318 results on '"Tipton M"'
Search Results
102. How do women feel cold water swimming affects their menstrual and perimenopausal symptoms?
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Pound M, Massey H, Roseneil S, Williamson R, Harper CM, Tipton M, Shawe J, Felton M, and Harper JC
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- Female, Humans, Hot Flashes etiology, Hot Flashes psychology, Depression, Anxiety, Perimenopause psychology, Swimming
- Abstract
Objective: This study aimed to determine how women felt cold water swimming affected their menstrual and perimenopausal symptoms., Study Design: An online survey that asked women who regularly swim in cold water about their experiences. The survey was advertised for 2 months on social media. Questions related to cold water swimming habits and menstrual and perimenopausal symptoms were analysed., Main Outcome Measures: Quantitative and qualitative data including; frequency of menstrual and menopause symptoms, the effect of cold water swimming on these symptoms., Results: 1114 women completed the survey. Women reported that cold water swimming reduced their menstrual symptoms, notably psychological symptoms such as anxiety (46.7%), mood swings (37.7%) and irritability (37.6%). Perimenopausal women reported a significant improvement in anxiety (46.9%), mood swings (34.5%), low mood (31.1%) and hot flushes (30.3%). The majority of women with symptoms swam specifically to reduce these symptoms (56.4% for period and 63.3% for perimenopause symptoms). Women said they felt it was the physical and mental effects of the cold water that helped their symptoms. For the free text question, five themes were identified: the calming and mood-boosting effect of the water, companionship and community, period improvements, an improvement in hot flushes and an overall health improvement., Conclusion: Women felt that cold water swimming had a positive overall effect on menstrual and perimenopause symptoms. Studies on other forms of exercise to relieve menstrual and perimenopause symptoms may show similar findings., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Joyce Harper gives paid talks on menopause to employers and conferences. more...
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- 2024
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103. Access to technology, internet usage, and online health information-seeking behaviors in a racially diverse, lower-income population.
- Author
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Adepoju OE, Singh M, Tipton M, Peperone G, Trujillo M, and Ojinnaka C
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- Humans, Female, Cross-Sectional Studies, Internet, Income, Internet Use, Information Seeking Behavior
- Abstract
Background: This study examined access to technology, internet usage, and online health information-seeking behaviors, in a racially diverse, lower-income population., Methods: Data were obtained via a cross-sectional survey of low-income communities in Houston, Los Angeles, and New York between April and August 2023. Binary responses to the following online health information-seeking behaviors, internet and technology access, were examined: using the internet to (i) understand a medical diagnosis, (ii) fill a prescription, (iii) schedule a healthcare appointment, (iv) email communication with a healthcare provider, and (v) access electronic health records and medical notes., Results: 41% of survey respondents identified as non-Hispanic Black individuals, 33% as non-Hispanic White individuals, and 22% as Hispanic individuals. 69% reported a pre-tax annual household income of less than $35,000. 97% reported ownership/access to a smart device; 97% reported access to reliable internet. In the past year, only 59% reported using the internet to better understand their medical diagnosis, 36% reported filling a prescription online, 47% scheduled a medical appointment online, 47% viewed electronic health records online, and 56% emailed healthcare providers. Female sex, higher incomes, and having at least a bachelor's degree were significantly associated with all five online health information-seeking attributes., Conclusion: Despite high technology adoption rates, we observed suboptimal online health information-seeking behaviors. This underutilization has potential adverse implications for healthcare access and use given the documented advantage of HIT. Efforts to increase health information-seeking behaviors should explore the identification of HIT barriers, and patient education to increase familiarity and usage in this population., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Adepoju, Singh, Tipton, Peperone, Trujillo and Ojinnaka.) more...
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- 2024
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104. Association between air temperature and unintentional drowning risk in the United Kingdom 2012-2019: A nationwide case-crossover study.
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Hills SP, Hobbs M, Brown P, Tipton M, and Barwood M
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- Humans, Male, Female, Cross-Over Studies, Temperature, Risk Factors, Water, Drowning
- Abstract
Objective: Drowning is a leading cause of death. The World Health Organization (WHO) and United Nations (UN) emphasise the need for population-level data-driven approaches to examine risk factors to improve water safety policies. Weather conditions, have the potential to influence drowning risk behaviours as people are more likely to spend time around water and/or undertake risky activities in aquatic spaces as a behavioural thermoregulatory response (e.g., seeking coolth)., Methods: A case-crossover approach assessed associations between changes in daily maximum air temperature (data from the nearest weather station to each drowning event) and unintentional drowning risk using anonymous data from the validated UK Water Incident Database 2012-2019 (1945 unintentional deaths, 82% male). Control days were selected using a unidirectional time-stratified approach, whereby seven and 14 days before the hazard day were used as the controls., Results: Mean maximum air temperature on case and control days was 15.36 °C and 14.80 °C, respectively. A 1 °C increase in air temperature was associated with a 7.2% increase in unintentional drowning risk. This relationship existed for males only. Drowning risk was elevated on days where air temperature reached 15-19.9 °C (Odds Ratio; OR: 1.75), 20-24.9 °C (OR: 1.87), and ≥ 25 °C (OR: 4.67), compared with days <10 °C. The greatest elevations in risk appeared to be amongst males and when alcohol intoxication was suspected. Precipitation showed no significant association with unintentional drowning risk., Conclusions: Identifying such relationships highlights the value of considering weather conditions when evaluating environmental risk factors for drowning, and may inform water safety policy and allocating resources to prevention and rescue., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.) more...
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- 2024
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105. Urine and Dried Blood Spots From Children and Pregnant Women Reveal Phytochemicals, Amino Acids, and Carnitine Metabolites as Cowpea Consumption Biomarkers.
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Tipton M, Baxter BA, Pfluger BA, Sayre-Chavez B, Muñoz-Amatriaín M, Broeckling CD, Shani I, Steiner-Asiedu M, Manary M, and Ryan EP
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- Child, Adult, Humans, Female, Pregnancy, Amino Acids, Pregnant Women, Health Promotion, Carnitine, Vegetables, Metabolomics methods, Lipids, Phytochemicals, Biomarkers urine, Vigna, Fabaceae, Malnutrition, Cysteine analogs & derivatives
- Abstract
Scope: Legumes consumption has been proven to promote health across the lifespan; cowpeas have demonstrated efficacy in combating childhood malnutrition and growth faltering, with an estimated malnutrition prevalence of 35.6% of children in Ghana. This cowpea feeding study aimed to identify a suite of metabolic consumption biomarkers in children and adults., Methods and Results: Urine and dried blood spots (DBS) from 24 children (9-21 months) and 21 pregnant women (>18 years) in Northern Ghana are collected before and after dose-escalated consumption of four cowpea varieties for 15 days. Untargeted metabolomics identified significant increases in amino acids, phytochemicals, and lipids. The carnitine metabolism pathway is represented by 137 urine and 43 DBS metabolites, with significant changes to tiglylcarnitine and acetylcarnitine. Additional noteworthy candidate biomarkers are mansouramycin C, N-acetylalliin, proline betaine, N2, N5-diacetylornithine, S-methylcysteine, S-methylcysteine sulfoxide, and cis-urocanate. S-methylcysteine and S-methylcysteine sulfoxide are targeted and quantified in urine., Conclusion: This feeding study for cowpea biomarkers supports the utility of a suite of key metabolites classified as amino acids, lipids, and phytochemicals for dietary legume and cowpea-specific food exposures of global health importance., (© 2024 Wiley-VCH GmbH.) more...
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- 2024
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106. Persistent CD8 + T cell proliferation and activation in COVID-19 adult survivors with post-acute sequelae: a longitudinal, observational cohort study of persistent symptoms and T cell markers.
