Is the combined auriculotherapy approach superior to magneto-auriculotherapy alone in aging males with lower urinary tract symptoms? A randomized controlled trial.

OBJECTIVES: The negative impact of lower urinary tract symptoms (LUTS) on affected males is substantial. This study aims to assess whether a combined auriculotherapy (AT) using laser AT (LAT) and magneto-AT (MAT) is more effective than using MAT alone or placebo for managing LUTS of aging males.Methods: A randomized controlled, double-blinded trial was conducted. Sixty-two aging males with moderate or severe LUTS symptoms were randomly allocated into groups: Group 1, placebo LAT plus placebo MAT (n = 20); Group 2, combined AT approach using LAT plus MAT (n = 20); and Group 3, placebo LAT followed by MAT (n = 22). Six ear acupoints assumed to be suitable for alleviating LUTS were used. The total treatment period was 4 weeks, with follow-up visits till 3 months. Generalized estimating equations model was used for the examination of the interactions among the groups over time.Results: A combined AT approach exhibited a stronger treatment effect in relieving voiding problems, improving the peak urinary flow rate, and reducing the post-void residual urine than the placebo group or MAT alone.Conclusions: This study demonstrates that the AT protocol used in this study for aging males with LUTS is feasible and can be adopted in future study of increased scale.

Posttransplant Lymphoproliferative Disorder in Pediatric Patients: Characteristics of Disease in EBV-seropositive Recipients.

BACKGROUND: Patients at greatest risk of posttransplant lymphoproliferative disorder (PTLD) are those who acquire primary Epstein-Barr virus (EBV) infection after solid organ transplantation. The incidence of PTLD among patients who are EBV-seropositive before transplant is lower, and little is known about the differences in presentation and outcome of this population. We describe the characteristics of EBV-seropositive transplant recipients (R+) who developed PTLD and compare survival outcomes with EBV-seronegative recipients (R-). METHODS: A hospital-based registry was used to identify all patients with biopsy-proven PTLD for the period 2000-2014. Characteristics and outcomes were compared between R+ and R- patients with PTLD. RESULTS: Sixty-nine patients were included, among which 20 (29.0%) were R+ and 49 (71.0%) were R-. Multiorgan transplant patients accounted for 25% of PTLD cases in R+ patients, while accounting for only 2.1% of all transplants during the study period. There was no difference in PTLD site between R+ and R- patients. PTLD among R+ individuals occurred during the second year after transplant (median: 1.92; range: 0.35-3.09 y) compared with during the first year for R- individuals (median: 0.95; range: 0.48-2.92 y; P = 0.380). There was a trend for a higher overall mortality among R+ individuals (log rank: 0.09). PTLD-related mortality did not differ between R+ and R- individuals (log rank: 0.17). CONCLUSIONS: PTLD among R+ individuals was more likely to occur among multiorgan recipients, and there was a tendency for poorer outcomes at 1 and 5 years after the diagnosis of PTLD.

Self-Administered Auricular Acupressure Integrated With a Smartphone App for Weight Reduction: Randomized Feasibility Trial.

BACKGROUND: Obesity is a common global health problem and increases the risk of many chronic illnesses. Given the adverse effects of antiobesity agents and bariatric surgeries, the exploration of noninvasive and nonpharmacological complementary methods for weight reduction is warranted. OBJECTIVE: The study aimed to determine whether self-administered auricular acupressure (AA) integrated with a smartphone app was more effective than using AA alone or the controls for weight reduction. METHODS: This study is a 3-arm randomized waitlist-controlled feasibility trial. A total of 59 eligible participants were randomly divided into either group 1 (AA group, n=19), group 2 (AA plus smartphone app, n=19), or group 3 (waitlist control, n=21). A total of 6 reflective zones or acupoints for weight reduction were chosen. The smartphone app could send out daily messages to the subjects to remind them to perform self-pressing on the 6 ear acupoints. A "date picker" of the 8-week treatment course was used to enable the users to input the compliance of pressing and the number of bowel movement daily instead of using the booklet for recordings. The app also served as a reminder for the subjects regarding the dates for returning to the center for acupoint changing and assessments. Treatment was delivered 2 times a week, for 8 weeks. Generalized estimating equations were used to examine the interactions among the groups before and after intervention. RESULTS: Subjects in group 2 expressed that the smartphone app was useful (7.41 out of 10). The most popular features were the daily reminders for performing self-pressing (88%), the ear diagram indicating the locations and functions of the 6 ear points (71%), and ear pressing method demonstrated in the video scripts (47%). Nearly 90% of the participants completed the 8-week intervention, with a high satisfaction toward the overall arrangement (8.37 out of 10). The subjects in group 1 and 2 achieved better therapeutic effects in terms of body weight, body mass index (BMI), waist circumference, and hip circumference and perceived more fullness before meals than the waitlist controls. Although no significant differences in the pairwise comparisons between the 2 groups were detected (P>.05), the decrease in body weight, BMI, body fat, visceral fat rating and leptin level, and increase in adiponectin level were notable in group 2 before and after the intervention. CONCLUSIONS: The high compliance rate and high satisfaction toward the trial arrangement indicate that AA can be used to achieve weight reduction and applied in future large-scale studies. AA integrated with the smartphone app has a more notable effect than using AA alone for weight reduction. Larger sample size should be considered in future trials to determine the causal relationship between treatment and effect. TRIAL REGISTRATION: ClinicalTrials.gov NCT03442712; https://clinicaltrials.gov/ct2/show/NCT03442712 (Archived by WebCite at http://www.webcitation.org/78L2tO8Ql).

