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1.
Nutrients ; 16(7)2024 Mar 30.
Article in English | MEDLINE | ID: mdl-38613045

ABSTRACT

Biotransformation of minerals via glycosylation by microorganisms such as yeast and/or probiotics yields nutrients bound to a food matrix, resulting in increased bioavailability. The purpose of this study was to compare the effects of glycoprotein matrix-bound zinc (GPM) on absorption compared to inorganic zinc oxide. Sixteen participants ingested 11 mg of zinc as either GPM™ Soy-Free Zinc (GPM, Ashland, Kearny, NJ, USA) or zinc oxide (USP). Blood samples were taken at 0 (i.e., baseline), 30, 60, 90, 120, 180, 240, 300, 360, 420, and 480 min post-ingestion. GPM zinc concentrations were significantly higher at 120 min (p = 0.02; 12.4 ± 5.1 mcg/dL), 180 min (p = 0.002; 16.8 ± 5.1 mcg/dL), and 240 min (p = 0.007; 14.6 ± 5.1 mcg/dL) in comparison to USP zinc oxide. In addition, GPM zinc significantly increased iAUC by 40% (5840 ± 2684 vs. 4183 ± 1132 mcg/dL * 480 min, p = 0.02), and Cmax values were 10% higher in GPM compared to USP (148 ± 21 mcg/dL vs. 135 ± 17.5 mcg/dL, p = 0.08). Tmax was 12% slower in GPM compared to USP (112.5 ± 38.7 min vs. 127.5 ± 43.1 min); however, differences in Tmax failed to reach statistical significance (p = 0.28). Zinc bound to a glycoprotein matrix significantly increased absorption compared to zinc oxide.


Subject(s)
Probiotics , Zinc Oxide , Humans , Zinc , Cross-Over Studies , Glycoproteins , Saccharomyces cerevisiae
2.
Acta Physiol (Oxf) ; 239(1): e14024, 2023 09.
Article in English | MEDLINE | ID: mdl-37551144

ABSTRACT

AIMS: Motor unit recruitment and firing rate patterns of the vastus lateralis (VL) have not been compared between sexes during moderate- and high-intensity contraction intensities. Additionally, the influence of fiber composition on potential sex-related differences remains unquantified. METHODS: Eleven males and 11 females performed 40% and 70% maximal voluntary contractions (MVCs). Surface electromyographic (EMG) signals recorded from the VL were decomposed. Recruitment thresholds (RTs), MU action potential amplitudes (MUAPAMP ), initial firing rates (IFRs), mean firing rates (MFRs), and normalized EMG amplitude (N-EMGRMS ) at steady torque were analyzed. Y-intercepts and slopes were calculated for MUAPAMP , IFR, and MFR versus RT relationships. Type I myosin heavy chain isoform (MHC) was determined with muscle biopsies. RESULTS: There were no sex-related differences in MU characteristics at 40% MVC. At 70% MVC, males exhibited greater slopes (p = 0.002) for the MUAPAMP , whereas females displayed greater slopes (p = 0.001-0.007) for the IFR and MFR versus RT relationships. N-EMGRMS at 70% MVC was greater for females (p < 0.001). Type I %MHC was greater for females (p = 0.006), and was correlated (p = 0.018-0.031) with the slopes for the MUAPAMP , IFR, and MFR versus RT relationships at 70% MVC (r = -0.599-0.585). CONCLUSION: Both sexes exhibited an inverse relationship between MU firing rates and recruitment thresholds. However, the sex-related differences in MU recruitment and firing rate patterns and N-EMGRMS at 70% MVC were likely due to greater type I% MHC and smaller twitch forces of the higher threshold MUs for the females. Evidence is provided that muscle fiber composition may explain divergent MU behavior between sexes.


