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1. A tertiary care centre experience with Elranatamab: A report of three cases

Author

Disha Kakkar, Aakanksha Singh, Reshmi Harikumar Pillai, Tribikram Panda, Roy J Palatty, Rohan Halder, Narendra Agrawal, and Dinesh Bhurani

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Introduction: The introduction of proteasome inhibitors, immunomodulatory drugs, and monoclonal antibodies has changed the treatment paradigm of multiple myeloma. With the advent of these new therapeutic options, life expectancy has substantially increased for myeloma patients which has led to an increased number of patients with triple-class refractory disease. Thus, there remains an unmet need for effective novel therapies with good tolerability and safety profile. Elranatamab, is the most widely used bispecific antibody currently in the Indian setting. However, it has only been used on a clinical trial basis till now, and real-world data especially in the Indian setting is missing. Here, we present our experience with three cases of multi-line treated relapsed/refractory multiple myeloma on elranatamab monotherapy. Case report: We here discuss three of our patients with triple class refractory multiple myeloma who recieved elranatamab monotherapy. While one of our patient had been switched to fortnightly treatment, two patients were still continuing weekly treatment. The common adverse effects observed were grade 1–2 cytokine release syndrome, cytopenias, CMV reactivation and hypo-gammaglobulinemia. While two of our patients are doing well, one patient had grade 3 neurological toxicity, likely drug related and succumbed. Discussion: B-cell maturation antigen is highly expressed on mature B cells and is critical for the survival and proliferation of plasma cells. It has emerged as a novel target for anti-myeloma therapies in the form of bispecific cell engager, antibody-drug conjugates, and chimeric antigen receptor (CAR) T-cell therapies.The phase II MM3 trial showed a promising efficacy with an ORR of 61% with a CR rate of >35%. With a median follow-up of 14.7 months, the median PFS was not reached and the 15-month PFS rate was 50.9%. While it is too early to comment on long term survival with the monotherapy, we here discuss response of Indian patients in the real world setting. Conclusion: Elranatamab monotherapy could prove to be an efficacious option for the treatment of relapsed /refractory multiple myeloma patients with triple-class refractory disease, with limited therapeutic options. However, patients need to be screened for infectious complications with appropriate prophylaxis and immunoglobulin replacement, if required. Also, a high suspicion is required for the neurological complications of the drug and a longitudinal neuro-cognitive screening is required for the patients.

Published
2024
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2. Intraoperative Fluoroscopy Versus Postoperative Radiographs in Assessing Distal Radius Volar Plate Position: Reliability of the Soong Classification

Author

Juston Fan, DO, Ryne Jenkins, BS, and Roy J. Caputo, MD

Subjects
Distal radius fracture, Fluoroscopy, Soong classification, Volar plate position, Surgery, RD1-811
Abstract

Purpose: Fluoroscopic imaging remains the standard intraoperative imaging modality for volar locking plate fixation of distal radius fractures, and correlation with postoperative radiographs remains unclear. The purpose of this study was to assess the reliability of the Soong classification system between intraoperative fluoroscopy and postoperative radiographs for distal radius volar plate position. Methods: Eleven hand surgery resident physicians (3 in postgraduate year 2, 2 in postgraduate year 3, 3 in postgraduate year 4, and 3 in postgraduate year 5) and 4 attending physicians classified images using the Soong classification system. Fluoroscopic and radiographic lateral images from 30 patients were randomized and deidentified. Thirty percent of the images were duplicated for intraobserver reliability. Seventy-eight images were randomized and presented to each observer in 1 consecutive session. Cohen kappa values were calculated for intraobserver reliability, and Fleiss kappa values were calculated for interobserver reliability. Results: Intraobserver reliability demonstrated moderate reliability overall. The intraobserver reliability was highest among postgraduate year 4 residents and attending physicians demonstrating substantial reliability. Lateral intraoperative fluoroscopic and postoperative radiographic imaging demonstrated no difference in intraobserver reliability overall. Interobserver reliability was highest among postgraduate year 5 residents demonstrating moderate reliability and attending physicians demonstrating substantial reliability. Conclusions: There was no difference in the intraobserver reliability of the Soong classification system between the lateral images of intraoperative fluoroscopy and postoperative radiographs. Fluoroscopic analysis using the Soong classification system is a reliable method to determine plate prominence and has demonstrated increasing reliability based on year of training. Fluoroscopic analysis using the Soong classification system and direct visualization during surgery for the assessment of plate prominence is recommended, with the understanding that higher Soong grades are associated with increased rates of complications. Type of study/level of evidence: Diagnostic III.

Published
2022
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9. Contributors

Author

Abete, Itziar, primary, Aboussaleh, Youssef, additional, Accardi, Giulia, additional, Aiello, Anna, additional, Alkhatib, Ahmad, additional, Alves Castro, Inar, additional, Andújar, Isabel, additional, Antonopoulou, Smaragdi, additional, Arsic, Aleksandra, additional, Arvanitidou, Eirini-Iro, additional, Assaf-Balut, Carla, additional, Barabash, Ana, additional, Barbagallo, Mario, additional, Bastida, Sara, additional, Beccari, Giovanni, additional, Benedí, Juana, additional, Bentrad, Najla, additional, Bernal-Lopez, M. Rosa, additional, Bonaccio, Marialaura, additional, Bonanni, Americo, additional, Bordiú, Elena, additional, Bottalico, Francesco, additional, Boutopoulou, Barbara, additional, Buscemi, Silvio, additional, Calle-Pascual, Alfonso Luis, additional, Cámara, Montaña, additional, Candore, Giuseppina, additional, Capone, Roberto, additional, Caputo, Marina, additional, Cardone, Gianluigi, additional, Caruso, Calogero, additional, Caso, Giulia, additional, Castro-Quezada, Itandehui, additional, Cebadera-Miranda, Laura, additional, Cerezo, Ana B., additional, Corleo, Davide, additional, Corrêa, Rúbia C.G., additional, Covarelli, Lorenzo, additional, Czarczyńska-Goślińska, Beata, additional, Davinelli, Sergio, additional, del Valle, Laura, additional, Delgado-Andrade, Cristina, additional, Demetriou, Christiana A., additional, Detopoulou, Paraskevi, additional, Di Gioia, Francesco, additional, Diamantopoulos, E.J., additional, Dominguez, Ligia J., additional, Donati, Maria Benedetta, additional, Douros, Konstantinos, additional, Durán, Alejandra, additional, El Bilali, Hamid, additional, El Kinany, Khaoula, additional, El Rhazi, Karima, additional, Ergoren, Mahmut Cerkez, additional, De Feo, Vincenzo, additional, Ferreira, Isabel C.F.R., additional, Formica, Melissa, additional, Fragopoulou, Elizabeth, additional, Fratianni, Florinda, additional, de Gaetano, Giovanni, additional, Gaforio, José J., additional, Galarregui, Cristina, additional, Gallardo-Escribano, Cristina, additional, Galozzi, Paola, additional, Galvano, Fabio, additional, Garces-Martin, Maria, additional, Garcia-Larsen, Vanessa, additional, Garcia-Parrilla, M. Carmen, additional, Garcimartín, Alba, additional, Geliebter, Jan, additional, George, Elena S., additional, Georgousopoulou, Ekavi N., additional, Gesteiro, E., additional, Gkiouras, Konstantinos, additional, Gómez-Pérez, Ana María, additional, Goulis, Dimitrios G., additional, Gouveri, E., additional, Grammatikopoulou, Maria G., additional, Hadjisavvas, Andreas, additional, Hamida-Ferhat, Asma, additional, Hardman, Roy J., additional, Hornedo-Ortega, Ruth, additional, Iacoviello, Licia, additional, Iriti, Marcello, additional, Jeszka-Skowron, Magdalena, additional, Kakkoura, Maria G., additional, Karras, Spyridon N., additional, Knox, E., additional, Kotsa, Kalliopi, additional, Koufakis, Theocharis, additional, Koumpagioti, Despina, additional, Kyriacou, Kyriacos, additional, de la Torre, Nuria García, additional, Lampropoulou, Maria, additional, Loizidou, Maria A., additional, De Lorenzo, Antonino, additional, Macho-González, Adrián, additional, Magriplis, Emmanuella, additional, Marakomichelakis, G., additional, Martínez, J. Alfredo, additional, De Martino, Laura, additional, Medina, F. Xavier, additional, Mellor, Duane D., additional, Menotti, Alessandro, additional, Mesías, Marta, additional, Molina-Vega, María, additional, Morales, Patricia, additional, Moreno, Juan A., additional, Muros, J.J., additional, Nazzaro, Filomena, additional, Nomikos, Tzortzis, additional, Oliviero, Francesca, additional, Ottomano Palmisano, Giovanni, additional, de Pablos, Rocío M., additional, Panagiotakos, Demosthenes B., additional, Papandreou, Christopher, additional, Petropoulos, Spyridon A., additional, Prodam, Flavia, additional, Puddu, Paolo Emilio, additional, Punzi, Leonardo, additional, Quiles, José L., additional, Ramirez-Perez, Cristina, additional, Ramirez-Tortosa, Cesar L., additional, Ramírez-Tortosa, MCarmen, additional, Richard, Tristan, additional, Ricotti, Roberta, additional, Ríos, José-Luis, additional, Rodríguez-García, Carmen, additional, Román-Viñas, Blanca, additional, Ros, Emilio, additional, Rubio, Miguel Angel, additional, Ruiz-Moreno, M. Isabel, additional, Sacerdote, Carlotta, additional, Salas-Salvadó, Jordi, additional, Sánchez-Muniz, Francisco J., additional, Sánchez-Quesada, Cristina, additional, Scapagnini, Giovanni, additional, Scolaro, Bianca, additional, Seiquer, Isabel, additional, Serra-Majem, Lluís, additional, Sfriso, Paolo, additional, Spinella, Paolo, additional, Theodoridis, Xenophon, additional, Tinahones, Francisco J., additional, Tini, Francesco, additional, Tiwari, Raj, additional, Tranidou, Antigoni, additional, Troncoso, Ana M., additional, Tsofliou, Fotini, additional, Tuncel, Gulten, additional, Valerio, Johanna, additional, Varoni, Elena Maria, additional, Vilches-Perez, Alberto, additional, Vineis, Paolo, additional, Vitalini, Sara, additional, Zalvan, Craig H., additional, Zampelas, Antonis, additional, Zebekakis, Pantelis, additional, and Zulet, M. Angeles, additional

