Publications by authors named "J W Harrison"

3,633 Publications

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Lung cancer risk and effective dose coefficients for radon: UNSCEAR review and ICRP conclusions.

Authors:
John D Harrison

J Radiol Prot 2021 Apr 6. Epub 2021 Apr 6.

Radiation Effects, Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxfordshire, OX11 ORQ, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND.

The United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) has provided a detailed and authoritative update of its reviews of the epidemiology and dosimetry of radon and progeny. Lifetime risk of lung cancer calculated using data for several miner cohorts were 2.4 - 7.5 x 10-4 per Working Level Month (WLM) of radon-222 progeny exposure for a mixed male / female population and 3.0 - 9.6 x 10-4 per WLM for a male population. Dosimetric models gave mean values of effective dose coefficients from radon-222 progeny of 12 mSv per WLM for mines, 16 mSv per WLM for indoor workplaces and 11 mSv per WLM for homes. The lifetime risk coefficient used by the International Commission on Radiological Protection (ICRP) is 5 x 10-4 per WLM and it has recently recommended an effective dose coefficient for radon-222 and progeny of 3 mSv per mJ h m-3 (about 10 mSv per WLM) for most circumstances of exposure. The ICRP risk and dose coefficients are supported by the UNSCEAR review and provide a clear and firm basis for current international advice and standards for protection from radon. UNSCEAR will continue to use a lower value of effective dose coefficient of 5.7 mSv per WLM for assessments of population exposures.
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http://dx.doi.org/10.1088/1361-6498/abf547DOI Listing
April 2021

Insect-Specific Flavivirus Replication in Mammalian Cells Is Inhibited by Physiological Temperature and the Zinc-Finger Antiviral Protein.

Viruses 2021 Mar 29;13(4). Epub 2021 Mar 29.

Laboratory of Virology, Wageningen University and Research, 6708 PB Wageningen, The Netherlands.

The genus contains pathogenic vertebrate-infecting flaviviruses (VIFs) and insect-specific flaviviruses (ISF). ISF transmission to vertebrates is inhibited at multiple stages of the cellular infection cycle, via yet to be elucidated specific antiviral responses. The zinc-finger antiviral protein (ZAP) in vertebrate cells can bind CpG dinucleotides in viral RNA, limiting virus replication. Interestingly, the genomes of ISFs contain more CpG dinucleotides compared to VIFs. In this study, we investigated whether ZAP prevents two recently discovered lineage II ISFs, Binjari (BinJV) and Hidden Valley viruses (HVV) from replicating in vertebrate cells. BinJV protein and dsRNA replication intermediates were readily observed in human ZAP knockout cells when cultured at 34 °C. In ZAP-expressing cells, inhibition of the interferon response via interferon response factors 3/7 did not improve BinJV protein expression, whereas treatment with kinase inhibitor C16, known to reduce ZAP's antiviral function, did. Importantly, at 34 °C, both BinJV and HVV successfully completed the infection cycle in human ZAP knockout cells evident from infectious progeny virus in the cell culture supernatant. Therefore, we identify vertebrate ZAP as an important barrier that protects vertebrate cells from ISF infection. This provides new insights into flavivirus evolution and the mechanisms associated with host switching.
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http://dx.doi.org/10.3390/v13040573DOI Listing
March 2021

Method Development for Enteric Virus Recovery from Primary Sludge.

Viruses 2021 Mar 9;13(3). Epub 2021 Mar 9.

Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Suite 100, Seattle, WA 98195, USA.

Enteric viruses, such as poliovirus, are a leading cause of gastroenteritis, which causes 2-3 million deaths annually. Environmental surveillance of wastewater supplements clinical surveillance for monitoring enteric virus circulation. However, while many environmental surveillance methods require liquid samples, some at-risk locations utilize pit latrines with waste characterized by high solids content. This study's objective was to develop and evaluate enteric virus concentration protocols for high solids content samples. Two existing protocols were modified and tested using poliovirus type 1 (PV1) seeded into primary sludge. Method 1 (M1) utilized acid adsorption, followed by 2 or 3 elutions (glycine/sodium chloride and/or threonine/sodium chloride), and skimmed milk flocculation. Method 2 (M2) began with centrifugation. The liquid fraction was filtered through a ViroCap filter and eluted (beef extract/glycine). The solid fraction was eluted (beef extract/disodium hydrogen phosphate/citric acid) and concentrated by skimmed milk flocculation. Recovery was enumerated by plaque assay. M1 yielded higher PV1 recovery than M2, though this result was not statistically significant (26.1% and 15.9%, respectively). M1 was further optimized, resulting in significantly greater PV1 recovery when compared to the original protocol ( < 0.05). This method can be used to improve understanding of enteric virus presence in communities without liquid waste streams.
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http://dx.doi.org/10.3390/v13030440DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8000433PMC
March 2021

Virtual reality, the COVID-19 pandemic and rehabilitation for community-dwelling older adults.

Br J Community Nurs 2021 Apr;26(4):196-198

Senior Academic Research Nurse, Lancashire Teaching Hospitals NHS Foundation Trust.

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http://dx.doi.org/10.12968/bjcn.2021.26.4.196DOI Listing
April 2021

Unlicenced cannabis-based product use in adult palliative medicine.

