Resolution and recurrence pattern of RP-CME after dexamethasone treatment showed that the INL is the primary layer of cystic change, and this suggests its pathogenesis is most likely due to Müller cell dysfunction.

Resolution and recurrence pattern of RP-CME after dexamethasone treatment showed that the INL is the primary layer of cystic change, and this suggests its pathogenesis is most likely due to Müller cell dysfunction.On November 22, 1963, John F. Kennedy, the 35th president of the United States, was assassinated in Dallas, Texas. John B. Connally, the Governor of Texas, simultaneously was injured in the shooting. Both Kennedy and Connally were transported to and cared for at the Parkland Memorial Hospital. Within 3 hours, the accused assassin, Lee Harvey Oswald, was arrested and taken to the Dallas City Jail in the Downtown Municipal Building. When the authorities were transferring Oswald from the City to the County Jail at midday on November 24, Jack Ruby shot him as the event was televised and broadcast live to the nation. Oswald was rushed to Parkland Memorial Hospital where he was operated on by the same surgeons who had attended Kennedy and Connally 2 days previously. This article reviews the operative treatment that Oswald received before discussing the state of abdominal vascular trauma in the 1960s.

Despite current neurological guidelines that a single brain death examination (SBDE) is sufficient to determine brain death, a vast majority of hospitals still use a two brain death examination (TBDE) policy based on historical practice. The purpose of this study was to analyze the outcomes and implications of an SBDE policy compared with a TBDE policy with respect to organ donation outcomes.

We retrospectively reviewed all adult patients declared dead by neurological criteria between 2010 and 2018 at a high-volume trauma center. The study population was divided into SBDE and TBDE cohorts. Primary outcomes included time to organ donation, terminal donor creatinine and bilirubin, and number of procured and transplanted organs.

A total of 327 patients comprised the study population 66.7% SBDE (n = 218 of 327 patients) and 33.3% TBDE (n = 109 of 327 patients). The SBDE group had a shorter median time from examination to procurement (38 vs. 44 hours, p = 0.02) as well as lower terminal donor creatinine (1.1 vs. 1.35 mg/dL, p = 0.004) and bilirubin (0.8 vs. 1.1 mg/dL, p = 0.04). Furthermore, the SBDE group had a significantly greater proportion of kidneys (90.6% vs. 81.6%, p = 0.02), lungs (11.8% vs. 4.6%, p = 0.02), and total organs (58.2% vs. 46.6%; p = 0.0001) procured with intent to transplant and a greater proportion of total organs transplanted (53.1% vs. 42.4%, p = 0.0004). Multivariable regression analysis confirmed that SBDE was independently associated with a shorter time to procurement, lower terminal creatinine, and increased number of procured organs.

These data highlight the potential benefit of an SBDE policy with regards to organ donation outcomes at a high-volume trauma center and should facilitate future randomized prospective studies to more rigorously test this hypothesis.

Therapeutic/Care Management, level IV.

Therapeutic/Care Management, level IV.

The care of trauma patients in combat operations is handwritten on a five-page flow sheet. The process requires the manual scanning and uploading of paper documents to bridge the gap between electronic and paper record management. There is an urgent operational need for an information technology solution that will enable medics to better capture patient treatment information, which will improve long-term health care without impacting short-term care responsibilities.

We conducted a process improvement project to evaluate the ability of T6 Health Systems Mobile Application to improve combat casualty care data collection at a deployed trauma hospital. We performed a head-to-head comparison of the completeness and accuracy of data capture of electronic versus handwritten records to determine noninferiority.

During the 90-day pilot, there were 131 trauma evaluations of which 53 casualty resuscitations (40.5%) were also documented in the electronic application. We compared completeness and accuracy of admit,ecision support and real-time data analysis.

Care Management, level IV.

Care Management, level IV.

To explore the significance of sodium taurocholate cotransporting polypeptide (NTCP) deficiency and its clinical features in Chinese children presenting with isolated persistent hypercholanemia.

The exon and adjacent regions of SLC10A1, the gene encoding NTCP, were sequenced in 33 Chinese children presenting with isolated hypercholanemia. Clinical history and medical data were reviewed. Growth milestones were compared to the national standard. The serum direct bilirubin concentration at last follow-up was compared to age and sex-matched controls.

A variant, c.800C>T, p. S267F of SLC10A1 was detected in all subjects; 30 patients were homozygotes and 3 were compound heterozygotes. Nine patients presented with transient neonatal cholestasis, and one with a persistent mild conjugated hyperbilirubinemia. The serum direct bilirubin level in NTCP deficient patients was significantly higher than age- and sex-matched controls even after the neonatal cholestasis stage (2.85 ± 1.50 μmol/L vs. 1.49 ± 0.70 μmol/L, P = 0.00008). No growth delay or other severe long-term clinical consequences were observed.

NTCP deficiency is the exclusive or major cause of isolated hypercholanemia in Han Chinese children, with c.800C>T the major contributing genetic variation. The defect may affect bilirubin metabolism and present as transient neonatal cholestasis and/or persistent mild conjugated hyperbilirubinmia, but with no apparent long-term clinical consequences.

T the major contributing genetic variation. The defect may affect bilirubin metabolism and present as transient neonatal cholestasis and/or persistent mild conjugated hyperbilirubinmia, but with no apparent long-term clinical consequences.

The aim of the study was to examine the frequency of rickets and bone fractures and to assess areal bone mineral density (aBMD) in childhood among patients with biliary atresia (BA).

We gathered data on all patients diagnosed with BA in Finland that survived to ≥1 year of age between 1 January 2000 to 30 June 2018. Data on gestational age, birth weight, postsurgical medications, and history of rickets and bone fractures were collected retrospectively. Serum levels of 25-hydroxyvitamin D [25(OH)D] postportoenterostomy (PE) were collected. Plain radiographs and dual energy X-ray absorptiometry (DXA) measurements of study subjects were reviewed.

