Effects of a combined strengthening, stretching and functional training program versus usual-care on gait biomechanics and foot function for diabetic neuropathy: a randomized controlled trial

Background: Polyneuropathy is a complication of diabetes mellitus that has been very challenging for clinicians. It results in high public health costs and has a huge impact on patients' quality of life. Preventive interventions are still the most important approach to avoid plantar ulceration and amputation, which is the most devastating endpoint of the disease. Some therapeutic interventions improve gait quality, confidence, and quality of life; however, there is no evidence yet of an effective physical therapy treatment for recovering musculoskeletal function and foot rollover during gait that could potentially redistribute plantar pressure and reduce the risk of ulcer formation. Methods/Design: A randomised, controlled trial, with blind assessment, was designed to study the effect of a physiotherapy intervention on foot rollover during gait, range of motion, muscle strength and function of the foot and ankle, and balance confidence. The main outcome is plantar pressure during foot rollover, and the secondary outcomes are kinetic and kinematic parameters of gait, neuropathy signs and symptoms, foot and ankle range of motion and function, muscle strength, and balance confidence. The intervention is carried out for 12 weeks, twice a week, for 40-60 min each session. The follow-up period is 24 weeks from the baseline condition. Discussion: Herein, we present a more comprehensive and specific physiotherapy approach for foot and ankle function, by choosing simple tasks, focusing on recovering range of motion, strength, and functionality of the joints most impaired by diabetic polyneuropathy. In addition, this intervention aims to transfer these peripheral gains to the functional and more complex task of foot rollover during gait, in order to reduce risk of ulceration. If it shows any benefit, this protocol can be used in clinical practice and can be indicated as complementary treatment for this disease.

Planktonic community structure and variability in the Canary Islands waters: the role of microplankton

[ES] En este trabajo hemos contribuido al estudio de la estructura de la comunidad planctónica y a su variabilidad temporal, utilizando un enfoque de end-to-end , desde las bacterias hasta el mesozooplancton haciendo especial énfasis en el microplancton. Nuestro trabajo muestra la importancia de los efectos bottom-up y top-down que regulan la estructura de las comunidades planctónicas.

Ichthyofauna associated with Cymodocea nodosa meadows in the Canarian Archipelago (central eastern Atlantic): Community structure and nursery role

We carried out 84 trawls in 41 seagrass meadows composed of the phanerogam Cymodocea nodosa at three islands of the Canarian Archipelago, during June to September 2003, in order to describe the associated ichthyofauna (composition, richness, and abundance), to analyze the role that this habitat can play in fish recruitment, and to determine the potential relationship between the spatial structure of the seagrass meadow and the patterns of richness and abundance of the fish assemblage. A total of 8298 individuals were captured. The five most relevant species, in terms of abundance and frequency, were Spondyliosoma cantharus, Diplodus annularis, Syngnathus typhle, Mullus surmuletus, and Pagellus erythrinus. Gran Canaria had the largest species richness (36 species) and mean number of species per sample (8.69 ± 0.49; mean ± SE). Lanzarote had the largest number of individuals (64.83% of the total registered) and mean total abundance per sample (168.39 ± 30.91). High densities of individuals were registered (95.86 ± 13.5) and 92.91% of fishes were juveniles. Our data showed that the physical configuration of the seagrass meadows did not significantly affect the patterns of richness and abundance of the associated fish assemblage. In conclusion, the C. nodosa meadows exhibited a singular ichthyofauna and they contribute to the maintenance of the diversity of the coastal fish assemblages in the Canarian Archipelago. This habitat constitutes, during spring and summer, a nursery habitat for juvenile fishes of many species, several of them commercially targeted.

