Return to competitive gymnastics training in the UK following the first COVID-19 national lockdown

Following the outbreak of COVID-19 (coronavirus), the UK entered a national lockdown, and all sport was suspended. The study aimed to explore the process of returning to gymnastics training after several months away from the gym, with a particular interest towards training load and injury. Twenty-six, national programmed gymnasts from Men's artistic, Women's artistic and Trampoline gymnastics recorded training load and injury whilst returning to training. At the end of data collection, three coaches were interviewed to further explore the experiences and practices of returning to training. Home-based training during lockdown was seen as beneficial in maintaining a level of fitness. Coaches described a gradual increase in training to reduce the risk of injury, and this partly explains a non-significant association between training load and a substantial injury (p = 0.441). However, week-to-week changes in training load following periods of additional restrictions (additional lockdown, periods of isolation, or substantial restrictions) were not always gradual. There was a significant association between an injury in the preceding week (niggle or substantial injury to a different body part) and a substantial injury in the subsequent week (RR: 5.29, p = 0.011). Monitoring training was described to be a useful practice during the process of returning to training. Coaches believed that although the short-term development of their gymnasts was affected, the long-term development would not be impacted from COVID-19. It is anticipated that learnings from this study can be applied to future practices and situations, particularly when gymnasts are away from the gym for an extended period.     

Mechanical and morphological determinants of peak power output in elite cyclists

Mechanical peak power output (PPO) is a determinant of performance in sprint cycling. The purpose of this study was to examine the relationship between PPO and putative physiological determinants of PPO in elite cyclists, and to compare sprint performance between elite sprint and endurance cyclists. Thirty-five elite cyclists (18 endurance; 17 sprint) performed duplicate sprint cycling laboratory tests to establish PPO and its mechanical components. Quadriceps femoris (Q_VOL) and hamstring muscle volume (HAM_VOL) were assessed with MRI, vastus lateralis pennation angle (Pθ_VL) and fascicle length (FL_VL) were determined with ultrasound imaging, and neuromuscular activation of three muscles was assessed using EMG at PPO during sprint cycling. For the whole cohort, there was a wide variability in PPO (range 775-2025 W) with very large, positive, bivariate relationships between PPO and Q_VOL (r = .87), HAM_VOL (r = .71), and Pθ_VL (r = .81). Step-wise multiple regression analysis revealed that 87% of the variability in PPO between cyclists was explained by two variables Q_VOL (76%) and Pθ_VL (11%). The sprint cyclists had greater PPO (+61%; P < .001 vs endurance), larger Q_VOL (P < .001), and BF_VOL (P < .001) as well as more pennate vastus lateralis muscles (P < .001). These findings emphasize the importance of quadriceps muscle morphology for sprint cycling events.     

Effect of a Structured Teaching Module Including Intensive Prophylactic Measures on Reducing the Incidence of Capecitabine-Induced Hand-Foot Syndrome: Results of a Prospective Randomized Phase III Study

Lessons Learned

• A structured teaching module including intensive prophylactic measures to alleviate hand‐foot syndrome (HFS) during capecitabine therapy is feasible but ineffective at protecting patients from HFS.
• Pharmacologic therapeutic interventions should be investigated for the management of this complication.

BackgroundCapecitabine‐induced hand‐foot syndrome (HFS) has a detrimental effect on quality of life. The effect of a structured teaching module including intensive prophylactic measures was evaluated.MethodsThis non‐crossover phase III double‐blinded clinical trial randomized patients in a 1:1 ratio to either a control group or to a group administered a structured teaching model including intensive prophylactic measures on HFS administered by a trained oncology nurse at regular intervals (case) versus standard information on HFS care administered by treating clinician (control). The primary endpoint was comparison of fraction of patients in both arms developing at least grade 2 HFS.ResultsBetween June 15, 2016, and April 4, 2018, 280 patients (140 to case and 140 to control) were enrolled. The median number of capecitabine chemotherapy cycles was eight; 269 patients (96%) were evaluable for HFS, of whom 89 patients (33.08%) developed at least grade 2 HFS (grade 2 HFS, 73 patients [26.1%]; grade 3 HFS, 16 patients (5.7%}). There was no difference in at least grade 2 HFS between evaluable case and control arms of the study (control group, 45/135 [33.3%]; case, 44/134 [32.8%]; p = .93).ConclusionThe use of a structured teaching module including intensive prophylactic measures was feasible, but this did not reduce the incidence and severity of capecitabine‐induced HFS.     

Store–Operated Ca2+ Channels in Mesangial Cells Inhibit Matrix Protein Expression