Published
2020
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10. Thioredoxin Interacting Protein Is Required for a Chronic Energy-Rich Diet to Promote Intestinal Fructose Absorption

Author

Anu Shah, Sezin Dagdeviren, Jordan P. Lewandowski, Angela B. Schmider, Elisabeth M. Ricci-Blair, Niranjana Natarajan, Henna Hundal, Hye Lim Noh, Randall H. Friedline, Charles Vidoudez, Jason K. Kim, Amy J. Wagers, Roy J. Soberman, and Richard T. Lee

Subjects
Human Metabolism, Molecular Biology, Science
Abstract

Summary: Increased consumption of fats and added sugars has been associated with an increase in metabolic syndromes. Here we show that mice chronically fed an energy-rich diet (ERD) with high fat and moderate sucrose have enhanced the absorption of a gastrointestinal fructose load, and this required expression of the arrestin domain protein Txnip in the intestinal epithelial cells. ERD feeding induced gene and protein expression of Glut5, and this required the expression of Txnip. Furthermore, Txnip interacted with Rab11a, a small GTPase that facilitates the apical localization of Glut5. We also demonstrate that ERD promoted Txnip/Glut5 complexes in the apical intestinal epithelial cell. Our findings demonstrate that ERD facilitates fructose absorption through a Txnip-dependent mechanism in the intestinal epithelial cell, suggesting that increased fructose absorption could potentially provide a mechanism for worsening of metabolic syndromes in the setting of a chronic ERD.

Published
2020
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11. Objectively measured habitual physical activity and sleep-related phenomena in 1645 people aged 1–91 years: The Nakanojo Community Study

Author

Yukitoshi Aoyagi, Sungjin Park, Sunyoung Cho, and Roy J. Shephard

Subjects
Medicine
Abstract

Relationships between habitual physical activity and sleep-related phenomena were examined in 623 male and 1022 female Japanese participating in the Nakanojo Community Study, using data collected in 2012–2013. Ages ranged from infancy to very old. Daily step count and daily duration of exercise at an intensity >3 metabolic equivalents (METs) were determined by pedometer/accelerometer, 24 h/day for 1 week. Duplicate axillary temperatures were also taken on rising and when retiring. Total bed time was noted, and the efficiency of sleep determined as hours of actual sleep (from a validated pedometer/accelerometer algorithm) divided by bed time. Step counts and especially duration of activity >3 METs peaked in teenagers and decreased as age advanced (p

Published
2018
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12. List of Contributors

