An anonymous questionnaire-designed to observe factors known to increase stress fracture incidence-was distributed to members of the current and previous seasons' teams. Running surface, sleep hours, intake of calcium, and shoe type were among the factors investigated. Eleven lower extremity stress fractures were found in nine athletes. Athletes with stress fractures reported significantly fewer workouts per week on the new track. All other study parameters had no statistically significant effect on stress fractures in these athletes.

Enhancing TB case detection: experience in offering upfront Xpert MTB/RIF testing to pediatric presumptive TB and DR TB cases for early rapid diagnosis of drug sensitive and drug resistant TB.

PubMed

Raizada, Neeraj; Sachdeva, Kuldeep Singh; Nair, Sreenivas Achuthan; Kulsange, Shubhangi; Gupta, Radhey Shayam; Thakur, Rahul; Parmar, Malik; Gray, Christen; Ramachandran, Ranjani; Vadera, Bhavin; Ekka, Shobha; Dhawan, Shikha; Babre, Ameet; Ghedia, Mayank; Alavadi, Umesh; Dewan, Puneet; Khetrapal, Mini; Khanna, Ashwini; Boehme, Catharina; Paramsivan, Chinnambedu Nainarappan

2014-01-01

Diagnosis of pulmonary tuberculosis (PTB) in children is challenging due to difficulties in obtaining good quality sputum specimens as well as the paucibacillary nature of disease. Globally a large proportion of pediatric tuberculosis (TB) cases are diagnosed based only on clinical findings. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents the results from pediatric groups taking part in a large demonstration study wherein Xpert MTB/RIF testing replaced smear microscopy for all presumptive PTB cases in public health facilities across India. The study covered a population of 8.8 million across 18 programmatic sub-district level tuberculosis units (TU), with one Xpert MTB/RIF platform established at each study TU. Pediatric presumptive PTB cases (both TB and Drug Resistant TB (DR-TB)) accessing any public health facilities in study area were prospectively enrolled and tested on Xpert MTB/RIF following a standardized diagnostic algorithm. 4,600 pediatric presumptive pulmonary TB cases were enrolled. 590 (12.8%, CI 11.8-13.8) pediatric PTB were diagnosed. Overall 10.4% (CI 9.5-11.2) of presumptive PTB cases had positive results by Xpert MTB/RIF, compared with 4.8% (CI 4.2-5.4) who had smear-positive results. Upfront Xpert MTB/RIF testing of presumptive PTB and presumptive DR-TB cases resulted in diagnosis of 79 and 12 rifampicin resistance cases, respectively. Positive predictive value (PPV) for rifampicin resistance detection was high (98%, CI 90.1-99.9), with no statistically significant variation with respect to past history of treatment. Upfront access to Xpert MTB/RIF testing in pediatric presumptive PTB cases was associated with a two-fold increase in bacteriologically-confirmed PTB, and increased detection of rifampicin-resistant TB cases under routine operational conditions across India. These results suggest that routine Xpert MTB/RIF testing is a promising solution to

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…

Burden of tuberculosis in intensive care units in Cape Town, South Africa, and assessment of the accuracy and effect on patient outcomes of the Xpert MTB/RIF test on tracheal aspirate samples for diagnosis of pulmonary tuberculosis: a prospective burden of disease study with a nested randomised controlled trial.

PubMed

Calligaro, Gregory L; Theron, Grant; Khalfey, Hoosain; Peter, Jonathan; Meldau, Richard; Matinyenya, Brian; Davids, Malika; Smith, Liezel; Pooran, Anil; Lesosky, Maia; Esmail, Aliasgar; Miller, Malcolm G; Piercy, Jenna; Michell, Lancelot; Dawson, Rodney; Raine, Richard I; Joubert, Ivan; Dheda, Keertan

