October 6 University

IMPORTANCE: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE: To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEW: The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). FINDINGS: In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCE: The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.

Autologous bone grafts harvested from the iliac crest are commonly used in reconstructive orthopaedic surgery. Autologous bone is used to help promote bone healing in fractures and to provide structural support for reconstructive surgery. The results of autologous bone grafting are more predictable than the use of xenografts, cadaveric allografts, or synthetic bone substitutes because autologous bone grafts provide osteoinductive and osteoconductive properties, are not immunogenic, and are usually well incorporated into the graft site. In a retrospective review of 414 consecutive cases of iliac crest bone graft procedures performed at Brooke Army Medical Center from 1983 to 1993, 41 (10%) minor and 24 (5.8%) major complications were identified. Minor complications included superficial infections, superficial seromas, and minor hematomas. Major complications included herniation of abdominal contents through massive bone graft donor sites, vascular injuries, deep infections at the donor site, neurologic injuries, deep hematoma formation requiring surgical intervention, and iliac wing fractures. Harvesting of iliac crest bone graft can be associated with significant morbidity. However, with adequate preoperative planning and proper surgical technique, the incidence of these complications can be reduced.

BACKGROUND: Coagulopathy and hemorrhage are known contributors to trauma mortality; however, the actual relationship of prothrombin time (PT) and partial thromboplastin time (PTT) to mortality is unknown. Our objective was to measure the predictive value of the initial coagulopathy profile for trauma-related mortality. METHODS: We reviewed prospectively collected data on trauma patients presenting to a Level I trauma center. A logistic regression analysis was performed of PT, PTT, platelet count, and confounders to determine whether coagulopathy is a predictor of all-cause mortality. RESULTS: From a trauma registry cohort of 20103 patients, 14397 had complete disposition data for initial analysis and 7638 had complete data for all variables in the final analysis. The total cohort was 76.2% male, the mean age was 38 years (range, 1-108 years), and the median Injury Severity Score was 9. There were 1276 deaths (all-cause mortality, 8.9%). The prevalence of coagulopathy early in the postinjury period was substantial, with 28% of patients having an abnormal PT (2994 of 10790) and 8% of patients having an abnormal PTT (826 of 10453) on arrival at the trauma bay. In patients with disposition data and a normal PT, 489 of 7796 died, as compared with 579 of 2994 with an abnormal PT (6.3% vs. 19.3%; chi2 = 414.1, p < 0.001). Univariate analysis generated an odds ratio of 3.6 (95% confidence interval [CI], 3.15-4.08; p < 0.0001) for death with abnormal PT and 7.81 (95% CI, 6.65-9.17; p < 0.001) for deaths with an abnormal PTT. The PT and PTT remained independent predictors of mortality in a multiple regression model, whereas platelet count did not. The model also included the independent risk factors age, Injury Severity Score, scene and trauma-bay blood pressure, hematocrit, base deficit, and head injury. The model generated an adjusted odds ratio of 1.35 for PT (95% CI, 1.11-1.68; p < 0.001) and 4.26 for PTT (95% CI, 3.23-5.63; p < 0.001). CONCLUSION: The incidence of coagulation abnormalities, early after trauma, is high and they are independent predictors of mortality even in the presence of other risk factors. An initial abnormal PT increases the adjusted odds of dying by 35% and an initial abnormal PTT increases the adjusted odds of dying by 326%.

