Tour of Truffles: Aromas, Aphrodisiacs, Adaptogens, and More.

Truffles are the fruiting bodies of ascomycete fungi that form underground. Truffles are globally valued, culturally celebrated as aphrodisiacs, and highly sought-after delicacies in the culinary world. For centuries, naturalists have speculated about their mode of formation, and in cultures surrounding the Mediterranean Sea, many species have been prized as a delectable food source. Truffle fruiting bodies form underground and emit a variety of volatile organic compounds (VOCs). Truffle volatiles are believed to have evolved to attract animals that disperse their spores. The main VOCs identified from truffles include sulfur compounds, such as dimethyl sulfide (DMS) and dimethyl disulfide (DMDS); in addition, 1-octen-3-ol and 2-methyl-1-propanol have been found in most truffle species. Humans use pigs and dogs trained to detect truffle VOCs in order to find these prized subterranean macrofungi. Truffles have pharmacological potential, but until more reliable cultivation methods become available their high price means they are unlikely to see widespread use as medicinals.

The Utilization of Core Exercises in Patients With Patellofemoral Pain: A Critically Appraised Topic.

Clinical Scenario: Patellofemoral pain (PFP) is characterized by general anterior knee pain around the patella and is one of the most prevalent knee conditions. PFP is challenging to treat due to a wide range of contributing factors and often has chronic, reoccurring symptoms. Traditional treatment focuses on quadriceps and gluteal strengthening with minimal emphasis on deep trunk musculature. Recently, there has been a growing body of literature supporting the beneficial effects of core stability exercises as a treatment option for PFP. Clinical Question: Are core stability exercises coupled with traditional rehabilitation more effective than only traditional rehabilitation techniques for decreasing pain in patients with PFP? Summary of Key Findings: Three articles met the inclusion criteria and investigated core strengthening exercises as a treatment for PFP. Two studies investigated a 4-week exercise protocol and demonstrated a greater decrease in pain when compared to the control group. The third study examined the effects of a 6-week program where both the intervention and control groups resulted in similar reduction of pain. All articles included received a minimum of 6 on the PEDro scale. Clinical Bottom Line: There is evidence that supports core stability exercise protocols coupled with traditional rehabilitation as being more effective in reducing pain in patients with PFP when compared to traditional rehabilitation alone. Strength of Recommendation: The grade of A is recommended based on the Strength of Recommendation Taxonomy.

Treatment of alcohol use disorder among people of South Asian ancestry in Canada and the United States: A narrative review.

To explore access and treatment for alcohol use disorders (AUDs) among people of South Asian ancestry living in Canada or the United State, EQUATOR guidelines were applied to 34 manuscripts identified through an English language literature search (1946-2017) for this narrative review. The population studied has poor access to and engagement with treatment for AUD. Early evidence suggests benefit from adopting language-specific materials, offering South Asian-specific therapy groups, and incorporating traditional healers. Specific engagement and therapy considerations may increase AUD treatment access and effectiveness among South Asians living in Canada or the United States.

Protracted Cardiovascular Impairments After Anterior Cruciate Ligament Injury: A Critically Appraised Topic.

Clinical Scenario: Anterior cruciate ligament (ACL) tear is a devastating knee injury with negative long-term consequences, such as early-onset knee osteoarthritis, biomechanical compensations, and reduced physical activity. Significant reduction in physical activity is a powerful indicator of cardiovascular (CV) disease; therefore, those with a history of ACL injury may be at increased risk for CV disease compared with noninjured individuals. Focused Clinical Question: Do individuals with a history of ACL injury demonstrate negative CV changes compared with those without a history of ACL injury? Summary of Key Findings: Three articles met the inclusion criteria and investigated CV changes after ACL injury. Both cross-sectional studies compared participants with ACL injury with matched controls. Bell et al compared time spent in moderate to vigorous physical activity and step count, whereas Almeida et al compared maximum rate of oxygen consumption, ventilatory thresholds, isokinetic quadriceps strength, and body composition. Collectively, both quantitative studies found that individuals with a history of ACL injury had less efficient CV systems compared with matched controls and/or preoperative data. Finally, a qualitative study of 3506 retired National Football League athletes showed an increased rate of arthritis and knee replacement surgery after an ACL injury when compared with other retired National Football League members, in addition to a >50% increased rate of myocardial infarction. Clinical Bottom Line: A history of ACL injury is a source of impaired physical activity. Preliminary data indicate that these physical activity limitations negatively impair the CV system, and individuals with a history of ACL injury demonstrate lower maximum oxygen consumption, self-reported disability, and daily step count compared with noninjured peers. These complications support the need for greater emphasis on CV wellness. Strength of Recommendation: Consistent findings from 2 cross-sectional studies and 1 survey study suggest level IIB evidence to support that ACL injury is associated with negative CV health.

Are there perceptual differences to varying levels of blood flow restriction?