- Author
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LaVergne SM, Dutt TS, McFann K, Baxter BA, Webb TL, Berry K, Tipton M, Stromberg S, Sullivan BM, Dunn J, Henao-Tamayo M, and Ryan EP
- Subjects
- Humans, Adult, CD8-Positive T-Lymphocytes, Retrospective Studies, Convalescence, Leukocytes, Mononuclear, Ki-67 Antigen, Post-Acute COVID-19 Syndrome, Quality of Life, SARS-CoV-2, CD4-Positive T-Lymphocytes, Cohort Studies, CD3 Complex, Disease Progression, Inflammation, Cell Proliferation, Survivors, Dyspnea, Chest Pain, COVID-19 complications
- Abstract
Introduction: Post-acute sequelae of COVID-19 affects the quality of life of many COVID-19 survivors, yet the etiology of post-acute sequelae of COVID-19 remains unknown. We aimed to determine if persistent inflammation and ongoing T-cell activation during convalescence were a contributing factor to the pathogenesis of post-acute sequelae of COVID-19., Methods: We evaluated 67 individuals diagnosed with COVID-19 by nasopharyngeal polymerase chain reaction for persistent symptoms during convalescence at separate time points occurring up to 180 days post-diagnosis. Fifty-two of these individuals were evaluated longitudinally. We obtained whole blood samples at each study visit, isolated peripheral blood mononuclear cells, and stained for multiple T cell activation markers for flow cytometry analysis. The activation states of participants' CD4
+ and CD8+ T-cells were next analyzed for each of the persistent symptoms., Results: Overall, we found that participants with persistent symptoms had significantly higher levels of inflammation at multiple time points during convalescence when compared to those who fully recovered from COVID-19. Participants with persistent dyspnea, forgetfulness, confusion, and chest pain had significantly higher levels of proliferating effector T-cells (CD8+ Ki67+ ), and those with chest pain, joint pain, difficulty concentrating, and forgetfulness had higher levels of regulatory T-cells (CD4+ CD25+ ). Additionally, those with dyspnea had significantly higher levels of CD8+ CD38+ , CD8+ Granzyme B+ , and CD8+ IL10+ cells. A retrospective comparison of acute phase inflammatory markers in adults with and without post-acute sequelae of COVID-19 showed that CD8+ Ki67+ cells were significantly higher at the time of acute illness (up to 14 days post-diagnosis) in those who developed persistent dyspnea., Discussion: These findings suggest continued CD8+ T-cell activation following SARS-CoV-2 infection in adults experiencing post-acute sequelae of COVID-19 and that the increase in T regulatory cells for a subset of these patients represents the ongoing attempt by the host to reduce inflammation., Competing Interests: BS is employed by Arcturus Therapeutics which is developing a COVID-19 vaccine. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 LaVergne, Dutt, McFann, Baxter, Webb, Berry, Tipton, Stromberg, Sullivan, Dunn, Henao-Tamayo and Ryan.) more...- Published
- 2024
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107. Proxy use of patient portals on behalf of children: Federally Qualified Health Centers as a case study.
- Author
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Dang P, Chavez A, Pham C, Tipton M, Woodard LD, and Adepoju OE
- Abstract
Objective: This study examined the proxy use of patient portals for children in a large Federally Qualified Health Centers (FQHC) network in Texas., Methods: We used de-identified individual-level data of patients, 0-18 years, who had 1+ visits between December 2018 and November 2020. Logistic regression was used to examine patient-, clinic-, and geographic-level factors associated with portal usage by an assumed proxy (i.e. parent or guardian)., Results: The proxy portal usage rate increased from 28% in the pre-pandemic months (November 2018-February 2020) to 34% in the pandemic months (March-Nov 2020). Compared to patients 0-5 years, patients aged 6 to 18 years had lower odds of portal usage (6-10 OR: 0.77, p < 0.001; 11-14 OR: 0.62, p < 0.001; 15-18 OR: 0.51, p < 0.001). Minoritized groups had significantly lower odds of portal usage when compared to their non-Hispanic White counterparts (non-Hispanic Black OR: 0.78, p < 0.001; Hispanic OR 0.63, p < 0.001; Asian OR: 0.69, p < 0.001). Having one chronic condition was associated with portal usage (OR: 1.57, p < 0.001); however, there were no significant differences in portal usage between those with none or multiple chronic conditions. Portal usage also varied by service lines, with obstetrics and gynecology (OR: 1.84, p < 0.001) and behavioral health (OR 1.82, p < 0.001) having the highest odds of usage when compared to pediatrics. Having a telemedicine visit was the strongest predictor of portal usage (OR: 2.30, p < 0.001), while residence in zip codes with poor broadband internet access was associated with lower odds of portal usage (OR: 0.97, p < 0.001)., Conclusion: While others have reported portal usage rates as high as 64% in pediatric settings, our analysis suggests proxy portal usage rates of 30% in pediatric FQHC settings, with race/ethnicity, age group, and chronic disease status being significant drivers of portal non-usage. These findings highlight the need for appropriate and responsive health information technology approaches for vulnerable populations receiving care in low-resource settings., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.) more...
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- 2024
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108. Quantifying the physical demands undertaken by offshore wind technicians during a working day and casualty evacuations.
- Author
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O'Halloran J, Tipton M, and Milligan G
- Subjects
- Humans, Male, Female, Physical Examination, Surveys and Questionnaires, Wind, Industry
- Abstract
Background: Offshore wind technicians (WTs) have been identified as having an occupation with high physical demands., Objective: To characterise the physical demands of WTs, during the working day and when performing casualty rescues., Methods: Data collection consisted of two components. Component A, 14 WTs (n = 13 male, 1 female) were monitored over three consecutive working days. The data collected consisted of: a questionnaire; heart rate and movement data; and accelerometer data. Component B, 5 WTs (n = 5 male) were assessed undertaking two simulated casualty evacuations. Heart rate and metabolic data were collected., Results: A working day lasted 7.5 hrs to 9 hrs, with WTs covering, on average, 4.7 km on the turbine. WTs spent 28% of their time undertaking "light activity", 69% "moderate activity" and 3% working "vigorously". The greatest amount of time in a day was spent working on manual handling tasks such as torque and tensioning (up to 4 hours in total). Both rescues were performed largely aerobically, with similar cardiac and metabolic demands (14.56 (4.84) mL.kg-1.min-1 vs. 17.07 (3.54) mL.kg-1.min-1). Higher RPE values were reported for the rescue from within the Hub (median (range), 13 (12-14)) compared to down the ladder (11 (7-12)), likely due to a greater requirement to manoeuvre the casualty in tight spaces., Conclusion: The results presented characterise the physical requirements of WTs during the working day and two casualty evacuations. These data play an important role in supporting the job task analysis for WTs working in the offshore wind industry. more...
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- 2024
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109. The swimming habits of women who cold water swim.
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Pound M, Massey H, Roseneil S, Williamson R, Harper M, Tipton M, Shawe J, Felton M, and Harper J
- Subjects
- Humans, Female, Adult, Middle Aged, Surveys and Questionnaires, United Kingdom, Menopause physiology, Habits, Young Adult, Menstruation physiology, Swimming physiology, Cold Temperature
- Abstract
Background: Cold water swimming is growing in popularity, especially among women. We have previously reported that women felt that cold water swimming helps with their menstrual and menopause symptoms. But little is known about the habits of women who cold water swim., Objectives: To determine the habits of women who cold water swim., Design: This was a mixed-methods study., Methods: An online survey asked women who cold water swim about their experience of swimming and how this affected their menstrual and menopause symptoms. The survey was advertised for 2 months on social media, with a focus on advertising in cold water swimming Facebook groups. In this article, only the questions on the women's swimming habits were analyzed., Results: The analysis of 1114 women, mainly from the United Kingdom, revealed that most had been swimming for 1-5 years (79.5%). Most swim in the sea (64.4%), and only 15.5% swim alone. The majority (89.0%) swim all year around, swimming for mainly 30-60 min in the summer and 5-15 min in the winter. The women mostly swim wearing swimming costumes (skins) throughout the year. The majority of the free-text responses showed women found mental and physical benefits from cold water swimming., Conclusion: It was not surprising to learn that women swim for longer in the summer than the winter, but hearing how they feel cold water swimming helps their physical and mental health is important. With the limitations on access and safety of many wild swimming sites in the United Kingdom, it is time to ensure that cold water swimming is safer and more supported. more...
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- 2024
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110. Quantifying the essential tasks of offshore wind technicians.
- Author
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Milligan G, O'Halloran J, and Tipton M
- Subjects
- Humans, Physical Examination, Surveys and Questionnaires, Focus Groups, Employment, Industry
- Abstract
Background: Offshore wind technicians (WTs) have been identified as having an occupation with varying physical demands. Therefore, in order to assess WTs capability to undertake the job, there was a need to identify and quantify the physical requirements of the essential tasks., Objective: To establish the essential tasks and quantify the associated minimum physical demands of being an offshore WT., Methods: Wind Farm organisations (n = 10) across five countries, undertook a multi-modal observational approach comprising of semi-structured interviews (n = 45), focus groups (n = 14), survey (n = 167). In addition, observations, objective measurements, video footage and standard operating procedures were reviewed. A service campaign was broken down into component tasks, and analysed in terms of technical specifications, e.g. equipment, frequency, duration, rest breaks, clothing ensembles, and the methods of best practice for undertaking each of the tasks. Task descriptions were produced and minimum performance standards recommended., Results: The job tasks associated with WTs can be broken down into two categories and five areas of work (Essential infrequent = casualty evacuation and prolonged ladder climbing; Essential frequent = short ladder climbs, manual handling and working in restricted spaces)., Conclusions: The results presented constitute work carried out in Phases 1 and 2 of a three phased work programme to establish a physical employment standard required by WTs working in offshore wind. These findings will underpin the development of a minimum performance standard for the global offshore wind industry. more...
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- 2024
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111. The effect of repeated hot water immersion on insulin sensitivity, heat shock protein 70, and inflammation in individuals with type 2 diabetes mellitus.
