Sex differences in the detection of motor unit action potentials identified using high-density surface electromyography

Sex-related disparities in force production of humans have been widely observed. Previous literature has attributed differences in peripheral traits, such as muscle size, to explain these disparities. However, less is known about potential sex-related differences in central neuromuscular traits and many comparable studies, not exploring sex-related differences, exhibit a selection-bias in the recruitment of subjects making the generalization of their findings difficult. Utilizing high-density electromyography arrays and motor unit (MU) decomposition, the aim of the current study is to compare MU yield and discharge properties of the tibialis anterior between male and female humans. Twenty-four subjects (10 females) performed two submaximal (20%) isometric dorsiflexion contractions. On average, males yielded nearly twice the amount of MUs as females. Further, females had significantly higher MU discharge rate, lower MU action potential amplitude, and lower MU action potential frequency content than males despite similar levels of torque and MU discharge variability. These findings suggest differences in central neuromuscular control of force production between sexes; however, it is unclear how lower yield counts affect the accuracy of these results.     

Faster intrinsic rate of torque development in elbow flexors than knee extensors: Effect of muscle architecture?

We studied the effect of pennate vs. fusiform muscle architecture on the rate of torque development (RTD) by examining the predominately fusiform elbow flexors (EF) and highly-pennate knee extensors (KE). Seventeen male volunteers (28.4 ± 6.2 years) performed explosive isometric EF and KE contractions (MVCs). Biceps brachii and vastus lateralis fascicle angles were measured to confirm their architecture, and both the rate of voluntary muscle activation (root-mean-square EMG in the 50 ms before contraction onset; EMG_-50) and electromechanical delay (EMD; depicting muscle-tendon series elasticity) were assessed as control variables to account for their influence on RTD. MVC torque, early (RTD₅₀) and late (RTD₂₀₀) RTDs were calculated and expressed as absolute and normalized values. Absolute MVC torque (+412%), RTD₅₀ (+215%), and RTD₂₀₀ (+427%) were significantly (p < 0.001) higher in KE than EF. However, EF RTD₅₀ was faster (+178%) than KE after normalization (p = 0.02). EMG_-50 and EMD did not differ between muscle groups. The results suggest that the faster absolute RTD in KE is largely associated with its higher maximal torque capacity, however in the absence of differences in rates of muscle activation, fiber type, and EMD the fusiform architecture of EF may be considered a factor allowing its faster early RTD relative to strength capacity.     

Normalising surface EMG of ten upper-extremity muscles in handcycling: Manual resistance vs. sport-specific MVICs

Muscular activity in terms of surface electromyography (sEMG) is usually normalised to maximal voluntary isometric contractions (MVICs). This study aims to compare two different MVIC-modes in handcycling and examine the effect of moving average window-size. Twelve able-bodied male competitive triathletes performed ten MVICs against manual resistance and four sport-specific trials against fixed cranks. sEMG of ten muscles [M. trapezius (TD); M. pectoralis major (PM); M. deltoideus, Pars clavicularis (DA); M. deltoideus, Pars spinalis (DP); M. biceps brachii (BB); M. triceps brachii (TB); forearm flexors (FC); forearm extensors (EC); M. latissimus dorsi (LD) and M. rectus abdominis (RA)] was recorded and filtered using moving average window-sizes of 150, 200, 250 and 300 ms. Sport-specific MVICs were higher compared to manual resistance for TB, DA, DP and LD, whereas FC, TD, BB and RA demonstrated lower values. PM and EC demonstrated no significant difference between MVIC-modes. Moving average window-size had no effect on MVIC outcomes. MVIC-mode should be taken into account when normalised sEMG data are illustrated in handcycling. Sport-specific MVICs seem to be suitable for some muscles (TB, DA, DP and LD), but should be augmented by MVICs against manual/mechanical resistance for FC, TD, BB and RA.     

