Órtese de tornozelo: efeito sobre a razão de pico torque muscular eversor excêntrico/inversor concêntrico do tornozelo durante simulação do basquetebol

The ankle sprains represent the most common injuries in sports and basketball. In this sense, the use of ankle bracing and strength capacity analysis of the ankle evertor and invertor muscles, have been suggested as preventive measures and important tools for identifying risk factors associated with ankle sprains. However, questions still persist as to effect of the use ankle bracing on biomechanical variables related to the stability of the ankle. For this reason, this study aims to analyze the effect of the use of ankle bracing on peak torque (PT) of ankle evertor and invertor muscles and on eccentric evertor/concentric invertor torque ratio (EVEECC/INVCON), during the basketball match-play simulation. Ten healthy college basketball players, without mechanics or functional ankle instability performed a laboratory-based protocol representative of work rates observed during basketball match-play, in two different situations, with and without use of ankle bracing. The test was composed of a succession of intermittent physical effort equally distributed in four periods of 10 minutes each, considering the mechanical and physiological demands of a basketball match-play. Prior to the start of the trial (Evaluation 1) and after 2° (Evaluation 2) and 4° (Evaluation 3) periods, the subjects performed five maximal isokinetic concentric and eccentric contractions of ankle invertor and evertor muscles, separated by two minutes rest, at 60 °/s and 120 °/s. After testing for normality of data distribution with the Shapiro-Wilk test, was used the ANOVA repeated measures for two factors and post-hoc Bonferroni test for comparison of variables between assessments. Was adopted p < 0.05. There was no significant difference for PT and EVEECC/INVCON torque ratio between assessments. There was a decrease in PT EVEECC at 60º/s and 120º/s for the ...(Complete abstract click electronic access below)

Expressão dos fatores de regulação miogênica em cultura de mioblastos submetidos ao TNF-α/IFN-γ

A insuficiência cardíaca (IC) está associada a miopatia dos músculos esqueléticos dos membros, com perda da massa muscular, diminuição na proporção das fibras do tipo I (contração lenta) e aumento na proporção das fibras do tipo II (contração rápida). É provável que alterações na expressão de fatores de transcrição pertencentes à família “basic helix-loop-helix” (bHLH), da qual fazem parte a MyoD, Miogenina, Myf5 e o MRF-4, conhecidos como fatores de regulação miogênica (MRFs), sejam responsáveis pelas mudanças nos tipos de fibras. Enquanto que a Miogenina é expressa em níveis superiores aos da MyoD em músculos lentos, o oposto é verdadeiro para músculos rápidos. Similarmente, a MyoD está associada com a expressão das isoformas de miosina de cadeia pesada rápidas dos tipos IIX e IIB. Estudos in vitro, demonstraram que o TNF-α inibe a expressão de MyoD e miogenina diminuindo a atividade de genes músculo específicos. A ação do TNF-α diminuindo a expressão da MyoD mostra-se mais acentuada quando em associação com o IFN-γ, no entanto, há poucas informações na literatura a respeito do papel desta associação na expressão dos fatores de regulação miogênica, in vitro. Avaliar a expressão dos fatores de regulação miogênica, MyoD, miogenina, Myf5, e MRF-4 em cultura de mioblastos C2C12 submetidos ao TNF-α/IFN-γ. Nossos resultados mostraram um aumentou na expressão dos gene MyoD, Myf5 e miogenina sob tratamento com IFN-γ quando comparado aos grupos controle e TNF-α/IFN-γ. A expressão gênica do MRF-4 na cultura de células não foi detectada em nenhum dos grupos analisados. O GAPDH foi utilizado para normalizar os valores de expressão dos outros genes analisados. O presente estudo demonstrou que o IFN-γ exógeno administrado à culturas de mioblastos... (Resumo completo, clicar acesso eletrônico abaixo)

Morfologia e expressão dos MRF’s no músculo esquelético de ratos submetidos a estímulo atrófico e recuperação por treinamento físico