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James TJ, Corbett J, Cummings M, Allard S, Shute JK, Belcher H, Mayes H, Gould AAM, Piccolo DD, Tipton M, Perissiou M, Saynor ZL, and Shepherd AI
- Subjects
- Humans, Blood Glucose metabolism, Glucose, HSP70 Heat-Shock Proteins, Immersion, Inflammation, Insulin metabolism, Insulin pharmacology, Water, Hot Temperature, Diabetes Mellitus, Type 2 metabolism, Insulin Resistance
- Abstract
Repeated hot water immersion (HWI) can improve glycemic control in healthy individuals but data are limited for individuals with type 2 diabetes mellitus (T2DM). The present study investigated whether repeated HWI improves insulin sensitivity and inflammatory status and reduces plasma ([extracellular heat shock protein 70]) [eHSP70] and resting metabolic rate (RMR). Fourteen individuals with T2DM participated in this pre- versus postintervention study, with outcome measures assessed in fasted (≥12 h) and postprandial (2-h post-75 g glucose ingestion) states. HWI consisted of 1 h in 40°C water (target rectal temperature 38.5°C-39°C) repeated 8-10 times within a 14-day period. Outcome measures included insulin sensitivity, plasma [glucose], [insulin], [eHSP70], inflammatory markers, RMR, and substrate utilization. The HWI intervention increased fasted insulin sensitivity (QUICKI; P = 0.03) and lowered fasted plasma [insulin] ( P = 0.04), but fasting plasma [glucose] ( P = 0.83), [eHSP70] ( P = 0.08), [IL-6] ( P = 0.55), [IL-10] ( P = 0.59), postprandial insulin sensitivity ( P = 0.19), plasma [glucose] ( P = 0.40), and [insulin] ( P = 0.47) were not different. RMR was reduced by 6.63% ( P < 0.05), although carbohydrate ( P = 0.43) and fat oxidation ( P = 0.99) rates were unchanged. This study shows that 8-10 HWIs within a 14-day period improved fasting insulin sensitivity and plasma [insulin] in individuals with T2DM, but not when glucose tolerance is challenged. HWI also improves metabolic efficiency (i.e., reduced RMR). Together these results could be clinically important and have implications for metabolic health outcomes and well-being in individuals with T2DM. NEW & NOTEWORTHY This is the first study to investigate repeated HWI to raise deep body temperature on insulin sensitivity, inflammation, eHSP70, and substrate utilization in individuals with T2DM. The principal novel findings were improvements in fasting insulin sensitivity and fasting plasma [insulin] but no change in fasting plasma [glucose], postprandial insulin sensitivity, plasma [insulin], or [glucose]. There was also no change in eHSP70, inflammatory status, or substrate utilization but there were reductions in RMR and oxygen consumption. more...
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- 2023
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112. Comprehensive assessment of physiological responses in women during the ESA dry immersion VIVALDI microgravity simulation.
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Robin A, Van Ombergen A, Laurens C, Bergouignan A, Vico L, Linossier MT, Pavy-Le Traon A, Kermorgant M, Chopard A, Py G, Green DA, Tipton M, Choukér A, Denise P, Normand H, Blanc S, Simon C, Rosnet E, Larcher F, Fernandez P, de Glisezinski I, Larrouy D, Harant-Farrugia I, Antunes I, Gauquelin-Koch G, Bareille MP, Billette De Villemeur R, Custaud MA, and Navasiolava N more...
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- Humans, Female, Cardiovascular Deconditioning physiology, Immersion, Weightlessness Simulation, Space Flight, Weightlessness adverse effects
- Abstract
Astronauts in microgravity experience multi-system deconditioning, impacting their inflight efficiency and inducing dysfunctions upon return to Earth gravity. To fill the sex gap of knowledge in the health impact of spaceflights, we simulate microgravity with a 5-day dry immersion in 18 healthy women (ClinicalTrials.gov Identifier: NCT05043974). Here we show that dry immersion rapidly induces a sedentarily-like metabolism shift mimicking the beginning of a metabolic syndrome with a drop in glucose tolerance, an increase in the atherogenic index of plasma, and an impaired lipid profile. Bone remodeling markers suggest a decreased bone formation coupled with an increased bone resorption. Fluid shifts and muscular unloading participate to a marked cardiovascular and sensorimotor deconditioning with decreased orthostatic tolerance, aerobic capacity, and postural balance. Collected datasets provide a comprehensive multi-systemic assessment of dry immersion effects in women and pave the way for future sex-based evaluations of countermeasures., (© 2023. Springer Nature Limited.) more...
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- 2023
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113. Prevention and Treatment of Nonfreezing Cold Injuries and Warm Water Immersion Tissue Injuries: A Supplement to the Wilderness Medical Society Clinical Practice Guidelines
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Zafren K, Hollis S, Weiss EA, Danzl D, Wilburn J, Kimmel N, Imray C, Giesbrecht G, and Tipton M
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- Humans, Water, Immersion, Practice Patterns, Physicians', Societies, Medical, Cold Temperature, Immersion Foot prevention & control, Wilderness Medicine, Frostbite prevention & control
- Abstract
We convened an expert panel to develop evidence-based guidelines for the evaluation, treatment, and prevention of nonfreezing cold injuries (NFCIs; trench foot and immersion foot) and warm water immersion injuries (warm water immersion foot and tropical immersion foot) in prehospital and hospital settings. The panel graded the recommendations based on the quality of supporting evidence and the balance between benefits and risks/burdens according to the criteria published by the American College of Chest Physicians. Treatment is more difficult with NFCIs than with warm water immersion injuries. In contrast to warm water immersion injuries that usually resolve without sequelae, NFCIs may cause prolonged debilitating symptoms, including neuropathic pain and cold sensitivity., (Copyright © 2023 Wilderness Medical Society. All rights reserved.) more...
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- 2023
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114. Non-freezing cold injury: A little-known big problem.
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Tipton M and Eglin C
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- Humans, Acclimatization, Cold Temperature, Cold Injury
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- 2023
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115. Peripheral sensory function in non-freezing cold injury patients and matched controls.
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Wright J, Massey H, Hollis S, Vale T, Bennett DL, Maley M, Montgomery H, Tipton M, and Eglin C
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- Humans, Sensation, Foot, Cold Temperature, Cold Injury
- Abstract
New Findings: What is the central question of this study? Is peripheral sensory function impaired in the chronic phase of non-freezing cold injury (NFCI)? What is the main finding and its importance? Warm and mechanical detection thresholds are elevated and intraepidermal nerve fibre density is reduced in individuals with NFCI in their feet when compared to matched controls. This indicates impaired sensory function in individuals with NFCI. Interindividual variation was observed in all groups, and therefore a diagnostic cut-off for NFCI has yet to be established. Longitudinal studies are required to follow NFCI progression from formation to resolution ABSTRACT: The aim of this study was to compare peripheral sensory neural function of individuals with non-freezing cold injury (NFCI) with matched controls (without NFCI) with either similar (COLD) or minimal previous cold exposure (CON). Thirteen individuals with chronic NFCI in their feet were matched with the control groups for sex, age, race, fitness, body mass index and foot volume. All undertook quantitative sensory testing (QST) on the foot. Intraepidermal nerve fibre density (IENFD) was assessed 10 cm above the lateral malleolus in nine NFCI and 12 COLD participants. Warm detection threshold was higher at the great toe in NFCI than COLD (NFCI 45.93 (4.71)°C vs. COLD 43.44 (2.72)°C, P = 0.046), but was non-significantly different from CON (CON 43.92 (5.01)°C, P = 0.295). Mechanical detection threshold on the dorsum of the foot was higher in NFCI (23.61 (33.59) mN) than in CON (3.83 (3.69) mN, P = 0.003), but was non-significantly different from COLD (10.49 (5.76) mN, P > 0.999). Remaining QST measures did not differ significantly between groups. IENFD was lower in NFCI than COLD (NFCI 8.47 (2.36) fibre/mm
2 vs. COLD 11.93 (4.04) fibre/mm2 , P = 0.020). Elevated warm and mechanical detection thresholds may indicate hyposensitivity to sensory stimuli in the injured foot for individuals with NFCI and may be due to reduced innervation given the reduction in IENFD. Longitudinal studies are required to identify the progression of sensory neuropathy from the formation of injury to its resolution, with appropriate control groups employed., (© 2022 The Authors. Experimental Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.) more...- Published
- 2023
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116. Sex differences in response to exercise heat stress in the context of the military environment.
