Recovery kinetics following eccentric exercise is volume-dependent

The present study compared the effect of 75 vs 150 vs 300 intensity-matched eccentric contractions on muscle damage and performance recovery kinetics. Ten healthy males participated in a randomized, cross-over study consisted of 4 experimental trials (ECC75, ECC150, ECC300 and Control - no exercise) with a 4-week washout period in-between. Performance and muscle damage, inflammatory and oxidative stress markers were evaluated at baseline, post-exercise, 24, 48 and 192 hours following each exercise protocol. Concentric and eccentric peak torque decreased similarly in ECC150 and ECC300 during the first 48 h of recovery (p < 0.05) but remained unaffected in ECC75. Countermovement jump indices decreased post-exercise and at 24 h in ECC150 and ECC300, with ECC300 inducing a more pronounced reduction (p < 0.05). Creatine kinase increased until 48 h of recovery in all trials and remained elevated up to 192 h only in ECC300 (p < 0.05). Delayed onset of muscle soreness increased, and knee-joint range of motion decreased in a volume-dependent manner during the first 48 h (p < 0.05). Likewise, a volume-dependent decline of glutathione and a rise of protein carbonyls was observed during the first 48 h of recovery (p < 0.05). Collectively, our results indicate that muscle damage and performance recovery following eccentric exercise is volume dependent, at least in lower limbs.

Near-infrared spectroscopy estimation of combined skeletal muscle oxidative capacity and O2 diffusion capacity in humans

The final steps of the O2 cascade during exercise depend on the product of the microvascular-to-intramyocyteP O 2 ${P}_{{{\rm{O}}}_{\rm{2}}}$ difference and muscle O2 diffusing capacity (D m O 2 $D{{\rm{m}}}_{{{\rm{O}}}_2}$ ). Non-invasive methods to determineD m O 2 $D{{\rm{m}}}_{{{\rm{O}}}_2}$ in humans are currently unavailable. Muscle oxygen uptake (mV ̇ O 2 ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ ) recovery rate constant (k), measured by near-infrared spectroscopy (NIRS) using intermittent arterial occlusions, is associated with muscle oxidative capacity in vivo. We reasoned that k would be limited byD m O 2 $D{{\rm{m}}}_{{{\rm{O}}}_2}$ when muscle oxygenation is low (kLOW ), and hypothesized that: (i) k in well oxygenated muscle (kHIGH ) is associated with maximal O2 flux in fibre bundles; and (ii) ∆k (kHIGH  - kLOW ) is associated with capillary density (CD). Vastus lateralis k was measured in 12 participants using NIRS after moderate exercise. The timing and duration of arterial occlusions were manipulated to maintain tissue saturation index within a 10% range either below (LOW) or above (HIGH) half-maximal desaturation, assessed during sustained arterial occlusion. Maximal O2 flux in phosphorylating state was 37.7 ± 10.6 pmol s-1  mg-1 (∼5.8 ml min-1  100 g-1 ). CD ranged 348 to 586 mm-2 . kHIGH was greater than kLOW (3.15 ± 0.45 vs. 1.56 ± 0.79 min-1 , P < 0.001). Maximal O2 flux was correlated with kHIGH (r = 0.80, P = 0.002) but not kLOW (r = -0.10, P = 0.755). Δk ranged -0.26 to -2.55 min-1 , and correlated with CD (r = -0.68, P = 0.015). mV ̇ O 2 ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ k reflects muscle oxidative capacity only in well oxygenated muscle. ∆k, the difference in k between well and poorly oxygenated muscle, was associated with CD, a mediator ofD m O 2 $D{{\rm{m}}}_{{{\rm{O}}}_2}$ . Assessment of muscle k and ∆k using NIRS provides a non-invasive window on muscle oxidative and O2 diffusing capacity. KEY POINTS: We determined post-exercise recovery kinetics of quadriceps muscle oxygen uptake (mV ̇ O 2 ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ ) measured by near-infrared spectroscopy (NIRS) in humans under conditions of both non-limiting (HIGH) and limiting (LOW) O2 availability, for comparison with biopsy variables. The mV ̇ O 2 ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ recovery rate constant in HIGH O2 availability was hypothesized to reflect muscle oxidative capacity (kHIGH ) and the difference in k between HIGH and LOW O2 availability (∆k) was hypothesized to reflect muscle O2 diffusing capacity. kHIGH was correlated with phosphorylating oxidative capacity of permeabilized muscle fibre bundles (r = 0.80). ∆k was negatively correlated with capillary density (r = -0.68) of biopsy samples. NIRS provides non-invasive means of assessing both muscle oxidative and oxygen diffusing capacity in vivo.