BMJ Support Palliat Care 2021 Apr 1. Epub 2021 Apr 1.

Department of Palliative Care, Saint Francis Hospice, Romford, London, UK.

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http://dx.doi.org/10.1136/bmjspcare-2021-003012DOI Listing
April 2021

Surgical sutureless and sutured aortic valve replacement in low-risk patients.

Ann Thorac Surg 2021 Mar 29. Epub 2021 Mar 29.

Departments of Cardiac Surgery, University of Michigan Hospitals, Ann Arbor, MI.

Background: Randomized clinical trials have shown that transcatheter aortic valve replacement (TAVR) is noninferior to surgery in low surgical risk patients. We compared outcomes in patients treated with a sutured (stented or stentless) or sutureless surgical valve from the Evolut Low Risk Trial.

Methods: The Evolut Low Risk Trial enrolled patients with severe aortic stenosis and low surgical risk. Patients were randomized to self-expanding TAVR or surgery. Use of sutureless or sutured valves was at the surgeons' discretion.

Results: There were 680 patients who underwent surgical aortic valve implantation (205 sutureless, 475 sutured). The VARC-2 30-day safety composite endpoint was similar in the sutureless and sutured group (10.8% vs 11.0%, P=.93). All-cause mortality between groups was similar between groups at 30 days (0.5% vs 1.5%, P=.28) and 1 year (3.3% vs 2.6%, P=.74). Disabling stroke was also similar at 30 days (2.0% vs 1.5%, P=.65) and 1 year (2.6% vs 2.2%, P=.76). Permanent pacemaker implantation at 30 days was significantly higher in the sutureless compared with the sutured group (14.4% vs 2.9%, P<.001). AV-related hospitalizations occurred more often at 1 year with sutureless valves (9.1% vs 5.1%, P=.04). Mean gradients 1 year after sutureless and sutured AVR were 9.9±4.2 vs 11.7±4.7mm Hg (P<.001).

Conclusions: Among low-risk patients, sutureless versus sutured valve use did not demonstrate a benefit in terms of 30-day complications and produced marginally better hemodynamics, but with an increased rate of pacemaker implantation and valve-related hospitalizations.
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http://dx.doi.org/10.1016/j.athoracsur.2021.03.048DOI Listing
March 2021

A suite of rare microbes interacts with a dominant, heritable, fungal endophyte to influence plant trait expression.

ISME J 2021 Mar 31. Epub 2021 Mar 31.

Ecology, Evolution, and Conservation Biology Program, Biology Department, University of Nevada, Reno, NV, USA.

Endophytes are microbes that live, for at least a portion of their life history, within plant tissues. Endophyte assemblages are often composed of a few abundant taxa and many infrequently observed, low-biomass taxa that are, in a word, rare. The ways in which most endophytes affect host phenotype are unknown; however, certain dominant endophytes can influence plants in ecologically meaningful ways-including by affecting growth and immune system functioning. In contrast, the effects of rare endophytes on their hosts have been unexplored, including how rare endophytes might interact with abundant endophytes to shape plant phenotype. Here, we manipulate both the suite of rare foliar endophytes (including both fungi and bacteria) and Alternaria fulva-a vertically transmitted and usually abundant fungus-within the fabaceous forb Astragalus lentiginosus. We report that rare, low-biomass endophytes affected host size and foliar %N, but only when the heritable fungal endophyte (A. fulva) was not present. A. fulva also reduced plant size and %N, but these deleterious effects on the host could be offset by a negative association we observed between this heritable fungus and a foliar pathogen. These results demonstrate how interactions among endophytic taxa determine the net effects on host plants and suggest that the myriad rare endophytes within plant leaves may be more than a collection of uninfluential, commensal organisms, but instead have meaningful ecological roles.
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http://dx.doi.org/10.1038/s41396-021-00964-4DOI Listing
March 2021

Bacterial cyclic diguanylate signaling networks sense temperature.

Nat Commun 2021 03 31;12(1):1986. Epub 2021 Mar 31.

Department of Biological Sciences, University of Calgary, Calgary, AB, Canada.

Many bacteria use the second messenger cyclic diguanylate (c-di-GMP) to control motility, biofilm production and virulence. Here, we identify a thermosensory diguanylate cyclase (TdcA) that modulates temperature-dependent motility, biofilm development and virulence in the opportunistic pathogen Pseudomonas aeruginosa. TdcA synthesizes c-di-GMP with catalytic rates that increase more than a hundred-fold over a ten-degree Celsius change. Analyses using protein chimeras indicate that heat-sensing is mediated by a thermosensitive Per-Arnt-SIM (PAS) domain. TdcA homologs are widespread in sequence databases, and a distantly related, heterologously expressed homolog from the Betaproteobacteria order Gallionellales also displayed thermosensitive diguanylate cyclase activity. We propose, therefore, that thermotransduction is a conserved function of c-di-GMP signaling networks, and that thermosensitive catalysis of a second messenger constitutes a mechanism for thermal sensing in bacteria.
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http://dx.doi.org/10.1038/s41467-021-22176-2DOI Listing
March 2021

Safety and efficacy of catheter directed thrombolysis (CDT) in elderly with pulmonary embolism (PE).

