Influence of gravity on biomechanics in flywheel squat and leg press.

Resistance exercise on Earth commonly involves both body weight and external load. When developing exercise routines and devices for use in space, the absence of body weight is not always adequately considered. This study compared musculoskeletal load distribution during two flywheel resistance knee-extension exercises, performed in the direction of (vertical squat; S) or perpendicular to (horizontal leg press; LP) the gravity vector. Eleven participants performed these two exercises at a given submaximal load. Motion analysis and musculoskeletal modelling were used to compute joint loads and to simulate a weightless situation. The flywheel load was more than twice as high in LP as in S (p < 0.001). Joint moments and forces were greater during LP than during S in the ankle, hip and lower back (p < 0.01) but were similar in the knee. In the simulated weightless situation, hip and lower-back loadings in S were higher than corresponding values at Earth gravity (p ≤ 0.01), whereas LP joint loads did not increase. The results suggest that LP is a better terrestrial analogue than S for knee-extension exercise in weightlessness and that the magnitude and direction of gravity during resistance exercise should be considered when designing and evaluating countermeasure exercise routines and devices for space.

Lumbar Loads and Muscle Activity During Flywheel and Barbell Leg Exercises.

ABSTRACT: Sjöberg, M, Eiken, O, Norrbrand, L, Berg, HE, and Gutierrez-Farewik, EM. Lumbar loads and muscle activity during flywheel and barbell leg exercises. J Strength Cond Res 37(1): 27-34, 2023-It is anticipated that flywheel-based leg resistance exercise will be implemented in future long-duration space missions, to counter deconditioning of weight-bearing bones and postural muscles. The aim was to examine low back loads and muscle engagements during flywheel leg press (FWLP) and flywheel squat (FWS) and, for comparisons, free-weight barbell back squat (BBS). Eight resistance-trained subjects performed 8 repetition maximums of FWLP, FWS, and BBS. Motion analysis and inverse dynamics-based musculoskeletal modeling were used to compute joint loads and muscle forces. Muscle activities were measured with electromyography (EMG). At the L4-L5 level, peak vertebral compression force was similarly high in all exercise modes, whereas peak vertebral posteroanterior shear force was greater ( p < 0.05) in FWLP and BBS than in FWS. Among the back-extensor muscles, the erector spinae longissimus exerted the greatest peak force, with no difference between exercises. Peak force in the lumbar multifidus was lower ( p < 0.05) during FWLP than during FWS and BBS. Peak EMG activity in the lumbar extensor muscles ranged between 31 and 122% of maximal voluntary isometric contraction across muscles and exercise modes, with the greatest levels in the lumbar multifidus. The vertebral compression forces and muscle activations during the flywheel exercises were sufficiently high to presume that when implementing such exercise in space countermeasure regimens, they may be capable of preventing muscle atrophy and vertebral demineralization in the lumbar region.

Comparison of Joint and Muscle Biomechanics in Maximal Flywheel Squat and Leg Press.

The aim was to compare the musculoskeletal load distribution and muscle activity in two types of maximal flywheel leg-extension resistance exercises: horizontal leg press, during which the entire load is external, and squat, during which part of the load comprises the body weight. Nine healthy adult habitually strength-training individuals were investigated. Motion analysis and inverse dynamics-based musculoskeletal modelling were used to compute joint loads, muscle forces, and muscle activities. Total exercise load (resultant ground reaction force; rGRF) and the knee-extension net joint moment (NJM) were slightly and considerably greater, respectively, in squat than in leg press (p ≤ 0.04), whereas the hip-extension NJM was moderately greater in leg press than in squat (p = 0.03). Leg press was performed at 11° deeper knee-flexion angle than squat (p = 0.01). Quadriceps muscle activity was similar in squat and leg press. Both exercise modalities showed slightly to moderately greater force in the vastii muscles during the eccentric than concentric phase of a repetition (p ≤ 0.05), indicating eccentric overload. That the quadriceps muscle activity was similar in squat and leg press, while rGRF and NJM about the knee were greater in squat than leg press, may, together with the finding of a propensity to perform leg press at deeper knee angle than squat, suggest that leg press is the preferable leg-extension resistance exercise, both from a training efficacy and injury risk perspective.