The accuracy of needle electrode placement by trainees in selected forearm muscles using verification by neuromuscular ultrasound

IntroductionAnatomic landmarks alone may not always be sufficient to accurately guide electromyography (EMG) electrode needle placement.MethodsSenior residents and fellows (n = 11) targeted 4 forearm muscles with anatomic landmarks alone versus with audiovisual EMG feedback. Accuracy of EMG needle placement was verified using neuromuscular ultrasound imaging.ResultsWhile relatively large and superficial FCR muscle was sampled at a rate of 100% with and without audiovisual EMG feedback, accuracy of deeper and/or smaller forearm muscles (FPL, EIP, and SUP) diminished significantly without audiovisual EMG feedback.DiscussionOur study suggests that in clinical scenarios in which an electrodiagnostician relies on anatomic landmarks alone to target small and deep muscles, the risk of misplacement of needle electrode is increased. Consideration for neuromuscular ultrasound to augment training and/or real time guidance in EMG practice may be appropriate.     

Post-COVID-19 effect on biochemical parameters in children: Should we take heed?

The aim of this research is to analyze the potential impact of the COVID-19 infection on the serum biochemical concentration of children 6 months after recovery from the infection.The study included 72 children with a median age of 11 years. The case group consisted of 37 children who had contracted COVID-19 6 months prior to the analysis. They reported no other pre- or post-covid chronic or systemic diseases. The control group consisted of 35 children who had no prior record of COVID-19 infection.The analysis showed a substantial variation (P = 0.026) in the mean urea values (mmol/L) between the case group (4.513 ± 0.839) and the control group (5.425 ± 1.173). However, both groups' urea levels were within the normal range of their age group. No statistical differences were found analyzing the variations between the two groups in the levels of LDH, AST, ALT, BiliT, GGT, AlbBCG2, CRP, CK, AlKP, UA, Phos, Crea2, Gluc, Ca, Na, K, Cl, TP, TC, TG, and HDL (P > 0.05). The DMFT score was substantially greater (P < 0.002) in the infected team (5.38 ± 2.841) in comparison to the non-infected group (2.6 ± 2.257).The study indicates that COVID-19 infection does not leave biochemical alterations among children who did not have pre-existing conditions. The biochemical analysis suggests that children recover better than adults from COVID-19. Furthermore, it calls for investigating non-lethal COVID-19 infection as a tool to discover underlying conditions. The DMFT score shows a correlation between COVID-19 infection and caries. However, the nature of the correlation is yet to be investigated.     

Early vs. late rate of torque development: Relation with maximal strength and influencing factors

We re-examined the relationship between rate of torque development (RTD) and maximal voluntary contractions (MVC) torque, and investigated some possible neuromuscular determinants of early (≤100 ms) and late (≥200 ms) RTD. Seventeen healthy men performed maximal explosive isometric knee extensions at five joint angles, from which MVC torque, RTD at different time intervals (50–250 ms), and early quadriceps EMG activity (EMG₅₀) were evaluated. Quadriceps muscle thickness (MT) was quantified by longitudinal ultrasonography. The relationship between MVC torque, EMG₅₀ and MT against RTD was assessed with Pearson’s and repeated measures correlation coefficients. Moderate-to-strong correlation coefficients were observed between MVC torque and RTD (r = 0.50–0.88, p < 0.001), with stronger relationships for late RTD than for early RTD. Weak-to-strong correlation coefficients were observed amongst RTD and EMG₅₀ (r = 0.37–0.83, p < 0.001), with stronger relationships for early RTD than for late RTD. Only late RTD was significantly correlated with MT, though only moderately (r = 0.50–0.52, p < 0.05). These findings suggest that early and late knee extension RTD are potentially governed by different neuromuscular factors. Neuromuscular activation seems to have a greater influence on early RTD than on late RTD, and vice versa for muscle mass.     

Fatty Liver Through the Ages: Nonalcoholic Steatohepatitis

ObjectiveThe global epidemic of obesity and type 2 diabetes mellitus is the main driver of the growing global prevalence of nonalcoholic fatty liver disease (NAFLD). We aimed to review the current literature on NAFLD and nonalcoholic steatohepatitis (NASH) as it impacts children and adults.MethodsWe performed a literature search on fatty liver specifically NAFLD and NASH among children and adults.ResultsThe prevalence of NAFLD in children ranges from 8% to 12%, while the prevalence in adults ranges 25% to 48%. The prevalence of NASH among children with NAFLD is 23%, while it ranges from 13% to 65% in adults. There are similar risk factors for NAFLD among children and adults. However, in children, the diagnostic tests in the studies of NAFLD are limited to the elevation of the alanine aminotransferase level or a liver biopsy. In adults, additional diagnostic modalities, including noninvasive tests, have been used. From the spectrum of NAFLD, patients with NASH are predominantly at risk of progressive liver disease to cirrhosis and liver-related mortality. NAFLD is associated with impairment of health-related quality of life and substantial economic burden.ConclusionThe comprehensive burden (clinical, health-related quality of life, and economic) of NAFLD is high and increasing.     

