Neuromuscular Electrical Stimulation Effects on Skeletal Muscle Fatigue in Older Adults

Neuromuscular electrical stimulation (NMES) is often used as a rehabilitative modality and evidence has suggested that high frequencies of NMES may elicit increases in muscle strength. However, little is known regarding the effects of a high-frequency NMES intervention on voluntary skeletal muscle fatigue. PURPOSE: The aim of this study was to determine the effect of a 4-week high-frequency NMES intervention on voluntary muscular fatigue and changes in neuromuscular activation patterns of the quadriceps during voluntary fatiguing muscle contractions in older adults. METHODS: Seventeen healthy, older adults (68.8 ± 1.8 years old) participated in the study (NMES: n = 12; SHAM: n = 5). Each participant was seated on an isokinetic dynamometer, and a 40-min NMES treatment was applied to the quadriceps muscles of each leg 3x/week for 4 weeks with the stimulation frequency set at 60 Hz. Stimulation intensity was set to achieve 15% of knee extension maximal voluntary contraction (MVC). Those in the SHAM group underwent the same treatment procedures but did not receive the NMES treatment. All subjects performed maximal voluntary contractions (MVC) and an intermittent knee extension isometric submaximal voluntary fatigue task at 50% MVC until the fatigue criteria were met for pre-post testing. Surface electromyography (sEMG) of the vastus lateralis (VL) and vastus medialis (VM) muscles were recorded during the fatigue task to examine changes in muscle activation. EMG data were quantified for root mean square (RMS) EMG and reported as a percent rate of change over the duration of the fatigue task and median frequency (MF) is reported as the average MF during the fatigue task. Repeated measures ANOVAs were used to determine differences pre-post NMES for muscular endurance time, MVC and EMG measures. Statistical significance was set at p \u3c 0.05. RESULTS: MVC increased pre-post NMES in the NMES group (117.1 ± 8.7 Nm vs 127.6 ± 11.1 Nm, p = 0.049; pre- and post-training, respectively) with no change in SHAM (p = 0.96). Muscular endurance time did not change pre-post NMES (NMES: 159.3 ± 20.1s vs 141.9 ± 21.2s, p = 0.29; SHAM: 242.2 ± 43.3s vs 202.9 ± 23.3s, p = 0.13; pre- and post-training, respectively). RMS EMG rate of change did not change following NMES treatment (NMES: VL: 16.6 ± 3.6% vs 18.8 ± 10.4%, p = 0.84; VM: 11.4 ± 2.1% vs 19.6 ± 5.5%, p = 0.15; SHAM: VL: 7.8 ± 1.6% vs 7.1 ± 3.0%, p = 0.81; VM: 7.1 ± 3.3% vs 5.9 ± 2.2%, p = 0.55; pre- and post-training, respectively). Also, there was no difference in MF EMG with NMES training (NMES: VL: 77.6 ± 4.1 Hz vs 74.9 ± 3.6 Hz, p = 0.13; VM: 72.5 ± 2.4 Hz vs 72.6 ± 2.2 Hz, p = 0.97; SHAM: VL: 79.3 ± 3.4 Hz vs 80.2 ± 4.9 Hz, p = 0.85; VM: 76.9 ± 3.7 Hz vs 83.9 ± 5.1 Hz, p = 0.12; pre- and post-training, respectively). CONCLUSION: Treatment with high-frequency NMES did not improve muscle endurance or related EMG parameters. It is possible that NMES induced adaptations may be frequency-specific and that high-frequency NMES may not be efficacious when the goal is to improve skeletal muscle endurance

Physical versus biological spring transition: 2005

In 2005, the onset of spring conditions in the physics of the coastal ocean (lowered sea level, spin-up of vertically-sheared equatorward coastal jet) came about 50 days later than average off Newport Oregon, on May 24. There was a further delay of 50 days before the subsurface upwelled water penetrated into the anomalously stratified surface layer, becoming most available for biological activity. The warm anomaly in sea surface temperature which provided the surface cap was observed at mid-shelf locations from Washington to central California, but it ended sooner south of Oregon. Biological impacts of these delays to several trophic levels have been reported

Sentinel lymph node mapping and intraoperative assessment in a prospective, international, multicentre, observational trial of patients with cervical cancer: The SENTIX trial

