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Energy generation from biomass is a promising alternative to fossil fuels since biomass resources are available in most parts of the world and offer great flexibility through their capacity for use in different forms of energy carriers. However, its cost-competitiveness remains difficult to assess due to the large variability of bioenergy costs, to which the cost of biomass feedstock contributes disproportionately. To address this issue, this paper evaluates the production cost of primary energy production from ligno-cellulosic biomass based on a literature review covering 106 references in academic and grey literature from 45 countries. Our data relate to five types of ligno-cellulosic biomass: managed forest, wood energy crops, grass energy crops, agricultural residues and forest residues. Our results provide insight into the variability of feedstock costs within and between biomass types. We found that the cost of residues from forestry and agriculture is significantly lower than the other biomass types. We did not find any significant difference between the cost of grass energy crops, wood energy crops and managed forest. Biomass grown in Europe is significantly more expensive than in other regions, while biomass grown in Latin America is significantly cheaper. • We review the production costs of ligno-cellulosic biomass in 45 countries. • The collected data covers five types of biomass worldwide. • There is significant variability in production costs within and between biomass types. • Biomass residues from agriculture and forestry have the lowest production cost. • Production costs are highest in Europe and lowest in Latin America. [ABSTRACT FROM AUTHOR]

Study Design:Randomized controlled trial.Objectives:To evaluate the effectiveness of the physical activity guidelines (PAG) for adults with spinal cord injury (SCI) to improve aspects of physical fitness.Setting:Community exercise facility.Methods:Twenty-three participants (age: 40.4±11.6 years, C1-T11, 12.0±10.0 years post injury) were randomized into PAG training (n=12) or active control (CON, n=11) groups. PAG training was 2x per week for 16 weeks and involved 20 min of aerobic exercise at a moderate to vigorous intensity and three sets of 10 repetitions (at 50-70% 1 repetition maximum; 1RM). Pre- and post-testing included peak exercise and aerobic endurance tests on an arm ergometer and 1RM testing.Results:Nineteen participants (PAG, n=11; CON, n=8) completed the 16-week training program and post-testing. There was a significant (P<0.05) increase in peak aerobic capacity (relative VO2peak: 17.2%, absolute VO2peak: 9.9%) and submaximal power output (26.3%) in the PAG group only. Increases in strength ranged from 11.5-38.9% and were significantly (P<0.05) different from CON for vertical bench press, seated row, and rickshaw press. Adherence to the exercise program was 85.2±8.3% for PAG, 44.4±34.3% for CON (P<0.01).Conclusion:The PAG for adults with SCI are sufficient to improve aspects of aerobic and muscular fitness and should be promoted as a means to improve physical capacity.Sponsorship:Ontario Neurotrauma Foundation (ONF), Natural Sciences and Engineering Research Council (NSERC) of Canada. [ABSTRACT FROM AUTHOR]

Study design:Cross-sectional.Objectives:To evaluate exercise equipment preferences and compare cardiometabolic demand for passive hybrid and arm-only exercise among adults with paraplegia (PP) and those with tetraplegia (TP).Setting:Four community exercise programmes.Methods:Thirty-six adults (mean age: 41.1±12.1 years) with chronic (11.4±10.7 years post injury) TP (C3-C8; n=17) or PP (T3-T12; n=19) were recruited. Participants completed 20 min of submaximal aerobic exercise at moderate to vigorous intensity on four types of aerobic exercise equipment: arm cycle ergometer (ACE), arm glider (AG), arm-leg recumbent stepper (ALRS), and arm-leg cycle ergometer (ALCE). Participants also completed 3 sets of 10 repetitions of resistance exercise using wall pulleys (WP) and weight stack (WS) equipment. A questionnaire was administered to evaluate equipment preference. Heart rate (HR) and oxygen uptake (VO2) were measured in a subset of participants (n=9) during submaximal aerobic exercise.Results:Arm-only exercise modes were perceived as being safer than passive hybrid exercise modes. There were no differences in perceived enjoyment between equipment types and groups. There were significant group but not equipment differences in HR (TP: 101.4 bpm; PP: 124.9 bpm) and VO2 (TP: 6.5 ml•kg−1•min−1; PP: 10.5 mL•kg−1•min−1) during submaximal aerobic exercise.Conclusion:In this cross-community assessment of exercise equipment preferences after spinal cord injury (SCI), arm-only exercise modes were perceived as safer than hybrid exercise modes and there were no differences between equipment types in physiological responses. [ABSTRACT FROM AUTHOR]

