抗原变异可使得多种致病微生物易于逃避宿主免疫应答。表达在感染红细胞表面的恶性疟原虫红细胞表面蛋白1（PfPMP1）与感染红细胞、内皮细胞、树突状细胞以及胎盘的单个或多个受体作用，在黏附及免疫逃避中起关键的作用。每个单倍体基因组var基因家族编码约60种成员，通过启动转录不同的var基因变异体为抗原变异提供了分子基础。

疟原虫var基因转换速率变化导致抗原变异[英]／Paul H, Robert P, Christodoulou Z, et al//Proc Natl Acad Sci U S A

To revise 1998 recommendations on childhood obesity, an Expert Committee, comprised of representatives from 15 professional organizations, appointed experienced scientists and clinicians to 3 writing groups to review the literature and recommend approaches to prevention, assessment, and treatment. Because effective strategies remain poorly defined, the writing groups used both available evidence and expert opinion to develop the recommendations. Primary care providers should universally assess children for obesity risk to improve early identification of elevated BMI, medical risks, and unhealthy eating and physical activity habits. Providers can provide obesity prevention messages for most children and suggest weight control interventions for those with excess weight. The writing groups also recommend changing office systems so that they support efforts to address the problem. BMI should be calculated and plotted at least annually, and the classification should be integrated with other information such as growth pattern, familial obesity, and medical risks to assess the child’s obesity risk. For prevention, the recommendations include both specific eating and physical activity behaviors, which are likely to promote maintenance of healthy weight, but also the use of patient-centered counseling techniques such as motivational interviewing, which helps families identify their own motivation for making change. For assessment, the recommendations include methods to screen for current medical conditions and for future risks, and methods to assess diet and physical activity behaviors. For treatment, the recommendations propose 4 stages of obesity care; the first is brief counseling that can be delivered in a health care office, and subsequent stages require more time and resources. The appropriateness of higher stages is influenced by a patient’s age and degree of excess weight. These recommendations recognize the importance of social and environmental change to reduce the obesity epidemic but also identify ways healthcare providers and health care systems can be part of broader efforts.

/pdf/expert-committee-recommendations-regarding-the-prevention-38kyxmdgpa.pdf

Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report

Statistical Methods for Health Care Research

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Biomechanics And Motor Control Of Human Movement

High-resistance strength training (HRST) is one of the most widely practiced forms of physical activity, which is used to enhance athletic performance, augment musculo-skeletal health and alter body aesthetics. Chronic exposure to this type of activity produces marked increases in muscular strength, which are attributed to a range of neurological and morphological adaptations. This review assesses the evidence for these adaptations, their interplay and contribution to enhanced strength and the methodologies employed. The primary morphological adaptations involve an increase in the cross-sectional area of the whole muscle and individual muscle fibres, which is due to an increase in myofibrillar size and number. Satellite cells are activated in the very early stages of training; their proliferation and later fusion with existing fibres appears to be intimately involved in the hypertrophy response. Other possible morphological adaptations include hyperplasia, changes in fibre type, muscle architecture, myofilament density and the structure of connective tissue and tendons. Indirect evidence for neurological adaptations, which encompasses learning and coordination, comes from the specificity of the training adaptation, transfer of unilateral training to the contralateral limb and imagined contractions. The apparent rise in whole-muscle specific tension has been primarily used as evidence for neurological adaptations; however, morphological factors (e.g. preferential hypertrophy of type 2 fibres, increased angle of fibre pennation, increase in radiological density) are also likely to contribute to this phenomenon. Changes in inter-muscular coordination appear critical. Adaptations in agonist muscle activation, as assessed by electromyography, tetanic stimulation and the twitch interpolation technique, suggest small, but significant increases. Enhanced firing frequency and spinal reflexes most likely explain this improvement, although there is contrary evidence suggesting no change in cortical or corticospinal excitability. The gains in strength with HRST are undoubtedly due to a wide combination of neurological and morphological factors. Whilst the neurological factors may make their greatest contribution during the early stages of a training programme, hypertrophic processes also commence at the onset of training.

http://performancetrainingsystems.net/Resources/Adaptations_to_Strength_Training.pdf

The adaptations to strength training : morphological and neurological contributions to increased strength.