BMJ Open Respir Res 2021 Mar;8(1)

Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.

Introduction: Acute pulmonary embolism (PE) remains a common cause for morbidity and mortality in patients over 65 years. Given the increased risk of bleeding in the elderly population with the use of systemic thrombolysis, catheter-directed therapy (CDT) is being increasingly used for the treatment of submassive PE. Nevertheless, the safety of CDT in the elderly population is not well studied. We, therefore, aimed to evaluate the safety of CDT in our elderly patients.

Methods: We conducted a retrospective observational study of consecutive patients aged 65 years with a diagnosis of PE from our Pulmonary Embolism Response Team database. We compared the treatment outcomes of CDT versus anticoagulation (AC) in elderly. Propensity score matching was used to construct two matched cohorts for final outcomes analysis.

Results: Of 346 patients with acute PE, 138 were 65 years, and of these, 18 were treated with CDT. Unmatched comparison between CDT and AC cohorts demonstrated similar in-hospital mortality (11.1% vs 5.6%, p=0.37) and length of stay (LOS) (3.81 vs 5.02 days, p=0.5395), respectively. The results from the propensity-matched cohort mirrored results of the unmatched cohort with no significant difference between CDT and AC in-hospital mortality (11.8% vs 5.9%, p=0.545) or median LOS (3.76 vs 4.21 days, p=0.77), respectively.

Conclusion: In this observational study using propensity score-matched analysis, we found that patients >65 years who were treated with CDT for management of acute PE had similar mortality and LOS compared with those treated with AC. Further studies are required to confirm these findings.
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http://dx.doi.org/10.1136/bmjresp-2021-000894DOI Listing
March 2021

Resolving the Dynamic Motions of SARS-CoV-2 nsp7 and nsp8 Proteins Using Structural Proteomics.

bioRxiv 2021 Mar 6. Epub 2021 Mar 6.

Coronavirus (CoV) non-structural proteins (nsps) assemble to form the replication-transcription complex (RTC) responsible for viral RNA synthesis. nsp7 and nsp8 are important cofactors of the RTC, as they interact and regulate the activity of RNA-dependent RNA polymerase (RdRp) and other nsps. To date, no structure of full-length SARS-CoV-2 nsp7:nsp8 complex has been published. Current understanding of this complex is based on structures from truncated constructs or with missing electron densities and complexes from related CoV species with which SARS-CoV-2 nsp7 and nsp8 share upwards of 90% sequence identity. Despite available structures being solved using crystallography and cryo-EM representing detailed snapshots of the nsp7:nsp8 complex, it is evident that the complex has a high degree of structural plasticity. However, relatively little is known about the conformational dynamics of the complex and how it assembles to interact with other nsps. Here, the solution-based structural proteomic techniques, hydrogen-deuterium exchange mass spectrometry (HDX-MS) and crosslinking mass spectrometry (XL-MS), illuminate the structural dynamics of the SARS-CoV-2 full-length nsp7:nsp8 complex. The results presented from the two techniques are complementary and validate the interaction surfaces identified from the published three-dimensional heterotetrameric crystal structure of SARS-CoV-2 truncated nsp7:nsp8 complex. Furthermore, mapping of XL-MS data onto higher order complexes suggests that SARS-CoV-2 nsp7 and nsp8 do not assemble into a hexadecameric structure as implied by the SARS-CoV full-length nsp7:nsp8 crystal structure. Instead our results suggest that the nsp7:nsp8 heterotetramer can dissociate into a stable dimeric unit that might bind to nsp12 in the RTC without altering nsp7-nsp8 interactions.
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http://dx.doi.org/10.1101/2021.03.06.434214DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7941636PMC
March 2021

Comparison of irrigant activation devices and conventional needle irrigation on smear layer and debris removal in curved canals. (Smear layer removal from irrigant activation using SEM).

Aust Endod J 2021 Mar 8. Epub 2021 Mar 8.

School of Dentistry and Health Sciences - Faculty of Science, Charles Sturt University, Orange, NSW, Australia.

Aim: To compare the effectiveness of smear layer and debris removal in the final rinse of curved canals of permanent molars using different commercially available irrigant activation devices.

Methods: The mesial roots of 74 extracted maxillary and mandibular molars were instrumented using the Mtwo nickel-titanium rotary system (VDW GmbH, Munich, Germany). They were then randomly assigned to one of three groups, varying in their final rinse protocol. Group 1 (n = 15) - conventional needle irrigation with 4% NaOCl; Group 2 (n = 19) - EndoActivator® (Dentsply Tulsa Dental Specialties, Tulsa, OK, USA) with 4% NaOCl; Group 3 (n = 17) - XP-endo® Finisher (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) with 4% NaOCl. After the final rinse, all canals were flushed with 1 mL 15% EDTA for 60 s and then flushed with saline. The roots were split longitudinally and prepared for scanning electron microscope imaging. ImageJ for Windows was utilised to assess the images for smear layer removal, while two blinded investigators assessed debris presence in the middle and apical thirds using a 5-point scale.

Results: There was no significant difference in smear layer and debris removal between treatment and control groups in the same canal zones. A significant difference was noted across different canal zones both within and across the groups.

