The Added Value of Musculoskeletal Simulation for the Study of Physical Performance in Military Tasks

The performance of military tasks is often exacerbated by additional load carriage, leading to increased physical demand. Previous studies showed that load carriage may lead to increased risk of developing musculoskeletal injuries, a reduction in task speed and mobility, and overall performance degradation. However, these studies were limited to a non-ambulatory setting, and the underlying causes of performance degradation remain unclear. To obtain insights into the underlying mechanisms of reduced physical performance during load-carrying military activities, this study proposes a combination of IMUs and musculoskeletal modeling. Motion data of military subjects was captured using an Xsens suit during the performance of an agility run under three different load-carrying conditions (no load, 16 kg, and 31 kg). The physical performance of one subject was assessed by means of inertial motion-capture driven musculoskeletal analysis. Our results showed that increased load carriage led to an increase in metabolic power and energy, changes in muscle parameters, a significant increase in completion time and heart rate, and changes in kinematic parameters. Despite the exploratory nature of this study, the proposed approach seems promising to obtain insight into the underlying mechanisms that result in performance degradation during load-carrying military activities.

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VTE risk assessment in cancer

Onkologische Welt ◽

10.1055/s-0038-1624994 ◽

2016 ◽

Vol 07 (01) ◽

pp. 20-25

Author(s):

I. Pabinger ◽

C. Ay

Keyword(s):

Risk Assessment ◽

Cancer Patients ◽

Medical Oncology ◽

Clinical Importance ◽

Cancer Surgery ◽

Ambulatory Setting ◽

Oncology Patients ◽

Related Factors ◽

Risk Assessment Models ◽

Increased Risk

SummaryVenous thromboembolism (VTE) in patients with cancer is associated with an increased morbidity and mortality, and its prevention is of major clinical importance. However, the VTE rates in the cancer population vary between 0.5% - 20%, depending on cancer-, treatment- and patient-related factors. The most important contributors to VTE risk are the tumor entity, stage and certain anticancer treatments. Cancer surgery represents a strong risk factor for VTE, and medical oncology patients are at increased risk of developing VTE, especially when receiving chemotherapy or immunomodulatory drugs. Also biomarkers have been investigated for their usefulness to predict risk of VTE (e.g. elevated leukocyte and platelet counts, soluble P-selectin, D-dimer, etc.). In order to identify cancer patients at high risk of VTE and to improve risk stratification, risk assessment models have been developed, which contain both clinical parameters and biomarkers. While primary thromboprophylaxis with lowmolecular- weight-heparin (LMWH) is recommended postoperatively for a period of up to 4 weeks after major cancer surgery, the evidence is less clear for medical oncology patients. Thromboprophylaxis in hospitalized medical oncology patients is advocated, and is based on results of randomized controlled trials which evaluated the efficacy and safety of LMWH for prevention of VTE in hospitalized medically ill patients. In recent trials the benefit of primary thromboprophylaxis in cancer patients receiving chemotherapy in the ambulatory setting has been investigated. However, at the present stage primary thromboprophylaxis for prevention of VTE in these patients is still a matter of debate and cannot be recommended for all cancer outpatients.

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Mechanisms underlying heart failure in type 2 diabetes mellitus

Heart and Metabolism - Heart Failure in patients with Diabetes ◽

10.31887/hm.2019.80/hbugger ◽

2019 ◽

pp. 37-39

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Experimental Studies ◽

Vascular Complications ◽

Molecular Alterations ◽

Increased Risk ◽

Cardioprotective Effects ◽

Underlying Mechanisms ◽

Cardio Vascular

The prevalence of heart failure is markedly increased in individuals with diabetes mellitus. Numerous observational studies suggest that this increased risk for heart failure can be attributed to exacerbated vascular complications and the presence of increased risk factors in diabetic subjects. In addition, experimental studies revealed the presence of a number of distinct molecular alterations in the myocardium that occur independently of vascular disease and hypertension. Many of these molecular alterations are similarly observed in failing hearts of nondiabetic patients and have thus been proposed to contribute to the increased risk for heart failure in diabetes. The interest in understanding the underlying mechanisms of impaired cardio- vascular outcomes in diabetic individuals has much increased since the demonstration of cardioprotective effects of SGLT-2 inhibitors and GLP-1 receptor agonists in recent clinical trials. The current review therefore summarizes the distinct mechanisms that have been proposed to increase the risk for heart failure in diabetes mellitus.

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Could Antioxidant Supplementation Delay Progression of Cardiovascular Disease in End-Stage Renal Disease Patients?

