Saturday, February 6, 2016

Reconceptualizing Autonomy: A Relational Turn in Bioethics

 2016 Feb 5. doi: 10.1002/hast.544. [Epub ahead of print]

Reconceptualizing Autonomy: A Relational Turn in Bioethics.

Abstract

History's judgment on the success of bioethics will not depend solely on the conceptual creativity and innovation in the field at the level of ethical and political theory, but this intellectual work is not insignificant. One important new development is what I shall refer to as the relational turn in bioethics. This development represents a renewed emphasis on the ideographic approach, which interprets the meaning of right and wrong in human actions as they are inscribed in social and cultural practices and in structures of lived meaning and interdependence; in an ideographic approach, the task of bioethics is to bring practice into theory, not the other way around. The relational turn in bioethics may profoundly affect the critical questions that the field asks and the ethical guidance it offers society, politics, and policy. The relational turn provides a way of correcting the excessive atomism of many individualistic perspectives that have been, and continue to be, influential in bioethics. Nonetheless, I would argue that most of the work reflecting the relational turn remains distinctively liberal in its respect for the ethical significance of the human individual. It moves away from individualism, but not from the value of individuality.In this review essay, I shall focus on how the relational turn has manifested itself in work on core concepts in bioethics, especially liberty and autonomy. Following a general review, I conclude with a brief consideration of two important recent books in this area: Jennifer Nedelsky's Law's Relations and Rachel Haliburton's Autonomy and the Situated Self.

"Are today's parents, who put crash helmets on tykes before they put the tykes on tricycles, going to allow these children to play football? Not likely."

George Will: The Super Bowl's 60 minutes of damage


"Today's game will be 60 minutes of football -- an adrenaline-and-testosterone bath stretched by commercial breaks (two of them called "two minute warnings"), replay challenges and other delays to about 200 minutes -- embedded in an all-day broadcast of manufactured frenzy. It would be nice, but probably fanciful, to think that even 1 percent of tonight's expected television audience of more than 110 million will have qualms about the ethics of their enjoyment.
.............
Are today's parents, who put crash helmets on tykes before they put the tykes on tricycles, going to allow these children to play football? Not likely. This game will be different, or much less popular -- or perhaps both -- when in 2066 the national campfire is lit for Super Bowl C."

Read more here: http://www.ledger-enquirer.com/opinion/op-ed/article58872823.html#storylink=cpy

Pathologists and medical error disclosure: don't wait for an invitation

 2015 Feb;139(2):163-4. doi: 10.5858/arpa.2014-0136-ED.

Pathologists and medical error disclosure: don't wait for an invitation.

Author information

  • 1From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Cohen); and the Department of Pathology, University of Texas Medical Branch, Galveston (Dr Allen).

"Like our clinical colleagues, pathologists should not wait for an invitation to participate in error disclosure—far from it—pathologists should become active participants in discussing with patients the events surrounding a potential medical error, how it was discovered, and what is being done to ensure that the medical error never happens again. They should absolutely be involved in every situation for which there is potential pathologist or laboratory error; they should invite themselves to actively participate in situations for which a laboratory issue may have played an indirect role; and they should liberally offer to participate in other, nonlaboratoryrelated, disclosure conversations in case a question or concern regarding the laboratory arises. It is in such an advocacy role that pathologists can best serve their patients."

"...each extra hour of daily sitting posture was associated with a 22 per cent increased risk of developing type 2 diabetes."

Longer you sit, more chances of diabetes develop- study says


"Not only obesity, the longer you spent by sitting even increase the risk of diabetes, warned new study. 
According to the study conducted by Julianne van der Berg of Maastricht University in the Netherlands and colleagues researched that cross-sectional associations of total duration and patterns of sedentary behaviour with glucose metabolism status and the metabolic syndrome.
Researchers said that each extra hour of daily sitting posture was associated with a 22 per cent increased risk of developing type 2 diabetes."

"...the level of venality and greed and cynicism required to perpetuate a business that depends on millions of people watching young men shorten their lives is breathtaking."