2015-08-01

treatment (adjusted HR 4·49, 95% CI 1·45-13·89) or who received inotropes (4·33, 1·49-12·60) were more likely to die. However, tuberculosis status was not associated with 28-day or 90-day mortality. In the substudy, we randomly assigned 115 patients to smear microscopy and 111 to Xpert MTB/RIF. Smear microscopy detected six (43%) of 14 culture-positive patients, and Xpert MTB/RIF detected 11 (100%) of 11 culture-positive patients (p=0·002). The proportion of culture-positive patients on treatment at 48 h was higher in the Xpert MTB/RIF group than in the smear microscopy group (11 [92%] of 12 vs nine [53%] of 17; p=0·043), although use of Xpert MTB/RIF had no effect on mortality or other patient outcomes. Tuberculosis is fairly common in ICUs in high-burden settings, and clinicians should screen and test patients for tuberculosis with Xpert MTB/RIF where available. This test improves diagnostic yield and rates of treatment initiation, and reduces unnecessary treatment, but might not increase the total number of patients on treatment when empirical treatment is widely used. A suspected diagnosis of pulmonary tuberculosis should not exclude patients from ICU care in resource-limited settings because mortality is unaffected by the presence of this disease. European and Developing Countries Clinical Trials Partnership, South African Medical Research Council, and the Discovery Foundation. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

Physiological responses of low-time private pilots to cross-country flying.

DOT National Transportation Integrated Search

1971-04-01

Various physiological, biochemical, and psychophysiological measurements were made on low-time private pilots who each flew three cross-country flights. The round-trip flights were 320, 520, and 960 NM in length. Heart rate was recorded continuously ...

Effect of a marathon run on serum lipoproteins, creatine kinase, and lactate dehydrogenase in recreational runners.

PubMed

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

2005-12-01

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 level was significantly elevated postrace, then fell 30% below baseline 1 day after the run, and returned to baseline after 1 week. Total cholesterol responded less dramatically but with a similar pattern. High-density lipoprotein cholesterol remained significantly elevated and low-density lipoprotein cholesterol was transiently reduced for 3 days after the run. The total cholesterol/high-density cholesterol ratio was significantly lowered for 3 days. Serum lactate dehydrogenase activity significantly doubled postrace and then declined but remained elevated for 2 weeks. Serum creatine kinase activity peaked 24 hr after the run, with a 15-fold rise, and returned to baseline after 1 week. The rise of these enzymes reflects mechanically damaged muscle cells leaking contents into the interstitial fluid. It is concluded that a prolonged strenuous exercise bout in recreational runners, such as a marathon, produces beneficial changes in lipid blood profiles that are significant for only 3 days. However, muscle damage is also evident for 1 week or more from the dramatic and long-lasting effect on enzyme levels. Laboratory values for these runners were outside normal ranges for some days after the race.

The impact of self-reported psychological stress levels on changes to peripheral blood immune biomarkers in recreational marathon runners during training and recovery.

PubMed

Rehm, Kristina E; Elci, Okan U; Hahn, Kathryn; Marshall, Gailen D

2013-01-01

Marathon training is both physically and psychologically stressful, both of which can lead to altered immunity. The purpose of this study was to determine if the overall immunoregulatory changes associated with the physical stress of marathon training are affected by psychological stress. Nineteen recreational marathoners completed the Perceived Stress Scale (PSS), State-Trait Anxiety Inventory (STAI) and Penn State Worry Questionnaire (PSWQ), and had levels of T cell subpopulations and cytokine (IFNγ, IL4 and IL10) production determined 4 weeks before (baseline), 24-48 h before (prerace) and 1 week after (recovery) participation in a marathon. PSS scores decreased at the prerace visit compared to baseline and remained low at recovery. Compared to baseline, there were significant changes to numerous immune measures at the prerace visit, including decreases in Th1/Th2 ratio, Tc1/Tc2 ratio, Tr1 and Th3 cell populations as well as decreases in IFNγ/IL4 cytokine ratio and IL10 production. Most immune parameters had returned to near baseline values at the recovery visit. Higher levels of perceived stress, anxiety and worry exacerbated many of the alterations in immunity that were observed at the prerace visit. Higher levels of perceived stress and worry had significant effects on changes to Treg, IL4 production and the IFNγ/IL4 cytokine ratio. Stress had an additional impact on changes in IL10 production. High anxiety levels resulted in significant changes to Treg, Tr1 and Th3. These data suggest that recreational marathon runners with higher levels of psychological stress may be more at risk for the immune alterations that are common during periods of prolonged physical training. Copyright © 2013 S. Karger AG, Basel.