Current Vascular Pharmacology ◽

10.2174/1570161118666200317151553 ◽

2020 ◽

Vol 19 (1) ◽

pp. 41-54 ◽

Cited By ~ 1

Author(s):

Stefanos Roumeliotis ◽

Athanasios Roumeliotis ◽

Xenia Gorny ◽

Peter R. Mertens

Keyword(s):

Oxidative Stress ◽

Renal Disease ◽

End Stage Renal Disease ◽

Close Association ◽

Omega 3 ◽

Endstage Renal Disease ◽

Increased Risk ◽

Underlying Mechanisms ◽

Stage Renal Disease ◽

End Stage

In end-stage renal disease patients, the leading causes of mortality are of cardiovascular (CV) origin. The underlying mechanisms are complex, given that sudden heart failure is more common than acute myocardial infarction. A contributing role of oxidative stress is postulated, which is increased even at early stages of chronic kidney disease, is gradually augmented in parallel to progression to endstage renal disease and is further accelerated by renal replacement therapy. Oxidative stress ensues when there is an imbalance between reactive pro-oxidants and physiologically occurring electron donating antioxidant defence systems. During the last decade, a close association of oxidative stress with accelerated atherosclerosis and increased risk for CV and all-cause mortality has been established. Lipid peroxidation has been identified as a trigger for endothelial dysfunction, the first step towards atherogenesis. In order to counteract the deleterious effects of free radicals and thereby ameliorate, or delay, CV disease, exogenous administration of antioxidants has been proposed. Here, we attempt to summarize existing data from studies that test antioxidants for CV protection, such as vitamins E and C, statins, omega-3 fatty acids and N-acetylcysteine.

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Effect of an on-hip load-carrying belt on physiological and perceptual responses during bimanual anterior load carriage

Applied Ergonomics ◽

10.1016/j.apergo.2016.02.005 ◽

2016 ◽

Vol 55 ◽

pp. 133-137 ◽

Cited By ~ 4

Author(s):

Z.G. Gao ◽

S.Q. Sun ◽

R.S. Goonetilleke ◽

D.H.K. Chow

Keyword(s):

Load Carriage ◽

Load Carrying

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Genotoxicity and inflammatory potential of stainless steel welding fume particles: an in vitro study on standard vs Cr(VI)-reduced flux-cored wires and the role of released metals

Archives of Toxicology ◽

10.1007/s00204-021-03116-x ◽

2021 ◽

Author(s):

Sarah McCarrick ◽

Valentin Romanovski ◽

Zheng Wei ◽

Elin M. Westin ◽

Kjell-Arne Persson ◽

...

Keyword(s):

Dna Damage ◽

In Vitro Study ◽

Human Monocyte ◽

Welding Fumes ◽

Welding Fume ◽

Increased Risk ◽

Underlying Mechanisms ◽

Cored Wires

AbstractWelders are daily exposed to various levels of welding fumes containing several metals. This exposure can lead to an increased risk for different health effects which serves as a driving force to develop new methods that generate less toxic fumes. The aim of this study was to explore the role of released metals for welding particle-induced toxicity and to test the hypothesis that a reduction of Cr(VI) in welding fumes results in less toxicity by comparing the welding fume particles of optimized Cr(VI)-reduced flux-cored wires (FCWs) to standard FCWs. The welding particles were thoroughly characterized, and toxicity (cell viability, DNA damage and inflammation) was assessed following exposure to welding particles as well as their released metal fraction using cultured human bronchial epithelial cells (HBEC-3kt, 5–100 µg/mL) and human monocyte-derived macrophages (THP-1, 10–50 µg/mL). The results showed that all Cr was released as Cr(VI) for welding particles generated using standard FCWs whereas only minor levels (< 3% of total Cr) were released from the newly developed FCWs. Furthermore, the new FCWs were considerably less cytotoxic and did not cause any DNA damage in the doses tested. For the standard FCWs, the Cr(VI) released in cell media seemed to explain a large part of the cytotoxicity and DNA damage. In contrast, all particles caused rather similar inflammatory effects suggesting different underlying mechanisms. Taken together, this study suggests a potential benefit of substituting standard FCWs with Cr(VI)-reduced wires to achieve less toxic welding fumes and thus reduced risks for welders.

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Experience sampling research in psychopathology: opening the black box of daily life

Psychological Medicine ◽

10.1017/s0033291708004947 ◽

2009 ◽

Vol 39 (9) ◽

pp. 1533-1547 ◽

Cited By ~ 389

Author(s):

I. Myin-Germeys ◽

M. Oorschot ◽

D. Collip ◽

J. Lataster ◽

P. Delespaul ◽

...