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Corbett J, Wright J, and Tipton MJ
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- Female, Humans, Male, Sex Characteristics, Exercise physiology, Heat-Shock Response, Military Personnel, Heat Stress Disorders
- Abstract
Women can now serve in ground close combat (GCC) roles, where they may be required to operate alongside men in hot environments. However, relative to the average male soldier, female soldiers are less aerobically fit, with a smaller surface area ( A ), lower mass (m) with higher body fat and a larger
D /m ratio. This increases cardiovascular strain, reduces heat exchange with the environment and causes a greater body temperature increase for a given heat storage, although a large A /m ratio can be advantageous. Physical employment standards for GCC roles might lessen the magnitude of fitness and anthropometric differences, yet even when studies control for these factors, women sweat less than men at high work rates. Therefore, the average female soldier in a GCC role is likely to be at a degree of disadvantage in many hot environments and particularly during intense physical activity in hot-arid conditions, although heat acclimation may mitigate some of this effect. Any thermoregulatory disadvantage may be exacerbated during the mid-luteal phase of the menstrual cycle, although the data are equivocal. Likewise, sex differences in behavioural thermoregulation and cognition in the heat are not well understood. Interestingly, there is often lower reported heat illness incidence in women, although the extent to which this is influenced by behavioural factors or historic differences in role allocation is unclear. Indeed, much of the extant literature lacks ecological validity and more work is required to fully understand sex differences to exercise heat stress in a GCC context.D /m ratio. This increases cardiovascular strain, reduces heat exchange with the environment and causes a greater body temperature increase for a given heat storage, although a large AD /m ratio can be advantageous. Physical employment standards for GCC roles might lessen the magnitude of fitness and anthropometric differences, yet even when studies control for these factors, women sweat less than men at high work rates. Therefore, the average female soldier in a GCC role is likely to be at a degree of disadvantage in many hot environments and particularly during intense physical activity in hot-arid conditions, although heat acclimation may mitigate some of this effect. Any thermoregulatory disadvantage may be exacerbated during the mid-luteal phase of the menstrual cycle, although the data are equivocal. Likewise, sex differences in behavioural thermoregulation and cognition in the heat are not well understood. Interestingly, there is often lower reported heat illness incidence in women, although the extent to which this is influenced by behavioural factors or historic differences in role allocation is unclear. Indeed, much of the extant literature lacks ecological validity and more work is required to fully understand sex differences to exercise heat stress in a GCC context., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.) more...- Published
- 2023
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117. Cognitive performance of military men and women during prolonged load carriage.
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Armstrong NC, Smith SJR, Risius D, Doyle D, Wardle SL, Greeves JP, House JR, Tipton M, and Lomax M
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- Male, Humans, Female, Walking physiology, Weight-Bearing physiology, Time Factors, Cognition physiology, Military Personnel psychology
- Abstract
Background: This study evaluated cognitive workload in soldiers undertaking a long duration march wearing different loads., Methods: Military participants (n=12 men and n=10 women) performed four 3-hour loaded marches (12.25 km at 4.9 km/hour) wearing either 21 kg, 26 kg, 33 kg or 43 kg. During the march, accuracy and response time were measured using the verbal working memory n-back test (0, 1, 2 and 3) and two bespoke Go/No Go tests (visual/auditory) to assess inhibition of a pre-potent response., Results: The physical demands of the march increased with load and march duration but remained at moderate intensity. N-back test accuracy ranged from 74% to 98% in men and 62% to 98% in women. Reduced accuracy was observed as load and time increased. Accuracy during the visual Go/No Go test also reduced with load, accuracy ranged from 69% to 89% in men and 65% to 90% in women. No differences due to load or time were observed during completion of the auditory Go/No Go task; accuracy ranged from 93% to 97% in men and 77% to 95% in women. A number of participants were unable to complete the march due to discomfort. Reports of discomfort were more frequent in women, which may have contributed to the greater reductions in accuracy observed., Conclusion: These data provide further evidence that cognitive performance of military personnel can be affected during long duration loaded marching. Women reported discomfort from equipment more frequently than men, which may make them more susceptible to declines in cognitive performance. These findings highlight important considerations for equipment procurement., Competing Interests: Competing interests: None declared., (© Crown copyright (2023), Dstl and MOD.) more...
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- 2023
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118. Plasma, urine, and stool metabolites in response to dietary rice bran and navy bean supplementation in adults at high-risk for colorectal cancer.
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Hill EB, Baxter BA, Pfluger B, Slaughter CK, Beale M, Smith HV, Stromberg SS, Tipton M, Ibrahim H, Rao S, Leach H, and Ryan EP
- Abstract
Introduction: Dietary intake of whole grains and legumes and adequate physical activity (PA) have been associated with reduced colorectal cancer (CRC) risk. A single-blinded, two-arm, randomized, placebo-controlled pilot trial was implemented to evaluate the impact of a 12-week dietary intervention of rice bran + navy bean supplementation and PA education on metabolite profiles and the gut microbiome among individuals at high risk of CRC., Methods: Adults (n=20) were randomized 1:1 to dietary intervention or control. All participants received PA education at baseline. Sixteen study foods were prepared with either heat-stabilized rice bran + navy bean powder or Fibersol
® -2 as a placebo. Intervention participants consumed 30 g rice bran + 30 g navy bean powder daily; those in the control group consumed 10 g placebo daily. Non-targeted metabolite profiling was performed by UPLC-MS/MS to evaluate plasma, urine, and stool at 0, 6, and 12 weeks. Stool was also analyzed for primary and secondary bile acids (BAs) and short chain fatty acids (SCFAs) by UPLC-MS/MS and microbial community structure via 16S amplicon sequencing. Two-way ANOVA was used to compare differences between groups for metabolites, and mixed models were used to compare differences between groups for BAs, SCFAs, and alpha and beta diversity measures of microbial community structure., Results: Across biological matrices, the intervention resulted in changes to several amino acid and lipid metabolites, compared to control. There was a 2.33-fold difference in plasma (p<0.001) and a 3.33-fold difference in urine (p=0.008) for the amino acid S-methylcysteine at 12 weeks. Fold-differences to 4-methoxyphenol sulfate in plasma and urine after 6 and 12 weeks (p<0.001) was a novel result from this combined rice bran and navy bean intervention in people. A 2.98-fold difference in plasma (p=0.002) and a 17.74-fold difference in stool (p=0.026) was observed for the lipid octadecenedioylcarnitine at 12 weeks. For stool BAs, 3-oxocholic acid was increased at 12 weeks compared to control within a subset of individuals (mean difference 16.2 ug/uL, p=0.022). No significant differences were observed between groups for stool SCFAs or microbial community structure., Discussion: Dietary intake of rice bran + navy beans demonstrates beneficial modulation of host and gut microbial metabolism and represents a practical and affordable means of increasing adherence to national guidelines for CRC control and prevention in a high-risk population., Competing Interests: Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. more...- Published
- 2023
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119. Correlation between 25-hydroxyvitamin D/D3 Deficiency and COVID-19 Disease Severity in Adults from Northern Colorado.
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Baxter BA, Ryan MG, LaVergne SM, Stromberg S, Berry K, Tipton M, Natter N, Nudell N, McFann K, Dunn J, Webb TL, Armstrong M, Reisdorph N, and Ryan EP
- Subjects
- Adult, Humans, Cholecalciferol, Longitudinal Studies, Chromatography, Liquid, Colorado epidemiology, Tandem Mass Spectrometry, Dietary Supplements, SARS-CoV-2, Vitamin D, Calcifediol, Patient Acuity, COVID-19 epidemiology, Vitamin D Deficiency
- Abstract
Vitamin D deficiency is common in the United States and leads to altered immune function, including T cell and macrophage activity that may impact responses to SARS-CoV-2 infection. This study investigated 131 adults with a history of a positive SARS-CoV-2 nasopharyngeal PCR and 18 adults with no COVID-19 diagnosis that were recruited from the community or hospital into the Northern Colorado Coronavirus Biorepository (NoCo-COBIO). Participants consented to enrollment for a period of 6 months and provided biospecimens at multiple visits for longitudinal analysis. Plasma 25-hydroxyvitamin D levels were quantified by LC-MS/MS at the initial visit (n = 149) and after 4 months (n = 89). Adults were classified as deficient (<30 nM or <12 ng/mL), insufficient (<30−50 nM or 12−20 ng/mL), or optimal (50−75 nM or >20 ng/mL) for 25-hydroxyvitamin D status. Fisher’s exact test demonstrated an association between disease severity, gender, and body mass index (BMI) at baseline. Mixed model analyses with Tukey-Kramer were used for longitudinal analysis according to BMI. Sixty-nine percent (n = 103) of the entire cohort had optimal levels of total 25(OH)D, 22% (n = 32) had insufficient levels, and 9% (n = 14) had deficent levels. Participants with severe disease (n = 37) had significantly lower 25-hydroxyvitamin D (total 25(OH)D) when compared to adults with mild disease (p = 0.006) or no COVID-19 diagnosis (p = 0.007). There was 44% of the cohort with post-acute sequalae of COVID-19 (PASC) as defined by experiencing at least one of the following symptoms after 60 days’ post-infection: fatigue, dyspnea, joint pain, chest pain, forgetfulness or absent-mindedness, confusion, or difficulty breathing. While significant differences were detected in 25-hydroxyvitamin D status by sex and BMI, there were no correlations between 25-hydroxyvitamin D for those without and without PASC. This longitudinal study of COVID-19 survivors demonstrates an important association between sex, BMI, and disease severity for 25-hydroxyvitamin D deficiency during acute stages of infection, yet it is not clear whether supplementation efforts would influence long term outcomes such as developing PASC. more...
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- 2022
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120. Survival time and search time in water: Past, present and future.
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Tipton M, McCormack E, Elliott G, Cisternelli M, Allen A, and Turner AC
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- Water
- Abstract
The prediction of survival time for those immersed in water remains a key element in the function of search and rescue organisations around the globe. The data on which such predictions are made come from laboratory studies and actual incidents. The UK National Immersion Incident Survey (UKNIIS) represents one of the largest surveys undertaken in this area. The UKNIIS data are obtained by questionnaire from immersion incidents around the British Isles. The survey has been in operation since 1991 and at the time of writing contained almost 1600 cases. The aim of the present work was to analyse these cases with the aim of establishing a model for the prediction of survival time in water. This analysis is described in this paper: two model approaches are presented and their strengths and weaknesses are discussed. Recommendations for the use and development of such models are made., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.) more...
