This study introduces a new method to understand how added load affects human performance across a broad range of athletic tasks (ten obstacles) embedded in an outdoor obstacle course. The method employs an array of wearable inertial measurement units (IMUs) to wirelessly record the movements of major body segments to derive obstacle-specific metrics of performance. The effects of load are demonstrated on (N = 22) participants who each complete the obstacle course under four conditions including unloaded (twice) and with loads of 15% and 30% of their body weight (a total of 88 trials across the group of participants). The IMU-derived performance metrics reveal marked degradations in performance with increasing load across eight of the ten obstacles. Overall, this study demonstrates the significant potential in using this wearable technology to evaluate human performance across multiple tasks and, simultaneously, the adverse effects of body-borne loads on performance. The study addresses a major need of military organizations worldwide that frequently employ standardized obstacle courses to understand how added loads influence warfighter performance. Importantly, the findings and conclusions drawn from IMU data would not be possible using traditional timing metrics used to evaluate task performance.

Field surveys are commonplace and essential for off-grid power projects in developing countries where availability of data may be scarce. Critical decisions such as site selection, technology choice, business models employed, and approach to community engagement are all greatly assisted by data that can be gathered through field surveys. Paper-based field surveys, the de facto standard approach, are prone to error, slow to deploy and adjust, and have other practical challenges despite the obvious advantage of having fewer technological dependencies. Over recent years, improvement in freely available surveying software, smartphones and tablets, as well as good cellular coverage throughout the world offers humanitarian organizations an opportunity to implement digital field surveys with relative ease. This article presents the experience implementing KoboCollect by Kilowatts for Humanity (KWH), a non-profit that implements sustainable energy kiosks in developing countries. KoboCollect is an open-source data collection software platform designed to support humanitarian and research organizations. In this paper, limitations of paper-based field surveys from previous KWH projects, as well as from the extant literature, are considered with respect to their ultimate impact on the implementation of the development project. A new approach is presented in which survey questions are refined based on past experience and are directly related to pre-defined project indicators. Key benefits and challenges are identified from the adoption of the new approach and methodological questions around sampling and decision-making following data collection are discussed. The new method is discussed in the context of a KWH survey project being conducted in the summer of 2018 in three locations in the Philippines. A major goal of this work is to open a discussion about the successes and failures of the shoestring, paper-based survey methodology and point to current best practices.

Objective Retrospective chart review to assess the effectiveness of an institutional intravenous (IV) dihydroergotamine (DHE) therapy protocol for refractory migraine in the pediatric population. Background Limited high‐quality evidence exists to guide the approach to treatment of refractory migraine with IV DHE, particularly in the pediatric population. This study reviews our institutional experience in implementing an IV DHE protocol in children to identify areas for improvement. We specifically sought to determine whether the outcome differed at follow‐up between children who completed the full course of DHE (8 or 9 doses) as specified in our institutional protocol and those who did not. In addition, given the limited Food and Drug Administration‐approved treatments for chronic migraine (CM) in the pediatric population, re‐evaluating the response rate in this group of patients was of particular interest. Methods A retrospective cohort based on a chart review of 159 consecutive pediatric patients who received IV DHE while inpatient at University of Virginia Children’s Hospital over a 9‐year period (January 2011‐January 2019) was identified. Patients were classified according to the International Classification of Headache Disorders, 3rd edition criteria as having CM, status migrainosus, or, in a small number of patients, Other headache with migrainous features. To investigate any benefit of completing the full course of DHE, patients were categorized as having completed the DHE protocol (“Protocol Complete” 8 or 9 doses) or not completing the protocol (“Protocol Incomplete” <8 doses). Patient‐reported pain scores upon admission and discharge were recorded, and follow‐up outcomes were categorized as headache freedom, >50% relief, <50% relief, or no relief. Pain outcomes were analyzed with respect to DHE protocol complete status and headache classification. Results A total of 159 patients were included in the analysis. The headache diagnosis was CM in 49% (78/159), status migrainosus in 44% (70/159), and Other headache with migrainous features in 7% (11/159). At discharge, 60% (96/159) of patients achieved headache freedom, and no statistically significant difference was found in relative change in headache among the CM, status migrainosus, and Other headache groups. Patients who completed the full 8 or 9 dose IV DHE protocol were more likely to have persistent headache at discharge, with a median pain score of 1.0 (IQR 0.0‐4.0) compared to a score of 0.0 (IQR 0.0‐1.0) in the DHE incomplete group (P < .001). No difference was found in pain relief outcomes at follow‐up in the DHE protocol complete and DHE protocol incomplete groups. Conclusions Although limited by the absence of a control group, our data support repetitive IV DHE as an abortive therapy for pediatric patients with status migrainosus or CM, with no evidence of differential efficacy in these groups. A higher rate of headache at discharge in the DHE protocol complete group reflects in large part the common decision to discontinue treatment once headac...