Out of 49 patients, 7 (14%) were diagnosed with rickets during infancy. Clearance of jaundice [odds ratio 0.055, 95% confidence interval [CI] 0.00266-0.393; P < 0.01] was a protective factor against rickets. Sufficient 25(OH)D levels were reached 3 months post-PE. Eleven (22%) patients suffered at least one bone fracture (range 1-9) during childhood and adolescence. In DXA measurements, median lumbar spine aBMD anthropometrically adjusted z-scores were as follows in native liver survivors 0.8 (interquartile range [IQR] -1.9 to 1.4) at 5 and -0.3 (IQR -1.3 to 0.8) at 10 years and for liver transplanted patients 0.4 (IQR -0.2 to 1.1) at 5 and 0.6 (IQR -0.1 to 1.3) at 10 years.

BA patients have an increased risk for rickets and bone fractures compared with the normal population. Most BA patients have aBMD within normal range between 5 and 10 years of age irrespective of liver transplantation status.

BA patients have an increased risk for rickets and bone fractures compared with the normal population. Most BA patients have aBMD within normal range between 5 and 10 years of age irrespective of liver transplantation status.

In many pediatric acute liver failure (PALF) cases, a diagnosis is not identified, and the etiology is indeterminate (IND-PALF). Our pilot study found dense CD8 T-cell infiltrates and increased T-cell clonality in liver specimens from IND-PALF patients. We aimed to validate these findings in a multicenter cohort with investigators blinded to diagnosis.

PALF Study Group registry subjects with IND-PALF (n = 37) and known diagnoses (DX-PALF) (n = 18), ages 1 to 17 years, with archived liver tissue were included. Liver tissue slides were stained for T cells (CD8 and CD4), B cells (CD20), macrophages (CD163), perforin, and tissue resident-memory T cells (Trm, CD103), and scored as minimal, moderate, or dense. Lymphocytes were isolated from frozen liver tissue for T-cell receptor beta (TCRβ) sequencing.

Dense hepatic CD8 staining was found in significantly more IND-PALF (n = 29, 78%) compared with DX-PALF subjects (n = 5, 28%) (P = 0.001). IND-PALF subjects were more likely to have dense or moderate perforin are needed to characterize potential antigens, host risk factors, and inflammatory pathways with the goal of developing targeted therapies.

Acute exacerbations of inflammatory bowel disease (IBD) may involve enteric pathogen. We aimed to assess the frequency and outcomes of Clostridium difficille toxin (CDT) and non-CDT enteric infections in symptomatic pediatric patients with IBD.

Patients’ records were retrospectively searched for disease flares in which stool samples were collected for enteric pathogens. Each patient with a positive sample was matched with a patient with IBD flare and negative samples for analyzing 1-year outcomes following sampling.

A total of 618 pediatric patients with IBD [Crohn’s disease, n = 439 (71%), mean age at diagnosis 13.0 ± 3.4 years, girls, n = 264 (42.7%)] had 1048 stool samples during the study period (2001-2018). Of 914 bacterial cultures, 40 (4.3%) were positive, 30 (75%) of which, positive for Campylobacter jejuni. Of 393 samples for CDT, 28 (7.1%) were positive while parasitic infection rate was 21/529 (3.9%).Overall, 19 positive C jejuni cases and 19 positive CDT cases with matching controls were examined. During 12 months of follow-up, the mean number of disease flares and emergency room visits was higher among patients with positive CDT (1.5 ± 1.4 vs 0.5 ± 0.9, P = 0.019, 1.3 ± 1.5 vs 0.4 ± 0.8, P = 0.05, respectively) with a numeric increase of surgical interventions (3 vs 0, P = 0.08). There were no significant differences in disease outcomes between patients with C jejuni infections and matched controls.

C difficile and C jejuni are the most common enteric infections among pediatric patients with IBD but only clostridial infection was associated with a more severe disease course within 12 months.

C difficile and C jejuni are the most common enteric infections among pediatric patients with IBD but only clostridial infection was associated with a more severe disease course within 12 months.

In this study we investigated the role of the Cannabinoid Receptor type 2 (CB2) in the bone loss associated with Celiac Disease (CD) evaluating the effect of its pharmacological modulation on osteoclast activity. We previously demonstrated a significant association between the CB2 Q63R variant and CD, suggesting it as a possible disease biomarker. Moreover, CB2 stimulation is beneficial for reducing osteoclast activity in several bone pathologic conditions.

in vitro osteoclasts (OCs) were differentiated from peripheral blood mononuclear cells of healthy donors, CD children at diagnosis and after one year of gluten free diet (GFD) and characterized by Real Time PCR and Western Blot for the expression of CB2 and specific osteoclastic markers, TRAP and Cathepsin K. TRAP assay and Bone Resorption assay were performed to evaluate osteoclast activity before and after 48 h exposure to CB2 selective drugs (JWH-133 and AM630) and Vitamin D.

We found in CD patients an osteoclast hyper-activation and low levels of CB2. CB2 stimulation with JWH-133 agonist is more effective than Vitamin D in reducing osteoclast activity while CB2 blockade with AM630 increases osteoclast activation. The anti-osteoporotic effect of JWH-133 decreases when used in co-treatment with vitamin D. GFD reduces osteoclast activity without restore CB2 expression.

CB2 could be a molecular marker to predict the risk of bone alterations in CD and a pharmacological target to reduce bone mass loss in patients who need a direct intervention on bone metabolism, in addition to the GFD.

CB2 could be a molecular marker to predict the risk of bone alterations in CD and a pharmacological target to reduce bone mass loss in patients who need a direct intervention on bone metabolism, in addition to the GFD.

Acute-on-chronic liver failure (ACLF), whereas increasingly well-defined in adults, has been poorly characterized in pediatric patients other than having a poor prognosis. This study aimed to identify ACLF and evaluate prognosis in the American pediatric population.

