The effects of sustained, low- and high-intensity isometric tasks on performance fatigability and the perceived responses that contributed to task termination

PURPOSE

The present study examined the effects of sustained, isometric low- versus high-intensity tasks on time to task failure (TTF), performance fatigability (PF), ratings of perceived exertion (RPE), and the perceived causes of task termination from a post-test questionnaire (PTQ).

METHODS

Ten men (mean ± SD: age = 21.1 ± 2.3 years; height = 180.2 ± 5.7 cm; body mass = 79.5 ± 8.8 kg) performed maximal voluntary isometric contractions (MVICs) before and after fatiguing, isometric forearm flexion tasks anchored to the torque corresponding to RPE values of 2 (TRQ2FT = 23.8 ± 7.1 N·m) and 8 (TRQ8FT = 60.9 ± 11.4 N·m). In addition, the subjects completed a PTQ which surveyed whether the perceived sensations of fatigue or pain, and/or the psychological factors of loss of focus and motivation contributed to the decision to terminate the task. Repeated measures ANOVAs, Wilcoxon-Signed Rank tests, and Spearman's Rank-Order Correlations were used to analyze the data.

RESULTS

Across the fatiguing tasks, there were similar decreases in MVIC torque (95.2 ± 20.3 vs. 68.9 ± 15.6 N·m; p < 0.001) and RPE values (p = 0.122) at task failure for TRQ2FT (7.4 ± 2.7) and TRQ8FT (8.9 ± 1.0), but a longer (p = 0.005) TTF for the TRQ2FT (245.0 ± 177.0 s) than TRQ8FT (36.8 ± 11.1 s).

CONCLUSIONS

Despite reaching task failure, the subjects were able to perform MVICs that were 100-300% greater than the target torque values within seconds of terminating the tasks. Thus, we hypothesized that task failure was not caused by an inability to produce sufficient torque to sustain the tasks, but rather an unwillingness to continue the task.

The Effects of Anchoring a Fatiguing Forearm Flexion Task to a High vs. Low Rating of Perceived Exertion on Torque and Neuromuscular Responses

ABSTRACT

Ortega, DG, Housh, TJ, Smith, RW, Arnett, JE, Neltner, TJ, Schmidt, RJ, and Johnson, GO. The effects of anchoring a fatiguing forearm flexion task to a high versus low rating of perceived exertion on torque and neuromuscular responses. J Strength Cond Res 38(5): e219-e225, 2024-This study examined the torque and neuromuscular responses following sustained, isometric, forearm flexion tasks anchored to 2 ratings of perceived exertion (RPE). Nine men (mean ± SD: age = 21.0 ± 2.4 years; height = 179.5 ± 5.1 cm; body mass = 79.6 ± 11.4 kg) completed maximal voluntary isometric contractions (MVIC) before and after sustained, isometric, forearm flexion tasks to failure anchored to RPE = 2 and RPE = 8. The amplitude (AMP) and mean power frequency (MPF) of the electromyographic (EMG) signal were recorded from the biceps brachii. Normalized torque was divided by normalized EMG AMP to calculate neuromuscular efficiency (NME). A dependent t-test was used to assess the mean difference for time to task failure (TTF). Repeated-measures analysis of variances was used to compare mean differences for MVIC and normalized neuromuscular parameters. There was no significant difference in TTF between RPE = 2 and RPE = 8 (p = 0.713). The MVIC decreased from pretest to posttest at RPE = 2 (p = 0.009) and RPE = 8 (p = 0.003), and posttest MVIC at RPE = 8 was less than that at RPE = 2 (p < 0.001). In addition, NME decreased from pretest to posttest (p = 0.008). There was no change in normalized EMG AMP or EMG MPF (p > 0.05). The current findings indicated that torque responses were intensity specific, but TTF and neuromuscular responses were not. Furthermore, normalized EMG AMP and EMG MPF remained unchanged but NME decreased, likely due to peripheral fatigue and excitation-contraction coupling failure. Thus, this study provides information regarding the neuromuscular responses and mechanisms of fatigue associated with tasks anchored to RPE, which adds to the foundational understanding of the relationship between resistance exercise and the perception of fatigue.

Are performance and perceived fatigability dependent on the anchor scheme of fatiguing isometric tasks in men?

BACKGROUND

Ratings of perceived exertion (RPE) can be used to regulate exercise intensity. This study examined the effect of anchor scheme on performance fatigability and neuromuscular responses following fatiguing forearm flexion tasks.

METHODS

Twelve men (age 20.9±2.2 years; height 179.8±5.3 cm; body mass 80.2±9.9 kg) performed sustained, isometric forearm flexion tasks to failure anchored to RPE=6 (RPEFT) and the torque (TRQFT) that corresponded to RPE=6. Pre-test and post-test maximal voluntary isometric contractions (MVIC) were performed to quantify changes in the amplitude (AMP) and mean power frequency (MPF) of the electromyographic (EMG) and mechanomyographic (MMG) signals. Neuromuscular efficiency (NME) was calculated by dividing normalized torque by normalized EMG AMP. A dependent t-test was used to assess the mean difference for time to task failure (TTF). Repeated measures ANOVAs were used to compare mean differences for performance fatigability and normalized neuromuscular parameters.

RESULTS

The RPEFT had a greater TTF than the TRQFT (P<0.001). MVIC and NME decreased from pre-test to post-test following the RPEFT and TRQFT (P<0.05) with no differences between anchor schemes. Following the TRQFT, normalized EMG MPF decreased from pre-test to post-test (P=0.004). Following the RPEFT, normalized MMG MPF increased from pre-test to post-test (P=0.021). There were no changes in normalized EMG AMP or MMG AMP (P>0.05).

CONCLUSIONS

These findings indicated anchor scheme-specific neuromuscular responses and TTF, despite no difference in performance fatigability. Furthermore, performance fatigability was likely due to peripheral fatigue (based on normalized EMG MPF and NME) following the TRQFT, but peripheral and central fatigue (based on normalized MMG MPF and NME) following the RPEFT.

Unilateral and Bilateral Isokinetic Leg Extensions Exhibit No Differences in Neuromuscular Excitation Under Maximal and Fatiguing Conditions

Anders, JPV, Neltner, TJ, Smith, RW, Arnett, JE, Housh, TJ, Schmidt, RJ, and Johnson, GO. Unilateral and bilateral isokinetic leg extensions exhibit no differences in neuromuscular activation under maximal and fatiguing conditions. J Strength Cond Res 38(3): 474–480, 2024—The bilateral deficit is a phenomenon where force production during a bilateral (BL) muscle action is less than the sum of force produced when the muscle action is performed unilaterally (UL) with both limbs. The purpose of this study was to compare peak force, electromyographic (EMG) amplitude (AMP), and mean power frequency (MPF) of the nondominant leg between UL and BL isokinetic leg extensions. Eleven recreationally trained men (mean ± SD; age = 20.8 ± 1.7 years; body mass = 84.0 ± 16.2 kg; height = 179.3 ± 7.2 cm) volunteered to participate in this study. The 2 test visits included UL and BL maximal isokinetic leg extensions at 180°·second−1 followed by a fatiguing task of either 50 UL or 25 UL followed immediately by 25 BL (ULBL) maximal, isokinetic leg extensions at 180°·second−1, in random order on separate days. The results demonstrated a significant (p = 0.015, = 0.460) bilateral deficit in force (UL = 56.29 ± 11.20 kg; BL = 50.32 ± 7.35 kg; d = 0.63; 95% CI [1.42, 10.52]) but no significant bilateral deficit in EMG AMP (p = 0.892, = 0.002). The peak force during the fatiguing task demonstrated a significant main effect for repetition (p < 0.001, = 0.943) characterized by a reduced peak force from repetitions 20–50. Similarly, EMG MPF demonstrated a significant main effect for repetition (p < 0.001, = 0.702) characterized by a reduced EMG MPF from repetitions 35–50. There were no significant effects (p = 0.102–0.387, = 0.096–0.203) for EMG AMP. These findings suggested that the bilateral deficit was not associated with a neuromuscular deficit and UL muscle actions may be used to potentiate force production of subsequent BL muscle actions.

