The Autoregulation Rest-Redistribution Training Method Mitigates Sex Differences in Neuromuscular and Perceived Fatigue During Resistance Training.

PURPOSE: To examine the sex differences in performance and perceived fatigue during resistance training prescribed using traditional (TRA) and autoregulation rest-redistribution training (ARRT) approaches. METHODS: Twelve resistance-trained men and 12 women completed 2 sessions including the bench-press exercise matched for load (75% of 1-repetition maximum), volume (24 repetitions), and total rest (240 s). Sessions were performed in a counterbalanced randomized design with TRA consisting of 3 sets of 8 repetitions with 120-second interset rest and ARRT employing a personalized combination of clusters, repetitions per cluster, and between-clusters rest regulated with a 20% velocity-loss threshold. The effects of TRA and ARRT on velocity loss, unilateral isometric peak force, and rating of fatigue (ROF) were compared between sexes. RESULTS: The velocity loss was generally lower during ARRT compared with TRA (-0.47% [0.11%]), with velocity loss being mitigated by ARRT to a greater extent among males compared with females (-0.37% [0.15%]). A smaller unilateral isometric peak force decline was observed after ARRT than TRA among males compared with females (-38.4 [8.4] N). Lower ROF after ARRT than TRA was found among males compared to females (-1.97 [0.55] AU). Additionally, males reported greater ROF than females across both conditions (1.92 [0.53] AU), and ARRT resulted in lower ROF than TRA overall (-0.83 [0.39] AU). CONCLUSIONS: The ARRT approach resulted in decreased velocity loss, peak force impairment, and ROF compared with TRA in both sexes. However, male subjects exhibited more pronounced acute within-session benefits from the ARRT method.

Pediatric Collagenous Gastroenteritis and Colitis Presenting as Protein-Losing Enteropathy.

There is a lack of literature on pediatric collagenous colitis. This is a report of a child with collagenous gastroenteritis and colitis who presented with chronic, nonbloody diarrhea and lower extremity edema secondary to protein-losing enteropathy. Collagenous colitis is rare in children; collagenous gastroenteritis and colitis are even less documented; and this diagnosis does not typically present with protein-losing enteropathy. The pediatric patient in this report had a presentation of a rare disease. Her disease self-resolved, and she has remained asymptomatic without pharmacologic intervention. This illness should be considered in a child presenting with this constellation of symptoms.

Perception of Bar Velocity Loss in Resistance Exercises: Accuracy Across Loads and Velocity Loss Thresholds in the Bench Press.

PURPOSE: Velocity-based training is used to prescribe and monitor resistance training based on velocity outputs measured with tracking devices. When tracking devices are unavailable or impractical to use, perceived velocity loss (PVL) can be used as a substitute, assuming sufficient accuracy. Here, we investigated the accuracy of PVL equal to 20% and 40% relative to the first repetition in the bench-press exercise. METHODS: Following a familiarization session, 26 resistance-trained men performed 4 sets of the bench-press exercise using 4 different loads based on their individual load-velocity relationships (∼40%-90% of 1-repetition maximum [1RM]), completed in a randomized order. Participants verbally reported their PVL at 20% and 40% velocity loss during the sets. PVL accuracy was calculated as the absolute difference between the timing of reporting PVL and the actual repetition number corresponding to 20% and 40% velocity loss measured with a linear encoder. RESULTS: Linear mixed-effects model analysis revealed 4 main findings. First, across all conditions, the absolute average PVL error was 1 repetition. Second, the PVL accuracy was not significantly different between the PVL thresholds (ß = 0.16, P = .267). Third, greater accuracy was observed in loads corresponding to the midportion of the individual load-velocity relationships (∼50%-60% 1RM) compared with lighter (<50% 1RM, ß = 0.89, P < .001) and heavier loads (>60% 1RM, 0.63 ≤ ß ≤ 0.84, all P values < .001). Fourth, PVL accuracy decreased with consecutive repetitions (ß = 0.05, P = .017). CONCLUSIONS: PVL can be implemented as a monitoring and prescription method when velocity-tracking devices are impractical or absent.

Personalizing Resistance Training Mitigates Neuromuscular and Perceived Fatigue: The Autoregulation Cluster Training Method.