Study design:Sixteen-week follow-up study.Objective:To evaluate the efficacy of referral from a health-care provider to regular exercise combined with 16 weeks of counselling support following discharge from inpatient or outpatient spinal cord injury (SCI) rehabilitation.Setting:Two rehabilitation centres in Canada.Methods:Seventeen participants (age 42.1±10.6 years, C3-T12, ASIA impairment score A-C) were recruited at discharge from inpatient (n=9; 5.2±1.3 months post-injury) or outpatient (n=8; 14.2±3.8 months post-injury) rehabilitation and were given a referral for regular exercise. Telephone counselling support was provided and adherence to the prescribed program was monitored for 16 weeks.Results:There was a nonsignificant difference in exercise adherence rates (percentage of available sessions attended) between participants discharged from inpatient (71.4±44.9%) and those from outpatient (39.5±27.2%) rehabilitation programs. The most common barriers to participation were physical health problems (50%) and transportation (36%). An exercise beliefs questionnaire revealed that participants value exercise at discharge from rehabilitation, despite the common report of a relative lack of confidence in their ability to perform or adapt aerobic and resistance exercises to their specific capabilities.Conclusion:A system of direct referral and ongoing counselling support following discharge from either inpatient or outpatient SCI rehabilitation appears to encourage sustained participation, although future health promotion strategies should continue to provide specific information about how to adapt and complete aerobic and resistance exercises.Sponsorship:Rick Hansen Institute and Ontario Neurotrauma Foundation. [ABSTRACT FROM AUTHOR]

Study design:The study design used is cross-sectional.Objectives:The aim of this study is to examine muscle contractile and excitability characteristics during fatigue of the tibialis anterior in six individuals with chronic spinal cord injury (SCI) and matched able-bodied (AB) controls.Setting:McMaster University, Hamilton, ON, Canada.Methods:Muscle compound action potential (M-wave) characteristics, muscle twitch properties, and summated force were examined during a 2 min fatigue protocol of intermittent bursts at 30 Hz (4 s tetanus, 2 s rest) or maximal voluntary contraction (MVC). Evoked twitch responses were followed during a recovery period.Results:M-wave amplitude was smaller in SCI (2.5±1.6 mV in SCI, 5.7±3.2 mV in AB) at baseline, but there was no change in M-wave amplitude or area during fatigue in either group. There was an increase in M-wave duration toward the end of recovery in the SCI group. Peak torque (PT) was not different between groups at baseline (3.8±1.8 Nm in SCI, 3.7±0.6 Nm in AB); PT potentiated significantly during fatigue in the AB, but not SCI group. There was significantly greater fatigue of both PT (43% decline) and summated force (57% decline) in the SCI group compared with the AB group (13% increase and 22% decline for PT and MVC, respectively).Conclusion:The dorsiflexor muscles in people with SCI are significantly more fatiguable than those in AB controls, but decreases in muscle excitability do not seem to be an important contributor to the increased fatiguability. The mechanisms behind the increased fatigue must lie distal to the muscle membrane. [ABSTRACT FROM AUTHOR]

Abstract: Diffuse optical imaging uses light to provide a surrogate measure of neuronal activation through the hemodynamic responses. The relative low absorption of near-infrared light enables measurements of hemoglobin changes at depths reaching the first centimeter of the cortex. The rapid rate of acquisition and the access to both oxy and deoxy-hemoglobin leads to new challenges when trying to uncouple physiology from the signal of interest. In particular, recent work provided evidence of the presence of a 1/f noise structure in optical signals and showed that a general linear model based on wavelets can be used to decorrelate the structured noise and provide a superior estimator of response amplitude when compared with conventional techniques. In this work the wavelet techniques are extended to recover the full temporal shape of the hemodynamic responses. A comparison with other models is provided as well as a case study on finger-tapping data. [Copyright &y& Elsevier]

Study design:A cross-sectional design.Objectives:To examine the length–tension relationship of dorsiflexion (DF) and plantarflexion (PF) muscle groups in seven individuals with chronic spinal cord injury (SCI; C2–T7; age 43±10.1 years) and compare it with a group of age and sex-matched able-bodied (AB) controls.Setting:McMaster University, Hamilton, ON, Canada.Methods:Isometric single twitch properties, 0.5-s tetanic contractions (SCI) and maximal voluntary contractions (AB) were measured at nine joint angles from 20° DF to 20° PF.Results:In the DF muscles, peak-evoked twitch (PT) torque occurred at 20° PF for SCI (3.4±1.1 N m) and AB (3.8±1.4 N m) with no difference in peak torque between groups, whereas peak summated force occurred at 10° PF in AB and 20° PF in SCI (P<0.01). In the PF muscles, PT torque occurred at 15° DF in AB (18.6±2.6 N m) and at 5° DF (6.8±3.3 N m; P<0.01) in SCI, and peak-summated force occurred at 15° DF in AB. The SCI group did not show any change in PF peak-summated force with varying joint angles. Rates of contraction and relaxation were not different between the two groups.Conclusions:The results suggest a significant change in the length–tension relationship of the PF muscles after SCI, but no change in the DF muscle group. Rehabilitation programs should focus on maintaining PF muscle length in order to optimize muscle strength and function after SCI. [ABSTRACT FROM AUTHOR]