Effects of a Sustained, Isometric Forearm Flexion Task to Failure on Torque and Neuromuscular Responses at 3 Elbow Joint Angles

ABSTRACT

Ortega, DG, Housh, TJ, Smith, RW, Arnett, JE, Neltner, TJ, Anders, JPV, Schmidt, RJ, and Johnson, GO. The effects of a sustained, isometric forearm flexion task to failure on torque and neuromuscular responses at 3 elbow joint angles. J Strength Cond Res 38(1): e25-e33, 2024-This study examined the effects of a sustained, isometric forearm flexion task anchored to torque to task failure on maximal voluntary isometric contraction (MVIC) and neuromuscular responses at 3 elbow joint angles. Eleven women (mean ± SD: age = 20.8 ± 2.7 years, height = 169.3 ± 7.4 cm, body mass = 67.7 ± 6.9 kg) performed two 3s forearm flexion MVICs at elbow joint angles (JAs) of 75°, 100°, and 125° before and after a sustained, isometric forearm flexion task to failure at a fatiguing joint angle of 100° anchored to a torque value that corresponded to a rating of perceived exertion of 8 (RPE = 8). The amplitude (AMP) and mean power frequency (MPF) of the electromyographic (EMG) and mechanomyographic (MMG) signals were recorded from the biceps brachii. Repeated-measures ANOVAs were used to compare mean differences for MVIC and neuromuscular parameters. Collapsed across JAs, MVIC (p < 0.001) and EMG MPF (p = 0.006) pretest values were greater than posttest values. Collapsed across time, EMG MPF at JA75 was greater than JA100 (p < 0.001) and JA125 (p < 0.001), and JA100 was greater (p = 0.007) than JA125. For EMG AMP, there was a fatigue-induced decrease at JA75 (p = 0.003). For neuromuscular efficiency (NME = normalized torque/normalized EMG AMP), there were decreases from pretest to posttest at JA100 (p = 0.002) and JA125 (p = 0.008). There were no significant interactions or main effects for MMG AMP and MMG MPF. From these findings, it was hypothesized that the decline in MVICs at JA75, JA100, and JA125 was due to fatigue-induced metabolic perturbations that resulted in JA-specific neuromuscular responses. Thus, neuromuscular parameters may provide insight into the JA-specific mechanisms of fatigue.

Promise and peril: how health system reforms impacted public health in three Canadian provinces

OBJECTIVES

Several Canadian provinces and territories have reformed their health systems by centralizing power, resources, and responsibilities. Our study explored motivating factors and perceived impacts of centralization reforms on public health systems and essential operations.

METHODS

A multiple case study design was used to examine three Canadian provinces that have undergone, or are in the process of undergoing, health system reform. Semi-structured interviews were conducted with 58 participants within public health at strategic and operational levels, from Alberta, Ontario, and Québec. Data were analyzed using a thematic analytical approach to iteratively conceptualize and refine themes.

RESULTS

Three major themes were developed to describe the context and impacts of health system centralization reforms on public health: (1) promising "value for money" and consolidating authority; (2) impacting intersectoral and community-level collaboration; and (3) deprioritizing public health operations and contributing to workforce precarity. Centralization highlighted concerns about the prioritization of healthcare sectors. Some core public health functions were reported to operate more efficiently, with less duplication of services, and improvements in program consistency and quality, particularly in Alberta. Reforms were also reported to have diverted funding and human resources away from core essential functions, and diminished the public health workforce.

CONCLUSION

Our study highlighted that stakeholder priorities and a limited understanding about public health systems influenced how reforms were implemented. Our findings support calls for modernized and inclusive governance, stable public health funding, and investment in the public health workforce, which may help inform future reforms.

Effects of High-Intensity, Eccentric-Only Muscle Actions on Serum Biomarkers of Collagen Degradation and Synthesis

ABSTRACT

Neltner, TJ, Sahoo, PK, Smith, RW, Anders, JPV, Arnett, JE, Ortega, DG, Schmidt, RJ, Johnson, GO, Natarajan, SK, and Housh, TJ. Effects of high-intensity, eccentric-only muscle actions on serum biomarkers of collagen degradation and synthesis. J Strength Cond Res 37(9): 1729-1737, 2023-The purpose of this study was to examine the effects of high-intensity, eccentric-only muscle actions of the leg extensors on (a) serum biomarkers of collagen degradation (hydroxyproline [HYP] and C-terminal telopeptide of type I collagen [C1M]) and synthesis (pro-c1α1) and (b) the time course of changes in maximal voluntary isometric contraction (MVIC) and ratings of muscle soreness after the eccentric-only exercise bout. Twenty-five recreationally active men (mean ± SD: age = 21.2 ± 2.0 years) completed 5 sets of 10 bilateral, eccentric-only dynamic constant external resistance muscle actions of the leg extensors at a load of 110% of their concentric leg extension 1 repetition maximum. Analysis of variances (p < 0.05) and a priori planned pairwise comparisons using Bonferroni corrected (p < 0.0167) paired t tests were used to examine mean changes in blood biomarkers from baseline to 48 hours postexercise as well as in MVIC and soreness ratings immediately, 24 hours, and 48 hours postexercise. There were increases in HYP (3.41 ± 2.37 to 12.37 ± 8.11 μg·ml-1; p < 0.001) and C1M (2.50 ± 1.05 to 5.64 ± 4.89 μg·L-1; p = 0.003) from preexercise to 48 hours postexercise, but no change in pro-c1α1. Maximal voluntary isometric contraction declined immediately after the exercise bout (450.44 ± 72.80 to 424.48 ± 66.67 N·m; p = 0.002) but recovered 24 hours later, whereas soreness was elevated immediately (6.56 ± 1.58; p < 0.001), 24 hours (3.52 ± 1.53; p < 0.001), and 48 hours (2.60 ± 1.32; p = 0.001) postexercise. The eccentric-only exercise bout induced increases in collagen degradation but had no effect on collagen synthesis. These findings provide information for clinicians to consider when prescribing exercise after an acute injury or surgery.

Performance Fatigability and Neuromuscular Responses Are Not Joint Angle Specific Following a Sustained Isometric Forearm Flexion Task Anchored to a High Perceptual Intensity in Women

OBJECTIVES

To examine the effects of joint angle (JA) on maximal voluntary isometric contractions (MVIC) and neuromuscular responses following a sustained, isometric forearm flexion task anchored to a rating of perceived exertion (RPE) of 8 (RPE=8).

METHODS

Nine women (age: 20.7±2.9 yrs; height: 168.8±7.2 cm; body mass: 66.3±6.8 kg) performed 2,3s forearm flexion MVICs at JAs of 75°, 100°, and 125° prior to and following a sustained, isometric forearm flexion task anchored to RPE=8 to task failure (torque reduced to zero) at JA100. Electromyographic (EMG) and mechanomyographic (MMG) signals were recorded from the biceps brachii.

RESULTS

The MVIC at JA100 (collapsed across Time) was significantly greater (p<0.05) than JA75 and JA125. The pre-test MVIC was significantly greater (p<0.001) than the post-test. For EMG amplitude (AMP) and EMG mean power frequency (MPF), pre-test values were significantly greater (p<0.05) than the post-test values, with no differences between JAs. For MMG AMP and MMG MPF, there were no significant (p>0.05) differences between Time or JAs. Pre-test neuromuscular efficiency (normalized MVIC/normalized EMG AMP) was significantly greater (p=0.005) than post-test.

CONCLUSION

Following a sustained, isometric forearm flexion task anchored to RPE=8 at JA100, the fatigue-induced MVIC and neuromuscular responses were not affected by JA.