Recent research advances in understanding the cellular and molecular mechanisms that underlie the processes of hypertrophy and atrophy. This may contribute to development of effective therapeutic strategies to attenuate or block the loss of muscle tissue associated with aging and pathological conditions. In this context, myogenic factors that control the activity of satellite cells have been studied to better understand the events involved in the recovery of muscle mass. Among them, we highlight the Myogenic Regulatory Factors (MRFs), which have been described as potential mediators of muscle growth. The objectives of this study evaluated the morphofunctional adaptations and gene expression of MRFs (MyoD and myogenin) in skeletal muscle (soleus) subjected to an atrophic stimulus followed by physical training. It was used 64 male Wistar rats (80 days, 250 to 300 g), divided into 8 groups (n = 8): C: control animals a week, I: Animals immobilized a week, C3: control animals 3 days; R3: Animals immobilized and recovered for 3 days, T3: Animals immobilized and submitted to exercise for 3 days; C7: Animals controls 7 days; R7: Animals immobilized and subsequently recovered by 7 days, T7: Animals immobilized and subsequently subjected to exercise for 7 days. Initially, the animals in groups I, R3, R7, T3 and T7, were submitted to 7 days of immobilization of the hind limb. Muscle atrophy was confirmed after a direct statistical comparison of the values of cross-sectional area (CSA) of muscle fibers studied in animals in groups I and C, sacrificed immediately after the immobilization period. Then, the groups T3 and T7 were submitted a rehabilitation program with muscle aerobic exercise (swimming) for 3 and 7 days respectively. The groups C, C3 and C7 were kept without stimulus atrophic and were not subjected to exercise. At the end of the experiment, the animals were sacrified and the soleus muscle removed. The quantitative analysis of gene expression ...

Diferentes métodos de diagnóstico molecular na diferenciação das espécies de Sarcocystis spp

The Sarcocystis genus includes obligatory two-host life cycle protozoan parasites. It is the most numerous of the six genera of the Sarcocystidae family. The infection caused by parasites of this genus is a zoonotic and cosmopolitan disease known as sarcosistosis or sarcosporidiosis. The sarcositosis though frequently asymptomatic in its definitive hosts can be fatal in its intermediate hosts. The usual diagnoses of sarcosistosis takes place through a histological demonstration of schizonts in blood vessels and organs, and the presence of cysts in muscle tissue by necropsy or biopsy, this second method still more common and based on morphological features of the sarcocyst. However, these methods can be inadequate to a precise identification of the infector species once that, besides the genus being of numerous species, these often present similar morphological features. Another factor that makes the diagnostic more difficult is the non specificity of some Sacocystis species to their hosts. Consequently, molecular diagnostic methods have been used in order to identify the infector species and the parasite specific biological cycles, demonstrating also new species and coevolutive aspects between parasite and host. Among the most employed molecular techniques the Polimerase Chain Reaction (PCR), the nested-PCR and the Restriction Fragment Length Polymorphism (RFLP) stands out

Efeito agudo de diferentes volumes de alongamento estático na contração voluntária máxima de idosas

Several studies have shown that different stretching routines can lead to decreases on acute neuromuscular system performance. Although the deficit in muscle strength mediated by different methods of stretching has been systematically observed, few studies have investigated the possible existence of a dose-response relationship between the amount of stretching and muscle strength deficit in older adults. In this context, the objective of this study was to investigate the acute effect of two different stretching volumes on isometric force-time curve (Cf-t) in elderly women. The study included 13 older women (64.08 ± 4.27 years, 69.98 ± 10.56 kg, 157.90 ± 8.66 cm, 28.25 ± 4.22 kg/m²). The participants visited the laboratory for five consecutive days, among which the first two were used for familiarization. During the other three days the participants underwent experimental conditions: control (C) stretch 30 seconds (AE30) and stretch 60 seconds (AE60). For the AE30 and AE60 conditions, three series of passive static stretching were performed, with duration of 30 and 60 seconds, respectively. The experimental conditions were performed with an interval of at least 24 hours between them and the order of execution was randomized. The recording of isometric Cf-t of the knee extensor muscles was performed in extensor chair connected to a force transducer. Measurements were recorded immediately after each experimental condition, for five seconds. For statistical analysis, descriptive procedures were used and ANOVA one way to check possible changes on the Maximal Voluntary Contraction (CVM) and Peak Rate of Force Development (TDFP) among the three conditions (p <0.05). The ANOVA showed no statistically significant difference for CVM and TDFP, between the three conditions. It can be concluded that different volumes of static stretching, three sets ...(Complete abstract click electronic access below)

Tromboembolismo na aorta abdominal terminal em felinos

Clinical manifestations of arterial thromboembolism in cats depends on the location of embolization, the severity and duration of occlusion, the functionality of the collateral circulation and the development of complications. In case of location in the terminal abdominal aorta usually presents animal paresis/paralysis, pulses are weak or nonpalpable, pain, cold limbs. Gastrocnemius and tibialis muscles generally have become bulbous, swollen and sore because of ischemic neuromyopathy. The nail beds become pale or very dark (purple to black), and do not bleed when cut. Due to the small number of researches in the area it’s until not possible to determine which medication, dosage and frequency of administration are more suitable for the treatment of arterial thromboembolism in cats. Among the options currently available the cheapest, easiest to administer and which requires no periodic monitoring is the low-dose aspirin