Epidemiological investigation on hand hygiene knowledge and behaviour: a cross-sectional study on gender disparity.

BACKGROUND: The hand hygiene (HH) behaviour of the general public and its effect on illnesses are issues of growing importance. Gender is associated with HH behaviour. HH efficiency is a combination of washing efficiency and hand drying, but information about the knowledge level and HH behaviour of the general public is relatively limited. The findings of this cross-sectional study can substantially contribute to the understanding on the knowledge gap and public behaviour towards HH, thereby providing information on gender-specific health promotion activities and campaigns to improve HH compliance. METHODS: An epidemiological investigation by using a cross-sectional study design on the general public was conducted either via an online platform (SurveyMonkey) or paper-and-pen methods. The hand-washing and -drying questionnaire was used for data collection. RESULTS: A total of 815 valid questionnaires were collected. Majority of the respondents can differentiate the diseases that can or cannot be transmitted with poor HH, but the HH knowledge of the respondents was relatively inadequate. The female respondents had a significantly better HH knowledge than male respondents. The multiple regression analysis results also indicated that females had a significantly higher knowledge score by 0.288 towards HH than males after adjusting for age and education level. Although the majority of the respondents indicated that they performed hand cleaning under different specific situations, they admitted only using water instead of washing their hands with soap. More males than females dried their hands on their own clothing, whereas more females dried their hands through air evaporation. The average time of using warm hand dryers was generally inadequate amongst the respondents. CONCLUSIONS: Being a female, middle-aged and having tertiary education level are protective factors to improve HH knowledge. Misconceptions related to the concepts associated with HH were noted amongst the public. Self-reported practice on hand drying methods indicated that additional education was needed. The findings of this study can provide information on gender-specific health promotion activities and creative campaigns to achieve sustained improvement in HH practices.

The public washroom - friend or foe? An observational study of washroom cleanliness combined with microbiological investigation of hand hygiene facilities.

Background: Many people use handwashing and hand-drying facilities in public washrooms under the impression that these amenities are hygienic. However, such facilities may be potential sites for the transmission of pathogenic bacteria. This study aimed to examine the hygiene facilities provided including handwashing and hand-drying facilities in public washrooms. Total bacterial counts and species identification were determined for hand-drying facilities. Antimicrobial susceptibilities were performed. Methods: The bacterial contamination levels of 55 public washrooms ranging in category from low class communities to high end establishments, were examined. The hygienic environment and facilities of the washrooms were analysed using an electronic checklist to facilitate immediate data entry. Pre-moistened sterile swabs were used to collect samples from areas around the outlet of paper towel dispensers, air outlet of air dryers, exit door handles and paper towels in the washrooms. Total bacterial counts were performed and isolates identified using matrix-assisted laser desorption ionisation time-of-flight mass spectrometry. Antimicrobial susceptibility was determined by disk diffusion. Results: The high and middle-income categories washrooms generally had cleaner facilities and environment followed by those in low categories. Fifty-two bacterial species were identified from the 55 investigated washrooms. Over 97% of the pathogenic Staphylococcus spp. tested were resistant to at least one first-line antimicrobial therapeutic agent, including penicillin, cefoxitin, erythromycin, co-trimoxazole, clindamycin and gentamicin, and 22.6% demonstrated co-resistance to at least three antimicrobial agents, with co-resistance to penicillin, erythromycin and clindamycin being the most common. Conclusion: Our findings suggest that hand-drying facilities in public washrooms can act as reservoirs of drug-resistant bacteria. The importance of frequent cleaning and maintenance of public washrooms to promote safe hand hygiene practices for the public are emphasised.