This paper describes the development of the contact area during indentation of polycarbonate. The contact area was measured in situ using an instrumented indentation microscope and compared with numerical simulations using an elasto-plastic constitutive model. The parameters in the model were obtained using macroscopic tests. Indentations were performed on samples with different thermal histories and at different speeds. For all cases, the numerical model correctly predicted the development of the contact area during indentation. For increasing strain rates, the contact area decreased at equal indentation depths. Annealing the samples resulted in a smaller contact area at equal indentation depth. Using only numerical simulation, it was also shown that pile-up around the indenter resulted from localization effects and was, thus, promoted by strain-softening properties of the indented material. Strain hardening, on the other hand, will tend to promote sink-in. Finally, we performed simulations of load relaxation during indentation. The results indicate that about 40% of the total observed relaxation may be assigned to plastic effects. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: We propose a simple methodology for heterogeneous data collection and central repository-style database design in healthcare. Our method can be used with or without other software development frameworks, and we argue that its application can save a relevant amount of implementation effort. Also, we believe that the method can be used in other fields of research, especially those that have a strong interdisciplinary nature. Background: The idea emerged during a healthcare research project, which consisted among others in grouping information from heterogeneous and distributed information sources. We developed this methodology by the lessons learned when we had to build a data repository, containing information about elderly patients flows in the UK''s long-term care system (LTC). Design: We explain thoroughly those aspects that influenced the methodology building. The methodology is defined by six steps, which can be aligned with various iterative development frameworks. We describe here the alignment of our methodology with the RUP (rational unified process) framework. The methodology emphasizes current trends, as early identification of critical requirements, data modelling, close and timely interaction with users and stakeholders, ontology building, quality management, and exception handling. Results: Of a special interest is the ontological engineering aspect, which had the effects with the highest impact after the project. That is, it helped stakeholders to perform better collaborative negotiations that brought better solutions for the overall system investigated. An insight into the problems faced by others helps to lead the negotiators to win-win situations. We consider that this should be the social result of any project that collects data for better decision making that leads finally to enhanced global outcomes. [Copyright &y& Elsevier]

A good estimate of the length of stay (LOS) of elderly people in institutional long-term care (ILTC) is essential to both care providers (care home owners) and purchasers (local authorities in the UK) in order to forecast their resource availability and future requirements. Existing methods usually rely on cohort data, which needs to be collected on a continuous basis for several years and are often not available electronically. In this paper we develop an approach based on multi-census data to fit a Markov model in continuous-time for the LOS of elderly people in ILTC (residential and nursing care), We use 3 year placement data provided by London Borough of Merton Social Services to compare the estimates of the model parameters obtained using multi-census data with those derived from cohort data, hence to validate the multi-census approach in this context. The implications of the proposed multi-census approach and its advantages in the context of long-term care planning are discussed. [ABSTRACT FROM AUTHOR]

A microbial survey of 27 activated sludge (AS) systems included 16 conventional activated sludge (CAS) systems, five sequential batch reactors (SBR) and six oxygen-activated sludge (OAS) systems, all treating pulp and paper effluents. The most prevalent filaments observed were Thiothrix (26%) and Type 021N (22%). The designs of the activated sludge systems seemed to have an effect on the filament types. We found Thiothrix to be the most common filament associated with bulking. For CAS systems, a completely mixed mode of operation promoted Thiothrix and Type 021N growth. Type 021N was favoured in CAS systems with food to microorganism (F/M) ratios higher than 0.2, and with dissolved oxygen (DO) residuals higher than 2 ppm, while Thiothrix generally proliferated at lower F/M ratio and DO residuals. Nutrient deficiencies as well as nutrient dosage variations were suspected in most of the systems having Thiothrix and Type 021N as the most prevalent filaments. Thiothrix appeared to prefer polyphosphate and/or ammonia rather than urea/phosphoric acid as N and P sources. Systems with aerobic selectors showed the lowest filament counts, while systems with no selectors showed the highest filament counts. [ABSTRACT FROM AUTHOR]