Accumulation of extracellular matrix derived from glomerular mesangial cells is an early feature of diabetic nephropathy. Ca²⁺ signals mediated by store–operated Ca²⁺ channels regulate protein production in a variety of cell types. The aim of this study was to determine the effect of store–operated Ca²⁺ channels in mesangial cells on extracellular matrix protein expression. In cultured human mesangial cells, activation of store–operated Ca²⁺ channels by thapsigargin significantly decreased fibronectin protein expression and collagen IV mRNA expression in a dose-dependent manner. Conversely, inhibition of the channels by 2-aminoethyl diphenylborinate significantly increased the expression of fibronectin and collagen IV. Similarly, overexpression of stromal interacting molecule 1 reduced, but knockdown of calcium release–activated calcium channel protein 1 (Orai1) increased fibronectin protein expression. Furthermore, 2-aminoethyl diphenylborinate significantly augmented angiotensin II–induced fibronectin protein expression, whereas thapsigargin abrogated high glucose– and TGF-β1–stimulated matrix protein expression. In vivo knockdown of Orai1 in mesangial cells of mice using a targeted nanoparticle siRNA delivery system resulted in increased expression of glomerular fibronectin and collagen IV, and mice showed significant mesangial expansion compared with controls. Similarly, in vivo knockdown of stromal interacting molecule 1 in mesangial cells by recombinant adeno–associated virus–encoded shRNA markedly increased collagen IV protein expression in renal cortex and caused mesangial expansion in rats. These results suggest that store–operated Ca²⁺ channels in mesangial cells negatively regulate extracellular matrix protein expression in the kidney, which may serve as an endogenous renoprotective mechanism in diabetes.     

Enhanced Transdermal Peptide Delivery and Stability by Lipid Conjugation: Epidermal Permeation,Stereoselectivity and Mechanistic Insights

Purpose

Efficient delivery of therapeutic peptides to the skin will facilitate better outcomes in dermatology. The tetrapeptide AAPV, an elastase inhibitor with potential utility in the management of psoriasis was coupled to short chain lipoamino acids (Laa: C6-C10) to enhance the peptide permeation into and through human epidermis.

Methods

AAPV was conjugated to Laas by solid phase synthesis. Peptide stability, skin distribution and permeation, elastase activity and surface activity were determined.

Results

Laas increased peptide permeation into the skin. The permeation lag time and amount of peptide remaining in the skin increased with the carbon chain length of the Laa conjugate. We also demonstrated stereoselective permeation enhancement in favour of the D-diastereomer. Importantly, the elastase inhibition activity of the peptide was largely retained after coupling to the Laa conjugates, showing potential therapeutic utility. The Laa-peptide structures were shown to be surface active, suggesting that this surfactant-like activity coupled with enhanced lipophilicity may contribute to their interaction with and permeation through the lipid domains of the stratum corneum.

Conclusions

This study suggests that the Laa conjugation approach may be useful for enhancing the permeation of moderately sized peptide drugs with potential application in the treatment of skin disorders.     

Efficacy of Titanium Mesh Osteosynthesis in Maxillofacial Fractures

Introduction

Trauma is steadily increasing in the modern world and thus becoming a major public problem. Maxillofacial injuries constitute a substantial proportion of cases of trauma and occur in a variety of situations like road traffic accidents, interpersonal violence, falls or as a result of contact sports. The aim of this prospective study was to evaluate the efficacy of titanium mesh for osteosynthesis of maxillofacial fractures.

Materials and Methods

Fifteen patients of maxillofacial fractures who were treated with titanium mesh were included in this prospective study. The patients were evaluated preoperatively, intraoperatively and postoperatively at 7th day, 3rd week, 6th week and 12th week.

Results

The mean age of fifteen patients was 31.3 years with a male:female ratio of 14:1. The most common mode of injury was road traffic accident (86.6%). The mean time interval between injury and surgical procedure was found to be 7.6 days. The majority of fracture sites (88%) were comminuted. 93.3% of the patients achieved good occlusion by 12th week postoperatively. Postoperative complications included residual hypoaesthesia in four patients and wound dehiscence in one patient.

Conclusion

We conclude that titanium mesh is a versatile option for maxillofacial fractures. It provided good stabilization especially in comminuted fractures. As a fixation method, it was quick in placement and highly adaptable, and thus, it proved to be valuable in restoring the form and function in maxillofacial trauma patients.

     

Evaluation of Biocompatibility and Osteogenic Potential of Tricalcium Silicate–based Cements Using Human Bone Marrow–derived Mesenchymal Stem Cells

Introduction

The success of endodontic regeneration lies in the appropriate combination of stem cells and bioactive materials. Several novel dental materials are available on the market in this regard. Hence, the current study aimed to evaluate the proliferation, differentiation, and osteogenic potential of human bone marrow–derived mesenchymal stem cells (hBMSCs) onto biomaterials like ProRoot MTA (MTA; Dentsply Tulsa Dental, Tulsa, OK), Biodentine (BD; Septodont, Saint Maur de Fosses, France), and EndoSequence Root Repair Material (ERRM; Brasseler USA, Savannah, GA).

Improvements in health-related quality of life after treatment with tocilizumab in patients with rheumatoid arthritis refractory to tumour necrosis factor inhibitors: results from the 24-week randomized controlled RADIATE study

Objective. To investigate the effect of tocilizumab on patient-reported outcomes (PROs) in RA patients with inadequate responses to TNF inhibitors (TNFis). Methods. In a Phase III randomized controlled trial, 489 patients received 4 or 8 mg/kg tocilizumab or placebo every 4 weeks plus MTX for 24 weeks. Mean changes from baseline over time and proportions of patients reporting improvements greater than or equal to minimum clinically important differences (MCIDs) in PROs were analyzed. Results. At week 24, 8?mg/kg resulted in significantly greater improvements vs placebo in pain, global assessment of disease activity (P?=?0.001), Health Assessment Questionnaire-Disability Index (HAQ-DI; P?相似文献