The NFL machine grinds on: I love football, but I can’t watch Super Bowl 50 — or the game, ever again

For too long, I looked past what I knew about the sport so I could enjoy it—but I can't ignore the truth anymore



"The fact that the giant football machine grinds on despite the known risks to players’ sanity and lifespans can be explained by many things, the top two surely being love of the game and money. When did it go from being a sport to being a $10 billion corporatized entertainment industry? Perhaps I’m naïve, and football was always about greed. Still, the level of venality and greed and cynicism required to perpetuate a business that depends on millions of people watching young men shorten their lives is breathtaking. (So is NFL commissioner Roger Goodell’s $44 million salary.) Professional football, in Steve Almond’s words, is “capitalism on steroids.”
A third reason must be willful ignorance. I’m guilty. For a long time I filed away the information at hand so I could keep enjoying the occasional game."

Rio Rancho teen’s case puts concussion concerns on lawmakers’ radar

Rio Rancho teen’s case puts concussion concerns on lawmakers’ radar


"The bill in New Mexico is part of a national discussion on player safety, especially in collision sports such as football and rugby. The National Football League, which 20 years ago said concussions were infrequent and were not a long-term health concern for its players, has changed its position and its policies. The NFL now requires on-the-spot medical evaluations of players who may have a concussion. Those diagnosed with a brain injury cannot return to the field until they have medical clearance. Colleges, high schools and youth programs are implementing similar protections.
Sanchez’s bill extends to nonscholastic youth athletic activities. Organized teams, such as those in Little League Baseball and youth soccer programs, would also have to follow the state protocol for brain injuries."



Super Bowl’s 50th birthday marred by concussion & homeless scandals

Super Bowl’s 50th birthday marred by concussion & homeless scandals


"San Francisco taxpayers are left paying the bill for the NFL's party, despite the league’s reported revenue of $12bn last season, far more than the city’s annual budget."

NFL: “There’s enough good publicity and entertainment value in the product to more than offset all the bad publicity they get from the other places.”

Despite troubles aplenty, NFL and Super Bowl popular as ever


“That’s what you have to look at — the NFL and the Super Bowl as an entertainment product, and a whole lot of people who really do love that entertainment product,” Deninger said. “There’s enough good publicity and entertainment value in the product to more than offset all the bad publicity they get from the other places.”

"... his 60s were a nightmare of memory loss, insomnia and disorientation, with headaches so severe that he often spent whole days in silence."

Another Super Bowl, another brain trauma casualty


"Score one more for CTE, the degenerative brain disease increasingly linked with football. Few athletes were as charismatic as The Snake during his young, hellraising years with the Oakland Raiders. And few men have endured a middle age as crippling.
His partner, Kim Bush, said his 60s were a nightmare of memory loss, insomnia and disorientation, with headaches so severe that he often spent whole days in silence. As he witnessed other retired athletes succumbing to dementia, depression and other neurological problems, he agreed to donate his brain to science; CTE, which is believed to arise from repetitive brain trauma, can only be diagnosed posthumously."

"It’s serious business because, in theory, it threatens to end the business."

Mara gets defensive about concussions



"It’s serious business because, in theory, it threatens to end the business. But while Mara takes seriously the increase in concussions, like others connected to the league he has tried to explain the increase in concussions by pointing to something other than, you know, the actual increase in concussions.
“Yes, when that statistic came out it certainly caught my attention,” Mara said. “But I want to understand the reasons for that. Are we just diagnosing [concussions] more? Is there more self-reporting? Or are we actually having more incidents? I don’t fully understand that yet. That’s something [the health and safety] committee will look at in Indianapolis in a couple of weeks.”
Some have suggested that the Case Keenum debacle sparked a sudden culture change, with more diagnosis and self-reporting of concussions coming after it. But that incident happened in late November, not early September. Besides, it’s hard to call it a watershed moment when the fine-happy NFL opted to impose discipline on no one for failing to grab Keenum by the facemask and dragging him off the field when he clearly was concussed."

'Concussion' and the Serious Impact of Repeated Head Trauma | ABC News

"By ‘understandable’ I suspect she means ‘cowardly.’"

Should Dangerous Sports Be Banned?


