Reply to ”Laterality of Motor Control as Revealed in Biceps Electromyography: Why Seizures Always Start in the Major Hemisphere”

We are very grateful for Dr Derakhshan's interest and comments (Derakhshan, 2016) regarding our recent study on electromyographical changes in epileptic seizures (Hagge et al., 2016).

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Laterality of Motor Control as Revealed in Biceps Electromyography: Why Seizures Always Start in the Major Hemisphere

As a clinical neurologist with interest in laterality of motor control and epilepsy, I read the recent contribution by Hagge and colleagues to the Journal with great interest and have the following observations and comments:

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Social and nonsocial affective processing in schizophrenia – An ERP study

Publication date: Available online 18 June 2016
Source:International Journal of Psychophysiology
Author(s): Ł. Okruszek, A. Wichniak, M. Jarkiewicz, A. Schudy, M. Gola, K. Jednoróg, A. Marchewka, E. Łojek
Background: Despite social cognitive dysfunction that may be observed in patients with schizophrenia, the knowledge about social and nonsocial affective processing in schizophrenia is scant. The aim of this study was to examine neurophysiological and behavioural responses to neutral and negative stimuli with (faces, people) and without (animals, objects) social content in schizophrenia.Methods: Twenty-six patients with schizophrenia (SCZ) and 21 healthy controls (HC) completed a visual oddball paradigm with either negative or neutral pictures from the Nencki Affective Picture System (NAPS) as targets while EEG was recorded. Half of the stimuli within each category presented social content (faces, people).Results: Negative stimuli with social content produced lower N2 amplitude and higher mean LPP than any other type of stimuli in both groups. Despite differences in behavioural ratings and alterations in ERP processing of affective stimuli (lack of EPN differentiation, decreased P3 to neutral stimuli) SCZ were still able to respond to specific categories of stimuli similarly to HC.Conclusions: The pattern of results suggests that with no additional emotion-related task demands patients with schizophrenia may present similar attentional engagement with negative social stimuli as healthy controls.



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Common and differential electrophysiological mechanisms underlying semantic object memory retrieval probed by features presented in different stimulus types

Publication date: Available online 18 June 2016
Source:International Journal of Psychophysiology
Author(s): Hsueh-Sheng Chiang, Justin Eroh, Jeffrey S. Spence, Michael A. Motes, Mandy J. Maguire, Daniel C. Krawczyk, Matthew R. Brier, John Hart, Michael A. Kraut
How the brain combines the neural representations of features that comprise an object in order to activate a coherent object memory is poorly understood, especially when the features are presented in different modalities (visual vs. auditory) and domains (verbal vs. nonverbal). We examined this question using three versions of a modified Semantic Object Retrieval Test, where object memory was probed by a feature presented as a written word, a spoken word, or a picture, followed by a second feature always presented as a visual word. Participants indicated whether each feature pair elicited retrieval of the memory of a particular object. Sixteen subjects completed one of the three versions (N = 48 in total) while their EEG were recorded simultaneously. We analyzed EEG data in four separate frequency bands (delta: 1-4 Hz, theta: 4-7 Hz; alpha: 8-12 Hz; beta: 13-19 Hz) using a multivariate data-driven approach. We found that alpha power time-locked to response was modulated by both cross-modality (visual vs. auditory) and cross-domain (verbal vs. nonverbal) probing of semantic object memory. In addition, retrieval trials showed greater changes in all frequency bands compared to non-retrieval trials across all stimulus types in both response-locked and stimulus-locked analyses, suggesting dissociable neural subcomponents involved in binding object features to retrieve a memory. We conclude that these findings support both modality/domain-dependent and modality/domain-independent mechanisms during semantic object memory retrieval.



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Reply to ”Laterality of Motor Control as Revealed in Biceps Electromyography: Why Seizures Always Start in the Major Hemisphere”

Publication date: Available online 18 June 2016
Source:Clinical Neurophysiology
Author(s): Mareike Hagge, Hajo M. Hamer




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Disease-specific sparing of the anterior semicircular canals in bilateral vestibulopathy

Publication date: August 2016
Source:Clinical Neurophysiology, Volume 127, Issue 8
Author(s): Alexander A. Tarnutzer, Christopher J. Bockisch, Elena Buffone, Stefan Weiler, Lucas M. Bachmann, Konrad P. Weber
ObjectiveBilateral vestibular loss (BVL) is often diagnosed with great delay and an underlying cause is only identified in 50–80%. We measured horizontal and vertical semicircular canal function using the video-head-impulse test (vHIT) and hypothesized that specific vHIT-patterns may be linked to certain etiologies.MethodsWe retrospectively analyzed 109 BVL-patients linked to aminoglycoside vestibulotoxicity (n=16), Menière's disease (n=10), infectious inner-ear disorders (n=11), sensorineural hearing-loss (n=11), cerebellar-ataxia-neuropathy-vestibular-areflexia-syndrome (CANVAS, n=5), other causes (n=19) as well as those with unknown origin (n=47). Vestibulo-ocular reflex gains and cumulative saccade amplitudes were measured with vHIT, and the functional integrity of all semicircular canals was rated.ResultsOverall, anterior canal hypofunction (n=86/218) was identified significantly (p<0.001) less often than horizontal (n=186/218) and posterior (n=194/218) hypofunction. Preserved anterior canal function was associated with aminoglycoside vestibulotoxicity, Menière's disease and BVL of unknown origin, while no such sparing was found for inner-ear infections, CANVAS and sensorineural hearing loss.ConclusionsSemicircular canal function in BVL shows disease-specific dissociations, potentially related to reduced vulnerability or superior recovery of the anterior canals.SignificanceIn patients with suspected BVL we recommend quantifying vHIT gains and saccade amplitudes for all semicircular canals as the pattern of canal hypofunction may help identifying the underlying disorder.



