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Transcutaneous pCO2-monitoring for the evaluation of the anaerobic threshold. Comparison to lactate and ventilatory thresholds.

The monitoring of transcutaneous pCO2 (pCO2(tc) is an alternative to the invasive determination of the anaerobic threshold by analysis of arterial lactate concentration or to the uncomfortable determination of the ventilatory threshold. We compared the threshold determination by pCO2(tc)-monitoring to the 4 mmol/l lactate threshold and to the ventilatory threshold (point where the ventilatory equivalent of oxygen started to increase continuously) in 15 athletes during cycle exercise. The first distinct deflection point in the pCO2(tc) time course after the start of exercise was chosen to indicate the anaerobic threshold. The mean threshold determined by pCO2(tc) occurred at the same workload as the ventilatory threshold but at a lower workload than the lactate threshold. In spite of the good correspondence in the respective means there was a wide range of individual differences between the pCO2(tc) derived thresholds and both reference thresholds. Thus, looking at an individual, the continuous monitoring of the pCO2(tc) does not provide reliable data on the occurrence of the transition from aerobic to anaerobic metabolism.

Adolescent↗

Low luteal phase serum progesterone levels in regularly cycling women are predictive of subtle ovulation disorders.

Serial hormonal and ultrasound measurements were performed in a group of 50 infertile women with regular menstrual cycles of normal length, and evidence of luteinization by measurement of biphasic basal body temperature (BBT). The progesterone levels however, remained below a critical threshold of 32 nmol/l (1 nmol/l = 0.315 ng/ml) in two cycles. In 50 cycles, 25 showed definite abnormalities. In 16 other cycles, ovulation was observed, but relatively low luteal progesterone followed. Although pregnancy in these 16 cycles could be less likely, the real significance of this finding is questionable. The etiology of these 'subtle cycle anomalies' is not clear and may be multifactorial. For this reason, no therapy other than use of ovulation-inducing agents by trial and error is as yet available. Preliminary results indicate that cycle disturbances may persist under ovulation induction, even though progesterone levels are normalized.

Adult↗

Critical power test for ramp exercise.

The critical power test for cycle ergometry has been criticised as providing an overestimate of the real value of the critical power. Part of the blame may rest in the practical problem associated with getting reliable measurements of longer endurance times when power settings are not much above the critical power. However, by adjusting the incremental slope of ramp exercises, exhaustion brought about by high power and in a reasonably short time can be ensured, so avoiding this practical problem. This communication presents the theory and methods required to obtain estimates of both anaerobic work capacity and critical power from several ramp tests conducted to exhaustion. The method is illustrated with published laboratory data collected from exercising subjects.

Anaerobic Threshold↗

The measurement of plasma catecholamine and lactate thresholds: a comparison of methods.

Plasma lactate and catecholamine thresholds were calculated using three different variations of linear regression, an algorithmic linear regression method, a log-log transformation method and a semi-log method. A group of 18 male sports science students undertook an incremental test to exhaustion on a cycle ergometer. A 5-ml blood sample was drawn at rest, after 4 min of exercise and every 2 min thereafter until the cessation of the test. Lactate, adrenaline and noradrenaline concentrations were measured. Lactate threshold (Th1a), adrenaline threshold (ThA) and noradrenaline threshold (ThNA) were calculated using each of the three methods. The best fits of the methods were examined by comparing their standard error of estimates (SEEs). The algorithmic method demonstrated a higher SEE than the other two methods, but only for Th1a and ThNA. The power output for which each method calculated the thresholds demonstrated a main effect for method. Tukey post hoc tests showed that the algorithmic method produced significantly higher outputs than the other two methods, which did not differ significantly from one another. Comparison of these power outputs showed that Th1a and ThA differed significantly, regardless of method, there were no other significant differences. Plasma concentrations of lactate, adrenaline and noradrenaline showed that the values of Th1a and ThNA calculated by the algorithmic method were significantly higher than those calculated using the other two methods, which did not differ significantly from one another. The only significant difference for ThA was between the algorithmic and semi-log methods. Correlations between the power outputs at which each method calculated the thresholds varied greatly between methods, and were at best only moderate (r = 0.63). It was concluded that the algorithmic method was less powerful than the other two methods, and that Th1a, ThA and ThNA are not highly correlated.