Conclusion: There is no statistically significant difference in effectiveness between activated irrigation techniques and manual activation. Further investigations are required to evaluate all methods available and determine the most efficient technique to irrigate successfully.
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http://dx.doi.org/10.1111/aej.12482DOI Listing
March 2021

Does Integration of Palliative Care and Infection Management Reduce Hospital Transfers among Nursing Home Residents?

J Palliat Med 2021 Feb 19. Epub 2021 Feb 19.

RAND Corporation, Boston, Massachusetts, USA.

An estimated 50% of nursing home (NH) residents experience hospital transfers in their last year of life, often due to infections. Hospital transfers due to infection are often of little clinical benefit to residents with advanced illness, for whom aggressive treatments are often ineffective and inconsistent with goals of care. Integration of palliative care and infection management (i.e., merging the goals of palliative care and infection management at end of life) may reduce hospital transfers for residents with advanced illness. Evaluate the association between integration and (1) all-cause hospital transfers and (2) hospital transfers due to infection. Cross-sectional observational study. 143,223 U.S. NH residents, including 42,761 residents in the advanced stages of dementia, congestive heart failure (CHF), and chronic obstructive pulmonary disease (COPD). Cross-sectional, nationally representative NH survey data (2017-2018) were combined with resident data from the Minimum Data Set 3.0 and Medicare inpatient data (2016-2017). NH surveys measured integration of palliative care and infection management using an index of 0-100. Logistic regression models were used to estimate the relationships between integration intensity (i.e., the degree to which NHs follow best practices for integration) and all-cause hospital transfer and transfer due to infection. Among residents with advanced dementia, integration intensity was inversely associated with all-cause hospital transfer and transfer due to infection ( < 0.001). Among residents with advanced COPD, integration intensity was inversely associated with all-cause hospital transfer ( < 0.05) but not transfers due to infection. Among residents with advanced CHF, integration intensity was not associated with either outcome. NH policies aimed to promote integration of palliative care and infection management may reduce burdensome hospital transfers for residents with advanced dementia. For residents with advanced CHF and COPD, alternative strategies may be needed to promote best practices for infection management at end of life.
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http://dx.doi.org/10.1089/jpm.2020.0577DOI Listing
February 2021

Refractory thoracic conidiobolomycosis treated with mepolizumab immunotherapy.

J Allergy Clin Immunol Pract 2021 Feb 16. Epub 2021 Feb 16.

Infectious Diseases Unit, Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia; Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.

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http://dx.doi.org/10.1016/j.jaip.2021.01.044DOI Listing
February 2021

"I would not go to him": Focus groups exploring community responses to a public health campaign aimed at reducing unnecessary diagnostic imaging of low back pain.

Health Expect 2021 Feb 18. Epub 2021 Feb 18.

Faculty of Medicine and Health, Institute for Musculoskeletal Health, Sydney School of Public Health, The University of Sydney and Sydney Local Health District, Sydney, NSW, Australia.

Background: Community awareness of the harms of overdiagnosis remains low.

Objective: To evaluate community responses to a public health campaign designed for health service waiting rooms that focuses on the harms of unnecessary diagnostic imaging for low back pain.

Methods: We conducted two focus groups of 19 community members with or without low back pain in Sydney, Australia. This study formed the fourth and final stage of the development process of a public health campaign: (a) initial design, (b) expert review and revision, (c) online experiment and (d) community views & revision. We evaluated reactions to components of the campaign that included digital posters and an information leaflet using strong imagery and messaging about the risk of overdiagnosis. We conducted a qualitative thematic analysis to identify main themes.

Results: Community members reacted with surprise, initial mistrust, and occasionally anger towards imagery and messaging that suggested diagnostic imaging tests could be unnecessary and harmful. With further reflection and discussion, and after reading longer format information about overdiagnosis, the participants found some of the messages informative and useful. Participants appeared to gain a better understanding of the concept of overdiagnosis and the importance of not rushing to imaging.

Conclusions: Public health campaigns including posters and leaflets displayed in waiting rooms could raise awareness about overuse of diagnostic imaging and the harms of overdiagnosis more broadly. However, negative reactions are possible and must be managed carefully.

Patient Or Public Contribution: We involved a community participation manager who provided advice on the focus group discussion guide, participant recruitment and manuscript presentation.
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http://dx.doi.org/10.1111/hex.13211DOI Listing
February 2021

Does insulin resistance influence neurodegeneration in non-diabetic Alzheimer's subjects?

Alzheimers Res Ther 2021 02 17;13(1):47. Epub 2021 Feb 17.

Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK.

Background: Type 2 diabetes is a risk factor for Alzheimer's disease (AD), and AD brain shows impaired insulin signalling. The role of peripheral insulin resistance on AD aetiopathogenesis in non-diabetic patients is still debated. Here we evaluated the influence of insulin resistance on brain glucose metabolism, grey matter volume and white matter lesions (WMLs) in non-diabetic AD subjects.