Chinese translation and validation of the Sport Concussion Assessment Tool 3 (SCAT3).

OBJECTIVE: The aim of this study was to translate, adapt and validate the Sport Concussion Assessment Tool 3rd edition (SCAT3), a test for assessing athletes for concussion, into the Chinese context. METHODS: Translation and adaptation were performed in several stages, which included forward translation by two independent teams, translation merging, backward translation, reviews by both native Cantonese-speaking and Mandarin-speaking multidisciplinary expert panels (n=49) for semantic and conceptual equivalence and reviews by pitch-side physiotherapists (n=18) as end-users of the SCAT3 and rugby players (n=11) for face validity. The Serial 3 s subtraction test was used as a substitute for the Months Backward Test (MBT) for measures of concentration in the Standardized Assessment of Concussion subscale. English-speaking and Chinese-speaking rugby players (n=52) were recruited to perform these tests to assess the level of difficulty, time for completion and accuracy. Inter-rater and test-retest reliability were assessed in 33 and 38 healthy young individuals, respectively. RESULTS: Despite the longer mean completion time (p<0.05) for the Serial 3 s test, no significant difference was found in the percentage accuracy between MBT and the Serial 3 s test. No significant difference was found in either the percentage accuracy or completion time between English-speaking and Cantonese-speaking rugby players. All subscales in the Chinese SCAT3 had excellent levels of inter-rater reliability for all items (ICC2,1 range: 0.96-0.99) but a low to moderate test-retest reliability (ICC3,2 range: 0.32-0.65). The mean completion time of the Chinese SCAT3 was 10.6±1.1 min. CONCLUSION: Chinese SCAT3 is a valid instrument for pitch-side assessment of concussed Chinese-speaking athletes.

Overexpression of Mechano-Growth Factor Modulates Inflammatory Cytokine Expression and Macrophage Resolution in Skeletal Muscle Injury.

In muscle regeneration, infiltrating myeloid cells, such as macrophages mediate muscle inflammation by releasing key soluble factors. One such factor, insulin-like growth factor 1 (IGF-1), suppresses inflammatory cytokine expression and mediates macrophage polarization to anti-inflammatory phenotype during muscle injury. Previously the IGF-1Ea isoform was shown to be anti-inflammatory. Another isoform of IGF-1, mechano-growth factor (MGF), is structurally and functionally distinct from IGF-1Ea, but its role in muscle inflammation has not yet been characterized. In this study, we hypothesized that MGF expression in muscle injury modulates muscle inflammation. We first investigated changes of transcription and expression of MGF in response to skeletal muscle injury induced by cardiotoxin (CTX) in vivo. At 1-2 days post-injury, Mgf expression was significantly upregulated and positively correlated with that of inflammatory cytokines. Immunostaining revealed that infiltration of neutrophils and macrophages coincided with Mgf upregulation. Furthermore, infiltrating neutrophils and macrophages expressed Mgf, suggesting their contribution to MGF upregulation in muscle injury. Macrophages seem to be the predominant source of MGF in muscle injury, whereas neutrophil depletion did not affect muscle Mgf expression. Given the association of MGF and macrophages, we then studied whether MGF could affect macrophage infiltration and polarization. To test this, we overexpressed MGF in CTX-injured muscles and evaluated inflammatory marker expression, macrophage populations, and muscle regeneration outcomes. MGF overexpression delayed the resolution of macrophages, particularly the pro-inflammatory phenotype. This coincided with upregulation of inflammatory markers. Annexin V-based flow cytometry revealed that MGF overexpression likely delays macrophage resolution by limiting macrophage apoptosis. Although MGF overexpression did not obviously affect muscle regeneration outcomes, the findings are novel and provide insights on the physiological roles of MGF in muscle regeneration.

Qualitative insights into the experiences of living with moderate-to-severe lower urinary tract symptoms among community-dwelling ageing males.

