Changes in the microbiota have been linked to persistent inflammation during treated HIV infection. In this pilot double-blind study, we study 30 HIV-infected subjects on antiretroviral therapy (ART) ...with a CD4/CD8 ratio < 1 randomized to either weekly fecal microbiota capsules or placebo for 8 weeks. Stool donors were rationally selected based on their microbiota signatures. We report that fecal microbiota transplantation (FMT) is safe, not related to severe adverse events, and attenuates HIV-associated dysbiosis. FMT elicits changes in gut microbiota structure, including significant increases in alpha diversity, and a mild and transient engraftment of donor's microbiota during the treatment period. The greater engraftment seems to be achieved by recent antibiotic use before FMT. The Lachnospiraceae and Ruminococcaceae families, which are typically depleted in people with HIV, are the taxa more robustly engrafted across time-points. In exploratory analyses, we describe a significant amelioration in the FMT group in intestinal fatty acid-binding protein (IFABP), a biomarker of intestinal damage that independently predicts mortality. Gut microbiota manipulation using a non-invasive and safe strategy of FMT delivery is feasible and deserves further investigation. Trial number: NCT03008941.
The main aims of the present research were 1) to characterise the inter-subject and intra-subject timing of the preparatory movements of competitive swimmers during relay starts and 2) to relate the ...preparatory movements with the relay start outcome. Nine international youth swimmers performed 10 relay freestyle starts (one-step technique) filmed at 120 Hz from a lateral viewpoint. Results obtained (0.14 ± 0.10 s changeover time, 0.31 ± 0.07 s entry time, 2.59 ± 0.09 m entry distance and 0.96 ± 0.06 s time to 5 m) indicated that the longer the preparation time (from the initial position to the swimmer's take-off), the better the changeover time, entry distance, and 5 m time. Specifically, a mixed linear model identified preparation time (p < 0.001, F (1,80.01) = 56.36), and entry distance (p = 0.008, F (1,80.01) = 7.36) as predicting variables for 5 m time. Also, faster swimmers on times to 5 m were found to be more consistent - lower levels of intra-subject variability - in 5 m (r = 0.76, p = 0.018) and changeover (r = 0.72, p = 0.029) times. In summary, the timing of the preparatory movements seems to be a key aspect to optimise relay start performances.
The aim of the current experiment was to examine the spatiotemporal control of expert tennis players while executing first service returns within a representative experimental setting. We recruited ...and tested 12 male expert tennis players in hard courts. A comprehensive analysis of the timing (eleven temporal variables analysed at 300 Hz) and performance success of the return actions were carried out, while simultaneously considering task constraints such as the accuracy and the speed of the serves. Temporal organisation of return actions were scaled relative to the server's racket-ball contact (5 ms), an adaptation of fly-time of the split-step, which resulted in consistent landings (133 ms), and initiation of lateral movements towards the ball - with no response errors - after the server's stroke (around 177 ms). Poorer returns occurred when responding to accurate serves accompanied by late trunk movements towards the ball. Returners scaled the timing of the response to the unfolding action of the serve in order to support both spatial and temporal accuracy. These novel findings highlight the significance of the study of fast-ball sports in representative settings and offer further detail on the spatiotemporal control of skilful perception-action.
Every parasport is currently encouraged to consider evidence-based classification to develop their respective classification system. Therefore, the aims of this study were to: (1) assess the ...relationship between trunk function and anaerobic power determining proficiency in wheelchair basketball, and (2) define “natural classes” in wheelchair basketball based on anaerobic power. Fifty-nine elite players (representing five national teams) were divided into four main functional classes: Group 1 (n=17), Group 2 (n=14), Group 3 (n=16), Group 4 (n=12). They performed the 6x10s Anaerobic Power Test using an arm crank ergometer. Average values of mean power, peak power, relative mean power, relative peak power, and power decrement were calculated for the 6x10s and 3x10s tests. The Spearman’s correlation matrix revealed significant correlations between classes and values recorded in the 6x10s test. This confirmation between anaerobic power and players’ classification endorses the division of players into different classes. Furthermore, cluster analysis (with fair quality) divided players into two “natural classes”. The first resulting class was mainly formed of participants from Group 1 (71%). An important complement to this research could be to consider wheelchair acceleration and the volume of trunk action in wheelchair basketball classification.