Modified ACLF definitions (p-CLIF) were applied to 11,300 children listed for liver transplantation from March 2002 through 2017 in the Organ Procurement and Transplantation Network (OPTN) database.

Pediatric ACLF patients have greater mortality within 90 days from listing (46.6% by p-CLIF) than other types of failure (<30%), including acute liver failure, as well as greater mortality within the first 30 and 90 days after transplantation than all other types of liver failure, but do not have increased mortality rates relative to other groups between 90 and 365 days from transplant. Although some ACLF listings also received 1B status, ACLF mortality at 90 days was greater than the general 1B population (50 vs 29.4%). Model for End-Stage Liindicate greater attention to ACLF is needed, as scoring systems may not capture these children’s risk of early death, which appears to currently be mitigated by exceptions. Multicenter, clinical, preferably prospective study of ACLF is necessary to determine how to prioritize ACLF relative to other liver failure types to address its relatively higher early mortality.

Autoimmune hepatitis (AIH) is designated as type 1 or 2 (AIH-1/2) on the basis of serum autoantibody (Ab) profiles. In children, AIH may present as acute or chronic liver failure or cirrhotic AIH (ALF/CLF/CAIH) with or without overlap sclerosing cholangitis (SC). The aim of this study was to compare demographics, presentation, and outcomes between groups in children.

A retrospective electronic chart review of children with AIH who met standard diagnostic criteria with histologic confirmation at Texas Children’s Hospital was performed, with de novo AIH after liver transplant (LT) excluded. Patients were identified and divided into AIH-1, AIH-2, ALF, CAIH, AIH-SC, and LT and compared using chi-square analysis, Student t-test, and Mood median test.

Among 91 children with AIH, 72 (79.1%) had AIH-1, 19 (20.9%) had AIH-2, 13 (14.3%) had ALF, 25 (27.5%) had CAIH, and 14 (15.4%) had AIH-SC. Both AIH-1/2 had female and Hispanic predominance (72.2/89.5%, 40.3/57.9%). AIH-2 presented at younger mean age in years than AIH-1 (6.8, 12.1, P < 0.05). Both AIH-1/2 had low rates of remission after 1 year of IS (25.4, 35.7%) and most recent (30.6, 54.5%) follow-up. Twenty-two (24.2) patients received LT 16 had AIH-1 (72.7%), 6 had AIH-2 (27.3%), 9 (40.9%) had ALF, and 13 (59.1%) had CAIH. One-year patient and graft survivals were 100%.

The epidemiology and clinical presentation of AIH-1 and -2 had a few subtle differences. AIH-1 was associated with more complications after LT. More data are needed to better characterize the 2 as separate disease entities.

The epidemiology and clinical presentation of AIH-1 and -2 had a few subtle differences. AIH-1 was associated with more complications after LT. More data are needed to better characterize the 2 as separate disease entities.

Prophylactic colectomy at a premalignant stage is the cornerstone of management of familial adenomatous polyposis (FAP). Prior to surgery, colonoscopy surveillance is recommended in children with FAP. This study aimed to examine the natural history of FAP in children by evaluating adenoma progression and factors influencing timing of colectomy.

Patients with FAP under the age of 18 years at first surveillance colonoscopy and who had undergone more than one colonoscopy were identified. Demographic, endoscopic, genetic and surgical data were retrieved. Cumulative adenoma (polyp) counts were obtained whilst accounting for any polypectomies during the study period. The rate of polyp progression and factors influencing the timing of colectomy.were evaluated.

Eighty-four patients (50% male; mean age at first colonoscopy 13 years [SD 1.97]) were identified, of which 83 had a family history of FAP. At first colonoscopy, 67 (79%) had <100 adenomas and 29 (35%) had colonic polyps identified despite rectal sparing. The median rate of polyp progression per patient was 12.5 polyps/year (range 0-145). Of the 45 (54%) patients who had undergone surgery, 41 (91%) underwent colectomy with ileorectal or ileodistal sigmoid anastomosis. Polyp progression did not alter the choice of surgical intervention in any patient.

Our results suggest that adenoma number remains relatively stable in the majority of children under surveillance. Tailored surveillance intervals according to phenotype are a more appropriate strategy as recommended by recently published guidelines.

