PurposeThe relationship between changes in muscle size and strength may be affected by both measurement and statistical approaches, but their effects have not been fully considered or quantified. Therefore, the purpose of this investigation was to explore how different methods of measurement and analysis can affect inferences surrounding the relationship between hypertrophy and strength gain.MethodsData from a previous study—in which participants performed eight weeks of elbow flexor training, followed by an eight-week period of detraining—were reanalyzed using different statistical models, including standard between-subject correlations, analysis of covariance, and hierarchical linear modeling.ResultsThe associative relationship between strength and hypertrophy is highly dependent upon both method/site of measurement and analysis; large differences in variance accounted for (VAF) by the statistical models were observed (VAF = 0–24.1%). Different sites and measurements of muscle size showed a range of correlations coefficients with one another (r = 0.326–0.945). Finally, exploratory analyses revealed moderate-to-strong relationships between within-individual strength-hypertrophy relationships and strength gained over the training period (ρ = 0.36–0.55).ConclusionsMethods of measurement and analysis greatly influence the conclusions that may be drawn from a given dataset. Analyses that do not account for inter-individual differences may underestimate the relationship between hypertrophy and strength gain, and different methods of assessing muscle size will produce different results. It is suggested that robust experimental designs and analysis techniques, which control for different mechanistic sources of strength gain and inter-individual differences (e.g., muscle moment arms, muscle architecture, activation, and normalized muscle force), be employed in future investigations.
AstraZeneca coronavirus disease 2019 vaccinations have recently been implicated in thromboembolism formations. Our aim was to investigate the outcomes of patients with thromboembolic events following the AstraZeneca vaccine (ChAdOx1 nCoV-19, AZD1222). A literature search was performed from December 2019 to September 2021. Eligible studies must report participants older than 18 years vaccinated with AstraZeneca and outcomes of thromboembolic events. Pooled mean or proportion were analyzed using a randomeffects model. A total of 45 unique studies (number of patients U 144, 64.6% women, mean age 21-68 years) were included. The most common presenting adverse events were headache (12.1%), intracerebral hemorrhage (7.5%), and hemiparesis (7%). The most common thromboembolic adverse events were cerebral venous sinus thrombosis (38.5%) and deep vein thrombosis/pulmonary embolism (21.1%). The most common radiologic finding were intracerebral hemorrhage and cerebral venous thrombosis. Laboratory findings included thrombocytopenia (75%) and hypofibrinogenemia (41%). On admission, 64 patients tested positive for PF4-Heparin ELISA assay (80%). Seventy-four patients were hospitalized with 22 being admitted to the ICU. A total of 78 patients recovered while 39 patients died. This meta-analysis presents evidence to suggest vaccine-induced immune thrombotic thrombocytopenia (VITT) following AstraZeneca vaccine. Clinical practice must, therefore, account for the possibility of VITT and subsequent embolic events in certain individuals' postvaccination with adenovirus-based COVID-19 vaccines. Serum anti-PF4 suggests diagnostic value for VITT and could subsequently inform treatment choices in such instances. Blood Coagul Fibrinolysis 33:90-112
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