Fatiguing Joint Angle Does Not Influence Torque and Neuromuscular Responses Following Sustained, Isometric Forearm Flexion Tasks Anchored to Perceptual Intensity in Men

This study examined the effects of joint angle (JA) on maximal voluntary isometric contraction (MVIC) and neuromuscular responses following fatiguing tasks anchored to RPE. Nine men (mean ± SD: age = 20.7 ± 1.2 yrs) performed forearm flexion MVICs at elbow JAs of 75° and 125° before and after sustained, isometric forearm flexion tasks to failure at fatiguing joint angles (FJA) of 75° and 125° anchored to RPE = 8. The amplitude and frequency of the electromyographic and mechanomyographic signals were recorded. Neuromuscular efficiency was calculated by dividing normalized torque by normalized electromyographic amplitude. A dependent t-test was used to assess the mean difference for time to task failure (TTF) between FJA. Repeated measure ANOVAs were used to assess mean differences for pre-test to post-test MVIC and neuromuscular responses. There was no significant difference between FJA for TTF (p = 0.223). The MVIC (collapsed across FJA and MVIC JA) decreased from pre-test to post-test (51.1 ± 5.0 vs. 45.3 ± 5.6 Nm, p < 0.001). Normalized neuromuscular parameters remained unchanged (p > 0.05). The FJA resulted in similar torque and neuromuscular responses, and the decreases in MVIC were not tracked by changes in the neuromuscular parameters. Thus, the neuromuscular parameters were not sensitive to fatigue, and pre-test to post-test measures may be compared between different FJA.

Benchmarking Social Isolation, Loneliness, and Smoking: Challenges and Opportunities for Public Health

Over the past decade, the health implications of social isolation and loneliness garnered global attention due in part to a widely cited meta-analysis that benchmarked associations between cigarette smoking and mortality with associations between several social-relationship measures and mortality. Leaders in health systems, research, government, and popular media have since claimed that the harms of social isolation and loneliness are comparable to that of cigarette smoking. Our commentary examines the basis of this comparison. We suggest that comparisons between social isolation, loneliness, and smoking have been helpful for raising awareness of robust evidence linking social relationships and health. However, the analogy often oversimplifies the evidence and may overemphasize treating social isolation or loneliness at the individual level without sufficient attention on population-level prevention. As communities, governments, and health and social sector practitioners navigate opportunities for change, we believe now is time to focus greater attention on the structures and environments that promote and constrain healthy relationships.

The Effects of Anchor Schemes on Performance Fatigability, Neuromuscular Responses and the Perceived Sensations That Contributed to Task Termination

The present study examined the effect of anchor schemes on the time to task failure (TTF), performance fatigability, neuromuscular responses, and the perceived sensations that contributed to task termination following the sustained, isometric forearm flexion tasks. Eight women completed sustained, isometric forearm flexion tasks anchored to RPE = 8 (RPEFT) and the torque (TRQFT) that corresponded to RPE = 8. The subjects performed pre-test and post-test maximal isometric contractions to quantify performance fatigability and changes in electromyographic amplitude (EMG AMP) and neuromuscular efficiency (NME). In addition, the subjects completed a post-test questionnaire (PTQ) to quantify the contributions of perceived sensations to task termination. Repeated measure ANOVAs were used to assess the mean differences for TTF, performance fatigability, and neuromuscular responses. Wilcoxon Signed Rank Tests were used to assess the differences between anchor schemes for the average values from the PTQ item scores. For TTF, the RPEFT was longer than the TRQFT (174.9 ± 85.6 vs. 65.6 ± 68.0 s; p = 0.006). Collapsed across the anchor scheme, there were decreases in torque (23.7 ± 5.5 Nm vs. 19.6 ± 4.9 Nm; p < 0.001) and NME (1.00 ± 0.00 vs. 0.76 ± 0.15; p = 0.003). There were no significant (p > 0.577) changes for EMG AMP. For the PTQ, there were no differences (p > 0.05) between anchor schemes. There were, however, inter-individual differences in the response scores. The current findings indicated that performance fatigability was likely due to peripheral fatigue (based on NME), not central fatigue (based on EMG AMP). Furthermore, the use of a PTQ may serve as a simple tool to assess the contributions of perceived sensations to task termination.

Self-esteem influences the willingness to engage in COVID-19 prevention behavior and persuasion efficacy

RATIONALE

Behaviors such as hand-washing and vaccination save human lives during the COVID-19 pandemic and beyond. Yet, people differ widely in their willingness to engage in them. This investigation examines whether people's willingness to protect themselves physically from contracting coronavirus depends on their self-esteem. Based on self-verification theory, we propose that people who hold negative self-views are less motivated to protect their health which reduces their willingness to engage in recommended preventive measures such as mask-wearing and social-distancing.

OBJECTIVE

We set out to test (i) whether self-esteem predicts people's willingness to engage in COVID-19 prevention behaviors, (ii) whether this relationship is due to variance in motivation to protect one's health (as well as alternative mechanisms), and (iii) whether health messages can more successfully persuade low self-esteem people to follow preventive measures by framing those behaviors around protecting the health of others (vs. oneself).

METHODS

Four studies were conducted with U.S. and German residents. In Study 1, we examine the association between self-esteem, willingness to engage in self-protection behavior, health motivation, and several alternative accounts. In Study 2, we manipulate state self-esteem, and in Studies 3 and 4, we vary the target of COVID-19 prevention behaviors (self vs. other).

RESULTS

People with chronic or temporarily induced low self-esteem report a lower willingness to engage in COVID-19 prevention behaviors because they lack motivation to protect their health. Varying the protection target of preventive behaviors (self vs. others) interacts with self-esteem: Low self-esteem people are more willing to follow preventive measures (e.g., vaccination) when they are framed as protecting others (vs. oneself).

CONCLUSIONS

Self-esteem impacts people's behavior during a global pandemic and needs to be considered when designing health communications. Public health messages can increase compliance among individuals with lower self-esteem by framing prevention behaviors as a way to protect the health of others.

Utilizing the RPE-Clamp model to examine interactions among factors associated with perceived fatigability and performance fatigability in women and men

PURPOSE

The purpose of the present study was to examine the interactions between perceived fatigability and performance fatigability in women and men by utilizing the RPE-Clamp model to assess the fatigue-induced effects of a sustained, isometric forearm flexion task anchored to RPE = 8 on time to task failure (TTF), torque, and neuromuscular responses.

METHODS

Twenty adults (10 men and 10 women) performed two, 3 s forearm flexion maximal voluntary isometric contractions (MVICs) followed by a sustained, isometric forearm flexion task anchored to RPE = 8 using the OMNI-RES (0-10) scale at an elbow joint angle of 100°. Electromyographic amplitude (EMG AMP) was recorded from the biceps brachii. Torque and EMG AMP values resulting from the sustained task were normalized to the pretest MVIC. Neuromuscular efficiency was defined as NME = normalized torque/normalized EMG AMP. Mixed factorial ANOVAs and Bonferroni corrected dependent t tests and independent t tests were used to examine differences across time and between sex for torque and neuromuscular parameters.

RESULTS

There were no differences between the women and men for the fatigue-induced decreases in torque, EMG AMP, or NME, and the mean decreases (collapsed across sex) were 50.3 ± 8.6 to 2.8 ± 2.9% MVIC, 54.7 ± 12.0 to 19.6 ± 5.3% MVIC, and 0.94 ± 0.19 to 0.34 ± 0.16, respectively. Furthermore, there were no differences between the women and men for TTF (251.8 ± 74.1 vs. 258.7 ± 77.9 s).

CONCLUSION

The results suggested that the voluntary reductions in torque to maintain RPE and the decreases in NME were likely due to group III/IV afferent feedback from peripheral fatigue that resulted in excitation-contraction coupling failure.

Effects of 8 Weeks of Shilajit Supplementation on Serum Pro-c1α1, a Biomarker of Type 1 Collagen Synthesis: A Randomized Control Trial

Type 1 collagen is an abundant structural protein with importance to the skin, eyes, bones, ligaments, tendons, and muscles. Shilajit supplementation has been shown to increase gene expression of collagen synthesis, however, it is unclear if increased gene expression translates to increases in circulating levels. Therefore, the purpose of the present study was to examine the effects of 8 weeks of daily supplementation with 500 mg·d-1 and 1000 mg·d-1 of Shilajit versus placebo on serum pro-c1α1, a biomarker of type 1 collagen synthesis. Thirty-five recreationally trained men (mean ± SD: age = 21.1 ± 1.8 yrs; body mass = 80.7 ± 12.4 kg; height = 180.9 ± 6.7 cm) volunteered to participate in this study. Mixed factorial and one-way ANOVAs were used to analyze mean differences between groups, with follow-up t-tests when necessary. Individual subject responses were assessed using the minimal clinically important difference and Chi-squared tests. There were significant (Low dose: p = 0.008, d = 1.2; High dose: p = 0.007, d = 1.3) increases in serum pro-c1α1 from pre- (Low dose: 42.5 ± 12.4 ng·mL-1; High dose: 42.7 ± 12.7 ng·mL-1) to post-supplementation (Low dose: 82.3 ± 46.5 ng·mL-1; High dose: 113.1 ± 78.7 ng·mL-1) for the low and high dose groups, however, no change (p > 0.05) for the placebo group. A greater proportion (p = 0.03) of subjects exhibited increases in pro-c1α1 that exceeded the minimal clinically important difference in the high dose Shilajit group (75%) compared to the placebo group (30%), but no differences (p = 0.06) between the low dose Shilajit group (69%) and placebo. In conclusion, 8 weeks of Shilajit supplementation with 500 and 1000 mg·d-1 increased type 1 collagen synthesis as indicated by serum levels of pro-c1α1.