Is there a seamount effect on microbial community structure and biomass?: the case study of Seine and Sedlo seamounts (Northeast Atlantic)

[EN] Seamounts are considered to be ??hotspots?? of marine life but, their role in oceans primary productivity is still under discussion. We have studied the microbial community structure and biomass of the epipelagic zone (0?150 m) at two northeast Atlantic seamounts (Seine and Sedlo) and compared those with the surrounding ocean. Results from two cruises to Sedlo and three to Seine are presented. Main results show large temporal and spatial microbial community variability on both seamounts. Both Seine and Sedlo heterotrophic community (abundance and biomass) dominate during winter and summer months, representing 75% (Sedlo, July) to 86% (Seine, November) of the total plankton biomass. In Seine, during springtime the contribution to total plankton biomass is similar (47% autotrophic and 53% heterotrophic). Both seamounts present an autotrophic community structure dominated by small cells (nano and picophytoplankton). It is also during spring that a relatively important contribution (26%) of large cells to total autotrophic biomass is found. In some cases, a ??seamount effect?? is observed on Seine and Sedlo microbial community structure and biomass. In Seine this is only observed during spring through enhancement of large autotrophic cells at the summit and seamount stations. In Sedlo, and despite the observed low biomasses, some clear peaks of picoplankton at the summit or at stations within the seamount area are also observed during summer. Our results suggest that the dominance of heterotrophs is presumably related to the trapping effect of organic matter by seamounts. Nevertheless, the complex circulation around both seamounts with the presence of different sources of mesoscale variability (e.g. presence of meddies, intrusion of African upwelling water) may have contributed to the different patterns of distribution, abundances and also changes observed in the microbial community.

Phytoplankton community composition and size-abundance spectra in areas of the Alborán sea with different hydrological characteristics

[EN] Size-abundance spectra (SAS) were analyzed in different phytoplankton assemblages of the Alborán Sea collected in areas with contrasting hydrological features (upwelling areas and anticyclonic gyre). Abundance of micro-plankton cells decreased following the hydrological gradient from the most productive stations towards offshore stations. This size-fraction of phytoplankton was dominated by diatoms. Pico-plankton followed an opposite gradient. Concordantly, the slope of the SAS trended to decrease from coastal areas (upwelling) towards the anticyclonic gyre. However, phytoplankton assemblages featuring similar SAS values presented a quite different taxonomical composition of their diatom communities. According to the previous available information about the taxonomical composition of the phytoplankton communities in the Alborán Sea, these differences in diatom composition are indicative of differences in productivity of the phytoplankton. Consequently, the utility of phytoplankton SAS as an indicator of changes in the phytoplankton communities of the Alborán Sea is discussed.

The Influence of Baseline Metabolic Rate and Exercise Training on Cardio-Respiratory Dynamics

Speeding the VO2 kinetics results in a reduction of the O2 deficit. Two factors might determine VO2 kinetics: oxygen delivery to muscle (Tschakovsky and Hughson 1999) and a muscle 'metabolic inertia' (Grassi et al. 1996). Therefore, in study 1 we investigated VO2 kinetics and cardiovascular system adaptations during step exercise transitions in different regions of the moderate domain. In study 2 we investigated muscle oxygenation and cardio-pulmonary adaptations during step exercise tests before, after and over a period of training. Study 1 methods: Seven subjects (26 ± 8 yr; 176 ± 5 cm; 69 ± 6 kg) performed 4 types of step transition from rest (0-50W; 0-100W) or elevate baseline (25-75W; 25-125W). GET and VO2max were assessed before testing. O2 uptake and were measured during testing. Study 2 methods: 10 subjects (25 ± 4 yr; 175 ± 9 cm; 71 ± 12 kg) performed a step transition test (0 to 100 W) before, after and during 4 weeks of endurance training (ET). VO2max and GET were assessed before and after of ET (40 minutes, 3 times a week, 60% O2max). VO2 uptake, Q and deoxyheamoglobin were measured during testing. Study 1 results: VO2 τ and the functional gain were slower in the upper regions of the moderate domain. Q increased more abruptly during rest to work condition. Q τ was faster than VO2 τ for each exercise step. Study 2 results: VO2 τ became faster after ET (25%) and particularly after 1 training session (4%). Q kinetics changed after 4 training sessions nevertheless it was always faster than VO2 τ. An attenuation in ∆[HHb] /∆VO2 was detectible. Conclusion: these investigations suggest that muscle fibres recruitment exerts a influence on the VO2 response within the moderate domain either during different forms of step transition or following ET.

