scholarly journals Combining Exercise, Protein Supplementation and Electric Stimulation to Mitigate Muscle Wasting and Improve Outcomes for Survivors of Critical Illness - the ExPrES Study

2021 ◽  
Author(s):  
Avelino Verceles ◽  
Monica Serra ◽  
Derik Davis ◽  
Gad Alon ◽  
Chris Wells ◽  
...  
Keyword(s):  
Nitrogen Balance ◽  
Clinical Status ◽  
Neuromuscular Electrical Stimulation ◽  
Rehabilitation Program ◽  
Protein Supplementation ◽  
Muscle Volume ◽  
Lower Extremity Muscle ◽  
Cross Section Area ◽  
Section Area ◽  
And Function

Abstract Background: The combination of neuromuscular electrical stimulation (NMES) with high protein supplementation (HPRO) to preserve muscle mass and function has not been assessed in ICU patients. We compared the effects of a multimodal intervention combining NMES and HPRO with mobility and strength rehabilitation program (NMES+HPRO+PT) to standardized ICU care (SC). Methods: Over 14 days the SC group received usual critical care and rehabilitation while the NMES+HPRO+PT received 30 minutes NMES twice daily for 10 days applied to the quadriceps and dorsiflexors bilaterally and a mean 1.3±0.4 HPRO g/kg body weight in addition to SC. Nonresponsive patients received passive exercises and once responsive were encouraged to exercise actively. Primary outcome measures were muscle volume and cross-section area (CSA) measured using CT-imaging. Secondary outcomes included nutritional status, nitrogen balance, effect on delirium, and days on mechanical ventilation (MV).Results: On day 14, the NMES+HPRO+PT group lost significantly less muscle volume of both thighs and lower legs compared to SC group. The mean combined left and right thigh CSA and volume of the NMES+HPRO+PT group was significantly larger than the SC group on day 14. The nitrogen balance of the SC group was negative throughout the study duration, while the NMES+HPRO+PT group was positive on days 5, 9, and 14. At any time during their ICU stay SC patients experienced more delirium than the PT+NMES+HPRO group (46% vs 32%, p=0.09) although not statistically significant. There were no differences between groups when comparing length of stay or days on MV. Conclusion: The combination of NMES, HPRO and PT resulted in mitigation of lower extremity muscle loss and amelioration of clinical status of patients admitted to the ICU. The value of NMES, HPRO and PT independently in the initial and ongoing care of ICU survivors beyond 14 days of admission remains to be evaluated.Trial Registration: Clinicaltrials.gov identifier: NCT3195127

EFFECT OF BEDLOAD SEDIMENT NATURAL COMPOSITION ON GEOMETRIC AND DINAMIC CHARACTERISTICS OF CHANNEL FORMS

2018 ◽  
pp. 36-39
Author(s):  
N Ikramov ◽  
T Majidov
Keyword(s):  
Research Work ◽  
Laboratory Data ◽  
Hydroelectric Station ◽  
Negative Consequences ◽  
Movement Velocity ◽  
Reservoir Volume ◽  
Pump Station ◽  
Cross Section Area ◽  
Section Area ◽  
Bedload Sediment

The article brings up data on sediment diversity at watercourse bed and on their movement in the form of ridges. The ridge form movement of sediment leads to the reduction of reservoir volume and canal cross section area, which has an effect on their carrying capacity, filling of pump station forechambers and hydroelectric station pressure basins with sediment. The presence of sediment in flow leads to abrasive deterioration of pumps, water motors and pressure pipes and to other negative consequences. Research work tasks on the study of these effects have been examined with the purpose of preventing such negative consequences. On the basis of laboratory data diagrams and relationships were obtained for ridge length, height and movement velocity vs. sediment hydraulic and geometric sizes.

scholarly journals The Effectiveness Of Quadriceps Strengthening Exercises Combined With Neuromuscular Electrical Stimulation on Patellofemoral Pain Syndrome