Estudo comparativo do perfil morfológico e histoquímico da musculatura peitoral de pererecas do gênero Scinax

A musculatura peitoral de anuros gera a potência necessária para a produção das vocalizações, tendo seu perfil histológico descrito para apenas uma espécie. Para esta, a musculatura peitoral apresenta 100% de fibras oxidativas rápidas. Entretanto, a taxa de vocalização apresenta enorme variação interespecífica, mesmo considerando espécies pertencentes a um mesmo gênero, como é o caso do gênero Scinax. Acreditamos que o perfil morfológico e histoquímico da musculatura peitoral, particularmente no tocante à capacidade oxidativa aeróbia, deve covariar com o desempenho aeróbio. Desta forma, o objetivo deste projeto foi realizar uma análise comparativa da morfologia e histoquímica do músculo peitoral de três diferentes espécies de pererecas do gênero Scinax. Os animais foram coletados durante o pico de atividade reprodutiva. Estes foram pesados e eutanaziados para a retirada dos músculos peitorais. Fragmentos musculares foram congelados em nitrogênio líquido e armazenados em freezer -80°C. Cortes histológicos (10μm), obtidos em criostato, foram submetidos à coloração HE (Hematoxilina-Eosina) para avaliação do padrão morfológico das fibras, e NADH-TR (Nicotinamida Adenina Dinucleotídeo-Tetrazólico Redutase), para avaliação do metabolismo oxidativo das fibras. Não houve diferenças qualitativas e quantitativas na morfologia e área das fibras entre as espécies. Provavelmente as diferenças comportamentais interespecíficas devem estar associadas a caracteres ultraestruturais da musculatura como capilarização, volume mitocondrial e tipo de miosina (MHC) presente na fibra muscular. O músculo peitoral de S. perereca e S. fuscovarius apresentou forte reação NADH-TR, o que demonstra alto metabolismo oxidativo, enquanto que Scinax hiemalis apresentou uma população de fibras com metabolismo oxidativo mais moderado; isso está de acordo com dados... (Resumo completo, clicar acesso eletrônico abaixo)

Reprodutibilidade do pico de torque do músculo tríceps braquial em nadadores treinados

A natação é um esporte praticado em meio líquido o que a torna muito dependente da técnica do nadador, pelo fato de apresentar maior resistência quando comparado com o meio terrestre. A força muscular, composição corporal e a técnica do nado são alguns fatores determinantes para a melhora do desempenho esportivo do atleta. Sendo assim, a capacidade de gerar força propulsiva e minimizar a resistência ao meio líquido são altamente influenciadoras do desempenho nesta modalidade. Um dos principais músculos utilizados na propulsão da braçada do nado crawl é o tríceps braquial o qual é responsável pela extensão do cotovelo. O nível de força dos membros dominante e não dominante também pode influenciar no desequilíbrio muscular dos nadadores e consequentemente na propulsão do atleta. Sendo assim, o objetivo deste estudo foi analisar a reprodutibilidade de pico de torque (PT) durante as contrações isométrica e isocinética concêntrica em diferentes velocidades do músculo tríceps braquial nos membros dominante e não dominante em nadadores. Participaram do estudo nadadores velocistas e meio fundistas do gênero masculino, com idade entre 18 e 28 anos, com experiência no mínimo de 3 anos na modalidade. Os voluntários foram solicitados a comparecer no laboratório em 3 ocasiões em dias diferentes. Primeiramente para obter as medidas antropométricas (massa, estatura, envergadura e dobras cutâneas) e logo em seguida foi feita a familiarização ao teste isométrico e isocinético no dinamômetro. Nas próximas visitas os atletas realizaram no dinamômetro isocinético, o teste máximo para determinação do PT da contração isométrica e isocinéticas concêntricas em diferentes velocidades. O procedimento foi realizado duas vezes em dias diferentes. O teste para determinação do PT isométrico e isocinético foi realizado de forma aleatória... (Resumo completo, clicar acesso eletrônico abaixo)

Influência do alongamento prévio no pico de torque e na taxa de força em exercício de contração isométrica