Subject(s)
Muscle, Skeletal , Myosin Heavy Chains , Male , Female , Humans , Muscle, Skeletal/physiology , Isometric Contraction/physiology , Quadriceps Muscle/physiology , Muscle Fibers, Skeletal , Action Potentials/physiology , Recruitment, Neurophysiological/physiology , Electromyography
3.
Res Q Exerc Sport ; : 1-12, 2023 Jun 27.
Article in English | MEDLINE | ID: mdl-37369135

ABSTRACT

Purpose: To examine the effects of a 5-week continuous cycling training intervention on electromyographic amplitude (EMGRMS)- and mechanomyographic amplitude (MMGRMS)-torque relationships of the vastus lateralis (VL) during a prolonged contraction. Methods: Twenty-four sedentary, young adults performed maximal voluntary contractions (MVCs) and a prolonged isometric trapezoidal contraction at the same absolute 40% MVC for the knee extensors before (PRE) and after training (POSTABS). Individual b- (slopes) and a-terms (y-intercepts) were calculated from the log-transformed electromyographic amplitude (EMGRMS)- and mechanomyographic amplitude (MMGRMS)-torque relationships during the increasing and decreasing segments of the trapezoid. EMGRMS and MMGRMS was normalized for the 45-s steady torque segment. Results: At PRE, b-terms for the EMGRMS-torque relationships during the linearly decreasing segment were greater than the increasing segment (p < .001), and decreased from PRE to POSTABS (p = .027). a-terms were greater during the linearly increasing than decreasing segment at PRE, while the a-terms for the linearly decreasing segment increased from PRE to POSTABS (p = .027). For the MMGRMS-torque relationships, b-terms during the linearly decreasing segment decreased from PRE to POSTABS (p = .013), while a-terms increased from PRE to POSTABS when collapsed across segments (p = .022). Steady torque EMGRMS increased for POSTABS (p < .001). Conclusion: Although cycling training increased aerobic endurance, incorporating resistance training may benefit athletes/individuals as the alterations in neuromuscular parameters post-training suggest a greater neural cost (EMGRMS) and mechanical output (MMGRMS) to complete the same pre-training fatiguing contraction.

4.
Med Eng Phys ; 111: 103946, 2023 01.
Article in English | MEDLINE | ID: mdl-36792240

ABSTRACT

This study examined relationships between percent myosin heavy chain (%MHC) expression and mechanomyographic amplitude (MMGRMS). Fifteen females (age ± SD=21.3 ± 5.3 yrs) completed isometric trapezoidal contractions at 30% and 70% maximal voluntary contraction (MVC). MMG was recorded from the vastus lateralis (VL). Participants gave a muscle biopsy of the VL post-testing. MMGRMS-torque relationships during the linearly varying segments were log-transformed and linear regressions were applied to calculate b terms (slopes). For the steady torque segment, MMGRMS was averaged. Correlations were performed for type I%MHC with the MMG variables. Multiple regression was utilized to examine prediction equations for type I%MHC. Type I%MHC was significantly correlated with the b terms during the increasing segment of the 70% MVC (p = 0.003; r = -0.718), and MMGRMS during steady torque at 30% (p = 0.008; r = -0.652) and 70% MVC (p = 0.040; r = -0.535). Type I%MHC reduced the linearity of the MMGRMS-torque relationship during the high-intensity linearly increasing segment, and MMGRMS at a low- and high-intensity steady torque. A combination of MMG variables estimated type I%MHC expression with 81.2% accuracy. MMG recorded during a low- and high-intensity isometric trapezoidal contraction may offer a simple, noninvasive test for estimating type I%MHC expression of the VL in sedentary females.


Subject(s)
Myosin Heavy Chains , Quadriceps Muscle , Female , Humans , Electromyography , Isometric Contraction/physiology , Linear Models , Multivariate Analysis , Muscle, Skeletal/physiology , Myosin Heavy Chains/metabolism , Quadriceps Muscle/physiology , Torque , Adolescent , Young Adult , Adult
5.
J Musculoskelet Neuronal Interact ; 22(1): 27-36, 2022 03 01.
Article in English | MEDLINE | ID: mdl-35234156

ABSTRACT

OBJECTIVE: This study examined motor unit (MU) firing rates during a prolonged isometric contraction of the vastus lateralis (VL) for females and males. METHODS: Surface electromyographic (sEMG) signals were recorded from the VL for eleven females and twelve males during a 45-second isometric trapezoid muscle actions at 40% of maximal voluntary contraction (MVC). For each MU, mean firing rate (MFR) was calculated for the initial and final 10-second epochs of the steady torque segment and regressed against recruitment threshold (RT, expressed as %MVC), as well as time at recruitment (TREC, seconds). MFR was also averaged for each subject. RESULTS: Significant differences existed across epochs for the y-intercepts (P=0.009) of the MFR vs. TREC relationship, as well as the grouped MFR analysis (P<0.001); no differences were observed between epochs for the MFR vs. RT relationship. Significant differences existed between sexes for the grouped MFR analysis (P=0.049), but no differences were observed for the MFR vs. TREC or MFR vs. RT relationships. CONCLUSION: Analysis method may impact interpretation of firing rate behavior; increases in MU firing rates across a prolonged isometric contraction were observed in the MFR vs. TREC relationship and the grouped MFR analysis.