Oil price and exchange rate co-movements in Asian countries: Detrended cross-correlation approach

NASA Astrophysics Data System (ADS)

Hussain, Muntazir; Zebende, Gilney Figueira; Bashir, Usman; Donghong, Ding

2017-01-01

Most empirical literature investigates the relation between oil prices and exchange rate through different models. These models measure this relationship on two time scales (long and short terms), and often fail to observe the co-movement of these variables at different time scales. We apply a detrended cross-correlation approach (DCCA) to investigate the co-movements of the oil price and exchange rate in 12 Asian countries. This model determines the co-movements of oil price and exchange rate at different time scale. The exchange rate and oil price time series indicate unit root problem. Their correlation and cross-correlation are very difficult to measure. The result becomes spurious when periodic trend or unit root problem occurs in these time series. This approach measures the possible cross-correlation at different time scale and controlling the unit root problem. Our empirical results support the co-movements of oil prices and exchange rate. Our results support a weak negative cross-correlation between oil price and exchange rate for most Asian countries included in our sample. The results have important monetary, fiscal, inflationary, and trade policy implications for these countries.

Electrocardiographic abnormalities in amateur male marathon runners.

PubMed

Kaleta, Anna M; Lewicka, Ewa; Dąbrowska-Kugacka, Alicja; Lewicka-Potocka, Zuzanna; Wabich, Elżbieta; Szerszyńska, Anna; Dyda, Julia; Sobolewski, Jakub; Koenner, Jakub; Raczak, Grzegorz

2018-06-18

Sports activity has become extremely popular among amateurs. Electrocardiography is a useful tool in screening for cardiac pathologies in athletes; however, there is little data on electrocardiographic abnormalities in the group of amateur athletes. The aim of this study was to analyze the abnormalities in resting and exercise electrocardiograms (ECGs) in a group of amateur athletes, and try to determine whether the criteria applied for the general population or for athletes' ECGs should be implemented in this group. In 40 amateur male marathon runners, 3 consecutive 12-lead ECGs were performed: 2-3 weeks before (stage 1), just after the run (stage 2) and 2-3 weeks after the marathon (stage 3). Resting (stage 1) and exercise (stage 2) ECGs were analyzed following the refined criteria for the assessment of athlete's ECG (changes classified as training-related, borderline or training-unrelated). In resting ECGs, at least 1 abnormality was found in 92.5% of the subjects and the most common was sinus bradycardia (62.5%). In post-exercise ECGs, at least 1 abnormality was present in 77.5% of the subjects and the most common was right atrium enlargement (RAE) (42.5%). Training-related ECG variants were more frequent at rest (82.5% vs 42.5%; p = 0.0008), while borderline variants - after the run (22.5% vs 57.5%; p = 0.0004). Training-unrelated abnormalities were found in 15% and 10% of the subjects, respectively (p-value - nonsignificant), and the most common was T-wave inversion. Even if the refined criteria rather than the criteria used for normal sedentary population were applied, the vast majority of amateur runners showed at least 1 abnormality in resting ECGs, which were mainly training-related variants. However, at rest, in 15% of the subjects, pathologic training-unrelated abnormalities were found. The most frequent post-exercise abnormality was right atrial enlargement. General electrocardiographic screening in amateur athletes should be taken into consideration.

Optimized molecular resolution of cross-contamination alerts in clinical mycobacteriology laboratories.

PubMed

Martín, Ana; Herranz, Marta; Lirola, Miguel Martínez; Fernández, Rosa Fernández; Bouza, Emilio; García de Viedma, Darío

2008-02-14

The phenomenon of misdiagnosing tuberculosis (TB) by laboratory cross-contamination when culturing Mycobacterium tuberculosis (MTB) has been widely reported and it has an obvious clinical, therapeutic and social impact. The final confirmation of a cross-contamination event requires the molecular identification of the same MTB strain cultured from both the potential source of the contamination and from the false-positive candidate. The molecular tool usually applied in this context is IS6110-RFLP which takes a long time to provide an answer, usually longer than is acceptable for microbiologists and clinicians to make decisions. Our purpose in this study is to evaluate a novel PCR-based method, MIRU-VNTR as an alternative to assure a rapid and optimized analysis of cross-contamination alerts. MIRU-VNTR was prospectively compared with IS6110-RFLP for clarifying 19 alerts of false positivity from other laboratories. MIRU-VNTR highly correlated with IS6110-RFLP, reduced the response time by 27 days and clarified six alerts unresolved by RFLP. Additionally, MIRU-VNTR revealed complex situations such as contamination events involving polyclonal isolates and a false-positive case due to the simultaneous cross-contamination from two independent sources. Unlike standard RFLP-based genotyping, MIRU-VNTR i) could help reduce the impact of a false positive diagnosis of TB, ii) increased the number of events that could be solved and iii) revealed the complexity of some cross-contamination events that could not be dissected by IS6110-RFLP.