PURPOSE: The aim of the present study was to study the effects of aerobic training on performance during soccer match and soccer specific tests. METHODS: Nineteen male elite junior soccer players, age 18.1 +/- 0.8 yr, randomly assigned to the training group (N = 9) and the control group (N = 10) participated in the study. The specific aerobic training consisted of interval training, four times 4 min at 90-95% of maximal heart rate, with a 3-min jog in between, twice per week for 8 wk. Players were monitored by video during two matches, one before and one after training. RESULTS: In the training group: a) maximal oxygen uptake (VO2max) increased from 58.1 +/- 4.5 mL x kg(-1) x min(-1) to 64.3 +/- 3.9 mL x kg(-1) x min(-1) (P < 0.01); b) lactate threshold improved from 47.8 +/- 5.3 mL x kg(-1) x min(-1) to 55.4 +/- 4.1 mL x kg(-1) x min(-1) (P < 0.01); c) running economy was also improved by 6.7% (P < 0.05); d) distance covered during a match increased by 20% in the training group (P < 0.01); e) number of sprints increased by 100% (P < 0.01); f) number of involvements with the ball increased by 24% (P < 0.05); g) the average work intensity during a soccer match, measured as percent of maximal heart rate, was enhanced from 82.7 +/- 3.4% to 85.6 +/- 3.1% (P < 0.05); and h) no changes were found in maximal vertical jumping height, strength, speed, kicking velocity, kicking precision, or quality of passes after the training period. The control group showed no changes in any of the tested parameters. CONCLUSION: Enhanced aerobic endurance in soccer players improved soccer performance by increasing the distance covered, enhancing work intensity, and increasing the number of sprints and involvements with the ball during a match.

PURPOSE: We addressed three questions: 1) Is there a dose-response relation between physical activity and health? 2) Is there a dose-response relation between cardiorespiratory fitness and health? 3) If both activity and fitness have a dose-response relation to health, is it possible to determine which exposure is more important? METHODS: We identified articles by PubMed search (restricted from 1/1/90 to 8/25/00) using keywords related to physical activity, physical fitness, and health. An author scanned titles and abstracts of 9831 identified articles. We included for thorough review articles that included three or more categories of activity or fitness and a health outcome and excluded articles on clinical trials, review papers, comments, letters, case reports, and nonhuman studies. We used an evidence-based approach to evaluate the quality of the published data. RESULTS: We summarized results from 67 articles meeting final selection criteria. There is good consensus across studies with most showing an inverse dose-response gradient across both activity and fitness categories for morbidity from coronary heart disease (CHD), stroke, cardiovascular disease (CVD), or cancer; and for CVD, cancer, or all-cause mortality. CONCLUSIONS: All studies reviewed were prospective observational investigations; thus, conclusions are based on Evidence Category C. 1) There is a consistent gradient across activity groups indicating greater longevity and reduced risk of CHD, CVD, stroke, and colon cancer in more active individuals. 2) Studies are compelling in the consistency and steepness of the gradient across fitness groups. Most show a curvilinear gradient, with a steep slope at low levels of fitness and an asymptote in the upper part of the fitness distribution. 3) It is not possible to conclude whether activity or fitness is more important for health. Future studies should define more precisely the shape of the dose-response gradient across activity or fitness groups, evaluate the role of musculoskeletal fitness, and investigate additional health outcomes.

Abstract The paper presents the latest version of the International Reference Ionosphere model (IRI‐2016) describing the most important changes and improvements that were included with this version and discussing their impact on the IRI predictions of ionospheric parameters. IRI‐2016 includes two new model options for the F 2 peak height h m F 2 and a better representation of topside ion densities at very low and high solar activities. In addition, a number of smaller changes were made concerning the use of solar indices and the speedup of the computer program. We also review the latest developments toward a Real‐Time IRI. The goal is to progress from predicting climatology to describing the real‐time weather conditions in the ionosphere.

Cytomegalovirus (CMV) remains one of the most common infections after solid organ transplantation, resulting in significant morbidity, graft loss, and occasional mortality. Management of CMV varies considerably among transplant centers. A panel of experts on CMV and solid organ transplant was convened by The Infectious Diseases Section of The Transplantation Society to develop evidence and expert opinion-based consensus guidelines on CMV management including diagnostics, immunology, prevention, treatment, drug resistance, and pediatric issues.