PURPOSE: To compare predetermined and autoregulated resistance training sessions on velocity loss and perceived fatigue. METHODS: Twenty-six resistance-trained men completed 3 sessions including the back-squat and bench-press exercises matched for load (75% of 1-repetition maximum), volume (24 repetitions), and total rest (240 s). Sessions were randomly performed as traditional set (TRA), 3 sets of 8 repetitions with 120-second interset rests; cluster interset-rest redistribution (IRR), 6 clusters of 4 repetitions with 48-second between-clusters rests; and autoregulation cluster training (ACT), a personalized combination of clusters, repetitions per cluster, and between-clusters rest regulated on a velocity loss threshold. The comparative effects were evaluated on velocity loss outputs measured with a linear encoder and perceived fatigue responses reported using a single-item scale. RESULTS: IRR and ACT induced less velocity loss than TRA (b = -2.09, P < .001). ACT also mitigated velocity loss more than IRR (b = -2.31, P < .001). The back squat resulted in greater velocity loss compared to the bench press (b = 1.83, P < .001). Perceived fatigue responses mirrored the pattern observed for the velocity loss outputs (IRR and ACT vs TRA: b = -0.64, P < .001; ACT vs IRR: b = -1.05, P < .001; back squat vs bench press: b = 0.46, P = .005). CONCLUSIONS: IRR and ACT reduced neuromuscular and perceived fatigue, likely due to their cluster-set structures' embedding frequent windows of interset rest. However, the ACT was overall more effective, presumably given its personalized structure.

A plano-convex thick-lens velocity map imaging apparatus for direct, high resolution 3D momentum measurements of photoelectrons with ion time-of-flight coincidence.

Since their inception, velocity map imaging (VMI) techniques have received continued interest in their expansion from 2D to 3D momentum measurements through either reconstructive or direct methods. Recently, much work has been devoted to the latter of these by relating electron time-of-flight (TOF) to the third momentum component. The challenge is having a timing resolution sufficient to resolve the structure in the narrow (<10 ns) electron TOF spread. Here, we build upon the work in VMI lens design and 3D VMI measurement by using a plano-convex thick-lens (PCTL) VMI in conjunction with an event-driven camera (TPX3CAM) providing TOF information for high resolution 3D electron momentum measurements. We perform simulations to show that, with the addition of a mesh electrode to the thick-lens geometry, the resulting plano-convex electrostatic field extends the detectable electron cutoff energy range while retaining the high resolution. This design also extends the electron TOF range, allowing for a better momentum resolution along this axis. We experimentally demonstrate these capabilities by examining above-threshold ionization in xenon, where the apparatus is shown to collect electrons of energy up to ∼7 eV with a TOF spread of ∼30 ns, both of which are improved compared to a previous work by factors of ∼1.4 and ∼3.75, respectively. Finally, the PCTL-VMI is equipped with a coincident ion TOF spectrometer, which is shown to effectively extract unique 3D momentum distributions for different ionic species in a gas mixture. These techniques have the potential to lend themselves to more advanced measurements involving systems where the electron momentum distributions possess non-trivial symmetries.

Treatment of Inflammatory Bowel Disease and Pediatric Onset Multiple Sclerosis With Ocrelizumab and Ustekinumab in a JC-virus Positive Adolescent.

Inflammatory bowel disease (IBD) and multiple sclerosis (MS) are known to co-occur. Many disease modifying therapies for MS may exacerbate IBD and several carry risk of progressive multifocal leukoencephalopathy in JC-virus (JCV) positive patients. Some biologics used for IBD can exacerbate MS. These factors make comanagement of these diseases difficult. We report a 17-year-old female who presented with right leg weakness and paresthesia and was diagnosed with pediatric onset MS (POMS). She then had worsening abdominal pain and diarrhea, accompanied by weight loss, and was subsequently diagnosed with Crohn's disease. She was weakly JCV positive, so a short trial of natalizumab was initiated, which controlled her POMS well but not her IBD. Ustekinumab and ocrelizumab were initiated and achieved remission of both diseases. In the absence of established treatment guidelines, we recommend considering this combination of therapies for cases where standard treatment modalities are not viable options.

Occurrence, characterization, source, and risk assessment of petroleum-related hydrocarbons in sediments along St. Clair River, Ontario, Canada.