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…

Applied Sports Nutrition Support, Dietary Intake and Body Composition Changes of a Female Athlete Completing 26 Marathons in 26 Days: A Case Study.

PubMed

McManus, Chris J; Murray, Kelly A; Parry, David A

2017-03-01

The aim of this case study is to describe the nutrition practices of a female recreational runner (VO 2 max 48.9 ml · kg -1 · min -1 ) who completed 26 marathons (42.195 km) in 26 consecutive days. Information relating to the nutritional intake of female runners during multi-day endurance events is extremely limited, yet the number of people participating year-on-year continues to increase. This case study reports the nutrition intervention, dietary intake, body composition changes and performance in the lead-up and during the 26 days. Prior to undertaking the 26 marathon challenge, three consultations were held between the athlete and a sports nutrition advisor; planning and tailoring the general diet and race-specific strategies to the endurance challenge. During the marathons, the mean energy and fluid intake was 1039.7 ± 207.9 kcal (607.1 - 1453.2) and 2.39 ± 0.35 L (1.98 - 3.19). Mean hourly carbohydrate intake was 38.9 g·hr -1 . 11 days following the completion of the 26 marathons, body mass had reduced by 4.6 kg and lean body mass increasing by 0.53 kg when compared with 20 days prior. This case study highlights the importance of providing general and event-specific nutrition education when training for such an event. This is particularly prudent for multi-day endurance running events.

Transference of 3D accelerations during cross country mountain biking.

PubMed

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

2014-06-03

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. Copyright © 2014 Elsevier Ltd. All rights reserved.

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…

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

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

The impact of exercise intensity on the release of cardiac biomarkers in marathon runners.

PubMed

Legaz-Arrese, Alejandro; George, Keith; Carranza-García, Luis Enrique; Munguía-Izquierdo, Diego; Moros-García, Teresa; Serrano-Ostáriz, Enrique

2011-12-01

We sought to determine the influence of exercise intensity on the release of cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in amateur marathon runners. Fourteen runners completed three exercise trials of the same duration but at exercise intensities corresponding to: (a) a competitive marathon [mean ± SD: heart rate 159 ± 7 beat min(-1), finish time 202 ± 14 min]; (b) 95% of individual anaerobic threshold [heart rate 144 ± 6 beat min(-1)] and; (c) 85% of individual anaerobic threshold [heart rate 129 ± 5 beat min(-1)]. cTnI and NT-proBNP were assayed from blood samples collected before, 30 min and 3 h post-exercise for each trial. cTnI and NT-proBNP were not different at baseline before each trial. After exercise at 85% of individual anaerobic threshold cTnI was not significantly elevated. Conversely, cTnI was elevated after exercise at 95% of individual anaerobic threshold (0.016 μg L(-1)) and to an even greater extent after exercise at competition intensity (0.054 μg L(-1)). Peak post-exercise values of NT-proBNP were elevated to a similar extent after all exercise trials (P < 0.05). The upper reference limit for cTnI (0.04 μg L(-1)) was exceeded in six subjects at competition intensity. No data for NT-proBNP surpassed its upper reference limit. Peak post-exercise values for cTnI and NT-proBNP were correlated with their respective baseline values. These data suggest exercise intensity influences the release of cTnI, but not NT-proBNP, and that competitive marathon running intensity is required for cTnI to be elevated over its upper reference limit.

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.

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.

Endocrine response to an ultra-marathon in pre- and post-menopausal women.

PubMed

Copeland, J L; Verzosa, M L S

2014-06-01

Ultra-endurance competitions are becoming increasingly popular but there is limited research on female participants. The purpose of this study was to examine changes in estrogen and the IGF-I system in women after an ultra-marathon. Six pairs of pre- and post- menopausal women were matched for race finish times;mean finish time was 20 hours. Blood samples were drawn 24 hours before the race, at the finish, and 24 hours into recovery. Samples were analysed for estradiol, total IGF-I, IGFBP-1, and intact IGFBP-3. There was a significant increase in estradiol following the race in both groups (P < 0.05). Total IGF-I decreased after the race (P < 0.01) and remained lower in recovery. IGFBP-1 increased after the race (P < 0.001) but returned to pre-race levels after 24 hours, while intact IGFBP-3 was significantly lower post-race and in recovery (P < 0.001). Postmenopausal women had significantly lower estradiol at baseline, but there were no other group differences. These results demonstrate that among recreational female runners, an ultra-marathon is associated with IGF system changes that are consistent with an energy-deficient, catabolic state. Further research is needed to confirm the effect of these endocrine changes on health and performance.