PURPOSE: The purpose of this review was to address the question of interindividual variation in responsiveness to regular exercise training and to define the contributions of age, sex, race, and pretraining phenotype level to this variability. METHODS: A literature review was conducted of the studies reporting interindividual variation in responsiveness to standardized and controlled exercise-training programs, and included an analysis of the contribution of age, sex, race, and initial phenotype values to the heterogeneity in VO(2max), high-density lipoprotein (HDL)-C and submaximal exercise, heart rate (HR), and systolic blood pressure (SBP) training responses in subjects from the HERITAGE Family Study. RESULTS: Several studies have shown marked individual differences in responsiveness to exercise training. For example, VO(2max) responses to standardized training programs have ranged from almost no gain up to 100% increase in large groups of sedentary individuals. A similar pattern of heterogeneity has been observed for other phenotypes. Data from the HERITAGE Family Study show that age, sex, and race have little impact on interindividual differences in training responses. On the other hand, the initial level of a phenotype is a major determinant of training response for some traits, such as submaximal exercise heart rate and blood pressure (BP) but has only a minor effect on others (e.g., VO(2max), HDL-C). The contribution of familial factors (shared environment and genetic factors) is supported by data on significant familial aggregation of training response phenotypes. CONCLUSIONS: There is strong evidence for considerable heterogeneity in the responsiveness to regular physical activity. Age, sex, and ethnic origin are not major determinants of human responses to regular physical activity, whereas the pretraining level of a phenotype has a considerable impact in some cases. Familial factors also contribute significantly to variability in training response.

Thirty-eight patients maintained on opioid analgesics for non-malignant pain were retrospectively evaluated to determine the indications, course, safety and efficacy of this therapy. Oxycodone was used by 12 patients, methadone by 7, and levorphanol by 5; others were treated with propoxyphene, meperidine, codeine, pentazocine, or some combination of these drugs. Nineteen patients were treated for four or more years at the time of evaluation, while 6 were maintained for more than 7 years. Two-thirds required less than 20 morphine equivalent mg/day and only 4 took more than 40 mg/day. Patients occasionally required escalation of dose and/or hospitalization for exacerbation of pain; doses usually returned to a stable baseline afterward. Twenty-four patients described partial but acceptable or fully adequate relief of pain, while 14 reported inadequate relief. No patient underwent a surgical procedure for pain management while receiving therapy. Few substantial gains in employment or social function could be attributed to the institution of opioid therapy. No toxicity was reported and management became a problem in only 2 patients, both with a history of prior drug abuse. A critical review of patient characteristics, including data from the 16 Personality Factor Questionnaire in 24 patients, the Minnesota Multiphasic Personality Inventory in 23, and detailed psychiatric evaluation in 6, failed to disclose psychological or social variables capable of explaining the success of long-term management. We conclude that opioid maintenance therapy can be a safe, salutary and more humane alternative to the options of surgery or no treatment in those patients with intractable non-malignant pain and no history of drug abuse.

The importance of the cornea to the ocular structure and visual system is often overlooked because of the cornea’s unassuming transparent nature. The cornea lacks the neurobiological sophistication of the retina and the dynamic movement of the lens; yet, without its clarity, the eye would not be able to perform its necessary functions. The complexity of structure and function necessary to maintain such elegant simplicity is the wonder that draws us to one of the most important components of our visual system. Financial Disclosure: Neither author has a financial or proprietary interest in any material or method mentioned.

