Assessment of maximum inspiratory pressure: Prior submaximal respiratory muscle activity (‘warm-up’) enhances maximum inspiratory activity and attenuates the learning effect of repeated measurement

The official published version can be obtained from the link belowBackground: The variability of maximal inspiratory pressure (PImax) in response to repeated measurement affects its reliability; published studies have used between three and twenty PImax measurements on a single occasion. Objective: This study investigated the influence of a specific respiratory ‘warm-up’ upon the repeated measurement of inspiratory muscle strength and attempts to establish a procedure by which PImax can be assessed with maximum reliability using the smallest number of manoeuvres. Methods: Fourteen healthy subjects, familiar with the Mueller manoeuvre, were studied. The influence of repeated testing on a single occasion was assessed using an 18-measurement protocol. Using a randomised cross-over design, subjects performed the protocol, preceded by a specific respiratory warm-up (RWU) and on another occasion, without any preliminary activity (control). Comparisons were made amongst ‘baseline’ (best of the first 3 measurements), ‘short’ series (best of 7th to 9th measurement) and ‘long’ series (best of the last 3 measurements). Results: Under control conditions, the mean increase (‘baseline’ vs. ‘long’ series) was 11.4 (5.8)%; following the RWU, the increase (post RWU ‘baseline’ vs. ‘long’ series) was 3.2 (10.0)%. There were statistically significant differences between measurements made at all 3 protocol stages (‘baseline’, ‘short’ and ‘long’ series) under control conditions, but none following the RWU. Conclusions: The present data suggest that a specific RWU may attenuate the ‘learning effect’ during repeated PImax measurements, which is one of the main contributors of the test variability. The use of a RWU may provide a means of obtaining reliable values of PImax following just 3 measurements.This work was partially supported by a grant from the University of Wolverhampton, UK

Periodicity and frequency coding in human auditory cortex

Understanding the neural coding of pitch and frequency is fundamental to the understanding of speech comprehension, music perception and the segregation of concurrent sound sources. Neuroimaging has made important contributions to defining the pattern of frequency sensitivity in humans. However, the precise way in which pitch sensitivity relates to these frequency-dependent regions remains unclear. Single-frequency tones also cannot be used to test this hypothesis as their pitch always equals their frequency. Here, temporal pitch (periodicity) and frequency coding were dissociated using stimuli that were bandpassed in different frequency spectra (centre frequencies 800 and 4500 Hz), yet were matched in their pitch characteristics. Cortical responses to both pitch-evoking stimuli typically occurred within a region that was also responsive to low frequencies. Its location extended across both primary and nonprimary auditory cortex. An additional control experiment demonstrated that this pitch-related effect was not simply caused by the generation of combination tones. Our findings support recent neurophysiological evidence for a cortical representation of pitch at the lateral border of the primary auditory cortex, while revealing new evidence that additional auditory fields are also likely to play a role in pitch coding

The MRC trial of assessment and management of older people in the community: objectives, design and interventions [ISRCTN23494848].

BACKGROUND: The benefit of regular multidimensional assessment of older people remains controversial. The majority of trials have been too small to produce adequate evidence to inform policy. Despite the lack of a firm evidence base, UK primary care practitioners (general practitioners) are required to offer an annual health check to patients aged 75 years and over. DESIGN: Cluster-randomised factorial trial in primary care comparing a package of assessments (i) universal versus targeted assessment and (ii) management by the primary care team (PC) or a multidisciplinary geriatric assessment team (GM). The unit of randomization is the general practice. METHODS: Older people aged 75 and over eligible for the over 75s health check and excluding those in nursing homes or terminally ill were invited to participate. All participants receive a brief assessment covering all areas of the over 75s check. In the universal arm all participants also receive a detailed health and social assessment by a study nurse while in the targeted arm only participants with a pre-determined number and range of problems at the brief assessment go on to have the detailed assessment. The study nurse follows a standard protocol based on results and responses in the detailed assessment to make referrals to (i) the randomised management team (PC or GM) (ii) other medical services, health care workers or agencies (iii) emergency referrals to the GP. The main outcomes are mortality, hospital and institutional admissions and quality of life. 106 practices and 33,000 older people have been recruited to the trial

Commentary on child-adult differences in muscle activation - A review

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Chemical evaluation of Carcavelos fortified wine aged in portuguese (Quercus pyrenaica) and french (Quercus robur) oak barrels at medium and high toast

Adega do Casal Manteiga is a winery, publicly owned by the Municipality of Oeiras that produces Carcavelos fortified wine. Carcavelos fortified wine is an appellation of origin and demarcated as D.O.P. (Denominação de Origem Protegida). This study examines the effects of barrels made from botanical species (Quercus pyrenaica, and Quercus robur) and toasting method (medium and high) on a single vintage wine that has been aged for 8 years. Twenty barrels were used, with five replicates for each factor. The barrels were fabricated and toasted using the same cooperage, J.M. Gonçalves in Portugal. Significant differences were seen between the species Q. robur and Q. pyrenaica, with an impact on total phenolic content, including both flavonoids and non-flavonoids. The total phenols of the wine aged in Q. pyrenaica barrels was significantly higher than in the Q. robur barrels, and Q. pyrenaica contained more flavonoids than Q. robur in medium and high toast barrels. Q. pyrenaica showed more non-flavonoid compounds than Q. robur inhigh and medium toasted barrels, but this difference in non-flavonoids was only statistically significant in the high toasted barrels. The degree of toasting had significant effects on the flavonoid content of the wine, as well as the tanning power. Flavonoid content increased for both Q. pyrenaica and Q. robur in the wines that were aged in high tasted barrels compared to those that were medium toasted. The tannin power decreased for both Q. pyrenaica and Q. robur when the toasting increasedinfo:eu-repo/semantics/publishedVersio