No effect of coactivation on fatigue-induced decreases in isokinetic and isometric torque in healthy young male adults

BACKGROUND

Antagonist activation may contribute to fatigue-induced decreases in torque while assisting in the maintenance of joint stability. This study utilized a reciprocal, slow velocity (60°·s^-1) forearm flexion and extension fatiguing task to examine the contributions of coactivation to torque production at slow and moderate (180°·s^-1) velocities, as well as during a maximal voluntary isometric contraction (MVIC).

METHODS

Twelve recreationally active men (mean ± SD: age = 21.7 ± 1.6 years; body mass = 83.5 ± 8.8 kg; height = 179.4 ± 5.2 cm) completed isokinetic (60 and 180°·s^-1) and isometric pre-testing of forearm flexion and extension, followed by 50 maximal, reciprocal, isokinetic muscle actions at 60°·s^-1, followed by post-testing. The amplitude (AMP) of the electromyographic (EMG) signals from the biceps and triceps brachii were simultaneously recorded. Torque and EMG AMP were normalized to the corresponding values from the pre-testing peak torque movements. Repeated measures ANOVAs and pairwise comparisons were used to identify mean changes in torque, EMG AMP, and coactivation ratios.

RESULTS

The torque analyses indicated greater (p < 0.03) decreases for 180°·s^-1 (24%) and MVIC (23%) than 60°·s^-1 (14%) for forearm flexion. For forearm extension, there were no differences (p > 0.05) in fatigability between velocities. For EMG AMP there were no changes (p > 0.05) from pre- to post-testing for any velocity or movement. There were no changes (p > 0.05) in the coactivation ratio for forearm flexion, but significant increases (13.6 ± 6.6 to 16.9 ± 6.0; p = 0.003) for forearm extension, collapsed across Velocity.

CONCLUSIONS

There was velocity- and movement-specific fatigability for forearm flexion and extension. The parallel, fatigue-induced EMG AMP responses indicated that coactivation did not contribute to the decreases in torque and would not affect elbow joint stability.

“We cobble together a storyline of system performance using a diversity of things”: a qualitative study of perspectives on public health performance measurement in Canada

Background

There have been longstanding calls for public health systems transformations in many countries, including Canada. Core to these calls has been strengthening performance measurement. While advancements have been made in performance measurement for certain sectors of the health care system (primarily focused on acute and primary health care), effective use of indicators for measuring public health systems performance are lacking. This study describes the current state, anticipated challenges, and future directions in the development and implementation of a public health performance measurement system for Canada.

Methods

We conducted a qualitative study using semi-structured interviews with public health leaders (n = 9) between July and August 2021. Public health leaders included researchers, government staff, and former medical officers of health who were purposively selected due to their expertise and experience with performance measurement with relevance to public health systems in Canada. Thematic analysis included both a deductive approach for themes consistent with the conceptual framework and an inductive approach to allow new themes to emerge from the data.

Results

Conceptual, methodological, contextual, and infrastructure challenges were highlighted by participants in designing a performance measurement system for public health. Specifically, six major themes evolved that encompass 1) the mission and purpose of public health systems, including challenges inherent in measuring the functions and services of public health; 2) the macro context, including the impacts of chronic underinvestment and one-time funding injections on the ability to sustain a measurement system; 3) the organizational structure/governance of public health systems including multiple forms across Canada and underdevelopment of information technology systems; 4) accountability approaches to performance measurement and management; and 5) timing and unobservability in public health indicators. These challenges require dedicated investment, strong leadership, and political will from the federal and provincial/territorial governments.

Conclusion

Unprecedented attention on public health due to the coronavirus disease 2019 pandemic has highlighted opportunities for system improvements, such as addressing the lack of a performance measurement system. This study provides actionable knowledge on conceptual, methodological, contextual, and infrastructure challenges needed to design and build a pan-Canadian performance measurement system for public health.

Early Impacts of the COVID-19 Pandemic on Public Health Systems and Practice in 3 Canadian Provinces From the Perspective of Public Health Leaders: A Qualitative Study

CONTEXT

The COVID-19 pandemic has impacted health systems worldwide. Studies to date have largely focused on the health care system with less attention to the impact on public health systems and practice.

OBJECTIVE

To describe the early impacts of COVID-19 on public health systems and practice in 3 Canadian provinces from the perspective of public health system leaders and synthesize lessons learned.

DESIGN

A qualitative study using semistructured virtual interviews with public health leaders between October 2020 and April 2021. The World Health Organization's essential public health operations framework guided data collection and analysis.

SETTING

This study involved the Canadian provinces of Alberta, Ontario, and Québec. These provinces were chosen for their large populations, relatively high COVID-19 burden, and variation in public health systems.

PARTICIPANTS

Public health leaders from Alberta (n = 21), Ontario (n = 18), and Québec (n = 19) in organizations with a primary mandate of stewardship and/or administration of essential public health operations (total n = 58).

RESULTS

We found that the COVID-19 pandemic led to intensified collaboration in public health systems and a change in workforce capacity to respond to the pandemic. This came with opportunities but also challenges of burnout and disruption of non-COVID-19 services. Information systems and digital technologies were increasingly used and there was greater proximity between public health leaders and other health system leaders. A renewed recognition for public health work was also highlighted.

CONCLUSIONS

The COVID-19 pandemic impacted several aspects of public health systems in the provinces studied. Our findings can help public health leaders and policy makers identify areas for further investment (eg, intersectoral collaboration, information systems) and develop plans to address challenges (eg, disrupted services, workforce burnout) that have surfaced.

Coactivation does not contribute to fatigue-induced decreases in torque during reciprocal, isokinetic muscle actions

BACKGROUND: Studies of coactivation have typically utilized single movement isometric or isokinetic fatiguing muscle actions. OBJECTIVE: The purpose of the current study was to examine coactivation of the biceps brachii (BB) and triceps brachii (TB) in response to a maximal, reciprocal, isokinetic fatiguing task of the forearm flexors and extensors at slow (60∘/s) and moderate (180∘/s) isokinetic velocities in men. METHODS: Ten men (mean ± SD: age = 21.6 ± 1.3 years) completed 50 consecutive, maximal, reciprocal, isokinetic muscle actions of the right forearm flexors and extensors at 60 and 180∘/s. The amplitude (AMP) and mean power frequency (MPF) contents of the electromyographic (EMG) and mechanomyographic (MMG) signals from the BB and TB were recorded simultaneously throughout the fatiguing task. Repeated measures ANOVAs with Tukey post hocs were used to determine mean differences for the torque and neuromuscular parameters across repetitions. RESULTS: The torque analyses indicated greater fatigability at 180∘/s, compared to 60∘/s (p= 0.02). There were no significant changes in EMG AMP for either muscle during flexion or extension at 60∘/s (p> 0.05). At 180∘/s, there were significant increases in agonist EMG AMP (p= 0.01 to 0.004), however, no changes in antagonist EMG AMP (p> 0.05). For EMG MPF, there were significant decreases during flexion and extension (p< 0.001 to p= 0.02) at both velocities, collapsed across Muscle. There were no significant (p> 0.05) changes across repetition for MMG AMP or MPF. CONCLUSIONS: This study indicated velocity-specific responses to fatigue, with a greater magnitude of fatigability at 180∘/s. Furthermore, despite increases in EMG AMP of the agonist muscles at 180∘/s only, it was not sufficient to alter the ratio of coactivation, likely due to common neural drive between muscles. Thus, the decreases in torque in the present study were not attributable to increases in coactivation.