Different plantar flexors neuromuscular and mechanical characteristics depending on the preferred running form

Two main types of endurance runners have been identified: aerial runners (AER), who have a larger flight time, and terrestrial runners (TER), who have a longer ground contact time. The purpose of this study was to assess the neuromuscular characteristics of plantar flexors between AER and TER runners. Twenty-four well-trained runners participated in the experiment. They were classified either in a TER or AER group according to the Volodalen® scale. Plantar flexors’ maximal rate of force development (RFD) and maximal voluntary contraction force (MVC) were assessed. Percutaneous electrical stimulation was delivered to the posterior tibial nerve to evoke maximal M-waves and H-reflexes of the triceps surae muscles. These responses, as well as voluntary activation, muscle potentiation, and V-waves, were recorded by superimposing stimulations to MVCs. RFD was significantly higher in AER than in TER, while MVC remained unchanged. This was accompanied by higher myoelectrical activity recorded in the soleus muscle. While M-waves and other parameters remained unchanged, maximal H-reflex was significantly higher in AER than in TER, still in soleus only. The present study raised the possibility of different plantar flexors’ neuromuscular characteristics according to running profile. These differences seemed to be focused on the soleus rather than on the gastrocnemii.     

l-carnitine: Nutrition,pathology, and health benefits

Carnitine is a medically needful nutrient that contributes in the production of energy and the metabolism of fatty acids. Bioavailability is higher in vegetarians than in people who eat meat. Deficits in carnitine transporters occur as a result of genetic mutations or in combination with other illnesses such like hepatic or renal disease. Carnitine deficit can arise in diseases such endocrine maladies, cardiomyopathy, diabetes, malnutrition, aging, sepsis, and cirrhosis due to abnormalities in carnitine regulation. The exogenously provided molecule is obviously useful in people with primary carnitine deficits, which can be life-threatening, and also some secondary deficiencies, including such organic acidurias: by eradicating hypotonia, muscle weakness, motor skills, and wasting are all improved l-carnitine (LC) have reported to improve myocardial functionality and metabolism in ischemic heart disease patients, as well as athletic performance in individuals with angina pectoris. Furthermore, although some intriguing data indicates that LC could be useful in a variety of conditions, including carnitine deficiency caused by long-term total parenteral supplementation or chronic hemodialysis, hyperlipidemias, and the prevention of anthracyclines and valproate-induced toxicity, such findings must be viewed with caution.     

Influence of the number of muscles and strides on selective motor control during gait in individuals with cerebral palsy

ObjectiveTo evaluate the influence of the number of muscles and strides on estimating motor control accuracy during treadmill-gait, in individuals with cerebral palsy (CP).MethodsBilateral lower limb electromyography data were extracted for 44 children/adolescents with CP. The number of synergy solutions required to explain 90 % of the variance (tVAF-threshold) and the total variance accounted for by one synergy (tVAF₁) were calculated for a different number of strides (between 5 and 50) and muscles both unilaterally (four to seven) and bilaterally (eight to 14). The kappa and intraclass correlation coefficients were used to assess similarities in tVAF-threshold and tVAF₁ between the different number of strides and muscle sets.ResultsIn both analyses, the number of muscles influenced the tVAF-threshold. Additionally, using <30 strides led to only substantial-moderate agreement with 50 strides (k < 0.80). In both analyses, the mean tVAF₁ values demonstrated high-agreement between the different number of muscles (intraclass-correlations = 0.88–0.93) and strides (intraclass-correlations = 0.96–0.99); In the group level, it may result in an error of ≤2.3 %. However, in the individual level, using different number of muscles or <40 strides may result in an error of ≥6 %.ConclusionDiffering numbers of muscles and strides did not influence the group mean tVAF₁ value, but it influenced the tVAF-threshold value. In addition, using different number of muscles or strides can lead to a large measurement error in the individual tVAF₁ value.     