"The American Academy of Pediatrics believe that the problem should be dealt with by ensuring adult supervision of games, more coaching of players so that they tackle better, that physical therapists should be employed to increase the strength of the neck muscles of the young players and that certified trainers should be present at all games.

The author says, ‘It is understandable that the AAP has promulgated policy recommendations that seek to minimize the harm of tackle football as it is currently played, given the cultural predominance of football in the United States.’ By ‘understandable’ I suspect she means ‘cowardly.’  

Perhaps the only answer to injury in sport is to ban it altogether. Then the emergency departments of hospitals could get on with their real work, which is to say attending to drunks and drug-addicts."      

105 former NHL players join class-action concussion lawsuit against league

105 former NHL players join class-action concussion lawsuit against league


"NHL Commissioner Gary Bettman, who was deposed for testimony last July, has said the lawsuit is ‘‘without merit.’’ The league’s first attempt to dismiss the claims was denied last year by U.S. District Judge Susan Richard Nelson. There is another pending motion for dismissal, based on an argument that the issues should be addressed through collectively bargained arbitration instead of court.
The players seem to have plenty of chilling arguments on their side. The NHL has its share of legal defenses, too. For one, correlating current cognitive problems to specific NHL collisions could be difficult for players who have played hockey their whole lives."

"Sorry to say, the heads inside the helmets of those running backs and linebackers and linemen are just as susceptible to concussions as the ones of the defenseless guys making those one-handed receptions."


Let’s not play games with spike in concussion rate this season


"The league is quick to offer the phrase “change in culture,” but whether that concept is universally embraced is a question. A recent Associated Press survey showed that 61 percent of players are either not concerned about concussions or less concerned than they are about other injuries, such as wrecking a knee. Texans cornerback Charles James pointed out that “you can get a head injury from anywhere. A dude could sucker-punch me,” twisted logic that ignores that possibility a dude could get cold-cocked in a bar whether he plays football or not.
Clearly, quarterbacks and receivers are better off today than they were even a few years ago, before anyone gave much thought to the term “defenseless receiver.” But watch Sunday’s Super Bowl and count the number of times players lead with their helmets. It’s spearing, a term you still never hear. Sorry to say, the heads inside the helmets of those running backs and linebackers and linemen are just as susceptible to concussions as the ones of the defenseless guys making those one-handed receptions.
That’s one fact the league can’t deny."

Hollywood tackles concussion head-on

Hollywood tackles concussion head-on

    There is a lot we don't understand about the impact of head injuries in sport but a new Hollywood film called Concussion, starring Will Smith, aims to change that.
    Over the last few years, American Football has had to face up to the fact that repeated head collisions, which are a major feature of the sport, can have serious long-term health consequences.
    But for a long time, it wasn't a popular message.

"One way of saving money would be to disband pointless quangos like the National Institute for Health and Care Excellence (Nice), which regularly comes up with inane suggestions about how to improve the nation’s health."

Nagging adults about their weight won’t solve the obesity crisis – teaching children about nutrition might

It will take a decade to change attitudes to food, and cooking has to be a central part of the school day, with compulsory school meals that pupils help to prepare

"One way of saving money would be to disband pointless quangos like the National Institute for Health and Care Excellence (Nice), which regularly comes up with inane suggestions about how to improve the nation’s health. It would like GPs to get paid for encouraging patients with a body mass index (BMI) in the obese range to attend Weight Watchers and be offered advice about a healthier lifestyle. This morbid obsession with targeting the nation’s fatties is doomed. Being large does not necessarily mean you are unfit. 
The way to tackle overeating and poor diet is not by paying GPs (who are already very well rewarded) but by starting cookery and nutrition lessons at primary school, focusing on food preparation as a way of teaching social skills, maths and English."

Salon: This is the end of marriage, capitalism and God. Finally!

This is the end of marriage, capitalism and God. Finally!

My fellow boomers might mock millennials, but what if the new generation has the big questions absolutely right?



"The peer-to-peer nature of contemporary communication appears to be horizontal, democratic and inclusive, yet all of these smaller communities also result in exclusion—an exclusion from broader forms of sense-making. In other words, we have all of these micro-segments and there is little consensus: there is no grand worldview that we all share. Rather, there are personalized worldviews."