Author

Abrams, Mitch, primary, Allan, Veronica, additional, Altfeld, Sebastian, additional, Amorose, Anthony J., additional, Araújo, Duarte, additional, Atkinson, Michael, additional, Baird, Shannon M., additional, Baker, Joseph, additional, Balish, Shea, additional, Bardid, Farid, additional, Bar-Eli, Michael, additional, Barker, Jamie, additional, Barkoukis, Vassilis, additional, Barnett, Lisa, additional, Battochio, Randy C., additional, Baumeister, Roy F., additional, Beauchamp, Mark R., additional, Beckmann, Jürgen, additional, Behm, David G., additional, Bellomo, Eduardo, additional, Benson, Alex, additional, Berger, Bonnie G., additional, Bernache-Assollant, Iouri, additional, Bertollo, Maurizio, additional, Bhavsar, Nikita, additional, Biddell, Hannah L., additional, Biddle, Stuart, additional, Blodgett, Amy T., additional, Bloom, Gordon A., additional, Blumenstein, Boris, additional, Bolter, Nicole D., additional, Boudreau, Patrick, additional, Bredemeier, Brenda Light, additional, Brown, Chris, additional, Brueckner, Sebastian, additional, Bruner, Mark W., additional, Burke, Shauna M., additional, Busanich, Rebecca, additional, Busch, Lena, additional, Butcher, Lois A., additional, Carless, David, additional, Caron, Jeffrey G., additional, Carter, Leeja, additional, Castillo, Sarah L., additional, Chang, Yu-Kai, additional, Charboneau, Nicole D., additional, Chatzisarantis, Nikos L.D., additional, Cheng, Ming-Yang, additional, Chermette, Chloé, additional, Chow, Graig M., additional, Chu, I-Hua, additional, Chu, Theo, additional, Coakley, Jay, additional, Coholic, Diana, additional, Compton, Bernadette, additional, Corbetta, Daniela, additional, Côté, Jean, additional, Cotterill, Stewart, additional, Cropley, Brendan, additional, Cruz, Jaume, additional, Darroch, Francine, additional, Davids, Keith, additional, Deal, Colin J., additional, Debanne, Thierry, additional, Den Hartigh, Ruud J.R., additional, DesClouds, Poppy, additional, di Fronso, Selenia, additional, Douglas, Kitrina, additional, Downs, Danielle S., additional, Dreiskämper, Dennis, additional, Durand-Bush, Natalie, additional, Dzikus, Lars, additional, Eccles, David W., additional, Effenberg, Alfred O., additional, Elbe, Anne-Marie, additional, Emrich, Eike, additional, Etnier, Jennifer, additional, Etzel, Edward, additional, Evans, M. Blair, additional, Eys, Mark, additional, Fasting, Kari, additional, Feistenauer, Clemens, additional, Feltz, Deborah L., additional, Ferguson, Leah J., additional, Filho, Edson, additional, Fisher, Leslee A., additional, Fleming, Audrey, additional, Fletcher, David, additional, Frank, Cornelia, additional, Fransen, Katrien, additional, Freeman, Paul, additional, Friesen, Andrew, additional, Furley, Philip, additional, Galloway, Shaun M., additional, Gassmann, Freya, additional, Gaudreau, Patrick, additional, Ge, Yang, additional, Gernigon, Christophe, additional, Gershgoren, Lael, additional, Geukes, Katharina, additional, Gilbert, Wade D., additional, Gill, Diane L., additional, Glenn, Nicola, additional, Godfrey, Michael, additional, Gonsalves, Christine A., additional, Gould, Daniel, additional, Granacher, Urs, additional, Graupensperger, Scott, additional, Greenlees, Iain, additional, Grey, Robert, additional, Gucciardi, Daniel F., additional, Guerrero, Michelle D., additional, Güldenpenning, Iris, additional, H. Kerr, John, additional, Hackfort, Dieter, additional, Hagan, John E., additional, Hagemann, Norbert, additional, Halson, Shona L., additional, Hancock, David J., additional, Hanton, Sheldon, additional, Hardy, James, additional, Hardy, Will, additional, Harwood, Chris G., additional, Hausenblas, Heather A., additional, Heidari, Jahan, additional, Herbison, Jordan D., additional, Heuer, Andreas, additional, Hilliard, Bobby, additional, Hodge, Ken, additional, Hodges, Nicola J., additional, Holmes, Paul, additional, Holt, Nicholas L., additional, Horn, Thelma S., additional, Hristovski, Robert, additional, Hudson, Joanne, additional, Hüffmeier, Joachim, additional, Hung, Tsung-Min, additional, James, Jeffrey D., additional, Johnson, Carra, additional, Jones, Martin I., additional, Jowett, Gareth E., additional, Jowett, Sophia, additional, Justen, Christoph, additional, Kao, San-Fu, additional, Karau, Steven J., additional, Kavussanu, Maria, additional, Keegan, Richard, additional, Kellmann, Michael, additional, Kerr, Gretchen, additional, Killham, Margo E., additional, Kim, Jeemin, additional, Kim, Youngho, additional, Klämpfl, Martin, additional, Kleinert, Jens, additional, Kljajic, Kristina, additional, Klöppel, York-Peter, additional, Knowles, Zoe, additional, Koester, Dirk, additional, Kölling, Sarah, additional, Kornspan, Alan S., additional, Krane, Vikki, additional, Krause, Daniel, additional, Kunz, Philipp, additional, Laborde, Sylvain, additional, Lane, Andrew M., additional, Lariviere, Michel, additional, Larsen, Carsten H., additional, Lastella, Michele, additional, LaVoi, Nicole M., additional, Law, Barbi, additional, Lazuras, Lambros, additional, Leslie-Toogood, Adrienne, additional, Lewthwaite, Rebecca, additional, Lidor, Ronnie, additional, Lindeman, Kent, additional, Lippke, Sonia, additional, Lobinger, Babett, additional, Loffing, Florian, additional, Loughead, Todd M., additional, Lucidi, Fabio, additional, Mack, Diane E., additional, MacMahon, Clare, additional, Malhotra, Neha, additional, Marks, Donald R., additional, Marques, Marta M., additional, Martin, Luc J., additional, Masters, Rich, additional, McCullagh, Penny, additional, McGannon, Kerry R., additional, Meier, Henk E., additional, Mellalieu, Stephen D., additional, Memmert, Daniel, additional, Mentzel, Stijn V., additional, Mesagno, Christopher, additional, Michie, Susan, additional, Middleton, Thierry R.F., additional, Mokhtari, Pooneh, additional, Moore, Lee, additional, Moore, Whitney, additional, Moran, Aidan, additional, Morres, Ioannis D., additional, Mosley, Emma, additional, Moss, Tayo, additional, Munroe-Chandler, Krista J., additional, Munzert, Jörn, additional, Murgia, Mauro, additional, Murphy, Shane, additional, Neil, Rich, additional, Nicholls, Adam R., additional, Nitsch, Jürgen R., additional, Noce, Franco, additional, Norman, Paul, additional, Ntoumanis, Nikos, additional, Oddson, Bruce, additional, Oghene, Patrick Odirin, additional, Oglesby, Carole, additional, Oluyedun, Olufemi A., additional, Orbach, Iris, additional, Oudejans, Raôul R.D., additional, Papathomas, Anthony, additional, Paradis, Kyle F., additional, Parham, William D., additional, Pelka, Maximilian, additional, Pels, Fabian, additional, Peters, Heather J., additional, Petersen, Brennan, additional, Petitpas, Albert, additional, Petty, Lisa, additional, Phoenix, Cassandra, additional, Pierce, Scott, additional, Plessner, Henning, additional, Poczwardowski, Artur, additional, Podlog, Leslie, additional, Pöppel, Katharina, additional, Prochaska, James O., additional, Prochaska, Janice M., additional, Quartiroli, Alessandro, additional, Raab, Markus, additional, Rhind, Daniel J.A., additional, Rhodes, Ryan E., additional, Richard, Veronique, additional, Robazza, Claudio, additional, Robbins, Jamie E., additional, Roberts, Ross, additional, Ruiz, Montse C., additional, Sabiston, Catherine M., additional, Sachs, Michael L., additional, Sackett, Sarah C., additional, Samuel, Roy David, additional, Sarkar, Mustafa, additional, Scanlan, Tara, additional, Scanlan, Tara K., additional, Schack, Thomas, additional, Schinke, Robert J., additional, Schlattmann, Andreas, additional, Schleu, Joyce E., additional, Schöllhorn, Wolfgang I., additional, Schorer, Jörg, additional, Schott, Nadja, additional, Schwarzer, Ralf, additional, Seanor, Michelle, additional, Seiler, Roland, additional, Seiler, Stephen, additional, Selby, Christine L.B., additional, Shephard, Roy J., additional, Shields, David, additional, Si, Gangyan, additional, Smith, Alan L., additional, Smith, Brett, additional, Smith, Kristina, additional, Smith, Ronald E., additional, Sonn, Christopher C., additional, Sperlich, Billy, additional, Stambulova, Natalia B., additional, Standage, Martyn, additional, Steggemann-Weinrich, Yvonne, additional, Stirling, Ashley, additional, Storm, Vera, additional, Strauß, Bernd, additional, Surya, Mark, additional, Swann, Christian, additional, Tamminen, Katherine A., additional, Taylor, Ian M., additional, Tenenbaum, Gershon, additional, Terry, Peter C., additional, Thelwell, Richard, additional, Theodorakis, Yannis, additional, Thogersen-Ntoumani, Cecilie, additional, Thrower, Sam N., additional, Tietjens, Maike, additional, Tirp, Judith, additional, Toner, John, additional, Toogood, Adrienne L., additional, Turnnidge, Jennifer, additional, Uiga, Liis, additional, Utesch, Till, additional, Vallerand, Robert J., additional, van der Kamp, John, additional, van Duijn, Tina, additional, Van Slingerland, Krista, additional, Velentzas, Konstantinos, additional, Verner-Filion, Jérémie, additional, Vine, Samuel J., additional, Waldron, Jennifer J., additional, Wann, Daniel L., additional, Watson, Jack C., additional, Wattie, Nick, additional, Way, William, additional, Weigelt, Matthias, additional, Weinberg, Robert, additional, Westerberg, Anders I., additional, Whitehead, Amy, additional, Wiese-Bjornstal, Diane M., additional, Williams, Kipling D., additional, Williams, Toni L., additional, Wilson, Mark, additional, Wolanin, Andrew T., additional, Woodman, Tim, additional, Wright, Emily, additional, Wu, Carolyn, additional, Wulf, Gabriele, additional, Wunsch, Kathrin, additional, Yarrow, Kielan, additional, Zakrajsek, Rebecca A., additional, and Zhang, Chun-Qing, additional