Ergonomics for surgeons – prototype of an external surgeon support system reduces muscular activity and fatigue

BackgroundSince the unergonomic postures cannot be changed during a surgery, it seems reasonable to externally support the surgeon's posture in order to relieve the musculature. To evaluate this matter, we conducted a pilot study to investigate if a prototype of an external surgeon support system (S3) relieves the musculature in an objectively measurable manner.MethodsSimultaneous surface electromyography (EMG) was used alongside a combination of a laser Doppler flowmeter and a tissue spectrometer to record back and leg muscles during a simulated surgical situation.FindingsWith S3, muscle activity was significantly lower (p < 0.05) and also fatigue decreased when compared to without S3. Muscle blood flow and oxygenation were relatively close to baseline with S3, but increased without S3.InterpretationAn ergonomic S3 is a possible approach to reduce muscle activity and fatigue and may therefore prevent chronic back pain amongst surgeons in the long term.     

Community-based observational assessment of compliance by the public with COVID19 preventive measures in the south of Saudi Arabia

BackgroundAt the end of August 2020, a surge in the number of cases in the Jazan region has been observed. The number of reported cases by 19th of August in the Jazan region was more than 300, which exceeded the number of reported cases in larger regions such as Riyadh, and Makkah. This study aims to measure compliance by the public with COVID-19 preventive measures.MethodsThis study was a cross-sectional, field-based observational assessment of compliance by individuals in public settings with COVID-19 preventive measures in the Jazan region of Saudi Arabia. The assessment was performed in the last week of July 2020. The assessment was based on observing the actual compliance of individuals and different establishments in the Jazan region with COVID-19 preventive measures. To perform the field observations, a standardised check-list was adopted from COVID-19 preventive measures in the community, which was developed by the Saudi Centre for Disease Prevention and Control (CDC).ResultsA total of 1096 individuals were observed in 69 different locations in the Jazan region. Compliance by the observed individuals was variable depending on the age group, the setting and the recommended preventive practice. The findings indicate very low compliance of specific precautionary measures within public parks in comparison to other measured settings. Proportions of individuals not compliant with mask-wearing instructions varied according to settings and age group from 5% in malls and shopping areas to nearly 83% in public parks. Additionally, Proportions of children not compliant with mask-wearing instructions was higher in comparison to adults in all observed settings.ConclusionsThe findings of this study identified variability in the levels of compliance with specific preventive measures against COVID-19. Further assessment is needed to explore factors associated with the limited observed compliance, in particular with regard to limited compliance to precautionary measures applied in specific settings and compliance of children to mask-wearing instructions.     

Partial substitution of organic nitrogen with synthetic nitrogen enhances rice yield,grain starch metabolism and related genes expression under the dual cropping system

Improving grain filling in the presernt farming systems is crucial where grain filling is a concern due to the extreme use of chemical fertilizers (CF). A field experiment was conducted at the experimental station of Guangxi University, China in 2019 to test the hypothesis that cattle manure (CM) and poultry manure (PM) combined with CF could improve rice grain filling rate, yield, biochemical and qualitative attributes. A total of six treatments, i.e., no fertilizer (T₁), 100% CF (T₂), 60% CM + 40% CF (T₃), 30% CM + 70% CF (T₄), 60% PM + 40% CF (T₅), and 30% PM + 70% CF (T₆) were used in this study. Results showed that the combined treatment T₆increased starch metabolizing enzymes activity (SMEs), such as ADP-glucose phosphorylase (ADGPase) by 8 and 12%, soluble starch synthase (SSS) by 7 and 10%, granule bound starch synthesis (GBSS) by 7 and 9%, and starch branching enzyme (SBE) by 14 and 21% in the early and late seasons, respectively, compared with T₂. Similarly, higher rice grain yield, grain filling rate, starch, and amylose content were also recorded in combined treatments. In terms of seasons, higher activity of SMEs , grain starch, and amylose content was noted in the late-season compared to the early season. The increment in these traits was mainly attributed to a lower temperature in the late season during the grain filling period. Furthermore, our results suggested that an increment in starch accumulation and grain filling rate were mainly associated with the enhanced sink capacity by regulating key enzyme activities involved in Suc-to-starch conversion. In-addition, RT-qPCR analysis showed higher expression levels of AGPS2b, SSS1, GBSS1, and GBSE11b genes, which resultantly increased the activities of SMEs during the grain filling period under combined treatments. Linear regression analysis revealed that the activity of ADGPase, SSS, GBSS, and SBE were highly positively correlated with starch and amylose accumulation. Thus, we concluded that a combination of 30% N from PM or CM with 70% N from CF is a promising option in terms of improving rice grain yield and quality. Our study provides a sustainable fertilizer management strategy to enhance rice grain yield and quality at the lowest environmental cost.     