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- 2022
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121. Cold water therapies: minimising risks.
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Tipton M, Massey H, Mayhew A, and Morgan P
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- Humans, Body Temperature Regulation, Water, Cryotherapy
- Abstract
Competing Interests: Competing interests: None declared.
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- 2022
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122. Climate change, healthy ageing and the health crisis: is wisdom the link?
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Tipton M and Montgomery H
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- Climate Change, Healthy Aging
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- 2022
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123. Relationships between plasma fatty acids in adults with mild, moderate, or severe COVID-19 and the development of post-acute sequelae.
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Stromberg S, Baxter BA, Dooley G, LaVergne SM, Gallichotte E, Dutt T, Tipton M, Berry K, Haberman J, Natter N, Webb TL, McFann K, Henao-Tamayo M, Ebel G, Rao S, Dunn J, and Ryan EP
- Abstract
Background: SARS-CoV-2 has infected millions across the globe. Many individuals are left with persistent symptoms, termed post-acute sequelae of COVID-19 (PASC), for months after infection. Hyperinflammation in the acute and convalescent stages has emerged as a risk factor for poor disease outcomes, and this may be exacerbated by dietary inadequacies. Specifically, fatty acids are powerful inflammatory mediators and may have a significant role in COVID-19 disease modulation., Objective: The major objective of this project was to pilot an investigation of plasma fatty acid (PFA) levels in adults with COVID-19 and to evaluate associations with disease severity and PASC., Methods and Procedures: Plasma from adults with ( N = 41) and without ( N = 9) COVID-19 was analyzed by gas chromatography-mass spectrometry (GC-MS) to assess differences between the concentrations of 18 PFA during acute infection (≤14 days post-PCR + diagnosis) in adults with varying disease severity. Participants were grouped based on mild, moderate, and severe disease, alongside the presence of PASC, a condition identified in patients who were followed beyond acute-stage infection ( N = 23)., Results: Significant differences in PFA profiles were observed between individuals who experienced moderate or severe disease compared to those with mild infection or no history of infection. Palmitic acid, a saturated fat, was elevated in adults with severe disease ( p = 0.04), while behenic ( p = 0.03) and lignoceric acid ( p = 0.009) were lower in adults with moderate disease. Lower levels of the unsaturated fatty acids, γ-linolenic acid (GLA) ( p = 0.03), linoleic ( p = 0.03), and eicosapentaenoic acid (EPA) ( p = 0.007), were observed in adults with moderate disease. Oleic acid distinguished adults with moderate disease from severe disease ( p = 0.04), and this difference was independent of BMI. Early recovery-stage depletion of GLA ( p = 0.02) and EPA ( p = 0.0003) was associated with the development of PASC., Conclusion: Pilot findings from this study support the significance of PFA profile alterations during COVID-19 infection and are molecular targets for follow-up attention in larger cohorts. Fatty acids are practical, affordable nutritional targets and may be beneficial for modifying the course of disease after a COVID-19 diagnosis. Moreover, these findings can be particularly important for overweight and obese adults with altered PFA profiles and at higher risk for PASC., Clinical Trial Registration: [ClinicalTrials.gov], identifier [NCT04603677]., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Stromberg, Baxter, Dooley, LaVergne, Gallichotte, Dutt, Tipton, Berry, Haberman, Natter, Webb, McFann, Henao-Tamayo, Ebel, Rao, Dunn and Ryan.) more...
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- 2022
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124. Deaths in Open Water Swimming Races in Brazil from 2009 to 2019.
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DI Masi F, Costa E Silva G, DE Mello DB, Szpilman D, and Tipton M
- Abstract
Since the inclusion in the Olympic Games (2008), open swimming races have attracted greater media attention and, therefore, have a greater number of practitioners, especially in Brazil, an extremely favorable country for this sport. However, increasing reports of fatal incidents in open water races brought the medical and scientific community to attention. The aim of this study was to review the characteristics of deaths in open waters events in Brazil from 2009 to 2019. The survey was divided into 3 steps: 1) contacting sports-related federations and companies, including swimming and triathlon federations, master associations and event organizing companies; 2) internet search ; and 3) personal communication with athletes, coaches, organizers, and health personnel. A total of 12 deaths were observed in open water swimming races, including triathlon swimming segment races in Brazil from 2009 to 2019. The average was 1.1 deaths per year, whereas in the last 3 years (2017-2019) the average was 3 deaths per year. The male participants accounted for 11 deaths (91.7%), the average age was 47 years old, experienced athletes were more affected (80%), and incidents occurred mainly in ocean waters (75%). The increase of deaths in the last 3 years draws attention, and the best way to reduce the deaths by drowning in open waters in Brazil, is to understand the profile and causes, to propose solutions. more...
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- 2022
125. Covid-19 special issue editorial.
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Tipton M
- Subjects
- Humans, COVID-19
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- 2022
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126. Travelling back to normal.
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Tipton M and Montgomery H
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- 2022
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127. Safety and reactogenicity of a liquid formulation of human rotavirus vaccine (porcine circovirus-free): A phase III, observer-blind, randomized, multi-country study.
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Lau YL, Fan Leung T, Sirvan Cetin B, Cagri Dinleyici E, Huang LM, Halperin SA, Hsiao CC, Tapiero B, Tipton M, Campbell JD, Moerman L, Povey M, Bi D, and Singh T
- Subjects
- Humans, Infant, Vaccination, Vaccines, Attenuated, Circovirus, Rotavirus, Rotavirus Infections, Rotavirus Vaccines
- Abstract
Background: The introduction of rotavirus vaccines in national immunization programs has decreased mortality and hospitalizations due to diarrhea. GSK's live-attenuated, human rotavirus vaccine (HRV) is a 2-dose vaccine for oral administration. Following the detection of porcine circovirus type 1 (PCV-1) in HRV, a PCV-free (no detection of PCV-1 and PCV-2 according to the detection limits of tests used) HRV was developed. The immunogenicity, reactogenicity and safety of a liquid (liq) PCV-free HRV were assessed in two prior studies. The present study aimed to generate additional reactogenicity and safety data., Methods: This phase III, observer-blind, randomized, controlled multi-country study enrolled healthy 6-12-week-old infants. Infants were randomized to receive 2 doses of either the liq PCV-free HRV (N = 677) or the lyophilized (lyo) HRV (N = 674) 1-2 months apart. Solicited adverse events (AEs) were recorded for 8 days after each dose, unsolicited AEs for 31 days and serious AEs (SAEs) from dose 1 until the end of the 6-month safety follow-up., Results: The occurrence of solicited general AEs was comparable between the liq PCV-free HRV and the lyo HRV groups, with irritability/fussiness being the most frequently reported (74.9% [95% confidence interval: 71.4-78.1] and 72.1% [68.6-75.5]). Unsolicited AEs were reported for 29.7% (26.3-33.3) and 30.6% (27.1-34.2) of infants in the liq PCV-free HRV and the lyo HRV group. A total of 39 and 38 infants reported at least one SAE, respectively. The most common SAEs were upper respiratory tract (0.7% and 0.9%) and urinary tract infections (0.9% and 0.6%). One SAE (constipation) in the liq PCV-free HRV group was considered as potentially causally related to vaccination by the investigator. No deaths were reported., Conclusions: The study showed that the reactogenicity and safety profiles of the liq PCV-free HRV and the lyo HRV are similar., Clinicaltrials: gov identifier: NCT0395474., Competing Interests: 9. Declaration of Competing Interest DB, LM, MP and TS are employees of the GSK group of companies, and DB, LM and TS hold shares in the GSK group of companies as part of their employee remuneration. BT, ECD, JDC, SAH and YLL received grants from the GSK group of companies during the conduct of the study. BT’s institution received research grants for vaccine-related studies from Merck, GSK and Pfizer. SAH declares other financial relationships with Sanofi, Pfizer, Merck, Entos, IMV Inc. and VBI Vaccines outside of the submitted work. SAH declares having served on a data safety monitoring board for Medicago, advisory boards for Pfizer, Merck, GSK, Sanofi, AstraZeneca, Moderna, Medicago, and has received payment for expert testimony from the Province of Ontario, Canada. Additionally, SAH serves as a co-chair of the Vaccine Surveillance Reference Group, Public Health Agency of Canada. ECD declares other financial relationships with Sanofi Pasteur, Pfizer and the GSK group of companies outside of the submitted work. BSC, CCH, LMH, MT and TFL have no competing interest to declare. The authors have no non-financial competing interest to declare., (Copyright © 2022 GlaxoSmithKline Biologicals S.A. Published by Elsevier Ltd.. All rights reserved.) more...
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- 2022
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128. Quantifying Risk in Air Sports: Flying Activity and Incident Rates in Paragliding.
