Evaluation of inter-rater and test-retest reliability for near-infrared spectroscopy reactive hyperemia measures.

BACKGROUND: Near-infrared spectroscopy (NIRS) is a non-invasive tool used to measure blood flow in peripheral tissues. More information on inter-rater agreement and test-retest reliability of NIRS-based reperfusion assessments is needed. PURPOSE: To assess inter-rater agreement for NIRS based data analysis, and evaluate the measurement's reliability across days. METHODS: On three separate days (average days between visits 1 and 3: 19.4 ± 6.9 days), participants' (N = 15 males, 22 ± 2 yr.) post-occlusion reactive hyperemia (PORH) was measured in the left gastrocnemius muscle using Continuous-Wave NIRS (CW-NIRS). A blood pressure cuff was placed proximal to the knee and inflated to occlude lower leg blood flow for 5 min. The following CW-NIRS parameters were selected: (1) percent saturation in HbO2 (StO2%) at baseline; (2) the O2Hb range used to normalize the NIRS signal; (3) the time for the O2Hb signal to reach 50 % peak post-occlusion hyperemia (T1/2), and (4) the post peak hyperemic O2Hb recovery slope (O2REC-SLP). Absolute agreement between the two analysts was calculated using two-way random effects Intraclass Correlation Coefficients (ICC2,1). Consistency between analysts and across days was calculated using two-way mixed models (ICC3,1). Mean and 95 % confidence intervals (CI) of ICCs are reported. Coefficient of variation (CV) and standard error of the measurement (SEM) are reported. RESULTS: The ICC2,1 data indicated "adequate" to "excellent" absolute agreement between the two NIRS analysts. ICC2,3 data indicated "adequate" to "good" reliability across visits. The CV and SEM for rater 1 and rater 2 across visit were StO2 (CV: 3.79 % ± 2.71 % and 4.50 % ± 2.37 %; SEM: 3.42 and 3.82), O2Hb range (CV: 10.50 ± 5.93 and 12.79 ± 12.41; SEM: 3.26 and 4.71), T1/2 (CV: 11.15 % ± 5.52 % and 10.96 % ± 4.50; SEM: 1.22 and 1.11), and O2REC-SLP (CV: 19.49 % ± 9.99 % and 18.45 % ± 9.48 %; SEM: 0.04 and 0.04). CONCLUSION: It is concluded that NIRS parameters assessed show adequate reliability between analysts and across three visits. It is recommended, when feasible and because of the absence of 100 % reliability, that investigators employ more than one rater for scoring at least a portion of the data across each trial in a study's control condition in order to have the ability to estimate the magnitude of error attributable to imperfect reliability.

Influence of Regular Physical Activity on Sleep.

Good sleep and adequate physical activity are essential to health. Yet, large numbers of people are chronically deficient in sleep and physical activity. About 1 in 3 Americans get less than 7 h of sleep per night and only 1 of 4 adults regularly complete weekly physical activity in amounts recommended for good health. This chapter reviews research that has examined relationships between regular physical activity and sleep. The overall weight of evidence supports that regular physical activity is associated with better sleep quality among healthy adults, with epidemiological studies showing moderate-sized effects and more well-controlled randomized controlled trial experiments often showing larger effects. Large epidemiology studies suggest that the relationship between regular physical activity and better sleep quality may partially mediate the well-established associations between physical activity and reduced risk of mortality, cardiovascular diseases, and dementia. There is evidence that the completion of regular physical activity also is associated with better sleep quality among those with certain sleep disorders (i.e., insomnia, obstructive sleep apnea, and restless legs syndrome), mental health disorders (i.e., depression and posttraumatic stress disorder), and medical illnesses (i.e., breast cancer survivors). The evidence is inadequate to support that regular physical activity substantially improves sleep quality either (i) in children, adolescents, and older adults, (ii) in those with cancers except for breast cancer, (iii) in those with fibromyalgia, or (iv) among those with chronic kidney disease. Also, there is inadequate evidence to conclude that sleep quality is disrupted during weeks when competitive athletes engage in periods of overtraining.

Cerebrovascular carbon dioxide reactivity is intact in chronic kidney disease.