The impact of postoperative neurologic complications on recovery kinetics in cervical deformity surgery

Objective:

The objective of the study is to investigate which neurologic complications affect clinical outcomes the most following cervical deformity (CD) surgery.

Methods:

CD patients (C2-C7 Cobb >10°, CL >10°, cSVA >4 cm or chin-brow vertical angle >25°) >18 years with follow-up surgical and health-related quality of life (HRQL) data were included. Descriptive analyses assessed demographics. Neurologic complications assessed were C5 motor deficit, central neurodeficit, nerve root motor deficits, nerve sensory deficits, radiculopathy, and spinal cord deficits. Neurologic complications were classified as major or minor, then: intraoperative, before discharge, before 30 days, before 90 days, and after 90 days. HRQL outcomes were assessed at 3 months, 6 months, and 1 year. Integrated health state (IHS) for the neck disability index (NDI), EQ5D, and modified Japanese Orthopaedic Association (mJOA) were assessed using all follow-up time points. A subanalysis assessed IHS outcomes for patients with 2Y follow-up.

Results:

153 operative CD patients were included. Baseline characteristics: 61 years old, 63% female, body mass index 29.7, operative time 531.6 ± 275.5, estimated blood loss 924.2 ± 729.5, 49% posterior approach, 18% anterior approach, 33% combined. 18% of patients experienced a total of 28 neurologic complications in the postoperative period (15 major). There were 7 radiculopathy, 6 motor deficits, 6 sensory deficits, 5 C5 motor deficits, 2 central neurodeficits, and 2 spinal cord deficits. 11.2% of patients experienced neurologic complications before 30 days (7 major) and 15% before 90 days (12 major). 12% of neurocomplication patients went on to have revision surgery within 6 months and 18% within 2 years. Neurologic complication patients had worse mJOA IHS scores at 1Y but no significant differences between NDI and EQ5D (0.003 vs. 0.873, 0.458). When assessing individual complications, central neurologic deficits and spinal cord deficit patients had the worst outcomes at 1Y (2.6 and 1.8 times worse NDI scores, P = 0.04, no improvement in EQ5D, 8% decrease in EQ5D). Patients with sensory deficits had the best NDI and EQ5D outcomes at 1Y (31% decrease in NDI, 8% increase in EQ5D). In a subanalysis, neurologic patients trended toward worse NDI and mJOA IHS outcomes (P = 0.263, 0.163).

Conclusions:

18% of patients undergoing CD surgery experienced a neurologic complication, with 15% within 3 months. Patients who experienced any neurologic complication had worse mJOA recovery kinetics by 1 year and trended toward worse recovery at 2 years. Of the neurologic complications, central neurologic deficits and spinal cord deficits were the most detrimental.

Recovery Off-Kinetics Following Exhaustive Upper Body Exercise in Spinal Cord Injury

Background

People with spinal cord injury (SCI) present with impaired autonomic control when the lesion is above T6. This could lead to delayed cardiorespiratory recovery following vigorous physical activity.

Objectives

To characterize and compare gas exchange off-kinetics following exhaustive exercise in individuals with SCI and an apparently healthy control group.

Methods

Participants were 19 individuals with SCI who presented with the inability to voluntarily lift their legs against gravity (age, 44.6 ± 14.2 years; AIS A, n = 5; AIS B, n = 7; AIS C, n = 7; paraplegia, n = 14; tetraplegia, n = 5) and 10 healthy comparisons (COM; age, 30.5 ± 5.3 years). All participants performed an arm ergometer cardiopulmonary exercise test (aCPET) to volitional exhaustion followed by a 10-minute passive recovery. O₂ uptake (V̇o₂ ) and CO₂ output (V̇co₂ ) off-kinetics was examined using a mono-exponential model in which tau off (τ_off ) and mean response time (MRT) were determined. The off-kinetics transition constant (Kt_off ) was calculated as ΔV̇o₂ /MRT. Student t tests were used to compare SCI versus COM group means.

Results

COM had a significantly higher relative peak V̇o₂ compared to SCI (1.70 ± 0.55 L/min vs 1.19 ± 0.51 L/min, p = .019). No difference was observed for τ_off between the groups, however Kt_off for both V̇o₂ and V̇co₂ was significantly lower in the SCI compared to the COM group.