NFL has seen 58% increase in head injuries this season

NFL has seen 58% increase in head injuries this season

"But some experts say the league is trying to make the sport safer -- like Troy Aikman, who won three Super Bowls during the 1990s, and is now a TV analyst.
But is the NFL doing enough?
Others wonder if the violence will turn people away from the sport, but the simple answer no.
And that trend will probably continue -- as the appetite for the Super Bowl continues to increase in America -- where bigger is better and the hits continue to increase in violent intensity."

"Instead of focusing on player safety and the dangers of a concussion, the NFL should focus on the quality of the game."

The State Of Football Impacts Every NFL Fan




"The biggest problem the NFL has is that its biggest problem has no solution. The NFL has tried to enforce “player safety rules” but the number of concussions went up in the 2015 season. Football is a gladiator sport, where the biggest, strongest and fastest athletes collide on every single play. Football is a contact sport. Danger comes with it.
Instead of focusing on player safety and the dangers of a concussion, the NFL should focus on the quality of the game. Football fans should not be more frustrated with how the game is managed than how their team manages to perform. Somewhere along the line the NFL forgot that they were an entertainment based business.
By focusing on concussions and player safety the NFL is fighting a losing battle. By embracing the fact that football is inevitably going to lead to a random allotment of injuries to the brains and bodies of football players, they can focus on the quality of the game. Taking the fun out of football is more damaging than lawsuits can be. The lawsuits are inevitable, the public backlash is inevitable, the sad stories of retired players are inevitable.
As long as the masses spend their money to go to games, wear NFL merchandise and watch the NFL on television, the bottom line of the NFL will be filled with plenty of cash. Fans are fed up with the NFL right now but are so emotionally invested in their team. They’re not going anywhere for now."

Elastic spheres can walk on water

 2016 Feb 4;7:10551. doi: 10.1038/ncomms10551.

Elastic spheres can walk on water.

Author information

  • 1Naval Undersea Warfare Center Division Newport, 1176 Howell Street, Newport, Rhode Island 02841, USA.
  • 2Department of Mechanical and Aerospace Engineering, Utah State University, ENGR 419J, Logan, Utah 84322, USA.
  • 3School of Engineering, Brown University, 184 Hope Street, Providence, Rhode Island 02912, USA.

Abstract

Incited by public fascination and engineering application, water-skipping of rigid stones and spheres has received considerable study. While these objects can be coaxed to ricochet, elastic spheres demonstrate superior water-skipping ability, but little is known about the effect of large material compliance on water impact physics. Here we show that upon water impact, very compliant spheres naturally assume a disk-like geometry and dynamic orientation that are favourable for water-skipping. Experiments and numerical modelling reveal that the initial spherical shape evolves as elastic waves propagate through the material. We find that the skipping dynamics are governed by the wave propagation speed and by the ratio of material shear modulus to hydrodynamic pressure. With these insights, we explain why softer spheres skip more easily than stiffer ones. Our results advance understanding of fluid-elastic body interaction during water impact, which could benefit inflatable craft modelling and, more playfully, design of elastic aquatic toys.

New Study Shows Arkansas Has Highest Adult Obesity Rate in the Country

New Study Shows Arkansas Has Highest Adult Obesity Rate in the Country




Friday, February 5, 2016

"Approximately 1% of all physicians accounted for 32% of paid [medical malpractice] claims."

 2016 Jan 28;374(4):354-62. doi: 10.1056/NEJMsa1506137.

Prevalence and Characteristics of Physicians Prone to Malpractice Claims.

Author information

  • 1From Stanford University School of Medicine and Stanford Law School, Stanford, CA (D.M.S., M.M.M.); Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia (M.M.B., M.J.S.); and the Health Resources and Services Administration, Department of Health and Human Services, Rockville, MD (H.S.).

Abstract

BACKGROUND:

The distribution of malpractice claims among physicians is not well understood. If claim-prone physicians account for a substantial share of all claims, the ability to reliably identify them at an early stage could guide efforts to improve care.