Time course of changes in torque and neuromuscular parameters during a sustained isometric forearm flexion task to fatigue anchored to a constant rating of perceived exertion

OBJECTIVE

This study examined the time course of changes in torque and electromyographic (EMG) and mechanomyographic (MMG) responses during a sustained isometric task anchored to a constant perception of exertion (RPE).

METHODS

Twelve college-aged men performed an isometric forearm flexion task to failure anchored to RPE=7 (OMNI-RES scale). The amplitude (AMP) and frequency (MPF) of the EMG and MMG signals from the biceps brachii were recorded. Repeated measures ANOVAs were used to examine differences for the normalized (%MVIC) torque and neuromuscular parameters.

RESULTS

The time to task failure (TTF) was 678.0±468.1s. Torque decreased significantly (p<0.001, η_p²=0.774) across time and all subjects reduced torque to zero. Post-hoc comparisons indicated that the torque values from 20-100% TTF were less than the value at 10% TTF. There were no significant (p>0.05) changes from 10-100% TTF for the EMG and MMG parameters.

CONCLUSION

We hypothesize that RPE was maintained by various mechanisms throughout the task: group III/IV afferent neurons, adequate blood flow, and a combination of reduced contractile efficiency, collective afferent feedback (group III/IV afferents) from muscles involved with forearm flexion, and motivation that resulted in an initial decrease, plateau, and final decline in torque to zero, respectively.

Influence of Acute Water Ingestion and Prolonged Standing on Raw Bioimpedance and Subsequent Body Fluid and Composition Estimates

This study evaluated the influence of acute water ingestion and maintaining an upright posture on raw bioimpedance and subsequent estimates of body fluids and composition. Twenty healthy adults participated in a randomized crossover study. In both conditions, an overnight food and fluid fast was followed by an initial multi-frequency bioimpedance assessment (InBody 770). Participants then ingested 11 mL/kg of water (water condition) or did not (control condition) during a 5-minute period. Thereafter, bioimpedance assessments were performed every 10 minutes for one hour with participants remaining upright throughout. Linear mixed effects models were used to examine the influence of condition and time on raw bioimpedance, body fluids, and body composition. Water consumption increased impedance of the arms but not trunk or legs. However, drift in leg impedance was observed, with decreasing values over time in both conditions. No effects of condition on body fluids were detected, but total body water and intracellular water decreased by ~0.5 kg over time in both conditions. Correspondingly, lean body mass did not differ between conditions but decreased over the measurement duration. The increase in body mass in the water condition was detected exclusively as fat mass, with final fat mass values ~1.3 kg higher than baseline and also higher than the control condition. Acute water ingestion and prolonged standing exert practically meaningful effects on relevant bioimpedance variables quantified by a modern, vertical multi-frequency analyzer. These findings have implications for pre-assessment standardization, methodological reporting, and interpretation of assessments.

The Crystal Structure of Cysteamine Dioxygenase Reveals the Origin of the Large Substrate Scope of This Vital Mammalian Enzyme

We report the crystal structure of the mammalian non-heme iron enzyme cysteamine dioxygenase (ADO) at 1.9 Å resolution, which shows an Fe and three-histidine (3-His) active site situated at the end of a wide substrate access channel. The open approach to the active site is consistent with the recent discovery that ADO catalyzes not only the conversion of cysteamine to hypotaurine but also the oxidation of N-terminal cysteine (Nt-Cys) peptides to their corresponding sulfinic acids as part of the eukaryotic N-degron pathway. Whole-protein models of ADO in complex with either cysteamine or an Nt-Cys peptide, generated using molecular dynamics and quantum mechanics/molecular mechanics calculations, suggest occlusion of access to the active site by peptide substrate binding. This finding highlights the importance of a small tunnel that leads from the opposite face of the enzyme into the active site, providing a path through which co-substrate O2 could access the Fe center. Intriguingly, the entrance to this tunnel is guarded by two Cys residues that may form a disulfide bond to regulate O2 delivery in response to changes in the intracellular redox potential. Notably, the Cys and tyrosine residues shown to be capable of forming a cross-link in human ADO reside ∼7 Å from the iron center. As such, cross-link formation may not be structurally or functionally significant in ADO.

Cross-sectional and longitudinal associations between subcutaneous adipose tissue thickness and dual-energy X-ray absorptiometry fat mass

The present study examined cross-sectional and longitudinal relationships between total and segmental subcutaneous tissue thicknesses from ultrasonography (US) and total and segmental fat mass (FM) estimates from dual-energy X-ray absorptiometry (DXA). Traditional US FM estimates were also examined. Twenty resistance-trained males (mean ± SD; age: 22.0 ± 2.6 years; body mass: 74.8 ± 11.5 kg; DXA fat: 17.5 ± 4.5%) completed a 6-week supervised resistance training programme while consuming a hypercaloric diet. Pre- and post-intervention body composition was assessed by DXA and B-mode US. Data were analysed using Pearson's correlation (r), Lin's correlation coefficient (CCC), paired t-tests, Wilcoxon signed-rank tests and Bland-Altman analysis, as appropriate. Cross-sectionally, correlations were observed between total DXA FM and total subcutaneous tissue thickness (r = 0.88). Longitudinally, a correlation was observed between total DXA FM changes and total subcutaneous tissue changes (r = 0.49, CCC = 0.38). Correlations of similar magnitudes were observed for the upper body and trunk estimates, but DXA FM changes were unrelated to subcutaneous tissue changes for the lower body and arms. Cross-sectionally, US 2-compartment FM and DXA FM were correlated (r = 0.91, CCC = 0.83). Longitudinally, a weaker correlation was observed (r = 0.47, CCC = 0.33). In summary, longitudinal associations between US and DXA are weaker than cross-sectional relationships; additionally, correlations between US subcutaneous tissue and whole-body DXA FM appear to be driven by the trunk region rather than appendages. Reporting raw skinfold thicknesses rather than FM estimates alone may improve the utility of techniques based on subcutaneous tissue thickness, such as US and skinfolds.

The effects of phosphocreatine disodium salts plus blueberry extract supplementation on muscular strength, power, and endurance

BACKGROUND

Numerous studies have demonstrated the efficacy of creatine supplementation for improvements in exercise performance. Few studies, however, have examined the effects of phosphocreatine supplementation on exercise performance. Furthermore, while polyphenols have antioxidant and anti-inflammatory properties, little is known regarding the influence of polyphenol supplementation on muscular strength, power, and endurance. Thus, the purpose of the present study was to compare the effects of 28 days of supplementation with phosphocreatine disodium salts plus blueberry extract (PCDSB), creatine monohydrate (CM), and placebo on measures of muscular strength, power, and endurance.

METHODS

Thirty-three men were randomly assigned to consume either PCDSB, CM, or placebo for 28 days. Peak torque (PT), average power (AP), and percent decline for peak torque (PT%) and average power (AP%) were assessed from a fatigue test consisting of 50 maximal, unilateral, isokinetic leg extensions at 180°·s^- 1 before and after the 28 days of supplementation. Individual responses were assessed to examine the proportion of subjects that exceeded a minimal important difference (MID).

RESULTS

The results demonstrated significant (p < 0.05) improvements in PT for the PCDSB and CM groups from pre- (99.90 ± 22.47 N·m and 99.95 ± 22.50 N·m, respectively) to post-supplementation (119.22 ± 29.87 N·m and 111.97 ± 24.50 N·m, respectively), but no significant (p = 0.112) change for the placebo group. The PCDSB and CM groups also exhibited significant improvements in AP from pre- (140.18 ± 32.08 W and 143.42 ± 33.84 W, respectively) to post-supplementation (170.12 ± 42.68 W and 159.78 ± 31.20 W, respectively), but no significant (p = 0.279) change for the placebo group. A significantly (p < 0.05) greater proportion of subjects in the PCDSB group exceeded the MID for PT compared to the placebo group, but there were no significant (p > 0.05) differences in the proportion of subjects exceeding the MID between the CM and placebo groups or between the CM and PCDSB groups.

CONCLUSIONS

These findings indicated that for the group mean responses, 28 days of supplementation with both PCDSB and CM resulted in increases in PT and AP. The PCDSB, however, may have an advantage over CM when compared to the placebo group for the proportion of individuals that respond favorably to supplementation with meaningful increases in muscular strength.