Adult↗

Reproducibility of cardiopulmonary exercise measurements in patients with pulmonary arterial hypertension.

BACKGROUND AND OBJECTIVES: As part of a recent study, cardiopulmonary exercise tests (CPETs) were used to evaluate and follow up patients with pulmonary arterial hypertension (PAH). These patients were more impaired than those in other published series evaluating CPET reproducibility. We used these patient tests to assess patient performance variability and evaluate reading variability. To achieve this end, six independent evaluators graded key CPET measurements in patients with PAH who underwent duplicate CPETs within 3 days of each other. SETTING AND PATIENTS: Over a 15-month period at two tertiary-care teaching hospitals, 42 patients with PAH underwent repeated, paired CPETs using cycle ergometry. INTERVENTIONS AND MEASUREMENTS: Each patient underwent one to six pairs of cycle ergometry tests to maximal tolerance. Each pair of tests was separated by 3 months, with each test in the pair separated by 1 to 3 days. Specific guidelines were given to the independent evaluators for the key measurements assessed from each CPET study: peak O(2) uptake (Vo(2)), peak heart rate, peak O(2) pulse, anaerobic threshold (AT), and end-tidal Po(2), end-tidal Pco(2), and the ventilatory equivalent for CO(2) at the AT (Ve/Vco(2)@AT). RESULTS: There were no fatalities or complications occurring among the 242 tests performed on 42 patients. The mean peak Vo(2) was 722 mL/min or 41% of predicted; 34 patients were Weber class C or D. Using the specific guidelines to measure the variability of measurements made by the six independent evaluators, the coefficients of variation were < 2.2% for peak Vo(2), peak heart rate, peak O(2) pulse, end-tidal values at the AT, and Ve/Vco(2)@AT, while for the AT, it was 8.5%. There were no significant differences in these measurements between the first and second tests of any pair or between the earlier and later sets of pairs. CONCLUSIONS: Using specific guidelines, key CPET measurements can be safely, reliably, and reproducibly assessed even in patients with severe exercise intolerance.

Adolescent↗

Using a combination of click- and tone burst-evoked auditory brain stem response measurements to estimate pure-tone thresholds.

DESIGN: A retrospective medical record review of evoked potential and audiometric data were used to determine the accuracy with which click-evoked and tone burst-evoked auditory brain stem response (ABR) thresholds predict pure-tone audiometric thresholds. METHODS: The medical records were reviewed of a consecutive group of patients who were referred for ABR testing for audiometric purposes over the past 4 yrs. ABR thresholds were measured for clicks and for several tone bursts, including a single-cycle, Blackman-windowed, 250-Hz tone burst, which has a broad spectrum with little energy above 600 Hz. Typically, the ABR data were collected because the patients were unable to provide reliable estimates of hearing sensitivity, based on behavioral test techniques, due to developmental level. Data were included only if subsequently obtained behavioral audiometric data were available to which the ABR data could be compared. Almost invariably, the behavioral data were collected after the ABR results were obtained. Because of this, data were included on only those ears for which middle ear tests (tympanometry, otoscopic examination, pure-tone air- and bone-conduction thresholds) indicated that middle ear status was similar at the times of both tests. With these inclusion criteria, data were available on 140 ears of 77 subjects. RESULTS: Correlation was 0.94 between click-evoked ABR thresholds and the average pure-tone threshold at 2 and 4 kHz. Correlations exceeded 0.92 between ABR thresholds for the 250-Hz tone burst and low-frequency behavioral thresholds (250 Hz, 500 Hz, and the average pure-tone thresholds at 250 and 500 Hz). Similar or higher correlations were observed when ABR thresholds at other frequencies were compared with the pure-tone thresholds at corresponding frequencies. Differences between ABR and behavioral threshold depended on behavioral threshold, with ABR thresholds overestimating behavioral threshold in cases of normal hearing and underestimating behavioral threshold in cases of hearing loss. CONCLUSIONS: These results suggest that ABR thresholds can be used to predict pure-tone behavioral thresholds for a wide range of frequencies. Although controversial, the data reviewed in this paper suggest that click-evoked ABR thresholds result in reasonable predictions of the average behavioral thresholds at 2 and 4 kHz. However, there were cases for which click-evoked ABR thresholds underestimated hearing loss at these frequencies. There are several other reasons why click-evoked ABR measurements were made, including that they (1) generally result in well-formed responses, (2) assist in determining whether auditory neuropathy exists, and (3) can be obtained in a relatively brief amount of time. Low-frequency thresholds were predicted well by ABR thresholds to a single-cycle, 250-Hz tone burst. In combination, click-evoked and low-frequency tone burst-evoked ABR threshold measurements might be used to quickly provide important clinical information for both ends of the audiogram. These measurements could be supplemented by ABR threshold measurements at other frequencies, if time permits. However, it may be possible to plan initial intervention strategies based on data for these two stimuli.