Our results suggest that adenoma number remains relatively stable in the majority of children under surveillance. Tailored surveillance intervals according to phenotype are a more appropriate strategy as recommended by recently published guidelines.We describe a 14-year-old boy with Wilson disease (WD) who first developed pseudo-pseudoxanthoma elasticum (PPXE) after 4.5 years of treatment with D-penicillamine. Although previously reported cases have occurred in adults following at least a decade of high-dose D-penicillamine use, this case demonstrates that D-penicillamine-induced PPXE can present in children with shorter treatment courses. Upon this diagnosis, the patient was switched from D-penicillamine to trientine, with adequate cupriuresis and stabilization of the skin lesion. Prompt diagnosis and management of PPXE in children can limit systemic progression and prevent long-term complications.Hawley, VS, Gurchiek, RD, and van Werkhoven, H. Can foot anthropometry predict vertical jump performance? J Strength Cond Res XX(X) 000-000, 2020-Vertical jumping is an important element of many sporting activities, and whether anthropometric adaptations can predict jumping performance is of interest. Few studies have specifically considered anthropometric measures of the foot and its link to performance. Furthermore, previous studies have mainly focused on a male subject pool, and whether relationships are consistent across sexes is unclear. The purpose of this study was to investigate relationships between common anthropometric measures, as well as specific foot measures, and jump performance in men and women. Anthropometric measures of 21 men (age 22.0 ± 1.5 years; stature 181.4 ± 6.3 cm; body mass 85.6 ± 9.4 kg) and 21 women (age 21.2 ± 1.8 years; stature 166.1 ± 7.5 cm; body mass 61.4 ± 11.4 kg) were taken before performing 3 maximal countermovement jumps (CMJs). Correlational analysis was used to determine relationships between anthropometric measures and CMJ height (a priori significance set at p≤ 0.05, effect size small >0.1; medium >0.3; large >0.5). There was no significant correlation between anthropometric variables and CMJ height for men, whereas for women, mass (r = -0.585, p = 0.005, large effect), foot length (r = -0.533, p = 0.013, large effect), and toe length (r = -0.604, p = 0.004, large effect) showed significant negative correlations with CMJ height. The unexpected result that smaller feet and toes predicted higher jumps for women warrants further investigation. Furthermore, these results highlight the need to incorporate diverse subject pools, and a need for caution when generalizing across sexes.McNeill, C, Beaven, CM, McMaster, DT, and Gill, N. Survey of eccentric-based strength and conditioning practices in sport. J Strength Cond Res 34(10) 2769-2775, 2020-Eccentric-based training (ECC) has been shown to be an effective training strategy in athletes; however, despite the theoretical benefits, the uptake by practitioners is currently unknown. This study investigated the current ECC strength and conditioning practices that are implemented in the training of athletes. Two hundred twenty-four practitioners were electronically surveyed anonymously with 98 responses available for analysis. Nearly all respondents (96%) had prescribed ECC in the last 24 months. Sport performance (64%), injury prevention (24%), and rehabilitation (8%) were the top-ranked reasons to include ECC. Respondents programmed ECC for strength (35%), hypertrophy (19%), and power (18%). A majority of respondents did not monitor ECC load (58%) or use eccentric-specific testing (75%). Seventeen respondents commented that high-intensity training such as sprinting and change of direction, were avoided during ECC blocks. Eccentric-based training intensity was prescribed as percentage of 1 repetition maximum (34%), rate of perceived exertion (20%), or velocity (16%). Respondents indicated muscle soreness and concurrent high-intensity activities were concerns during ECC but reported not using eccentric monitoring or testing. The efficacy of ECC is well supported, yet there seems to be a lack of defined protocol for integrating ECC research into practice. A greater understanding of eccentric contribution to sport performance and injury prevention may help define testing and monitoring procedures for the prescription of ECC interventions. Practitioners should consider factors such as periodization, soreness, and monitoring when designing ECC programs. The findings of this survey indicate that no uniform strategies exist for the prescription of ECC among experienced practitioners.Sorbie GG, Glen J, and Richardson AK Positive relationships between golf performance variables and upper body power capabilities. J Strength Cond Res XX(X) 000-000, 2020-The importance of lower body and trunk strength and power, as well as upper body strength in golf is well documented; however, the relationship between upper body power and golf performance has yet to be determined. Therefore, the purpose of the study was to investigate the relationships between golf performance and upper body power. Thirteen golfers (mean ± SD age 30 ± 7 years and handicap 6.1 ± 4.9) participated in the study. Club head velocity (CHV) and ball velocity were measured during the golf test. To assess upper body power, subjects completed a ballistic bench press and upper body Wingate test. Pearson product-moment correlations were used to assess the relationships between golf performance and upper body power. The results demonstrated that there were strong relationships between ballistic bench press and CHV and ball velocity when using the driver (r > 0.6-0.7), and moderate-to-strong relationships (r > 0.4-0.6) when using the 7-iron. Strong relationships were found between the upper body Wingate test and CHV and ball velocity (r > 0.5-0.8) when using the driver and 7-iron. As a result of the findings, strength and conditioning coaches may use both the ballistic bench press test and the Wingate test as a primary assessment to measure the effectiveness of upper body training interventions with the aim of improving golf performance. Although, when performing the golf swings at higher velocities (i.e., with the driver), the ballistic bench press may be more beneficial.Helme, M, Emmonds, S, and Low, C. Is the rear foot elevated split squat unilateral? An investigation into the kinetic and kinematic demands. J Strength Cond Res XX(X) 000-000, 2020-The purpose of the study was to determine the unilateral nature of the rear foot elevated split squat (RFESS). Specifically, the production of force by the rear leg was examined to better understand its role, if any, toward successful completion of the exercise. Male volunteers were recruited (n = 26, age = 23.8 ± 4.6 years, body mass = 88.1 ± 10.7 kg, and height = 1.79 ± 0.1 m), who were recreationally trained and engaged in a structured strength and conditioning program, including both bilateral and unilateral exercises, and had at least 2 years supervised training experience. Subjects participated in an incremental 5 repetition maximum protocol after familiarization. Kinetic data were recorded through 2 independent force plates, 1 integral to the floor and the