The objective of this study was to investigate the influence of previous active static stretch on the isometric peak torque (PT) and rate of force development (RFD) measured from different time intervals from the beginning of muscle contraction. Participated of this study 15 male individuals, apparently healthy, with ages between 18 and 25 years, without regular physical activity practice. The individuals were submitted in different days to the following tests: 1) Familiarization session to the isokinetic dynamometer; 2) Two maximal isometric concentric contractions for knee extensors in isokinetic dynamometer to determine PT and RFD (Control), and; 3) Two active static stretching exercises for the dominant leg extensors (10 x 30 s for each exercise, with 20 s of rest). After the stretching, the isokinetic test was repeated (Post-Stretching). The conditions 2 and 3 were performed in random order. The RFD was considered as the mean slope of the moment-time curve at time intervals of 0-30, 0-50 and 0-100ms relative to the beginning of muscle contraction. It was verified significant reduction for both maximal RFD and PT after the stretching (p < 0.05). At intervals of 0- 30ms, 0-50ms and 0-100ms, the RFD at the conditions with stretching was similar to the RFD without stretching (p > 0.05). At intervals of 0-150ms and 0-200ms, the RFD obtained at the contraction without stretching was significantly higher that that obtained at the contraction with stretching (p < 0.05). It can be concluded that the static stretching, performed with duration of 600 s diminish isometric PT, maximal RFD and RFD measured at late phase (> 100 ms) of muscle contraction.

Interpretação da fadiga muscular por meio da eletromiografia durante corrida em esteira

O presente estudo teve como objetivo identificar a fadiga muscular por meio da amplitude e freqüência do sinal eletromiográfico (EMG) do músculo vasto lateral (VL) e reto femoral (RF) do membro inferior direito, durante protocolo incremental de corrida em esteira e nas contrações isométricas submáximas realizadas no início e após cada velocidade. Participaram deste estudo 07 voluntários saudáveis, do gênero masculino, experientes em corrida na esteira, com idade média de 25 anos (± 4,3), sem antecedentes de doenças músculo-esqueléticas nos membros inferiores e de antropometria semelhante. Foram realizadas três contrações isométricas voluntárias máximas (CIVM = 100%) de extensão do joelho para posterior determinação da contração submáxima de 50% da CIVM (CI-50%). O protocolo de corrida foi composto de um aquecimento de 5 minutos (9 km/h), e após iniciou-se o teste com velocidade inicial de 10 km/h e incremento de 1 km/h a cada 3 minutos, até a exaustão voluntária, havendo uma pausa entre cada velocidade de aproximadamente 2 minutos. Antes do início da corrida e após cada velocidade realizou-se uma contração isométrica com 50% da CIVM (CI-50%) de 5s de duração. No sinal eletromiográfico coletado durante a corrida, os valores de RMS (Root Mean Square) dos músculos VL e RF foram obtidos no período correspondente a um ciclo completo da passada a 10% e 100% do tempo analisado (120 segundos finais de cada velocidade) por meio de rotina específica (Matlab). No sinal eletromiográfico coletado durante as CI-50% (5s), os valores de RMS e FM (freqüência mediana) foram obtidos no período de 1s (intervalo de 1 a 2s). A normalidade dos dados foi determinada através do teste de Shapiro-Wilk. Utilizou-se teste-t de Student para amostras pareadas, e o nível de significância (p) adotado foi de p<0,05. Os resultados...(Resumo completo, clicar acesso eletrônico abaixo)

Análise de variáveis eletromiográficas e cinemáticas em protocolo incremental de corrida na esteira

Muscle fatigue is described as a cause of injuries among the many related to the running practice. Therefore, the purpose of this study was to analyze the behavior of the amplitude (RMS) and median frequency (MF) of EMG signal of the iliocostalis (CI), rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM) biceps femoris (long head) (BFCL), tibialis anterior (TA) and gastrocnemius (lateral) (LNG) from the right lower limb, and the behavior of the parameters of amplitude (AP) and frequency (PF) spent in different percentages of the maximum speed during incremental protocol of treadmill running. 10 volunteers participated in this study, athletes, male, aged between 18 and 30 years with no history of injury in lower limbs and similar anthropometry. The protocol consisted of a treadmill test with initial velocity of 10 km.h-¹ and increments of 1 km.h-¹ each three minutes until volitional exhaustion, without rest interval. Synchronized collections were made of electromyographic and kinematic data. The signals were obtained through an acquisition module of biological signals (Telemyo 900 - Noraxon - USA) and software (Myoresearch - Noraxon - USA) calibrated with a sampling frequency of 1000 Hz, gain 2000 times. The raw data were filtered with a 60Hz notch filter, high pass and low pass 20Hz to 500Hz. To capture the image was used a digital video recorder (model NV-GS320, PANASONIC brand), and for image scanning and kinematic data collection was used the software Peak Motus 9.0 (ViconPeak). To obtain the values of RMS and FM analyzed the last ten passes of each speed through a specific routine (Matlab). To obtain these variables AP (m) and FP (stride I min) were analyzed for the last ten past each speed, using specific software (Peak Motus 9.0). After verification of data normality (Shapiro-Wilk) and homogeneity of the data (Levene), the comparison ...(Complete abstract click electronic access below)