BACKGROUND: Lower urinary tract symptoms (LUTS) comprise a highly prevalent chronic condition among the aging male population. Existing literature on the experiences of men with LUTS is scarce given that only a few studies explored medical care-seeking behaviors and coping strategies. The current understanding of the experiences of elderly males with LUTS is considerably limited. Therefore, the present study aimed to identify the experiences of living with moderate-to-severe LUTS among community-dwelling Chinese ageing males and their coping strategies to facilitate the management of LUTS by healthcare providers. METHODS AND FINDINGS: A qualitative exploratory design using thematic analysis was used. Semi-structured interviews with 24 Chinese ageing males with moderate-to-severe LUTS were conducted. According to the participants, LUTS adversely affect the physical aspects of their daily lives. Most of them were unwilling to seek social support and were even embarrassed to share this topic with their peers. A range of psychological responses could be observed from the participants that range from regarding the condition as a natural life course to loss of one's self-esteem. Most of the interviewees lacked knowledge and held misconceptions toward LUTS, which prevented them from pursuing medical advice. Most of the participants also sought alternative treatments and developed self-help methods to cope with their symptoms. CONCLUSION: LUTS affects the physical and social aspects of sufferers. The findings of this qualitative study can raise awareness about the life experiences, perceptions, misconceptions, and help-seeking behaviors of Chinese elderly with LUTS. Proper health education and advice can be provided for this population.

Association between Auricular Signals and the Risk Factors of Metabolic Syndrome.

Objective: This study aims to determine the association between auricular signals and the risk factors of metabolic syndrome (MS). Methods: A case-control study with an equal number of cases and controls matched by age group and gender was conducted. A total of 204 participants were recruited. Patients were verified as having MS based on the International Diabetes Federation (IDF) criteria. Auricular assessment was conducted in the following sequence: visual inspection, electrical skin resistance test (ESRT), and pressure pain test (PPT). Results: MS+ patients tend to have much more oily auricle complexion than the controls. The 'endocrine' (right) of the participants with MS indicated a significantly higher electrical conductivity compared to that of the controls. The MS group participants experienced significant tenderness on the 'heart' and 'endocrine' acupoints. A number of auricular signals were also associated with the risk factors of MS, including age, gender, smoking status, family history of diabetes, and comorbid illnesses. Both the 'heart' and 'endocrine' acupoints showed the highest sensitivity to tenderness (60.8%), followed by the 'endocrine' (59.8%) and 'pancreas and gallbladder' (55.9%). Conclusions: The results of this study suggest that electrical conductivity and tenderness of a number of auricular points, including the 'heart', 'pancreas and gall bladder', and 'endocrine', are associated with MS and its risk factors. Further investigations with a larger sample size could be conducted to verify the value of these auricular signals on MS risk prediction so that this method can be used as an early screening method for the population with a high MS risk.

Risk factors that predict severe injuries in university rugby sevens players.

OBJECTIVES: To investigate injury incidence and the influence of physical fitness parameters on the risk of severe injuries in players on rugby sevens university teams. DESIGN: Prospective cohort study. METHODS: Rugby players from three universities (N=104; 90M:14F; 20.6±1.9years) were recruited before the beginning of the season. Players underwent pre-season assessments of power, strength, speed, agility, endurance, stability, and flexibility. Throughout the season, rugby-related injury and exposure data were collected. Potential predictor variables were analyzed using Cox proportional regression model to identify risk factors associated with severe injuries (time loss>28days). RESULTS: Thirty-one injuries occurred during the rugby season. The match and training injury incidence rates were 59.3 injuries and 3.3 injuries per 1000 player-hours, respectively. Lower limb injuries were most common and most severe. The ankle joint was the most prevalent site of injury, and ligamentous injury was most common (48.4%). Nine severe injuries were sustained resulting in an average time loss of 51.3±14.6days. Female (hazard ratio [HR]=8.35; 95% confidence intervals [CI]=2.01-34.8), slower (HR=3.51; 95% CI=1.17-10.5), and less agile (HR=2.22; 95% CI=1.26-3.92) players as well as those with hip flexors tightness (HR=1.12; 95% CI=1.00-1.25) were at significantly greater risk for sustaining severe injuries. CONCLUSIONS: Limited studies are available on risk factors associated with amateur rugby players in the Sevens version. The development of gender-specific injury prevention measures that emphasize speed and agility training, and improve hip flexor extensibility may be important to reduce the risk of severe injuries.

Using auriculotherapy for osteoarthritic knee among elders: a double-blinded randomised feasibility study.

