This project was funded by, in part, by start-up funds from Wayne State University to M.H. Malek.

Tutte le procedure sono state approvate dalla Università Institutional Review Board per soggetti umani. 1. Preparazione del D.Lgs del Partecipante <ol><li> Hanno il partecipante ordinatamente rimboccarsi le corti per la gamba desiderata. Poi nastro le corti in modo che il quadricipite femorale gruppo muscolare è esposto e tracciare una linea intorno alla zona del partecipante ha bisogno di radersi. </li><li> IMPORTANTE: Avere il partecipante radersi la gamba prima della prova, piuttosto che il giorno precedente come questo assicura che non ci sono stoppie che possono interferire con il segnale EMG. </li><li> Una volta che il partecipante ha finito la rasatura della zona desiderata della gamba, pulire la zona rasata con alcool per garantire non ci sono i resti del gel da barba (o crema), che possono interferire con il segnale EMG. </li></ol> 2. Misura di piedino a degli elettrodi <ol><li> Per posizionare l&#39;elettrodo EMG sul muscolo vasto laterale, fare il foMisure llowing <ol><li> Hanno il partecipante stare dritto di fronte al ricercatore. </li><li> Individuare la spina iliaca anteriore superiore (ASIS) e la parte laterale della rotula. Il ASIS è l&#39;osso dell&#39;anca; palpazione, posizionando il mano su entrambi i lati del ventre sotto l&#39;ombelico. </li><li> Con una misura di nastro, misurare la distanza tra le due posizioni sopra identificati e prendere 2/3 di tale valore sulla linea dalla ASIS al lato laterale della rotula. Nota: Per ulteriori informazioni riguardanti il ​​posizionamento degli elettrodi EMG può essere trovato sul SENIAM (elettromiografia di superficie per la valutazione non invasiva di muscoli) URL: http://www.seniam.org/ </li></ol></li></ol> 3. posizionamento degli elettrodi EMG <ol><li> Dopo aver individuato dove si vasto laterale, prendere gli elettrodi EMG (la maggior parte dei ricercatori usano in commercio e getta elettrodi Ag-Ag Cl) e posto sul vasto laterale senza rimuovere l&#39;adesivo shield. Poi, con una penna contrassegnare la zona in cui la parte del gel dell&#39;elettrodo fa contatto con il muscolo. Assicuratevi che la distanza interelettrodica è di 20 mm da centro a centro. </li><li> Usare un pezzo di carta vetrata (60 grossolana) di abradere delicatamente queste due aree per rimuovere lo strato superficiale della pelle. Durante questo periodo, chiedere al partecipante loro livello di disagio. Smettere di abrasione quando il partecipante indica la zona è caldo. </li><li> Pulire le zone abrase con un asciugamano che è inumidito con alcool o un tampone imbevuto di alcool. Lasciare che l&#39;area sulla gamba si asciughi prima di posizionare gli elettrodi EMG. </li><li> Posizionare gli elettrodi EMG sui siti che sono stati abrasa (Figura 2). Fate attenzione a non posizionare gli elettrodi sulla banda ileotibiale (banda IT). Chiedere al partecipante di contrarre i muscoli quadricipite femorale, al fine di palpare vasto laterale. Posizionare gli elettrodi sul muscolo per assicurarsi che non è sulla banda IT. Nota: Se gli elettrodi sulla banda IT, il segnale wou EMGld essere inumidito quando il partecipante viene chiesto ad un massimo di contratto. </li><li> Inserire l&#39;elettrodo di riferimento (3 Elettrodo rd) su un sito di attacco ossea come il ASIS quindi non interferire con il movimento degli arti inferiori durante il periodo di esercizio. </li></ol> 4. Controllo del segnale EMG <ol><li> Prima di iniziare il test da sforzo, controlla l&#39;impedenza interelettrodica. Nota: Questo passaggio è fondamentale, perché se il segnale è troppo rumore, allora i dati EMG raccolti durante il test da sforzo non saranno validi. <ol><li> Hanno il partecipante sedersi su una sedia e collegare il EMG conduce ai rispettivi elettrodi applicati alla gamba del partecipante. </li><li> A questo punto, il partecipante ha rilassare la gamba, con nessuna tensione nel muscolo. Poi, dopo circa 30 secondi di relax, hanno il partecipante al massimo contrarre i loro muscoli quadricipiti femorale per 5 secondi e poi tornare ad essere completamente rilassati. </li><li> Quando si esegue l&#39;operazione unBove (fase 4.1.2), registrare il segnale di partecipanti EMG sul computer. </li><li> Assicurarsi che l&#39;impedenza fra gli elettrodi è &lt;2.000 ohm. Inoltre, se un voltmetro è disponibile in laboratorio, quindi controllare il rumore di fondo e tenere sotto 5 mV. Inoltre, impostare la frequenza di campionamento di 1.000 Hz. </li></ol></li></ol> 5. Costituzione del cicloergometro <ol><li> Dopo aver controllato l&#39;impedenza gli elettrodi, avere il passaggio partecipante dalla sedia al cicloergometro. </li><li> Avere il partecipante stare accanto al cicloergometro e sollevare il ginocchio fino a