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Black, CD, Haskins, KR, Bemben, MG, and Larson, RD. Carbohydrate mouth rinsing does not alter central or peripheral fatigue after high-intensity and low-intensity exercise in men. J Strength Cond Res 36(1) 142-148, 2022-Carbohydrate (CHO) mouth rinsing improves performance during endurance exercise. However, its ability to attenuate fatigue during strength-based exercise is less certain. This study sought to determine the effects of a CHO mouth rinse on torque production and voluntary activation (VA%) after high-intensity and low-intensity isometric exercise. Twelve male subjects (22.5 ± 2.3 years; 183.5 ± 6.5 cm; 82.2 ± 13.9 kg) completed 4 testing sessions in a double-blind crossover fashion. Knee extension maximal voluntary isometric strength (MVC) was assessed before(Pre), immediately (iPost-Ex), and 5 minutes (5-min Post Ex) after isometric exercise performed at 80% or 20% of MVC. An 8% CHO solution or placebo (PLA) was rinsed for 20 seconds after exercise. VA% was determined by twitch interpolation. Areductions in MVC were found at iPost-Ex after exercise at 20% compared with 80% of MVC (-25 ± 14% vs. -11 ± 8%; p less then 0.001) as well as for VA% (-17 ± 14% vs. -8 ± 14%; p less then 0.004). No differences were observed in the CHO vs. PLA condition (p ≥ 0.34). We were successful in eliciting differing levels of central and peripheral fatigue by exercising at a low and high intensity. Despite significantly larger declines in VA% after exercise at 20% of MVC, CHO mouth rinsing had no effects compared with placebo on any measured variable.

Klawitter, L, Vincent, BM, Choi, BJ, Smith, J, Hammer, KD, Jurivich, DA, Dahl, LJ, and McGrath, R. Handgrip strength asymmetry and weakness are associated with future morbidity accumulation in americans. J Strength Cond Res 36(1) 106-112, 2022-Identifying strength asymmetries in physically deconditioned populations may help in screening and treating persons at risk for morbidities linked to muscle dysfunction. Our investigation sought to examine the associations between handgrip strength (HGS) asymmetry and weakness on accumulating morbidities in aging Americans. The analytic sample included 18,506 Americans aged ≥50 years from the 2006-2016 Health and Retirement Study. Handgrip strength was measured on each hand with a handgrip dynamometer, and persons with an imbalance in strength >10% between hands had HGS asymmetry. Men with HGS <26 kg and women with HGS <16 kg were considered as weak. Subjects reported the presence of healthcare provider-diagnosed morbidities hypertension, diabetes, cancer, chrbidities. Handgrip-strength asymmetry, as another potential indicator of impaired muscle function, is associated with future morbidity status during aging. Exercise professionals and related practitioners should consider examining asymmetry and weakness with handgrip dynamometers as a simple and noninvasive screening method for helping to determine muscle dysfunction and future chronic disease risk.

Jean, LMY, Gross, DP, and Chiu, LZF. Knee extensor strength in anterior cruciate ligament-deficient individuals following normal and modified squats a randomized controlled trial. J Strength Cond Res 36(1) 47-54, 2022-Training with barbell squats, which load the quadriceps, increases knee extensor strength. Anterior cruciate ligament (ACL) injury results in a quadriceps avoidance substitution strategy, which may impair the efficacy of barbell squat training. Modified squats to promote quadriceps loading have been proposed to facilitate restoring knee extensor strength and function. This research compared resistance training using traditional squats (TRAD) versus traditional plus modified squats (EXP) in ACL-deficient individuals. Thirty-seven ACL-deficient individuals were randomly assigned to TRAD or EXP. Knee extensor function was assessed using maximum isometric strength testing and 3D motion analysis of sit-to-stand. Effect sizes for minimum meaningful improvement were established (d = 0.28-0.47). Thereolved limb knee extensor net joint moment work in sit-to-stand (95% CI [0.034, 0.135] J·kgBM-1, d = 0.48) increased in both groups. Squat training was effective for increasing involved limb isometric knee extensor strength and knee extensor work performed in the sit-to-stand. Modified squats do not seem to provide additional benefit.