BACKGROUND: Osteoarthritic knee (OA knee) is a common condition in the elderly. Exploration of non-invasive complementary therapies for OA knee is warranted given the limitations of pharmacologic therapies. Auriculotherapy (AT) is a therapeutic method in which specific points on the auricle are stimulated to treat various disorders of the body, and the therapeutic value and synergistic effect of laser auriculotherapy (LAT) when combined with magneto-auriculotherapy (MAT) merits further investigation. METHODS: This study adopted a double-blinded four-arm randomized placebo design. The aims of study are (1) to assess the feasibility of AT among elders with OA knee in a future large-scale study, including the use of blinding in subjects and evaluators, acceptance of treatment protocol, and estimating the effect size and attrition rate; and (2) to evaluate the preliminary effect of AT in elders with OA knee. Subjects were randomly divided into four groups with different modes of AT with/without placebo objects. A total of 43 subjects completed the 6-week intervention and post-assessment. Assessments included a numerical rating scale of pain (NRS), the timed-up-and-go test (TUGT), and standard goniometer measurements during knee flexion and extension, Kruskal-Wallis test was used to evaluate differences among groups, and Wilcoxon sign-ranked test for examining within-group comparison. RESULTS: Preliminary results indicated the absence of differences in the NRS, TUGT, and active/passive knee flexion and extension at baseline, as well as post-therapy, between the four groups. Even though the differences of these parameters between groups were not significant, the relative differences of NRS and TUGT in subjects who received combined MAT plus LAT were higher than those treated with MAT or LAT alone, or the placebo group. Four of the six parameters demonstrated significant within group differences in subjects who received MAT and/or LAT, whereas no significant differences were found in the placebo group. CONCLUSION: This study demonstrates that the AT protocol adopted in this study for elders with OA knee is feasible and could be applied in future larger-scale study. Larger sample size should be considered in a future trial to determine the causal relationship between treatment and effect. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02352636 . Registered on 23 January 2015.

Acute Effects of Kinesio Taping on Knee Extensor Peak Torque and Stretch Reflex in Healthy Adults.

Kinesio Tex tape (KT) is used to prevent and treat sports-related injuries and to enhance muscle performance. It has been proposed that the direction of taping may either facilitate or inhibit the muscle by having different effects on cutaneous receptors that modulate excitability of the motor neurons. This study had 2 goals. First, we wished to determine if KT application affects muscle performance and if the method of application facilitates or inhibits muscle performance. This was assessed by measuring isokinetic knee extension peak torque in the knee extensor. Second, we assessed neurological effects of taping on the excitability of the motor neurons by measuring the reflex latency and action potential by electromyography (EMG) in the patellar reflex. The study was a single-blind, placebo-controlled crossover trial with 28 healthy volunteers with no history of knee injuries. Participants received facilitative KT treatment, inhibitory KT treatment, or Hypafix taping of the knee extensor. There were significant differences in the peak torque between 3 treatments (F(2,54) = 4.873, P < 0.01). Post hoc analysis revealed that facilitative KT treatment resulted in higher knee extensor peak torque performance than inhibitory KT treatment (P = 0.036, effect size 0.26). There were, however, no significant differences in the reflex latency (F(2,54) = 2.84, P = 0.067) nor in the EMG values (F(2,54) = 0.18, P = 0.837) in the patellar reflex between the 3 taping applications. The findings suggest that the direction of KT application over the muscle has specific effects on muscle performance. Given the magnitude of effect is small, interpretation of clinical significance should be considered with caution. The underlying mechanism warrants further investigation.

Effects of Cold Water Immersion on Muscle Oxygenation During Repeated Bouts of Fatiguing Exercise: A Randomized Controlled Study.

Postexercise cold water immersion has been advocated to athletes as a means of accelerating recovery and improving performance. Given the effects of cold water immersion on blood flow, evaluating in vivo changes in tissue oxygenation during cold water immersion may help further our understanding of this recovery modality. This study aimed to investigate the effects of cold water immersion on muscle oxygenation and performance during repeated bouts of fatiguing exercise in a group of healthy young adults. Twenty healthy subjects performed 2 fatiguing bouts of maximal dynamic knee extension and flexion contractions both concentrically on an isokinetic dynamometer with a 10-min recovery period in between. Subjects were randomly assigned to either a cold water immersion (treatment) or passive recovery (control) group. Changes in muscle oxygenation were monitored continuously using near-infrared spectroscopy. Muscle performance was measured with isokinetic dynamometry during each fatiguing bout. Skin temperature, heart rate, blood pressure, and muscle soreness ratings were also assessed. Repeated measures ANOVA analysis was used to evaluate treatment effects. The treatment group had a significantly lower mean heart rate and lower skin temperature compared to the control group (P < 0.05). Cold water immersion attenuated a reduction in tissue oxygenation in the second fatiguing bout by 4% when compared with control. Muscle soreness was rated lower 1 day post-testing (P < 0.05). However, cold water immersion had no significant effect on muscle performance in subsequent exercise. As the results show that cold water immersion attenuated decreased tissue oxygenation in subsequent exercise performance, the metabolic response to exercise after cold water immersion is worthy of further exploration.