The main objective of this study was to investigate the potential impact of body organochlorine (OC) pollution on the adaptive change in thermogenesis induced by body weight loss. Fat mass (FM), fat-free mass (FFM), and sleeping metabolic rate (SMR) were measured in obese individuals before and after a weight-reducing program. The measured values of SMR were then compared to those predicted from a reference equation established from FM and FFM in control subjects. Plasma OC, leptin, total tri-iodothyronine, and free thyroxine concentrations were also measured in obese subjects before and after weight loss. After weight loss, the measured decrease in SMR was greater than that predicted by changes in FM and FFM. Increased plasma OC concentration was the factor explaining the greatest proportion of the difference between predicted and measured SMR changes induced by body weight loss. OC pollution seems to be a new factor affecting the control of thermogenesis in some obese individuals experiencing body weight loss.International Journal of Obesity (2004) 28, 936-939. doi:10.1038/sj.ijo.0802527 Published online 18 May 2004 [ABSTRACT FROM AUTHOR]

Summary Organochlorines are fat-soluble chemical compounds resistant to degradation, so they are stored in the adipose tissue of practically every organism on the planet, including humans. Accumulation of these compounds in the body seems to be related to fat mass, obese individuals having a higher plasma organochlorine concentration than lean subjects. During body weight loss, lipid mobilization and a decrease in fat mass result in increased concentrations of organochlorines in plasma and adipose tissue. Organochlorines may have adverse health effects. For example, they have been associated with altered immune and thyroid functions and with some types of cancer. As these compounds may reach their target organs whilst in the circulation, their increase in plasma during weight loss might be associated with some physiological changes occurring during weight loss. Relationships have indeed been reported among weight loss-induced increase in plasma organochlorine concentration and decreased triiodothyronine (T3 ) concentration, resting metabolic rate, and skeletal muscle markers for fat oxidation. Although further studies are needed to assess the causality of these relationships, they raise concern about some potential undesirable effects of weight loss. Indeed, the effects of organochlorines on energy balance could complicate body weight loss and even favour weight regain. These notions lend support for weight-loss strategies favouring a moderate weight loss, which would reduce risks for cardiovascular diseases, diabetes and hypertension, without resulting in a substantial release of organochlorines. [ABSTRACT FROM AUTHOR]

A colony immunoblotting method has been developed to allow detection of the probiotic Bifidobacterium animalis strain DN-173 010 in human faecal samples. Rabbits were immunized with heat-killed DN-173 010 bacteria resulting in the production of an antiserum highly specific for bacteria belonging to Bif. animalis species. Of the 89 strains representative of 29 different bifidobacterial species tested, only the 15 strains of the Bif. animalis species could be detected with the antiserum. In Western immunoblotting the serum reacts with a protein of 45-kDa apparent molecular weight. None of the bacteria classically encountered in human faecal samples and able to grow on non-selective Columbia blood agar (enterobacteria, Bacteroides or Lactobacillus for instance) reacted with the antiserum. Taking advantage of the high specificity of the antiserum and of the absence of Bif. animalis bacteria in faeces samples of five human volunteers, we demonstrated that strain DN-173 010 survives the intestinal transit. Being based on a combination of semiselective cultivation and colony immunoblotting techniques, the method allowed detection of the Bif. animalis strain even when it represented only one thousandth of the total bifidobacterial population. [ABSTRACT FROM AUTHOR]

This multi-stage study aimed to design and validate a patient treatment acceptability outcome measure that is fit-for-purpose across the psoriasis disease severity spectrum. Stage 1 involved a group concept mapping (GCM) exercise to explore and understand patient perspectives and unmet needs in psoriasis treatment in patients newly diagnosed with mild psoriasis. This study aimed to develop a measure across the psoriasis disease severity spectrum that would bolster patient and clinician communication on treatment expectations. [Extracted from the article]

We report a new case of acute necrotizing oesophagitis, diagnosing on a patient hospitalised in intensive care unit. This pathology is still a rare event; the definition excludes patients with a history of recent caustic ingestion. Oesophageal necrosis can be diagnosed at endoscopy by the presence of black necroting appearing oesophagus. Contrary to the caustic oesophagitis whose treatment is often surgical, treatment of the acute necrositing oesophagitis is primarily medical. The prognosis for patients who develop acute necrotizing oesophagitis is generally poor, even if one can hope for the cure without after-effect of it. [Copyright &y& Elsevier]