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4h versus 1h-nap-Video-EEG monitoring in an Epileptology Unit

Publication date: Available online 18 June 2016
Source:Clinical Neurophysiology
Author(s): Vi-Huong Nguyen-Michel, Vera Dinkelacker, Ovidio Solano, Pierre-P. Levy, Virginie Lambrecq, Claude Adam, Sophie Dupont, Lionel Naccache, Emmanuel Fournier, Michel Baulac, Vincent Navarro
ObjectiveTo compare the performance of 4h-video EEG monitoring (VEEG) and 1h-nap-VEEG in an Epileptology Unit.MethodsWe examined short-term VEEG data from 196 patients admitted to characterize their: (i) clinical events; (ii) epileptic syndromes or (iii) state after status epilepticus or surgery. We compared the 4h-VEEG and 1h-nap-VEEG performances using three measures: (i) the capability to detect epileptic seizures (ES), psychogenic non-epileptic seizures (PNES), interictal epileptiform abnormalities (IEA) and sleep-related IEA; (ii) the usefulness to answer questions on referral; (iii) the sensitivity for the final diagnosis.ResultsThe 4h-VEEG test recorded clinical events in 53.6% of 196 patients, IEA in 41.3%, sleep-related IEA in 34.7%, and was judged as useful in 66.8%. The 4h-VEEG was compared to the 1h-nap-VEEG in 129 patients. 4h-VEEG had a better capability to record clinical events (50.3 vs 6.2%, p<0.001), a higher usefulness (63.5 vs 37.2%, p<0.001), and a higher sensitivity for both ES (69.3 vs 49.3%, p=0.0035) and PNES (61.3 vs 15.4%, p=0.0014) than nap-EEG.ConclusionsThis work found 4h-VEEG records were superior to the 1h-nap-VEEG test on the basis of three complementary measures, capability, usefulness and sensitivity.Significance4h-VEEG is a useful alternative investigation tool in an Epileptology Unit.



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Laterality of Motor Control as Revealed in Biceps Electromyography: Why Seizures Always Start in the Major Hemisphere

Publication date: Available online 18 June 2016
Source:Clinical Neurophysiology
Author(s): I. Derakhshan




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Automatic detection of high frequency oscillations during epilepsy surgery predicts seizure outcome

Publication date: Available online 18 June 2016
Source:Clinical Neurophysiology
Author(s): Tommaso Fedele, Maryse van't Klooster, Sergey Burnos, Willemiek Zweiphenning, Nicole van Klink, Frans Leijten, Maeike Zijlmans, Johannes Sarnthein
ObjectiveHigh frequency oscillations (HFOs) and in particular fast ripples (FRs) in the post-resection electrocorticogram (ECoG) have recently been shown to be highly specific predictors of outcome of epilepsy surgery. FR visual marking is time consuming and is prone to observer bias. We validate here a fully automatic HFO detector against seizure outcome.MethodsPre-resection ECoG dataset (N=14 patients) with visually marked HFOs were used to optimize the detector's parameters in the time-frequency domain. The optimized detector was then applied on a larger post-resection ECoG dataset (N=54) and the output was compared with visual markings and seizure outcome. The analysis was conducted separately for ripples (80-250 Hz) and FRs (250-500 Hz).ResultsChannel-wise comparison showed a high association between automatic detection and visual marking (p<0.001 for both FRs and ripples). Automatically detected FRs were predictive of clinical outcome with positive predictive value PPV = 100% and negative predictive value NPV = 62%, while for ripples PPV = 43% and NPV =100%.ConclusionsOur automatic and fully unsupervised detection of HFO events matched the expert observer's performance in both event selection and outcome prediction.SignificanceThe detector provides a standardized definition of clinically relevant HFOs, which may spread its use in clinical application.



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How do medical teachers in Mauritius feel about teaching-learning communication skills? Development of a tool of communication skills teaching-learning perception score

2016-06-18T09-28-26Z
Source: International Journal of Research in Medical Sciences
Madhav Mutalik, Maitreyee Mutalik, Rama Srivastava.
Background: Since communication skills (CS) are essential for medical professionals, many medical institutes have included communication skills as an integral part of medical curriculum. The present study was done to assess the perceptions of medical teachers in a medical college in Mauritius towards teaching and learning communication skills. Methods: A 14-item questionnaire with modified Likert-like scale was designed and administered to medical teachers at a medical college in Mauritius to assess their perceptions on teaching-learning communication skills. Positive scale scores and negative scale scores were calculated to know the perceptions on positive-sounding and negative-sounding items respectively. Based on these scores, the Communication skills teaching-learning perception score (CSTLPS) was calculated. Results: The medical teachers had an average positive scale score of 21.7 (Range 12-28). Their average negative scale score was 15.7 (Range 10-20). The average CSTLPS was 6.0652 with a range of minus 6 to 17. More than 80 percent teachers agreed on all the positive-sounding items, whereas 50 or more percentage of teachers disagreed on most of the negative-sounding items. Conclusions: The medical teachers in Mauritius had a positive attitude towards teaching-learning communication skills in medical college. Finding out CSTLPS can serve as a useful tool.


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Methods to learn human anatomy: perceptions of medical students in paraclinical and clinical phases regarding cadaver dissection and other learning methods

2016-06-18T09-28-26Z
Source: International Journal of Research in Medical Sciences
Maitreyee Mutalik, Swati Belsare.
Background: Though the medical students learn human anatomy during their first year of curriculum, the application of the anatomy knowledge truly starts when they enter the preclinical and clinical phases. Therefore, it is more important and worth knowing from paraclinical and clinical students that which methods of learning gross anatomy during their first year curriculum were useful to them. Methods: The present study was based on the feedback through a 16-item questionnaire inquiring into the role of cadaveric dissection and other methods in learning human anatomy from the medical students in paraclinical and clinical phases (2nd year, 3rd year and interns), who have undergone the process of cadaveric dissection as a part of anatomy course in their first year of medical education. Results: Most of the respondents gave positive feedback about the cadaveric dissection as learning methodology, however around 20% students also gave a feedback about the limitation of this method as time consuming when the course duration is less while around 85% felt the need of less crowded dissection tables for better understanding. About 25% students also said that they understood anatomy better with other methods than dissection. More than 70% students expressed that more importance to living and radiological anatomy was needed in the curriculum to benefit them in the future clinical practice. About one fourth of the students felt that complete replacement of cadaveric dissection by combination of other methods to learn anatomy is possible, especially when the newer technologies can be used to understand the subject. Conclusions: Perception of knowledge by an individual student is different based on the individual primary mental abilities. Therefore, some individuals may show better learning by particular methods. Hence a blend of different methodologies to teach a subject is helpful for majority of the students. In the teaching of human gross anatomy too, a combination of different methods has been in use. However, in the era of decrease in course duration, high student:cadaver ratio, and easy availability of newer technologies, there is a need to review the priorities and preferences of the methods or to find out different ways to use the existing methods to increase their effectiveness.