Comparison of Indirect Calorimetry and Common Prediction Equations for Evaluating Changes in Resting Metabolic Rate Induced by Resistance Training and a Hypercaloric Diet

ABSTRACT

Rodriguez, C, Harty, PS, Stratton, MT, Siedler, MR, Smith, RW, Johnson, BA, Dellinger, JR, Williams, AD, White, SJ, Benavides, ML, and Tinsley, GM. Comparison of indirect calorimetry and common prediction equations for evaluating changes in resting metabolic rate induced by resistance training and a hypercaloric diet. J Strength Cond Res XX(X): 000-000, 2021-The ability to accurately identify resting metabolic rate (RMR) changes over time allows practitioners to prescribe appropriate adjustments to nutritional intake. However, there is a lack of data concerning the longitudinal utility of commonly used RMR prediction equations. The purpose of this study was to evaluate the validity of several commonly used prediction equations to track RMR changes during a hypercaloric nutritional intervention and supervised resistance exercise training program. Twenty resistance-trained men completed the study. The protocol lasted 6 weeks, and subjects underwent RMR assessments by indirect calorimetry (IC) preintervention and postintervention to obtain reference values. Existing RMR prediction equations based on body mass (BM) or dual-energy X-ray absorptiometry fat-free mass (FFM) were also evaluated. Equivalence testing was used to evaluate whether each prediction equation demonstrated equivalence with IC. Null hypothesis significance testing was also performed, and Bland-Altman analysis was used alongside linear regression to assess the degree of proportional bias. Body mass and FFM increased by 3.6 ± 1.7 kg and 2.4 ± 1.6 kg, respectively. Indirect calorimetry RMR increased by 165 ± 97 kcal·d-1, and RMR:FFM increased by 5.6 ± 5.2%. All prediction equations underestimated mean RMR changes relative to IC, with magnitudes ranging from 75 to 155 kcal·d-1, while also displaying unacceptable levels of negative proportional bias. In addition, no equation demonstrated equivalence with IC. Common RMR prediction equations based on BM or FFM did not fully detect the increase in RMR observed with resistance training plus a hypercaloric diet. Overall, the evaluated prediction equations are unsuitable for estimating RMR changes in the context of this study.

Predicting Adaptations to Resistance Training Plus Overfeeding Using Bayesian Regression: A Preliminary Investigation

Relatively few investigations have reported purposeful overfeeding in resistance-trained adults. This preliminary study examined potential predictors of resistance training (RT) adaptations during a period of purposeful overfeeding and RT. Resistance-trained males (n = 28; n = 21 completers) were assigned to 6 weeks of supervised RT and daily consumption of a high-calorie protein/carbohydrate supplement with a target body mass (BM) gain of ≥0.45 kg·wk-1. At baseline and post-intervention, body composition was evaluated via 4-component (4C) model and ultrasonography. Additional assessments of resting metabolism and muscular performance were performed. Accelerometry and automated dietary interviews estimated physical activity levels and nutrient intake before and during the intervention. Bayesian regression methods were employed to examine potential predictors of changes in body composition, muscular performance, and metabolism. A simplified regression model with only rate of BM gain as a predictor was also developed. Increases in 4C whole-body fat-free mass (FFM; (mean ± SD) 4.8 ± 2.6%), muscle thickness (4.5 ± 5.9% for elbow flexors; 7.4 ± 8.4% for knee extensors), and muscular performance were observed in nearly all individuals. However, changes in outcome variables could generally not be predicted with precision. Bayes R2 values for the models ranged from 0.18 to 0.40, and other metrics also indicated relatively poor predictive performance. On average, a BM gain of ~0.55%/week corresponded with a body composition score ((∆FFM/∆BM)*100) of 100, indicative of all BM gained as FFM. However, meaningful variability around this estimate was observed. This study offers insight regarding the complex interactions between the RT stimulus, overfeeding, and putative predictors of RT adaptations.

Social isolation and risk of heart disease and stroke: analysis of two large UK prospective studies

BACKGROUND

Social isolation has been associated with increased risk of coronary heart disease and stroke. However, it is unclear whether the associations differ between fatal and non-fatal events or by the type of isolation (living alone or having few social contacts). We aimed to examine these associations in two large UK prospective cohorts.

METHODS

Million Women Study and UK Biobank participants without previous coronary heart disease or stroke who provided data in median year 2010 (IQR 2009-2011) on social contacts were included in this prospective analysis. Participants were followed up to median year 2017 (2017-2017) by electronic linkage to national hospital and death records. Risk ratios (RRs) were calculated using Cox regression for first coronary heart disease and stroke event (overall, and separately for hospital admission as the first event and for death without an associated hospital admission as the first event) by three levels of social isolation (based on living alone, contact with family or friends, and group participation) adjusted for age, sex, study, region, deprivation, smoking, alcohol intake, body-mass index, physical activity, and self-rated health.

FINDINGS

938 558 participants were included in our analyses (mean age 63 years [SD 9]): 481 946 participants from the Million Women Study (mean age 68 years [5]) and 456 612 participants (mean age 57 years [8]) from UK Biobank. During a mean follow-up period of 7 years (2), 42 402 first coronary heart disease events (of which 1834 were fatal without an associated hospital admission) and 19 999 first stroke events (of which 529 were fatal without an associated hospital admission) occurred. Little, if any, association was found between social isolation and hospital admission for a first coronary heart disease or stroke event (combined RR for both studies 1·01 [95% CI 0·98-1·04] for coronary heart disease and 1·13 [1·08-1·18] for stroke, when comparing the most isolated group with the least isolated group). However, the risk of death without an associated hospital admission was substantially higher in the most isolated group than the least isolated group for coronary heart disease (1·86 [1·63-2·12]) and stroke (1·91 [1·48-2·46]). For coronary heart disease or stroke death as the first event, RRs were substantially higher (test for heterogeneity, p=0·002) for participants living alone versus those not living alone (1·60 [1·46-1·75]) than for those with fewer versus more contact with family, friends, or groups (1·27 [1·16-1·38]). These findings did not differ greatly between studies, or by self-rated health.

INTERPRETATION

Social isolation seems to have little direct effect on the risk of developing a first coronary heart disease or stroke. By contrast, social isolation substantially increases the risk that the first such event is fatal before reaching hospital, particularly among people who live alone, perhaps because of the absence of immediate help in responding to an acute heart attack or stroke.

FUNDING

UK Medical Research Council, Cancer Research UK.

Longitudinal agreement of four bioimpedance analyzers for detecting changes in raw bioimpedance during purposeful weight gain with resistance training

BACKGROUND

Due to inherent errors involved in the transformation of raw bioelectrical variables to body fluids or composition estimates, the sole use of resistance (R), reactance (Xc), and phase angle (φ) has been advocated when quantifying longitudinal changes. The aim of this investigation was to assess the ability of four bioimpedance analyzers to detect raw bioimpedance changes induced by purposeful weight gain with resistance training.

METHODS

Twenty-one resistance trained males completed a 6-week lifestyle intervention with the aim of purposeful weight gain. Bioimpedance analysis was performed before and after the intervention using four different analyzers (MFBIA_InBody: InBody 770; MFBIA_SECA: Seca mBCA 515/514; BIS: ImpediMed SFB7; SFBIA: RJL Quantum V) for the quantification of R, Xc, and φ at the 50-kHz frequency. Repeated measures ANOVA and follow up tests were performed.

RESULTS

Analysis revealed main effects of time and method for R, Xc, and φ (p ≤ 0.02), without significant time x method interactions (p ≥ 0.07). Follow up for time main effects indicated that, on average, R decreased by 4.5-5.8%, Xc decreased by 2.3-4.0%, and φ increased by 1.8-2.6% across time for all analyzers combined. However, varying levels of disagreement in absolute values were observed for each bioelectrical variable.

CONCLUSIONS

The differences in absolute bioelectrical values suggests that analyzers should not be used interchangeably, which holds particular importance when reference values are utilized. Despite absolute differences, analyzers with varying characteristics demonstrated similar abilities to detect changes in R, Xc, and φ over time.