Acoustic Stimulation↗

Noninvasive detection and quantification of left-to-right shunts in children using oxygen-15 labeled carbon dioxide.

A method for the detection and quantification of left-to-right intracardiac shunts is described which utilizes a single breath inhalation of oxygen-15 labeled carbon dioxide (C15O2). The inhaled gas rapidly crosses the alveolar membrane and the oxygen-15 label is exchanged through the carbonate cycle to form oxygen-15 labeled water within the pulmonary capillary blood. Pulmonary indicator clearance curves are measured by external scintillation probes. A simplified method of shunt flow quantification was developed from indicator dilution principles and used for the analysis of the clearance curves. Inhalation studies were performed with 62 children on the day prior to cardiac catheterization. The presence or absence of left-to-right shunt was confirmed by contrast angiography in all cases. Twenty-six children were found to have no shunts by C15O2 inhalation, oximetry or angiography. Of the 36 with shunts, 34 were detected by C15O2. Two of these were designated as equivocal because they were considered to be less than the threshold of definitive detection by C15O2 (having Qp/Qs less than 1.2); 32 were positive and there were two false negatives with small ventricular septal defects. There were no false positives by C15O2. The correlation coefficient between C15O2 and oximetry values of shunt flow for those patients with proven shunts was 0.82.

Adolescent↗

The follicle-stimulating hormone threshold level for follicle maturation in superovulated cycles.

OBJECTIVE: To compare the FSH threshold level for follicle growth up to the preovulatory stage between superovulated and natural cycles. DESIGN: Normally cycling women were investigated during an untreated spontaneous cycle (control) and three cycles treated with FSH. SETTING: Infertility clinic in a university hospital. PATIENTS: Thirteen normally ovulating women with unexplained infertility. INTERVENTIONS: Follicle-stimulating hormone was injected at the single dose of six ampules on cycle day 2 without extra FSH (FSH + 0 cycle) or with extra FSH from cycle day 4 onward at the daily dose of either one ampule (FSH + 1 cycle) or two ampules (FSH + 2 cycle). MAIN OUTCOME MEASURES: Serum FSH and E2 during the follicular phase. Number of follicles and growth rate by ultrasound. RESULTS: Multiple follicular development occurred in all FSH treated cycles. In these cycles the growth rate of the first (dominant) follicle was similar to that in the control cycles. In the presence of physiological concentrations of FSH (control and FSH + 0 cycles), only one follicle was > 15 mm at midcycle. When serum FSH values increased (FSH + 1 and FSH + 2 cycles), the growth rate of the second and third in order follicles and subsequently the number of the preovulatory follicles (> 15 mm) increased in proportion to the FSH increment. CONCLUSIONS: Follicles recruited by exogenous FSH in the early follicular phase of the cycle require supraphysiological concentrations of FSH throughout the follicular phase to become preovulatory. The extra FSH acts through an increase in the growth rate of these follicles.