METHODS:

Using data from the National Practitioner Data Bank, we analyzed 66,426 claims paid against 54,099 physicians from 2005 through 2014. We calculated concentrations of claims among physicians. We used multivariable recurrent-event survival analysis to identify characteristics of physicians at high risk for recurrent claims and to quantify risk levels over time.

RESULTS:

Approximately 1% of all physicians accounted for 32% of paid claims. Among physicians with paid claims, 84% incurred only one during the study period (accounting for 68% of all paid claims), 16% had at least two paid claims (accounting for 32% of the claims), and 4% had at least three paid claims (accounting for 12% of the claims). In adjusted analyses, the risk of recurrence increased with the number of previous paid claims. For example, as compared with physicians who had one previous paid claim, the 2160 physicians who had three paid claims had three times the risk of incurring another (hazard ratio, 3.11; 95% confidence interval [CI], 2.84 to 3.41); this corresponded in absolute terms to a 24% chance (95% CI, 22 to 26) of another paid claim within 2 years. Risks of recurrence also varied widely according to specialty--for example, the risk among neurosurgeons was four times as great as the risk among psychiatrists.

CONCLUSIONS:

Over a recent 10-year period, a small number of physicians with distinctive characteristics accounted for a disproportionately large number of paid malpractice claims.

Identification of microRNA expression profile related to lymph node status in women with early-stage grade 1–2 endometrial cancer

Modern Pathology advance online publication 5 February 2016; doi: 10.1038/modpathol.2016.30

Identification of microRNA expression profile related to lymph node status in women with early-stage grade 1–2 endometrial cancer

Geoffroy Canlorbe1,2,3, Zhe Wang1, Enora Laas2, Sofiane Bendifallah2,4, Mathieu Castela1, Marine Lefevre5, Nathalie Chabbert-Buffet1,2, Emile Daraï1,2,3, Selim Aractingi1, Céline Méhats6,7 and Marcos Ballester1,2,3,7
  1. 1INSERM, UMR S 938, University Pierre et Marie Curie, Paris, France
  2. 2Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, et Paris, Paris, France
  3. 3Institut Universitaire de Cancérologie (IUC), Paris, France
  4. 4INSERM UMR S 707, Epidemiology, Information Systems, Modeling, University Pierre and Marie Curie, Paris, France
  5. 5Department of Pathology, Tenon University Hospital, University Pierre and Marie Curie, Paris, France
  6. 6Cochin Institute, Inserm U1016, CNRS 8104, Université Paris Descartes, Paris, France
Correspondence: Dr G Canlorbe, MD, Service de Gynécologie-Obstétrique, Hôpital Tenon, 4 rue de la Chine, 75020 Paris, France. E-mail: geoffroy.canlorbe@aphp.fr
7These authors contributed equally to this work.
Received 25 October 2015; Revised 5 December 2015; Accepted 21 December 2015
Advance online publication 5 February 2016
Top

Abstract

Conventional methods used for histologic classification and grading of endometrial cancer (EC) are not sufficient to predict lymph node metastases. microRNA signatures have recently been related to EC pathologic characteristics or prognosis. The aim of this study was to evaluate whether microRNA profiles of grade 1–2 endometrioid adenocarcinomas can be related to nodal status and used as a tool to adapt surgical staging in early-stage EC. microRNA expression was assessed in nine formalin-fixed paraffin-embedded (FFPE) EC primary tumors with positive lymph node and in 27 FFPE EC primary tumors with negative lymph node, matched for grade, stage, and lymphovascular space involvement status. A microarray analysis showed that there was more than a twofold significant difference in the expression of 12 microRNAs between the two groups. A quantitative reverse transcriptase–PCR assay was used to confirm these results: the expression levels of five microRNAs (microRNA-34c-5p, -375, -184, -34c-3p, and -34b-5p) were significantly lower in the EC primary tumor with positive lymph node compared with those with negative lymph node. A minimal P-value approach revealed that women with a microRNA-375-fold change <0.30 were more likely to have positive lymph node (n=8; 53.3%) compared with those with a microRNA-375-fold change >0.30 (n=1; 4.8%), P=0.001. Furthermore, women with a microRNA 184-fold change <0.30 were more likely to have positive lymph node (n=6; 60.0%) compared with those with a microRNA 184-fold change >0.30 (n=3; 11.5%), P=0.006. This is the first study investigating the relative expression of mature microRNA genes in early-stage grade 1–2 EC primary tumors according to the nodal status. This microRNA expression profile provides a potential basis for further study of the microRNA function in EC and could be used as a diagnostic tool for nodal status.