A Field-based Three-Compartment Model Derived from Ultrasonography and Bioimpedance for Estimating Body Composition Changes

PURPOSE

The purpose of this study was to assess the agreement between a field-based three-compartment (3CFIELD) model and a laboratory-based three-compartment (3CLAB) model for tracking body composition changes over time.

METHODS

Resistance-trained males completed a supervised nutrition and resistance training intervention. Before and after the intervention, assessments were performed via air displacement plethysmography (ADP), bioimpedance spectroscopy (BIS), portable ultrasonography (US), and bioelectrical impedance analysis (BIA). ADP body density and BIS body water were used within the reference 3CLAB model, whereas US-derived body density and BIA body water were used within the 3CFIELD model. Two-compartment model body composition estimates provided by US and BIA were also examined. Changes in fat-free mass and fat mass were analyzed using repeated-measures ANOVA, equivalence testing, Bland-Altman analysis, linear regression, and related validity analyses.

RESULTS

Significant increases in fat-free mass (3CLAB, 4.0 ± 4.5 kg; 3CFIELD, 3.9 ± 4.2 kg; US, 3.2 ± 4.3 kg; BIA, 3.9 ± 4.2 kg) and fat mass (3CLAB, 1.3 ± 2.2 kg; 3CFIELD, 1.4 ± 2.2 kg; US, 2.1 ± 2.6 kg; BIA, 1.4 ± 2.9 kg) were detected by all methods. However, only the 3CFIELD model demonstrated equivalence with the 3CLAB model. In addition, the 3CFIELD model exhibited superior performance to US and BIA individually, as indicated by the total error (3CFIELD, 1.0 kg; US, 1.8 kg; BIA, 1.6 kg), 95% limits of agreement (3CFIELD, ±2.1 kg; US, ±3.3 kg; BIA, ±3.1 kg), correlation coefficients (3CFIELD, 0.79-0.82; US, 0.49-0.55; BIA, 0.61-0.72), and additional metrics.

CONCLUSIONS

The present study demonstrated the potential usefulness of a 3CFIELD model incorporating US and BIA data for tracking body composition changes over time, as well as its superiority to US or BIA individually. As such, this accessible multicompartment model may be suitable for implementation in field or limited-resource settings.

Model reduction of genome-scale metabolic models as a basis for targeted kinetic models

Constraint-based, genome-scale metabolic models are an essential tool to guide metabolic engineering. However, they lack the detail and time dimension that kinetic models with enzyme dynamics offer. Model reduction can be used to bridge the gap between the two methods and allow for the integration of kinetic models into the Design-Built-Test-Learn cycle. Here we show that these reduced size models can be representative of the dynamics of the original model and demonstrate the automated generation and parameterisation of such models. Using these minimal models of metabolism could allow for further exploration of dynamic responses in metabolic networks.

Addressing social determinants of noncommunicable diseases in primary care: a systematic review

OBJECTIVE

To explore how primary care organizations assess and subsequently act upon the social determinants of noncommunicable diseases in their local populations.

METHODS

For this systematic review we searched the online databases of PubMed®, MEDLINE®, Embase® and the Health Management Information Consortium from inception to 28 June 2019, along with hand-searching of references. Studies of any design that examined a primary care organization assessing social determinants of noncommunicable diseases were included. For quality assessment we used Cochrane's tool for assessing risk of bias in non-randomized studies of interventions. We used narrative data synthesis to appraise the extent to which the assessments gathered data on the domains of the World Health Organization social determinants of health framework.

FINDINGS

We identified 666 studies of which 17 were included in the review. All studies used descriptive study designs. Clinic-based and household surveys and interviews were more commonly used to assess local social determinants than population-level data. We found no examples of organizations that assessed sociopolitical drivers of noncommunicable diseases; all focused on sociodemographic factors or circumstances of daily living. Nevertheless, the resulting actions to address social determinants ranged from individual-level interventions to population-wide measures and introducing representation of primary care organizations on system-level policy and planning committees.

CONCLUSION

Our findings may help policy-makers to consider suitable approaches for assessing and addressing social determinants of health in their domestic context. More rigorous observational and experimental evidence is needed to ascertain whether measuring social determinants leads to interventions which mitigate unmet social needs and reduce health disparities.

Addressing social determinants of noncommunicable diseases in primary care: a scoping review

Background

Noncommunicable diseases (NCDs) are the leading cause of global mortality, and their risk factors largely manifest at the community level. In collaboration with public health, primary care is well placed to assess and address the local social determinants of NCDs (SDONCDs). Post-Astana, many countries are reorienting their primary care systems to incorporate these traditional public health functions, but there is little evidence to guide reform. We aimed to collate examples of primary care organisations that already engage in this activity.

Methods

Following Cochrane guidance, PubMed, MEDLINE, Embase & HMIC were searched from inception to 28/7/2019, along with hand-searching of references for any study designs that examined international primary care organisation(s) that addressed local SDONCDs. Independent dual review was used for screening, data extraction, and quality assessment - for which we used ROBINS-i.

Results

Searches identified 666 studies of which 17 studies from Canada, South Africa, UK, and USA were included. All used descriptive study designs. Individual-level surveys and interviews were the most common SDONCD data collection methods reported. Fewer studies collated population-level data held by external agencies. Actions ranged from individual-level interventions to novel representation of primary care organisations on system-level policy and planning committees. Several enablers and barriers to collecting and mobilising social determinant data within well- and under-resourced primary care settings were identified.

Conclusions

Several models of integrated public health and primary care already exist that fulfil the Astana mandate of developing place-based preventive services, tailored to local needs. Public health input at this granular level is required to support primary care services as they extend their scope of practice, and to assist with monitoring and evaluation of new initiatives to mitigate unmet health and social needs.

Key messages

Primary care organisations are increasingly being encouraged to assess and address local social determinants of noncommunicable diseases but there is weak evidence to guide reform. The different approaches described in our review can help policymakers tasked with integrating public health functions into primary care.

Effects of Bang® Keto Coffee Energy Drink on Metabolism and Exercise Performance in Resistance-Trained Adults: A Randomized, Double-blind, Placebo-controlled, Crossover Study

BACKGROUND

Energy drinks are often consumed by the general population, as well as by active individuals seeking to enhance exercise performance and augment training adaptations. However, limited information is available regarding the efficacy of these products. Thus, the purpose of this study was to determine the effects of a commercially available caffeine- and protein-containing energy drink on metabolism and muscular performance.

METHODS

Sixteen resistance-trained males (n = 8; mean ± SD; age: 22.4 ± 4.9 years; body mass: 78.8 ± 14.0 kg; body fat: 15.3 ± 6.4%) and females (n = 8; age: 24.5 ± 4.8 years; body mass: 67.5 ± 11.9 kg; body fat: 26.6 ± 7.1%) participated in this randomized, double-blind, placebo-controlled, crossover study. Following a familiarization visit, participants completed two identical visits to the laboratory separated by 5-10 days, each of which consisted of indirect calorimetry energy expenditure (EE) assessments before and after consumption of the beverage (Bang® Keto Coffee; 130 kcal, 300 mg caffeine, 20 g protein) or placebo (30 kcal, 11 mg caffeine, 1 g protein) as well as after exercise testing. In addition, participants' subjective feelings of energy, fatigue, and focus as well as muscular performance (leg press one-repetition maximum and repetitions to fatigue, maximal isometric and isokinetic squat testing) were assessed. Multiple repeated measures ANOVAs with Tukey post-hoc tests were used to analyze data. Estimates of effect size were quantified via partial eta squared (ηP2) and Hedge's g.

RESULTS

A significant interaction effect was identified for EE (p < 0.001, ηP2 = 0.52) but not respiratory exchange ratio (p = 0.17, ηP2 = 0.11). Following consumption of the beverage, EE was 0.18 [corrected]  kcal·min- 1 greater than placebo at the post-beverage time point (p < 0.001) and 0.08 [corrected]  kcal·min- 1 greater than placebo at the post-exercise time point (p = 0.011). However, no between-condition differences were detected for any subjective or muscular performance outcomes.

CONCLUSIONS

The results of this study suggest that consumption of the energy drink had minimal effects on lower-body muscular performance and subjective factors in the context of a laboratory setting. However, the beverage was found to significantly increase energy expenditure compared to placebo immediately following ingestion as well as during the recovery period after an exercise bout, suggesting that active individuals may improve acute metabolic outcomes via consumption of a caffeine- and protein-containing energy drink.