LEE, I-M., and P. J. SKERRETT. Physical activity and all-cause mortality: what is the dose-response relation? Med. Sci. Sports Exerc., Vol. 33, No. 6, Suppl., 2001, pp. S459–S471. Purpose: The purpose of this review is to assess the dose-response relation between physical activity and all-cause mortality. We examined these parameters of physical activity dose: volume, intensity, duration, and frequency. Methods: We used a computer-assisted literature search to identify papers on this topic. After excluding papers examining only two levels of physical activity or fitness, papers investigating specific causes of mortality, reviews, and those not written in English, 44 papers satisfying all criteria were included in this review. Results: There is clear evidence of an inverse linear dose-response relation between volume of physical activity and all-cause mortality rates in men and women, and in younger and older (≥60 yr) persons. Minimal adherence to current physical activity guidelines, which yield an energy expenditure of about 1000 kcal·wk-1 (4200 kJ·wk-1), is associated with a significant 20-30% reduction in risk of all-cause mortality. Further reductions in risk are observed at higher volumes of energy expenditure. It is unclear whether a volume of <1000 kcal·wk-1 also may be associated with lower risk; there are some data supporting this. Due to limited data, it is also unclear whether vigorous-intensity activity confers additional benefit beyond its contribution to volume of physical activity when compared with moderate-intensity activity. No data are available on duration and frequency of physical activity in relation to all-cause mortality rates after controlling for volume of physical activity. Conclusions: All studies in this review are observational studies, so conclusions are based on Evidence Category C. There is an inverse linear dose-response relation between volume of physical activity and all-cause mortality. Further research is needed to clarify the contributions of its components—intensity, duration, and frequency—to decreased all-cause mortality rates.

PURPOSE: The purpose of this study is to review the effects of aerobic exercise training (AET) on blood lipids and assess dose-response relationships and diet interactions. METHODS: We reviewed papers published over the past three decades pertaining to intervention trials on the effects of > or = 12 wk of AET on blood lipids and lipoprotein outcomes in adult men and women. Included were studies with simultaneous dietary and AET interventions, if they had appropriate comparison groups. Studies were classified by the participants' relative weights expressed as mean BMIs. Information was extracted on baseline characteristics of study subjects, including age, sex, and relative baseline cholesterol levels; details on the training programs; and the responses to training of body weight, VO(2max), and blood total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), and triglyceride (TG). RESULTS: We identified 51 studies, 28 of which were randomized controlled trials. AET was generally performed at a moderate to hard intensity, with weekly energy expenditures ranging from 2,090 to >20,000 kJ. A marked inconsistency was observed in responsiveness of blood lipids. The most commonly observed change was an increase in HDL-C (with reductions in TC, LDL-C, and TG less frequently observed). Insufficient data are available to establish dose-response relationships between exercise intensity and volume with lipid changes. The increase in HDL-C with AET was inversely associated with its baseline level (r = -0.462), but no significant associations were found with age, sex, weekly volume of exercise, or with exercise-induced changes in body weight or VO(2max). CONCLUSION: Moderate- to hard-intensity AET inconsistently results in an improvement in the blood lipid profile, with the data insufficient to establish dose-response relationships.

OBJECTIVE: We examined the relationship between survival and time in the emergency department (ED) before laparotomy for hypotensive patients bleeding from abdominal injuries. METHODS: Patients in the Pennsylvania Trauma Systems Foundation trauma registry with isolated abdominal vascular, solid organ, or wall injuries grade 3 to 6 and hypotension were identified. Deaths were predicted from the prehospital time, systolic blood pressure (SBP) on ED admission, and time in the ED before either laparotomy or ED death. RESULTS: Two-hundred forty-three patients met the criteria. SBP ranged from 30 to 90 mm Hg. Time to the ED ranged from 7 to 185 minutes. Time in the ED ranged from 7 to 915 minutes. Overall, 98 patients died (40%). The risk ratio for the SBP increased, as expected, as SBP dropped. The risk ratio for time spent in the ED before laparotomy increased until 90 minutes, then significantly decreased below all earlier values. Logistic regression on the 165 patients spending 90 minutes or less in the ED showed that the probability of death increased with time in the ED. The increase was as much as 0.35% per minute. CONCLUSION: Among patients in a trauma registry who were hypotensive on arrival in the ED and had major injuries isolated to the abdomen requiring emergency laparotomy, the probability of death showed a relationship to both the extent of hypotension and the length of time in the ED for patients who were in the ED for 90 minutes or less. The probability of death increased approximately 1% for each 3 minutes in the ED.