Methods: In total, 130 non-diabetic AD subjects underwent MRI and [18F]FDG PET scans with arterial cannula insertion for radioactivity measurement. T1 Volumetric and FLAIR sequences were acquired on a 3-T MRI scanner. These subjects also had measurement of glucose and insulin levels after a 4-h fast on the same day of the scan. Insulin resistance was calculated by the updated homeostatic model assessment (HOMA2). For [18F]FDG analysis, cerebral glucose metabolic rate (rCMRGlc) parametric images were generated using spectral analysis with arterial plasma input function.

Results: In this non-diabetic AD population, HOMA2 was negatively associated with hippocampal rCMRGlc, along with total grey matter volumes. No significant correlation was observed between HOMA2, hippocampal volume and WMLs.

Conclusions: In non-diabetic AD, peripheral insulin resistance is independently associated with reduced hippocampal glucose metabolism and with lower grey matter volume, suggesting that peripheral insulin resistance might influence AD pathology by its action on cerebral glucose metabolism and on neurodegeneration.
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http://dx.doi.org/10.1186/s13195-021-00784-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7890851PMC
February 2021

Methodology for a six-state survey of primary care nurse practitioners.

Nurs Outlook 2021 Feb 13. Epub 2021 Feb 13.

Department of Acute & Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, PA; RAND Corporation, Pittsburgh, PA.

Background: Primary care practices employing nurse practitioners (NPs) can play an important role in improving access to high quality health care services. However, most studies on the NP role in health care use administrative data, which have many limitations.

Purpose: In this paper, we report the methods of the largest survey of primary care NPs to date.

Methods: To overcome the limitations of administrative data, we fielded a cross-sectional, mixed-mode (mail/online) survey of primary care NPs in six states to collect data directly from NPs on their clinical roles and practice environments.

Findings: While we were able to collect data from over 1,200 NPs, we encountered several challenges with our sampling frame, including provider turnover and challenges with identification of NP specialty.

Discussion: In future surveys, researchers can employ strategies to avoid the issues we encountered with the sampling frame and enhance large scale survey data collection from NPs.
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http://dx.doi.org/10.1016/j.outlook.2021.01.010DOI Listing
February 2021

Bone Mineral Density Differences Across Female Olympic Lifters, Power Lifters, and Soccer Players.

J Strength Cond Res 2021 Mar;35(3):638-643

Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas.

Abstract: Jeon, W, Harrison, JM, Stanforth, PR, and Griffin, L. Bone mineral density differences across female Olympic lifters, power lifters, and soccer players. J Strength Cond Res 35(3): 638-643, 2021-Athletic training improves bone mineral density (BMD) through repeated mechanical loading. The location, intensity, and direction of applied mechanical pressure play an important role in determining BMD, making some sports more advantageous at improving BMD at specific regions. Thirty-seven (10 power lifters [PL], 8 Olympic lifters [OL], 8 soccer players [SP], and 11 recreationally active [RA]) women participated in a cross-sectional study. We measured lumbar spine (L1-L4), femoral neck, total-body BMD, and overall body composition (total fat mass, lean mass, percent body fat) with dual-energy x-ray absorptiometry. All athletic groups had greater total BMD than RA (p = 0.01 [PL]; p < 0.001 [OL]; p = 0.01 [SP]). Olympic lifters had the highest total BMD than all other athletic groups. Olympic lifters had the significantly greater total BMD than PL (p = 0.018), but there was no difference in total BMD between PL and SP. As compared with RA, OL showed greater BMD at both the total lumbar spine (p = 0.002) and the femoral neck (p = 0.007), whereas PL showed greater BMD only for the total lumbar spine (p = 0.019) and SP showed greater BMD only for the femoral neck (p = 0.002). Olympic-style lifting includes both high-impact and odd-impact loading modalities that are associated with the highest BMD at both the lumbar spine and femoral neck.
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http://dx.doi.org/10.1519/JSC.0000000000003944DOI Listing
March 2021

The use of dose quantities in radiological protection: ICRP Publication 147 Ann ICRP 50(1) 2021.

J Radiol Prot 2021 Feb 11. Epub 2021 Feb 11.

The University of Manchester, Manchester, M13 9PL, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND.

The International Commission on Radiological Protection has recently published a report (ICRP Publication 147; 2021) on the use of dose quantities in radiological protection, under the same authorship as this Memorandum. Here, we present a brief summary of the main elements of the report. ICRP Publication 147 consolidates and clarifies the explanations provided in the 2007 ICRP Recommendations (Publication 103) but reaches conclusions that go beyond those presented in Publication 103. Further guidance is provided on the scientific basis for the control of radiation risks using dose quantities in occupational, public and medical applications. It is emphasised that best estimates of risk to individuals will use organ/tissue absorbed doses, appropriate relative biological effectiveness factors and dose-risk models for specific health effects. However, bearing in mind uncertainties including those associated with risk projection to low doses or low dose rates, it is concluded that in the context of radiological protection, effective dosemay be consideredas an approximate indicator of possible risk of stochastic health effects following low-level exposure to ionising radiation. In this respect, it should also be recognised that lifetime cancer risks vary with age at exposure, sex and population group. The ICRP report also concludes that equivalent dose is not needed as a protection quantity. Dose limits for the avoidance of tissue reactions for the skin, hands and feet, and lens of the eye will be more appropriately set in terms of absorbed dose rather than equivalent dose.
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http://dx.doi.org/10.1088/1361-6498/abe548DOI Listing
February 2021

Snaps of a tiny amphipod push the boundary of ultrafast, repeatable movement.