second mounted on top of solid weightlifting blocks. Kinematic data were captured through 3-dimensional motion analysis. A total of 715 repetitions were analyzed, and the mean contribution of the lead foot to total vertical force production was 84.36 ± 3.6%. An almost certainly small positive correlation (rho = 0.25, confidence interval [CI] 0.18-0.33) was found between the percentage of force produced by the lead foot, with increasing exercise intensity. A most likely trivial, nonsignificant correlation (rho = -0.01, CI -0.09 to 0.06) with rear foot force production, representing the mass of the rear leg. Data from this study do not indicate that the rear foot contributes to the kinetic demands of the exercise and therefore suggests that the RFESS is a valid unilateral exercise.González-Hernández, JM, Jiménez-Reyes, P, Cerón, JJ, Tvarijonaviciute, A, Llorente-Canterano, FJ, Martínez-Aranda, LM, and García-Ramos, A. Response of muscle damage markers to an accentuated eccentric training protocol do serum and saliva measurements agree? J Strength Cond Res XX(X) 000-000, 2020-This study aimed (a) to examine the acute and delayed responses of 3 muscle damage biomarkers creatine kinase (CK), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) to an accentuated eccentric training protocol in serum, and (b) to explore the changes of these biomarkers in saliva and compare them with serum. Sixteen resistance-trained university students (10 men [age = 26.6 ± 4.8 years, full squat one repetition maximum [1RM] = 103.4 ± 14.4 kg] and 6 women [age = 22.7 ± 1.4 years, full squat estimated 1RM = 68.3 ± 10.5 kg]) completed an accentuated eccentric strength training protocol with the full squat exercise consisting of 8 sets of 10 repetitions against the 120% estimated 1RM load with 5 minutes of interset rest. The activity of muscle damage biomarkers (CK, AST, and LDH) was measured in serum and saliva before training (Pre), 24 hours after training (Post24), and 96 hours after training (Post96). In serum, lower values of the 3 muscle damage markers were observed at Pre compared to Post24 and Post96, whereas no significant differences were observed between Post24 and Post96 for any analyte. In saliva, there was a significant increase in men at Post96 compared with Pre in CK. The correlations between the measurements in serum and saliva ranged from trivial to small (r = -0.034 to 0.212). These results suggest that the measurement of muscle damage markers in serum and saliva do not provide the same information in the conditions of our study.Martínez-Navarro, I, Montoya-Vieco, A, Collado, E, Hernando, B, Panizo, N, and Hernando, C. Muscle Cramping in the marathon Dehydration and electrolyte depletion vs. muscle damage. J Strength Cond Res XX(X) 000-000, 2020-Our aim was to compare dehydration variables, serum electrolytes, and muscle damage serum markers between runners who suffered exercise-associated muscle cramps (EAMC) and runners who did not suffer EAMC in a road marathon. We were also interested in analyzing race pacing and training background. Nighty-eight marathoners took part in the study. Subjects were subjected to a cardiopulmonary exercise test. Before and after the race, blood and urine samples were collected and body mass (BM) was measured. Immediately after the race EAMC were diagnosed. Eighty-eight runners finished the marathon, and 20 of them developed EAMC (24%) during or immediately after the race. Body mass change, post-race urine specific gravity, and serum sodium and potassium concentrations were not different between crampers and noncrampers. Conversely, runners who suffered EAMC exhibited significantly greater post-race creatine kinase (464.17 ± 220.47 vs. 383.04 ± 253.41 UI/L, p = 0.034) and lactate dehydrogenase (LDH) (362.27 ± 72.10 vs. 307.87 ± 52.42 UI/L, p = 0.002). Twenty-four hours post-race also values of both biomarkers were higher among crampers (CK 2,438.59 ± 2,625.24 vs. 1,166.66 ± 910.71 UI/L, p = 0.014; LDH 277.05 ± 89.74 vs. 227.07 ± 37.15 UI/L, p = 0.021). The difference in the percentage of runners who included strength conditioning in their race training approached statistical significance (EAMC 25%, non-EAMC 47.6%; p = 0.074). Eventually, relative speed between crampers and noncrampers only differed from the 25th km onward (p less then 0.05). Therefore, runners who suffered EAMC did not exhibit a greater degree of dehydration and electrolyte depletion after the marathon but displayed significantly higher concentrations of muscle damage biomarkers.Menezes, GB, Alexandre, DR, Pinto, JC, Assis, TV, Faigenbaum, AD, and Mortatti, AL. Effects of integrative neuromuscular training on motor performance in prepubertal soccer players. J Strength Cond Res XX(X) 000-000, 2020-The present study examined the effects of integrative neuromuscular training (INT) on motor performance in prepubertal soccer players. Subjects were randomly assigned to the experimental group (INT; n = 20, age 8.2 ± 1.2 years; body mass 28.4 ± 6.4 kg; height 1.3 ± 0.1 m) or the control group (CON; n = 18, age 8.5 ± 1.3 years; body mass 32.8 ± 8.9 kg; height 1.3 ± 0.1 m). Integrative neuromuscular training program was performed twice per week during the 12-week training intervention. Balance, flexibility, countermovement vertical jump height (CVJH), sprint speed, and change of direction speed (CODS) were assessed in both groups at baseline, sixth week and 12th week. A mixed model repeated measures analysis of variance was used to examine the group changes in performance for each variable. Thepubertal soccer players.Grier, T, Brooks, RD, Solomon, Z, and Jones, BH. Injury risk factors associated with weight training. J Strength Cond Res XX(X) 000-000, 2020-The purpose of this evaluation was to identify injury risk factors associated with weight training (WT). Subjects were 4,785 men and 542 women in a U.S. Army Division. Personal characteristics, unit training, personal training, fitness, and 12-month injury history were obtained by an electronic survey. Risk factors for WT injuries were explored using backward stepping multivariable logistic regression. Risk ratios, odds ratios (ORs), and 95% confidence intervals (95% CIs) were calculated for each risk factor. Over a one-year period, 4.5% of men and 0.6% of women experienced a WT injury. Weight-training injury incidence was 0.31 and 0.05 per 1,000 hours of WT for men and women, respectively. Overall, men were 7.4 times more likely to experience a WT injury compared with women. For men who participated in WT, independent risk factors for a WT injury included older age (OR [23-27/≤ 22 years] = 1.99, 95% CI 1.22-3.27; OR [>28/≤ 22 years] = 2.48, 95% CI 1.52-4.03) and higher amounts of personal WT per week (OR [60-165/≥ 166 minutes] = 0.58, 95% CI 0.39-0.88; and OR [15-59/≥ 166 minutes] = 0.40, 95% CI 0.24-0.66). A linear trend was revealed indicating an increasing risk of a WT injury with greater amounts of time spent WT per week (p less then 0.01). Performing moderate amounts of WT may reduce the risk of experiencing a WT injury. However, because muscle strength is an important component of fitness for Soldiers, specialized WT programs that improve strength while minimizing injury risks are needed.