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

Socioeconomic and country variations in cross-border cigarette purchasing as tobacco tax avoidance strategy. Findings from the ITC Europe Surveys

PubMed Central

Nagelhout, Gera E.; van den Putte, Bas; Allwright, Shane; Mons, Ute; McNeill, Ann; Guignard, Romain; Beck, François; Siahpush, Mohammad; Joossens, Luk; Fong, Geoffrey T.; de Vries, Hein; Willemsen, Marc C.

2014-01-01

Background Legal tobacco tax avoidance strategies such as cross-border cigarette purchasing may attenuate the impact of tax increases on tobacco consumption. Little is known about socioeconomic and country variations in cross-border purchasing. Objective To describe socioeconomic and country variations in cross-border cigarette purchasing in six European countries. Methods Cross-sectional data from adult smokers (n = 7,873) from the International Tobacco Control (ITC) Surveys in France (2006/7), Germany (2007), Ireland (2006), the Netherlands (2008), Scotland (2006), and the rest of the United Kingdom (2007/8) were used. Respondents were asked whether they had bought cigarettes outside their country in the last six months and how often. Findings In French and German provinces/states bordering countries with lower cigarette prices, 24% and 13% of smokers respectively reported purchasing cigarettes frequently outside their country. In non-border regions of France and Germany and in Ireland, Scotland, the rest of the United Kingdom, and the Netherlands, frequent purchasing of cigarettes outside the country was reported by 2% to 7% of smokers. Smokers with higher levels of education or income, younger smokers, daily smokers, heavier smokers, and smokers not planning to quit smoking were more likely to purchase cigarettes outside their country. Conclusion Cross-border cigarette purchasing is more common in European regions bordering countries with lower cigarette prices and is more often reported by smokers with higher education and income. Increasing taxes in countries with lower cigarette prices and reducing the number of cigarettes that can be legally imported across borders could help to avoid cross-border purchasing. PMID:23644287

Socioeconomic and country variations in cross-border cigarette purchasing as tobacco tax avoidance strategy. Findings from the ITC Europe Surveys.

PubMed

Nagelhout, Gera E; van den Putte, Bas; Allwright, Shane; Mons, Ute; McNeill, Ann; Guignard, Romain; Beck, François; Siahpush, Mohammad; Joossens, Luk; Fong, Geoffrey T; de Vries, Hein; Willemsen, Marc C

2014-03-01

Legal tobacco tax avoidance strategies such as cross-border cigarette purchasing may attenuate the impact of tax increases on tobacco consumption. Little is known about socioeconomic and country variations in cross-border purchasing. To describe socioeconomic and country variations in cross-border cigarette purchasing in six European countries. Cross-sectional data from adult smokers (n=7873) from the International Tobacco Control (ITC) Surveys in France (2006/2007), Germany (2007), Ireland (2006), The Netherlands (2008), Scotland (2006) and the rest of the UK (2007/2008) were used. Respondents were asked whether they had bought cigarettes outside their country in the last 6 months and how often. In French and German provinces/states bordering countries with lower cigarette prices, 24% and 13% of smokers, respectively, reported purchasing cigarettes frequently outside their country. In non-border regions of France and Germany, and in Ireland, Scotland, the rest of the UK and The Netherlands, frequent purchasing of cigarettes outside the country was reported by 2-7% of smokers. Smokers with higher levels of education or income, younger smokers, daily smokers, heavier smokers and smokers not planning to quit smoking were more likely to purchase cigarettes outside their country. Cross-border cigarette purchasing is more common in European regions bordering countries with lower cigarette prices and is more often reported by smokers with higher education and income. Increasing taxes in countries with lower cigarette prices, and reducing the number of cigarettes that can be legally imported across borders could help to avoid cross-border purchasing.

Cross-country differences in basal and stress-induced cortisol secretion in older adults.