The involvement of transient receptor potential canonical type 1 in skeletal muscle regrowth after unloading-induced atrophy.

KEY POINTS: Decreased mechanical loading results in skeletal muscle atrophy. The transient receptor potential canonical type 1 (TRPC1) protein is implicated in this process. Investigation of the regulation of TRPC1 in vivo has rarely been reported. In the present study, we employ the mouse hindlimb unloading and reloading model to examine the involvement of TRPC1 in the regulation of muscle atrophy and regrowth, respectively. We establish the physiological relevance of the concept that manipulation of TRPC1 could interfere with muscle regrowth processes following an atrophy-inducing event. Specifically, we show that suppressing TRPC1 expression during reloading impairs the recovery of the muscle mass and slow myosin heavy chain profile. Calcineurin appears to be part of the signalling pathway involved in the regulation of TRPC1 expression during muscle regrowth. These results provide new insights concerning the function of TRPC1. Interventions targeting TRPC1 or its downstream or upstream pathways could be useful for promoting muscle regeneration. ABSTRACT: Decreased mechanical loading, such as bed rest, results in skeletal muscle atrophy. The functional consequences of decreased mechanical loading include a loss of muscle mass and decreased muscle strength, particularly in anti-gravity muscles. The purpose of this investigation was to clarify the regulatory role of the transient receptor potential canonical type 1 (TRPC1) protein during muscle atrophy and regrowth. Mice were subjected to 14 days of hindlimb unloading followed by 3, 7, 14 and 28 days of reloading. Weight-bearing mice were used as controls. TRPC1 expression in the soleus muscle decreased significantly and persisted at 7 days of reloading. Small interfering RNA (siRNA)-mediated downregulation of TRPC1 in weight-bearing soleus muscles resulted in a reduced muscle mass and a reduced myofibre cross-sectional area (CSA). Microinjecting siRNA into soleus muscles in vivo after 7 days of reloading provided further evidence for the role of TRPC1 in regulating muscle regrowth. Myofibre CSA, as well as the percentage of slow myosin heavy chain-positive myofibres, was significantly lower in TRPC1-siRNA-expressing muscles than in control muscles after 14 days of reloading. Additionally, inhibition of calcineurin (CaN) activity downregulated TRPC1 expression in both weight-bearing and reloaded muscles, suggesting a possible association between CaN and TRPC1 during skeletal muscle regrowth.

Optimizing Electrical Stimulation for Promoting Satellite Cell Proliferation in Muscle Disuse Atrophy.

OBJECTIVE: The aim of this study was to investigate the optimal electrical stimulation (ES) protocol in attenuating disuse muscle atrophy by influencing satellite cell activity. DESIGN: This study used a pretest-posttest design. Six ES protocols of different duration (3 hrs day or 2 × 3 hrs day) and frequencies (2, 10, or 20 Hz) were applied on the soleus muscle in mice (n = 8 in each group) that were hindlimb-suspended for 14 days. Muscle mass, cross-sectional area and fiber-type composition, and peak tetanic force of the muscles were measured. Immunohistochemical staining was used to evaluate satellite cell content, activation, proliferation, and differentiation. Cell apoptosis was detected by TdT-mediated dUTP nick end labeling (TUNEL) assay. RESULTS: ES at 2 Hz for 2 × 3 hrs day achieved the best effect in attenuating the loss of muscle fiber cross-sectional area and force. This stimulation parameter led to a 1.2-fold increase in satellite cell proliferation and was effective in rescuing cells from apoptosis. Besides, satellite cells in the atrophic muscles required different stimulation protocols for different cellular activities such as activation, proliferation, and myogenic differentiation. CONCLUSIONS: This study showed that ES at 2 Hz for 2 × 3 hrs day is the optimal protocol for counteracting muscle disuse atrophy.

Descriptors used to define running-related musculoskeletal injury: a systematic review.

