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

Search for gravitational-lensing signatures in the full third observing run of the LIGO-Virgo network

Gravitational lensing by massive objects along the line of sight to the source causes distortions of gravitational wave-signals; such distortions may reveal information about fundamental physics, cosmology and astrophysics. In this work, we have extended the search for lensing signatures to all binary black hole events from the third observing run of the LIGO--Virgo network. We search for repeated signals from strong lensing by 1) performing targeted searches for subthreshold signals, 2) calculating the degree of overlap amongst the intrinsic parameters and sky location of pairs of signals, 3) comparing the similarities of the spectrograms amongst pairs of signals, and 4) performing dual-signal Bayesian analysis that takes into account selection effects and astrophysical knowledge. We also search for distortions to the gravitational waveform caused by 1) frequency-independent phase shifts in strongly lensed images, and 2) frequency-dependent modulation of the amplitude and phase due to point masses. None of these searches yields significant evidence for lensing. Finally, we use the non-detection of gravitational-wave lensing to constrain the lensing rate based on the latest merger-rate estimates and the fraction of dark matter composed of compact objects

Search for eccentric black hole coalescences during the third observing run of LIGO and Virgo

Despite the growing number of confident binary black hole coalescences observed through gravitational waves so far, the astrophysical origin of these binaries remains uncertain. Orbital eccentricity is one of the clearest tracers of binary formation channels. Identifying binary eccentricity, however, remains challenging due to the limited availability of gravitational waveforms that include effects of eccentricity. Here, we present observational results for a waveform-independent search sensitive to eccentric black hole coalescences, covering the third observing run (O3) of the LIGO and Virgo detectors. We identified no new high-significance candidates beyond those that were already identified with searches focusing on quasi-circular binaries. We determine the sensitivity of our search to high-mass (total mass M>70 M⊙) binaries covering eccentricities up to 0.3 at 15 Hz orbital frequency, and use this to compare model predictions to search results. Assuming all detections are indeed quasi-circular, for our fiducial population model, we place an upper limit for the merger rate density of high-mass binaries with eccentricities 0<e≤0.3 at 0.33 Gpc−3 yr−1 at 90\% confidence level