Estradiol↗

Development of Bacteroides 16S rRNA gene TaqMan-based real-time PCR assays for estimation of total, human, and bovine fecal pollution in water.

Bacteroides species are promising indicators for differentiating livestock and human fecal contamination in water because of their high concentration in feces and potential host specificity. In this study, a real-time PCR assay was designed to target Bacteroides species (AllBac) present in human, cattle, and equine feces. Direct PCR amplification (without DNA extraction) using the AllBac assay was tested on feces diluted in water. Fecal concentrations and threshold cycle were linearly correlated, indicating that the AllBac assay can be used to estimate the total amount of fecal contamination in water. Real-time PCR assays were also designed for bovine-associated (BoBac) and human-associated (HuBac) Bacteroides 16S rRNA genes. Assay specificities were tested using human, bovine, swine, canine, and equine fecal samples. The BoBac assay was specific for bovine fecal samples (100% true-positive identification; 0% false-positive identification). The HuBac assay had a 100% true-positive identification, but it also had a 32% false-positive rate with potential for cross-amplification with swine feces. The assays were tested using creek water samples from three different watersheds. Creek water did not inhibit PCR, and results from the AllBac assay were correlated with those from Escherichia coli concentrations (r2= 0.85). The percentage of feces attributable to bovine and human sources was determined for each sample by comparing the values obtained from the BoBac and HuBac assays with that from the AllBac assay. These results suggest that real-time PCR assays without DNA extraction can be used to quantify fecal concentrations and provide preliminary fecal source identification in watersheds.

Animals↗

Physiological profile of best Czech male and female young triathletes.

To characterize the physiological profile of top young triathletes, 13 top female (mean age = 17.1 +/- 1.4 years, body mass = 58.8 +/- 4.7 kg, body height = 168.4 +/- 2.0 cm and body fat = 10.4 +/- 2.6%) and 23 top male triathletes (age = 17.7 +/- 2.2 years, mass = 66.7 +/- 7.1 kg, height = 176.5 +/- 5.1 cm and fat 8.2 +/- 2.3%) were evaluated by means of an incremental exercise (increment was 1 km.h-1, and exercise starting at 11 km.h-1 in females and 13 km.h-1 in males) on a treadmill with 5% inclination. Mean VO2max was 67.9 +/- 5.9 ml.kg-1 min-1 in boys and 56.1 +/- 2.4 ml.kg-1.min-1 in girls. mean value of maximal running speed was 18.6 +/- 1.2 km.h-1 in mean and 15.4 +/- 0.6 km.h-1 in females and LAmax was 12.5 +/- 2.3 mmol.l-1 in boys and 12.6 +/- 1.2 mmol.l-1 in girls. The selected functional variables at ventilatory threshold (VT) level in boys and girls corresponded to VO2max.kg-1 56.0 +/- 5.4 and 46.6 +/- 2.6 ml.kg-1.min-1, respectively, %VO2max.kg-1 at VT 82.4 +/- 2.1 and 83.1 +/- 1.7%, respectively, speed of running 15.2 +/- 1.4 and 12.7 +/- 0.7 km.h-1, respectively, %Vmax at VT 81.8 +/- 2.6 and 82.3 +/- 1.6%, respectively and the coefficient of energy cost of running c was 3.74 +/- 0.42 and 3.71 +/- 0.39 J.kg-1.m-1, respectively. A comparison of the functional profiles of these triathletes with elite young athletes from the sports of swimming (age 17.5 +/- 2.0 and 17.2 +/- 1.7 years, respectively, VO2max 61.6 +/- 3.6 and 52.1 +/- 3.6 ml.kg-1. min-1, respectively, Vmax 17.5 +/- 0.8 and 15.0 +/- 0.9 km.h-1, respectively, LAmax 11.1 +/- 3.2 and 11.8 +/- 3.3 mmol.l-1, respectively) cycling (17.7 +/- 1.8-17.0 +/- 1.7 years; 65.4 +/- 5.1-55.1 +/- 2.4 ml.kg-1. min-1, 18.2 +/- 0.7-15.2 +/- 0.8 km.h-1; 13.3 +/- 3.5-12.9 +/- 3.7 mmol.l-1) and middle-distance running (17.8 +/- 1.9-17.2 +/- 2.1 years; 66.8 +/- 4.7-57.3 +/- 2.6 ml.kg-1.min-1, 19.1 +/- 0.9-16.1 +/- 0.9 km.h-1; 13.1 +/- 2.6-13.7 +/- 3.0 mmol.l-1) showed the physiological characteristics of triathletes to be similar to those of middle-distance runners. According to our results and according to the data from the literature we can conclude that physiological predispositions for success in international triathlon may be as follows in boys and girls: VO2max.kg-1 higher than 65 and 60 ml.kg-1 min-1, respectively, Vmax (5%) higher than 18 and 16 km.h-1, respectively, LAmax higher than 12 and 11 mmol.l-1, respectively, running speed at "anaerobic threshold" higher than 15.0 and 13 km.h-1, respectively, %VO2max at "anaerobic threshold" level higher than 82.5% in both sexes, and the coefficient of energy cost of running lower than 3.75 and 3.73 J.kg-1.m-1, respectively. As in other sports events of an endurance native, these data are not the sole predictor of racing success. Nevertheless these standards are necessary but not sufficient conditions for success in triathlon. These data play a decisive role in the selection of talent for the triathlon.