The evaluation of rate of force development during rapid contractions has recently become quite popular for characterising explosive strength of athletes, elderly individuals and patients. The main aims of this narrative review are to describe the neuromuscular determinants of rate of force development and to discuss various methodological considerations inherent to its evaluation for research and clinical purposes. Rate of force development (1) seems to be mainly determined by the capacity to produce maximal voluntary activation in the early phase of an explosive contraction (first 50–75 ms), particularly as a result of increased motor unit discharge rate; (2) can be improved by both explosive-type and heavy-resistance strength training in different subject populations, mainly through an improvement in rapid muscle activation; (3) is quite difficult to evaluate in a valid and reliable way. Therefore, we provide evidence-based practical recommendations for rational quantification of rate of force development in both laboratory and clinical settings.

/pdf/rate-of-force-development-physiological-and-methodological-5a4kwox9nh.pdf

Rate of force development: physiological and methodological considerations

The main aim of this review is to discuss some evidence-based physiological and methodological considerations for optimal use of neuromuscular electrical stimulation (NMES) in healthy and impaired skeletal muscles. After a quick overview of the main applications, interests and limits of NMES use, the first section concentrates on two crucial aspects of NMES physiology: the differences in motor unit recruitment pattern between NMES and voluntary contractions, and the involvement of the nervous system during peripheral NMES. The second section of the article focuses on the most common NMES parameters, which entail the characteristics of both the electrical current (the input) and the evoked contraction (the output).

Physiological and methodological considerations for the use of neuromuscular electrical stimulation

Vertical jump is one of the most prevalent acts performed in several sport activities. It is therefore important to ensure that the measurements of vertical jump height made as a part of research or athlete support work have adequate validity and reliability. The aim of this study was to evaluate concurrent validity and reliability of the Optojump photocell system (Microgate, Bolzano, Italy) with force plate measurements for estimating vertical jump height. Twenty subjects were asked to perform maximal squat jumps and countermovement jumps, and flight time-derived jump heights obtained by the force plate were compared with those provided by Optojump, to examine its concurrent (criterion-related) validity (study 1). Twenty other subjects completed the same jump series on 2 different occasions (separated by 1 week), and jump heights of session 1 were compared with session 2, to investigate test-retest reliability of the Optojump system (study 2). Intraclass correlation coefficients (ICCs) for validity were very high (0.997-0.998), even if a systematic difference was consistently observed between force plate and Optojump (-1.06 cm; p < 0.001). Test-retest reliability of the Optojump system was excellent, with ICCs ranging from 0.982 to 0.989, low coefficients of variation (2.7%), and low random errors (±2.81 cm). The Optojump photocell system demonstrated strong concurrent validity and excellent test-retest reliability for the estimation of vertical jump height. We propose the following equation that allows force plate and Optojump results to be used interchangeably: force plate jump height (cm) = 1.02 × Optojump jump height + 0.29. In conclusion, the use of Optojump photoelectric cells is legitimate for field-based assessments of vertical jump height.

Validity and reliability of Optojump photoelectric cells for estimating vertical jump height.

Purpose:To establish the validity and reliability of a new vertical jump force test (VJFT) for the assessment of bilateral strength asymmetry in a total of 451 athletes.Methods:The VJFT consists of countermovement jumps with both legs simultaneously: one on a single force platform, the other

A vertical jump force test for assessing bilateral strength asymmetry in athletes.

The effects of prolonged cycling on neuromuscular parameters were studied in nine endurance-trained subjects during a 5-h exercise sustained at 55% of the maximal aerobic power. Torque during maximal voluntary contraction (MVC) of the quadriceps muscle decreased progressively throughout the exercise (P < 0.01) and was 18% less at the end of exercise compared with the preexercise value. Peak twitch torque, contraction time, and total area of mechanical response decreased significantly (P < 0.05) after the first hour of exercise. In contrast, changes in M-wave characteristics were significant only after the fourth hour of the exercise. Significant reductions (P < 0.05) in electromyographic activity normalized to the M wave occurred after the first hour for the vastus lateralis muscle but only at the end of the exercise for the vastus medialis muscle. Muscle activation level, assessed by the twitch interpolation technique, decreased by 8% (P < 0.05) at the end of the exercise. The results suggest that the time course is such that the contractile properties are significantly altered after the first hour, whereas excitability and central drive are more impaired toward the latter stages of the 5-h cycling exercise.

/pdf/neuromuscular-fatigue-during-a-long-duration-cycling-4bwijodsi0.pdf

Nicola A. Maffiuletti

Papers

Rate of force development: physiological and methodological considerations

Physiological and methodological considerations for the use of neuromuscular electrical stimulation

Validity and reliability of Optojump photoelectric cells for estimating vertical jump height.

A vertical jump force test for assessing bilateral strength asymmetry in athletes.

Neuromuscular fatigue during a long-duration cycling exercise