Subject(s)
Isometric Contraction , Recruitment, Neurophysiological , Action Potentials/physiology , Electromyography , Female , Humans , Isometric Contraction/physiology , Male , Muscle, Skeletal/physiology , Quadriceps Muscle/physiology , Recruitment, Neurophysiological/physiology
6.
Exp Brain Res ; 240(3): 825-839, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35048160

ABSTRACT

This study examined the effects of continuous endurance training on motor unit (MU) mean firing rates (MFR), percent myosin heavy chain (%MHC) isoforms, and muscle cross-sectional area (mCSA) of the vastus lateralis (VL). Twelve females completed 5-weeks of continuous cycling-training (CYC), while 8 females were controls (CON). Participants performed maximal voluntary contractions (MVCs) and 40% MVCs of the knee extensors before (PRE) and after the 5-week treatment period at the same absolute pre-treatment submaximal torque (POSTABS) and relative to post-treatment MVCs (POSTREL). Surface electromyographic (EMG) signals were decomposed with the Precision Decomposition III algorithm. MU firing times and waveforms were validated with reconstruct-and-test and spike trigger average procedures. MFRs at steady torque, recruitment thresholds (RT), and normalized EMG amplitude (N-EMGRMS) were analyzed. Y-intercepts and slopes were calculated for the MFR vs. RT relationships. MHC isoforms and mCSA were determined with muscle biopsies and ultrasonography. CYC decreased MVCs and type IIX %MHC isoform without changes in mCSA. The slopes for the MFR vs. RT relationships decreased for CYC during POSTREL and POSTABS while N-EMGRMS increased for POSTABS with no differences between PRE and POSTREL. Type I %MHC isoform was correlated with the slope for the MFR vs. RT relationship during POSTABS and POSTREL for CYC. This study provides evidence that decreases in the MFRs of higher threshold MUs post-CYC is likely a function of changes in input excitation (POSTABS) and the firing frequency-excitation relationships (POSTREL). Evidence is provided that MHC isoforms influence the firing rate scheme of the muscle following short-term training.


Subject(s)
Myosin Heavy Chains , Quadriceps Muscle , Action Potentials/physiology , Electromyography , Female , Humans , Isometric Contraction/physiology , Muscle, Skeletal/physiology , Quadriceps Muscle/diagnostic imaging , Quadriceps Muscle/physiology , Recruitment, Neurophysiological/physiology , Torque
7.
Eur J Appl Physiol ; 121(12): 3389-3398, 2021 Dec.
Article in English | MEDLINE | ID: mdl-34477930

ABSTRACT

PURPOSE: Changes in motor unit (MU) activity pre- to post-interventions is of high interest. However, there is minimal information regarding day-to-day changes or the reliability of measuring MU activity. This study examined the reliability of relationships calculated via the MU action potential (AP) trains derived from surface electromyography signal decomposition. A comparison between reliability statistics was made between MUAP trains verified with only the reconstruct-and-test versus verification including reconstruct-and-test with spike trigger average (STA) procedures. METHODS: Twenty-one individuals performed isometric muscle actions at 50% of maximal voluntary contraction of the first dorsal interosseous on two separate visits. MUs included for reliability analyses initially met the > 90% accuracy from the reconstruct-and-test. STA was applied as an additional exclusionary procedure. Linear regressions were applied to the firing rate and AP amplitude versus recruitment threshold relationships with and without MUs that met the STA criteria. Reliability statistics were also performed on relationships that met a strict range of recruitment thresholds. Reliability was established with intraclass correlation coefficients (ICC) along with other traditional parameters. RESULTS: The firing rate versus recruitment threshold relationships were reliable (ICC > 0.56) and improved (ICC > 0.84) when recruitment ranges were controlled. The slopes of the MUAP amplitude versus recruitment threshold relationships were reliable (ICC > 0.78) while the y-intercepts were reliable (ICC > 0.81) once corrections were made to combat negative scores. CONCLUSIONS: Electromyographic signal decomposition without the secondary STA verification procedures can be used to detect intervention-related changes in neural drive with confidence when recorded MU recruitment thresholds are similar across days.