Transmission of Clostridium difficile spores in isolation room environments and through hospital beds.

The aim of this study was to determine the dissemination of Clostridium difficile (CD) spores in a hospital setting where the potassium monopersulfate-based disinfectant Virkon™ was used for cleaning. In the initial part of the study, we sampled 16 areas of frequent patient contact in 10 patient rooms where a patient with CD infection (CDI) had been accommodated. In the second part of the study, we obtained samples from 10 patient beds after discharge of CDI patients, both before and after the beds were cleaned. In the first part, CDspores were isolated in only 30% of the rooms. In the second part, which focused on transmission to hospital beds, C. difficile was found in four of 10 beds either before or after cleaning. In conclusion, in both parts of the study, we demonstrated a moderate spread of CD spores to the environment despite routine cleaning procedures involving Virkon™.

Hand disinfectant practice: the impact of an education intervention.

The primary hypothesis of this study was that a lecture on basic hygiene routines could be associated with an increase in the use of disinfectant for hand hygiene. A secondary hypothesis was that the lecture could positively affect the staff's knowledge of and attitudes toward basic hygiene routines.A quasi-experimental design including one ward of the department of orthopedics in a Swedish university hospital was adopted.During the pre-intervention test period the consumption of hand disinfectant was measured for 30 days and a questionnaire was distributed to all staff. The hospital hygiene nurse subsequently provided a lecture on basic hygiene routines to all employees on the ward. During the post-intervention test period the hand disinfectant consumption was measured for another 30 days, and the questionnaire was distributed once again. A follow-up measurement was performed 9 months after the intervention.After the lecture on hygiene routines, the consumption of hand disinfectant increased by 93%. Nine months after the intervention, the consumption was still 21% higher than before the intervention. The result of the questionnaire showed that the employees considered themselves applying the disinfectant more thoroughly after the intervention. Some employees changed their perspective on basic hygiene routines after the lecture and stopped using watches and private clothes at work.Our findings suggest that a single education session, a hygiene lecture, could be a simple and cost-effective method to increase the use of hand disinfectant, thereby reducing the number of nosocomial infections on the wards.

Febrile Plasmodium falciparum malaria 4 years after exposure in a man with sickle cell disease.

We report a case of symptomatic Plasmodium falciparum malaria that manifested 4 years after a visit to an area of endemicity in an 18-year-old male patient with sickle cell disease. The exceptionally long incubation time raises the questions of how and where P. falciparum parasites can reside for several years before suddenly causing disease.

Mechanisms of estrogen receptor signaling: convergence of genomic and nongenomic actions on target genes.

Estrogen receptors (ERs) act by regulating transcriptional processes. The classical mechanism of ER action involves estrogen binding to receptors in the nucleus, after which the receptors dimerize and bind to specific response elements known as estrogen response elements (EREs) located in the promoters of target genes. However, ERs can also regulate gene expression without directly binding to DNA. This occurs through protein-protein interactions with other DNA-binding transcription factors in the nucleus. In addition, membrane-associated ERs mediate nongenomic actions of estrogens, which can lead both to altered functions of proteins in the cytoplasm and to regulation of gene expression. The latter two mechanisms of ER action enable a broader range of genes to be regulated than the range that can be regulated by the classical mechanism of ER action alone. This review surveys our knowledge about the molecular mechanism by which ERs regulate the expression of genes that do not contain EREs, and it gives examples of the ways in which the genomic and nongenomic actions of ERs on target genes converge. Genomic and nongenomic actions of ERs that do not depend on EREs influence the physiology of many target tissues, and thus, increasing our understanding of the molecular mechanisms behind these actions is highly relevant for the development of novel drugs that target specific receptor actions.