Introduction Rendre la vaccination plus « acceptable » par les populations est un enjeu de santé publique. Les épidémies récentes de rougeole sont liées à une baisse de la couverture vaccinale. Dans ce contexte nous développons le concept de la vaccination personnalisée. En effet, la seconde dose (rattrapage) de vaccin rougeole n’est justifiée que pour ceux qui n’ont pas répondu à la première dose. Un nombre élevé d’enfants reçoivent ainsi une dose inutile. Nous avons développé un test rapide destiné à discriminer les personnes justifiant de la seconde dose de vaccin. Nous présentons les performances du premier test rapide mondiale rougeole, entièrement développé en France. Matériels et méthodes Les patients inclus venaient pour un contrôle sérologique (ex : HBV). Leur statut vaccinal était attesté par un carnet de vaccination. Chaque patient a eu un prélèvement capillaire pour réalisation du test rapide. La lecture du résultat (à 15 min) était réalisée de façon indépendante par deux opérateurs. Le prélèvement sanguin veineux a permis la réalisation du test quantitatif de référence (Liaison Measles ® ). Les données ont été analysées à l’aide du logiciel R. Les mesures de sensibilité et spécificité ont été déterminées au seuil de 16,5 UA/mL correspondant à 175 UI/mL, taux protecteur selon l’OMS. Résultats Au total, 139 personnes ont été incluses dans l’étude. Deux jamais vaccinées, 24 avaient reçu une seule dose, 82 avaient reçu 2 doses, 2 avaient reçu 3 doses, 16 avaient présenté une rougeole dans l’enfance et 13 étaient indéterminés. Au total, 79 % des personnes ayant eu une seule dose dans l’enfance et 88 % de ceux ayant eu 2 doses étaient protégés au seuil de 175 UI/mL (taux d’efficacité vaccinale). La sensibilité et la spécificité du test rapide étaient respectivement de 66,7 % (IC 95 % : 58,2 %–75,1 %) et de 96,7 % (90,5 %–100 %), la VPP était de 98,7 % et le rapport de vraisemblance positif et négatif étaient respectivement 12,6 et 0,35 témoignant d’une très forte liaison entre le test rapide et la présence d’IgG (coef Yule : 0,95). Pour les personnes n’ayant reçu qu’une dose de vaccin ( n = 24), 19 avaient un taux d’IgG > 175 UI/mL (79 %) : le test rapide était négatif pour 10 d’entre eux. Cinq (21 %) avaient un taux d’IgG < 175 UI/mL : parmi eux, aucun test rapide n’était positif. Conclusion Le test Biosynex Measles présente des performances techniques prometteuses. Tous les patients non immuns après une dose avaient un test rapide négatif et seraient éligibles pour la seconde dose. Au total, 52 % des patients immunisés après une dose recevraient une seconde dose versus 79 % selon la stratégie vaccinale actuelle. Si les performances du test étaient confirmées à plus large échelle, en France, sur 800 000 naissances annuelles le test rapide permettrait d’éviter 300 000 vaccinations. [ABSTRACT FROM AUTHOR]

State‐of‐the‐art climate models rely on bulk formulae arising from the Monin–Obukhov semi‐empirical theory to estimate turbulent air–sea fluxes. The mathematical structure of those formulae implies several difficulties when trying to study the numerical properties of coupling algorithms used for practical applications. This article introduces a methodology for building physically realistic approximations of existing bulk formulae which would also satisfy suitable mathematical properties (explicit character, regularity, differentiability). This is achieved by applying the Sobol' method to compute sensitivity indices in order to reduce the number of inputs and derive a simple metamodel for the parametrization of turbulent air–sea fluxes. Numerical results show excellent agreement between our approximations and the standard bulk formulae. In particular, single‐column simulations using the TOGA–COARE experiment within the LMDZ atmospheric model show negligible changes in numerical results. [ABSTRACT FROM AUTHOR]

Objective: Although reported to be effective as a performance validity test (PVT) in TBI and ADHD, little is known about the ability of the CPT-II to model performance validity in psychiatric patients. Also, while repeat CPT-II administrations have been shown to enhance its diagnostic accuracy in ADHD evaluations, the effect of such strategic redundancy on validity assessment is largely unknown. Method: CPT-II subtests previously identified as embedded PVTs (ePVTs) were systematically tested in a sample of 30 patients with a variety of psychiatric conditions but without credible evidence of neuropsychological impairment. Neurocognitive profiles were classified as valid (n = 18) and invalid (n = 12) using a composite measure based on 20 independent PVTs. The CPT-II was administered twice, at the beginning and at the end of the testing session. Results: Significant improvement in signal detection properties was observed from Time 1 to Time 2 for Commission T ≥ 60, Perseveration T ≥ 70, Variability T ≥ 60 and the combination of Commission T ≥ 60 and Variability T ≥ 60. No difference was found for Omission T ≥ 80 and Hit RT T ≥ 60. Negligible loss in sensitivity was noted on Hit RT SE T ≥ 90. Conclusion(s): Results suggest that the ePVTs in the CPT-II developed in TBI and ADHD samples generalize to other clinical populations. Furthermore, invalid neuropsychological profiles are common in psychiatric patients (40% of the current sample). Finally, repeating the CPT-II or administering it later during the day tends to improve its signal detection properties as a PVT. [ABSTRACT FROM AUTHOR]

The article examines the vertical component of the ground reaction force reflecting in the inertial and gravitational loading forces and time distance parameters. It mentions the estimated fore parameters such as initial impact peak force (PKF) and tolerance to impact. It states that to keep a safe and efficient running pattern, strategies were provided to and from unweighing phases. It also emphasizes the necessity to lighten the lower limb muscles extensors for limb kinematic control.