Antioxidant supplementation and endurance training: Win or loss?

Typically, free radicals are thought of as perpetrators of cell damage, ageing, even cancer, whereas antioxidants are seen as the defence against these threats. Accordingly, antioxidants are among the most common sports supplements used by amateur and professional athletes. However, the sensibility of this practice has recently been challenged in the scientific literature. This article briefly summarizes both positive and negative physiological effects of free radicals and antioxidants, culminating with emphasis on the signalling roles played by free radicals during training adaptations and the ability of superfluous antioxidants to weaken these desired signals, as revealed in several recent publications. The aim of this article is not to explicitly condemn antioxidant supplementation by athletes, but to underscore complexity of the situation and to champion efforts to achieve a deeper understanding of circumstances (e.g. dosage, timing, and setting) that might deem antioxidant supplementation as either largely beneficial or largely detrimental for endurance athletes in training.

Atrial remodeling, autonomic tone, and lifetime training hours in nonelite athletes

Endurance athletes have an increased risk of developing atrial fibrillation (AF) at 40 to 50 years of age. Signal-averaged P-wave analysis has been used for identifying patients at risk for AF. We evaluated the impact of lifetime training hours on signal-averaged P-wave duration and modifying factors. Nonelite men athletes scheduled to participate in the 2010 Grand Prix of Bern, a 10-mile race, were invited. Four hundred ninety-two marathon and nonmarathon runners applied for participation, 70 were randomly selected, and 60 entered the final analysis. Subjects were stratified according to their lifetime training hours (average endurance and strength training hours per week × 52 × training years) in low (<1,500 hours), medium (1,500 to 4,500 hours), and high (>4,500 hours) training groups. Mean age was 42 ± 7 years. From low to high training groups signal-averaged P-wave duration increased from 131 ± 6 to 142 ± 13 ms (p = 0.026), and left atrial volume increased from 24.8 ± 4.6 to 33.1 ± 6.2 ml/m(2) (p = 0.001). Parasympathetic tone expressed as root of the mean squared differences of successive normal-to-normal intervals increased from 34 ± 13 to 47 ± 16 ms (p = 0.002), and premature atrial contractions increased from 6.1 ± 7.4 to 10.8 ± 7.7 per 24 hours (p = 0.026). Left ventricular mass increased from 100.7 ± 9.0 to 117.1 ± 18.2 g/m(2) (p = 0.002). Left ventricular systolic and diastolic function and blood pressure at rest were normal in all athletes and showed no differences among training groups. Four athletes (6.7%) had a history of paroxysmal AF, as did 1 athlete in the medium training group and 3 athletes in the high training group (p = 0.252). In conclusion, in nonelite men athletes lifetime training hours are associated with prolongation of signal-averaged P-wave duration and an increase in left atrial volume. The altered left atrial substrate may facilitate occurrence of AF. Increased vagal tone and atrial ectopy may serve as modifying and triggering factors.

THE EXPERIENCE OF RESEARCH, GROWTH, DEVELOPMENT AND LEADERSHIP OF THE MiTEP PROGRAM

Chapter 1. The Action Research in this report was to focus on improving the reading comprehension of students with expository text in relation to identifying the main idea and supporting details. Students were given an expository text to read and identify main idea and 2 -3 supporting details as a pre assessment. Students were provided instruction and support in DRTA (Directed Reading Thinking Activity) and SQ3R (Survey, Question, Read, Recite, Review) methodology to identify the Main Idea and supporting details of a selected expository text for both pre & posttest. Results were compiled and analyzed on the effectiveness of the strategies by overall student growth in accurately identifying the Main Idea and being able to state at least 2 supporting details. Analysis of the data will show that the methods were effective in middle school students’ ability to read and extrapolate the necessary information from expository text. Chapter 2 is a reflective essay on the MiTEP Michigan Teacher Excellence Program and its impact on my teaching practices, lesson delivery and leadership development.