Curr Biol 2021 Feb;31(3):R116-R117

Department of Biology, Duke University, Durham, NC 27708, USA. Electronic address:

Surprisingly, the fastest motions are not produced by large animals or robots. Rather, small organisms or structures, including cnidarian stinging cells, fungal shooting spores, and mandible strikes of ants, termites, and spiders, hold the world acceleration records. These diverse systems share common features: they rapidly convert potential energy - stored in deformed material or fluid - into kinetic energy when a latch is released. However, the fastest of these are not repeatable, because mechanical components are broken or ejected. Furthermore, some of these systems must overcome the added challenge of moving in water, where high density and viscosity constrain acceleration at small sizes. Here we report the kinematics of repeatable, ultrafast snaps by tiny marine amphipods (Dulichiella cf. appendiculata). Males use their enlarged major claw, which can exceed 30% of body mass, to snap a 1 mm-long dactyl with a diameter equivalent to a human hair (184 μm). The claw snaps closed extremely rapidly, averaging 93 μs, 17 m s, and 2.4 x 10 m s. These snaps are among the smallest and fastest of any documented repeatable movement, and are sufficiently fast to operate in the inertial hydrodynamic regime (Reynolds number (Re) >10,000). They generate audible pops and rapid water jets, which occasionally yield cavitation, and may be used for defense. These amphipod snaps push the boundaries of acceleration and size for repeatable movements, particularly in water, and exemplify how new biomechanical insights can arise from unassuming animals. VIDEO ABSTRACT.
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http://dx.doi.org/10.1016/j.cub.2020.12.025DOI Listing
February 2021

Failed Trapeziectomy Treated by Thumb Metacarpal Base Arthrodesis: A Case Series.

Tech Hand Up Extrem Surg 2021 Feb 2. Epub 2021 Feb 2.

Health Education North East, Newcastle upon Tyne Department of Trauma & Orthopaedic Surgery, Queen Elizabeth Hospital, Gateshead, England.

Trapeziometacarpal joint arthritis is a prevalent condition with a preponderance to women. Most cases are asymptomatic, but typical symptoms are pain, reduced dexterity, and functional decline. Trapeziectomy is the most common surgical treatment in the United Kingdom for patients who remain significantly symptomatic despite nonoperative measures, and this generally produces acceptable outcomes; however, a proportion of patients remain significantly symptomatic. The authors present a case series of 4 patients who underwent successful thumb metacarpal base to index metacarpal base arthrodesis with either distal radial or iliac crest bone grafting. Three of these patients had persisting symptoms after a primary trapeziectomy and 1 patient had gross subluxation of the thumb related to rheumatoid arthritis. Technically, this is a simple procedure to perform. All patients had improved symptoms with satisfactory functional outcomes and an improved cosmetic appearance of the hand.
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http://dx.doi.org/10.1097/BTH.0000000000000338DOI Listing
February 2021

Antiferromagnetic half-skyrmions and bimerons at room temperature.

Nature 2021 02 3;590(7844):74-79. Epub 2021 Feb 3.

Clarendon Laboratory, Department of Physics, University of Oxford, Oxford, UK.

In the quest for post-CMOS (complementary metal-oxide-semiconductor) technologies, driven by the need for improved efficiency and performance, topologically protected ferromagnetic 'whirls' such as skyrmions and their anti-particles have shown great promise as solitonic information carriers in racetrack memory-in-logic or neuromorphic devices. However, the presence of dipolar fields in ferromagnets, which restricts the formation of ultrasmall topological textures, and the deleterious skyrmion Hall effect, when skyrmions are driven by spin torques, have thus far inhibited their practical implementation. Antiferromagnetic analogues, which are predicted to demonstrate relativistic dynamics, fast deflection-free motion and size scaling, have recently become the subject of intense focus, but they have yet to be experimentally demonstrated in natural antiferromagnetic systems. Here we realize a family of topological antiferromagnetic spin textures in α-FeO-an Earth-abundant oxide insulator-capped with a platinum overlayer. By exploiting a first-order analogue of the Kibble-Zurek mechanism, we stabilize exotic merons and antimerons (half-skyrmions) and their pairs (bimerons), which can be erased by magnetic fields and regenerated by temperature cycling. These structures have characteristic sizes of the order of 100 nanometres and can be chemically controlled via precise tuning of the exchange and anisotropy, with pathways through which further scaling may be achieved. Driven by current-based spin torques from the heavy-metal overlayer, some of these antiferromagnetic textures could emerge as prime candidates for low-energy antiferromagnetic spintronics at room temperature.
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http://dx.doi.org/10.1038/s41586-021-03219-6DOI Listing
February 2021

Antiferromagnetic half-skyrmions and bimerons at room temperature.

Nature 2021 02 3;590(7844):74-79. Epub 2021 Feb 3.

Clarendon Laboratory, Department of Physics, University of Oxford, Oxford, UK.