Conclusion

A reduced Kt_off during recovery may suggest inefficiencies in replenishing muscle ATP stores and lactate clearance in these participants with SCI. These findings may contribute to the observed lower cardiorespiratory fitness and greater fatigability typically reported in individuals with SCI.

Anatomical and Functional Recovery Kinetics After Epiretinal Membrane Removal

Purpose

To investigate the nature of anatomical and functional recovery kinetics after epiretinal membrane (ERM) removal.

Methods

The records of 42 patients (45 eyes) with idiopathic ERM treated with pars plana vitrectomy and surgical peeling of the ERM performed by a single surgeon at Massachusetts Eye and Ear between 2012 and 2017 were retrospectively reviewed. Outcome measures included spectral domain optical coherence tomography-measured central macular thickness (CMT) pre-operatively and at post-operative day 1, week 1, months 1, 3, 6, 12 and 24 as well as best-corrected visual acuity (BCVA). Correlations between baseline or early values and final anatomical and functional outcomes were investigated.

Results

Improvement in CMT was statistically significant after 1 week, 1, 3, 6, 12 and 24 months (p < 0.01). BCVA improvement was statistically significant after 1, 6, 12 and 24 months follow-up (p<0.01). The improvement of BCVA and CMT with time was found to be logarithmic (R² =0.96, R² =0.84) suggesting that early (<30 days) post-operative functional and anatomical changes may be predictive of long-term outcomes. Preoperative BCVA and CMT revealed a weak positive correlation with the respective BCVA and CMT at 24 months (R²=0.13 and R²=0.16). When plotted as a percentage of the fellow normal eye CMT, first week proportional improvement in CMT from pre-operative baseline was found to be correlated with final CMT proportional decrease (R²=0.72) suggesting that first week postoperative CMT could be predictive of final CMT.

Conclusion

There is a logarithmic improvement in CMT and BCVA after ERM peel with BCVA improvement following the CMT improvement. Early (less than 30 days) post-operative anatomical changes can be predictive of long-term anatomical outcomes.

[Suppression and Recovery Characteristics of Pilot-scale ANAMMOX-ASBR System Treating Desulfurization and Denitrification Tailings from Thermal Power Plant]

A pilot-scale anaerobic sequencing batch reactor (ASBR, working volume 530 L), inoculated with oxygen-segmented sludge in an oxidation ditch process, was developed to investigate the start-up of anaerobic ammonium oxidation (ANAMMOX) and its combination with denitrification for deep-level nitrogen removal from desulfurization and denitrification tailings of a thermal power plant. The results showed that, under conditions with a temperature of (35±1)℃and reaction time of 20 h, ANAMMOX was successfully started up after 180 days. During the stable operations phase, total nitrogen (TN) removal rate and removal efficiency reached 91.1% and 0.3 kg·(m³·d)^-1, respectively. During the activity suppression stage of the ANAMMOX-ASBR treating real desulfurization and denitrification tailings, the recovery of its activity could be achieved in 93 days by removing inhibitory factors (Cl^- concentration) and reducing the concentration of influent substrate. In addition, by gradually increasing the addition ratio of desulfurization and denitrification tails (30%, 70%, and 100%), the coupling of ANAMMOX and denitrification was achieved in the ASBR to ensure stable effluent TN removal rate and COD concentrations below 92% and 88.5 mg·L^-1, respectively. The modified logistic model was more suitable for the NRR recovery process after ANAMMOX was impacted by desulfurization and denitrification tailings. The NRR recovery delay time λ was 17.777 cycles, the and R² was 0.92948.

Temporal regulation of terpene synthase gene expression in Eucalyptus globulus leaves upon ozone and wounding stresses: relationships with stomatal ozone uptake and emission responses

Ozone and wounding are key abiotic factors but, their interactive effects on temporal changes in terpene synthase gene expression and emission responses are poorly understood. Here, we applied combined acute ozone and wounding stresses to the constitutive isoprenoid-emitter Eucalyptus globulus and studied how isoprene, 1,8-cineole, and isoledene synthase genes were regulated, and how the gene expression was associated with temporal changes in photosynthetic characteristics, product emission rates, and stomatal ozone uptake through recovery phase. Photosynthetic characteristics and emission rate of isoprene, 1,8-cineole, and isoledene were synergistically altered, while three TPS gene expressions were antagonistically altered by combined stress applications. A time-delay analysis indicated that the best correspondences between gene expression and product emission rates were observed for 0 h time-shift for wounding and 0-2 h time-shifts for separate ozone, and combined ozone and wounding treatments. The best correspondence between ozone uptake and gene expression was observed for 0-4 h time-shifts for separate ozone and combined ozone and wounding treatments. Overall, this study demonstrated that expression profiles of isoprene, the monoterpene 1,8-cineole, and the sesquiterpene isoledene synthase genes differentially influenced their corresponding product emissions for separate and combined ozone and wounding treatments through recovery.