Estrogen receptor-dependent activation of AP-1 via non-genomic signalling.

BACKGROUND: Ligand-bound estrogen receptor alpha (ERalpha) and estrogen receptor beta (ERbeta) modulate AP-1-dependent transcription via protein-protein interactions on DNA, in a manner that depends on the type of cells and the subtype of ER. We present here evidence for an additional mechanism by which ERs modulate the transcriptional activity of AP-1. RESULTS: We show that ERs located in the cytoplasm efficiently activate transcription at AP-1 sites in response to 17beta-estradiol, while ERs present in the nucleus repress transcription under the same conditions. 17beta-estradiol-induced activation of the coll-73-luc reporter correlated with cytoplasmic localization of various ERalpha and ERbeta mutant receptors, and was inhibited in the presence of the full estrogen antagonist ICI 182,780 and the MAP-kinase inhibitor UO126. We also show that the selective estrogen receptor modulator (SERM) tamoxifen is as potent as 17beta-estradiol in inducing activation of AP-1 when ERalpha is present in the cytoplasm. CONCLUSIONS: These results suggest that non-genomic signalling is involved in the mechanism by which ERalpha and ERbeta influence AP-1-dependent transcription. We have previously shown that Stat3 and Stat5 are targeted by non-genomic actions of ERs, and the results presented here allow us to conclude that ERs bound to 17beta-estradiol mediate the transcriptional activation of promoters regulated by AP-1 and by Stat proteins via different combinations of signal transduction pathways. Our observations thereby provide new insights into the mechanisms by which ERs act at alternate response elements, and suggest a mechanism by which tamoxifen exerts its action as a tissue-selective agonist.

Mutations in the estrogen receptor DNA-binding domain discriminate between the classical mechanism of action and cross-talk with Stat5b and activating protein 1 (AP-1).

Estrogen receptors (ERs) efficiently potentiate the transcriptional activity of prolactin-activated Stat5b through a mechanism that involves the ER DNA-binding domain (DBD) and the hinge domain. We have identified residues within the DBD of ER that are critical for the functional interaction of ER with Stat5b. We show that disruption of the second zinc finger structure abrogated cross-talk between ER and Stat5b, while the structure of the first zinc finger was not important. Furthermore, we confirm that intact DNA binding activity was not required for potentiation of Stat5b activity and that the dimerization of ER did not seem to be involved. Ligand-bound ERs also modulated activating protein 1-dependent transcription, and our data demonstrate that both zinc finger structures of the ER DBD are important for an intact response. We show that introduction of various point mutations within the DBD altered the response of the receptor to 17beta-estradiol and to the estrogen antagonists 4-hydroxytamoxifen and ICI 182,870 on the collagenase promoter. These findings provide new insights into the mechanisms by which ERs act in cross-talk with non-related transcription factors.

Signal transducers and activators of transcription as downstream targets of nongenomic estrogen receptor actions.

17Beta-estradiol-activated estrogen receptor alpha (ERalpha) and beta (ERbeta) are able to induce transcriptional activation of signal transducer and activator of transcription (Stat)-regulated promoters via cytoplasmic signal transduction pathways. Stat5 and Stat3 are required for promoter induction, which correlates with cytoplasmic sublocalization of ERs and is independent of intact coactivator binding sites and DNA-binding domains. In endothelial cells, Stat5 and Stat3 are rapidly phosphorylated on both tyrosine and serine residues in response to 17beta-estradiol, and nuclear translocation is subsequently induced. 17Beta-estradiol-induced transactivation of a Stat-regulated promoter requires at least three different signal transduction pathways, including MAPK, Src-kinase, and phosphatidylinositol-3-kinase activities. In conclusion, this work identifies a novel pathway involving an agonist-bound ER-activated phosphorylation cascade, resulting in nuclear transcriptional activation of target transcription factors. These findings reveal novel targets for the development of drugs that modulate a nongenomic-to-genomic ER-dependent mechanism.