In France, a national surveillance plan to monitor congenital Schmallenberg virus (SBV) outbreaks was set up in January 2012, and has shown that SBV had become widespread throughout the country since mid-2011. However, the number of SBV-infected farms cannot accurately be estimated through congenital SBV reporting alone. Therefore, GDS France (National Animal Health Farmers' Organization) conducted serological investigations in cattle and sheep holdings in several departments in spring 2012 to assess SBV exposure in 2011. A serological study was also conducted in the department of Saône-et-Loire (southern Burgundy) to establish an accurate local overview of circulation of virus in 2011 among cattle. The study was conducted following guidelines elaborated by the French Platform for animal health surveillance. Results indicated differences in within-herd seroprevalence between cattle herds and sheep herds in departments where outbreaks of congenital SBV were reported in early 2012 and a great heterogeneity in seroprevalence between areas (even between areas geographically close to each other). In departments which had been severely affected in early 2012, the overall impact of SBV infection in cattle herds during the 2012-2013 calving season will probably be low. On the other hand, given the low proportion of immunised ewes in sheep SBV outbreaks, sheep flocks which were already affected in early 2012 may once again face congenital cases of SBV [ABSTRACT FROM AUTHOR]

Study design:Systematic review.Objectives:To conduct a systematic review of evidence surrounding the effects of exercise on physical fitness in people with spinal cord injury (SCI).Setting:Canada.Methods:The review was limited to English-language studies (published prior to March 2010) of people with SCI that evaluated the effects of an exercise intervention on at least one of the four main components of physical fitness (physical capacity, muscular strength, body composition and functional performance). Studies reported at least one of the following outcomes: oxygen uptake/consumption, power output, peak work capacity, muscle strength, body composition, exercise performance or functional performance. A total of 166 studies were identified. After screening, 82 studies (69 chronic SCI; 13 acute SCI) were included in the review. The quality of evidence derived from each study was evaluated using established procedures.Results:Most studies were of low quality; however, the evidence was consistent that exercise is effective in improving aspects of fitness. There is strong evidence that exercise, performed 2-3 times per week at moderate-to-vigorous intensity, increases physical capacity and muscular strength in the chronic SCI population; the evidence is not strong with respect to the effects of exercise on body composition or functional performance. There were insufficient high-quality studies in the acute SCI population to draw any conclusions.Conclusions:In the chronic SCI population, there is good evidence that exercise is effective in improving both physical capacity and muscular strength, but insufficient quality evidence to draw meaningful conclusions on its effect on body composition or functional capacity. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We sought to assess the impact of the integration of the new roles of primary health care nurse practitioners (NPs) and physician assistants (PAs) on patient flow, wait times and proportions of patients who left without being seen in 6 Ontario emergency departments (EDs). METHODS: We performed a retrospective review of health records data on patient arrival time, time of initial assessment by a physician, time of discharge from the ED and discharge status. RESULTS: Whether a PA or NP was directly involved in the care of patients or indirectly involved by being on duty, the wait times, lengths of stay and proportion of patients who left without being seen were significantly reduced. When a PA or NP were directly involved in patients' care, patients were 1.6 (95% confidence interval [CI] 1.3-2.1, p < 0.05) and 2.1 (95% CI 1.6-2.8, p < 0.05) times more likely to be seen within the wait time benchmarks, respectively. Lengths of stay were 30.3% (95% CI 21.6%-39.0%, p < 0.01) and 48.8% (95% CI 35.0%-62.7%, p < 0.01) lower when PAs and NPs, respectively, were involved. When PAs and NPs were not on duty, the proportion of patients who left without being seen were 44% (95% CI 31%-63%, p < 0.01) and 71% (95% CI 53%-96%, p < 0.05), respectively. CONCLUSION: The addition of PAs or NPs to the ED team can improve patient flow in medium-sized community hospital EDs. Given the ongoing shortage of physicians, use of alternative health care providers should be considered. These results require validation, as their generalizability to other locations or types of EDs is not known. [ABSTRACT FROM AUTHOR]