It is widely accepted that the sources of information used to guide interceptive actions depend on conflicting spatiotemporal task demands. However, there is a paucity of evidence that shows how ...information pick-up during interceptive actions is adapted to such conflicting constraints. The present study therefore examined the effects of systematic manipulations of spatiotemporal constraints on performance, timing and gaze in an in situ interceptive action. To this end, expert futsal goalkeepers faced penalty kicks taken from 10 m and 6 m. With the more lenient spatiotemporal constraints (i.e., kicks from 10 m), the goalkeepers saved more kicks, initiated their actions later, and looked longer toward ball relative to the penalty takers' body. Furthermore, analysis of gaze patterns showed that interindividual variations in information pick-up were related to the unfolding of the penalty taker's action, revealing a less variable, funnel-like gaze pattern toward the end of the action. These findings are interpreted to reflect that changes in spatiotemporal demands induce the differential use of information for the accurate control of interceptive actions.
Public Significance Statement
When facing penalty kicks, expert goalkeepers can ensure that they dive to the correct goal location if they wait until ball flight. However, in doing so, goalkeepers are likely to move too late for ball interception. Alternatively, goalkeepers can move early and anticipate based on the actions of the penalty taker. We examined how elite futsal goalkeepers adapt to these conflicting spatiotemporal demands by examining their attempts to save penalty kicks taken from 10 m and 6 m. Goalkeepers prioritized moving early to arrive in sufficient time to intercept the ball, although such action coincided with a decrease in anticipation accuracy during 6-m compared to 10-m kicks. These findings are important for the study of perception and action during social coordination (as exemplified by 2 opponents in sport situations) as the use of video or virtual reality (VR)-technologies in research fail to safeguard the temporal nature of real-time interactions.
Stroke is the second leading cause of death worldwide. Nearly two-thirds of strokes are produced by cardioembolisms, and half of cardioembolic strokes are triggered by Atrial Fibrillation (AF), the ...most common type of arrhythmia. A more recent cause of cardioembolisms is Transcatheter Aortic Valve Replacements (TAVRs), which may onset post-procedural adverse events such as stroke and Silent Brain Infarcts (SBIs), for which no definitive treatment exists, and which will only get worse as TAVRs are implanted in younger and lower risk patients. It is well known that some specific characteristics of elderly patients may lower the safety and efficacy of anticoagulation therapy, making it a real urgency to find alternative therapies. We propose a device consisting of a strut structure placed at the base of the treated artery to model the potential risk of cerebral embolisms caused by dislodged debris of varying sizes. This work analyzes a design based on a patented medical device, intended to block cardioembolisms from entering the cerebrovascular system, with a particular focus on AF, and potentially TAVR patients. The study has been carried out in two stages. Both of them based on computational fluid dynamics (CFD) coupled with Lagrangian particle tracking method. The first stage of the work evaluates a variety of strut thicknesses and inter-strut spacings, contrasting with the device-free baseline geometry. The analysis is carried out by imposing flowrate waveforms characteristic of both healthy and AF patients. Boundary conditions are calibrated to reproduce physiological flowrates and pressures in a patient's aortic arch. In the second stage, the optimal geometric design from the first stage was employed, with the addition of lateral struts to prevent the filtration of particles and electronegatively charged strut surfaces, studying the effect of electrical forces on the clots if they are considered charged. Flowrate boundary conditions were used to emulate both healthy and AF conditions. Results from numerical simulations coming form the first stage indicate that the device blocks particles of sizes larger than the inter-strut spacing. It was found that lateral strut space had the highest impact on efficacy. Based on the results of the second stage, deploying the electronegatively charged device in all three aortic arch arteries, the number of particles entering these arteries was reduced on average by 62.6% and 51.2%, for the healthy and diseased models respectively, matching or surpassing current oral anticoagulant efficacy. In conclusion, the device demonstrated a two-fold mechanism for filtering emboli: while the smallest particles are deflected by electrostatic repulsion, avoiding microembolisms, which could lead to cognitive impairment, the largest ones are mechanically filtered since they cannot fit in between the struts, effectively blocking the full range of particle sizes analyzed in this study. The device presented in this manuscript offers an anticoagulant-free method to prevent stroke and SBIs, imperative given the growing population of AF and elderly patients.
It is well known that flow patterns at the anastomosis of coronary artery bypass graft (CABG) are complex and may affect the long-term patency. Various attempts at optimal designs of anastomosis have ...not improved long-term patency. Here, we hypothesize that mild anastomotic stenosis (area stenosis of about 40-60%) may be adaptive to enhance the hemodynamic conditions, which may contribute to slower progression of atherosclerosis. We further hypothesize that proximal/distal sites to the stenosis have converse changes that may be a risk factor for the diffuse expansion of atherosclerosis from the site of stenosis. Twelve (12) patient-specific models with various stenotic degrees were extracted from computed tomography images using a validated segmentation software package. A 3-D finite element model was used to compute flow patterns including wall shear stress (WSS) and its spatial and temporal gradients (WSS gradient, WSSG, and oscillatory shear index, OSI). The flow simulations showed that mild anastomotic stenosis significantly increased WSS (>15 dynes · cm(-2)) and decreased OSI (<0.02) to result in a more uniform distribution of hemodynamic parameters inside anastomosis albeit proximal/distal sites to the stenosis have a decrease of WSS (<4 dynes · cm(-2)). These findings have significant implications for graft adaptation and long-term patency.