Background: SENTIX (ENGOT-CX2/CEEGOG-CX1) is an international, multi centre, prospective observational trial evaluating sentinel lymph node (SLN) biopsy without pelvic lymph node dissection in patients with early-stage cervical cancer. We report the final preplanned analysis of the secondary end-points: SLN mapping and outcomes of intraoperative SLN pathology. Methods: Forty-seven sites (18 countries) with experience of SLN biopsy participated in SENTIX. We preregistered patients with stage IA1/lymphovascular space invasion-positive to IB2 (4 cm or smaller or 2 cm or smaller for fertility-sparing treatment) cervical cancer without suspicious lymph nodes on imaging before surgery. SLN frozen section assessment and pathological ultrastaging were mandatory. Patients were registered postoperatively if SLN were bilaterally detected in the pelvis, and frozen sections were negative. Trial registration: ClinicalTrials.gov (NCT02494063). Results: We analysed data for 395 preregistered patients. Bilateral detection was achieved in 91% (355/395), and it was unaffected by tumour size, tumour stage or body mass index, but it was lower in older patients, in patients who underwent open surgery, and in sites with fewer cases. No SLN were found outside the seven anatomical pelvic regions. Most SLN and positive SLN were localised below the common iliac artery bifurcation. Single positive SLN above the iliac bifurcation were found in 2% of cases. Frozen sections failed to detect 54% of positive lymph nodes (pN1), including 28% of cases with macrometastases and 90% with micrometastases. Interpretation: SLN biopsy can achieve high bilateral SLN detection in patients with tumours of 4 cm or smaller. At experienced centres, all SLN were found in the pelvis, and most were located below the iliac vessel bifurcation. SLN frozen section assessment is an unreliable tool for intraoperative triage because it only detects about half of N1 cases. (C) 2020 The Author(s). Published by Elsevier Ltd

Central Pathology Review in SENTIX, a Prospective Observational International Study on Sentinel Lymph Node Biopsy in Patients with Early-Stage Cervical Cancer (ENGOT-CX2)

The quality of pathological assessment is crucial for the safety of patients with cervical cancer if pelvic lymph node dissection is to be replaced by sentinel lymph node (SLN) biopsy. Central pathology review of SLN pathological ultrastaging was conducted in the prospective SENTIX/European Network of Gynaecological Oncological Trial (ENGOT)-CX2 study. All specimens from at least two patients per site were submitted for the central review. For cases with major or critical deviations, the sites were requested to submit all samples from all additional patients for second-round assessment. From the group of 300 patients, samples from 83 cases from 37 sites were reviewed in the first round. Minor, major, critical, and no deviations were identified in 28%, 19%, 14%, and 39% of cases, respectively. Samples from 26 patients were submitted for the second-round review, with only two major deviations found. In conclusion, a high rate of major or critical deviations was identified in the first round of the central pathology review (28% of samples). This reflects a substantial heterogeneity in current practice, despite trial protocol requirements. The importance of the central review conducted prospectively at the early phase of the trial is demonstrated by a substantial improvement of SLN ultrastaging quality in the second-round review

Estimating The Quality Of Phonetic Transcriptions And Segmentations Of Speech Signals

Our approach to the problem of evaluating segmentations and transcriptions of speech data is presented. We developed an automatic pattern-matching procedure that relates different manual or automatic segmentations to each other. The comparison of segmentations refers to the degree of identity concerning the chosen labels and of identity of segment boundaries. As we exemplify our evaluation method on the basis of automatic transcriptions of the Munich AUtomatic Segmentation System (MAUS) that is currently being developed at the IPSK (Kipp et al. [4]) our data also give information on the quality of the system's segmentation and transcription performance. 1. INTRODUCTION For phonetic and phonologic investigations as well as for many applications in speech technology a large amount of segmented and labelled speech data are required e.g. for training and testing purposes in ASR. Already a few years ago with the creation of speech databases that contained manually labelled speech data the..

The role of IQ, expertise, and motivation in the recall of familiar Information

High- and low-IQ children in the first, third, and fifth grades performed two free-recall tasks: a sort-recall task with sets of categorically related pictures, and a class-recall task, with children recalling the current members of their school class. All children were deemed to be experts concerning the composition of their school class, but, unlike experts in other domains, had no special motivation associated with their expertise. Recall and clustering on both tasks were high. The high-IQ children performed better than low-IQ children only on the sort-recall task. IQ was significantly correlated with measures of performance on the sort-recall task but not on the class-recall task. The results reflect the fact that the memory benefits associated with being an expert (here, elimination of IQ effects) are related to the greater knowledge the expert possesses and not to factors of motivation

Automatic Detection And Segmentation Of Pronunciation Variants In German Speech Corpora

In this paper we present a hybrid statistical and rule-based segmentation system which takes into account phonetic variation of German. Input to the system is the orthographic representation and the speech signal of an utterance to be segmented. The output is the transcription (SAM-PA) with the highest overall likelihood and the corresponding segmentation of the speech signal. The system consists of three main parts: In a first stage the orthographic representation is converted into a linear string of phonetic units by lexicon lookup. Phonetic rules are applied yielding a graph that contains the canonic form and presumed variations. In a second HMM-based stage the speech signal of the concerning utterance is time-aligned by a Viterbi search which is constrained by the graph of the first stage. The outcome of this stage is a string of phonetic labels and the corresponding segment boundaries. A rule-based refinement of the segment boundaries using phonetic knowledge takes place in a thir..