Post-Exercise Oxygen Uptake Recovery Delay: A Novel Index of Impaired Cardiac Reserve Capacity in Heart Failure

OBJECTIVES

This study sought to characterize the functional and prognostic significance of oxygen uptake (VO₂) kinetics following peak exercise in individuals with heart failure (HF).

BACKGROUND

It is unknown to what extent patterns of VO₂ recovery following exercise reflect circulatory response during exercise in HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF).

METHODS

We investigated patients (30 HFpEF, 20 HFrEF, and 22 control subjects) who underwent cardiopulmonary exercise testing with invasive hemodynamic monitoring and a second distinct HF cohort (n = 106) who underwent noninvasive cardiopulmonary exercise testing with assessment of long-term outcomes. Fick cardiac output (CO) and cardiac filling pressures were measured at rest and throughout exercise in the initial cohort. A novel metric, VO₂ recovery delay (VO₂RD), defined as time until post-exercise VO₂ falls permanently below peak VO₂, was measured to characterize VO₂ recovery kinetics.

RESULTS

VO₂RD in patients with HFpEF (median 25 s [interquartile range (IQR): 9 to 39 s]) and HFrEF (28 s [IQR: 2 to 52 s]) was in excess of control subjects (5 s [IQR: 0 to 7 s]; p < 0.0001 and p = 0.003, respectively). VO₂RD was inversely related to cardiac output augmentation during exercise in HFpEF (ρ = -0.70) and HFrEF (ρ = -0.73, both p < 0.001). In the second cohort, VO₂RD predicted transplant-free survival in univariate and multivariable Cox regression analysis (Cox hazard ratios: 1.49 and 1.37 per 10-s increase in VO₂RD, respectively; both p < 0.005).

CONCLUSIONS

Post-exercise VO₂RD is an easily recognizable, noninvasively derived pattern that signals impaired cardiac output augmentation during exercise and predicts outcomes in HF. The presence and duration of VO₂RD may complement established exercise measurements for assessment of cardiac reserve capacity.

Life quality improvement in hoarse patients with early glottic cancer after transoral laser microsurgery

BACKGROUND

The purpose of this study was to evaluate the recovery kinetics of voice and quality of life (QOL) over time in patients with early glottic cancer who underwent transoral laser microsurgery (TLM).

METHODS

A prospective cohort study was conducted in which acoustic and aerodynamic voice assessments and QOL analyses were done using health-related questionnaires (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-questions [EORTC-QLQ-C30] and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck 35-questions [EORTC-QLQ-H&N35]) were administered at designated times.

RESULTS

Most voice laboratory parameters worsened during the first month, then recovered to baseline after 6 months. The QLQ-H&N35 speech subscale was significantly improved. Among the voice laboratory parameters, pretreatment harmonics-to-noise ratio was an independent predictor (P = .041) for improvement on the speech subscale at the endpoint.

CONCLUSION

Despite an initial deterioration of voice and QOL in the first month, patients who underwent TLM recovered to a plateau since the sixth month and then to better than preoperative status afterward. A greater improvement in QOL was seen in patients with poorer baseline voice quality.

[Recovery Performance of ANAMMOX Process after Inhibition Resulting from Seawater]

An anaerobic sequencing batch reactor (ASBR) was operated to investigate the recovery performance of ANAMMOX reactor after the inhibition of 100% seawater concentration. The results showed that the nitrogen removal performance of ANAMMOX reactor suffered inhibition of high salinity concentration. However, it could enter a period of stable nitrogen removal efficiency again after an interim stable period and a recovery period. The nitrogen removal rate (NRR) could reach 0.52 kg·(m³·d)^-1, which was similar to the control group, containing 10% seawater and having a NRR of 0.462 kg·(m³·d)^-1. The modified Logistic model and modified Gompertz model were revised and their application field was broadened. The re-modified Logistic model was suggested to be used to simulate the NRR recovery process of ANAMMOX reactor that suffered inhibition of 100% seawater concentration. The doubling time of NRR was calculated to be 11.359 d using the prediction formula established for the recovery time of NRR.