quando la coscia è parallelo al suolo. Poi hanno il partecipante mantenere questa posizione e regolare l&#39;altezza del sedile in modo che corrisponda alla stessa altezza coscia del partecipante. </li><li> Successivamente, hanno il partecipante sedersi sul sedile cicloergometro e poi pedalare un paio di volte chiedendo loro se sono confortevoli, con l&#39;altezza del sedile. Se necessario, regolare l&#39;altezza del sedile. </li><li> Garantire that gambe dei partecipanti sono vicino estensione completa con una leggera curva (~ 5 °) alle ginocchia durante ogni giro del pedale. </li><li> Prima di iniziare la prova, hanno il partecipante indossare un cardiofrequenzimetro Polar in modo che la frequenza cardiaca può essere documentato in tutto il test da sforzo. </li></ol> 6. Esecuzione della soglia protocollo EMG Fatica <ol><li> Avere il partecipante inizia ciclismo e aumentare gradualmente la loro cadenza a 70 giri / min. Quindi aumentare la potenza sul cicloergometro a 50 W. </li><li> Hanno il ciclo di partecipante a questa potenza per circa 2-3 minuti. Nota: Questo è un esercizio a bassa intensità e servirà come il warm-up. </li><li> Dopo il periodo di riscaldamento, aumentare la potenza da 25 W ogni 2 min fino a che il partecipante non è più in grado di mantenere il 70 giri / min cadenza o richiede che il test viene interrotto. Nota: Si deve notare che durante la prova di esercizio, il segnale EMG viene registrato per 10sec epoche durante ogni fase 2 min per 10-20 secondi, 30-40, 50-60, 70-80, 90-100 e 110-120 21. Maggior parte dei sistemi EMG avranno la possibilità di impostare la registrazione automatica all&#39;intervallo desiderato. Così, per ogni fase ci dovrebbero essere 6 file di dati. </li><li> Una volta che il test incrementale ha concluso, hanno il partecipante effettuare un raffreddamento a 50 W. Verificare che la lunghezza del raffreddamento corrisponde con avere frequenza cardiaca ritorno del partecipante al valore durante la fase di riscaldamento. Monitorare questo controllando la frequenza cardiaca del partecipante utilizzando il cardiofrequenzimetro polar. </li><li> Una volta che il raffreddamento è completato, rimuovere l&#39;EMG porta e hanno il partecipante scendere il cicloergometro e tornare alla sedia. Quindi rimuovere con attenzione gli elettrodi EMG e pulire le zone con un panno pulito inumidito con alcool o un tampone imbevuto di alcool. </li></ol> 7. Elaborazione del segnale EMG <ol><li> Dopo il test, proCESS i file di dati EMG grezzi che sono stati raccolti durante la prova esercizio in modo che i dati possano essere utilizzati per determinare la soglia di fatica EMG. <ol><li> Eseguire l&#39;elaborazione del segnale EMG sia con il software utilizzato per raccogliere il segnale EMG o software scritto personalizzato utilizzando diverse piattaforme come MATLAB o LabVIEW. </li><li> Filtra i segnali EMG raccolti usando un filtro passa-banda. Utilizzare un&#39;impostazione di 10 a 500 Hz. Nota: Ciò altera la frequenza del segnale in modo che artefatti bassa frequenza dovuti a movimenti dei cavi EMG (&lt;10 Hz), e manufatti alta frequenza dall&#39;ambiente (&gt; 500 Hz), vengono rimossi. Utilizzare un filtro notch di 60 Hz se c&#39;è qualche interferenza dalla alimentazione del computer o sistema EMG. </li><li> Una volta che il segnale è stato filtrato, determinare l&#39;ampiezza del segnale calcolando il valore quadratico medio del segnale: Piazza ciascuno dei punti di dati, li somma, dividere per il numero di punti di dati, poi prendere la radice quadrata del valore risultante. Eseguire questi calcoli con il software di cui sopra. </li></ol></li></ol> 8. Determinazione della soglia EMG di fatica per ogni partecipante <ol><li> Effettuare le seguenti operazioni per ogni partecipante. <ol><li> Dopo il segnale EMG è stato elaborato; utilizzare un programma statistico (es: GraphPad Prism) ed etichettare la prima colonna &quot;Time&quot; e le colonne successive con le uscite di potenza utilizzati per la prova. </li><li> Per ogni uscita di potenza, fill-in corrispondente valore di ampiezza EMG per ogni intervallo di 20 sec. </li><li> Per ogni uscita di potenza, analizzare il tempo (asse x) vs ampiezza EMG (asse y) rapporto con la regressione lineare per determinare se la pendenza della retta di regressione è significativamente (p &lt;0,05) diversa da zero. </li><li> Dopo aver eseguito l&#39;analisi di regressione lineare per tutte le uscite di potenza, identificare la potenza più elevata con una non significativa (p&gt; 0.05) pendio. </li><li> Quindi identificare il lowest potenza con una significativa (p &lt;0.05) pendio. </li><li> Una volta individuati questi due uscite di potenza, aggiungerli e dividere per 2; la potenza risultante è la stima del limite di fatica EMG. </li></ol></li></ol>