In the quest for post-CMOS (complementary metal-oxide-semiconductor) technologies, driven by the need for improved efficiency and performance, topologically protected ferromagnetic 'whirls' such as skyrmions and their anti-particles have shown great promise as solitonic information carriers in racetrack memory-in-logic or neuromorphic devices. However, the presence of dipolar fields in ferromagnets, which restricts the formation of ultrasmall topological textures, and the deleterious skyrmion Hall effect, when skyrmions are driven by spin torques, have thus far inhibited their practical implementation. Antiferromagnetic analogues, which are predicted to demonstrate relativistic dynamics, fast deflection-free motion and size scaling, have recently become the subject of intense focus, but they have yet to be experimentally demonstrated in natural antiferromagnetic systems. Here we realize a family of topological antiferromagnetic spin textures in α-FeO-an Earth-abundant oxide insulator-capped with a platinum overlayer. By exploiting a first-order analogue of the Kibble-Zurek mechanism, we stabilize exotic merons and antimerons (half-skyrmions) and their pairs (bimerons), which can be erased by magnetic fields and regenerated by temperature cycling. These structures have characteristic sizes of the order of 100 nanometres and can be chemically controlled via precise tuning of the exchange and anisotropy, with pathways through which further scaling may be achieved. Driven by current-based spin torques from the heavy-metal overlayer, some of these antiferromagnetic textures could emerge as prime candidates for low-energy antiferromagnetic spintronics at room temperature.
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http://dx.doi.org/10.1038/s41586-021-03219-6DOI Listing
February 2021

High carbohydrate diet ingestion increases post-meal lipid synthesis and drives respiratory exchange ratios above 1.

J Exp Biol 2021 Feb 25;224(Pt 4). Epub 2021 Feb 25.

School of Life Sciences, Arizona State University, Tempe, AZ 85287, USA.

Locusts have been reported to elevate metabolic rate in response to high carbohydrate diets; this conclusion was based on metabolic rates calculated from CO production, a common practice for insects. However, respiratory exchange ratio (RER, CO production divided by O consumption) can rise above 1 as a result of lipid synthesis, providing an alternative possible explanation of the prior findings. We studied the relationship between macronutrient ingestion, RER and lipid synthesis using South American locusts () reared on artificial diets varying in protein:carbohydrate (p:c) ratio. RER increased and rose above 1 as dietary p:c ratio decreased. Lipid accumulation rates were strongly positively correlated with dietary carbohydrate content and ingestion. RERs above 1 were only observed for animals without food in the respirometry chamber, suggesting that hormonal changes after a meal may drive lipid synthesis. does not elevate metabolic rate on low p:c diets; in fact, the opposite trend was observed.
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http://dx.doi.org/10.1242/jeb.240010DOI Listing
February 2021

Consumption of field-realistic doses of a widely used mito-toxic fungicide reduces thorax mass but does not negatively impact flight capacities of the honey bee (Apis mellifera).

Environ Pollut 2021 Apr 20;274:116533. Epub 2021 Jan 20.

School of Life Sciences, Arizona State University, 427 East Tyler Mall, Tempe, AZ, 85281, USA.

Commercial beekeepers in many locations are experiencing increased annual colony losses of honey bees (Apis mellifera), but the causes, including the role of agrochemicals in colony losses, remain unclear. In this study, we investigated the effects of chronic consumption of pollen containing a widely-used fungicide (Pristine®), known to inhibit bee mitochondria in vitro, which has recently been shown to reduce honey bee worker lifespan when field-colonies are provided with pollen containing field-realistic levels of Pristine®. We fed field colonies pollen with a field-realistic concentration of Pristine® (2.3 ppm) and a concentration two orders of magnitude higher (230 ppm). To challenge flight behavior and elicit near-maximal metabolic rate, we measured flight quality and metabolic rates of bees in two lower-than-normal air densities. Chronic consumption of 230 but not 2.3 ppm Pristine® reduced maximal flight performance and metabolic rates, suggesting that the observed decrease in lifespans of workers reared on field-realistic doses of Pristine®-laced pollen is not due to inhibition of flight muscle mitochondria. However, consumption of either the 230 or 2.3 ppm dose reduced thorax mass (but not body mass), providing the first evidence of morphological effects of Pristine®, and supporting the hypothesis that Pristine® reduces forager longevity by negatively impacting digestive or nutritional processes.
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http://dx.doi.org/10.1016/j.envpol.2021.116533DOI Listing
April 2021

Commentary: Composite cognitive and functional measures for early stage Alzheimer's disease trials.

Authors:
John E Harrison

Alzheimers Dement (Amst) 2020 15;12(1):e12009. Epub 2020 May 15.

Metis Cognition Ltd, Park House Kilmington Common Wiltshire UK.

In this commentary I consider the issues raised in Schneider and Goldberg's review of composite cognitive and functional measures. I find much to agree with in their commentary and especially their concerns regarding satisfactory psychometric validation of composite measures. I endorse also their provision for analysis by cognitive domain, backed by the use of statistical methods for grouping test variables. The authors helpfully mention the possibility that treatment effects may be peculiar to specific domains of cognitive function. I develop this view and argue for exploratory studies of new therapeutic interventions to include broad assessments of the cognitive domains known to be compromised in early Alzheimer's disease. I suggest that the results of exploratory studies be used to help identify target domains for confirmatory studies. Finally, I note that computerized cognitive composite assessments have often been validated in the fashion that the authors recommend for composite measures.
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http://dx.doi.org/10.1002/dad2.12009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7819351PMC
May 2020

A Novel Surgical Technique for Glenoid Reconstruction in the Trauma Setting With a Distal Tibia Allograft: A Case Report.