Published
2019
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15. Contributors

Author

Aadil, Rana Muhammad, primary, Abraham, Jayanthi, additional, Aguiar, Flávio Henrique Baggio, additional, Alexandria, Adílis Kalina, additional, Andrian, Sorin, additional, Arif, Sania, additional, Aron, Nicoleta Maftei, additional, BaniHani, Alaa, additional, Barão, Carlos Eduardo, additional, Bekar, Ertürk, additional, Bonvini, Andrea, additional, Cámara-Martos, F., additional, Campos-Pérez, J., additional, Chatterjee, Ankita, additional, Çopur, Ömer Utku, additional, Coqueiro, Audrey Yule, additional, da Silva Fidalgo, Tatiana Kelly, additional, de Almeida Neves, Aline, additional, Farcasanu, Ileana C., additional, İncedayı, Bige, additional, Ishaq, Anum, additional, Ivana, Beara, additional, Iyer, Ajay Balu, additional, Junaid, Muhammad, additional, Karabacak, Azime Özkan, additional, Khalid, Nauman, additional, Khan, Rao Sanaullah, additional, Klososki, Suellen Jensen, additional, Lima, Débora Alves Nunes Leite, additional, Maia, Lucianne Cople, additional, Marcolino, Vanessa Aparecida, additional, Marija, Lesjak, additional, Mehmood, Abdul Mohaimen Mohammad Talha, additional, Munir, Muhammad Shahid, additional, Nazir, Wahab, additional, Oprea, Eliza, additional, Paiva, Teresa, additional, Pimentel, Tatiana Colombo, additional, Pini, Núbia Inocencya Pavesi, additional, Rahman, Ubaid ur, additional, Raizel, Raquel, additional, Rosset, Michele, additional, Ruta, Lavinia L., additional, Sahar, Amna, additional, Shephard, Roy J., additional, Silva, Maria-Raquel G., additional, Silva, Hugo-Henrique, additional, Stoleriu, Simona, additional, Tahmassebi, Jinous F., additional, Theobaldo, Jéssica Dias, additional, Tirapegui, Julio, additional, Valença, Ana Maria Gondim, additional, and Vieira, Thiago Isidro, additional

Published
2019
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16. Every hit matters: White matter diffusivity changes in high school football athletes are correlated with repetitive head acceleration event exposure

Author

Ikbeom Jang, Il Yong Chun, Jared R. Brosch, Sumra Bari, Yukai Zou, Brian R. Cummiskey, Taylor A. Lee, Roy J. Lycke, Victoria N. Poole, Trey E. Shenk, Diana O. Svaldi, Gregory G. Tamer, Jr, Ulrike Dydak, Larry J. Leverenz, Eric A. Nauman, and Thomas M. Talavage

Subjects
Computer applications to medicine. Medical informatics, R858-859.7, Neurology. Diseases of the nervous system, RC346-429
Abstract

Recent evidence of short-term alterations in brain physiology associated with repeated exposure to moderate intensity subconcussive head acceleration events (HAEs), prompts the question whether these alterations represent an underlying neural injury. A retrospective analysis combining counts of experienced HAEs and longitudinal diffusion-weighted imaging explored whether greater exposure to incident mechanical forces was associated with traditional diffusion-based measures of neural injury—reduced fractional anisotropy (FA) and increased mean diffusivity (MD). Brains of high school athletes (N = 61) participating in American football exhibited greater spatial extents (or volumes) experiencing substantial changes (increases and decreases) in both FA and MD than brains of peers who do not participate in collision-based sports (N = 15). Further, the spatial extents of the football athlete brain exhibiting traditional diffusion-based markers of neural injury were found to be significantly correlated with the cumulative exposure to HAEs having peak translational acceleration exceeding 20 g. This finding demonstrates that subconcussive HAEs induce low-level neurotrauma, with prolonged exposure producing greater accumulation of neural damage. The duration and extent of recovery associated with periods in which athletes do not experience subconcussive HAEs now represents a priority for future study, such that appropriate participation and training schedules may be developed to minimize the risk of long-term neurological dysfunction. Keywords: Subconcussive injury, Traumatic brain injury, Magnetic resonance imaging, Diffusion-weighted imaging, Diffusion tensor imaging

Published
2019
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17. Prowashonupana barley dietary fibre reduces body fat and increases insulin sensitivity in Caenorhabditis elegans model

Author

Chenfei Gao, Michael L. King, Zachary L. Fitzpatrick, Wenqian Wei, Jason F. King, Mingming Wang, Frank L. Greenway, John W. Finley, Jeffrey H. Burton, William D. Johnson, Michael J. Keenan, Frederick M. Enright, Roy J. Martin, and Jolene Zheng

Subjects
Obesity, Barley, Animal models, Insulin sensitivity, Ageing, Nutrition. Foods and food supply, TX341-641
Abstract

Prowashonupana barley (PWB) is high in β-glucan with moderate content of resistant starch. PWB reduced intestinal fat deposition (IFD) in wild type Caenorhabditis elegans (C. elegans, N2), and in sir-2.1 or daf-16 null mutants, and sustained a surrogate marker of lifespan, pharyngeal pumping rate (PPR), in N2, sir-2.1, daf-16, or daf-16/daf-2 mutants. Hyperglycaemia (2% glucose) reversed or reduced the PWB effect on IFD in N2 or daf-16/daf-2 mutants with a sustained PPR. mRNA expression of cpt-1, cpt-2, ckr-1, and gcy-8 were dose-dependently reduced in N2 or daf-16 mutants, elevated in daf-16/daf-2 mutants with reduction in cpt-1, and unchanged in sir-2.1 mutants. mRNA expressions were increased by hyperglycaemia in N2 or daf-16/daf-2 mutants, while reduced in sir-2.1 or daf-16 mutants. The effects of PWB in the C. elegans model appeared to be primarily mediated via sir-2.1, daf-16, and daf-16/daf-2. These data suggest that PWB and β-glucans may benefit hyperglycaemia-impaired lipid metabolism.