Abstract: We report a 69-year-old man admitted in intensive care unit for aseptic meningoencephalitis. Initially, suspicion of an infectious etiology led to introduce an anti-infectious treatment. Behçet''s disease was diagnosed during hospitalization incited to screen for noninfectious etiologies. A high dose steroid therapy was rapidly effective. The diagnosis of neuro-Behçet''s disease was entertained. [Copyright &y& Elsevier]

Flat-tip micro-indentation tests were performed on quenched and annealed polymer glasses at various loading speeds. The results were analyzed using an elasto-viscoplastic constitutive model that captures the intrinsic deformation characteristics of a polymer glass: a strain-rate dependent yield stress, strain softening and strain hardening. The advantage of this model is that changes in yield stress due to physical aging are captured in a single parameter. The two materials studied (polycarbonate (PC) and poly(methyl methacrylate) (PMMA)) were both selected for the specific rate-dependence of the yield stress that they display at room temperature. Within the range of strain rates experimentally covered, the yield stress of PC increases linearly with the logarithm of strain rate, whereas, for PMMA, a characteristic change in slope can be observed at higher strain rates. We demonstrate that, given the proper definition of the viscosity function, the flat-tip indentation response at different indentation speeds can be described accurately for both materials. Moreover, it is shown that the model captures the mechanical response on the microscopic scale (indentation) as well as on the macroscopic scale with the same parameter set. This offers promising possibilities of extracting mechanical properties of polymer glasses directly from indentation experiments. [ABSTRACT FROM AUTHOR]

Disease-modifying therapies (DMTs) can reduce multiple sclerosis (MS) relapse rates; however, effectiveness of treatments may vary. We describe MS relapses related to treatment patterns among patients who switch treatment after their first DMT. [Extracted from the article]

In all, 1,645 biologic-naive psoriasis patients initiating apremilast were matched to 1,645 biologic-naive psoriasis patients initiating biologics (TNF: n=1,207; IL: n=438). Biologic-naive psoriasis patients initiating apremilast had significantly lower healthcare costs than patients initiating TNF and IL inhibitors. [Extracted from the article]

Disease-modifying therapies (DMTs) can reduce multiple sclerosis (MS) relapse rates; understanding treatment patterns and effectiveness in relapse reduction across all available DMTs using real-world data is important. We describe treatment patterns and post-DMT initiation relapses stratified by the number of pre-initiation relapses among newly treated MS patients overall, and by treatment. [Extracted from the article]

Astaxanthin (ASTX) is a keto carotenoid, which possesses a non-polar linear central conjugated chain and polar β-ionone rings with ketone and hydroxyl groups at the extreme ends. It is well known as a super anti-oxidant, and recent clinical studies have established its nutritional benefits. Although it occurs in several forms, including free molecule, crystalline, aggregates and various geometrical isomers, in nature it exists primarily in the form of esters. Marine animals accumulate ASTX from primary sources such as algae. Nordic shrimps (P. borealis), which are harvested widely in the Atlantic Ocean, form a major source of astaxanthin esters. “Astaxanthin-rich shrimp oil” was developed as a novel product in a shrimp processing plant in Eastern Canada. A compositional analysis of the shrimp oil was performed, with a view to possibly use it as a nutraceutical product for humans and animals. Astaxanthin-rich shrimp oil contains 50% MUFAs and 22% PUFAs, of which 20% are omega-3. In addition, the shrimp oil contains interesting amounts of EPA and DHA, with 10%/w and 8%/w, respectively. Astaxanthin concentrations varied between 400 and 1000 ppm, depending on the harvesting season of the shrimp. Astaxanthin and its esters were isolated from the oil and analysed by NMR, FTIR and Micro-Raman spectroscopy. Astaxanthin mono- and diesters were synthesized and used as standards for the analysis of astaxanthin-rich shrimp oil. NMR and vibrational spectroscopy techniques were successfully used for the rapid characterization of monoesters and diesters of astaxanthin. Raman spectroscopy provided important intermolecular interactions present in the esterified forms of astaxanthin molecules. Also discussed in this paper is the use of NMR, FTIR and Micro-Raman spectroscopy for the detection of astaxanthin esters in shrimp oil. [ABSTRACT FROM AUTHOR]