Identifying consistent biomechanical parameters across rising-to-walk subtasks to inform rehabilitation in practice: A systematic literature review

© 2020 Elsevier B.V. Background: :The best approach to rehabilitate the control of everyday whole-body movement (e.g. rise-to-walk) after pathology remains unclear in part because the associated controlled performance variables are not known. Rise-to-walk can be performed fluidly (sit-to-walk) or non-fluidly (sit-to-stand, proceeded by gait-initiation). Biomechanical variables that remain consistent in health regardless of how rise-to walk is performed represent controlled performance variable candidates which could monitor rehabilitative change. Research Question: :To determine if any biomechanical parameters remain consistent across rising-to-walk (RTW) subtasks (sit-to-stand, gait-initiation, and sit-to-walk) in healthy adults for purposes of movement control assessment in clinical practice. Methods: :Data sources included Medline, Cinahl, and Scopus databases, and the grey literature. Study selection was based on eligibility criteria and must have reported spatiotemporal, kinematic and/or kinetic biomechanical parameters featuring >1 RTW subtask. Data extraction and synthesis; standardised-mean-differences (SMDs) were calculated (pooled if replicated in >1 study) for each parameter. Consistency was determined if SMD95 %CIs included the zero-effect line. Results: :Nine studies (n = 99) were included (40 ± 7.5yrs). Seven parameters were replicated in >1 study and subjected to meta-analysis (fixed-effect model). Two were consistent between sit-to-stand and sit-to-walk: flexion-momentum time (M(95 %CI) = 0.055(-0.423 to 0.533); p = 0.823) and peak whole-body-centre-of-mass vertical velocity (M(95 %CI)= -0.415(-0.898 to 0.069); p = 0.093); and centre-of-pressure to whole-body-centre-of-mass distance at toe-off (M(95 %CI)= -0.137(-0.712 to 0.439); p = 0.642) between gait-initiation and sit-to-walk. Another 20 parameters were consistent based on single-study SMDs. Significance: :Consistent parameters might exist across RTW subtasks. However, the evidence is based on few studies with small samples and variable RTW protocols. Future studies designed to confirm consistency using a standardised RTW protocol are needed

The Spectroscopic Age of 47 Tuc

High signal-to-noise integrated spectra of the metal-rich globular cluster 47 Tuc, spanning the H-gamma(HR) and Fe4668 line indices, have been obtained. The combination of these indices has been suggested (Jones & Worthey 1995, ApJ, 446, L31) as the best available mechanism for cleanly separating the age-metallicity degeneracy which hampers the dating of distant, unresolved, elliptical galaxies. For the first time, we apply this technique to a nearby spheroidal system, 47 Tuc, for which independent ages, based upon more established methods, exist. Such an independent test of the technique's suitability has not been attempted before, but is an essential one before its application to more distant, unresolved, stellar populations can be considered valid. Because of its weak series of Balmer lines, relative to model spectra, our results imply a spectroscopic ``age'' for 47 Tuc well in excess of 20 Gyr, at odds with the colour-magnitude diagram age of 14+/-1 Gyr. The derived metal abundance, however, is consistent with the known value. Emission ``fill-in'' of the H-gamma line as the source of the discrepancy cannot be entirely excluded by existing data, although the observational constraints are restrictive.Comment: 17 pages, 4 figures, LaTeX, accepted for publication in The Astronomical Journal, also available at http://casa.colorado.edu/~bgibson/publications.htm

Glycoprotein IIb/IIIa Inhibitors Use and Outcome after Percutaneous Coronary Intervention for Non-ST Elevation Myocardial Infarction

Aims. We investigate the effect of glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors on long-term outcomes following percutaneous coronary intervention (PCI) after non-ST elevation myocardial infarction (NSTEMI). Meta-analyses indicate that these agents are associated with improved short-term outcomes. However, many trials were undertaken before the routine use of P2Y12 inhibitors. Recent studies yield conflicting results and registry data have suggested that GP IIb/IIIa inhibitors may cause more bleeding than what trials indicate. Methods and Results. This retrospective observational study involves 3047 patients receiving dual-antiplatelet therapy who underwent PCI for NSTEMI. Primary outcome was all-cause mortality. Major adverse cardiac events (MACE) were a secondary outcome. Mean follow-up was 4.6 years. Patients treated with GP IIb/IIIa inhibitors were younger with fewer comorbidities. Although the unadjusted Kaplan-Meier analysis suggested that GP IIb/IIIa inhibitor use was associated with improved outcomes, multivariate analysis (including propensity scoring) showed no benefit for either survival (P=0.136) or MACE (P=0.614). GP IIb/IIIa inhibitor use was associated with an increased risk of major bleeding (P=0.021). Conclusion. Although GP IIb/IIIa inhibitor use appeared to improve outcomes after PCI for NSTEMI, patients who received GP IIb/IIIa inhibitors tended to be at lower risk. After multivariate adjustment we observed no improvement in MACE or survival and an increased risk of major bleeding