Published
2015
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18. EUS-guided coiling of rectal varices

Author

Roy J. Mukkada, MD, DNB, Pradeep G. Mathew, MD, V. Francis Jose, MD, DM, Antony Paul Chettupuzha, MD, DM, Rajesh Antony, MD, and Abraham Koshy, MD, DM

Subjects
Diseases of the digestive system. Gastroenterology, RC799-869
Published
2017
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21. Hybrid ensemble machine learning approaches for landslide susceptibility mapping using different sampling ratios at East Sikkim Himalayan, India

Author

Saha, S, Roy, J, Pradhan, B, and Hembram, TK

Subjects
Aerospace & Aeronautics, 0201 Astronomical and Space Sciences, 0901 Aerospace Engineering, 0913 Mechanical Engineering
Abstract

Landslide is a big problem in the mountainous region all over the world. Sikkim Himalayan region is also suffering from landslide problem. This study's main objective was to generate landslide susceptibility map (LSM) considering the hybrid ensemble of machine learning approaches using different sample ratios. Random Forest (RF) as the base classifier an ensemble with bagging, Rotation Forest (RTF), and Random Subspace (RS) Meta classifiers were used for spatial landslide modeling. First, collected 86 landslides locations through field investigation and from Sikkim district disaster office were mapped as a landslide inventory. Collected landslide locations were categorized into training and testing datasets randomly using four sample ratios (50:50, 60:40, 70:30 and 80:20). Based on the four sampling ratios and fifteen conditioning factors, a total of sixteen LSMs were prepared using RF, Bagging-RF (B-RF), RTF-RF and RS-RF in GIS platform. For assessing the modeling accuracy and comparison among these, the area under the receiver operating characteristics (AUROC) and other statistical methods such as root-mean-square-error (RMSE), mean-absolute-error (MAE) and R-index methods were used. The overall proficiency of RS-RF (AUC = 0.871, 0.847 of 50%:50%, AUC = 0.925, 0.931 of 60%:40%, AUC = 0.933, 0.939 of 70%:30%; AUC = 0.927, 0.933 of 80%:20%) was found to be substantially greater than the results of RF, B-RF, and RTF-RF. The RS-RF model and 70:30 sample ratio had the highest goodness-of-fit and accuracy as per the RMSE, MAE, and R-index methods. Furthermore, the model based on RS-RF is a promising and acceptable way of mapping regional landslides.

Published
2021

23. The Mediterranean style diet and cognition

Author

Melissa Formica and Roy J. Hardman

Subjects
Gerontology, Mediterranean diet, business.industry, medicine, Cognition, Disease, Cognitive decline, medicine.disease, business, Obesity, Depression (differential diagnoses), Middle age, Sedentary lifestyle
Abstract

Cognitive aging in humans is considered a normal part of aging with minor declines in mental functions such as vocabulary, numerical skills, and general knowledge. Cognitive aging typically begins from middle age onward, although some mental capabilities begin to decline even earlier. As there is currently no available medical intervention available to treat cognitive decline, early intervention through the use of modifiable risk factors is imperative in middle age to prevent the onset and progression of cognitive decline into mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Previous research suggests that various lifestyle interventions, which modify the risk for conditions including obesity, sedentary lifestyle, hypertension, depression, cardiovascular disease, potentially arterial stiffness, oxidative stress, and hyperlipidemia, have the ability to reduce the risk for cognitive decline (Parrott and Greenwood, 2007; Mathers, 2013; Dauncey, 2014; Kiefte-De Jong et al., 2014; Vandewoude et al., 2016). The impact of how dietary changes and dietary patterns such as the Mediterranean diet may modify age-associated changes in cognitive function is the focus of this chapter.

Published
2020

27. Mechanical behaviour of composites

Author

Roy J. Crawford and Peter Martin

Subjects
Matrix (mathematics), Materials science, Matrix algebra, Stress–strain curve, Thermosetting polymer, Modulus, Composite material, Reinforcement, Rule of mixtures
Abstract

This chapter explains the mechanical behaviour of composites. It begins by introducing the different forms of reinforced plastics including fibrous and particulate composites. It describes the types of reinforcement that are commonly employed and the use of thermosets and thermoplastics as matrix materials. It then concentrates on the analysis of continuous fibre composites. These are introduced initially using the Rule of Mixtures before being treated as a single ply and later as multi-ply laminates. Analysis is presented in the form of matrix algebra which is set out through a series of example calculations. These show how properties such as modulus and Poisson’s ratio may be computed for symmetrical and asymmetrical laminates, and then used to evaluate stress and strain. The effects of fatigue and impact on reinforced plastics are briefly considered at the end of the chapter.

Published
2020

29. Contributors

Author

Ahmad, Saba, primary, Alter, Craig A., additional, Anderson, Brett R., additional, Ayzen, Marsha, additional, Bagatell, Rochelle, additional, Baluarte, H. Jorge, additional, Bamba, Vaneeta, additional, Bearden, David R., additional, Beier, Ulf H., additional, Beslow, Lauren A., additional, Bhat, Shazia, additional, Bonafide, Christopher P., additional, Brodsky, Jill L., additional, Brown, Naomi, additional, Caboot, Jason B., additional, Calabria, Andrew C., additional, Castelo-Soccio, Leslie, additional, Chahroudi, Ann, additional, Chao, David, additional, Chatfield, Kathryn, additional, Christ, Lori A., additional, Chu, Andrew, additional, Collins, R. Thomas, additional, Copelovitch, Lawrence, additional, Danzig, Jennifer A., additional, Daymont, Carrie, additional, DeLeón, Diva D., additional, Denburg, Michelle, additional, Desai, Melissa, additional, Devon, Erin Pete, additional, Donoghue, Aaron, additional, Evageliou, Nicholas, additional, Farah, Mirna M., additional, Feemster, Kristen A., additional, Feinstein, James Aaron, additional, Feldman, Amy, additional, Felling, Ryan J., additional, Flibotte, John J., additional, Flynn, Stephen G., additional, Foglia, Elizabeth E., additional, Forbes, Lisa, additional, Garrett, Jackie P.D., additional, Gober, Laura, additional, Gober, Michael D., additional, Goldsmith, Kelly C., additional, Goyal, Monika, additional, Green, Abby, additional, Grimberg, Adda, additional, Haldeman-Englert, Chad R., additional, Kevin Hall, E., additional, Healy, Fiona, additional, Hills, Jessica L., additional, Hofmann, Melissa A., additional, Horton, Daniel B., additional, Hunter, Anna, additional, Ince, Elif E., additional, Jethva, Reena, additional, John, Anitha S., additional, Jones, Amanda, additional, Kahle, Eden, additional, Kalish, Jennifer M., additional, Kennedy, Melissa, additional, Khojasteh, Soorena, additional, Kim, Roy J., additional, Koren, Dorit, additional, Kronman, Matthew P., additional, Langdon, David R., additional, LaRosa, Christopher, additional, Lasa, Javier J., additional, Lee, Lara Wine, additional, Leyva-Vega, Melissa, additional, Lieberman, Scott M., additional, Lilley, Jessica Sparks, additional, Linton, Julie M., additional, Lowenthal, Elizabeth, additional, Magge, Sheela N., additional, Mangino, Jennifer, additional, Marsenic, Olivera, additional, Mazzeo, Pamela A., additional, McGuire, Jennifer L., additional, McNally, Paul, additional, Minturn, Jane E., additional, Mittal, Manoj K., additional, Mondello, Melissa, additional, Murphy, Kathryn M., additional, Myers, Sage, additional, Nadel, Frances, additional, Nelson, Kyle, additional, Nino, Gustavo, additional, Mucha-Le Ny, Bettina, additional, O’Byrne, Michael L., additional, Oza, Vikash S., additional, Palladino, Andrew A., additional, Parikh, Shefali, additional, Petersen, Tara, additional, Peterson, Amy L., additional, Piccone, Connie M., additional, Pinney, Sara E., additional, Posner, Jill, additional, Posner, Kari R., additional, Pradhan, Madhura, additional, Raffaelli, Ryan M., additional, Rahimi, Homaira, additional, Ray, Kristin N., additional, Rheingold, Susan R., additional, Ryan, Nicole, additional, Sahn, Benjamin A., additional, Sampayo, Esther Maria, additional, Sampson, Matthew G., additional, Schiffman, Alisa B., additional, Schinasi, Dana Aronson, additional, Schwab, Sandra, additional, Scott, Halden F., additional, Seiden, Jeffrey A., additional, Sepe, Dana, additional, Shah, Nilika B., additional, Shah, Rachana, additional, Shah, Samir S., additional, Shelov, Eric D., additional, Sievert, Angela J., additional, Swami, Sanjeev K., additional, Szperka, Christina Lynch, additional, Taub, Kathryn S., additional, Teplick, Alexis, additional, Thacker, Deepika, additional, Tomescu, Oana, additional, Topol, Howard, additional, Tuchman, Shamir, additional, Utidjian, Levon H., additional, Varela, Carly R., additional, Viteri, Shirley D., additional, Waldman, Amy T., additional, Wallis, Elizabeth M., additional, Weiser, Daniel A., additional, Wen, Jessica, additional, Whitney, Deborah, additional, Wilkes, Jennifer J., additional, Wood, Kamillah, additional, Wusthoff, Courtney J., additional, Yang, Joyce, additional, and Zonfrillo, Mark R., additional