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Comparative study on prediction of paediatric endotracheal tube size by ultrasonography and by age based formulas

2016-06-18T09-28-26Z
Source: International Journal of Research in Medical Sciences
Paul O. Raphael, Ershad Thasim, Binu P. Simon, Rajagopal P..
Background: Age-based formulas have been widely used to predict the appropriate size of the endotracheal tube (ETT) for intubation in paediatric age group. These formulas often fail to reliably predict the proper size of ETT. The objective of the study is to determine whether the tracheal internal diameter imaged by ultrasound is a better predictor of ETT size than age based formulas. Methods: The study included a total of 60 patients of ASA 1 and 2 aged between 2 and 15 years of either sex posted for elective surgery under general anaesthesia. After institutional ethical committee approval and written consent from the parents, anaesthesia was induced as per the protocol. The tracheal diameter was measured after induction of anaesthesia, during mask ventilation prior to intubation. A linear high frequency ultrasound probe (GE venue 40) was used to measure the tracheal diameter. The size of ETT was selected according to the measured tracheal diameter. The leak test and adequate oxygenation/ventilation were the objective tests used to validate the appropriateness of the ETT chosen. The ETT sizes determined by age based formulas and by the use of ultrasound were statistically compared with the appropriate ETT size used clinically for intubation. Results: The estimation of endotracheal tube size with the aid of ultrasound was found to be superior when compared with age based formulas. Ultrasound tube size determination correlated well with clinically used ETT size. Conclusions: Determination of endotracheal tube size by ultrasound is a good predictor of proper sized ETT in paediatric age group when compared with age based formulas.


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A cross sectional study on prevalence and factors influencing anxiety and depression among patients with type II diabetes mellitus

2016-06-18T09-28-26Z
Source: International Journal of Research in Medical Sciences
Krishna Kodakandla, Gopinath Maddela, Shahid Pasha Mohammed, Ramakrishna Vallepalli.
Background: Numerous study findings documented higher risk of depression and anxiety that diabetic population. Anxiety and depression in turn are proven to have strong negative influence on glycemic control, complications and quality of life in diabetic patients. Major portion of evidence linking DM, depression and anxiety comes from developed countries, and there is scarcity of research in this regard in developing and low-income countries. Aim of the study was to assess the prevalence of depression and anxiety and factors associated with them in type II diabetes mellitus patients. Methods: The study was a descriptive cross sectional study, conducted in a tertiary care teaching hospital. The study included 135 sequentially recruited type II diabetic patients. Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A) were used to assess the severity of depression/anxiety. Results: A total of 135 participants were included in the study. More than half (59.3%) of the study subjects have reported history of perceived stress. The proportions of subjects, reporting either anxiety or depression were 64.4%. Depression alone was present in 60.7% of the subjects and anxiety alone was present in 44.4% of the subjects. New onset of diabetes mellitus (Odds ratio 3.51, 95% CI 1.3 to 5.38), presence of diabetic neuropathy (Odds ratio 1.64, 95% CI 1.28 to 3.57), presence of diabetic retinopathy (Odds ratio 2.70, 95% CI 1.63 to 6.78) and history of perceived stress (Odds ratio 40.32, 95% CI 10.95 to 148.32), were associated with anxiety and depression. Conclusions: Prevalence of depression and anxiety was very high in diabetic population; hence evaluation and management should be part of routine care. Special focus should be given to patients with new onset diabetes, suffering from neuropathy or nephropathy and patients with history of stressors.


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A study of potential drug-drug interactions among critically ill patients at a tertiary care hospital

2016-06-18T08-41-11Z
Source: International Journal of Basic & Clinical Pharmacology
Manjeeta Gupta, Aparna S Chincholkar, Ranjit J Wagh, Nidhi Maheshwari, Waseem Siddiqui.
Background: Drug interaction is said to occur when presence of one drug affects the activity of another drug when both are administered together. This action can be synergistic or antagonistic. The objective was to study the prevalence of potential drug-drug interactions (pDDI), their severity, clinical significance, and their association with patient characteristics in intensive care unit (ICU) at a tertiary care hospital. Methods: A prospective, observational study was conducted in ICU patients for a period of 3 months to assess the pDDI using Medscape drug checker software and Lexi-Comp, inc. version: 2.7.5. drug interact android mobile application. Results: A total of 183 subjects were included in the study with a prevalence of 76.50% pDDI occurring in patients, majority of which were suffering from cardiovascular conditions (26.23%). In those with hospital stay more than five days, 92% had pDDI. There were 229 potentially interacting drug pairs with corticosteroids, aspirin, beta blockers, and diuretics being commonly involved in pDDI. A total of 2336 interactions were observed with an occurrence rate of 12.76 DDI per patient. Severity was moderate in 64%, interaction mechanism was pharmacodynamic in 72.49% and risk rating category was C in 77.1% of the study population. Conclusions: The present study showed high concomitant administration of potentially interacting drugs. The prevalence confirmed the association of age and polypharmacy. Vigilant prescribing approach is needed to prevent hazardous outcomes of pDDI.


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A study of placental histological changes in gestational diabetes mellitus on account of fetal hypoxia

2016-06-18T08-33-47Z
Source: International Journal of Medical Science and Public Health
Geena Augustine, Mumtaz Pulikkathodi, Renjith S, Jithesh TK.
Background: Diabetes in pregnancy has been associated with increased fetal growth and with a high risk of prenatal and postnatal complications. Metabolic impairments in maternal obesity and gestational diabetes mellitus (GMD) provoke an unusual commotion in peripheral blood and prompt vascular structure alterations, which affect the placental development and function. These fetal metabolic changes seem to be related to the duration of diabetes. Objective: To find out placental histological changes in GDM, as the placenta is the regulator of nutrient composition and supply from mother to fetus and the source of hormonal signals that affect maternal and fetal metabolism, appropriate development of the placenta is crucial to healthy fetal development. Hypoxia has significant effects on placental development, causing hypercapillarization of the villous vasculature. Materials and Methods: A prospective study was conducted comprising 58 subjects. The placenta was collected soon after delivery. After gross examination, placenta was processed for histological study. Result: Placenta shows significant difference between the test and control group. There were significant microscopic findings. The area of GDM placenta is 219.65 ± 31.34 and that of the normal placenta is 182.52 ± 28.66. The thickness of GDM placenta is 3.15 ± 0.40 and that of the normal placenta is 1.67 ± 0.28. The circumference of GDM placenta is 52.32 ± 3.70 and that of the normal placenta is 48.35 ± 4.66. The diabetic placenta showed increased syncytial knots, fibrinoid necrosis, decreased vascular syncytial membrane, and chorangiosis. Conclusion: Intrauterine hypoxia can cause cellular damage that occurs within the central nervous system. This study showed several significant morphological and histological differences in the placenta of the mother with GDM. These changes were absent in normal placenta. The assessment of various histological changes in the placenta on account of hypoxia in GDM is helpful for the retrospective explanations of complications in pregnancy.