Chronic kidney disease (CKD) is characterized by an elevated risk for cerebrovascular disease including stroke. One mechanism that may contribute to this heightened risk is an impairment in cerebrovascular carbon dioxide reactivity (CVR). We compared CVR between CKD patients stages III-IV and controls (CON) without CKD but matched for hypertension and diabetes status. CVR was measured via 5% CO2 inhalation followed by voluntary hyperventilation in 14 CKD and 11 CON participants while mean arterial pressure, end-tidal carbon dioxide, and middle cerebral artery blood velocity (MCAv) were measured continuously. CVR was quantified as the linear relationship between etCO2 and MCAv. We observed no difference in CVR between groups. Hypercapnic CVR: CKD = 1.2 ± 0.9 cm/s/mm Hg, CON = 1.3 ± 0.8 cm/s/mm Hg, hypocapnic CVR: CKD = 1.3 ± 0.9 cm/s/mm Hg, CON = 1.5 ± 0.7 cm/s/mm Hg, integrated CVR: CKD = 1.5 ± 1.1 cm/s/mm Hg, CON = 1.7 ± 0.8 cm/s/mm Hg, p ≥ 0.48. Unexpectedly, CVR was inversely related to estimated glomerular filtration rate in CKD (R2 = 0.37, p = 0.02). We report that CVR remains intact in CKD and is inversely related to eGFR. These findings suggest that other mechanisms beyond CVR contribute to the elevated stroke risk observed in CKD.

Identification of functional single nucleotide polymorphism of Populus trichocarpa PtrEPSP-TF and determination of its transcriptional effect.

In plants, the phenylpropanoid pathway is responsible for the synthesis of a diverse array of secondary metabolites that include lignin monomers, flavonoids, and coumarins, many of which are essential for plant structure, biomass recalcitrance, stress defense, and nutritional quality. Our previous studies have demonstrated that Populus trichocarpa PtrEPSP-TF, an isoform of 5-enolpyruvylshikimate 3-phosphate (EPSP) synthase, has transcriptional activity and regulates phenylpropanoid biosynthesis in Populus. In this study, we report the identification of single nucleotide polymorphism (SNP) of PtrEPSP-TF that defines its functionality. Populus natural variants carrying this SNP were shown to have reduced lignin content. Here, we demonstrated that the SNP-induced substitution of 142nd amino acid (PtrEPSP-TFD142E) dramatically impairs the DNA-binding and transcriptional activity of PtrEPSP-TF. When introduced to a monocot species rice (Oryza sativa) in which an EPSP synthase isoform with the DNA-binding helix-turn-helix (HTH) motif is absent, the PtrEPSP-TF, but not PtrEPSP-TFD142E, activated genes in the phenylpropanoid pathway. More importantly, heterologous expression of PtrEPSP-TF uncovered five new transcriptional regulators of phenylpropanoid biosynthesis in rice. Collectively, this study identifies the key amino acid required for PtrEPSP-TF functionality and provides a strategy to uncover new transcriptional regulators in phenylpropanoid biosynthesis.

PGC-1α overexpression partially rescues impaired oxidative and contractile pathophysiology following volumetric muscle loss injury.

Volumetric muscle loss (VML) injury is characterized by a non-recoverable loss of muscle fibers due to ablative surgery or severe orthopaedic trauma, that results in chronic functional impairments of the soft tissue. Currently, the effects of VML on the oxidative capacity and adaptability of the remaining injured muscle are unclear. A better understanding of this pathophysiology could significantly shape how VML-injured patients and clinicians approach regenerative medicine and rehabilitation following injury. Herein, the data indicated that VML-injured muscle has diminished mitochondrial content and function (i.e., oxidative capacity), loss of mitochondrial network organization, and attenuated oxidative adaptations to exercise. However, forced PGC-1α over-expression rescued the deficits in oxidative capacity and muscle strength. This implicates physiological activation of PGC1-α as a limiting factor in VML-injured muscle's adaptive capacity to exercise and provides a mechanistic target for regenerative rehabilitation approaches to address the skeletal muscle dysfunction.