Adipose Tissue↗

Non-invasive detection of respiratory muscles activity during assisted ventilation.

The instantaneous pressure applied by the respiratory muscles [Pmus(t)] of a patient under ventilatory support may be continuously assessed with the help of a model of the passive respiratory system updated cycle by cycle. Inspiratory activity (IA) is considered present when Pmus goes below a given threshold. In six patients, we compared IA with (i) inspiratory activity (IAref) obtained from esophageal pressure and diaphragmatic EMG and (ii) that (IAvent) detected by the ventilator. In any case, a ventilator support onset coincides with an IA onset but the opposite is not true. IA onset is always later than IAref beginning ((0.21 +/- 0.10 s) and IA end always precedes IAref end (0.46 +/- 0.16 s). These results clearly deteriorate when the model is not updated.

Aged↗

Preclinical activity of ABT-869, a multitargeted receptor tyrosine kinase inhibitor.

ABT-869 is a structurally novel, receptor tyrosine kinase (RTK) inhibitor that is a potent inhibitor of members of the vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) receptor families (e.g., KDR IC50 = 4 nmol/L) but has much less activity (IC50s > 1 micromol/L) against unrelated RTKs, soluble tyrosine kinases, or serine/threonine kinases. The inhibition profile of ABT-869 is evident in cellular assays of RTK phosphorylation (IC50 = 2, 4, and 7 nmol/L for PDGFR-beta, KDR, and CSF-1R, respectively) and VEGF-stimulated proliferation (IC50 = 0.2 nmol/L for human endothelial cells). ABT-869 is not a general antiproliferative agent because, in most cancer cells, >1,000-fold higher concentrations of ABT-869 are required for inhibition of proliferation. However, ABT-869 exhibits potent antiproliferative and apoptotic effects on cancer cells whose proliferation is dependent on mutant kinases, such as FLT3. In vivo ABT-869 is effective orally in the mechanism-based murine models of VEGF-induced uterine edema (ED50 = 0.5 mg/kg) and corneal angiogenesis (>50% inhibition, 15 mg/kg). In tumor growth studies, ABT-869 exhibits efficacy in human fibrosarcoma and breast, colon, and small cell lung carcinoma xenograft models (ED50 = 1.5-5 mg/kg, twice daily) and is also effective (>50% inhibition) in orthotopic breast and glioma models. Reduction in tumor size and tumor regression was observed in epidermoid carcinoma and leukemia xenograft models, respectively. In combination, ABT-869 produced at least additive effects when given with cytotoxic therapies. Based on pharmacokinetic analysis from tumor growth studies, efficacy correlated more strongly with time over a threshold value (cellular KDR IC50 corrected for plasma protein binding = 0.08 microg/mL, >or=7 hours) than with plasma area under the curve or Cmax. These results support clinical assessment of ABT-869 as a therapeutic agent for cancer.