This is a retrospective review of 81 patients with extracranial arteriovenous malformation of the head and neck who presented to the Vascular Anomalies Program in Boston over the last 20 years. This study focused on the natural history and effectiveness of treatment. The male to female ratio was 1:1.5. Arteriovenous malformations occur in anatomic patterns. Sixty-nine percent occurred in the midface, 14 percent in the upper third of the face, and 17 percent in the lower third. The most common sites were cheek (31 percent), ear (16 percent), nose (11 percent), and forehead (10 percent). A vascular anomaly was apparent at birth in 59 percent of patients (82 percent in men, 44 percent in women). Ten percent of patients noted onset in childhood, 10 percent in adolescence, and 21 percent in adulthood. Eight patients first noted the malformation at puberty, and six others experienced exacerbation during puberty. Fifteen women noted appearance or expansion of the malformation during pregnancy. Bony involvement occurred in 22 patients, most commonly in the maxilla and mandible. In seven patients, the bone was the primary site; in 15 other patients, the bone was involved secondarily. Arteriovenous malformations were categorized according to Schobinger clinical staging: 27 percent in stage I (quiescence), 38 percent in stage II (expansion), and 38 percent in stage III (destruction). There was a single patient with stage IV malformation (decompensation). Stage I lesions remained stable for long periods. Expansion (stage II) was usually followed by pain, bleeding, and ulceration (stage III). Once present, these symptoms and signs inevitably progressed until the malformation was resected. Resection margins were best determined intraoperatively by the bleeding pattern of the incised tissue and by Doppler. Subtotal excision or proximal ligation frequently resulted in rapid progression of the arteriovenous malformation. The overall cure rate was 60 percent, defined as radiographic absence of arteriovenous malformation. Cure rate for small malformations was 69 percent with excision only and 62 percent for extensive malformations with combined embolization-resection. The cure rate was 75 percent for stage I, 67 percent for stage II, and 48 percent for stage III malformations. Outcome was not affected significantly by age at treatment, sex, Schobinger stage, or treatment method. Mean follow-up was 4.6 years.

STUDY DESIGN: A quick-release method in four directions of isometric trunk exertions was used to study the muscle response patterns in 17 patients with chronic low back pain and 17 matched control subjects. OBJECTIVES: It was hypothesized that patients with low back pain would react to sudden load release with a delayed muscle response and would exhibit altered muscle recruitment patterns. SUMMARY OF BACKGROUND DATA: A delay in erector spinae reaction time after sudden loading has been observed in patients with low back pain. Muscle recruitment and timing pattern play an important role in maintaining lumbar spine stability. METHODS: Subjects were placed in a semiseated position in an apparatus that provided stable fixation of the pelvis. They exerted isometric contractions in trunk flexion, extension, and lateral bending. Each subject performed three trials at two constant force levels. The resisted force was suddenly released with an electromagnet and electromyogram signals from 12 trunk muscles were recorded. The time delay between the magnet release and the shut-off or switch-on of muscle activity (reaction time) was compared between two groups of subjects using two-factor analysis of variance. RESULTS: The number of reacting muscles and reaction times averaged over all trials and directions showed the following results: For healthy control subjects a shut-off of agonistic muscles (with a reaction time of 53 msec) occurred before the switch-on of antagonistic muscles (with a reaction time of 70 msec). Patients exhibited a pattern of co-contraction, with agonists remaining active (3.4 out of 6 muscles switched off) while antagonists switched on (5.3 out of 6 muscles). Patients also had longer muscle reaction times for muscles shutting off (70 msec) and switching on (83 msec) and furthermore, their individual muscle reaction times showed greater variability. CONCLUSIONS: Patients with low back pain, in contrast to healthy control subjects, demonstrated a significantly different muscle response pattern in response to sudden load release. These differences may either constitute a predisposing factor to low back injuries or a compensation mechanism to stabilize the lumbar spine.