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Wilkes M, Long G, Massey H, Eglin C, and Tipton M
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- Aircraft, Extremities, Accidents, Aviation, Aviation, Sports
- Abstract
Introduction: The volume, nature, and risks of paragliding are poorly quantified. More comprehensive understanding, including incident rates allowing comparison to similar disciplines, will help direct and appraise safety interventions., Methods: Paraglider pilots were surveyed regarding experience, incidents, recordkeeping, and risk perception. The survey could not capture those who had left the sport or died, so a subset of responses from UK pilots was compared to records from an incident database., Results: There were 1788 (25%) responses from 7262 surveyed. Respondents flew a total of 87,909 h in 96,042 flights during 2019. Local flying was most frequent (n=37,680 flights, 39%) but a higher proportion of hours were spent flying cross-country (n=33,933 h, 39%). The remainder were spent in competition, hike and fly, tandem, aerobatic, or instructional flight. Flying incidents led to 103 (6%) respondents seeking medical attention, attending hospital, or missing a day of work in 2019. Near misses were reported by 423 (26%) pilots. Asymmetry and rotational forces typically led to incidents, and limb and back injuries resulted. Pilots frequently failed to throw their reserve parachutes. Only 3 (0.6%) incidents involved equipment failure, with the remainder attributed to control or decision errors. Incident rates of paragliding were estimated as 1.4 (1.1-1.9) deaths and 20 (18-27) serious injuries per 100,000 flights, approximately twice as risky as general aviation and skydiving., Conclusions: Incidents usually resulted from pilot error (control and decision), rather than equipment failure. Future safety interventions should focus on improving glider control skills and encouraging reserve parachute deployment., (Copyright © 2021 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.) more...
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- 2022
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129. The experience of drowning.
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Tipton M and Montgomery H
- Subjects
- Humans, Drowning
- Abstract
Internationally, drowning is a leading cause of accidental death that features in many legal cases. In these cases, possible mitigations and the 'pain and suffering' in terms of the duration and subjective experience of drowning are often pivotal in determining levels of compensation and outcome. As a result, there is a requirement to understand the stages of the drowning process, and the duration and physiological and subjective responses associated with each stage. In this short review we focus on these issues. more...
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- 2022
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130. Comprehensive Immune Profiling Reveals CD56 + Monocytes and CD31 + Endothelial Cells Are Increased in Severe COVID-19 Disease.
- Author
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Dutt TS, LaVergne SM, Webb TL, Baxter BA, Stromberg S, McFann K, Berry K, Tipton M, Alnachoukati O, Zier L, Ebel G, Dunn J, Henao-Tamayo M, and Ryan EP
- Subjects
- Adolescent, Adult, Age Factors, Aged, Antibodies, Viral biosynthesis, Antibodies, Viral immunology, Biomarkers, CD56 Antigen analysis, COVID-19 blood, COVID-19 epidemiology, Child, Comorbidity, Endothelial Cells chemistry, Female, Flow Cytometry, Humans, Hypertension epidemiology, Hypertension immunology, Immunophenotyping, Lymphocyte Activation, Lymphocyte Subsets immunology, Lymphopenia etiology, Lymphopenia immunology, Male, Middle Aged, Monocytes chemistry, Neutrophils immunology, Obesity epidemiology, Obesity immunology, Platelet Endothelial Cell Adhesion Molecule-1 analysis, Severity of Illness Index, Spike Glycoprotein, Coronavirus immunology, Young Adult, COVID-19 immunology, Endothelial Cells immunology, Monocytes immunology, SARS-CoV-2 immunology
- Abstract
Immune response dysregulation plays a key role in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pathogenesis. In this study, we evaluated immune and endothelial blood cell profiles of patients with coronavirus disease 2019 (COVID-19) to determine critical differences between those with mild, moderate, or severe COVID-19 using spectral flow cytometry. We examined a suite of immune phenotypes, including monocytes, T cells, NK cells, B cells, endothelial cells, and neutrophils, alongside surface and intracellular markers of activation. Our results showed progressive lymphopenia and depletion of T cell subsets (CD3
+ , CD4+ , and CD8+ ) in patients with severe disease and a significant increase in the CD56+ CD14+ Ki67+ IFN-γ+ monocyte population in patients with moderate and severe COVID-19 that has not been previously described. Enhanced circulating endothelial cells (CD45- CD31+ CD34+ CD146+ ), circulating endothelial progenitors (CD45- CD31+ CD34+/- CD146- ), and neutrophils (CD11b+ CD66b+ ) were coevaluated for COVID-19 severity. Spearman correlation analysis demonstrated the synergism among age, obesity, and hypertension with upregulated CD56+ monocytes, endothelial cells, and decreased T cells that lead to severe outcomes of SARS-CoV-2 infection. Circulating monocytes and endothelial cells may represent important cellular markers for monitoring postacute sequelae and impacts of SARS-CoV-2 infection during convalescence and for their role in immune host defense in high-risk adults after vaccination., (Copyright © 2022 by The American Association of Immunologists, Inc.) more...- Published
- 2022
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131. Quality of Life (QoL) Is Reduced in Those with Severe COVID-19 Disease, Post-Acute Sequelae of COVID-19, and Hospitalization in United States Adults from Northern Colorado.
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McFann K, Baxter BA, LaVergne SM, Stromberg S, Berry K, Tipton M, Haberman J, Ladd J, Webb TL, Dunn JA, and Ryan EP
- Subjects
- Adult, Colorado epidemiology, Hospitalization, Humans, SARS-CoV-2, United States epidemiology, COVID-19, Quality of Life
- Abstract
The longitudinal quality of life (QoL) of COVID-19 survivors, especially those with post-acute sequelae (PASC) is not well described. We evaluated QoL in our COVID-19 survivor cohort over 6 months using the RAND SF-36 survey. From July 2020-March 2021 we enrolled 110 adults from the United States with a positive SARS-CoV-2 nasopharyngeal polymerase chain reaction (PCR) into the Northern Colorado Coronavirus Biobank (NoCo-COBIO). Demographic data and symptom surveillance were collected from 62 adults. In total, 42% were hospitalized, and 58% were non-hospitalized. The Rand SF-36 consists of 36 questions and 8 scales, and questions are scored 0-100. A lower-scale score indicates a lower QoL. In conclusion, hospitalization, PASC, and disease severity were associated with significantly lower scores on the RAND SF-36 in Physical Functioning, Role Limitation due to Physical Health, Energy/Fatigue, Social Functioning, and General Health. Long-term monitoring of COVID-19 survivors is needed to fully understand the impact of the disease on QoL and could have implications for interventions to alleviate suffering during recovery. more...
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- 2021
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132. A longitudinal SARS-CoV-2 biorepository for COVID-19 survivors with and without post-acute sequelae.
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LaVergne SM, Stromberg S, Baxter BA, Webb TL, Dutt TS, Berry K, Tipton M, Haberman J, Massey BR, McFann K, Alnachoukati O, Zier L, Heacock T, Ebel GD, Henao-Tamayo M, Dunn J, and Ryan EP
- Subjects
- Adult, Aged, COVID-19 blood, COVID-19 epidemiology, COVID-19 pathology, COVID-19 virology, Colorado epidemiology, Disease Progression, Female, Follow-Up Studies, Hospitalization, Humans, Longitudinal Studies, Male, Middle Aged, Specimen Handling, Young Adult, Post-Acute COVID-19 Syndrome, Biological Specimen Banks, COVID-19 complications, COVID-19 Testing methods, SARS-CoV-2 genetics, Survivors
- Abstract
Background: SARS-CoV-2 has swept across the globe, causing millions of deaths worldwide. Though most survive, many experience symptoms of COVID-19 for months after acute infection. Successful prevention and treatment of acute COVID-19 infection and its associated sequelae is dependent on in-depth knowledge of viral pathology across the spectrum of patient phenotypes and physiologic responses. Longitudinal biobanking provides a valuable resource of clinically integrated, easily accessed, and quality-controlled samples for researchers to study differential multi-organ system responses to SARS-CoV-2 infection, post-acute sequelae of COVID-19 (PASC), and vaccination., Methods: Adults with a history of a positive SARS-CoV-2 nasopharyngeal PCR are actively recruited from the community or hospital settings to enroll in the Northern Colorado SARS-CoV-2 Biorepository (NoCo-COBIO). Blood, saliva, stool, nasopharyngeal specimens, and extensive clinical and demographic data are collected at 4 time points over 6 months. Patients are assessed for PASC during longitudinal follow-up by physician led symptom questionnaires and physical exams. This clinical trial registration is NCT04603677 ., Results: We have enrolled and collected samples from 119 adults since July 2020, with 66% follow-up rate. Forty-nine percent of participants assessed with a symptom surveillance questionnaire (N = 37 of 75) had PASC at any time during follow-up (up to 8 months post infection). Ninety-three percent of hospitalized participants developed PASC, while 23% of those not requiring hospitalization developed PASC. At 90-174 days post SARS-CoV-2 diagnosis, 67% of all participants had persistent symptoms (N = 37 of 55), and 85% percent of participants who required hospitalization during initial infection (N = 20) still had symptoms. The most common symptoms reported after 15 days of infection were fatigue, loss of smell, loss of taste, exercise intolerance, and cognitive dysfunction., Conclusions: Patients who were hospitalized for COVID-19 were significantly more likely to have PASC than those not requiring hospitalization, however 23% of patients who were not hospitalized also developed PASC. This patient-matched, multi-matrix, longitudinal biorepository from COVID-19 survivors with and without PASC will allow for current and future research to better understand the pathophysiology of disease and to identify targeted interventions to reduce risk for PASC. Registered 27 October 2020 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04603677 ., (© 2021. The Author(s).) more...