3T3 Cells↗

Optimizing flow cytometric DNA ploidy and S-phase fraction as independent prognostic markers for node-negative breast cancer specimens.

Developing a reliable and quantitative assessment of the potential virulence of a malignancy has been a long-standing goal in clinical cytometry. DNA histogram analysis provides valuable information on the cycling activity of a tumor population through S-phase estimates; it also identifies nondiploid populations, a possible indicator of genetic instability and subsequent predisposition to metastasis. Because of conflicting studies in the literature, the clinical relevance of both of these potential prognostic markers has been questioned for the management of breast cancer patients. The purposes of this study are to present a set of 10 adjustments derived from a single large study that optimizes the prognostic strength of both DNA ploidy and S-phase and to test the validity of this approach on two other large multicenter studies. Ten adjustments to both DNA ploidy and S-phase were developed from a single node-negative breast cancer database from Baylor College (n = 961 cases). Seven of the adjustments were used to reclassify histograms into low-risk and high-risk ploidy patterns based on aneuploid fraction and DNA index optimum thresholds resulting in prognostic P values changing from little (P < 0.02) or no significance to P < 0.000005. Other databases from Sweden (n = 210 cases) and France (n = 220 cases) demonstrated similar improvement of DNA ploidy prognostic significance, P < 0.02 to P < 0.0009 and P < 0.12 to P < 0.002, respectively. Three other adjustments were applied to diploid and aneuploid S-phases. These adjustments eliminated a spurious correlation between DNA ploidy and S-phase and enabled them to combine independently into a powerful prognostic model capable of stratifying patients into low, intermediate, and high-risk groups (P < 0.000005). When the Baylor prognostic model was applied to the Sweden and French databases, similar significant patient stratifications were observed (P < 0.0003 and P < 0.00001, respectively). The successful transference of the Baylor prognostic model to other studies suggests that the proposed adjustments may play an important role in standardizing this test and provide valuable prognostic information to those involved in the management of breast cancer patients.

Breast Neoplasms↗

Non-invasive prediction of blood lactate response to constant power outputs from incremental exercise tests.

We determined the ability of gas exchange analyses during incremental exercise tests (IXT) to predict blood lactate levels associated with a range of constant power output cycle ergometer tests. Twenty-seven healthy young men performed duplicate IXT and four 15-min constant power output tests at intensities ranging from moderate to very severe, before and after a training program. End-exercise blood lactate levels were approximated from superficial venous samples obtained 60 s after each constant power output test. From IXT, the power outputs corresponding to peak oxygen uptake (Wmax) and lactic acidosis threshold (WLAT), were determined. We examined the ability of four measures of exercise intensity to predict blood lactate levels for power outputs above the LAT: (1) power output (W), (2) power difference (W-WLAT), (3) power fraction (W/Wmax) and (4) power difference to delta ratio [(W-WLAT)/(Wmax-WLAT)]. Correlation coefficients were r = 0.38, 0.69, 0.75, and 0.81, respectively. The best linear regression prediction equation was: lactate (mmol.l-1) = 12.2[(W-WLAT)/(Wmax-WLAT)] + 0.7 mmol.l-1. This relationship was not significantly affected by training, despite increased values of LAT and peak oxygen uptake. Normalizing exercise intensity to the range of power outputs between WLAT and Wmax provided an estimate of blood lactate response to constant power outputs with a standard error of the estimate of 1.66 mmol.l-1.