The effect of mild whole-body cold stress on isometric force control during hand grip and key pinch tasks

Prolonged exposure to cold can impair manual performance, which in turn can affect work task performance. We investigated whether mild whole-body cold stress would affect isometric force control during submaximal hand grip and key pinch tasks. Twelve male participants performed isometric hand grip and key pinch tasks at 10% and 30% of maximal voluntary contraction (MVC) for 30 and 10 s respectively, in cold (8 °C) and control (25 °C) conditions. Finger temperature decreased significantly by 18.7 ± 2.1 °C and continuous low-intensity shivering in the upper trunk increased significantly in intensity and duration during cold exposure. Rectal temperature decreased similarly for the 8 °C and 25 °C exposures. Force variability (FCv) was <2% for the hand grip tasks, and <3% for the key pinch tasks. No significant changes in FCv or force accuracy were found between the ambient temperatures. In conclusion, isometric force control during hand grip and key pinch tasks was maintained when participants experienced mild whole-body cold stress compared with when they were thermally comfortable.     

Studies on fragment-based design of allosteric inhibitors of human factor XIa

Human factor XIa (hFXIa) has emerged as an attractive target for development of new anticoagulants that promise higher level of safety. Different strategies have been adopted so far for the design of anti-hFXIa molecules including competitive and non-competitive inhibition. Of these, allosteric dysfunction of hFXIa’s active site is especially promising because of the possibility of controlled reduction in activity that may offer a route to safer anticoagulants. In this work, we assess fragment-based design approach to realize a group of novel allosteric hFXIa inhibitors. Starting with our earlier discovery that sulfated quinazolinone (QAO) bind in the heparin-binding site of hFXIa, we developed a group of two dozen dimeric sulfated QAOs with intervening linkers that displayed a progressive variation in inhibition potency. In direct opposition to the traditional wisdom, increasing linker flexibility led to higher potency, which could be explained by computational studies. Sulfated QAO 19S was identified as the most potent and selective inhibitor of hFXIa. Enzyme inhibition studies revealed that 19S utilizes a non-competitive mechanism of action, which was supported by fluorescence studies showing a classic sigmoidal binding profile. Studies with selected mutants of hFXIa indicated that sulfated QAOs bind in heparin-binding site of the catalytic domain of hFXIa. Overall, the approach of fragment-based design offers considerable promise for designing heparin-binding site-directed allosteric inhibitors of hFXIa.     

Current scenario of COVID-19 in pediatric age group and physiology of immune and thymus response

COVID-19 pandemic caused by SARS-CoV-2, continues to manifest with severe acute respiratory syndrome among the adults, however, it offers a convincing indication of less severity and fatality in pediatric age group (0–18 years). The current trend suggests that children may get infected but are less symptomatic with less fatality, which is concordant to earlier epidemic outbreaks of SARS-CoV and MERS-CoV, in 2002 and 2012, respectively. According to the available data, children appear to be at lower risk for COVID-19, as adults constitute for maximum number of the confirmed cases (308,592) and deaths (13,069) as on 22nd March (https://www.worldometers.info/coronavirus). However, rapid publications and information of the adult patients with COVID-19 is in progress and published, on the contrary, almost no comprehensive data or discussion about the COVID-19 in children is available. Therefore, in this review, we outline the epidemiology, clinical symptoms, diagnosis, treatment, prevention, possible immune response and role of thymus in children to combat the COVID-19 outbreak.     