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Neuro-cognition in patients of bipolar affective disorder (currently in remission) and their first degree healthy relatives

2016-06-18T08-33-47Z
Source: International Journal of Medical Science and Public Health
K. K. Verma, Sandeep Kumar Garg, Girish Chandra Baniya, Harful Singh.
Background: Bipolar patients do complain of persistent difficulties in concentration, memory, inability to perform optimally in challenging tasks or even, in day-to-day functioning, whereas variety of factors may be responsible for persistent functional impairments, at least a subgroup of patients are likely to experience poor psychosocial outcomes as a result of cognitive dysfunction. Objective: To assess the neurocognitive functions in patients of bipolar affective disorder currently in remission phase and their first-degree relatives. Materials and Methods: This study was carried out on a total of 60 subjects. Of which, 30 subjects belonged to patient group, who were patients of BPAD (currently in remission phase) attending outpatient department and remaining 30 were their first-degree healthy relatives who were included in healthy relative groups. Result: Mean age in both groups which was almost same, range between 42 and 45 years. Mean Hindi mini mental state examination (HMSE) test score obtained in patient group was 26.93 (SD = 2.066), in the healthy relative group 28.76 (SD = 1.278), and that in the control group was 29.133 (0.973). The performance of patient group and healthy relative group on the test of cognitive functions such as attention/psychomotor speed processing (Trail Making Test A), there was statistically significant difference in the TMT-A with patient. The performance of patient group and healthy relative group on the test of auditory verbal measure of simple span of attention (Digit Span Forward Test), there was statistically significant difference in the digit span forward test with patient group. The comparison of mean (2.60 ± 0.621 and 3.57 ± 0.568) between patients and healthy relative group was statistically significant (p = 0.00) in test of working memory (Digit span backward test). The comparison of mean (16.167 ± 1.839 and 19.00 ± 1.619) between patients and healthy relative group was statistically significant (p = 0.00) in test of immediate verbal memory and learning (VL and MT). Conclusion: Patients of BPAD currently in remission phase performed poorly on measure of all domains of neurocognition such as executive functions, working memory, verbal memory, visuospatial memory than healthy relatives.


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Clinical profile of scorpion sting envenomation in children

2016-06-18T04-23-53Z
Source: International Journal of Contemporary Pediatrics
C. Soren, K. Nageswara Rao.
Background: Scorpion sting envenomation is a life threatening emergency. The main objective is to study the clinical profile and outcome of scorpion sting envenomation in children. Methods: This retrospective study analyzed case records of children under 15 years of age who admitted with scorpion sting envenomation from Feb 2014 to Jan 2016. Case records were analyzed for age and sex of the patient; site of scorpion sting, time lapsed from the scorpion sting to hospitalization, season, clinical manifestations, duration of hospital stay and outcome. Results: During the study period, 164 children were admitted for scorpion sting. Majority of the children are from rural area, male sex, and stung in lower limb, mostly during nights of summer. Local pain at the site of sting and sweating are the commonest local symptoms and systemic sign, respectively. 53.65% children had class II severity. Mean duration of hospital stay was 3 days. Two patients died, both had pulmonary edema. Conclusions: Prompt referral and early therapy with prazocin is life saving for scorpion sting envenomation in children.


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Clinical profile of poisoning in children: a hospital based study

2016-06-18T04-23-53Z
Source: International Journal of Contemporary Pediatrics
Shruti Jadhav, Surbhi Rathi, Biakthansangi, Santosh Kondekar.
Background: Poisoning is a common medical emergency in children and most of the cases are accidental in nature. The objective was to study clinical profile of children presenting with poisoning to the pediatric emergency department of a tertiary care hospital in Mumbai, India. Methods: This is Prospective study conducted in a Pediatric ward over a period of 18 months after obtaining permission from institutional ethics committee. Total 50 cases fulfilling the inclusion criteria were enrolled in the study over the period of 18 months. Neonates and the children with snake, scorpion and animal envenomation were excluded. Children with allergic drug reaction or food poisoning were excluded. Descriptive analysis of the collected data was performed using SPSS v.15. Results: Fifty cases of poisoning formed 1.3% of all paediatric admissions (3700 admissions). Most of the cases were accidental (94%). There were 84 % children between 1-5 years of age with male preponderance. Kerosene oil poisoning remained the commonest (32%) accidental poisoning in this study. An interesting trend was concentrated HCL poisoning (now a common household product) as the second commonest poisoning (17.3%). This was followed by poisoning with various drugs used by adults in the house. Conclusions: Acute accidental kerosene poisoning in children is of frequent occurrence in the paediatric emergency department; and thorough knowledge about the management of each poison is essential. Most of the accidents are preventable and prompt treatment can reduce mortality and long term morbidity.


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Indications for intravitreal anti vascular endothelial growth factor in Kano, North Western, Nigeria

2016-06-18T03-19-13Z
Source: International Journal of Research in Medical Sciences
Abdulsalam Shuaib, Sadiq Hassan.
Background: To review the common indications for intravitreal anti vascular endothelial growth factor (VEGF) medications given at the retinal unit of Makkah Specialist Eye Hospital, Kano, Nigeria from January 2014 to December 2015. Methods: The case records of all patients given intravitreal anti VEGF medications were reviewed and age, diagnosis and indication for injection were recorded. Results were analyzed using the PAWS statistics version 18.0 (SPSS Inc., Chicago, IL). Results: A total of 174 injections consisting of 170 bevacizumab and 4 ranibizumab injections were given in the study period. The common indications for intravitreal injections were diabetic macula edema (42.5%), retinal vein occlusion (25.9%) and vitreous heamorrhage (9.8%). Conclusions: Diabetic macula edema and retinal vein occlusions are the major indications for intravitreal anti VEGF injections in Kano.