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0010
Author(s):  
Sezen Karabörklü Argut ◽  
Nilgün Türker ◽  
Derya Çelik ◽  
Önder İsmet Kılıçoğlu
Keyword(s):  
Electrical Stimulation ◽  
Muscle Strength ◽  
Neuromuscular Electrical Stimulation ◽  
Pain Syndrome ◽  
Quadriceps Strength ◽  
Patellofemoral Pain ◽  
Group I ◽  
Strengthening Exercises ◽  
Group Ii ◽  
And Function

Objective: The weakness of the quadriceps strength in patellofemoral pain syndrome (PFPS) is very evident. Therefore, quadriceps strengthening exercises are very important part of the rehabilitation program. Neuromuscular Electrical Stimulation (NMES) is considered one of the methods for increasing quadriceps muscle strength. To evaluate the effectiveness of combined NMES and strengthening exercises to improve the recovery of quadriceps strength and function in patients with PFPS. Methods: This study was planned as a randomized controlled pilot study. A total of 27 patients (mean age=38.9±10.8 years, range=20-60 years; 16 females) with PFPS were assessed and randomly assigned into 2 groups. Group I received a standard program (quadriceps strengthening, hip strengthening and hamstring stretching) and NMES combined with quadriceps strengthening exercises simultaneously. Group II received the same standard program without NMES. Both groups were enrolled 3 times per week for 40 minutes per day in 6 weeks. Patients were assessed at the baseline, 3 rd, 6th, and 12th weeks of treatment. Quadriceps strength was evaluated by isokinetic dynamometer. The range of motion at testing was set between 0 for extension to 90 for flexion. The test was performed at 60 degrees/sn and concentric maximum peak torque value was recorded. Kujala and Lysholm scores were used for functional assessments. The data were analyzed using the SPSS 20.0. Shapiro-Wilk test was used to assess the distribution of data. The changes in dependent variables before treatment, 3 rd, 6th, and 12th weeks were analyzed using a 2 by 4 mixed-model analysis of variance (ANOVA). Pairwise comparisons with paired t test were used to determine whether the Group I or Group II, has changed over time. An intention- to- treat analysis was performed to impute values for missing data. An alpha level of 0.05 was established. Results: The study was completed with 20 patients. Group I (n=10; mean age=39.4±8.5 years; 7 females) and group II (n=10; mean age=43.2±11.7 years; 5 females) had no differences in pre-operative measures (p>.05). There was significant improvements in within groups statistics of all parameters for both groups (p<.05). No differences in quadriceps strength, Kujala and Lysholm scores between groups were found at the different time points (F= 0.86; p = 0.12, F=0,001; p =0.97, F=0.12; p=0.73, respectively) Conclusion: NMES combined with quadriceps strengthening exercises has no additional effect on PFPS patients’ on muscle strength and function. When considering these results, we believe that there is no need to continue the study in progress. [Table: see text]

scholarly journals Long-term evaluation of rootstock effects on cropping and tree parameters of selected sweet cherry cultivars

2020 ◽  
Vol 47 (No. 1) ◽  
pp. 13-20
Author(s):  
Jitka Blažková ◽  
František Paprštein ◽  
Lubor Zelený ◽  
Adéla Skřivanová ◽  
Pavol Suran
Keyword(s):  
Sweet Cherry ◽  
Cross Section Area ◽  
Section Area ◽  
Natural Tendency ◽  
Term Evaluation ◽  
The Mean ◽  
Sweet Cherry Cultivars ◽  
Tree Characteristics ◽  
Gisela 5

The cropping of six sweet cherry cultivars that originated in the Research and Breeding Institute of Pomology at Holovousy, and a standard one, ‘Burlat’, were evaluated on three rootstocks in the period of 2007–2017. Trees planted in a spacing of 1.5 m × 5.0 m were trained as tall spindle axes utilising their natural tendency to develop a central leader. On the standard rootstock, P-TU-2, ‘Tim’ was the most productive with a mean total harvest of 47.6 kg per tree. ‘Sandra’ yielded the most on the PHLC rootstock with 56.2 kg per tree and ‘Helga’ yielded the most on Gisela 5 with a mean total harvest of 55.9 kg per tree. The mean impact of the rootstock on the tree vigour, measured upon the trunk cross section area, ranged from 148.4 cm2 on the standard rootstock P-TU-2 to 114.1 cm2 on the PHLC and 125.2 cm2 on Gisela 5 . On the standard rootstock P-TU-2, the most vigorous one according to this criterion was ‘Jacinta’ (178.0 cm2) whereas ‘Justyna’ (109.7 cm2) was the least vigorous. On the PHLC, the most vigorous was ‘Sandra’ (147.2 cm2) and the least was ‘Amid’ (94.0 cm2). The other tree characteristics were mainly dependant on the cultivar and minimally, or not at all, influenced by the rootstock vigour.