This is a retrospective review of 81 patients with extracranial arteriovenous malformation of the head and neck who presented to the Vascular Anomalies Program in Boston over the last 20 years. This study focused on the natural history and effectiveness of treatment. The male to female ratio was 1:1.5. Arteriovenous malformations occur in anatomic patterns. Sixty-nine percent occurred in the midface, 14 percent in the upper third of the face, and 17 percent in the lower third. The most common sites were cheek (31 percent), ear (16 percent), nose (11 percent), and forehead (10 percent). A vascular anomaly was apparent at birth in 59 percent of patients (82 percent in men, 44 percent in women). Ten percent of patients noted onset in childhood, 10 percent in adolescence, and 21 percent in adulthood. Eight patients first noted the malformation at puberty, and six others experienced exacerbation during puberty. Fifteen women noted appearance or expansion of the malformation during pregnancy. Bony involvement occurred in 22 patients, most commonly in the maxilla and mandible. In seven patients, the bone was the primary site; in 15 other patients, the bone was involved secondarily. Arteriovenous malformations were categorized according to Schobinger clinical staging: 27 percent in stage I (quiescence), 38 percent in stage II (expansion), and 38 percent in stage III (destruction). There was a single patient with stage IV malformation (decompensation). Stage I lesions remained stable for long periods. Expansion (stage II) was usually followed by pain, bleeding, and ulceration (stage III). Once present, these symptoms and signs inevitably progressed until the malformation was resected. Resection margins were best determined intraoperatively by the bleeding pattern of the incised tissue and by Doppler. Subtotal excision or proximal ligation frequently resulted in rapid progression of the arteriovenous malformation. The overall cure rate was 60 percent, defined as radiographic absence of arteriovenous malformation. Cure rate for small malformations was 69 percent with excision only and 62 percent for extensive malformations with combined embolization-resection. The cure rate was 75 percent for stage I, 67 percent for stage II, and 48 percent for stage III malformations. Outcome was not affected significantly by age at treatment, sex, Schobinger stage, or treatment method. Mean follow-up was 4.6 years. (Plast. Reconstr. Surg. 102: 643, 1998.)

BACKGROUND: Bio-products from stem/progenitor cells, such as extracellular vesicles, are likely a new promising approach for reprogramming resident cells in both acute and chronic kidney disease. Forty CKD patients stage III and IV (eGFR 15-60 mg/ml) have been divided into two groups; twenty patients as treatment group "A" and twenty patients as a matching placebo group "B". Two doses of MSC-derived extracellular vesicles had been administered to patients of group "A". Blood urea, serum creatinine, urinary albumin creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) have been used to assess kidney functions and TNF-α, TGF-β1 and IL-10 have been used to assess the amelioration of the inflammatory immune activity. RESULTS: Participants in group A exhibited significant improvement of eGFR, serum creatinine level, blood urea and UACR. Patients of the treatment group "A" also exhibited significant increase in plasma levels of TGF-β1, and IL-10 and significant decrease in plasma levels of TNF-α. Participants of the control group B did not show significant improvement in any of the previously mentioned parameters at any time point of the study period. CONCLUSION: Administration of cell-free cord-blood mesenchymal stem cells derived extracellular vesicles (CF-CB-MSCs-EVs) is safe and can ameliorate the inflammatory immune reaction and improve the overall kidney function in grade III-IV CKD patients.

PURPOSE: We investigated the relationship between age, aerobic fitness, and cognitive function by comparing high- and low-fit preadolescent children and adults. METHOD: Twenty-four children (mean age = 9.6 yr) and 27 adults (mean age = 19.3 yr) were grouped according to their fitness (high, low) such that four approximately equal groups were compared. Fitness was assessed using the Fitnessgram test, and cognitive function was measured by neuroelectric and behavioral responses to a stimulus discrimination task. RESULTS: Adults exhibited greater P3 amplitude at Cz and Pz sites, and decreased amplitude at the Oz site compared with children. High-fit children had greater P3 amplitude compared with low-fit children and high- and low-fit adults. Further, adults had faster P3 latency compared with children, and high-fit participants had faster P3 latency compared with low-fit participants at the Oz site. Adults exhibited faster reaction time than children; however, fitness interacted with age such that high-fit children had faster reaction time than low-fit children. CONCLUSION: These findings suggest that fitness was positively associated with neuroelectric indices of attention and working memory, and response speed in children. Fitness was also associated with cognitive processing speed, but these findings were not age-specific. These data indicate that fitness may be related to better cognitive functioning in preadolescents and have implications for increasing cognitive health in children and adults.