Glucocorticoids (GC) are hormones with anti-inflammatory actions. Their actions are mediated by the glucocorticoid receptor (GCR)␣. 〈 GCR isoform called ␤ with dominant negative effect has been described. The GCR␤ is overexpressed in response to proinflammatory cytokines and in chronic inflammatory diseases like rheumatoid arthritis. The GCR␤ overexpression could induced a GC resistant state, favoring the development of autoimmune diseases. A relationship between infectious diseases and autoimmune diseases has been frequently proposed but it is still a matter of controversy. We proposed that a glucocorticoid resistance is induced in infectious diseases, which may lead in the appropriate background to the development or relapse of autoimmune diseases. Therefore, we evaluate if LPS can modulate the expression of GCR isotypes in vitro inducing the expression of the inhibitory GCR␤ and/or decreasing the expression of the active GCR␣. Methods: GCR ␣ and ␤ expression were evaluated by Western Blotting in monocytic cells (K562) cultured in presence of LPS (0, 10 pg/ml, 10 ng/ml, 10 g/ml) for 6 and 18 hours. Statistical analysis: Wilcoxon test. Results: After 6 hours of culture in presence of LPS at all concentrations tested, there was a significant decreased expression of both GCR isoforms. After 18 hours of culture a greater decreased in GCR␣ expression was observed while the expression of the GCR␤ was higher than the control. Conclusion: LPS in vitro modulates the expression of GCR isoforms which could lead to a glucocorticoid resistant state. This action could be a novel link between infections and autoimmune diseases.FONDECYT #103/0442. Abstract: The presence of anti-Ro/SSA antibody and its subtypes, Ro 52 kDa and Ro 60 kDa, has been associated with the clinical features in patients with systemic lupus erythematosus (SLE) and SjögrenЈs syndrome (SS), although there are many contradictory reports about it. Objective: To establish the association between total anti-Ro/SSA, Ro/ SSA 52 kDa and Ro/SSA 60 kDa, and clinical features in patients with LES and SS. Methods: Anti-Ro/SSA antibodies were determined in sera from 59 patients with diagnosed SLE (according to the ACR classification criteria, 1999), and 34 patients with diagnosed primary SS (pSS) and SS secondary (sSS) to other collagenopathies that are not SLE (according to the American-European Consensus Group classification criteria, 2002), by 2 ELISA methods. A commercial ELISA (#1), where total anti-Ro/SSA antibodies are detected, and ELISA (#2), which uses recombinant proteins to detect anti-Ro/SSA 52 and 60 kDa. The following clinical features were analyzed in the 93 patients: xerostomia, xerophthalmia, arthralgia, arthritis, photosensitivity, malar rash, central nervous system compromise and hematological compromise. Results: From 166 evaluated patients, 93 met the inclusion criteria, these were diagnosed: 59 as SLE and 34 as pSS or sSS. From the 59 SLE patients, 30 were anti-Ro/SSA negative and 29 positive, among the last group 18 were double positive (Ro 5...