scholarly journals A Five-Ingredient Nutritional Supplement and Home-Based Resistance Exercise Improve Lean Mass and Strength in Free-Living Elderly

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2391 ◽  
Author(s):  
Mats I. Nilsson ◽  
Andrew Mikhail ◽  
Lucy Lan ◽  
Alessia Di Carlo ◽  
Bethanie Hamilton ◽  
...  
Keyword(s):  
Resistance Exercise ◽  
Old Age ◽  
Body Fat ◽  
Lean Mass ◽  
Daily Intake ◽  
Protein Supplementation ◽  
Muscle Quality ◽  
Free Living ◽  
Home Based ◽  
And Function

Old age is associated with lower physical activity levels, suboptimal protein intake, and desensitization to anabolic stimuli, predisposing for age-related muscle loss (sarcopenia). Although resistance exercise (RE) and protein supplementation partially protect against sarcopenia under controlled conditions, the efficacy of home-based, unsupervised RE (HBRE) and multi-ingredient supplementation (MIS) is largely unknown. In this randomized, placebo-controlled and double-blind trial, we examined the effects of HBRE/MIS on muscle mass, strength, and function in free-living, older men. Thirty-two sedentary men underwent twelve weeks of home-based resistance band training (3 d/week), in combination with daily intake of a novel five-nutrient supplement (‘Muscle5’; M5, n = 16, 77.4 ± 2.8 y) containing whey, micellar casein, creatine, vitamin D, and omega-3 fatty acids, or an isocaloric/isonitrogenous placebo (PLA; n = 16, 74.4 ± 1.3 y), containing collagen and sunflower oil. Appendicular and total lean mass (ASM; +3%, TLM; +2%), lean mass to fat ratios (ASM/% body fat; +6%, TLM/% body fat; +5%), maximal strength (grip; +8%, leg press; +17%), and function (5-Times Sit-to-Stand time; −9%) were significantly improved in the M5 group following HBRE/MIS therapy (pre vs. post tests; p < 0.05). Fast-twitch muscle fiber cross-sectional areas of the quadriceps muscle were also significantly increased in the M5 group post intervention (Type IIa; +30.9%, Type IIx, +28.5%, p < 0.05). Sub-group analysis indicated even greater gains in total lean mass in sarcopenic individuals following HBRE/MIS therapy (TLM; +1.65 kg/+3.4%, p < 0.05). We conclude that the Muscle5 supplement is a safe, well-tolerated, and effective complement to low-intensity, home-based resistance exercise and improves lean mass, strength, and overall muscle quality in old age.

Thermoacoustic Shape Optimization of a Subsonic Nozzle

2013 ◽  
Vol 135 (10) ◽  
Author(s):  
Alexis Giauque ◽  
Maxime Huet ◽  
Franck Clero ◽  
Sébastien Ducruix ◽  
Franck Richecoeur
Keyword(s):  
Acoustic Emission ◽  
Cross Section ◽  
Source Term ◽  
Combustion Noise ◽  
Noise Emission ◽  
Cross Section Area ◽  
Section Area ◽  
The Cross ◽  
Nozzle Flows ◽  
Subsonic Nozzle