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Gross Morphometry of Pectoral Girdle of Domestic Pigeon (Columba livia)

2016-06-18T02-14-52Z
Source: International Journal of Livestock Research
Md. Parvez, Mrs. Akter, Md. Gofur, Md. Sarder.
The pectoral girdle gives strength and range of motion to the wings of birds and plays functional role in flight mechanism of birds. Pectoral girdle of adult domestic pigeon (Columba livia) (n=10) was studied with special reference to the morphological and morphometric parameters. The girdle was composed of three pairs of bones viz. the scapulae, the coracoids and fused clavicles (furcula). The scapula was sword shaped with proximal extremity and a blade. The length and maximum width of scapula were 4.23 cm and 0.56 cm, respectively. The clavicle was in the form of thick curved plate to join the bone of opposite side forming the broad 'U' shaped furculum with rudimentary hypocleideum. The width of clavicle gradually decreased from proximal to distal end. Hypocleideum was not prominent at their meeting point. The curvature length and maximum width of clavicle were 6.38 cm and 1.61 cm, respectively. Coracoid was directed downwards and backwards to articulate the sternum distally. The length was 3.53 cm and width of distal extremity (1.45 cm) was about twice that of proximal one (0.70 cm). The proximal extremity of coracoid was hook like and articulated with proximal extremity of scapula and clavicle to form foramen triosseum (0.35 cm diameter).


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Effect of genotype on reproductive and productive performances of dairy cows under rural context in Bangladesh

2016-06-18T02-14-52Z
Source: International Journal of Livestock Research
Md. Rahman, Md. Gofur, Md. Rahman, Farida Bari, Nasrin Juyena.
Influence of genotypes (breed) on reproductive and productive attributes has been assessed in the local (L), Local x Friesian (LF) and Local x Friesian × Friesian (LFF) dairy cows (n=76) raised in randomly selected smallholder dairy farms in Barisal, Bangladesh. With regard to reproductive attributes, significant (p


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Whole-Body Vibration Intensities in Chronic Stroke: A Randomized Controlled Trial

Purpose: A single-blinded randomized controlled study was conducted to investigate the effects of different whole-body vibration (WBV) intensities on body functions/structures, activity, and participation in individuals with stroke. Methods: Eighty-four individuals with chronic stroke (mean age = 61.2 yr, SD = 9.2) with mild to moderate motor impairment (Chedoke–McMaster Stroke Assessment lower limb motor score: median = 9 out of 14, interquartile range = 7–11.8) were randomly assigned to a low-intensity WBV, high-intensity WBV, or control group. The former two groups performed various leg exercises while receiving low-intensity and high-intensity WBV, respectively. Controls performed the same exercises without WBV. All individuals received 30 training sessions over an average period of 75.5 d (SD = 5.2). Outcome measurements included knee muscle strength (isokinetic dynamometry), knee and ankle joint spasticity (Modified Ashworth Scale), balance (Mini Balance Evaluation Systems Test), mobility (Timed-Up-and-Go test), walking endurance (6-Minute Walk Test), balance self-efficacy (Activities-specific Balance Confidence scale), participation in daily activities (Frenchay Activity Index), perceived environmental barriers to societal participation (Craig Hospital Inventory of Environmental Factors), and quality of life (Short-Form 12 Health Survey). Assessments were performed at baseline and postintervention. Results: Intention-to-treat analysis revealed a significant time effect for muscle strength, Timed-Up-and-Go distance, and oxygen consumption rate achieved during the 6-Minute Walk Test, the Mini Balance Evaluation Systems Test, the Activities-specific Balance Confidence scale, and the Short-Form 12 Health Survey physical composite score domain (P 0.05). Conclusion: The addition of the 30-session WBV paradigm to the leg exercise protocol was no more effective in enhancing body functions/structures, activity, and participation than leg exercises alone in chronic stroke patients with mild to moderate motor impairments.

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Exercise in Eating Disorders Treatment: Systematic Review and Proposal of Guidelines

Introduction: Although exercise is an effective intervention for many psychological health issues, it has often been overlooked as a potential adjunct to eating disorder (ED) treatment. Thus, our objective was to summarize the literature by synthesizing themes identified in clinical studies and explicit guidelines or recommendations for the use or management of exercise in ED interventions into a proposed set of guidelines for the use of exercise in ED treatment. Methods: A literature search in exercise science, health psychology, and the ED literature was conducted. The focus was to obtain articles that reported on therapeutic effects and/or guidelines for the therapeutic use of exercise in individuals with ED. Results: Our review identified 11 core themes describing techniques that have been successful in using exercise therapeutically in ED treatment. These 11 guidelines are as follows: employ a team of relevant experts, monitor medical status, screen for exercise-related psychopathology, create a written contract of how therapeutic exercise will be used, include a psychoeducational component, focus on positive reinforcement, create a graded exercise program, begin with mild-intensity exercise, tailor the mode of exercise to the needs of the individual, include a nutritional component, and debrief after exercise sessions. Conclusion: Our review identifies specific guidelines that may enhance ED treatment outcomes. It is the first to summarize divergent literature and synthesizes previous successes that may guide the use of therapeutic exercise in some, but not all ED patients. This review provides a practical set of guidelines for the clinical management and therapeutic use of exercise in ED treatment by focusing on empowering individuals with exercise as a tool for healthy living.

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The Effect of Head Impact Location on Day of Diagnosed Concussion in College Football

Introduction: Scientists and clinicians have attempted to identify and understand biomechanical factors that influence concussion likelihood. The effect of impact frequency to a given head location before the concussion has not been evaluated. The purpose of this study was to compare the frequency of impacts to a given head location on days of diagnosed concussion to the frequency of impacts to a given head location before kinematically matched nonconcussive impacts. Methods: Head impact data were gathered from 33 Division I National Collegiate Athletic Association football players. Twenty-four concussions were identified and matched with impacts of similar kinematic and injury criterion values (linear acceleration, rotational acceleration, Gadd severity index, and head injury criterion) that occurred during the same event type (game, practice, or scrimmage). In addition, these same matching criteria were used to match all players to the closest kinematic/same player group. All impacts within a session before the impact of interest (concussive or matched impact) were analyzed. Results: On days of diagnosed concussion, the concussive group sustained a lower percentage of impacts to the front of the head (34.5%) and a greater frequency of impacts to the sides (19.6%) and top (18.9%) of the head (χ2(3) = 10.23, P = 0.017) as compared with the matched nonconcussive group (front = 42.5%, sides = 16.6%, top = 14.0%). No significant difference in frequency was found in impacts to the back of the head. Conclusion: It may be more difficult to mitigate concussive forces sustained in impacts to the top and sides of the head than the front of the head. These findings fall in line with previous research demonstrating that reduced impact magnitudes may lessen concussion risk. Studying appropriate training paradigms to develop safer playing techniques on the field is warranted.