STUDY DESIGN: Systematic review. OBJECTIVES: To systematically review the descriptors used to define running-related musculoskeletal injury and to analyze the implications of different definitions on the results of studies. BACKGROUND: Studies have developed their own definitions of running-related musculoskeletal injuries based on different criteria. This may affect the rates of injury, which can be overestimated or underestimated due to the lack of a standard definition. METHODS: Searches were conducted in the Embase, PubMed, CINAHL, SPORTDiscus, LILACS, and SciELO databases, without limits on date of publication and language. Only articles that reported a definition of running-related injury were included. The definitions were classified according to 3 domains and subcategories: (1) presence of physical complaint (symptom, body system involved, region), (2) interruption of training or competition (primary sports involved, extent of injury, extent of limitation, interruption, period of injury), and (3) need for medical assistance. Spearman rank correlation was performed to evaluate the correlation between the completeness of definitions and the rates of injury reported in the studies. RESULTS: A total of 48 articles were included. Most studies described more than half of the subcategories, but with no standardization between the terms used within each category, showing that there is no consensus for a definition. The injury rates ranged between 3% and 85%, and tended to increase with less specific definitions. CONCLUSION: The descriptors commonly used by researchers to define a running-related injury vary between studies and may affect the rates of injuries. The lack of a standardized definition hinders comparison between studies and rates of injuries.

Acute effects of kinesio taping on knee extensor peak torque and electromyographic activity after exhaustive isometric knee extension in healthy young adults.

OBJECTIVE: To evaluate the effect of Kinesio Tex tape and its method of application, Kinesio Taping (KT) on knee extensor performance before and after an exhaustive isometric knee extension exercise. DESIGN: Single-blinded, randomized control trial. SETTING: Centre for Sports Training and Rehabilitation at The Hong Kong Polytechnic University. PARTICIPANTS: Twenty-six healthy volunteers with no history of knee injuries. INTERVENTIONS: Subjects were randomized to either the KT or sham taping group. MAIN OUTCOME MEASURES: The effects of KT on the neuromuscular performance of the knee extensors were measured before and after KT application, and immediately and 5 and 10 minutes after an exhaustive isometric knee extension exercise. RESULTS: Within-group analyses revealed a significant effect of time on the peak torque in isometric knee extension (F2.73,65.44 = 24.5, P < 0.001), but no significant group (F2.73,65.44 = 2.13, P = 0.11) or interaction (F1,24 = 0.59, P = 0.45) effect. A significant time effect (F2.52,60.14 = 3.75, P = 0.02) and a significant time × group interaction (F1,24 = 4.59, P = 0.04) was found for the rate of peak torque development. Post hoc comparisons revealed significantly higher rates in the intervention group (F1,24 = 4.594, P = 0.04) over all 5 tests. No significant effects of time (F4,96 = 0.88, P = 0.48; F2.56,61.35 = 2.75, P = 0.06), group (F4,96 = 0.56, P = 0.69; F2.56,61.35 = 1.16, P = 0.33), or time × group interaction (F1,24 = 2.77, P = 0.11; F1,24 = 0.20, P = 0.66) were found for either the electromechanical delay or electromyographic results, respectively. CONCLUSIONS: The present study suggests that KT shortens the time required to generate peak torque during isometric knee extension, which has important implications for sports performances that require the rapid generation of peak muscular force. CLINICAL RELEVANCE: Kinesio taping is commonly seen in the sports arena. The popularity is presumably due to the general belief in its injury prevention and enhancement of muscle performance. The results of the present findings suggested that KT shortens the time to reach peak torque generation. Aside from this, there is no other significant positive effect on muscle performance. Further investigation on the effects of KT on muscle performance is warranted.

Correlates of illness severity in infectious mononucleosis.