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- 2021
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133. Timing of acute passive heating on glucose tolerance and blood pressure in people with type 2 diabetes: a randomized, balanced crossover, control trial.
- Author
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James TJ, Corbett J, Cummings M, Allard S, Young JS, Towse J, Carey-Jones K, Eglin C, Hopkins B, Morgan C, Tipton M, Saynor ZL, and Shepherd AI
- Subjects
- Blood Glucose, Blood Pressure, Glucose, Heating, Humans, Insulin, Diabetes Mellitus, Type 2, Insulin Resistance
- Abstract
Type 2 diabetes mellitus (T2DM) is characterized by chronic hyperglycemia and progressive insulin resistance, leading to macro and microvascular dysfunction. Passive heating has potential to improve glucose homeostasis and act as an exercise mimetic. We assessed the effect of acute passive heating before or during an oral glucose tolerance test (OGTT) in people with T2DM. Twelve people with T2DM were randomly assigned to the following three conditions: 1 ) 3-h OGTT (control), 2 ) 1-h passive heating (40°C water) 30 min before an OGTT (HOT-OGTT), and 3 ) 1-h passive heating (40°C water) 30 min after commencing an OGTT (OGTT-HOT). Blood glucose concentration, insulin sensitivity, extracellular heat shock protein 70 (eHSP70), total energy expenditure (TEE), heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were recorded. Passive heating did not alter blood glucose concentration [control: 1,677 (386) arbitrary units (AU), HOT-OGTT: 1,797 (340) AU, and OGTT-HOT: 1,662 (364) AU, P = 0.28], insulin sensitivity ( P = 0.15), or SBP ( P = 0.18) but did increase eHSP70 concentration in both heating conditions [control: 203.48 (110.81) pg·mL
-1 ; HOT-OGTT: 402.47 (79.02) pg·mL-1 ; and OGTT-HOT: 310.00 (60.53) pg·mL-1 , P < 0.001], increased TEE (via fat oxidation) in the OGTT-HOT condition [control: 263 (33) kcal, HOT-OGTT: 278 (40) kcal, and OGTT-HOT: 304 (38) kcal, P = 0.001], increased HR in both heating conditions ( P < 0.001), and reduced DBP in the OGTT-HOT condition ( P < 0.01). Passive heating in close proximity to a glucose challenge does not alter glucose tolerance but does increase eHSP70 concentration and TEE and reduce blood pressure in people with T2DM. NEW & NOTEWORTHY This is the first study to investigate the timing of acute passive heating on glucose tolerance and extracellular heat shock protein 70 concentration ([eHSP70]) in people with type 2 diabetes. The principal novel findings from this study were that both passive heating conditions: 1 ) did not reduce the area under the curve or peak blood glucose concentration, 2 ) elevated heart rate, and 3 ) increased [eHSP70], which was blunted by glucose ingestion, while passive heating following glucose ingestion, 4 ) increased total energy expenditure, and 5 ) reduced diastolic blood pressure. more...- Published
- 2021
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134. Ergonomics of paragliding reserve parachute deployment in linear acceleration.
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Wilkes M, Charles R, Long G, Massey H, Eglin C, and Tipton M
- Subjects
- Acceleration, Ergonomics, Humans, Accidents, Aviation, Aviation, Sports
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- 2021
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135. Experimental Physiology special issue: Extreme environmental physiology.
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Tipton M
- Subjects
- Athletes psychology, Humans, Physiology, Environment, Physiological Phenomena physiology, Stress, Physiological physiology
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- 2021
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136. Use of mobile applications in hand therapy.
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Valdes K, Gendernalik E, Hauser J, and Tipton M
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- Cell Phone, Female, Hand Injuries etiology, Hand Injuries physiopathology, Humans, Middle Aged, Motor Skills, Patient Education as Topic, Proprioception, Video Games, Hand Injuries rehabilitation, Mobile Applications
- Abstract
Introduction: Mobile devices can be incorporated into therapy as an engaging alternative to traditional therapy options. The use of mobile devices and smartphone applications can enhance the quality of care provided by health care professionals., Purpose: To find mobile apps that can be incorporated into hand therapy practice., Methods: Hand therapy evaluation, interventions, proprioception, laterality, and home exercise program applications can be incorporated into practice. Patient education can also be provided via the use of mobile applications., Conclusion: Smartphone applications can be a valuable intervention and impact performance in individuals with impaired hand function. Smartphone applications offer a client-centered, and potentially motivating, activity option that can be utilized to aid the hand therapist., (Copyright © 2020 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.) more...
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- 2020
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137. Thirst-guided participant-controlled intravenous fluid rehydration: a single blind, randomised crossover study.
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Lacey J, Corbett J, Shepherd A, Dubois A, Hughes F, White D, Tipton M, Mythen M, and Montgomery H
- Abstract
Background: Dehydration is common in hospitals and is associated with increased mortality and morbidity. Clinical assessment and diagnostic measures of dehydration are unreliable. We sought to investigate the novel concept that individuals might control their own intravenous rehydration, guided by thirst., Methods: We performed a single-blind, counterbalanced, randomised cross-over trial. Ten healthy male volunteers of mean age 26 (standard deviation [sd] 10.5) yr were dehydrated by 3-5% of their baseline body mass via exercising in the heat (35°C, 60% humidity). This was followed by a 4 h participant-controlled intravenous rehydration: individuals triggered up to six fluid boluses (4% dextrose in 0.18% sodium chloride) per hour in response to thirst. Participants undertook two blinded rehydration protocols which differed only by bolus volume: 50 ml (low volume [LV]) or 200 ml (high volume [HV]). Each hour during the rehydration phase, plasma osmolality (pOsm) was measured and thirst score recorded. Nude body mass was measured at baseline, after dehydration, and after the rehydration phase., Results: In both conditions, the mean dehydration-related body mass loss was 3.9%. Thirst score was strongly associated with pOsm (within-subject r=0.74) and demand for fluid decreased as pOsm corrected. In the HV condition, participants rapidly rehydrated themselves (mean fluid delivered 3060 vs 981 ml in the LV condition) to body mass and pOsm no different to their euhydrated state., Conclusion: Healthy individuals appear able to rely on thirst to manage intravenous fluid intake. Future work must now focus on whether patient-controlled intravenous fluids could represent a paradigm shift in the management of hydration in the clinical setting., Clinical Trial Registration: NCT03932890., (Copyright © 2019 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.) more...
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- 2020
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138. Matters of life and death: Change beyond planetary homeostasis.
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Montgomery H and Tipton M
- Subjects
- Animals, Environmental Health methods, Humans, Climate Change, Environmental Health trends, Homeostasis physiology
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- 2019
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- View/download PDF
139. Thermoregulation in Ectodermal Dysplasia: A Case Series.
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Massey H, House J, and Tipton M
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- Adolescent, Cold Temperature, Ear Canal physiopathology, Female, Humans, Male, Skin blood supply, Sweat Glands physiopathology, Sweating physiology, Body Temperature Regulation physiology, Ectodermal Dysplasia physiopathology, Skin Temperature physiology
- Abstract
Ectodermal dysplasia (ED) is a rare genetic disorder occurring as a consequence of gene mutations that code for the ectoderm of the developing embryo and results in numerous disorders of varying severity. The lack of functioning sweat glands in those affected with ED leads to high infant mortality and frequent complaints of hyperthermia. Temperature control of two adolescents affected with ED was assessed by conducting heat and exercise exposures while monitoring insulated auditory canal (T
ac ) and skin temperatures, sweating rates, and skin blood flow. One participant was able to sweat and regulate his Tac while a second participant could not regulate Tac without a cooling intervention. The heterogeneous nature of ED, and these cases highlight the need for a case-by-case review of temperature control of individuals affected with ED. This will determine cooling strategies that would be of most benefit to the individual. more...- Published
- 2019
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140. Heresy and transparency: Is sunlight the best disinfectant?
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Tipton M
- Subjects
- Publishing, Periodicals as Topic, Physiology trends
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- 2019
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141. MenACWY-CRM conjugate vaccine booster dose given 4-6 years after priming: Results from a phase IIIb, multicenter, open label study in adolescents and adults.