The Extension of Belgium's Euthanasia Law to Include Competent Minors

 2016 Feb 3. [Epub ahead of print]

The Extension of Belgium's Euthanasia Law to Include Competent Minors.

Raus K1,2.

Author information

  • 1Department of Philosophy and Moral Sciences, Ghent University, Blandijnberg 2, 9000, Gent, Belgium. Kasper.Raus@UGent.be.
  • 2End-of-Life Care Research Group Ghent University & Vrije Universiteit Brussel (VUB), Gent, Belgium. Kasper.Raus@UGent.be.

Abstract

Following considerable debate, the practice of euthanasia was legalized in Belgium in 2002, thereby making Belgium one of the few places in the world where this practice is legal. In 2014 the law was amended for the first time. The 2014 amendment makes euthanasia legally possible for all minors who repeatedly and voluntarily request euthanasia and who are judged to possess "capacity of discernment" (regardless of their biological age), as well as fulfil a number of other criteria of due care. This extension of the 2002 euthanasia law generated a lot of national and international debate and has been applauded by many and heavily criticized by others. This evolution is clearly of interest to end-of-life debates in the entire world. This paper will therefore describe how this amendment came to get passed using official documents from Belgium's Senate and Chamber of Representatives where this amendment was discussed and subsequently passed. Next, some of the most commonly given arguments in favour of the law are identified, as well as the arguments most often voiced against the amendment. All these arguments will be expanded upon and it will be examined whether they hold up to ethical scrutiny. Analysing the official documents and identifying the most commonly voiced arguments gives valuable insight into how Belgium came to amend its euthanasia law and why it did so in 2014. It also becomes clear that although the current amendment is often seen as far-reaching, more radical ideas were proposed during the drafting of the law. Also, in analysing those arguments in favour of the amendment and those against, it is clear that the validity of some of these is questionable.

Antibody-Mediated Rejection in Lung Transplantation: Clinical Outcomes and Donor-Specific Antibody Characteristics

 2016 Feb 4. doi: 10.1111/ajt.13589. [Epub ahead of print]

Antibody-Mediated Rejection in Lung Transplantation: Clinical Outcomes and Donor-Specific Antibody Characteristics.

Author information

  • 1Pneumology, Adult Cystic Fibrosis Center and Lung Transplantation Department, Foch Hospital, Suresnes, France.
  • 2Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, CA.
  • 3Université Versailles Saint-Quentin-en-Yvelines, UPRES EA220, Suresnes, France.
  • 4Pathology Department, Foch Hospital, Suresnes, France.
  • 5Thoracic Surgery Department, Foch Hospital, Suresnes, France.
  • 6Intensive Care Unit, Foch Hospital, Suresnes, France.
  • 7Thoracic Intensive Care Unit, Foch Hospital, Suresnes, France.
  • 8Anesthesiology Department, Foch Hospital, Suresnes, France.
  • 9Department of Microbiology,Immunology and Molecular Genetics, University of California Los Angeles, Los Angeles, CA.
  • 10Institute for Quantitative and Computational Biosciences, University of California Los Angeles, Los Angeles, CA.
  • 11Laboratoire Régional d'Histocompatibilité, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.