Background: We previously identified a functional variant in a let-7 microRNA (miRNA) complementary site in the 3'-untranslated region of the KRAS oncogene (rs61764370) which is associated with cancer. We aimed to investigate the association of this KRAS variant with breast cancer and tumour biology.Methods: We assessed frequency distributions of the KRAS variant in 415 patients with histologically confirmed breast cancer and 457 controls from Connecticut, USA (study group 1) and association of this variant with breast-cancer subtypes in 690 Irish women with known oestrogen receptor (ER), progesterone receptor (PR), and HER2 statuses, and 360 controls (study group 2). We pooled data for study groups 1 and 2 with a cohort of 140 women with triple-negative breast cancer and 113 controls to assess the association of the KRAS variant with triple-negative breast cancer risk, and genome-wide mRNA and specific miRNA expression in patients with triple-negative breast cancer.Findings: Although frequency distributions of the KRAS variant in study group 1 did not differ between all genotyped individuals, eight (33%) of 24 premenopausal women with ER/PR-negative cancer had the KRAS variant, compared with 27 (13%) of 201 premenopausal controls (p=0.015). In study group 2, the KRAS variant was significantly enriched in women with triple-negative breast cancer (19 [21%] of 90 cases) compared with 64 (13%) of 478 for luminal A, 13 (15%) of 87 for luminal B, and two (6%) of 35 for HER2-positive subgroups (p=0.044). Multivariate analysis in the pooled study groups showed that the KRAS variant was associated with triple-negative breast cancer in premenopausal women (odds ratio 2.307, 95% CI 1.261-4.219, p=0.0067). Gene-expression analysis of triple-negative breast-cancer tumours suggested that KRAS-variant positive tumours have significantly altered gene expression, and are enriched for the luminal progenitor and BRCA1 deficiency signatures. miRNA analysis suggested reduced levels of let-7 miRNA species in KRAS-variant tumours.Interpretation: The KRAS variant might be a genetic marker for development of triple-negative breast cancer in premenopausal women, and altered gene and miRNA expression signatures should enable molecular and biological stratification of patients with this subgroup of breast cancer.Funding: US National Institutes of Health. [ABSTRACT FROM AUTHOR]

Nucleophosmin (NPM), an oligomeric phosphoprotein and nucleolar target of the ARF tumor suppressor, contributes to several critical cellular processes. Previous studies have shown that the human NPM's phosphorylation by cyclin E–cyclin-dependent kinase 2 (cdk2) on threonine (Thr) 199 regulates its translocation from the centrosome during cell cycle progression. Given our previous finding that ARF directly binds NPM, impeding its transit to the cytoplasm and arresting cells before S-phase entry, we hypothesized that ARF might also inhibit NPM phosphorylation. However, ARF induction did not impair phosphorylation of the cdk2 target residue in murine NPM, Thr198. Furthermore, phosphorylation of Thr198 occurred throughout the cell cycle and was concomitant with increases in overall NPM expression. To investigate the cell's presumed requirement for NPM-Thr198 phosphorylation in promoting the processes of growth and proliferation, we examined the effects of a non-phosphorylatable NPM mutant, T198A, in a clean cell system in which endogenous NPM had been removed by RNA interference. Here, we show that the T198A mutant is fully capable of executing NPM's described roles in nucleocytoplasmic shuttling, ribosome export and cell cycle progression. Moreover, the proliferative defects observed with stable NPM knockdown were restored by mutant NPM-T198A expression. Thus, we demonstrate that the reduction in NPM protein expression blocks cellular growth and proliferation, whereas phosphorylation of NPM-Thr198 is not essential for NPM's capacity to drive cell cycle progression and proliferation. [ABSTRACT FROM AUTHOR]

To assess absenteeism and associated lost productivity costs among employed parents and spouses of patients with multiple sclerosis (MS). Caregivers were family members of children (n=229) and spouses (n=2,488) with MS; 8 family caregivers had both children and a spouse with MS. Conclusions There is a substantial indirect economic burden related to productivity loss among employed parent and spouse caregivers of patients with MS. [Extracted from the article]

Résumé: Les auteurs rapportent la réalisation d’une analgésie péridurale (APD) obstétricale chez une parturiente de 26ans présentant un déficit modéré en facteur XI (FXI). Si des pathologies de l’hémostase contre-indiquent habituellement une APD (risque d’hématome périmédullaire), un déficit modéré en FXI ne représente cependant pas une contre-indication absolue à la réalisation d’une telle APD. La desmopressine, parfois utilisée en chirurgie pour réduire le saignement, a été administrée ici pour retirer le cathéter dans des meilleures conditions d’hémostase. Aucun signe neurologique n’a été observé. [ABSTRACT FROM AUTHOR]

We report a case of scorpion envenomation occurring during combat in Tagab district, province of Kapisa, Afghanistan. A French soldier was stung by a yellow scorpion (suspected Androctonus australis) and sustained systemic envenomation with hemodynamic and neurological manifestations. We discuss the clinical features, prevention, and management of a scorpion sting. [ABSTRACT FROM AUTHOR]