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Effectiveness of Exercise on Visceral Adipose Tissue in Older South Asian Women

Introduction: Individuals of South Asian (SA) origin have a greater risk for type 2 diabetes and cardiovascular disease than other ethnic populations. This increased risk is in part explained by the unique obesity phenotype of elevated visceral adipose tissue (VAT) among this population. Aerobic exercise in Europeans is effective at reducing VAT, but this has not been studied in SA, who have some of the lowest levels of physical activity in the world. Therefore, the purpose of this study was to determine whether exercise can reduce VAT given the unique obesity phenotype and associated disease risk in the SA population. Methods: A total of 75 physically inactive, postmenopausal SA women were randomized to either culturally based (Bhangra dance), standard (gym-based), or control (nonexercise) program for 12-wk. The primary outcome was change in VAT. Results: The average attendance in the culturally based and standard program was 78% ± 33% and 67% ± 25%, respectively. After an intention-to-treat analysis, VAT was not significantly reduced in culturally based (−60 cm3, 95% confidence interval [CI] = −172 to 54, P = 0.300) or standard (−98 cm3, 95% CI = −216 to 21, P = 0.106) exercise compared with control after adjustment for baseline physical activity and age. In those participants who attended more than two-thirds of the exercise classes, VAT was significantly reduced compared with control (−109 cm3, 95% CI = −204 to −13, P = 0.026). Conclusion: In intention-to-treat analysis VAT was not significantly reduced after 12 wk of either standard or culturally based exercise. However, attendance in both standard and culturally based exercise was high, and VAT was significantly reduced among SA women who adhered to these programs.

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Influence of Step Rate on Shin Injury and Anterior Knee Pain in High School Runners

Purpose: High school cross-country runners have a high incidence of injury, particularly at the shin and knee. An increased step rate during running has been shown to reduce impact forces and loading of the lower extremity joints. The purpose of this prospective study was to examine step rate as a risk factor for injury occurrence. Materials and Methods: Running step rates of 68 healthy high school cross-country runners (47 females; 21 males; mean age 16.2 ± 1.3 yr) were assessed at a fixed speed (3.3 ± 0.0 m·s−1) and self-selected speed (mean, 3.8 ± 0.5 m·s−1). Runners were prospectively followed during the interscholastic season to determine athletic exposures, occurrences of shin injury and anterior knee pain (AKP), and days lost to injury. Results: During the season, 19.1% of runners experienced a shin injury and 4.4% experienced AKP. Most injuries (63.6%) were classified as minor (1–7 d lost). At the fixed speed, runners in the lowest tertile of step rate (≤164 steps per minute) were more likely (odds ratio, 6.67; 95% confidence interval, 1.2–36.7; P = 0.03) to experience a shin injury compared with runners in the highest tertile (≥174 steps per minute). Similarly, for self-selected speed, runners in the lowest tertile (≤166 steps per minute) (odds ratio, 5.85; 95% confidence interval, 1.1–32.1; P

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Heat Tolerance Test or Race Simulation Test for Return to Activity after Heat Stroke

No abstract available

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Environmental Endocrine Disruptor Affects Voluntary Physical Activity in Mice

Introduction: Voluntary physical activity levels are regulated by sex hormones. The purpose of this study was to determine the effect of the endocrine disruptor benzyl butyl phthalate (BBP) on the regulation of physical activity in mice. Methods: Mouse dams were treated with 500 mg·kg−1·d−1 of BBP or vehicle on gestation days 9–16. Pups were weaned and analyzed for voluntary physical activity levels, puberty development, sex hormone levels, and body composition during the 20-wk period. Results: Seventy-three offspring from BBP-treated dams were studied (n = 43 males and n = 30 females). Endocrine disruption was indicated by decreased anogenital distances in BBP-treated male offspring at 10 (P = 0.001) and 20 wk (P = 0.038) and delayed vaginal openings in BBP-treated female offspring (P = 0.001). Further, there was a significant decrease in serum testosterone concentration in male mice between control and BBP at 10 wk (P = 0.039) and at 20 wk (P = 0.022). In female mice, there was a significant increase in serum testosterone concentration in BBP mice at 20 wk (P = 0.002) and a significant increase in estrogen (estradiol) concentrations at 20 wk in the control female mice (P = 0.015). Overall, BBP mice ran significantly less distance (males, P = 0.008; females, P = 0.042) than controls. Other than a significant increase in BBP-treated males in fat mass at 20 wk (P = 0.040), there was no significant decrease in weight, lean mass, or fat mass in either female or male mice, regardless of treatment. Conclusion: Maternal endocrine disruption altered hormone response, but not body composition in either sex of offspring, with a corresponding decreased activity throughout early adulthood in all offspring. These results suggest that exposure to common environmental endocrine disruptors in utero can reduce and alter physical activity levels in offspring.

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Adaptations to Speed Endurance Training in Highly Trained Soccer Players

Purpose: The present study examined whether a period of additional speed endurance training would improve intense intermittent exercise performance in highly trained soccer players during the season and whether the training changed aerobic metabolism and the level of oxidative enzymes in type I and type II muscle fibers. Methods: During the last 9 wk of the season, 13 semiprofessional soccer players performed additional speed endurance training sessions consisting of two to three sets of 8–10 repetitions of 30-m sprints with 10 s of passive recovery (SET). Before and after SET, subjects completed a double-step exercise protocol that included transitions from standing to moderate-intensity running (~75% HRmax), followed by transitions from moderate- to high-intensity running (~90% HRmax) in which pulmonary oxygen uptake (V˙O2) was determined. In addition, the yo-yo intermittent recovery test level 1 was performed, and a muscle biopsy was obtained at rest. Results: The yo-yo intermittent recovery test level 1 performance was 11.6% ± 6.4% (mean ± SD) better (2803 ± 330 vs 3127 ± 383 m, P

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Ovariectomized Highly Fit Rats Are Protected against Diet-Induced Insulin Resistance