<ol>
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The authors have nothing to disclose.

Noi qui presentiamo un metodo per determinare la fatica neuromuscolare del quadricipite femorale per l&#39;esercizio dinamico. Questo metodo fornisce un approccio semplice e non invasivo per utilizzare EMG di superficie. Inoltre, la versatilità di questo metodo è che i ricercatori possono adattarlo ad altre modalità di esercizio, come il tapis roulant 20. Teoricamente, per intensità pari o inferiore al limite di fatica EMG il partecipante dovrebbe essere in grado di sostenere ...

Elettromiografia di superficie (EMG) è un approccio non invasivo di studiare unità assunzioni motore durante isometrico 1-3, 4-6 isocinetico, o continua azione 7-10 muscolare. L&#39;ampiezza del segnale EMG rappresenta attivazione muscolare che consiste nel numero di unità motorie attivate, la frequenza di scarica delle unità motorie, o entrambi 11. Il concetto di soglia di fatica EMG viene utilizzato per indicare il massimo carico di lavoro in cui un individuo può esercitare indefinitamente senza un aumento in ampiezza EMG 8. È importante brevemente discussione l&#39;origine della soglia di fatica EMG. Lo studio originale di deVries et al. 12 ha coinvolto un protocollo che consisteva di più (di solito 3-4) periodi di lavoro discontinui, in cui l&#39;ampiezza EMG è stata tracciata in funzione del tempo per ogni incontro di lavoro. La potenza in uscita è stata poi tracciata contro i coefficienti di pendenza della ampiezza EMG in funzione del tempo rela<html> tionship, e poi estrapolato a zero pendenza (l&#39;intercetta) 12. Gli autori 12 originariamente definito tale protocollo la capacità di lavoro fisico alla soglia di fatica (PWCFT). In un altro studio, deVries et al. 13 utilizzato periodi di lavoro discontinui, ma usato la regressione lineare per trovare la prima potenza che ha portato in un pendio significativo per l&#39;ampiezza EMG rispetto al rapporto tempo. Gli autori hanno 13 anche definiti che il protocollo PWCFT, creando una certa confusione nella letteratura. In un articolo successivo, deVries et al. 14 modificato loro precedente protocollo 13 e ha sviluppato un protocollo incrementale continuo. L&#39;ampiezza EMG stata rilevata in tempo per ciascuna uscita di potenza e la PWCFT è stato definito come la media della potenza massima che ha comportato una variazione in ampiezza EMG nel tempo e la potenza minima che ha provocato un aumento della ampiezza EMG nel tempo 14 . ent &quot;&gt; Si precisa che il termine PWC è stata originariamente introdotta alla fine del 1950 e 15,16 è sinonimo di una pletora di letteratura (passato, presente, e in diversi paesi) esaminando la capacità aerobica ad un determinato carico di lavoro 17. Inoltre, il termine è usato in letteratura ergonomica e industriale che concentrarsi su giorno per giorno la produttività di operatori che eseguono azioni ripetitive durante i giorni del lavoro otto ore come le persone in uno stabilimento di assemblaggio 18. La soglia di fatica EMG termine è stato inizialmente utilizzato da Matsumoto e colleghi 19 dopo aver modificato il protocollo deVries 12 dove la potenza di uscita rispetto a coefficienti di inclinazione di ampiezza EMG rispetto al rapporto tempo vengono tracciati e estrapolati al punto zero pendio. Più recentemente, Guffey et al. 20 e Briscoe et al. 8 usato il metodo di deVries et al. 14 e la terminologia di Matsumoto et unl. 19 per definire operativamente la soglia di fatica EMG. Andando avanti, si consiglia di utilizzare il termine soglia di EMG di fatica. Così, l&#39;ampiezza EMG contro relazione tempo è tracciata per ogni uscita di potenza e quindi analizzati utilizzando analisi di regressione lineare (Figura 1). Per stimare la soglia di fatica EMG, la più alta potenza con una non significativa (p&gt; 0.05) pendenza e la potenza più basso con un significativo (p &lt;0,05) pendenza viene identificato e quindi la media è calcolata 14. Questo protocollo è semplice, conveniente, e completato entro 15-20 minuti. Inoltre, il tasso incrementale può essere modulato in base al livello individuale di attività fisica abituale, e quindi ha potenziali applicazioni in ambito clinico.