Abstract

In the context of lung transplant (LT), because of diagnostic difficulties, antibody-mediated rejection (AMR) remains a matter of debate. We retrospectively analyzed an LT cohort at Foch Hospital to demonstrate the impact of AMR on LT prognosis. AMR diagnosis requires association of clinical symptoms, donor-specific antibodies (DSAs), and C4d+ staining and/or histological patterns consistent with AMR. Prospective categorization split patients into four groups: (i) DSA positive, AMR positive (DSApos AMRpos ); (ii) DSA positive, AMR negative (DSApos AMRneg ); (iii) DSA limited, AMR negative (DSALim ; equal to one specificity, with mean fluorescence intensity of 500-1000 once); and (iv) DSA negative, AMR negative (DSAneg ). AMR treatment consisted of a combination of plasmapheresis, intravenous immunoglobulin and rituximab. Among 206 transplanted patients, 10.7% were DSApos AMRpos (n = 22), 40.3% were DSApos AMRneg (n = 84), 6% were DSALim (n = 13) and 43% were DSAneg (n = 88). Analysis of acute cellular rejection at month 12 showed higher cumulative numbers (mean plus or minus standard deviation) in the DSApos AMRposgroup (2.1 ± 1.7) compared with DSApos AMRneg (1 ± 1.2), DSALim (0.75 ± 1), and DSAneg (0.7 ± 1.23) groups. Multivariate analysis demonstrated AMR as a risk factor for chronic lung allograft dysfunction (hazard ratio [HR] 8.7) and graft loss (HR 7.56) for DSApos AMRpos patients. Our results show a negative impact of AMR on LT clinical course and advocate for an early active diagnostic approach and evaluation of therapeutic strategies to improve prognosis.

Mindful eating may combat obesity

Mindful eating may combat obesity

"Said grace before dinner? Enjoyed a moment of silence before tearing into that savory plate of lechón asada?
You were mindfully eating — or, at least, starting out on the right path."

Is football an endangered species?

Is football an endangered species?



“Concussion,” with Smith playing the role of Omalu, paints a damning picture of the NFL as a multi-billion dollar industry trying to protect its product at the expense of its players. Released on Christmas Day, it simply stoked a debate that was already raging.

Effect of Docosahexaenoic Acid on a Biomarker of Head Trauma in American Football

 2016 Jan 13. [Epub ahead of print]

Effect of Docosahexaenoic Acid on a Biomarker of Head Trauma in American Football.

Author information

  • 11Sports Concussion Research Group, Department of Kinesiology, Texas Christian University, Fort Worth, TX; 2Division of Health and Human Performance, George Mason University, Manassas, VA; 3Department of Sport Medicine, Texas Christian University, Fort Worth, TX; 4Department of Sport Medicine, John Peter Smith Hospital, Fort Worth, TX; 5UmanDiagnostics, Umeå, Sweden; 6Clinical Neurochemistry Laboratory, Institute Of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; 7Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, United Kingdom.

Abstract

PURPOSE:

American football athletes are exposed to sub-concussive impacts over the course of the season resulting in elevations in serum neurofilament light (NFL), a biomarker of axonal injury. Docosahexaenoic acid (DHA) has been reported to reduce axonal trauma associated with traumatic brain injury in rodent models. However, the optimal dose in American football athletes is unknown. This study examined the effect of differing doses of DHA on serum NFL over the course of a season of American football.

METHODS:

In a randomized, double-blind, placebo-controlled, parallel design eighty-one (n = 81) National Collegiate Athletic Association (NCAA) Division I American football athletes were assigned to ingest either 2 g•d, 4 g•d, 6 g•d of DHA, or placebo. Blood was sampled at specific times over the course 189 days coincident with changes in intensity, hours of contact, and likely changes in head impacts. Standardized magnitude-based inference was used to define outcomes.

RESULTS:

DHA supplementation increased plasma DHA in dose-dependent manner (mean difference from baseline; ± 90% CL; 2 g•d: 1.3; ±0.6; 4 g•d: 1.6; ±0.7%; 6 g•d: 2.8; ±1.2%). Serum NFL increased to a greater extent in starters (AUC, 1995 ± 1383 pg•mL•day) versus non-starters (1398 ± 581 pg•mL•day; p = 0.024). Irrespective of dose, supplemental DHA likely attenuated serum NFL coincident with increases in serum NFL by likely small and moderate magnitude (ES = 0.4 to 0.7).

CONCLUSION:

Findings from this study, the first large scale study examining potential prophylactic use of DHA in American football athletes, include identification of optimal dose of DHA suggest a neuroprotective effect of DHA supplementation.