Published
2011
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36. List of Contributors

Author

Alleyne, Julia, primary, Amy, Eduardo, additional, Audette, Joseph F., additional, Bachl, Norbert, additional, Bailey, Allison, additional, Baron, Ramon, additional, Bergfeld, Deborah A., additional, Borg-Stein, Joanne, additional, Burry, Andrea, additional, Cantu, Robert C., additional, Cantu, Robert V., additional, Chan, Kai-Ming, additional, Chang, David S., additional, Chang, Joseph Jeremy Hsi-Tse, additional, Corrado, Gian, additional, Correa, José, additional, Crandell, David M., additional, Derman, Wayne E., additional, De Rose, Eduardo H., additional, d'Hemecourt, Pierre A., additional, Dugan, Sheila A., additional, Earp, Brandon E., additional, Ergen, Emin, additional, Fagnani, Federica, additional, Fields, Karl B., additional, Frontera, Walter R., additional, Gerbino, Peter, additional, Giombini, Arrigo, additional, Herring, Stanley A., additional, Hyman, Jeff, additional, Kennedy, Robert, additional, Kibler, W. Ben, additional, Kocher, Mininder S., additional, Krabak, Brian J., additional, Lennard, Ted A., additional, Mandelbaum, Bert R., additional, Martinez-Silvestrini, Julio A., additional, Micheli, Lyle J., additional, Micheo, William, additional, Nielson, Jason H., additional, Parisi, Attilio, additional, Pigozzi, Fabio, additional, Press, Joel M., additional, Proctor, Mark R., additional, Rizzo, Thomas D., additional, Shephard, Roy J., additional, Silver, Julie K., additional, Simons, Stephen M., additional, Smekal, Gerhard, additional, Solomon, Jennifer L., additional, Standaert, Christopher J., additional, Tucker, Rachael, additional, Ulkar, Bülent, additional, Waite, Brandee, additional, Walker, Katherine M., additional, Waters, Peter M., additional, Weiss, Jennifer M., additional, Wicker, Anton, additional, Wong, Fiona Chui-Yan, additional, Zetaruk, Merrilee, additional, and Zimmerman, Jerrad, additional

Published
2007
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37. Practical Guide to Rotational Moulding

Author

Roy J Crawford, Mark P Kearns, Roy J Crawford, and Mark P Kearns

Subjects
Plastics--Molding, Rotational molding of plastics
Abstract

Practical Guide to Rotational Moulding, Third Edition, takes a step-by-step approach to rotomoulding, covering applications, moulds, machinery, materials, and design. This third edition has been thoroughly revised to include the latest advances, including novel materials and moulds, new products, and automation. The book begins with a chapter that introduces the rotational moulding process, analyses advantages and disadvantages, and explores common applications for rotomoulded products. The subsequent chapters provide detailed, methodical coverage of moulds, machinery, materials, and design for functionality, supported by clear illustrations and diagrams. Finally, challenges and future developments are discussed. This hands-on technical guide helps engineers, designers and practitioners to understand all aspects of rotomoulding, with the aim of producing performant end products and parts, with uniform wall thickness and potentially in complex shapes. The book is also of great interest to professionals across the plastics industry, as well as researchers and advanced students in plastics engineering, industrial design, mechanical engineering, chemical engineering, and materials science and engineering. Provides a strong fundamental understanding of all aspects of the rotational moulding process, from material to finished product Offers a highly practical combination of technical content and clear illustrations Covers the latest developments in rotomoulding, including novel materials and moulds, new products, and automated systems

Published
2021

39. Management of atherosclerotic carotid and vertebral artery disease: 2017 clinical practice guidelines of the European Society for Vascular Surgery (ESVS)

Author

Naylor, A. R., Ricco, J. -B., de Borst, G. J., Debus, S., de Haro, J., Halliday, A., Hamilton, G., Kakisis, J., Kakkos, S., Lepidi, S., Markus, H. S., Mccabe, D. J., Roy, J., Sillesen, H., van den Berg, J. C., Vermassen, F., Kolh, P., Chakfe, N., Hinchliffe, R. J., Koncar, I., Lindholt, J. S., Vega de Ceniga, M., Verzini, F., Archie, J., Bellmunt, S., Chaudhuri, A., Koelemay, M., Lindahl, A. -K., Padberg, F., Venermo, M., ACS - Amsterdam Cardiovascular Sciences, Surgery, ACS - Atherosclerosis & ischemic syndromes, Naylor, A. R., Ricco, J. -B., de Borst, G. J., Debus, S., de Haro, J., Halliday, A., Hamilton, G., Kakisis, J., Kakkos, S., Lepidi, S., Markus, H. S., Mccabe, D. J., Roy, J., Sillesen, H., van den Berg, J. C., Vermassen, F., Kolh, P., Chakfe, N., Hinchliffe, R. J., Koncar, I., Lindholt, J. S., Vega de Ceniga, M., Verzini, F., Archie, J., Bellmunt, S., Chaudhuri, A., Koelemay, M., Lindahl, A. -K., Padberg, F., and Venermo, M.

Subjects
Bypa, Complications, Medical therapy, Stenting, Transient ischaemic attack, medicine.medical_treatment, Disease, 030204 cardiovascular system & hematology, Imaging, 0302 clinical medicine, Restenosis, Stroke, Endarterectomy, Thrombolysis, 3. Good health, Asymptomatic, Centre for Surgical Research, Cardiology, Screening, Vertebral, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Vertebral artery, Bypass, Thrombolysi, Restenosi, Symptomatic, 03 medical and health sciences, Carotid, Dementia, Patch infection, Surgical techniques, Internal medicine, medicine.artery, Surgery, medicine, business.industry, Surgical technique, Vascular surgery, medicine.disease, business, Complication, 030217 neurology & neurosurgery
Abstract

The European Society of Vascular Surgery (ESVS) has prepared guidelines for treating patients with atherosclerotic carotid and vertebral artery (VA) disease. This does not include non-atherosclerotic conditions such as fibromuscular dysplasia, dissection, arteritis, or trauma. Potential users include vascular surgeons, neurologists, stroke physicians, angiologists, primary care physicians, cardiologists, and interventional radiologists. Guidelines promote standards of care, based on evidence; however, they should not be viewed as the legal standard of care. This document is a “guiding principle” and care given depends on the individual patient (presentation, comorbidities, age) and treatment setting (techniques available, local expertise).

