Here, we compare the relative clinical efficacy of EGFR-targeted tyrosine kinase inhibitors ( EGFR TKIs) for EGFR-positive advanced non-small-cell lung cancer (NSCLC). The authors systematically searched 11 electronic databases from January 2004 to August 2018 for randomized controlled trials measuring clinical efficacy of first-line TKI therapies. Clinical efficacy outcomes included overall survival and progression-free survival. Bayesian network meta-analysis was used to assess the relative efficacy of first-line EGFR TKIs for overall survival and progression-free survival. This network meta-analysis showed that dacomitinib and osimertinib resulted in improved efficacy outcomes compared with afatinib, erlotinib and gefitinib. Both osimertinib and dacomitinib should be considered as standard first-line treatment options for patients diagnosed with advanced EGFR-positive non-small-cell lung cancer.

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Context: Near-infrared (NIR) light therapy is purported to act as an ergogenic aid by enhancing the contractile function of skeletal muscle. Improving muscle function is a new avenue for research in the area of laser therapy; however, very few researchers have examined the ergogenic effects of NIR light therapy and the influence it may have on the recovery process during rehabilitation.Objective: To evaluate the ergogenic effect of NIR light therapy on skeletal muscle function.Design: Crossover study. Main Outcome Measure(s): The dependent variables were elbow range of motion, muscle point tenderness, and strength (peak torque). Analysis of variance with repeated measures was used to assess changes in these measures between treatments at baseline and at follow-up, 48 hours postexercise. Additionally, immediate strength loss postexercise was compared between treatments using a paired t test.Results: Preexercise to postexercise strength loss for the active laser treatment, although small, was less than with the sham treatment (P ¼ .05).Conclusions: Applied to skeletal muscle before resistance exercise, NIR light therapy effectively attenuated strength loss. Therefore, NIR light therapy may be a beneficial, noninvasive modality for improving muscle function during rehabilitation after musculoskeletal injury. However, future studies using higher treatment doses are warranted.

Context: Athletic trainers use clinical pain and range of motion (ROM) to gauge recovery after musculoskeletal injury. Limited evidence to date suggests which shoulder ROM measures can predict symptomatic relief and functional recovery after delayed-onset muscle soreness (DOMS).Objective: To determine whether shoulder passive internal rotation, passive external rotation, active abduction, and active flexion and evoked pain with abduction are associated with resting pain experienced after exercise-induced DOMS.Design: Descriptive laboratory study. Setting: Controlled research laboratory. Patients or Other Participants: A total of 110 healthy, right-hand-dominant participants (44 men: age ¼ 25.39 6 7.00 years, height ¼ 178.93 6 7.01 cm, weight ¼ 78.59 6 14.04 kg; 66 women: age ¼ 22.98 6 6.11 years, height ¼ 164.64 6 6.94 cm, weight ¼ 61.86 6 11.67 kg).Intervention(s): Participants completed an exercise-induced DOMS protocol for the external rotators of the dominant shoulder to replicate muscle injury.Main Outcome Measure(s): Current resting pain was assessed daily for 96 hours using the Brief Pain Inventory. We evaluated functional recovery with measures of ROM in abduction, internal rotation, external rotation, and flexion. Evoked pain with active abduction was reported, and the pain rating served as the dependent variable in the regression model.Results: Impairment measures explained resting pain at 48 (R 2 ¼ 0.392) and 96 hours (R 2 ¼ 0.164). Abduction and internalrotation ROM and evoked pain with abduction predicted resting pain at 48 hours (P , .001). At 96 hours, evoked pain with abduction of the injured arm (P , .001) was the significant contributor to resting pain.Conclusions: These models suggest that resting pain after experimentally induced DOMS occurs at 48 hours and is associated with specific ranges of motion and evoked pain with abduction.Key Words: upper extremity, glenohumeral joint, functional impairment Key PointsAt 48 hours after exercise-induced delayed-onset muscle soreness, abduction and internal-rotation range of motion and evoked pain with abduction all predicted resting pain. At 96 hours, the most significant predictor of resting pain was evoked pain with abduction. Controlling pain after initial injury while restoring range of motion in abduction and internal rotation may speed the recovery process.

We investigated the acute myogenic response to resistance exercise with and without blood-flow restriction (BFR). Six men and women (22±1 years) performed unilateral knee extensions at 40% of 1-repetition maximum with BFR applied via pressure cuff inflated to 220 mmHg or without (CNTRL). Muscle biopsies were collected 4h and 24h post-exercise. Addition of BFR increased myoD and c-Met mRNA expression relative to CNTRL. Expression of hepatocyte growth factor (HGF) protein was significantly higher following CNTRL.