Subject(s)
Action Potentials/physiology , Electromyography , Isometric Contraction/physiology , Motor Neurons/physiology , Muscle, Skeletal/physiology , Recruitment, Neurophysiological/physiology , Female , Humans , Male , Reproducibility of Results , Young Adult
8.
J Strength Cond Res ; 35(5): 1256-1261, 2021 May 01.
Article in English | MEDLINE | ID: mdl-33900258

ABSTRACT

ABSTRACT: Fry, AC, Parra, ME, and Cabarkapa, D. Supplemental creatine modified with polyethylene glycol effectively loads skeletal muscle with lower doses. J Strength Cond Res 35(5): 1256-1261, 2021-The purpose of this study was to compare the efficacy of skeletal muscle uptake of creatine monohydrate (Cr H2O) with that of creatine bound to polyethylene glycol (Cr PEG). Healthy men (X ± SE; age = 23.5 ± 1.0 years) were divided into control (Con, n = 9, 20 g·d-1 of Cr H2O) and experimental (Exp, n = 8, 10 g·d-1 of Cr PEG) groups. Blood samples and muscle biopsies were used to determine acute gastrointestinal absorption over 5 hours and muscle cellular uptake over 5 days. Both groups exhibited significantly (p < 0.05) elevated concentrations of muscle-free Cr (M·gdw-1; Con, pre = 23.0 ± 4.2, post = 39.2 ± 2.7; Exp pre = 22.1 ± 2.9, post = 33.6 ± 3.2), total Cr (M·gdw-1, Con pre = 94.7 ± 5.4, post = 114.8 ± 7.4; Exp pre = 92.6 ± 5.4, post = 106.6 ± 8.4), which were also elevated when these values were normalized for adenosine triphosphate using molar ratios. Circulatory uptake of Cr was significantly different between the groups, with blood concentrations (mg·dL-1) for the Con group peaking at 2 hours post-ingestion (25.99 ± 2.96), whereas the concentrations for the Exp group were lower and were still rising at 5 hours (4.05 ± 0.87). The integrated area under the curve for the 5-hour postingestion period was 7-fold greater for the Con group. Although total Cr ingested over the 5 days supplementation period was less for the Cr PEG group, skeletal muscle uptake of Cr PEG was similar to Cr H2O. Based on circulating Cr concentrations, it seems that Cr PEG is cleared more slowly from the gastrointestinal tract. Thus, lower dosages of Cr may be ingested while maintaining optimal loading kinetics.


Subject(s)
Creatine , Polyethylene Glycols , Adenosine Triphosphate , Adult , Dietary Supplements , Humans , Male , Muscle, Skeletal , Young Adult
9.
Eur J Appl Physiol ; 121(5): 1367-1377, 2021 May.
Article in English | MEDLINE | ID: mdl-33604695

ABSTRACT

PURPOSE: To examine the effects of 10 weeks of endurance cycling training on mechanomyographic amplitude (MMGRMS)-torque relationships and muscle cross-sectional area (mCSA) of the vastus lateralis (VL) for 10 sedentary males (Age ± SD; 20.2 ± 1.9 years) and 14 sedentary females (21.9 ± 5.3 years). METHODS: Participants performed maximal voluntary contractions (MVCs) and an isometric ramp up muscle action to 70% MVC of the knee extensors before (PRE) and after training at the same absolute pre-treatment submaximal torque (POSTABS). MMG was recorded from the VL and b terms were calculated from the natural log-transformed MMGRMS-torque relationships for each subject. mCSA was determined with ultrasonography. RESULTS: Cycling decreased MVCs from pre- (168.10 ± 58.49 Nm) to post-training (160.78 ± 58.39 Nm; p = 0.005) without changes in mCSA. The b terms were greater for POSTABS (0.623 ± 0.204) than PRE (0.540 ± 0.226; p = 0.012) and for males (0.717 ± 0.171) than females (0.484 ± 0.168; p = 0.003). mCSA was correlated with the b terms for PRE (p < 0.001, r = 0.674) and POSTABS (p = 0.020, r = 0.471). CONCLUSION: The decrease in MVC and increase in MMGRMS (b terms) post-training suggests increased motor unit (MU) recruitment to match pre-training torques. The greater acceleration in the b terms by males may reflect sex-related differences in fiber-type area. MMGRMS-torque relationships during a high-intensity contraction provided insight on MU activation strategies following endurance training and between sexes. Furthermore, the findings suggest a relationship between MMGRMS and muscle size.