Introduction: In the absence of exercise training, rats selectively bred for high intrinsic aerobic capacity (high-capacity running (HCR)) are protected against ovariectomy (OVX)-induced insulin resistance (IR) and obesity compared with those bred for low intrinsic aerobic capacity (low-capacity running (LCR)). Purpose: This study determined whether OVX HCR rats remain protected with exposure to high-fat diet (HFD) compared with OVX LCR rats. Methods: Female HCR and LCR rats (n = 36; age, 27–33 wk) underwent OVX and were randomized to a standard chow diet (NC, 5% kcal fat) or HFD (45% kcal fat) ad libitum for 11 wk. Total energy expenditure, resting energy expenditure, spontaneous physical activity (SPA), and glucose tolerance were assessed midway, whereas fasting circulating metabolic markers, body composition, adipose tissue distribution, and skeletal muscle adenosine monophosphate-activated protein kinase (AMPK), and mitochondrial markers were assessed at sacrifice. Results: Both HCR and LCR rats experienced HFD-induced increases in total and visceral adiposity after OVX. Despite similar gains in adiposity, HCR rats were protected from HFD-induced IR and reduced total energy expenditure observed in LCR rats (P

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Stretching of Active Muscle Elicits Chronic Changes in Multiple Strain Risk Factors

Introduction: The muscle stretch intensity imposed during "flexibility" training influences the magnitude of joint range of motion (ROM) adaptation. Thus, stretching while the muscle is voluntarily activated was hypothesized to provide a greater stimulus than passive stretching. The effect of a 6-wk program of stretch imposed on an isometrically contracting muscle (i.e., qualitatively similar to isokinetic eccentric training) on muscle–tendon mechanics was therefore studied in 13 healthy human volunteers. Methods: Before and after the training program, dorsiflexion ROM, passive joint moment, and maximal isometric plantarflexor moment were recorded on an isokinetic dynamometer. Simultaneous real-time motion analysis and ultrasound imaging recorded gastrocnemius medialis muscle and Achilles tendon elongation. Training was performed twice weekly and consisted of five sets of 12 maximal isokinetic eccentric contractions at 10°·s−1. Results: Significant increases (P 0.05), a significant increase in tendon stiffness (31.2%, P

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Genetic Variant in ACVR2B Is Associated with Lean Mass

Introduction: Low lean mass (LM) is a risk factor for chronic disease, a major cause of disability and diminished quality of life, and is a heritable trait. However, relatively few specific genetic factors have been identified as potentially influencing this trait. Methods: In this study, we selected 1493 single-nucleotide polymorphisms (SNP) in 155 candidate genes involved in anabolic, catabolic, growth hormone, and other related pathways and examined their association with LM, assessed by dual-energy x-ray absorptiometry, in a sample of 2760 non-Hispanic and Hispanic white postmenopausal women from the Women's Health Initiative (WHI) Observational Study. We assessed the replication of our top findings in a meta-analysis of 20 genome-wide association studies (n = 38,292) conducted by the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium Musculoskeletal Working Group. Results: We identified 32 SNPs that had nominally significant associations with LM in the WHI cohort. In the replication stage, we find that SNP rs2276541 in the activin A receptor, type IIB (ACVR2B), was significantly associated with LM (β = 0.15, P = 2.17 × 10−5). ACVR2B codes for a receptor for a negative regulator of skeletal muscle, myostatin, and has previously been identified in a candidate gene study as a determinant of skeletal muscle mass. Conclusions: Our findings support a previously proposed role of ACVR2B allelic variation as a determinant of muscle mass and extend prior findings in men and women. Additional large-scale studies will be needed to confirm our findings in different populations.

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Hemoglobin Mass Expansion during 13 d of Altitude Training: Altitude or Training?

No abstract available

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Exercise Reduces Lung Fibrosis Involving Serotonin/Akt Signaling

Purpose: Idiopathic pulmonary fibrosis (IPF) is a chronic fibrosing interstitial pneumonia, which involves aberrant serotonin (5-hydroxytryptamine [5-HT]) and Akt signaling. As protective effects of chronic aerobic training (AT) have been demonstrated in the context of lung injury, this study investigated whether AT attenuates bleomycin-induced lung fibrosis partly via a reduction of 5-HT and AKT signaling. Methods: Seventy-two C57BL/6 male mice were distributed in Control (Co), Exercise (Ex), Fibrosis (Fi), and Fibrosis + Exercise (Fi + Ex) groups. Bleomycin (1.5 UI·kg−1) was administered on day 1 and treadmill AT began on day 15 and continued for 60 min·d−1, 5 d·wk−1 for 4 wk. We evaluated total and differential cell counts in bronchoalveolar lavage (BAL), interleukin (IL)-1β, IL-6, CXCL1/KC, IL-10, tumor necrosis factor α, and transforming growth factor β levels in BAL, collagen content in lung parenchyma, 5-HT levels in BAL fluid and in serum, the expression of 5-HT2B receptor, and Akt phosphorylation in lung tissue. Results: AT reduced bleomycin-increased number of total cells (P

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Functional Atlas of the Human Fascial System

No abstract available

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Intensive Exercise Does Not Preferentially Mobilize Skin-Homing T Cells and NK Cells

Purpose: This study investigated whether natural killer (NK) cells and CD8+ T cells expressing cutaneous lymphocyte antigen (CLA)—a homing molecule for endothelial cell leukocyte adhesion molecule 1, which enables transmigration to the skin—are selectively mobilized in response to acute exercise. Methods: Nine healthy men (mean ± SD age: 22.1 ± 3.4 yr) completed two exercise sessions: high-intensity continuous cycling ("continuous exercise" at 80% V˙O2max for 20 min) and low-volume high-intensity interval exercise (at 90% V˙O2max 10 × 1 min repetitions with 1 min recovery intervals). Blood was collected before, immediately and 30 min postexercise for cryopreservation of peripheral blood mononuclear cells. CLA+ and CLA− cells were quantified within NK subpopulations (CD56bright "regulatory" and CD56dim "cytotoxic" cells) as well as the following CD8+ T cell subpopulations: naive ("NA"; CD45RA+ CCR7+), central memory ("CM"; CD45RA− CCR7+), effector-memory ("EM"; CD45RA− CCR7−), and CD45RA-expressing effector-memory cells ("EMRA"; CD45RA+ CCR7−). Results: CLA+ NK cells and CD8+ memory T cells increased in response to both exercise bouts, but, overall, their numerical contribution to the exercise lymphocytosis was inferior to CLA− cells, which increased to a much greater extent during exercise. Tellingly, the most exercise-responsive cells—effector memory CD8+ cells and CD56dim cells—were CLA−. Conclusions: A small subset of CLA+ lymphocytes are mobilized into blood during acute intensive exercise, but CLA+ cells are not major contributors to exercise lymphocytosis, thus providing preliminary evidence that the skin is not a major origin, or homing destination, of exercise-sensitive lymphocytes.