The neural control of coactivation during fatiguing contractions revisited

In addition to the role of muscle coactivation, a major question in the field is how antagonist activation is controlled to minimize its opposing effect on agonist muscle performance. Muscle fatigue is an interesting condition to analyze the neural adjustments in antagonist muscle activity and to gain more insights into the control mechanisms of coactivation. In that context, previous studies have reported that although the EMG activity of agonists and antagonists increase in parallel, the ratio between EMG activities in the two sets of muscles during a fatiguing submaximal contraction decreased progressively and contributed to a reduction in the time to task failure. In contrast, more recent studies using a novel normalization procedure indicated that the agonist/antagonist ratio remained relatively constant, suggesting that the fatigue-related increase in coactivation does not impede performance. Current knowledge also indicates that peripheral mechanisms cannot by themselves mediate the intensity of antagonist coactivation during fatiguing contractions, implying that supraspinal mechanisms are involved. The unique modulation of the synaptic input from Ia afferents to the antagonist motor neurones during a fatiguing contraction of the agonist muscles further suggests a separate control of the two sets of muscles.     

Expression analysis of irisin during different development stages of skeletal muscle in mice

BackgroundAs a newly discovered muscle factor secreted by skeletal muscle cells, irisin is a polypeptide fragment formed from hydrolysis of fibronectin type Ⅲ domain-containing protein 5 (FNDC5). Irisin can promote beigeing of white adipose tissue (WAT) and regulate glucose and lipid metabolisms. However, the functions of irisin in skeletal muscle development remain largely unknown. In order to characterize the expression of irisin, this study investigated the expression of irisin precursor FNDC5 in myoblasts and skeletal muscles during different developmental stages of SPF mice.ResultsThe Western blot, quantitative real-time PCR (qRT-PCR), and immunofluorescence assay results showed that FNDC5 was expressed in all the developmental stages of myoblasts and gastrocnemius, but its expression differed at different stages. FNDC5 protein exhibited the highest expression in gastrocnemius of sexually mature mice, followed by elderly mice and adolescent mice, and it displayed the lowest expression in pups. Additionally, FNDC5 protein was mainly expressed in cytoplasm, and it had the highest expression in primary myoblasts, followed by the myotubes with the lowest expression in C2C12 myogenic cells.ConclusionsOverall, FNDC5 was mainly expressed in cytoplasm and extracellular matrix with different expression levels at different developmental stages of skeletal muscle cells and tissues in mice. This study will provide new strategies for promoting skeletal muscle development and treating muscle- and metabolism-related disease by using irisin.     

Beyond Body Mass Index - Body Composition Assessment by Bioimpedance in Routine Endocrine Practice

ObjectiveTo explore the body composition of pediatric patients referred for endocrine evaluation.MethodsThis real-life observational study conducted between January 2018 and January 2020 included 10 001 clinic visits of 3500 children and adolescents; first visits of 5 to 18-year-old patients were included. Anthropometric data, blood pressure levels, pubertal status, and bioelectrical impedance analysis (BIA, Tanita MC-780 MA) were extracted from medical files. Excluded from the analysis were patients participating in other studies.ResultsA total of 1001 patients (48% boys, mean age 11.3 ± 3.4 years, 33.5% prepubertal) were included. Mean anthropometric z-scores were normal and similar for boys and girls. Sex differences in body composition were as follows: boys had lower fat percentage, lower truncal fat percentage, higher appendicular skeletal muscle mass, and a higher muscle-to-fat ratio (MFR) than girls (P < .001 for all). MFR correlated with body mass index-standard deviation scores (BMI-SDS) in overweight/obese patients (r = −0.558, P < .001), although not in underweight patients. Systolic blood pressure (SBP) correlated with BMI-SDS in overweight/obese patients (r = 0.262, P < .001), although not in underweight patients. Diastolic blood pressure (DBP) did not correlate with BMI-SDS in either group of extreme weight status. MFR correlated with SBP and DBP in overweight/obese patients (r = −0.230, P < .001 and r = −0.141, P = .018, respectively) as well as in underweight patients (r = 0.331, P < .001 and r = 0.264, P = .005, respectively).ConclusionsOur findings support BIA for a more refined characterization of patients referred for endocrine evaluation than BMI-SDS. MFR may be a better surrogate marker of blood pressure levels than BMI-SDS in both underweight and overweight/obese pediatric patients.