PubMed

Souza-Talarico, Juliana N; Plusquellec, Pierrich; Lupien, Sonia J; Fiocco, Alexandra; Suchecki, Deborah

2014-01-01

Several studies have emphasized the association between socioeconomic status (SES) and inadequate response of the biological stress system. However, other factors related to SES are rarely considered, such as cultural values, social norms, organization, language and communication skills, which raises the need to investigate cross-country differences in stress response. Although some studies have shown differences in cortisol levels between immigrants and natives, there is no cross-country evidence regarding cortisol levels in country-native elders. This is particularly important given the high prevalence of stress-related disorders across nations during aging. The current study examined basal diurnal and reactive cortisol levels in healthy older adults living in two different countries. Salivary cortisol of 260 older adults from Canada and Brazil were analyzed. Diurnal cortisol was measured in saliva samples collected at home throughout two working days at awakening, 30 min after waking, 1400 h, 1600 h and before bedtime. Cortisol reactivity was assessed in response to the Trier Social Stress Test (TSST) in both populations. Our results showed that even under similar health status, psychological and cognitive characteristics, Brazilian elders exhibited higher basal and stress-induced cortisol secretion compared to the Canadian participants. These findings suggest that country context may modulate cortisol secretion and could impact the population health.

Task shifting from physicians to nurses in primary care in 39 countries: a cross-country comparative study.

PubMed

Maier, Claudia B; Aiken, Linda H

2016-12-01

Primary care is in short supply in many countries. Task shifting from physicians to nurses is one strategy to improve access, but international research is scarce. We analysed the extent of task shifting in primary care and policy reforms in 39 countries. Cross-country comparative research, based on an international expert survey, plus literature scoping review. A total of 93 country experts participated, covering Europe, USA, Canada, Australia and New Zealand (response rate: 85.3%). Experts were selected according to pre-defined criteria. Survey responses were triangulated with the literature and analysed using policy, thematic and descriptive methods to assess developments in country-specific contexts. Task shifting, where nurses take up advanced roles from physicians, was implemented in two-thirds of countries (N = 27, 69%), yet its extent varied. Three clusters emerged: 11 countries with extensive (Australia, Canada, England, Northern Ireland, Scotland, Wales, Finland, Ireland, Netherlands, New Zealand and USA), 16 countries with limited and 12 countries with no task shifting. The high number of policy, regulatory and educational reforms, such as on nurse prescribing, demonstrate an evolving trend internationally toward expanding nurses' scope-of-practice in primary care. Many countries have implemented task-shifting reforms to maximise workforce capacity. Reforms have focused on removing regulatory and to a lower extent, financial barriers, yet were often lengthy and controversial. Countries early on in the process are primarily reforming their education. From an international and particularly European Union perspective, developing standardised definitions, minimum educational and practice requirements would facilitate recognition procedures in increasingly connected labour markets. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

ASSOCIATION OF ISOMETRIC STRENGTH OF HIP AND KNEE MUSCLES WITH INJURY RISK IN HIGH SCHOOL CROSS COUNTRY RUNNERS.

PubMed

Luedke, Lace E; Heiderscheit, Bryan C; Williams, D S Blaise; Rauh, Mitchell J

2015-11-01

High school cross country runners have a high incidence of overuse injuries, particularly to the knee and shin. As lower extremity strength is modifiable, identification of strength attributes that contribute to anterior knee pain (AKP) and shin injuries may influence prevention and management of these injuries. To determine if a relationship existed between isometric hip abductor, knee extensor and flexor strength and the incidence of AKP and shin injury in high school cross country runners. Sixty-eight high school cross country runners (47 girls, 21 boys) participated in the study. Isometric strength tests of hip abductors, knee extensors and flexors were performed with a handheld dynamometer. Runners were prospectively followed during the 2014 interscholastic cross country season for occurrences of AKP and shin injury. Bivariate logistic regression was used to examine risk relationships between strength values and occurrence of AKP and shin injury. During the season, three (4.4%) runners experienced AKP and 13 (19.1%) runners incurred a shin injury. Runners in the tertiles indicating weakest hip abductor (chi-square = 6.140; p=0.046), knee extensor (chi-square = 6.562; p=0.038), and knee flexor (chi-square = 6.140; p=0.046) muscle strength had a significantly higher incidence of AKP. Hip and knee muscle strength was not significantly associated with shin injury. High school cross country runners with weaker hip abductor, knee extensor and flexor muscle strength had a higher incidence of AKP. Increasing hip and knee muscle strength may reduce the likelihood of AKP in high school cross country runners. 2b.