Moss, AC, Dinyer, TK, Abel, MG, and Bergstrom, HC. Methodological considerations for the determination of the critical load for the deadlift. J Strength Cond Res 35(2S) S31-S37, 2021-This study determined whether performance method during conventional deadlifting affects critical load (CL) estimates derived from the linear work limit (Wlim) vs. repetitions relationship. Eleven subjects completed 1-repetition maximum (1RM) deadlift testing followed by separate visits, to determine the number of repetitions to failure at 50, 60, 70, and 80% 1RM for both reset (RS) and touch-and-go (TG) methods. The CL was the slope of the line of total work completed (load [kg] × repetitions) vs. total repetitions for 4 intensities (50-80% 1RM). The number of repetitions to failure were determined at CLRS and CLTG. The kg values and repetitions to failure at CLRS and CLTG, and total repetitions at each intensity (50-80%) for each method (RS and TG) were compared. There were no significant mean differences (±SD) in kg values ( of CL or number of repetitions completed at submaximal loads. Thus, the estimates of CL from the modeling of total work vs. repetitions were relatively robust to variations in deadlifting methodologies. However, individual variability (range of scores) in kg values and repetition to failure at CLRS and CLTG indicated that deadlifting methods may differ in anatomical region of fatigue. The CL is an individually derived threshold that may be used to examine and describe performance capabilities.Douglas, AS, Rotondi, MA, Baker, J, Jamnik, VK, and Macpherson, AK. A comparison of on-ice external load measures between subelite and elite female ice hockey players. J Strength Cond Res XX(X) 000-000, 2020-This study quantified and examined differences in measures of on-ice external load for subelite and elite female ice hockey players. External load variables were collected from subelite (N = 21) and elite (N = 24) athletes using Catapult S5 monitors during the preseason. A total of 574 data files were analyzed from training and competition during the training camp. Significant differences between groups were found across all variables. Differences in training between the 2 groups ranged from trivial (forwards PlayerLoad, p = 0.03, effect-size [ES] = 0.18) to large (forwards Explosive Efforts [EEs], p less then 0.001, ES = 1.64; defense EEs, p less then 0.001, ES = 1.40). Match comparisons yielded similar results, with differences ranging from small (defense Low Skating Load [SL], p = 0.05, ES = 0.49; Medium SL, p = 0.04, ES = 0.52) to very large (forwards PlayerLoad, p less then 0.001. ES = 2.25; PlayerLoad·min, p less then 0.001, ES = 2.66; EEs, p less then 0.001, ES = 2.03; Medium SL, p less then 0.001, ES = 2.31; SL·min, p less then 0.001, ES = 2.67), respectively. The differences in external load measures of intensity demonstrate the need to alter training programs of subelite ice athletes to ensure they can meet the demands of elite ice hockey. As athletes advance along the development pathway, considerable focus of their off-ice training should be to improve qualities that enhance their ability to perform high-intensity on-ice movements.Molina Correa, JC, Padoin, S, Varoni, PR, Demarchi, MC, Flores, LJ, Nampo, FK, and de Paula Ramos, S. Ergogenic effects of photobiomodulation on performance in the 30-second Wingate test A randomized, double-blind, placebo-controlled, crossover study. J Strength Cond Res XX(X) 000-000, 2020-The purpose of this study was to evaluate the ergogenic effects of red light (630 nm) photobiomodulation on anaerobic capacity in the Wingate test. Sixteen healthy and physically active male volunteers (21.71 ± 2.49 years of age, body mass index between 18.5 and 24.9 kg/m) participated in this randomized, double-blind, placebo-controlled, crossover study. The subjects performed 3 Wingate test sessions, with a 48-hour interval between tests. In the first session (baseline session, BS), a Wingate test was performed to evaluate the initial performance. Subjects were paired by performance in the BS and allocated through a draw to receive either the phototherapy (630 nm, 4.6 J/cm, 6 J per point, 16 points, light-emitting diode [LED] session) or placebo intervention (PLA session) in the second test session. In the third test session, a crossover intervention was performed. The repeated-measures analysis of variance test, followed by Bonferroni post hoc test or Friedman test with Dunn’s post hoc test (p less then 0.05) and Cohen’s d statistic were used for comparisons. The LED session with phototherapy promoted an increase in performance in peak power (p less then 0.05), relative power (p less then 0.05), RPMpeak (p less then 0.05), and peak velocity (p less then 0.05), as well as total displacement (p less then 0.01) compared with PLA. The mean power (p less then 0.05), relative power (p less then 0.05), RPMmean (p less then 0.01), and mean velocity (p less then 0.01) were higher in the LED session than those of BS. We concluded that phototherapy improves performance in Wingate anaerobic exercise, possibly due to large effects on the anaerobic alactic metabolism.Mitchell, UH, Owen, PJ, Rantalainen, T, and Belavý, DL. Increased joint mobility is associated with impaired transversus abdominis contraction. J Strength Cond Res XX(X) 000-000, 2020-Increased joint mobility is a risk factor for joint injury, but muscle function may be able to compensate for it. Current evidence suggests reduced force production capacity in people with hypermobility. However, little is known about the lumbar spine. The purpose of this cross-sectional study was to assess whether there was a link between joint mobility and transverse abdominis and multifidus muscles contraction, muscles ascribed a core-stability role. Using a modified quantitative version of the Beighton scale (BOM score), we measured joint mobility of 30 middle-aged individuals without low back pain. These scores were correlated with magnetic resonance imaging-derived measures of transverse abdominis and multifidus muscle contraction during a spinal loading maneuver. The level of significance was set for p ≤ 0.05. The results showed greater joint mobility (a higher BOM score) correlated (r = 0.468; p = 0.009) with reduced transversus abdominis (TrA) shortening during contraction (i.e., less muscle shortening in people with greater joint mobility). The trunk subdomain score exhibited a correlation of 0.354 with TrA length change, but this did not reach statistical significance (p = 0.055). The subdomains of the BOM score did not correlate significantly with each other (p ≥ 0.097). No association was seen between multifidus contraction and joint mobility. The results suggest that greater general joint mobility is associated with impaired contraction of the TrA muscle. This should be considered when coaching athletes or treating patients with (functional) spinal instability. The quantitative approach we developed to measure joint mobility could be used in the future studies of global flexibility.Tan, J, Shi, X, Witchalls, J, Waddington, G, Lun Fu, AC, Wu, S, Tirosh, O, Wu, X, and Han, J. Effects of pre-exercise acute vibration training on symptoms of exercise-induced muscle damage a systematic review and meta-analysis. J Strength Cond Res XX(X) 000-000, 2020-Exercise-induced muscle damage (EIMD) normally occurs after unaccustomed high-intensity eccentric exercises. Symptoms of EIMD include delayed-onset muscle soreness (DOMS), tenderness, stiffness, swelling, reduced strength, and increased creatine kinase (CK) levels in the blood. Vibration training (VT) may be useful as a pre-exercise intervention in attenuating EIMD on the basis of tonic vibration reflex (TVR) through a more efficient distribution of contractile stress over muscle fibers. The objective of this meta-analysis is to examine the effects of acute VT on symptoms of EIMD when performed as the pre-exercise intervention. Randomized controlled trials (RCTs) published in the 8 databases of Cochrane Library, PubMed, Embase, Web of Science, EBnce to demonstrate that receiving acute VT before unaccustomed high-intensity eccentric exercises may be effective in attenuating markers of muscle damage and the development of DOMS when compared with a control group. The possible mechanisms of this effect could be attributed to an improved synchronization of muscle fiber caused by TVR, which could result in even distribution of exterior loads and eventually attenuate disruptions of muscle fibers. In addition, increased blood flow may also be helpful to prevent accumulation of metabolic substances and attenuate subsequent symptoms of EIMD. Vibration training may be used as a pre-exercise intervention to alleviate symptoms of EIMD caused by unaccustomed high-intensity eccentric exercise. Because of the limited quantity and quality of included studies, more high-quality studies are required to ascertain the effect of VT on symptoms of EIMD.