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Individual Endurance Training Prescription with Heart Rate Variability

Introduction: Measures of HR variability (HRV) have shown potential to be of use in training prescription. Purpose: The aim of this study was to investigate the effectiveness of using HRV in endurance training prescription. Methods: Forty recreational endurance runners were divided into the HRV-guided experimental training group (EXP) and traditional predefined training group (TRAD). After a 4-wk preparation training period, TRAD trained according to a predefined training program including two to three moderate- (MOD) and high-intensity training (HIT) sessions per week during an 8-wk intensive training period. The timing of MOD and HIT sessions in EXP was based on HRV, measured every morning. The MOD/HIT session was programmed if HRV was within an individually determined smallest worthwhile change. Otherwise, low-intensity training was performed. Maximal oxygen consumption (V˙O2max) and 3000-m running performance (RS3000m) were measured before and after both training periods. Results: The number of MOD and HIT sessions was significantly lower (P = 0.021, effect size = 0.98) in EXP (13.2 ± 6.0 sessions) compared with TRAD (17.7 ± 2.5 sessions). No other differences in training were found between the groups. RS3000m improved in EXP (2.1% ± 2.0%, P = 0.004) but not in TRAD (1.1% ± 2.7%, P = 0.118) during the intensive training period. A small between-group difference (effect size = 0.42) was found in the change in RS3000m. V˙O2max improved in both groups (EXP: 3.7% ± 4.6%, P = 0.027; TRAD: 5.0% ± 5.2%, P = 0.002). Conclusion: The results of the present study suggest the potential of resting HRV to prescribe endurance training by individualizing the timing of vigorous training sessions.

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Skeletal Muscle Erythropoietin Expression Is Responsive to Hypoxia and Exercise

Purpose: Erythropoietin is responsible for regulating the growth and development of red blood cells. Reports conflict on whether skeletal muscle is able to produce erythropoietin and release it into circulation and if exercise affects this. We set out to determine how erythropoietin is regulated in skeletal muscle and to determine whether skeletal muscle-derived erythropoietin can stimulate erythropoiesis. Methods: Using an in vitro approach, we exposed proliferating and differentiated skeletal muscle cells to various forms of exercise-induced physiological stimuli and measured erythropoietin gene expression. To understand if skeletal muscle cells were able to stimulate erythropoiesis, independent of other cell types found in skeletal muscle, we used myoblast-conditioned media to treat bone marrow and to measure erythropoiesis through flow cytometry. We also measured erythropoietin expression and hypoxia in mice subjected to an exercise protocol designed to induce skeletal muscle oxygen stress. Results: Hypoxia increased erythropoietin expression in C2C12 myoblasts, myotubes, and primary myoblasts in vitro by 50% to 130%. Bone marrow treated with media conditioned with hypoxic myoblasts for 24 h increased the number of Ter-119-positive cells by 32%. An erythropoietin-neutralizing antibody prevented this increase. Compared with unexercised controls, exhaustive exercise increased skeletal muscle HIF1α levels by 50% and HIF2α levels by 20%. Moreover, exercised skeletal muscle erythropoietin expression was 70% higher. Conclusion: These results demonstrate that skeletal muscle produces erythropoietin in a hypoxia and HIF-dependent manner and that hypoxia-treated muscle is capable of stimulating erythropoiesis in vitro.

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Multicomponent Fitness Training Improves Walking Economy in Older Adults

Background: Walking economy declines with increasing age, possibly leading to mobility limitation in older adults. Multicomponent fitness training could delay the decline in walking economy. Purpose: This study aimed to determine the effect of multicomponent fitness training on walking economy in older adults. Methods: Participants were untrained adults, age 50 to 83 yr (N = 26, 10 males, age = 63 ± 6 yr, BMI = 25.6 ± 2.1 kg·m−2, mean ± SD). A control group was also recruited (N = 16, 9 males, age = 66 ± 10 yr, BMI = 25.4 ± 3.0 kg·m−2), matching the intervention group for age, weight, body composition, and fitness. The intervention group followed a multicomponent fitness program of 1 h, twice per week during 1 yr. The control group did not take part in any physical training. Fat-free mass, walking economy, and maximal oxygen uptake (V˙O2max) were measured in both groups before and after the year. Walking economy was measured with indirect calorimetry as the lowest energy needed to displace 1 kg of body mass for 1 m while walking on a treadmill. The data were compared between the two groups with repeated-measures ANOVA. Results: Thirty-two subjects completed all measurements. There was an interaction between the effects of time and group on V˙O2max (P

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Studies of Sedentary Behavior, Activity, and Mortality: Duplication or Replication?

No abstract available

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Musculoskeletal Asymmetry in Football Athletes: A Product of Limb Function over Time

Purpose: Asymmetrical loading patterns are commonplace in football sports. Our aim was to examine the influence of training age and limb function on lower-body musculoskeletal morphology. Methods: Fifty-five elite football athletes were stratified into less experienced (≤3 yr; n = 27) and more experienced (>3 yr; n = 28) groups by training age. All athletes underwent whole-body dual-energy x-ray absorptiometry scans and lower-body peripheral quantitative computed tomography tibial scans on the kicking and support limbs. Results: Significant interactions between training age and limb function were evident across all skeletal parameters (F16, 91 = 0.182, P = 0.031, Wilks Λ = 0.969). Asymmetries between limbs were significantly larger in the more experienced players than the less experienced players for tibial mass (P ≤ 0.044, d ≥ 0.50), total cross-sectional area (P ≤ 0.039, d ≥ 0.53), and stress–strain indices (P ≤ 0.050, d ≥ 0.42). No significant asymmetry was evident for total volumetric density. More experienced players also exhibited greater lower-body tibial mass (P ≤ 0.001, d ≥ 1.22), volumetric density (P ≤ 0.009, d ≥ 0.79), cross-sectional area (P ≤ 0.387, d ≥ 0.21), stress–strain indices (P ≤ 0.012, d ≥ 0.69), fracture loads (P ≤ 0.018, d ≥ 0.57), and muscle mass and cross-sectional area (P ≤ 0.016, d ≥ 0.68) than less experienced players. Conclusions: Asymmetries were evident in athletes as a product of limb function over time. Chronic exposure to routine high-impact gravitational loads afforded to the support limb preferentially improved bone mass and structure (cross-sectional area and cortex thickness) as potent contributors to bone strength relative to the high-magnitude muscular loads predominantly afforded to the kicking limb.

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Graphic Anaesthesia.

No abstract available

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