<table border="0" cellpadding="0" cellspacing="0">
	<tbody>
		<tr>
			<td>839 E Monark cycle ergometer&#160;</td>
			<td>Monark Exercise AB</td>
			<td>839 E</td>
			<td></td>
		</tr>
		<tr>
			<td>Heart rate monitor</td>
			<td>Polar</td>
			<td>Polar H1</td>
			<td></td>
		</tr>
		<tr>
			<td>Laptop</td>
			<td>Dell Inspiron</td>
			<td>varies</td>
			<td>any laptop computer with USB slots should work.</td>
		</tr>
		<tr>
			<td>EMG amplifiers</td>
			<td>BioPac Systems, Inc.</td>
			<td>100B</td>
			<td>100C are the latest version</td>
		</tr>
		<tr>
			<td>Disposable EMG electrodes</td>
			<td>BioPac Systems, Inc.</td>
			<td>EL-500</td>
			<td></td>
		</tr>
		<tr>
			<td>Sandpaper</td>
			<td>Home Depot</td>
			<td>9 in. x 11 in. 60 Grit course no-slip grip Advanced Sandpaper (3-Pack)</td>
			<td></td>
		</tr>
	</tbody>
</table>

determining the electromyographic fatigue threshold following a single visit exercise test

Teoricamente, il elettromiografica (EMG) Soglia fatica è l&#39;intensità di esercizio un individuo può mantenere indefinitamente senza la necessità di assumere più unità a motore che è associato ad un aumento dell&#39;ampiezza EMG. Sebbene siano stati utilizzati diversi protocolli per stimare la soglia di fatica EMG richiedono visite multiple che sono poco pratico per un ambiente clinico. Qui, vi presentiamo un protocollo per la stima della soglia di fatica EMG per cicloergometro che richiede una sola visita. Questo protocollo è semplice, conveniente, e completato entro 15-20 minuti, quindi, ha il potenziale per essere tradotto in uno strumento che i medici possono utilizzare per la prescrizione degli esercizi.

Come mostrato in figura 1, per un singolo partecipante, ogni uscita di potenza che si completa ha sei punti di dati che rappresentano l&#39;ampiezza EMG del muscolo vasto laterale. Pertanto, in questo esempio, la più alta potenza con una non significativa (p&gt; 0.05) pendenza è 200 watt, mentre la potenza più basso con un significativo (p &lt;0,05) pendenza è 225 W. Di conseguenza, per questo partecipante l&#39;EMG soglia fatica è 213 W. Una volta la soglia di fatica EMG è deter...

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Determining The Electromyographic Fatigue Threshold Following a Single Visit Exercise Test

This protocol describes the electromyographic fatigue threshold which demarcates between nonfatiguing and fatiguing exercise workloads. This information could be used to develop a more individualized training program.

Determinazione della soglia elettromiografico Fatica A seguito di un esame esercizio sola visita

Theoretically, the electromyographic (EMG) fatigue threshold is the exercise intensity an individual can maintain indefinitely without the need to recruit ...

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12.4K Views.  Wayne State University. This protocol describes the electromyographic fatigue threshold which demarcates between nonfatiguing and fatiguing exercise workloads. This information could be used to develop a more individualized training program.