Mono- and sesquiterpene release from tomato (Solanum lycopersicum) leaves upon mild and severe heat stress and through recovery: from gene expression to emission responses

Plants frequently experience heat ramps of various severities, but how and to what degree plant metabolic activity recovers from mild and severe heat stress is poorly understood. In this study, we exposed the constitutive terpene emitter, Solanum. lycopersicum leaves to mild (37 and 41 °C), moderate (46 °C) and severe (49 °C) heat ramps of 5 min. and monitored foliage photosynthetic activity, lipoxygenase pathway volatile (LOX), and mono- and sesquiterpene emissions and expression of two terpene synthase genes, β-phellandrene synthase and (E)-β-caryophyllene/α-humulene synthase, through a 24 h recovery period upon return to pre-stress conditions. Leaf monoterpene emissions were dominated by β-phellandrene and sesquiterpene emissions by (E)-β-caryophyllene, and thus, these two terpene synthase genes were representative for the two volatile terpene classes. Photosynthetic characteristics partly recovered under moderate heat stress, and very limited recovery was observed under severe stress. All stress treatments resulted in elicitation of LOX emissions that declined during recovery. Enhanced mono- and sesquiterpene emissions were observed immediately after the heat treatment, but the emissions decreased even to below the control treatment during recovery between 2-10 h, and raised again by 24 h. The expression of β-phellandrene and (E)-β-caryophyllene synthase genes decreased between 2-10 h after heat stress, and recovered to pre-stress level in mild heat stress treatment by 24 h. Overall, this study demonstrates a highly sensitive heat response of terpenoid synthesis that is mainly controlled by gene level responses under mild stress, while severe stress leads to non-recoverable declines in foliage physiological and gene expression activities.

Dynamic assessment of ventilatory efficiency during recovery from peak exercise to enhance cardiopulmonary exercise testing

BACKGROUND

While cardiopulmonary exercise testing (CPX) assessment is generally regarded as an optimal means to assess functional capacity in heart failure (HF) patients, strength parameters are omitted. CPX indices collected in recovery may provide additional insight regarding function, including strength.

DESIGN AND METHODS

We performed a cross-sectional controlled study. Systolic HF patients (aged ≥ 50 years) and age-matched controls were assessed using CPX and strength evaluations. Standard CPX indices were assessed during exercise (peak oxygen consumption [VO2], first ventilatory threshold [1stVT], and ventilatory efficiency [VE/VCO2 slope]) as well as indices at 1-minute recovery (1 min VO2, 1 min VE/VCO2, and 1 min heart rate recovery [HRR]) and differences between peak and 1-minute recovery (ΔVO₂ and ΔVE/VCO₂). Lower extremity strength was evaluated using the 1-repetition maximum (1RM) and power.

RESULTS

Seventy adults (31 HF; 39 controls), mean age 66.2 ± 9.7 years were evaluated. Peak VO2 (15.4 ± 4.2 versus 23.4 ± 6.6 mlO₂·kg(-1)·min(-1), p < 0.0001) and 1stVT (10.9 ± 2.1 versus 14.4 ± 4.0 mlO₂·kg(-1)·min(-1), p < 0.0001) were diminished in HF versus controls and VE/VCO2 slope was increased (42.3 ± 12.2 versus 35.4 ± 8.3, p < 0.01). HF patients had reduced 1 minVO₂ (13.1 ± 2.9 versus 16.3 ± 3.7 mlO₂·kg(-1)·min(-1), p < 0.0001), 1 min HRR (6.7 ± 11.4 versus 12.4 ± 7.6 beats, p < 0.02), and ΔVO₂ (2.43 ± 2.3 versus 7.3 ± 5.0 mlO₂·kg(-1)·min(-1), p < 0.0001) as well as increased 1 min VE/VCO2 (37 ± 7.5 versus 31.5 ± 4.4, p < 0.001) and ΔVE/VCO₂ (1.17 ± 3.0 versus -0.5 ± 1.3, p < 0.0001). Strength parameters were relatively lower in HF. While CPX exercise parameters correlated with strength, stronger correlations were observed between CPX recovery parameters and strength.

CONCLUSIONS

CPX recovery indices corroborate disease-specific aerobic differences and distinguish differences in strength. Recovery ventilatory efficiency enhances CPX's value as a comprehensive physical function tool.