Keyword(s):

Daily Life ◽

Experience Sampling ◽

Added Value ◽

Cross Sectional ◽

Gene Environment ◽

Psychological Models ◽

Research Findings ◽

Underlying Mechanisms ◽

New Research ◽

Momentary Assessment

A growing body of research suggests that momentary assessment technologies that sample experiences in the context of daily life constitute a useful and productive approach in the study of behavioural phenotypes and a powerful addition to mainstream cross-sectional research paradigms. Momentary assessment strategies for psychopathology are described, together with a comprehensive review of research findings illustrating the added value of daily life research for the study of (1) phenomenology, (2) aetiology, (3) psychological models, (4) biological mechanisms, (5) treatment and (6) gene–environment interactions in psychopathology. Overall, this review shows that variability over time and dynamic patterns of reactivity to the environment are essential features of psychopathological experiences that need to be captured for a better understanding of their phenomenology and underlying mechanisms. The Experience Sampling Method (ESM) allows us to capture the film rather than a snapshot of daily life reality of patients, fuelling new research into the gene–environment–experience interplay underlying psychopathology and its treatment.

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Deep vein thrombosis after monoclonal gammopathy of undetermined significance and multiple myeloma

Blood ◽

10.1182/blood-2008-04-151076 ◽

2008 ◽

Vol 112 (9) ◽

pp. 3582-3586 ◽

Cited By ~ 97

Author(s):

Sigurdur Y. Kristinsson ◽

Thomas R. Fears ◽

Gloria Gridley ◽

Ingemar Turesson ◽

Ulf-Henrik Mellqvist ◽

...

Keyword(s):

Multiple Myeloma ◽

Monoclonal Gammopathy ◽

First Year ◽

Small Hospital ◽

Entire Study ◽

Crude Incidence ◽

Vein Thrombosis ◽

Increased Risk ◽

Underlying Mechanisms ◽

Undetermined Significance

Patients with multiple myeloma (MM) have an increased risk of deep venous thrombosis (DVT), particularly when treated with immunomodulatory drugs. Recently, 2 small hospital-based studies observed persons with the MM precursor condition, monoclonal gammopathy of undetermined significance (MGUS), to be at increased risk of developing DVT. Among 4 196 197 veterans hospitalized at least once at US Veterans Affairs hospitals, we identified a total of 2374 cases of MGUS, and 39 272 persons were diagnosed with DVT (crude incidence 0.9 per 1000 person-years). A total of 31 and 151 DVTs occurred among MGUS and MM patients, respectively (crude incidence 3.1 and 8.7 per 1000 person-years, respectively; P < .01). Compared with the entire study population, the relative risk (RR) of DVT after a diagnosis of MGUS and MM was 3.3 (95% confidence interval [CI], 2.3-4.7) and 9.2 (95% CI, 7.9-10.8), respectively. The most prominent excess risk of DVT was found during the first year after diagnosis of MGUS (RR = 8.4; 95% CI, 5.7-12.2) and MM (RR = 11.6; 95% CI, 9.2-14.5). Among 229 MGUS cases (9.5%) that progressed to MM, only one person had a DVT diagnosis before transformation. Our findings suggest the operation of shared underlying mechanisms causing coagulation abnormalities among patients with MGUS and MM.

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Psychopathic Traits in Childhood: Insights from Parental Warmth and Fearless Temperament via Conscience Development

Brain Sciences ◽

10.3390/brainsci11070923 ◽

2021 ◽

Vol 11 (7) ◽

pp. 923

Author(s):

Laura López-Romero ◽

Olalla Cutrín ◽

Lorena Maneiro ◽

Beatriz Domínguez-Álvarez ◽

Estrella Romero

Keyword(s):

Psychopathic Traits ◽

Parental Warmth ◽

Mediation Effects ◽

Child Conduct Problems ◽

Effective Strategies ◽

Callous Unemotional ◽

Early Parenting ◽

Increased Risk ◽

Negative Effect ◽

Underlying Mechanisms

The role of psychopathic traits in predicting more serious and persistent patterns of child conduct problems has been well documented. The jointly presence of interpersonal (grandiose–deceitful), affective (e.g., callous–unemotional), and behavioral psychopathic traits (impulsive–need of stimulation) identifies a group of children at increased risk of psychosocial maladjustment. The present study aims to disentangle the underlying mechanisms by examining how early parenting (i.e., warmth) and child temperament (i.e., fearlessness) predict later psychopathic traits, via conscience development (CD). Data were collected in a large sample of children (n = 2.266; 48.5% girls), aged 3 to 6 at the onset of the study (Mage = 4.25; SD = 0.91), who were followed up one and two years later. The results showed direct effects from fearlessness to interpersonal and behavioral psychopathic traits. Parental warmth, fearless temperament, and their interaction, predicted CD, which, in turn, showed a negative effect on psychopathic traits. The indirect effects indicated significant negative mediation effects of warmth through CD on psychopathic traits, which seem to be stronger when children present lower levels of fearlessness. Overall, these results contribute to better understand the development of child psychopathic traits and provide additional insight on effective strategies that will help to restrain the potential development of a high-risk profile in early childhood.