PURPOSE: The major purpose of the present study was to examine whether there exists a relationship between preseasonal physiological tests and performance results in the soccer league. Further, it investigated maximal oxygen uptake and maximal strength in proportion to body mass for soccer players. A secondary aim was to establish some normative data of Norwegian elite soccer players. METHODS: Two teams from the Norwegian elite soccer league participated in the study. RESULTS/CONCLUSION: The present study supports previous investigations indicating a positive relationship between maximal aerobic capacity, physical strength, and performance results in the elite soccer league. It is concluded that for soccer players, maximal oxygen uptake should be expressed in relation to body mass raised to the power of 0.75 and maximal strength in relation to body mass raised to the power of 0.67, when the aim is to evaluate maximal aerobic capacity when running and strength capacity among players with different body mass. Midfield players had significantly higher maximal oxygen uptake compared with defense players using the traditional expression, mL x kg(-1) x min(-1), while no significant differences were found expressing maximal oxygen uptake either absolutely (L x min[-1]) or in relation to body mass raised to the power of 0.75 (mL x kg[-0.75] x min[-1]) among players grouped by position. There was a significant correlation (r = 0.61, P < 0.01) between squat IRM and vertical jump height. Vertical jump heights for defense and forward players were significantly higher compared with midfield players. Mean results from the laboratory test were 63.7 mL x kg(-1) x min(-1) or 188.6 mL x kg[-0.75] x min(-1) for maximal oxygen uptake, 150 kg or 8.0 kg x mb(-0.67) for 90 degrees squats, 79.9 kg or 4.4 kg x mb(-0.67) for bench press. Mean values of vertical jump height were 54.9 cm.

In Brief Purpose: To evaluate the safety and efficacy of intravitreal bevacizumab (Avastin, Genentech Inc.) for the treatment of neovascular age-related macular degeneration (ARMD). Methods: A retrospective review was performed on consented patients with neovascular ARMD receiving intravitreal bevacizumab therapy. All patients received intravitreal bevacizumab at baseline with additional monthly injections given at the discretion of the treating physician. At each visit, a routine Snellen visual acuity assessment was performed followed by an ophthalmic examination and optical coherence tomography (OCT) imaging. Results: Fifty–three eyes of 50 patients received an intravitreal bevacizumab injection between May and August 2005. Including the month 3 visit, the average number of injections was 2.3 out of a maximum of 4 injections. No serious drug-related ocular or systemic adverse events were identified. Improvements in visual acuity and central retinal thickness measurements were evident by week 1 and continued through month 3. At month 3, the mean visual acuity improved from 20/160 to 20/125 (P<0.001) and the mean central retinal thickness decreased by 99.6 μm (P<0.001). Conclusion: Off-label intravitreal bevacizumab therapy for neovascular ARMD was well tolerated over 3 months with improvements in visual acuity and OCT central retinal thickness measurements. While the long-term safety and efficacy of intravitreal bevacizumab remain unknown, these short-term results suggest that intravitreal bevacizumab may be the most cost effective therapy for the treatment of neovascular ARMD. A retrospective review was performed on consecutively consented patients with neovascular ARMD receiving intravitreal bevacizumab therapy. While the long-term safety and efficacy of intravitreal bevacizumab remain unknown, the short-term results suggest that intravitreal bevacizumab may be the most cost effective therapy for the treatment of neovascular ARMD.