Mangine, GT, Serafini, PR, Stratton, MT, Olmos, AA, VanDusseldorp, TA, and Feito, Y. Effect of the repetitions-in-reserve resistance training strategy on bench press performance, perceived effort, and recovery in trained men. J Strength Cond Res 36(1) 1-9, 2022-This study examined the effects of the repetitions-in-reserve (RIR) strategy on resistance exercise performance, perceived effort, and recovery. Fourteen resistance-trained men (24.6 ± 3.0 years, 176 ± 5 cm, 85.7 ± 14.0 kg) completed 2 bench press protocols in a randomized crossover fashion. The protocols consisted of 4 sets at 80% of 1 repetition maximum (1RM) to a self-reported 3-RIR and a fifth set to failure or all 5 sets to failure (0-RIR). Barbell kinetics (velocity, rate of force development, and impulse), repetition volume, total work, and ratings of perceived exertion (RPE) were quantified on each set. Barbell kinetics were reassessed during one set of 3 repetitions at 80% 1RM completed at 24-hour, 48-hour, and 72-hour postexercise. Blood sa Separate, 2-way repeated-measures analysis of variance revealed significant interactions (p less then 0.001) where 3-RIR better maintained repetitions and work at greater average velocity (+0.6 m·s-1) and lower RPE (0-RIR = 10; 3-RIR = 8.2) across all sets. No differences were seen between conditions for CK at 6 hours postexercise (3-RIR 32.2 ± 55.3%; 0-RIR 40.8 ± 66.0%) or for CK and barbell kinetics at 24 hours to 72 hours postexercise. Although no differences were seen for recovery, the RIR strategy enabled work to be better sustained across sets at a lower perceived effort and higher average velocity. This strategy could be used to manage fatigue and better sustain effort and volume during a resistance training session.The coronavirus disease 2019 (COVID-19) pandemic has tested nurse staffing and other resources necessary for lifesaving treatment. The emergency use authorization in November 2020 of bamlanivimab as monotherapy and casirivimab/imdevimab as combination therapy brought hope to many as an option for outpatients at risk for severe illness. However, logistical concerns were soon revealed, because safe administration requires a location where patients can receive specialized care and monitoring for a period of 2 hours. This type of therapy would normally be offered at an outpatient infusion center. These centers often serve persons who are immunocompromised, and introducing COVID-19-positive individuals could threaten the safety of this population. This article describes the deployment of an emergency department-embedded infusion center set up for the purpose of supporting community members and providers electing for this treatment option.The creation of an electronic order set to identify appropriate vascular access device utilization was the basis of this prospective quality improvement investigation, at a Level 1 trauma center in southeastern Pennsylvania. The data used in this investigation were gathered over a 36-month time frame from January 2017 through December 2019. This patient-centered approach utilized the evidence-based guidelines developed from The Michigan Appropriateness Guide for Intravenous Catheters and recommendations from the Infusion Therapy Standards of Practice. The algorithmic approach developed by vascular access nurses led to statistically significant reductions in unnecessary peripherally inserted central catheter placement. The results also demonstrated an increase in appropriately placed peripheral intravenous catheters. Leveraging the electronic medical record with nursing expertise fosters patient safety across the continuum of care.

To quantify the burden of work-relevant persistent musculoskeletal (MSK) pain to a large UK employer.

A retrospective, longitudinal, analytical cohort study using linked Rolls-Royce data systems. Cases were employees with a MSK-related referral to occupational health; controls were age-, sex-, and job role-matched employees without such a referral. Outcomes were compared during 12 months' follow-up.

Overall, 2382 matched case-control pairs were identified (mean age 46 y; 82% male). Cases took 39,200 MSK-related sickness absence days in total (equating to £50 million in sickness absence costs). Cases took significantly more all-cause sickness absence days than controls (82,341 [£106 million] versus 19,628 [£26 million]; P < 0.0001).

Despite access to extensive occupational health services, the burden of work-relevant persistent MSK pain remains high in Rolls-Royce. There is a clear need to better understand how to effectively reduce this burden.

Despite access to extensive occupational health services, the burden of work-relevant persistent MSK pain remains high in Rolls-Royce. There is a clear need to better understand how to effectively reduce this burden.

Evaluate the clinical outcome of lateral clavicle malunion treated with all-arthroscopic coracoclavicular (CC) stabilization. Design Retrospective, case series.

Department of hand and upper extremity surgery, university hospital center.

45 patients with unstable and displaced lateral clavicle fracture treated between January 2015 and August 2019 Intervention Closed reduction and arthroscopic CC stabilization using cortical buttons.

Shoulder pain and active motion. PROMs included the Constant score, the Subjective Shoulder Value, the AcromioClavicular Joint Instability score (ACJI) and the Specific AcromioClavicular Score (SACS). Radiographic evaluation assessed bony union and malunion.

Mean follow-up of 25 months (12-60). Five (11%) patients had lateral clavicle non-union and 7 (16%) lateral clavicle malunion (5 in the coronal plane and 2 in the axial plane). Lateral clavicle malunion did not significantly affect clinical or functional outcomes (p>0.05). Mean active shoulder motion was forward flription of levels of evidence.Introduction/Objectives Peri-operative hypothermia is common in trauma and surgical patients. The aim of this study was to undertake a systematic review and meta-analysis to determine the relationship between perioperative hypothermia and mortality following surgery for hip fracture.

A systematic literature search of Medline, EMBASE, CINAHL, and Cochrane CENTRAL databases was performed using the Cochrane methodology for systematic reviews. The identified studies were assessed and compared against predetermined inclusion and exclusion criteria. Selleck 2-DG Data extraction and quality appraisal was performed on selected articles. A meta-analysis was conducted using a random-effects model.

The literature search identified 1016 records. After removing duplicates and those not meeting inclusion criteria, 3 studies measuring 30-day mortality were included. All included studies were carried out in the UK. The mortality rate was higher in the hypothermic groups as compared to the normothermic group in all the studies, with the difference being significant in two of the studies (p<0.