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High-Level Disinfection in Ambulatory Care: Overcoming the Barriers of a Decentralized System through Auditing and Education

Antimicrobial Stewardship & Healthcare Epidemiology ◽

10.1017/ash.2021.21 ◽

2021 ◽

Vol 1 (S1) ◽

pp. s11-s11

Author(s):

Sonja Rivera Saenz

Keyword(s):

Infection Control ◽

Ambulatory Care ◽

Inventory Management ◽

Ambulatory Setting ◽

Infection Control Team ◽

Care Network ◽

Standard Work ◽

Increased Risk ◽

Control Team ◽

High Level

Background: High-level disinfection (HLD) of semicritical instruments in a multispecialty ambulatory care network has the potential for increased risk due to the decentralized instrument reprocessing and lack of a sterile processing department. Attention to HLD practices is an important part of device-borne outbreak prevention. Method: An HLD database was developed to identify specific departments and locations where HLD occurred across a 30-medical practice ambulatory care network in eastern Massachusetts, which included otolaryngology, urology, endoscopy, and obstetrics/gynecology departments. Based on qualitative feedback from managers and reprocessing staff, this database centralized information that included the supply inventory including manufacturer and model information, HLD methodology, standard work, and listing of competency evaluations. The infection control team then led audits to directly observe compliance with instrument reprocessing and a monthly-driven HLD calendar was developed to enforce annual competencies. Result: The results of the audits demonstrated variability across departments with gaps in precleaning, transportation of used instruments, the dilution of enzymatic cleaner, and maintenance of quality control logs. Given the uniqueness of shape and size of various ambulatory locations, proper storage and separation between clean and dirty spaces were common pitfalls. Auditing also revealed different levels of staff understanding of standard work and variable inventory management. Centralized education sessions held jointly by the infection control team and various manufacturers for the reprocessing staff helped to create and reinforce best practices. Conclusion: Decentralized HLD that occurs across multiple ambulatory care sites led to gaps in instrument reprocessing and unique challenges due to variable geography of sites, physical space constraints, and an independent approach to procuring medical supplies. Through the auditing and feedback of all areas that perform HLD, an effective and sustainable strategy was created to ensure practice improvement. Streamlining standard work, seeking direct input from frontline staff, and collective educational events were critical to our success in the ambulatory setting.Funding: NoDisclosures: None

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Alpha-1 blocker use increased risk of subsequent renal cell carcinoma: A nationwide population-based study in Taiwan

PLoS ONE ◽

10.1371/journal.pone.0242429 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242429

Author(s):

Shian-Ying Sung ◽

Trang Thi Huynh Le ◽

Jin- Hua Chen ◽

Teng-Fu Hsieh ◽

Chia-Ling Hsieh

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Proportional Hazards ◽

Population Based ◽

Cox Proportional Hazards ◽

Research Database ◽

Antihypertensive Medications ◽

Increased Risk ◽

Underlying Mechanisms

Elevated Renal cell carcinoma (RCC) risk has been associated with the use of several antihypertensive medications but has not yet been elucidated in the populations prescribed alpha-1 blockers that are commonly used in the treatment of hypertension and lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS-BPH). The aim of the present study was to investigate the association between alpha-1 blocker use and the risk of developing RCC using a nationwide population-based database in Taiwan. Patients who were treated with alpha-1 blockers for at least 28 days were identified through the Taiwan National Health Insurance Research Database from 2000 to 2010. The unexposed participants were matched with the exposed cases according to age, sex, and index year at a ratio of 3:1. Cox proportional hazards regression, stratified by sex and comorbidities and adjusted for age, was performed to estimate hazard ratios (HRs) for the risk of subsequent RCC. Among 2,232,092 subjects, patients who received alpha-1 blocker treatment had a higher risk of RCC than the unexposed group. Taking into account hypertension and BPH, the adjusted HR was significantly higher in male alpha-1 blocker users who had no BPH and either the presence (HR: 1.63, 95% confidence interval [CI] = 1.22–2.18) or absence (HR: 2.31, 95% CI = 1.40–3.81) of hypertension than in men not receiving these drugs. Taken together, male alpha-1 blocker users who had no comorbidity of BPH exhibited an increased risk for developing RCC independent of hypertension. Further study is warranted to elucidate the underlying mechanisms of this association.

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