JBJS Case Connect 2020 12 10;10(4):e20.00184. Epub 2020 Dec 10.

Department of Orthopaedic Surgery, Naval Medical Center Portsmouth, Virginia.

Case: A 21-year-old woman presented with a chronic fracture dislocation of her left shoulder after striking a submerged tree during a watersport activity. She was initially treated at an outside hospital, where she underwent open reduction and internal fixation of her posterior scapula. She presented 8 weeks after index procedure with pain and severely decreased range of motion. Her comminuted and displaced fracture comprising 70% of the anterior superior glenoid was surgically reconstructed using a distal tibia allograft (DTA), resulting in a functional shoulder.

Conclusion: A DTA is a feasible option to reconstruct the glenoid surface in fracture dislocations of the shoulder with a significant loss of the articular surface.
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http://dx.doi.org/10.2106/JBJS.CC.20.00184DOI Listing
December 2020

Introduction to Artificial Intelligence and Machine Learning for Pathology.

Arch Pathol Lab Med 2021 Jan 25. Epub 2021 Jan 25.

the Department of Forensic Medicine, New York University, and Office of Chief Medical Examiner, New York, New York (Stram).

Context.—: Recent developments in machine learning have stimulated intense interest in software that may augment or replace human experts. Machine learning may impact pathology practice by offering new capabilities in analysis, interpretation, and outcomes prediction using images and other data. The principles of operation and management of machine learning systems are unfamiliar to pathologists, who anticipate a need for additional education to be effective as expert users and managers of the new tools.

Objective.—: To provide a background on machine learning for practicing pathologists, including an overview of algorithms, model development, and performance evaluation; to examine the current status of machine learning in pathology and consider possible roles and requirements for pathologists in local deployment and management of machine learning systems; and to highlight existing challenges and gaps in deployment methodology and regulation.

Data Sources.—: Sources include the biomedical and engineering literature, white papers from professional organizations, government reports, electronic resources, and authors' experience in machine learning. References were chosen when possible for accessibility to practicing pathologists without specialized training in mathematics, statistics, or software development.

Conclusions.—: Machine learning offers an array of techniques that in recent published results show substantial promise. Data suggest that human experts working with machine learning tools outperform humans or machines separately, but the optimal form for this combination in pathology has not been established. Significant questions related to the generalizability of machine learning systems, local site verification, and performance monitoring remain to be resolved before a consensus on best practices and a regulatory environment can be established.
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http://dx.doi.org/10.5858/arpa.2020-0541-CPDOI Listing
January 2021

Cognitive Go/No-Go decision-making criteria in Alzheimer's disease drug development.

Drug Discov Today 2021 Jan 21. Epub 2021 Jan 21.

Metis Cognition Ltd, Kilmington Common, UK; Alzheimer Center AUmc, Amsterdam, The Netherlands; Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.

Go/No-Go decision making in early phase clinical trials is challenging for drug developers working in Alzheimer's disease. Recent negative trial results have been attributed to a lack of efficacy and important safety concerns. Furthermore, demonstrated target engagement has rarely translated into demonstrable clinical efficacy. Cognitive data might provide valuable insights at various points during drug development, and a thoughtful and robust set of decision-making criteria, specified a priori, can and should be applied under many circumstances. This review provides insights into how to utilize cognitive data for Go/No-Go decisions, with an emphasis on how these cognitive criteria differ depending on the context (e.g., stage of development, mechanism of action and trial design).
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http://dx.doi.org/10.1016/j.drudis.2021.01.012DOI Listing
January 2021

Does Feedback to Physicians of a Patient-Reported Readiness for Discharge Checklist Improve Discharge?

J Patient Exp 2020 Dec 12;7(6):1144-1150. Epub 2020 Jan 12.

Division of Hospital Medicine, University of California, San Francisco, CA, USA.

Limited data exist describing how hospital discharge readiness checklists might be incorporated into care. To evaluate how assessing patient readiness for discharge effects discharge outcomes. We assessed hospitalized adults' readiness for discharge daily using a checklist. In the first feedback period, readiness data were given to patients, compared to the second feedback period, where data were given to patients and physicians. In the first feedback period, 163 patients completed 296 checklists, and in the second feedback period, 179 patients completed 371 checklists. In the first feedback period, 889 discharge barriers were identified, and 1154 in the second feedback period ( = .27). We found no association between the mean number of discharge barriers by hospital day and whether data were provided to physicians ( = .39). Eighty-nine physicians completed our survey, with 76 (85%) recalling receiving checklist data. Twenty-three (30%) of these thought the data helpful, and 45 (59%) stated it "never" or "rarely" highlighted anything new. Patients continued to report discharge barriers even when physicians received patient-reported data about key discharge transition domains.
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http://dx.doi.org/10.1177/2374373519895100DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7786742PMC
December 2020