Video: Determining The Electromyographic Fatigue Threshold Following a Single Visit Exercise Test

Making Sense of Listening: The IMAP Test Battery

The ability to hear is only the first step towards making sense of the range of information contained in an auditory signal. Of equal importance are the abilities to extract and use the information encoded in the auditory signal. We refer to these as listening skills (or auditory processing AP). Deficits in these skills are associated with delayed language and literacy development, though the nature of the relevant deficits and their causal connection with these delays is hotly debated.
When a child is referred to a health professional with normal hearing and unexplained difficulties in listening, or associated delays in language or literacy development, they should ideally be assessed with a combination of psychoacoustic (AP) tests, suitable for children and for use in a clinic, together with cognitive tests to measure attention, working memory, IQ, and language skills. Such a detailed examination needs to be relatively short and within the technical capability of any suitably qualified professional. Current tests for the presence of AP deficits tend to be poorly constructed and inadequately validated within the normal population. They have little or no reference to the presenting symptoms of the child, and typically include a linguistic component. Poor performance may thus reflect problems with language rather than with AP. To assist in the assessment of children with listening difficulties, pediatric audiologists need a single, standardized child-appropriate test battery based on the use of language-free stimuli.
We present the IMAP test battery which was developed at the MRC Institute of Hearing Research to supplement tests currently used to investigate cases of suspected AP deficits. IMAP assesses a range of relevant auditory and cognitive skills and takes about one hour to complete. It has been standardized in 1500 normally-hearing children from across the UK, aged 6-11 years. Since its development, it has been successfully used in a number of large scale studies both in the UK and the USA. IMAP provides measures for separating out sensory from cognitive contributions to hearing. It further limits confounds due to procedural effects by presenting tests in a child-friendly game-format. Stimulus-generation, management of test protocols and control of test presentation is mediated by the IHR-STAR software platform. This provides a standardized methodology for a range of applications and ensures replicable procedures across testers. IHR-STAR provides a flexible, user-programmable environment that currently has additional applications for hearing screening, mapping cochlear implant electrodes, and academic research or teaching.

A test battery (IMAP) for performing an in-depth assessment of auditory and cognitive abilities contributing to listening skills is described. It is quick to administer, child-friendly and free from linguistic confounds. Stimulus generation and protocol management are controlled via a software platform (IHR-STAR) to ensure replicable procedures.

Making Sense di Ascolto: La batteria di test IMAP

The ability to hear is only the first step towards making sense of the range of information contained in an auditory signal. Of equal importance are the ...

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Medicina

The Trier Social Stress Test Protocol for Inducing Psychological Stress

This article demonstrates a psychological stress protocol for use in a laboratory setting. Protocols that allow researchers to study the biological pathways of the stress response in health and disease are fundamental to the progress of research in stress and anxiety.1 Although numerous protocols exist for inducing stress response in the laboratory, many neglect to provide a naturalistic context or to incorporate aspects of social and psychological stress. Of psychological stress protocols, meta-analysis suggests that the Trier Social Stress Test (TSST) is the most useful and appropriate standardized protocol for studies of stress hormone reactivity.2 In the original description of the TSST, researchers sought to design and evaluate a procedure capable of inducing a reliable stress response in the majority of healthy volunteers.3 These researchers found elevations in heart rate, blood pressure and several endocrine stress markers in response to the TSST (a psychological stressor) compared to a saline injection (a physical stressor).3 Although the TSST has been modified to meet the needs of various research groups, it generally consists of a waiting period upon arrival, anticipatory speech preparation, speech performance, and verbal arithmetic performance periods, followed by one or more recovery periods. The TSST requires participants to prepare and deliver a speech, and verbally respond to a challenging arithmetic problem in the presence of a socially evaluative audience.3 Social evaluation and uncontrollability have been identified as key components of stress induction by the TSST.4 In use for over a decade, the goal of the TSST is to systematically induce a stress response in order to measure differences in reactivity, anxiety and activation of the hypothalamic-pituitary-adrenal (HPA) or sympathetic-adrenal-medullary (SAM) axis during the task.1 Researchers generally assess changes in self-reported anxiety, physiological measures (e.g. heart rate), and/or neuroendocrine indices (e.g. the stress hormone cortisol) in response to the TSST. Many investigators have adopted salivary sampling for stress markers such as cortisol and alpha-amylase (a marker of autonomic nervous system activation) as an alternative to blood sampling to reduce the confounding stress of blood-collection techniques. In addition to changes experienced by an individual completing the TSST, researchers can compare changes between different treatment groups (e.g. clinical versus healthy control samples) or the effectiveness of stress-reducing interventions.1

This article describes a protocol for inducing psychological stress in participants, which enables researchers to measure psychological, physiological and neuroendocrine responses to stress within single participants or between groups.

The Social Trier Protocollo di prova dello stress per indurre stress psicologico

This article demonstrates a psychological stress protocol for use in a laboratory setting.  Protocols that allow researchers to study the biological ...

Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication

Computerized dynamic posturography with the EquiTest is an objective technique for measuring postural strategies under challenging static and dynamic conditions. As part of a diagnostic assessment, the early detection of postural deficits is important so that appropriate and targeted interventions can be prescribed. The Sensory Organization Test (SOT) on the EquiTest determines an individual&#39;s use of the sensory systems (somatosensory, visual, and vestibular) that are responsible for postural control. Somatosensory and visual input are altered by the calibrated sway-referenced support surface and visual surround, which move in the anterior-posterior direction in response to the individual&#39;s postural sway. This creates a conflicting sensory experience. The Motor Control Test (MCT) challenges postural control by creating unexpected postural disturbances in the form of backwards and forwards translations. The translations are graded in magnitude and the time to recover from the perturbation is computed.
Intermittent claudication, the most common symptom of peripheral arterial disease, is characterized by a cramping pain in the lower limbs and caused by muscle ischemia secondary to reduced blood flow to working muscles during physical exertion. Claudicants often display poor balance, making them susceptible to falls and activity avoidance. The Ankle Brachial Pressure Index (ABPI) is a noninvasive method for indicating the presence of peripheral arterial disease and intermittent claudication, a common symptom in the lower extremities. ABPI is measured as the highest systolic pressure from either the dorsalis pedis or posterior tibial artery divided by the highest brachial artery systolic pressure from either arm. This paper will focus on the use of computerized dynamic posturography in the assessment of balance in claudicants.

Individuals with intermittent claudication exhibit poor balance compared to healthy controls. Computerized dynamic posturography is an objective method for measuring an individual's postural responses to balance disturbances. This provides an objective reflection of the person&#x2019;s ability to respond to situations under which sensory stimuli are altered and unexpected perturbations occur.

Computerized dynamic posturography with the EquiTest is an objective technique for measuring postural strategies under challenging static and dynamic ...

Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test

Cardiovascular disease is the primary cause of mortality and a major cause of disability worldwide. The dysfunction of the vascular endothelium is a pathological condition characterized mainly by a disruption in the balance between vasodilator and vasoconstrictor substances and is proposed to play an important role in the development of atherosclerotic cardiovascular disease. Therefore, a precise evaluation of endothelial function in humans represents an important tool that could help better understand the etiology of multiple cardio-centric pathologies.
Over the past twenty-five years, many methodological approaches have been developed to provide an assessment of endothelial function in humans. Introduced in 1989, the FMD test incorporates a forearm occlusion and subsequent reactive hyperemia that promotes nitric oxide production and vasodilation of the brachial artery. The FMD test is now the most widely utilized, non-invasive, ultrasonic assessment of endothelial function in humans and has been associated with future cardiovascular events.
Although the FMD test could have clinical utility, it is a physiological assessment that has inherited several confounding factors that need to be considered. This article describes a standardized protocol for determining FMD including the recommended methodology to help minimize the physiological and technical issues and improve the precision and reproducibility of the assessment.

The flow mediated dilation (FMD) test is the most commonly utilized, non-invasive, ultrasound assessment of endothelial function in humans. Although the FMD test has been related with the prediction of future cardiovascular disease and events, it is a physiological assessment with many inherent confounding factors that need to be considered.

Valutazione ecografica della funzione endoteliale: una Direttiva tecnica del test dilatazione flusso-mediata

Cardiovascular disease is the primary cause of mortality and a major cause of disability worldwide. The dysfunction of the vascular endothelium is a ...

Experimental Protocol of a Three-minute, All-out Arm Crank Exercise Test in Spinal-cord Injured and Able-bodied Individuals

Reliable exercise protocols are required to test changes in exercise performance in elite athletes. Performance improvements in these athletes may be small; therefore, sensitive tools are fundamental to exercise physiology. There are currently many exercise tests that allow for the examination of exercise capacity in able-bodied athletes, with protocols mainly for lower-body or whole-body exercise. There is a trend to test athletes in a sport-specific setting that closely resembles the actions that the participants are used to performing. Only a few protocols test short-term, high-intensity exercise capacity in participants with an impairment of the lower body. Most of these protocols are very sport-specific and are not applicable to a wide range of athletes. One well-known test protocol is the 30 s Wingate test, which is well-established in cycling and in arm crank exercise testing. This test analyzes high-intensity exercise performance over a 30 s time duration. In order to monitor exercise performance over a longer duration, a different method was modified for application to the upper body. The 3 min, all-out arm crank ergometer test allows athletes to be tested in a manner specific to 1,500 m wheelchair racing (in terms of exercise duration), as well as to upper body exercises such as rowing or hand-cycling. In order to increase the reliability with identical test conditions, it is crucial to precisely replicate settings such as the resistance (i.e., torque factor) and the position of the participants (i.e., the height of the crank, the distance between the crank and the participant, and the fixation of the participant). Another important issue concerns the beginning of the exercise test. Fixed revolutions per minute are required to standardize the test conditions for the start of the exercise test. This exercise protocol shows the importance of accurate operations to reproduce identical test conditions and settings.