Published
2017

40. Hemochromatosis in India: First Report of Whole Exome Sequencing With Review of the Literature()

Author

Jose V. Francis, Abraham Koshy, Pushpa Mahadevan, Roy J. Mukkada, Antony Chettupuzha, and Julio Chacko Kandathil

Subjects
Genetics, Cirrhosis, Hepatology, business.industry, Serum ferritin level, Chronic liver disease, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Mutation (genetic algorithm), medicine, 030211 gastroenterology & hepatology, Original Article, HAMP, business, Exome sequencing, Hemochromatosis, Hemojuvelin
Abstract

Background Primary hemochromatosis is unusual in India. The homeostatic iron regulator (HFE) gene C282Y mutation, a common cause for hemochromatosis in Europe, is considered almost nonexistent in India. We are reporting a case of hemochromatosis with the HFE gene C282Y mutation and two other adult cases with a novel hemojuvelin (HJV) mutation from Kerala. Methods Of 434 cases with chronic liver disease, 3 cases were identified with the serum ferritin level of more than 1000 ng/mL and primary hemochromatosis after excluding secondary causes. Whole exome sequencing, including genes HFE, HJV, SLC40A1, TFR2, FTH1, HAMP, SKIV2L, TTC37, and BMP2, was performed for blood samples in all 3 cases. Results One patient with hemochromatosis had a homozygous HFE gene C282Y mutation, and two other adult cases had a novel homozygous HJV D355Y mutation. This is the first report of hemochromatosis associated with the HFE C282Y mutation from Kerala and the second report in India. This is the second report of hemochromatosis associated with an HJV mutation from India. Conclusion HJV mutations may explain some of the adult onset primary hemochromatosis in India.

Published
2019

41. Contributors

Author

Rana Muhammad Aadil, Jayanthi Abraham, Flávio Henrique Baggio Aguiar, Adílis Kalina Alexandria, Sorin Andrian, Sania Arif, Nicoleta Maftei Aron, Alaa BaniHani, Carlos Eduardo Barão, Ertürk Bekar, Andrea Bonvini, F. Cámara-Martos, J. Campos-Pérez, Ankita Chatterjee, Ömer Utku Çopur, Audrey Yule Coqueiro, Tatiana Kelly da Silva Fidalgo, Aline de Almeida Neves, Ileana C. Farcasanu, Bige İncedayı, Anum Ishaq, Beara Ivana, Ajay Balu Iyer, Muhammad Junaid, Azime Özkan Karabacak, Nauman Khalid, Rao Sanaullah Khan, Suellen Jensen Klososki, Débora Alves Nunes Leite Lima, Lucianne Cople Maia, Vanessa Aparecida Marcolino, Lesjak Marija, Abdul Mohaimen Mohammad Talha Mehmood, Muhammad Shahid Munir, Wahab Nazir, Eliza Oprea, Teresa Paiva, Tatiana Colombo Pimentel, Núbia Inocencya Pavesi Pini, Ubaid ur Rahman, Raquel Raizel, Michele Rosset, Lavinia L. Ruta, Amna Sahar, Roy J. Shephard, Maria-Raquel G. Silva, Hugo-Henrique Silva, Simona Stoleriu, Jinous F. Tahmassebi, Jéssica Dias Theobaldo, Julio Tirapegui, Ana Maria Gondim Valença, and Thiago Isidro Vieira

Published
2019

42. List of Contributors

Author

Mitch Abrams, Veronica Allan, Sebastian Altfeld, Anthony J. Amorose, Duarte Araújo, Michael Atkinson, Shannon M. Baird, Joseph Baker, Shea Balish, Farid Bardid, Michael Bar-Eli, Jamie Barker, Vassilis Barkoukis, Lisa Barnett, Randy C. Battochio, Roy F. Baumeister, Mark R. Beauchamp, Jürgen Beckmann, David G. Behm, Eduardo Bellomo, Alex Benson, Bonnie G. Berger, Iouri Bernache-Assollant, Maurizio Bertollo, Nikita Bhavsar, Hannah L. Biddell, Stuart Biddle, Amy T. Blodgett, Gordon A. Bloom, Boris Blumenstein, Nicole D. Bolter, Patrick Boudreau, Brenda Light Bredemeier, Chris Brown, Sebastian Brueckner, Mark W. Bruner, Shauna M. Burke, Rebecca Busanich, Lena Busch, Lois A. Butcher, David Carless, Jeffrey G. Caron, Leeja Carter, Sarah L. Castillo, Yu-Kai Chang, Nicole D. Charboneau, Nikos L.D. Chatzisarantis, Ming-Yang Cheng, Chloé Chermette, Graig M. Chow, I-Hua Chu, Theo Chu, Jay Coakley, Diana Coholic, Bernadette Compton, Daniela Corbetta, Jean Côté, Stewart Cotterill, Brendan Cropley, Jaume Cruz, Francine Darroch, Keith Davids, Colin J. Deal, Thierry Debanne, Ruud J.R. Den Hartigh, Poppy DesClouds, Selenia di Fronso, Kitrina Douglas, Danielle S. Downs, Dennis Dreiskämper, Natalie Durand-Bush, Lars Dzikus, David W. Eccles, Alfred O. Effenberg, Anne-Marie Elbe, Eike Emrich, Jennifer Etnier, Edward Etzel, M. Blair Evans, Mark Eys, Kari Fasting, Clemens Feistenauer, Deborah L. Feltz, Leah J. Ferguson, Edson Filho, Leslee A. Fisher, Audrey Fleming, David Fletcher, Cornelia Frank, Katrien Fransen, Paul Freeman, Andrew Friesen, Philip Furley, Shaun M. Galloway, Freya Gassmann, Patrick Gaudreau, Yang Ge, Christophe Gernigon, Lael Gershgoren, Katharina Geukes, Wade D. Gilbert, Diane L. Gill, Nicola Glenn, Michael Godfrey, Christine A. Gonsalves, Daniel Gould, Urs Granacher, Scott Graupensperger, Iain Greenlees, Robert Grey, Daniel F. Gucciardi, Michelle D. Guerrero, Iris Güldenpenning, John H. Kerr, Dieter Hackfort, John E. Hagan, Norbert Hagemann, Shona L. Halson, David J. Hancock, Sheldon Hanton, James Hardy, Will Hardy, Chris G. Harwood, Heather A. Hausenblas, Jahan Heidari, Jordan D. Herbison, Andreas Heuer, Bobby Hilliard, Ken Hodge, Nicola J. Hodges, Paul Holmes, Nicholas L. Holt, Thelma S. Horn, Robert Hristovski, Joanne Hudson, Joachim Hüffmeier, Tsung-Min Hung, Jeffrey D. James, Carra Johnson, Martin I. Jones, Gareth E. Jowett, Sophia Jowett, Christoph Justen, San-Fu Kao, Steven J. Karau, Maria Kavussanu, Richard Keegan, Michael Kellmann, Gretchen Kerr, Margo E. Killham, Jeemin Kim, Youngho Kim, Martin Klämpfl, Jens Kleinert, Kristina Kljajic, York-Peter Klöppel, Zoe Knowles, Dirk Koester, Sarah Kölling, Alan S. Kornspan, Vikki Krane, Daniel Krause, Philipp Kunz, Sylvain Laborde, Andrew M. Lane, Michel Lariviere, Carsten H. Larsen, Michele Lastella, Nicole M. LaVoi, Barbi Law, Lambros Lazuras, Adrienne Leslie-Toogood, Rebecca Lewthwaite, Ronnie Lidor, Kent Lindeman, Sonia Lippke, Babett Lobinger, Florian Loffing, Todd M. Loughead, Fabio Lucidi, Diane E. Mack, Clare MacMahon, Neha Malhotra, Donald R. Marks, Marta M. Marques, Luc J. Martin, Rich Masters, Penny McCullagh, Kerry R. McGannon, Henk E. Meier, Stephen D. Mellalieu, Daniel Memmert, Stijn V. Mentzel, Christopher Mesagno, Susan Michie, Thierry R.F. Middleton, Pooneh Mokhtari, Lee Moore, Whitney Moore, Aidan Moran, Ioannis D. Morres, Emma Mosley, Tayo Moss, Krista J. Munroe-Chandler, Jörn Munzert, Mauro Murgia, Shane Murphy, Rich Neil, Adam R. Nicholls, Jürgen R. Nitsch, Franco Noce, Paul Norman, Nikos Ntoumanis, Bruce Oddson, Patrick Odirin Oghene, Carole Oglesby, Olufemi A. Oluyedun, Iris Orbach, Raôul R.D. Oudejans, Anthony Papathomas, Kyle F. Paradis, William D. Parham, Maximilian Pelka, Fabian Pels, Heather J. Peters, Brennan Petersen, Albert Petitpas, Lisa Petty, Cassandra Phoenix, Scott Pierce, Henning Plessner, Artur Poczwardowski, Leslie Podlog, Katharina Pöppel, James O. Prochaska, Janice M. Prochaska, Alessandro Quartiroli, Markus Raab, Daniel J.A. Rhind, Ryan E. Rhodes, Veronique Richard, Claudio Robazza, Jamie E. Robbins, Ross Roberts, Montse C. Ruiz, Catherine M. Sabiston, Michael L. Sachs, Sarah C. Sackett, Roy David Samuel, Mustafa Sarkar, Tara Scanlan, Tara K. Scanlan, Thomas Schack, Robert J. Schinke, Andreas Schlattmann, Joyce E. Schleu, Wolfgang I. Schöllhorn, Jörg Schorer, Nadja Schott, Ralf Schwarzer, Michelle Seanor, Roland Seiler, Stephen Seiler, Christine L.B. Selby, Roy J. Shephard, David Shields, Gangyan Si, Alan L. Smith, Brett Smith, Kristina Smith, Ronald E. Smith, Christopher C. Sonn, Billy Sperlich, Natalia B. Stambulova, Martyn Standage, Yvonne Steggemann-Weinrich, Ashley Stirling, Vera Storm, Bernd Strauß, Mark Surya, Christian Swann, Katherine A. Tamminen, Ian M. Taylor, Gershon Tenenbaum, Peter C. Terry, Richard Thelwell, Yannis Theodorakis, Cecilie Thogersen-Ntoumani, Sam N. Thrower, Maike Tietjens, Judith Tirp, John Toner, Adrienne L. Toogood, Jennifer Turnnidge, Liis Uiga, Till Utesch, Robert J. Vallerand, John van der Kamp, Tina van Duijn, Krista Van Slingerland, Konstantinos Velentzas, Jérémie Verner-Filion, Samuel J. Vine, Jennifer J. Waldron, Daniel L. Wann, Jack C. Watson, Nick Wattie, William Way, Matthias Weigelt, Robert Weinberg, Anders I. Westerberg, Amy Whitehead, Diane M. Wiese-Bjornstal, Kipling D. Williams, Toni L. Williams, Mark Wilson, Andrew T. Wolanin, Tim Woodman, Emily Wright, Carolyn Wu, Gabriele Wulf, Kathrin Wunsch, Kielan Yarrow, Rebecca A. Zakrajsek, and Chun-Qing Zhang