The application of blood flow restriction (BFR) with low load exercise has been shown to produce favorable muscle and vascular adaptations. Given the potential clinical utility of BFR, it is important to characterize the ratings of perceived exertion (RPE) and discomfort across a variety of relative pressures as the individual's perceptual response may ultimately dictate whether a participant continues with this modality of exercise. Fourteen participants completed 3 days of exercise. Conditions included unilateral elbow flexion with six pressures ranging from 40% to 90% arterial occlusion at 30% of their one repetition maximum (1RM). Differences in RPE (6: no exertion at all, 20: maximal exertion) were found across conditions for set 2 (range of 13-15), 3 (range of 15-16), and 4 (range of 15-17). Following Bonferroni adjustments, none were significant. Differences in discomfort (0: no discomfort at all; 10: maximum discomfort) were found across conditions for set 1 (range of 2-3), 2 (range of 3.2-5), 3 (range of 4-6.5), and 4 (range of 5-7). Post-hoc analyses only found differences within set 3. Although it is presently unknown if higher pressures are required for optimal adaption of tissues other than skeletal muscle, our results suggest that the perceptual rating during exercise is unlikely to be a limiting factor in the application of higher pressures.

Influence of relative blood flow restriction pressure on muscle activation and muscle adaptation.

INTRODUCTION: The aim of this study was to investigate the acute and chronic skeletal muscle response to differing levels of blood flow restriction (BFR) pressure. METHODS: Fourteen participants completed elbow flexion exercise with pressures from 40% to 90% of arterial occlusion. Pre/post torque measurements and electromyographic (EMG) amplitude of each set were quantified for each condition. This was followed by a separate 8-week training study of the effect of high (90% arterial occlusion) and low (40% arterial occlusion) pressure on muscle size and function. RESULTS: For the acute study, decreases in torque were similar between pressures [-15.5 (5.9) Nm, P = 0.344]. For amplitude of the first 3 and last 3 reps there was a time effect. After training, increases in muscle size (10%), peak isotonic strength (18%), peak isokinetic torque (180°/s = 23%, 60°/s = 11%), and muscular endurance (62%) changed similarly between pressures. CONCLUSION: We suggest that higher relative pressures may not be necessary when exercising under BFR.

Blood flow restriction in the upper and lower limbs is predicted by limb circumference and systolic blood pressure.

PURPOSE: To determine what factors should be accounted for when setting the blood flow restriction (BFR) cuff pressure for the upper and lower body. METHODS: One hundred and seventy one participants visited the laboratory for one testing session. Arm circumference, muscle (MTH) and fat (FTH) thickness were measured on the upper arm. Next, brachial systolic (SBP) and diastolic (DBP) blood pressure measurements were taken in the supine position. Upper body arterial occlusion was then determined using a Doppler probe. Following this, thigh circumference and lower body arterial occlusion were determined. Models of hierarchical linear regression were used to determine the greatest predictor of arterial occlusion in the upper and lower body. Two models were employed in the upper body, a Field (arm size) and a Laboratory model (arm composition). RESULTS: The Laboratory model explained 58 % of the variance in arterial occlusion with SBP (ß = 0.512, part = 0.255), MTH (ß = 0.363, part = 0.233), and FTH (ß = 0.248, part = 0.213) contributing similarly to explained variance. The Field model explained 60 % of the variance in arterial occlusion with arm circumference explaining the greatest amount (ß = 0.419, part = 0.314) compared to SBP (ß = 0.394, part = 0.266) and DBP (ß = 0.147, part = 0.125). For the lower body model the third block explained 49 % of the variance in arterial occlusion with thigh circumference (ß = 0.579, part = 0.570) and SBP (ß = 0.281, part = 0.231) being significant predictors. CONCLUSIONS: Our findings indicate that arm circumference and SBP should be taken into account when determining BFR cuff pressures. In addition, we confirmed our previous study that thigh circumference is the greatest predictor of arterial occlusion in the lower body.

Controlled soil warming powered by alternative energy for remote field sites.

Experiments using controlled manipulation of climate variables in the field are critical for developing and testing mechanistic models of ecosystem responses to climate change. Despite rapid changes in climate observed in many high latitude and high altitude environments, controlled manipulations in these remote regions have largely been limited to passive experimental methods with variable effects on environmental factors. In this study, we tested a method of controlled soil warming suitable for remote field locations that can be powered using alternative energy sources. The design was tested in high latitude, alpine tundra of southern Yukon Territory, Canada, in 2010 and 2011. Electrical warming probes were inserted vertically in the near-surface soil and powered with photovoltaics attached to a monitoring and control system. The warming manipulation achieved a stable target warming of 1.3 to 2 °C in 1 m(2) plots while minimizing disturbance to soil and vegetation. Active control of power output in the warming plots allowed the treatment to closely match spatial and temporal variations in soil temperature while optimizing system performance during periods of low power supply. Active soil heating with vertical electric probes powered by alternative energy is a viable option for remote sites and presents a low-disturbance option for soil warming experiments. This active heating design provides a valuable tool for examining the impacts of soil warming on ecosystem processes.

Management of premature prelabor rupture of the membranes.

Premature prelabor rupture of the fetal membranes affects about 3% of pregnancies. The cause is usually infection, especially at earlier gestations. The prognosis and the risks of delivery are both much worse at earlier gestations. Before viable pregnancy, termination may be offered. Once the fetus is viable, steroids to mature the fetal lungs and antibiotics to reduce infection are the mainstays of treatment. Delivery is recommended in the presence of signs of clear-cut infection at early gestational ages. At later ones, balancing the risks of infection from conservative treatment against the risk of prematurity from delivery is difficult. Published trials to date have not given clear guidance, but a number are ongoing.