Total petroleum hydrocarbons (TPH), n-alkanes, petroleum biomarkers, and polycyclic aromatic hydrocarbons (PAHs) were analyzed in the sediments collected from the shorelines and bottom of St. Clair River, Ontario, Canada. Most of the sampling sites had low TPH (< 20 µg/g). River bottom sediment usually had higher level of TPHs, total alkanes, total biomarkers, and total PAHs than most of the shoreline ones. Mixed biogenic and petrogenic n-alkanes were present in all the sites. Most sites had trace amounts of petroleum biomarkers. Mixed pyrogenic and petrogenic inputs with the predominant petroleum, have contributed to the detected PAHs at all sampling sites. PAHs detected would not show potential toxicity to benthic organisms in all shoreline sampling sites; however, some light molecular weight PAHs (e.g., phenanthrene, 2-methyl naphthalene, and acenaphthylene) are anticipated to have possible adverse impacts to sediment-dwelling organisms in part of the river bottom sediment.

Human research ethics committees members: ethical review personal perceptions.

This study aims to characterise Human Research Ethics Committee (HREC) members' perceptions on five main themes associated with ethics reviews, namely, the nature of research, ethical/moral issues, assent, participants' risk and HREC prerogatives issues. Three hundred and sixteen HREC members from over 200 HRECs throughout Australia responded to an online questionnaire survey. The results show that in general, HREC members' beliefs are reasoned and align with sound principles of ethical reviews. There seems to be a disposition for living up to ethical/moral values, avoiding the issue of consent waivers and respecting participants' welfare, as well as a sense of ambiguity about HREC prerogatives. Problematic areas were a tendency towards over-valuing quantitative research methods for their perceived validity and a neutral view on issuing consent waivers to participants with intellectual disability and, finally, the belief that research that limits disclosure, plans deception or actively conceals is morally unjustifiable. Implications for professional development and policy-making are discussed.

Evening wear of blue-blocking glasses for sleep and mood disorders: a systematic review.

Blue-blocking glasses, also known as amber glasses, are plastic glasses that primarily block blue light. Blue-blocking glasses have been studied as a sleep intervention for insomnia, delayed sleep-phase disorder, shift work, jet lag, and nonpathologic sleep improvement. Blue-blocking glasses have also been studied as a treatment for bipolar disorder, major depression, and postpartum depression. Blue-blocking glasses improve sleep by inducing dim-light melatonin onset by reducing activation of intrinsically photosensitive retinal ganglion cells (ipRGCs) which are most sensitive to blue light and are a major input for circadian regulation; their mechanism for mood regulation is unclear but may be similar to that of dark therapy for bipolar disorder where patients are kept in darkness for an extended period every night. A systematic search of the scientific literature identified a total of 29 experimental publications involving evening wear of blue-blocking glasses for sleep or mood disorders. These consisted of 16 randomized controlled trials (RCTs) published in journals with a total of 453 patients, 5 uncontrolled trials, 1 case series, 1 case study, and 6 abstracts from conference proceedings. Only 1 case study and 1 RCT were for acutely manic patients but both found substantial decreases in manic symptoms with the use of blue-blocking glasses; these give preliminary clinical evidence of efficacy that makes blue-blocking glasses a high-yield intervention to study for bipolar disorder. Findings in the 3 publications for major depression and postpartum depression were heterogeneous and conflicting as to their efficacy. Out of the 24 publications focusing on sleep, there was substantial evidence for blue-blocking glasses being a successful intervention for reducing sleep onset latency in patients with sleep disorders, jet lag, or variable shift work schedules. Given the well-established biological mechanism and clinical research showing that blue-blocking glasses are effective for inducing sleep, they are a viable intervention to recommend to patients with insomnia or a delayed sleep phase.

Problems and Needs Persist for Oklahoma City Bombing Survivors Many Years Later.