Published
2019

43. Every hit matters: White matter diffusivity changes in high school football athletes are correlated with repetitive head acceleration event exposure

Author

Eric A. Nauman, Taylor A. Lee, Brian Cummiskey, Jared R. Brosch, Trey E. Shenk, Sumra Bari, Gregory G. Tamer, Diana O. Svaldi, Victoria N. Poole, Larry J. Leverenz, Ulrike Dydak, Roy J. Lycke, Il Yong Chun, Yukai Zou, Thomas M. Talavage, and Ikbeom Jang

Subjects
Male, Poison control, Cumulative Exposure, Football, Audiology, lcsh:RC346-429, Traumatic brain injury, 0302 clinical medicine, Subconcussive injury, Schools, biology, 05 social sciences, Brain, Regular Article, White Matter, Diffusion tensor imaging, medicine.anatomical_structure, Neurology, lcsh:R858-859.7, Diffusion-weighted imaging, medicine.medical_specialty, Adolescent, Cognitive Neuroscience, Acceleration, lcsh:Computer applications to medicine. Medical informatics, 050105 experimental psychology, White matter, 03 medical and health sciences, Magnetic resonance imaging, Injury prevention, Fractional anisotropy, medicine, Humans, 0501 psychology and cognitive sciences, Radiology, Nuclear Medicine and imaging, Students, Brain Concussion, lcsh:Neurology. Diseases of the nervous system, business.industry, Athletes, medicine.disease, biology.organism_classification, Diffusion Magnetic Resonance Imaging, Neurology (clinical), business, Head, 030217 neurology & neurosurgery
Abstract

Recent evidence of short-term alterations in brain physiology associated with repeated exposure to moderate intensity subconcussive head acceleration events (HAEs), prompts the question whether these alterations represent an underlying neural injury. A retrospective analysis combining counts of experienced HAEs and longitudinal diffusion-weighted imaging explored whether greater exposure to incident mechanical forces was associated with traditional diffusion-based measures of neural injury—reduced fractional anisotropy (FA) and increased mean diffusivity (MD). Brains of high school athletes (N = 61) participating in American football exhibited greater spatial extents (or volumes) experiencing substantial changes (increases and decreases) in both FA and MD than brains of peers who do not participate in collision-based sports (N = 15). Further, the spatial extents of the football athlete brain exhibiting traditional diffusion-based markers of neural injury were found to be significantly correlated with the cumulative exposure to HAEs having peak translational acceleration exceeding 20 g. This finding demonstrates that subconcussive HAEs induce low-level neurotrauma, with prolonged exposure producing greater accumulation of neural damage. The duration and extent of recovery associated with periods in which athletes do not experience subconcussive HAEs now represents a priority for future study, such that appropriate participation and training schedules may be developed to minimize the risk of long-term neurological dysfunction., Highlights • Brain volumes evidencing injury are larger in football athletes than controls. • Spatial extent of decreased FA correlates with head acceleration event exposure. • Spatial extent of increased MD correlates with head acceleration event exposure.

Published
2019

45. Factors Influencing the Optimal Choice of Sports Beverages

Author

Roy J. Shephard

Subjects
biology, Athletes, Warm environment, business.industry, Environmental health, Physical activity, Medicine, Palatability, biology.organism_classification, business
Abstract

Research on sports beverages has often been sponsored by drink manufacturers, leading almost inevitably to a bias in the reporting of results. The appropriate beverage for athletes to take before, during, and after an event is situational; competitors should be guided by the need to replace depleted fluid and glycogen reserves without causing hyperhydration. Factors influencing the choice of beverage are its palatability, its rate of emptying from the stomach, and its absorption from the duodenum and small intestines. In a warm environment, the dominant need is usually for water, with performance deteriorating if an individual’s body mass decreases by > 2%. However, if vigorous physical activity continues for longer than 60–90 min, then there is also a need to replenish body stores of glycogen. In a cold environment, an excessive intake of hypotonic fluid can occasionally lead to a dangerous hyponatremia.

Published
2019

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