We present a protocol to test the aerobic and anaerobic power of the upper body muscles over a duration of 3 min in able-bodied as well as in paraplegic and tetraplegic individuals. The protocol presents specific modifications in its application for upper-body exercise in individuals with or without disability.

Protocollo sperimentale di un esercizio di tre minuti di allenamento a braccio del braccio in pazienti con lesioni colpite da spinali e abilità corporee

Reliable exercise protocols are required to test changes in exercise performance in elite athletes. Performance improvements in these athletes may be ...

A Technique for Subcutaneous Abdominal Adipose Tissue Biopsy via a Non-diathermy Method

Adipose tissue biopsies offer tissue samples that, upon analysis, may provide insightful overviews of mechanisms relating to metabolism and disease. To obtain subcutaneous adipose tissue biopsies in the abdominal area, researchers and physicians use either a surgical or a needle-based technique. However, surgical subcutaneous fat biopsies can offer tissue samples that may provide a more comprehensive overview of the complexities of biological indices in white adipose tissue. Usually, a surgical adipose tissue biopsy includes a diathermy treatment for cauterizing blood vessels to prevent excessive bleeding. Nevertheless, side effects, such as flash fires and skin lesions in the tissue, have been reported after diathermy. Therefore, we aimed to standardize a surgical abdominal adipose tissue biopsy performed under local anesthesia using a non-diathermy method. We conducted 115 subcutaneous adipose tissue biopsies in healthy men using a non-diathermy abdominal surgical biopsy method. Our results showed three cases of excessive post-operation bleeding out of 115 operations (2.61%).In conclusion, our standardized subcutaneous abdominal adipose tissue surgical biopsy using a non-diathermy method can be safely applied to healthy men at the bedside, with minimal side effects.

We standardized an abdominal adipose tissue biopsy using a non-diathermy method performed under local anesthesia. Three cases of excessive post-operation bleeding out of 115 operations (2.61%) occurred.We conclude that an abdominal adipose tissue surgical biopsy using a non-diathermy method can be safely applied to healthy men.

Una tecnica per la biopsia del tessuto adiposo sottocutaneo addominale tramite un metodo Non-diatermia

Adipose tissue biopsies offer tissue samples that, upon analysis, may provide insightful overviews of mechanisms relating to metabolism and disease. To ...

Taste Exam: A Brief and Validated Test

The emerging importance of taste in medicine and biomedical research, and new knowledge about its genetic underpinnings, has motivated us to supplement classic taste-testing methods in two ways. First, we explain how to do a brief assessment of the mouth, including the tongue, to ensure that taste papillae are present and to note evidence of relevant disease. Second, we draw on genetics to validate taste test data by comparing reports of perceived bitterness intensity and inborn receptor genotypes. Discordance between objective measures of genotype and subjective reports of taste experience can identify data collection errors, distracted subjects or those who have not understood or followed instructions. Our expectation is that fast and valid taste tests may persuade researchers and clinicians to assess taste regularly, making taste testing as common as testing for hearing and vision. Finally, because many tissues of the body express taste receptors, taste responses may provide a proxy for tissue sensitivity elsewhere in the body and, thereby, serve as a rapid, point-of-care test to guide diagnosis and a research tool to evaluate taste receptor protein function.

This protocol measures human taste responses and includes a brief anatomical assessment, a short taste test, and a validation method using the subject&#39;s reported sensation and taste receptor genotype.

Esame gustativo: Un Test breve e convalidato

The emerging importance of taste in medicine and biomedical research, and new knowledge about its genetic underpinnings, has motivated us to supplement ...