Subject(s)
Endurance Training , Quadriceps Muscle/physiology , Recruitment, Neurophysiological/physiology , Bicycling/physiology , Biomechanical Phenomena , Female , Humans , Male , Muscle Contraction/physiology , Sedentary Behavior , Sex Factors , Torque , Ultrasonography , Young Adult
10.
Hum Mov Sci ; 72: 102650, 2020 Aug.
Article in English | MEDLINE | ID: mdl-32721368

ABSTRACT

Motor unit (MU) firing rates of the vastus lateralis in children and adults were examined. Seven healthy adult males (mean ± SD, age = 21 ± 2.6 yrs) and six healthy male children (mean ± SD age = 8.8 ± 1.7) volunteered. Surface electromyography (EMG) signals were recorded from 20% and 60% maximal voluntary contractions (MVC). Surface EMG signals were decomposed into firing events of individual MUs and slopes and y-intercepts were calculated for the mean firing rate (MFR, pps) at steady torque vs. recruitment thresholds (RT) relationships for each subject. Muscle cross-sectional area (mCSA) was measured, via ultrasonography, with specific torque calculated (MVC/mCSA). Adults possessed greater mCSA (p = .002; children = 11.5 ± 2.1 cm2; adults = 31.80 ± 12.15 cm2) and greater specific torque (p = .018; children = 4.63 ± 1.4 Nm/cm2; adults = 7.1 ± 1.8 Nm/cm2) compared to children. The y-intercepts were significantly (p < .001) greater during the 60% (28.91 ± 4.56 pps) than the 20% MVC (23.5 ± 4.9 pps) collapsed across groups while the children had significantly (p = .036) lower y-intercepts (23.9 ± 5.4 pps) than the adults (28.2 ± 4.8 pps) when collapsed across intensities. Slopes of the MFR vs RT relationships were greater for the 60% (-0.342 ± 0.127 pps/%MVC) contraction than the 20% (-0.50 ± 0.159 pps/%MVC) MVC when collapsed across groups. Adults had greater firing rates regardless of recruitment threshold than children. This may be due to lower recruitment potential and overall excitation to the motoneuron pool of children as indicated with differences in specific torque and/or differences in antagonist co-activation.


Subject(s)
Isometric Contraction , Quadriceps Muscle/physiology , Recruitment, Neurophysiological , Action Potentials , Adult , Age Factors , Child , Electromyography , Female , Humans , Linear Models , Locomotion , Male , Motor Neurons/physiology , Quadriceps Muscle/diagnostic imaging , Torque , Ultrasonography , Young Adult
11.
Pediatr Exerc Sci ; 32(3): 157-164, 2020 05 25.
Article in English | MEDLINE | ID: mdl-32454457

ABSTRACT

BACKGROUND: Skeletal muscle is overlooked in the realm of insulin resistance in children who are overweight and obese despite the fact that it accounts for the most glucose disposal. OBJECTIVES: Therefore, this study examined fasted glucose levels and muscle cross-sectional area and echo intensity (EI) via ultrasound images of the first dorsal interosseous, vastus lateralis, and rectus femoris in children who are normal weight and overweight and obese aged 8-10 years. METHODS: In total, 13 males (age = 9.0 [0.7] y) and 7 females (age = 9.0 [0.8] y) volunteered for this study. Independent samples t tests and effect sizes (ESs) were used to examine potential differences in skeletal muscle composition and glucose concentrations. RESULTS: There were no significant differences between groups for glucose concentration (P = .07, ES = 0.86); however, the children who were overweight and obese had significantly greater EI (P < .01, ES = 0.98-1.63) for the first dorsal interosseous, vastus lateralis, and rectus femoris and lower cross-sectional area when normalized to EI when collapsed across muscles (P < .04, ES = 0.92). Glucose concentrations correlated with EI and cross-sectional area/EI for the vastus lateralis (r = .514 to -.593) and rectus femoris (r = .551 to -.513), but not the first dorsal interosseous. DISCUSSION: There is evidence that adiposity-related pathways leading to insulin resistance and skeletal muscle degradation are active in young children who are overweight and obese.