BACKGROUND: This study assesses long-term physical and emotional symptoms and unmet needs in direct survivors of the 1995 Oklahoma City terrorist bombing 18 ½ years after the event. METHODS: A telephone questionnaire assessed psychiatric symptoms, health problems and coping strategies in 138 terrorism survivors (of whom 80% were physically injured) from a state registry of directly exposed persons, and 171 non-exposed community controls. Structured survey questions measured psychiatric symptoms, posttraumatic growth, general health problems and health care utilization. Open-ended questions explored survivors' most important terrorism-related problems and needs. Quantitative and qualitative data analysis methods were undertaken. RESULTS: Survivors reported similar rates of major health problems and general health care utilization, more anxiety and depression symptoms, and more ancillary health care use than controls on structured assessments. Survivors also reported posttraumatic growth, using several positive coping skills. Open-ended questions identified survivors' specific continuing bombing-related problems, and needs which were not disclosed on the questionnaire; these included many lasting physical injuries, health problems (especially hearing difficulties), specific posttraumatic stress disorder (PTSD) symptoms, other emotional symptoms, work and financial problems, interpersonal issues, and desires to help others. CONCLUSIONS: Results suggest that extended recovery services are needed long after terrorism exposure, and that open-ended assessment is useful to identify those requiring services.

A comparison between predetermined and self-selected approaches in resistance training: effects on power performance and psychological outcomes among elite youth athletes.

BACKGROUND: The aim of this study was to investigate if choice over resistance training exercise order affects motor performance and psychological outcomes among elite youth hockey players. METHODS: Seventeen elite hockey players (male, n = 14; female, n = 3, age: 15.1 ± 1.1 years) participated in this study. In the first session, individual optimum power loads were calculated in the back squat, jump squat, bench press and bench throw exercises. Then, in four counterbalanced sessions, participants completed three sets of six repetitions in the same exercises loaded with their optimum power loads. In two sessions, athletes used a self-selected order of exercises, while in other two sessions the order was predetermined. Power outputs were estimated with a linear position transducer. Fatigue and enjoyment were measured during and after the sessions using standardized questionnaires. Repeated measures analyses of variance and a paired-sample t-test were used to compare the effects between conditions. RESULTS: We observed trivial to small differences between conditions in power outputs (p ≥ 0.07; ES ≤ 0.21), fatigue (p ≥ 0.42; ES ≤ 0.33) and enjoyment (p = 0.72; ES = 0.05). CONCLUSION: Given the comparable effects between approaches, both can be used when coaching youth athletes. Self-selecting the order of exercises based on preferences is a feasible and practical coaching option when working with youth athletes.

Prevalence and Impact of Functional Abdominal Pain Disorders in Children With Inflammatory Bowel Diseases (IBD-FAPD).

OBJECTIVES: We sought to describe the prevalence of the overlap of functional abdominal pain disorders (FAPDs) in children with inflammatory bowel diseases (IBDs), a condition we have designated as IBD-FAPD. We also aimed to describe the psychological profile of this group, and to assess predictors of disease and the impact of IBD-FAPD on quality of life. METHODS: This cross-sectional prospective study included patients ages 8 to 18 years with a diagnosis of IBD. Disease activity was assessed by physician's global assessment, laboratory studies, and abbreviated Pediatric Crohn's Disease Activity Index or Pediatric Ulcerative Colitis Activity Index scoring. Age-appropriate validated questionnaires were used to diagnose FAPDs according to the Rome III criteria, depression, anxiety symptoms, and quality of life. RESULTS: There were 128 patients recruited. Eighty-one (63%) completed questionnaires (36 girls; 45 boys; mean age 14.4 ±â€Š2.6 years) (62 Crohn disease, 19 ulcerative colitis). The prevalence of IBD-FAPD in clinical remission was 26% (17 Crohn disease, 4 ulcerative colitis; 95% confidence interval: 20.6%-79.4%), with significantly more girls having IBD-FAPD (P = 0.038). Anxiety symptoms were in 14.3% of patients with IBD-FAPD (P = 0.06) and depression in 23.8% (P = 0.006). The average Pediatric Quality of Life Inventory Gastrointestinal Symptoms score for the IBD-FAPD group was significantly lower than those without FAPDs (71 vs 86.5, P = 0.008). CONCLUSIONS: In our cohort, the prevalence of IBD-FAPD was 26%. This is the first study to assess all FAPDs using the Rome III criteria and to demonstrate increased anxiety, depression, and worse quality of life in children with IBD-FAPD. The identification of patients predisposed to IBD-FAPD may allow implementing strategies that could improve symptoms and quality of life.