- Author
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Tipton M, Daly W, Senders S, Block SL, Lattanzi M, Mzolo T, Barbi S, Pellegrini M, and Keshavan P
- Subjects
- Adolescent, Adult, Antibodies, Bacterial blood, Complement System Proteins immunology, Female, Humans, Immunization, Secondary, Immunologic Memory immunology, Male, Meningitis, Meningococcal immunology, Middle Aged, Vaccination, Young Adult, Immunogenicity, Vaccine immunology, Meningitis, Meningococcal prevention & control, Meningococcal Vaccines immunology, Neisseria meningitidis immunology
- Abstract
Background: Vaccination strategies against bacterial meningitis vary across countries. In the United States, a single dose of quadrivalent meningococcal conjugate vaccine (MenACWY) is recommended at 11-12 years of age, with a booster dose approximately 5 years later. We assessed immune responses to a booster dose of MenACWY-CRM vaccine after priming with MenACWY-CRM or MenACWY-D vaccines in adolescents and adults., Methods: In this phase IIIb, multicenter, open-label study, healthy 15-55-year-olds, who received MenACWY-CRM (N = 301) or MenACWY-D (N = 300) 4-6 years earlier or were meningococcal vaccine-naïve (N = 100), received one MenACWY-CRM vaccine dose. Immunogenicity was evaluated pre-vaccination, 3 or 5 days post-vaccination (sampling subgroups), and 28 days post-vaccination by serum bactericidal activity assay using human complement (hSBA). After vaccination, participants were monitored for 7 days for reactogenicity, 29 days for unsolicited adverse events (AEs), and 181 days for serious AEs and medically-attended AEs., Results: Sufficiency of the immune response to a MenACWY-CRM booster dose was demonstrated; the lower limit of the 1-sided 97.5% confidence interval for percentages of participants with hSBA seroresponse at 28 days post-vaccination was >75% for each serogroup in those primed with either the MenACWY-CRM or MenACWY-D vaccine. Seroresponse was observed in ≥93.24% of primed participants and ≥35.87% of naïve participants 28 days post-vaccination. At 5 days post-booster, among primed participants, hSBA titers ≥1:8 were achieved in ≥47.14% of participants for MenA and in ≥85.52% of participants for MenC, MenW and MenY, and 3.25- to 8.59-fold increases in hSBA geometric mean titers against each vaccine serogroup were observed. No safety concerns were raised throughout the 6-month follow-up period., Conclusions: A booster dose of the MenACWY-CRM vaccine induced a robust and rapid anamnestic response in adolescents and adults, irrespectively of either MenACWY-CRM or MenACWY-D vaccine administered 4-6 years earlier, with an acceptable clinical safety profile. ClinicalTrials.gov registration: NCT02986854., (Copyright © 2019 GlaxoSmithKline Biologicals SA. Published by Elsevier Ltd.. All rights reserved.) more...
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- 2019
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142. Drifting into unconsciousness: Jason Zirganos and the mystery of undetected hypothermia.
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Tipton M
- Subjects
- Adaptation, Physiological, Humans, Risk Factors, Unconsciousness physiopathology, United Kingdom, Competitive Behavior physiology, Hypothermia physiopathology, Swimming physiology, Unconsciousness etiology
- Abstract
Competing Interests: Competing interests: None declared.
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- 2019
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143. How cold is too cold? Establishing the minimum water temperature limits for marathon swim racing.
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Saycell J, Lomax M, Massey H, and Tipton M
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- Adolescent, Adult, Athletic Performance, Body Temperature, Female, Humans, Hypothermia etiology, Male, Middle Aged, Oxygen Consumption, Thermosensing, Cold Temperature, Swimming physiology, Water
- Abstract
Objectives: To provide a rationale for minimum water temperature rules for elite and subelite marathon swim racing and highlight factors that make individuals vulnerable to excessive cooling during open water swimming., Methods: 12 lean competitive swimmers swam for up to 2 hours, three times in different water temperatures between 14°C and 20°C, wearing standard swimming costumes and hats. Rectal temperature (T
re ), oxygen consumption, perception of cold and performance were measured., Results: In 16°C, half the swimmers did not complete a 2-hour swim; four became (or were predicted to become) hypothermic within 2 hours. In 18°C, three-quarters completed the swim; three became (or were predicted to become) hypothermic. In 20°C, one swimmer was predicted to become hypothermic in under 2 hours. The mean linear rate of fall of Tre was greater in 16°C (-1.57°C/hour) than 18°C (-1.07°C/hour) (p=0.03). There was no change in swimming performance during the swims or between conditions. Most of the cooling rate could be explained by metabolic heat production and morphology for both 16°C (R2 =0.94, p<0.01) and 18°C (R2 =0.82, p<0.01) conditions. No relationship was observed between Tre and perception of thermal sensation (r=0.25, p=0.13), and there was a weak correlation between Tre and thermal comfort (r=0.32, p=0.04)., Conclusion: We recommend that 16°C and 18°C water are too cold for elite marathon swim racing. FédérationInternationale de Natation rules were changed in 2017 to make wetsuits compulsory below 18°C and optional below 20°C., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.) more...- Published
- 2019
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144. Time bombs, sport and exercise science and the future of society.
- Author
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Tipton M
- Subjects
- Humans, Exercise physiology, Sports physiology
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- 2019
- Full Text
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145. Core Temperature in Triathletes during Swimming with Wetsuit in 10 °C Cold Water.
- Author
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Melau J, Mathiassen M, Stensrud T, Tipton M, and Hisdal J
- Abstract
Low water temperature (<15 °C) has been faced by many organizers of triathlons and swim-runs in the northern part of Europe during recent years. More knowledge about how cold water affects athletes swimming in wetsuits in cold water is warranted. The aim of the present study was therefore to investigate the physiological response when swimming a full Ironman distance (3800 m) in a wetsuit in 10 °C water. Twenty triathletes, 37.6 ± 9 years (12 males and 8 females) were recruited to perform open water swimming in 10 °C seawater; while rectal temperature (Tre) and skin temperature (Tskin) were recorded. The results showed that for all participants, Tre was maintained for the first 10-15 min of the swim; and no participants dropped more than 2 °C in Tre during the first 30 min of swimming in 10 °C water. However; according to extrapolations of the results, during a swim time above 135 min; 47% (8/17) of the participants in the present study would fall more than 2 °C in Tre during the swim. The results show that the temperature response to swimming in a wetsuit in 10 °C water is highly individual. However, no participant in the present study dropped more than 2 °C in Tre during the first 30 min of the swim in 10 °C water., Competing Interests: The authors declare no conflict of interest more...
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- 2019
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146. Editorial: Cross Adaptation and Cross Tolerance in Human Health and Disease.
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Lee BJ, Gibson OR, Thake CD, Tipton M, Hawley JA, and Cotter JD
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- 2019
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147. Humans: A homeothermic animal that needs perturbation?
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Tipton M
- Subjects
- Animals, Humans, Body Temperature physiology, Body Temperature Regulation physiology, Homeostasis physiology
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- 2019
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148. Introduction to Guest Editorials.
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Tipton M
- Subjects
- Humans, Science organization & administration, Medical Laboratory Personnel organization & administration, Physiology organization & administration
- Published
- 2018
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149. Open water swimming as a treatment for major depressive disorder.
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van Tulleken C, Tipton M, Massey H, and Harper CM
- Subjects
- Adult, Anxiety Disorders therapy, Female, Humans, Depressive Disorder, Major therapy, Exercise Therapy methods, Swimming physiology
- Abstract
A 24-year-old woman with symptoms of major depressive disorder and anxiety had been treated for the condition since the age of 17. Symptoms were resistant to fluoxetine and then citalopram. Following the birth of her daughter, she wanted to be medication-free and symptom-free. A programme of weekly open (cold) water swimming was trialled. This led to an immediate improvement in mood following each swim and a sustained and gradual reduction in symptoms of depression, and consequently a reduction in, and then cessation of, medication. On follow-up a year later, she remains medication-free., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.) more...
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- 2018
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150. Scientific rationale for changing lower water temperature limits for triathlon racing to 12°C with wetsuits and 16°C without wetsuits.
- Author
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Saycell J, Lomax M, Massey H, and Tipton M
- Subjects
- Adolescent, Adult, Bicycling, Body Temperature, Female, Humans, Male, Middle Aged, Running, Protective Clothing, Swimming, Temperature, Water
- Abstract
Objectives: To provide a scientific rationale for lower water temperature and wetsuit rules for elite and subelite triathletes., Methods: 11 lean, competitive triathletes completed a 20 min flume swim, technical transition including bike control and psychomotor testing and a cycle across five different wetsuit and water temperature conditions: with wetsuit: 10°C, 12°C and 14°C; without wetsuit (skins): 14°C and 16°C. Deep body (rectal) temperature (T
re ), psychomotor performance and the ability to complete a technical bike course after the swim were measured, as well as swimming and cycling performance., Results: In skins conditions, only 4 out of 11 athletes could complete the condition in 14°C water, with two becoming hypothermic (Tre <35°C) after a 20 min swim. All 11 athletes completed the condition in 16°C. Tre fell further following 14°C (mean 1.12°C) than 16°C (mean 0.59°C) skins swim (p=0.01). In wetsuit conditions, cold shock prevented most athletes (4 out of 7) from completing the swim in 10°C. In 12°C and 14°C almost all athletes completed the condition (17 out of 18). There was no difference in temperature or performance variables between conditions following wetsuit swims at 12°C and 14°C., Conclusion: The minimum recommended water temperature for racing is 12°C in wetsuits and 16°C without wetsuits. International Triathlon Union rules for racing were changed accordingly (January 2017)., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.) more...- Published
- 2018
- Full Text
- View/download PDF
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