Subject(s)
Blood Glucose , Muscle, Skeletal/diagnostic imaging , Overweight/physiopathology , Pediatric Obesity/physiopathology , Child , Female , Humans , Insulin Resistance , Male , Ultrasonography
12.
J Electromyogr Kinesiol ; 52: 102421, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32353708

ABSTRACT

This study included spike trigger averaging (STA) procedures to examine the acceptability of the Precision Decomposition (PD) III derived motor unit action potential (MUAP) trains that met the >90% accuracy criteria from the reconstruct-and-test. MUs met the >90% accuracy criteria from the reconstruct-and-test with STA procedures then applied. Y-intercepts and slopes were calculated for the firing rate- and MUAP amplitude-recruitment threshold relationships. Gaussian noise (1% of the SD of the mean interspike interval) was added to the firing times with the changes in MUAPs quantified. A total of 455 MUs were decomposed with 155 MUs removed as a result of the reconstruct-and-test. Five additional MUs were excluded via the STA criteria. The MUAP waveforms deteriorated with the inclusion of Gaussian noise. There were differences in the derived action potentials amplitudes of higher-threshold MUs between the PD III algorithm and the STA procedure. There was excellent agreement among the slopes and y-intercepts between the relationships that included or excluded MUs that did not meet the STA criteria. There was good agreement between the MUAP amplitude-recruitment threshold relationships derived from the PD III and STA procedure. The addition of the STA procedures did not alter the MU-derived relationships.


Subject(s)
Action Potentials , Motor Neurons/physiology , Muscle, Skeletal/physiology , Adult , Electromyography/methods , Electromyography/standards , Humans , Male , Muscle, Skeletal/innervation , Reaction Time , Reproducibility of Results
13.
Exp Brain Res ; 238(5): 1133-1144, 2020 May.
Article in English | MEDLINE | ID: mdl-32232542

ABSTRACT

Despite ample evidence that females are weaker and possess smaller muscle cross-sectional areas (CSAs) compared to males, it remains unclear if there are sex-related differences in the properties of motor units (MU). Eleven males (age 22 ± 3 years) and 12 females (age 21 ± 1 years) performed isometric trapezoid muscle actions at 10% and 70% of maximal voluntary contraction (MVC). Surface electromyography signals were recorded and decomposed into MU action potential (AP) waveforms and firing instances. Average MUAP amplitudes (MUAPAMPS), mean firing rates (MFRs), initial firing rates (IFRs), and recruitment thresholds (RT) were calculated for the 10% MVC, while MUAPAMPS, IFRs, and MFRs were regressed against RT for the 70% MVC. Ultrasonography was used to measure CSA of the first dorsal interosseous (FDI). Males had greater CSAs (p < 0.001; males 2.34 ± 0.28 cm2, females 1.82 ± 0.18 cm2) and MVC strength (p < 0.001; males 25.9 ± 5.5 N, females 16.44 ± 2.5 N). No differences existed for MUAPAMPS, IFRs, MFRs, or RTs (p > 0.05) during the 10% MVC. For the 70% MVC, the y-intercepts from the MUAPAMPS vs. RT relationships were greater (p < 0.05) for the males (males - 0.19 ± 0.53 mV; females - 0.78 ± 0.75 mV), while the inverse was true for the MFR vs. RT relationships (males 31.55 ± 6.92 pps, females 38.65 ± 6.71 pps) with no differences (p > 0.05) in the slopes. Therefore, smaller CSAs and weaker MVCs are likely the result of smaller higher-threshold MUs for females.


Subject(s)
Action Potentials/physiology , Motor Activity/physiology , Muscle Contraction/physiology , Muscle, Skeletal/physiology , Recruitment, Neurophysiological/physiology , Sex Characteristics , Adult , Electromyography , Female , Humans , Male , Muscle, Skeletal/diagnostic imaging , Sex Factors , Ultrasonography , Young Adult
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