'Boden Food Plate': Novel Interactive Web-based Method for the Assessment of Dietary Intake

Different methods can be used in research to assess dietary intake, many of which are still paper-based. Written estimated food diaries are often utilized in clinical trials, despite being a burden for both study participants and researchers. This method requires participant literacy, it is time consuming, labor intensive, and can easily lead to under-reporting. With advancements in technology, there is a growing interest in electronic diaries that automate the dietary assessment process. These are focused on improving accuracy, reducing both time and cost and providing users with a visual and more enjoyable experience. The methodology presented here aimed to validate the &#39;Boden Food Plate&#39;, a novel web-based platform for self-recording of food and drink items, compared to a traditional estimated food diary. The application was also rated on a satisfaction scale by study participants using a paper-based questionnaire. Sixty-seven participants completed the dietary measures on both the three-day electronic and paper food diaries. For the analysis, only dietary data completed at both study time points (baseline and week six) was utilized. Despite small mean differences between dietary data collection methods, Bland Altman analysis showed fairly wide 95% limits of agreement between the electronic platform and the written estimated food diary and there were few cases which did not fall within the 95% confidence intervals. Overall, participants found the electronic food diary to be more fun than the paper method and as easy to use as hard copy diaries. The new platform has potential as a self-recording tool for the collection of dietary data, particularly when utilized in clinical trial settings. However, further validation studies are needed to improve the validity of this novel electronic dietary data collection tool.

&#039;Boden Food Plate&#039;: Novel Interactive Web-based Method for the Assessment of Dietary Intake

The &#39;Boden Food Plate&#39; is an electronic food diary designed to be an interactive and fun method to collect dietary intake using visual depictions. The purpose of this study was to validate the web-based application against a traditional three-day estimated food diary method.

'Cibo Boden Plate': romanzo metodo interattivo basato su Web per la valutazione dell'assunzione alimentare

Different methods can be used in research to assess dietary intake, many of which are still paper-based. Written estimated food diaries are often utilized ...

Conducting Maximal and Submaximal Endurance Exercise Testing to Measure Physiological and Biological Responses to Acute Exercise in Humans

Regular physical activity has a positive effect on human health, but the mechanisms controlling these effects remain unclear. The physiologic and biologic responses to acute exercise are predominantly influenced by the duration and intensity of the exercise regimen. As exercise is increasingly thought of as a therapeutic treatment and/or diagnostic tool, it is important that standardizable methodologies be utilized to understand the variability and to increase the reproducibility of exercise outputs and measurements of responses to such regimens. To that end, we describe two different cycling exercise regimens that yield different physiologic outputs. In a maximal exercise test, exercise intensity is continually increased with a greater workload resulting in an increasing cardiopulmonary and metabolic response (heart rate, stroke volume, ventilation, oxygen consumption and carbon dioxide production). In contrast, during endurance exercise tests, the demand is increased from that at rest, but is raised to a fixed submaximal exercise intensity resulting in a cardiopulmonary and metabolic response that typically plateaus. Along with the protocols, we provide suggestions on measuring physiologic outputs that include, but are not limited to, heart rate, slow and forced vital capacity, gas exchange metrics, and blood pressure to enable the comparison of exercise outputs between studies. Biospecimens can then be sampled to assess cellular, protein, and/or gene expression responses. Overall, this approach can be easily adapted into both short- and long-term effects of two distinct exercise regimens.

To assess the influence of exercise intensity on physiologic and biologic responses, two different exercise testing protocols were utilized. Methods outlining exercise testing on a cycle ergometer as an incremental maximal oxygen consumption test and endurance, steady state submaximal endurance test are described.

Lo svolgimento di prova per misurare le risposte fisiologiche e biologiche all'esercizio acuto negli esseri umani di esercizio submassimale e massima resistenza

Regular physical activity has a positive effect on human health, but the mechanisms controlling these effects remain unclear. The physiologic and biologic ...

Setup and Execution Of the Blindfolded Code Training Exercise

Miscommunication is the most common cause of preventable patient harm in medicine. Currently, there is limited knowledge of innovative techniques to improve resident physician communication and leadership strategies in high-acuity situations. The blindfolded code training exercise removes visual stimuli from the team leader, forcing the team leader to effectively utilize closed-loop communication. The simple act of blindfolding the team leader creates a learning environment where the leader must utilize a conceptual framework and critical thinking strategies to organize the team and manage the resuscitation. An advantage to this teaching technique is that it does not require any special simulation equipment, making it a low-cost approach. The blindfolded code training exercise can be applied to the management of any critically ill patient where the primary objective is to focus on developing communication skills in acute resuscitations. The purpose of the description of the blindfolded code training exercise is to provide guidance on how to perform this innovative teaching technique to force effective closed-loop communication.

The blindfolded code training exercise, which blindfolds the team leader in a code resuscitation simulation, is an advanced teaching technique to improve closed-loop communication, organizational skills, and critical thinking.&#160;

L'installazione e l'esecuzione dell'esercizio di formazione con gli occhi bendati codice

Miscommunication is the most common cause of preventable patient harm in medicine. Currently, there is limited knowledge of innovative techniques to ...