INTRODUCTION: Understanding the spectrum and frequencies of Epstein-Barr virus (EBV) complications and markers of illness severity in immunocompetent patients with primary EBV infection will inform management of patients with EBV-related illnesses. OBJECTIVES: To determine the clinical and laboratory correlates of illness severity among infants, children and youth with infectious mononucleosis (IM). METHODS: Study subjects with confirmed IM were prospectively enrolled. Illness severity was assessed at baseline and at six weeks using a scoring tool. Peripheral blood viral loads served as a measure of viral burden. RESULTS: Among 32 children and young adults with IM, the median age was 16 years (range two to 24 years). The predominant clinical findings were lymphadenopathy (23 of 32 [72%]), pharyngitis (16 of 32 [50%]), fever (nine of 32 [28%]) and splenomegaly (six of 32 [19%]). With respect to symptoms or signs that persisted to at least six weeks after illness onset, the predominant complaint was lymphadenopathy in 35% of subjects available for reassessment. Deranged liver function tests were present at presentation in up to 44% of subjects. Patients with the highest viral loads at presentation had significantly higher illness severity scores associated with fatigue (P=0.02). Other than the scores associated with fatigue, viral load values were not significantly correlated with the illness severity scores at baseline and at six weeks. CONCLUSION: In IM, viral loads are not necessarily correlated with illness severity, with the exception of fatigue. EBV-related hepatitis is common in IM, confirming the status of this virus as a relatively common cause of transient hepatitis in children and youth. This entity is not necessarily a marker of disease severity.

INTRODUCTION: Il faut comprendre le spectre et la fréquence des complications et des marqueurs de gravité du virus d'Epstein-Barr (VEB) chez les patients immunocompétents atteints d'une infection primaire par le VEB pour étayer la prise en charge des patients ayant une maladie liée à ce virus. OBJECTIFS: Déterminer les corrélats cliniques et de laboratoire de gravité de la maladie chez des nourrissons, des enfants et des adolescents atteints de mononucléose infectieuse (MI). MÉTHODOLOGIE: Les sujets atteints d'une MI confirmée ont été enrôlés prospectivement dans l'étude. Les chercheurs ont évalué la gravité de la maladie en début d'étude et au bout de six semaines au moyen d'un outil d'évaluation. Les charges virales du sang périphérique ont été utilisées pour mesurer le fardeau viral. RÉSULTATS: Les 32 enfants et jeunes adultes atteints de MI avaient un âge médian de 16 ans (plage de deux à 24 ans). Les principales observations cliniques étaient une lymphadénopathie (23 cas sur 32 [72 %]), une pharyngite (16 sur 32 [50 %]), de la fièvre (neuf sur 32 [28 %]) et une splénomégalie (six sur 32 [16 %]). Parmi les signes ou symptômes qui ont persisté au moins six semaines après l'apparition de la maladie, la lymphadénopathie était le principal problème chez 35 % des sujets disponibles pour être réévalués. Jusqu'à 44 % des sujets présentaient des anomalies dans les tests de fonction hépatique. Les patients dont la charge virale était la plus élevée à la présentation obtenaient des indices de gravité de la maladie associée à la fatigue considérablement plus marqués (P=0,02). À part les indices associés à la fatigue, les valeurs de la charge virale n'avaient pas de corrélation significative avec les indices de gravité de la maladie en début d'étude et au bout de six semaines. CONCLUSION: En cas de MI, les charges virales ne sont pas nécessairement corrélées avec la gravité de la maladie, à l'exception de la fatigue. L'hépatite liée au VEB est courante en présence de MI. Ainsi, ce virus est une cause relativement fréquente d'hépatite transitoire chez les enfants et les adolescents. Cette entité n'est pas nécessairement un marqueur de gravité de la maladie.

Acute Whole-Body Vibration does not Facilitate Peak Torque and Stretch Reflex in Healthy Adults.

The acute effect of whole-body vibration (WBV) training may enhance muscular performance via neural potentiation of the stretch reflex. The purpose of this study was to investigate if acute WBV exposure affects the stretch induced knee jerk reflex [onset latency and electromechanical delay (EMD)] and the isokinetic knee extensor peak torque performance. Twenty-two subjects were randomly assigned to the intervention or control group. The intervention group received WBV in a semi-squat position at 30° knee flexion with an amplitude of 0.69 mm, frequency of 45 Hz, and peak acceleration of 27.6 m/s(2) for 3 minutes. The control group underwent the same semii-squatting position statically without exposure of WBV. Two-way mixed repeated measures analysis of variance revealed no significant group effects differences on reflex latency of rectus femoris (RF) and vastus lateralis (VL; p = 0.934 and 0.935, respectively) EMD of RF and VL (p = 0.474 and 0.551, respectively) and peak torque production (p = 0.483) measured before and after the WBV. The results of this study indicate that a single session of WBV exposure has no potentiation effect on the stretch induced reflex and peak torque performance in healthy young adults. Key PointsThere is no acute potentiation of stretch reflex right after whole body vibration.Acute whole body vibration does not improve mus-cle peak torque performance in healthy young adults.