Repeat endoscopy affects patient management in pediatric inflammatory bowel disease.

OBJECTIVES: Endoscopy is commonly performed in the diagnosis of children with inflammatory bowel disease (IBD). The utility of repeat endoscopy for the management of pediatric IBD has not been subject to investigation. The frequency and determinants of changes in medical management resulting from endoscopy are unknown. METHODS: We conducted a cross-sectional cohort study to assess the frequency and determinants of management change in all children (0-21 years) who underwent endoscopy for the surveillance or evaluation of established IBD between July 2002 and July 2006 at 2 referral centers in the United States. Patients were sampled from the Pediatric Endoscopy Database System Clinical Outcomes Research Initiative and a chart review was performed to identify demographic features (age, gender), blood work (hemoglobin, albumin, erythrocyte sedimentation rate, C-reactive protein), and endoscopy results (endoscopic and histologic). An endoscopic score was used to assess mucosal injury. Subjects were divided into two groups for comparative analysis: (i) patients with management changes based on endoscopic or histologic findings, and (ii) patients without changes. RESULTS: We analyzed 285 endoscopic procedures (137 colonoscopies, 109 esophagogastroduodenoscopy (EGD) with colonoscopy, 25 sigmoidoscopies, 8 EGDs, 6 EGDs with sigmoidoscopy) performed in 230 children (mean age 14.5) with established IBD, including 147 with Crohn's disease, 80 with ulcerative colitis, and 3 with indeterminant colitis. Management changes were documented in 119 (42%) procedures, including 58 (20%) immediately after endoscopy, 52 (18%) after histology review, and 9 (3%) after both. Management changes included new medications in 86 cases, discontinuation of a medication in 3 cases, hospital admission in 11, and surgical consult in 14. No significant differences between groups occurred with regard to age, gender, endoscopy type, or infliximab use. The presence of anemia, hypoalbuminemia, or elevated markers of inflammation (ESR, CRP) did not correlate with management outcome. Management changes after endoscopy were more frequent in patients with Crohn's disease as compared to patients with ulcerative colitis. Patients with mucosal injury were more likely to have a management change than those with mucosal healing (80% vs. 20%; P<0.001). CONCLUSIONS: The overall rate of management change after endoscopic evaluation in children with IBD is approximately 42%. Addition of a new medication is the most common intervention. Blood work and patient symptoms before the procedure did not predict management outcome; however, mucosal healing may be an important end point. Our findings suggest that endoscopy is valuable for the evaluation of children with IBD.

Vacuum-assisted closure for radiation-associated wound complications.

BACKGROUND AND OBJECTIVES: Vacuum-assisted closure (VAC) technology has proven to be effective in the management of soft tissue loss from infections, vascular insufficiency, and traumatic disorders and may have a similar benefit in the musculoskeletal oncology patient. This study reports a single institution's experience with VAC technology in the management of radiation-associated wound complications in patients with soft tissue sarcomas. MATERIALS: Twenty-two patients treated with both surgical intervention and radiation therapy developed either superficial or deep wound complications that were managed with the VAC device. This study group was compared to a retrospectively identified comparison group of 19 patients, in which the VAC device was not used. RESULTS: Hospital stay (P < 0.025), length of overall treatment (P < 0.025), number of operative debridements (P < 0.05) and success of wound closure without the need for soft tissue transposition (P < 0.01) was found to be significantly less in the study groups as compared to those not treated with the VAC device. CONCLUSION: VAC technology appears to be safe and effective in the treatment of radiation-associated wound complications.

Transhepatic thrombolysis in acute portal vein thrombosis after laparoscopic splenectomy.

Portal vein thrombosis is a relatively rare clinical entity that can result in substantial morbidity and mortality. Because of the risk of intestinal infarction, acute symptomatic portal vein thrombosis requires prompt intervention. Traditional treatment has included anticoagulation and/or systemic thrombolytic therapy. We report the successful management of acute portal vein thrombosis with percutaneous transphepatic thrombolytic therapy. In addition to the potential for improving regional clot lysis through direct infusion of the thrombolytic agent, this method may result in fewer systemic side effects than occur with other available treatment modalities.