Chronic coronary retroperfusion to treat myocardial ischemia has previously failed due to edema and hemorrhage of coronary veins suddenly exposed to arterial pressures. The objective of this study ...was to selectively adapt the coronary veins to become arterialized prior to coronary venous retroperfusion to avoid vascular edema and hemorrhage.
In 32 animals (Group I = 19 and Group II = 13), the left anterior descending (LAD) artery was occluded using an ameroid occlusion model. In Group I, the great cardiac vein was blocked with suture ligation (Group IA = 11) or with occlusion device (Group IB = 8) to arterialize the venous system within 2 weeks at intermediate pressure (between arterial and venous levels) before a coronary venous bypass graft (CVBG) was implemented through a left internal mammary artery (LIMA) anastomosis. Group II only received the LAD artery occlusion and served as control. Serial echocardiograms showed recovery of left ventricular (LV) function with this adaptation-arterialization approach, with an increase in ejection fraction (EF) in Group I from 38% ± 5% after coronary occlusion to 53% ± 7% eight weeks after CVBG, whereas in Group II the EF never recovered (41% ± 2%-33% ± 7%). The remodeling of the venous system not only allowed restoration of myocardial function when CVBG was implemented but possibly promoted a novel form of "collateralization" between the native arterioles and the newly arterialized venules, which revascularized the ischemic myocardium.
These findings form a potential rationale for a venous arterialization-revascularization treatment for the refractory angina and the "no-option" patients using a hybrid percutaneous (closure device for arterialization)/surgical approach (CVBG) to revascularize the myocardium.
This study addressed the question whether coaches better allow athletes to self-control their decisions when under pressure or whether to impose a decision upon them. To this end, an experiment was ...conducted that manipulated the soccer kickers' degree of control in decision-making. Two groups of elite under-19 soccer players (
= 18) took penalty kicks in a self-controlled (i.e., kickers themselves decided to which side to direct the ball) and an externally controlled condition (i.e., the decision to which side to direct the ball was imposed upon the kickers). One group performed the penalty kick under psychological pressure (i.e., the present coaching staff assessed their performance), while the second group performed without pressure. Just before and after performing the kicks, CSAI-2 was used to measure cognitive and somatic anxiety and self-confidence. Further, the number of goals scored, ball placement and speed, and the duration of preparatory and performatory behaviors were determined. The results verified increased levels of cognitive and somatic anxiety after performing the kicks in the pressured group compared to the no-pressure group. In addition, degree of self-control affected the participants' performance, particularly in the pressured group. They scored more goals and placed the kicks higher in the self-controlled than in the externally-controlled condition. Participants also took more time preparing and performing the run-up in the self-controlled condition. Findings indicate that increased self-control helps coping with the debilitating effects of pressure and can counter performance deteriorations. The findings are discussed within the framework of self-control theories, and recommendations for practitioners and athletes are made.
While the intestinal microbiome seems a major driver of persistent immune defects in people with HIV (PWH), little is known about its fungal component, the mycobiome. We assessed the inter-kingdom ...mycobiome-bacteriome interactions, the impact of diet, and the association with the innate and adaptive immunity in PWH on antiretroviral therapy. We included 24 PWH individuals and 12 healthy controls. We sequenced the Internal Transcribed Spacer 2 amplicons, determined amplicon sequence variants, measured biomarkers of the innate and adaptive immunity in blood and relations with diet. Compared to healthy controls, PWH subjects exhibited a distinct and richer mycobiome and an enrichment for Debaryomyces hansenii, Candida albicans, and Candida parapsilosis. In PWH, Candida and Pichia species were strongly correlated with several bacterial genera, including Faecalibacterium genus. Regarding the links between the mycobiome and systemic immunology, we found a positive correlation between Candida species and the levels of proinflammatory cytokines (sTNF-R2 and IL-17), interleukin 22 (a cytokine implicated in the regulation of mucosal immunity), and CD8+ T cell counts. This suggests an important role of the yeasts in systemic innate and adaptive immune responses. Finally, we identified inter-kingdom interactions implicated in fiber degradation, short-chain fatty acid production, and lipid metabolism, and an effect of vegetable and fiber intake on the mycobiome. Therefore, despite the great differences in abundance and diversity between the bacterial and fungal communities of the gut, we defined the changes associated with HIV, determined several different inter-kingdom associations, and found links between the mycobiome, nutrient metabolism, and systemic immunity.
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