Adult↗

In vivo validation of the historical in vitro thermocycling temperature range for dental materials testing.

In dental research, restorative materials have been regularly subjected to alternating in vitro thermal stress in investigations since the 1950s, in order to simulate in vivo alternating temperature stress and to artificially stress them in vitro. The provocation temperature is mostly 5 degrees C for cold provocation, and 55 degrees C for hot provocation. These temperatures are determined quite arbitrarily based on very few examinations in vivo. Extensive temperature data for the approximal space of teeth, which is decisive for the success of fillings adhesively attached to dentin, has so far not been addressed. The objective of this study was to examine the interproximal temperature characteristics created in the space of all teeth in vivo with thermal alternating stress, and therefore to validate the in vitro standardized thermal alternating stress of 5-55 degrees C. Fifteen study participants with healthy teeth were used to determine the temperature in each inter-dental space, resulting from hot/cold provocation in the upper and lower jaw, from the central incisor to the second molars. This was performed by a thermal element (cable sensor GTF 300, Greisinger Electronic GmbH, Regenstauf, Germany). The temperature sensor was attached with dental floss into the interproximal space and the temperature was recorded by the computer. The participants in the pilot test had to state when they were able to sip an 85 degrees C hot drink. That particular temperature value was taken for hot provocation as maximum temperature reference. Cold ice water (0 degrees C) was used for cold provocation as minimum temperature reference. The respective recordings with a total of 14 measurements for each individual were performed simultaneously in the upper and lower jaw. The study participants were to start with hot provocation, followed by cold provocation. This cycle was repeated at least once with an individual dwell time. The highest recorded approximal space temperature was 52.8 degrees C in the lower jaw, between the first and the second premolar. The lowest temperature of 13.7 degrees C was recorded in two participants in the upper jaw, between the 1st and 2nd incisor, and between the two central incisors. The mean of the maximum temperatures was 43.8+/-3.7 degrees C, and the mean of the minimum temperatures 24.2+/-4.6 degrees C. The mean initial temperature was 35.2+/-1.3 degrees C. None of the recordings reached either the upper threshold (55 degrees C) or the lower threshold (5 degrees C). This study showed that the actual thermal stress in the interproximal space of teeth is slightly lower than the one used in in vitro examinations. For class II cavities, most of the alternating temperature stress limits selected at 5-55 degrees C cover the actually occurring temperature interval quite well.

Adolescent↗

The relationship between the VO2 slow component, muscle metabolites and performance during very-heavy exhaustive exercise.

This study examined the relationship between the V O(2) response, particularly the slow component (SC), muscle metabolite changes and performance during very-heavy exhaustive exercise. Sixteen active females performed a graded exercise test to determine V O(2peak) and the lactate threshold followed 48h later by a constant-load cycle test to exhaustion (ET) at 85% V O(2peak) intensity. Muscle biopsies and capillary blood samples were obtained before and after the ET to determine changes in muscle ATP, pH, lactate and phosphocreatine and also plasma pH and lactate. Breath-by-breath data from the ET were smoothed using 5-s averages and fit to a three-component exponential model. The mean time to exhaustion (t(exh)) during the ET was 16.8 (+/-6.4) min. Results showed no correlation between the SC and t(exh) or any muscle metabolite changes (p>0.05). Significant correlations (p<0.05) were evident between t(exh) and tau; tau(0) (r=-0.54), tau(1) (r=-0.65), change in (Delta) pH(b) (r=-0.60), Delta[La(-)](b) (r=-0.58) and [La(-)](b post) (r=-0.64). Significant correlations (p<0.05) were also evident between tau(1) and [La(-)](b post) (r=0.54). Furthermore, a negative value resulted when the accumulated oxygen deficit was calculated for the entire duration of the ET. Results showed no association between the amplitude of the SC and t(ext) or to changes in muscle/blood metabolites, suggesting that the SC is not a determinant of high-intensity exercise tolerance. Furthermore, it is possible that a reduced perturbation of anaerobic energy sources, as a result of a faster tau(1), may have contributed to a longer t(exh).