Indirect combustion noise originates from the acceleration of nonuniform temperature or high vorticity regions when convected through a nozzle or a turbine. In a recent contribution (Giauque et al., 2012, “Analytical Analysis of Indirect Combustion Noise in Subcritical Nozzles,” ASME J. Eng. Gas Turbies Power, 134(11), p. 111202) the authors have presented an analytical thermoacoustic model providing the indirect combustion noise generated by a subcritical nozzle when forced with entropy waves. This model explicitly takes into account the effect of the local changes in the cross-section area along the configuration of interest. In this article, the authors introduce this model into an optimization procedure in order to minimize or maximize the thermoacoustic noise emitted by arbitrarily shaped nozzles operating under subsonic conditions. Each component of the complete algorithm is described in detail. The evolution of the cross-section changes are introduced using Bezier's splines, which provide the necessary freedom to actually achieve arbitrary shapes. Bezier's polar coordinates constitute the parameters defining the geometry of a given individual nozzle. Starting from a population of nozzles of random shapes, it is shown that a specifically designed genetic optimization algorithm coupled with the analytical model converges at will toward a quieter or noisier population. As already described by Bloy (Bloy, 1979, “The Pressure Waves Produced by the Convection of Temperature Disturbances in High Subsonic Nozzle Flows,” J. Fluid Mech., 94(3), pp. 465–475), the results therefore confirm the significant dependence of the indirect combustion noise with respect to the shape of the nozzle, even when the operating regime is kept constant. It appears that the quietest nozzle profile evolves almost linearly along its converging and diverging sections, leading to a square evolution of the cross-section area. Providing insight into the underlying physical reason leading to the difference in the noise emission between two extreme individuals, the integral value of the source term of the equation describing the behavior of the acoustic pressure of the nozzle is considered. It is shown that its evolution with the frequency can be related to the global acoustic emission. Strong evidence suggest that the noise emission increases as the source term in the converging and diverging parts less compensate each other. The main result of this article is the definition and proposition of an acoustic emission factor, which can be used as a surrogate to the complex determination of the exact acoustic levels in the nozzle for the thermoacoustic shape optimization of nozzle flows. This acoustic emission factor, which is much faster to compute, only involves the knowledge of the evolution of the cross-section area and the inlet thermodynamic and velocity characteristics to be computed.

Abstract 313: STIM1 Silencing Reverses Pressure-overload Induced Cardiac Hypertrophy In Mice

2013 ◽  
Vol 113 (suppl_1) ◽  
Author(s):  
Ludovic O Bénard ◽  
Daniel S Matasic ◽  
Mathilde Keck ◽  
Anne-Marie Lompré ◽  
Roger J Hajjar ◽  
...  
Keyword(s):  
Ventricular Hypertrophy ◽  
Contractile Function ◽  
Pressure Overload ◽  
Left Ventricular ◽  
Aortic Banding ◽  
Cross Section Area ◽  
Abdominal Aortic ◽  
Section Area

STromal Interaction Molecule 1 (STIM1), a membrane protein of the sarcoplasmic reticulum, has recently been proposed as a positive regulator of cardiomyocyte growth by promoting Ca2+ entry through the plasma membrane and the activation of Ca2+-mediated signaling pathways. We demonstrated that STIM1 silencing prevented the development of left ventricular hypertrophy (LVH) in rats after abdominal aortic banding. Our aim was to study the role of STIM1 during the transition from LVH to heart failure (HF). For experimental timeline, see figure. Transverse Aortic Constriction (TAC) was performed in C57Bl/6 mice. In vivo gene silencing was performed using recombinant Associated AdenoVirus 9 (AAV9). Mice were injected with saline or with AAV9 expressing shRNA control or against STIM1 (shSTIM1) (dose: 1e+11 viral genome), which decreased STIM1 cardiac expression by 70% compared to control. While cardiac parameters were similar between the TAC groups at weeks 3 and 6, shSTIM1 animals displayed a progressive and total reversion of LVH with LV walls thickness returning to values observed in sham mice at week 8. This reversion was associated with the development of significant LV dilation and severe contractile dysfunction, as assessed by echography. Hemodynamic analysis confirmed the altered contractile function and dilation of shSTIM1 animals. Immunohistochemistry showed a trend to more fibrosis. Despite hypertrophic stimuli, there was a significant reduction in cardiac myocytes cross-section area in shSTIM1-treated animals as compared to other TAC mice. This study showed that STIM1 is essential to maintain compensatory LVH and that its silencing accelerates the transition to HF.

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