Treatments that prevent worsening kyphosis are important due to the progressive nature of kyphosis with aging. We assessed long-term efficacy of treatment effects after a short-term kyphosis exercise and posture training intervention in a cohort study among older adults with hyperkyphosis, and investigated whether long-term treatment effects differ among males and females.

In the original kyphosis intervention, 112 older adults enrolled in a waitlist design randomized controlled trial. One hundred three participants, mean age 70.0 (5.7) years and kyphosis 52.0° (7.4°), completed a twice weekly, 3-month, group exercise and posture training intervention, and were eligible to enroll in the follow-up study. We compared (1) change in outcomes pre-/postintervention to change postintervention over the follow-up period, (2) change in outcomes pre-/postintervention and postintervention to follow-up, stratified by sex, and (3) long-term change postintervention to follow-up in males and females. Primary outcome was phosis exercise and posture training intervention is warranted.Current guidelines for severe herpes simplex virus infection recommend 21 days of intravenous therapy. The thrice-daily administration of intravenous acyclovir makes it challenging to deliver as outpatient therapy. We describe 2 cases with confirmed or presumed neonatal herpes simplex virus encephalitis treated with acyclovir administered as a continuous-infusion at home and review the pharmacologic and clinical evidence for continuous infusions of acyclovir.Uterine carcinosarcomas are biphasic neoplasms consisting of mixed epithelial and mesenchymal elements, representing less than 5% of all uterine malignancies. Carcinosarcomas are rare, although the most common cause of uterine cancer-specific death. Few information is available on the pathogenesis, and molecular characterization is poorly investigated. Consequently, the treatment has not changed over the last years and is far too being tailored, consisting of surgery and traditional chemotherapy and radiotherapy. Molecular characterization of liquid biopsy by circulating tumor DNA (ctDNA)/circulating cell-free DNA (ccfDNA) evaluation in a patient with uterine carcinosarcoma. Here, we describe a case report of an 83-year-old woman with carcinosarcomas, stage T3aN0M0. Cancer cells did not express estrogen nor progesterone receptors, while p53 and p16 were positive. Molecular characterization of ccfDNA and of ctDNA was performed by quantitative PCR, amplification-refractory mutation system technology. The presence of phosphatidylInositol-4,5-bisphosphate 3-Kinase catalytic subunit alpha p.E545A mutation was detected in plasma. This approach may suggest the use of liquid biopsy and the development of specific targeted therapy for precision personalized medicine even in rare carcinosarcomas.Teratoma with malignant transformation is a rare type of malignant teratoma. In the present case, we describe a patient with salivary gland carcinoma (SGC) generating in mediastinal mature teratoma. Next-generation sequencing showed BRCA1 and KRAS somatic mutations, which might be associated with malignant transformation of the mediastinal mature teratomas. To our knowledge, the present case is the first report of coexistence of BRCA1 and KRAS mutations in mature cystic teratoma with malignant transformation to SGC. And the tumor showed a good response to chemotherapy with cisplatin and paclitaxel according to the transformed histology.Among advanced non-small cell lung cancer (NSCLC) patients in whom grade 2/3 immune-related adverse events (irAEs) that had developed during the initial immune checkpoint inhibitor (ICI) therapy had been successfully controlled, we experienced three patients in whom ICI therapy was resumed at the diagnosis of progressive disease (PD group, n = 3) and four patients in whom it was resumed immediately after successful control of irAEs (non-PD group, n = 4). The tumor response rate, disease control rate to the resumed ICI and progression-free survival from the resumption of ICI therapy were 0%, 0% and 2 months in the PD group and 25%, 75% and 4.8 months in the non-PD group. In advanced NSCLC patients in whom resumption of discontinued ICI therapy was planned, the ICI therapy should be resumed immediately after successful control of irAEs, rather than at the diagnosis of PD.Ubiquitin-conjugating enzyme E2T (UBE2T) is overexpressed in several human cancer cells, but a role in cholangiocarcinoma (CAA) progression has not been investigated. We analyzed the expression of UBE2T in CAA tissues. Then, we generated UBE2T deregulation models in which it was overexpressed or silenced, and examined the effects on CAA malignant progression by flow cytometry, western blot, MTT assay, wound healing assay and transwell assay. We report the involvement of UBE2T in CAA malignant progression. UBE2T was found to be highly expressed in human CAA cells both in vitro and in vivo. Overexpression of UBE2T significantly enhanced epithelial-to-mesenchymal transition, proliferation, migration and invasion of CAA cells in vitro, while silencing UBE2T had opposing effects. Furthermore, UBE2T appears to exert its effects via the mammalian target of