Adenosine Triphosphate↗

Heart rate at the estimated lactate threshold in patients with chronic obstructive pulmonary disease: effects on the target intensity for dynamic exercise training.

BACKGROUND: Physical training at the range of exercise intensities associated with sustained blood lactate accumulation seems to rapidly improve aerobic performance in both healthy subjects and patients with chronic obstructive pulmonary disease (COPD). However, it is still unclear whether patients' heart rate (HR) at the estimated lactate threshold (HR [symbol: see text]L)--as expressed in percent attained peak HR (AHR), predicted peak HR (PHR) and HR reserve (HRR)--are comparable with the ranges of intensity that are commonly used for target exercise training in control subjects. METHODS: The authors evaluated 26 patients with stable COPD (forced expiratory volume in 1 second = 1.17 +/- 0.28 L) who were submitted for spirometric evaluation, and, after familiarization, to a symptom-limited ramp-incremental cardiopulmonary exercise testing on a cycle ergometer. RESULTS: The authors were able to identify [symbol: see text]L in only 18 patients (69%). The HR [symbol: see text]L corresponded to wide range of exercise intensities according to the three methods (ranging from 70-95% AHR, 50-90% PHR, and 35-60% HRR). However, most of the subjects would be trained within +/- 5% HR [symbol: see text]L if they had been exercised at 80 to 85% AHR and 40 to 45% HRR; these values correspond to higher (AHR) and lower (HRR) intensities than usually recommended for healthy subjects. CONCLUSIONS: Considering that [symbol: see text]L was not identified in approximately one third of the patients and there was ample variability on HR [symbol: see text]L as %AHR, %PHR, and %HRR, the use of HR and [symbol: see text]L targets for routine exercise prescription does not seem to be clinically justifiable in patients with COPD submitted to pulmonary rehabilitation.

Aged↗

The role of excitation-pattern cues and temporal cues in the frequency and modulation-rate discrimination of amplitude-modulated tones.

These experiments examine the influence of excitation-pattern cues and temporal-fine-structure cues on frequency difference limens (FDLs) measured as a function of duration. In the first three conditions, listeners were required to detect a change in carrier frequency from a baseline of 250 or 2000 Hz, for stimuli with half-amplitude durations ranging from 5 to 320 ms. In the "steady" condition, duration was manipulated by increasing the steady-state portion of the envelope between two 5-ms linear onset and offset ramps. This resulted in spectra and excitation patterns that broadened with decreasing duration. In the "modulated" condition, the carrier was amplitude modulated with a triangle function (period 10 ms) and duration was manipulated by varying the number of cycles of the modulator. In this case, the spectral envelope did not vary with duration, but the width of individual spectral lobes broadened with decreasing duration. The "low-peak-constant" condition was similar to the modulated condition, except that an increase in carrier frequency was accompanied by a decrease in the period of the modulator, so as to hold constant the frequency of the spectral lobe located roughly 100 Hz below the carrier frequency. In this condition, changes in carrier frequency resulted in minimal changes in excitation level on the low-frequency side of the excitation pattern, but changes on the high-frequency side were larger than for the first two conditions. Both the values of the FDLs, and their variation with frequency and duration, were similar in these three conditions. The fourth, "modulator varying," condition differed in that the carrier frequency was held constant and listeners were required to detect a change in modulator frequency. Thresholds were expressed as the change in frequency of the spectral side lobes adjacent to the carrier frequency ("equivalent" FDLs). Excitation-pattern cues in this condition were at least as large as in the first three conditions. However, equivalent FDLs were significantly higher than for the other three conditions. The higher FDLs are attributed to the lack of temporal fine-structure cues related to the carrier frequency. Overall, the results suggest that FDLs in the first three conditions were determined by temporal cues rather than by excitation-pattern cues. The increase of the FDLs with decreasing duration did not arise from increasing spectral splatter.

Auditory Perception↗