TRIAL REGISTRATION

This trial was prospectively registered at ClinicalTrials.gov (Identifier: NCT04180787 ; Registered 29 November 2019).

Extending the linear-noise approximation to biochemical systems influenced by intrinsic noise and slow lognormally distributed extrinsic noise

It is well known that the kinetics of an intracellular biochemical network is stochastic. This is due to intrinsic noise arising from the random timing of biochemical reactions in the network as well as due to extrinsic noise stemming from the interaction of unknown molecular components with the network and from the cell's changing environment. While there are many methods to study the effect of intrinsic noise on the system dynamics, few exist to study the influence of both types of noise. Here we show how one can extend the conventional linear-noise approximation to allow for the rapid evaluation of the molecule numbers statistics of a biochemical network influenced by intrinsic noise and by slow lognormally distributed extrinsic noise. The theory is applied to simple models of gene regulatory networks and its validity confirmed by comparison with exact stochastic simulations. In particular, we consider three important biological examples. First, we investigate how extrinsic noise modifies the dependence of the variance of the molecule number fluctuations on the rate constants. Second, we show how the mutual information between input and output of a network motif is affected by extrinsic noise. And third, we study the robustness of the ubiquitously found feed-forward loop motifs when subjected to extrinsic noise.

Optogenetic control shows that kinetic proofreading regulates the activity of the T cell receptor

The immune system distinguishes between self and foreign antigens. The kinetic proofreading (KPR) model proposes that T cells discriminate self from foreign ligands by the different ligand binding half-lives to the T cell receptor (TCR). It is challenging to test KPR as the available experimental systems fall short of only altering the binding half-lives and keeping other parameters of the interaction unchanged. We engineered an optogenetic system using the plant photoreceptor phytochrome B (PhyB) as a ligand to selectively control the dynamics of ligand binding to the TCR by light. This opto-ligand-TCR system was combined with the unique property of PhyB to continuously cycle between the binding and non-binding states under red light, with the light intensity determining the cycling rate and thus the binding duration. Mathematical modeling of our experimental datasets showed that indeed the ligand-TCR interaction half-life is the decisive factor for activating downstream TCR signaling, substantiating KPR.

Phytochrome B dynamics departs from photoequilibrium in the field

Vegetation shade is characterized by marked decreases in the red/far-red ratio and photosynthetic irradiance. The activity of phytochrome in the field has typically been described by its photoequilibrium, defined by the photochemical properties of the pigment in combination with the spectral distribution of the light. This approach represents an oversimplification because phytochrome B (phyB) activity depends not only on its photochemical reactions but also on its rates of synthesis, degradation, translocation to the nucleus, and thermal reversion. To account for these complex cellular reactions, we used a model to simulate phyB activity under a range of field conditions. The model provided values of phyB activity that in turn predicted hypocotyl growth in the field with reasonable accuracy. On the basis of these observations, we define two scenarios, one is under shade, in cloudy weather, at the extremes of the photoperiod or in the presence of rapid fluctuations of the light environment caused by wind-induced movements of the foliage, where phyB activity departs from photoequilibrium and becomes affected by irradiance and temperature in addition to the spectral distribution. The other scenario is under full sunlight, where phyB activity responds mainly to the spectral distribution of the light.

Probing the Quantum Interference between Singly and Doubly Resonant Top-Quark Production in pp Collisions at sqrt[s]=13 TeV with the ATLAS Detector

This Letter presents a normalized differential cross-section measurement in a fiducial phase-space region where interference effects between top-quark pair production and associated production of a single top quark with a W boson and a b-quark are significant. Events with exactly two leptons (ee, μμ, or eμ) and two b-tagged jets that satisfy a multiparticle invariant mass requirement are selected from 36.1  fb^{-1} of proton-proton collision data taken at sqrt[s]=13  TeV with the ATLAS detector at the LHC in 2015 and 2016. The results are compared with predictions from simulations using various strategies for the interference. The standard prescriptions for interference modeling are significantly different from each other but are within 2σ of the data. State-of-the-art predictions that naturally incorporate interference effects provide the best description of the data in the measured region of phase space most sensitive to these effects. These results provide an important constraint on interference models and will guide future model development and tuning.

Measurement of the Soft-Drop Jet Mass in pp Collisions at sqrt[s]=13 TeV with the ATLAS Detector

Jet substructure observables have significantly extended the search program for physics beyond the standard model at the Large Hadron Collider. The state-of-the-art tools have been motivated by theoretical calculations, but there has never been a direct comparison between data and calculations of jet substructure observables that are accurate beyond leading-logarithm approximation. Such observables are significant not only for probing the collinear regime of QCD that is largely unexplored at a hadron collider, but also for improving the understanding of jet substructure properties that are used in many studies at the Large Hadron Collider. This Letter documents a measurement of the first jet substructure quantity at a hadron collider to be calculated at next-to-next-to-leading-logarithm accuracy. The normalized, differential cross section is measured as a function of log_{10}ρ^{2}, where ρ is the ratio of the soft-drop mass to the ungroomed jet transverse momentum. This quantity is measured in dijet events from 32.9  fb^{-1} of sqrt[s]=13  TeV proton-proton collisions recorded by the ATLAS detector. The data are unfolded to correct for detector effects and compared to precise QCD calculations and leading-logarithm particle-level Monte Carlo simulations.

Search for Low-Mass Dijet Resonances Using Trigger-Level Jets with the ATLAS Detector in pp Collisions at sqrt[s]=13 TeV

Searches for dijet resonances with sub-TeV masses using the ATLAS detector at the Large Hadron Collider can be statistically limited by the bandwidth available to inclusive single-jet triggers, whose data-collection rates at low transverse momentum are much lower than the rate from standard model multijet production. This Letter describes a new search for dijet resonances where this limitation is overcome by recording only the event information calculated by the jet trigger algorithms, thereby allowing much higher event rates with reduced storage needs. The search targets low-mass dijet resonances in the range 450-1800 GeV. The analyzed data set has an integrated luminosity of up to 29.3  fb^{-1} and was recorded at a center-of-mass energy of 13 TeV. No excesses are found; limits are set on Gaussian-shaped contributions to the dijet mass distribution from new particles and on a model of dark-matter particles with axial-vector couplings to quarks.

DMPy: a Python package for automated mathematical model construction of large-scale metabolic systems

Background

Models of metabolism are often used in biotechnology and pharmaceutical research to identify drug targets or increase the direct production of valuable compounds. Due to the complexity of large metabolic systems, a number of conclusions have been drawn using mathematical methods with simplifying assumptions. For example, constraint-based models describe changes of internal concentrations that occur much quicker than alterations in cell physiology. Thus, metabolite concentrations and reaction fluxes are fixed to constant values. This greatly reduces the mathematical complexity, while providing a reasonably good description of the system in steady state. However, without a large number of constraints, many different flux sets can describe the optimal model and we obtain no information on how metabolite levels dynamically change. Thus, to accurately determine what is taking place within the cell, finer quality data and more detailed models need to be constructed.

Results

In this paper we present a computational framework, DMPy, that uses a network scheme as input to automatically search for kinetic rates and produce a mathematical model that describes temporal changes of metabolite fluxes. The parameter search utilises several online databases to find measured reaction parameters. From this, we take advantage of previous modelling efforts, such as Parameter Balancing, to produce an initial mathematical model of a metabolic pathway. We analyse the effect of parameter uncertainty on model dynamics and test how recent flux-based model reduction techniques alter system properties. To our knowledge this is the first time such analysis has been performed on large models of metabolism. Our results highlight that good estimates of at least 80% of the reaction rates are required to accurately model metabolic systems. Furthermore, reducing the size of the model by grouping reactions together based on fluxes alters the resulting system dynamics.

Conclusion

The presented pipeline automates the modelling process for large metabolic networks. From this, users can simulate their pathway of interest and obtain a better understanding of how altering conditions influences cellular dynamics. By testing the effects of different parameterisations we are also able to provide suggestions to help construct more accurate models of complete metabolic systems in the future.

Electronic supplementary material

The online version of this article (10.1186/s12918-018-0584-8) contains supplementary material, which is available to authorized users.