rapamycin (mTOR) pathway as the cellular effects caused by UBE2T overexpression are inhibited by the mTOR inhibitor rapamycin. Our findings suggest that UBE2T may have potential as a new therapeutic target for the prevention or treatment of CAA.Many homeobox (HOX) genes have been shown to be related to cancer progression. HOXB5, a member of the HOX genes, is overexpressed in retinoblastoma cancer and positively regulates the breast cancer cell proliferation as well as invasion. However, the role and underlying mechanism of HOXB5 in pancreatic cancer cells are still unclear. HOXB5 expression was measured in four pancreatic cancer cell lines, including PANC-1, ASPC-1, MIA-PaCa-2, and CFPAC-1. PANC-1 and ASPC-1 cells were selected for cell transfection experiments. Cell proliferation, migration, and invasion were measured by Cell Counting Kit-8 (CCK-8) assay, wound healing assay, and transwell assay. Expressions of epithelial-to-mesenchymal transition (EMT) markers were determined by western blotting. Immunofluorescence staining and cellular morphology were used to confirm the effect of HOXB5 dysregulation on pancreatic cancer cells. We found that HOXB5 was markedly expressed in pancreatic cancer cell lines. HOXB5 overexpression contributed to proliferation, migration, and invasion in ASPC-1 cells, whereas HOXB5 knockdown decreased proliferation, migration, and invasion of PANC-1 cells. Western blotting confirmed that overexpression of HOXB5 promoted the EMT process. Conversely, knockdown of HOXB5 alleviated EMT. Furthermore, knockdown of HOXB5 suppressed proliferation, migration, and invasion of pancreatic cancer cells via the Glycogen synthase kinase 3β (GSK3β)/β-catenin pathway. Our study demonstrates that HOXB5 is a tumor promoter in pancreatic cancer, and the GSK3β/β-catenin pathway is important in HOXB5-induced proliferation, migration, and invasion in pancreatic cancer cells.Cisplatin is a widely used chemotherapeutic drug in lung cancer treatment. Most cancer patients eventually develop cisplatin resistance, resulting in a poor prognosis. Previously, we identified a novel marker, family with sequence similarity 60A (FAM60A), that was responsible for resistance in cisplatin-resistant human lung adenocarcinoma A549 (A549/DDP) cells. Here, we investigated the biological effects of FAM60A in A549/DDP cells and explored the underlying molecular mechanisms to understand its functional role in cisplatin resistance. Real-time quantitative PCR and western blot analysis were used to determine the expression levels of FAM60A in A549/DDP cells. FAM60A and SKP2 were knockdown with small-interfering RNA (siRNA). Cancer cell viability was analyzed with flow cytometry. The mRNA and protein expression levels of FAM60A increased significantly and dose-dependently in A549/DDP cells following cisplatin treatment. FAM60A overexpression up-regulated MDR1 expression, inhibited caspase 3, cleaved-caspase 3, and caspase 8 expression, and prevented cancer cell death. Microarray analysis of cells transfected with siRNA against the FAM60A transcript and control samples showed that SKP2 expression was positively regulated by FAM60A. SKP2 knockdown using a short-hairpin RNA reversed the functions induced by FAM60A. These results suggest that overexpression of FAM60A in A549/DDP cells led to SKP2 upregulation and enhanced cisplatin resistance in cancer cells. These provide new insights into chemoresistance and may contribute to reversing cisplatin resistance during lung cancer treatment.Breast cancer affects women globally; the majority of breast cancer-related mortalities are due to metastasis. Acquisition of a mesenchymal phenotype has been implicated in the progression of breast cancer cells to an invasive, metastatic state. Triple-negative breast cancer (TNBC) subtypes have high rates of metastases, recurrence, and have poorer prognoses compared to other breast cancer types, partially due to lack of commonly targeted receptors. Kinases have diverse and pivotal functions in metastasis in TNBC, and discovery of new kinase targets for TNBC is warranted. We previously used a screening approach to identify intermediate-synthesis nonpotent, nonselective small-molecule inhibitors from the Published Kinase Inhibitor Set that reversed the mesenchymal phenotype in TNBC cells. Two of these inhibitors (GSK346294A and GSK448459A) are structurally similar, but have unique kinase activity profiles and exhibited differential biologic effects on TNBC cells, specifically on epithelial-to-mesenchymal transition (EMT). Here, we further interrogate these effects and compare activity of these inhibitors on transwell migration, gene (qRT-PCR) and protein (western blot) expressions, and cancer stem cell-like behavior. We incorporated translational patient-derived xenograft models in these studies, and we focused on the lead inhibitor hit, GSK346294A, to demonstrate the utility of our comparative analysis as a screening modality to identify novel kinase targets and signaling pathways to pursue in TNBC. This study introduces a new method for discovering novel kinase targets that reverse the EMT phenotype; this screening approach can be applied to all cancer types and is not limited to breast cancer.