Diferenciação miogênica “in vitro” de células tronco mesenquimais murinas de diferentes origens

Muscular dystrophy refers to a group of more than 30 genetical disorders characterized by progressive weakness and degeneration of the skeletal muscle. No effective therapy is available at present. Recent studies have reported that the transplantation of stem cells can offer an important potential therapy for genetic diseases. Adult bone marrow mesenchymal stem cells have been identified as a nonhematopoietic stem cell population capable of self-renewal with the ability to differentiate into many cell lineages, including bone, fat, cartilage and connective tissue. Because of their similarity with muscle progenitor cells, when they are injected in affected individuals, they are able to migrate into areas of skeletal muscle degeneration and participate in the regeneration process. The adipose tissue represents an alternative source of MSCs that, as the MSCs derived from bone marrow, are capable of in vitro differentiation into osteogenic, adipogenic, myogenic and chondrogenic lineages. The objective of this project is to investigate the “in vitro” myogenic potential of mesenchymal stem cells derived from murine bone marrow and adipose tissue. Four experimental groups were analyzed: mice from lineages Lama2dy-2J/J and C57black and, C2C12 lineage cells and transformed C2C12 expressing the eGFP protein. MSCs cultures were obtained by flushing the bone marrow femurs and tibials with α-MEM or by the subcutaneous and inguinal fat from the mice. Their characterization was done by flow cytometry and in vitro differentiation. Muscle differentiation was studied through the analysis of the expression of transcriptional factors involved in muscle differentiation and/or the presence and amount of specific proteins from muscle differentiated cell. The pluripotency from bone marrow MSCs of the two lineages was evidenced and, in the muscular differentiation... (Complete abstract click electronic access below)

Corpo e cultura: culto ao corpo e vigorexia

Currently the company suffers a heavy influence of media, through their tentacles people are reached and clawed into a consumerist context, and the reason for the success of this market share is linked to aesthetics. An ideal beauty standard is followed, aimed at recognizing social, emotional success, professional and loving. Thus, people are accustomed from his childhood with the image of a perfect prince or princess, heroes that is becoming increasingly more muscular and developed throughout the evolution of cinema. While the aesthetic perfection is internalized by society and see that this beauty is not a particular good for some people, but everyone should become pretty standard to suit hence those who do not fit this stereotype are somehow excluded from the circle of society standard. One way people try to develop and hone the look is through weight training exercises in specialized academies. The problem is when it appears not the contentment of the individual in relation to his body. Even when your muscles are increasing, for the person who suffers from Vigorexia changes are significant to the point never to be content with their state of development, which is seen distorted and underestimated. Thus this paper aims to describe the situation and how the routine Vigorexia context and people are distorted to suit the aesthetic and social demands that are made, through a literature search on the muscle dysmorphia. It is of paramount importance to know the pathological picture of Vigorexia not only by professionals of Psychology, Psychiatry and Medicine, but also for Physical Educators that are constantly present in an active and that can positively or negatively influence the routine and pathological picture of these people with Muscular Dysmorphia

Expressão gênica dos receptores nicotínicos de acetilcolina (nAChR) e caracterização morfológica das junções neuromusculares em músculo esquelético de ratos com insuficiência cardíaca

A insuficiência cardíaca (IC) está associada à miopatia dos músculos esqueléticos com aumento da expressão das isoformas rápidas da cadeia pesada de miosina e alterações na matriz extracelular. Os fatores de regulação miogência(MRF),como a MyoD e MRF4, pertecem a uma família de fatores transcricionais que controlam vários genes músculo-específicos.Esses fatores forma heterodímeros com proteínas HLH e ligam-se a seqüências de DNA conhecidas como Ebox, presentes na região promotora de vários genes músculo–específicos, incluindo todos aqueles que codificam as subunidades dos receptores nicotínicos de acetilcolina (nAChR) da junção neuromuscular (JNM). Baseado no fato de que na IC há uma diminuição na expressão da MyoD e MRF4 no músculo sóleo de ratos com IC induzida por monocrotalina, o objetivo do presente trabalho é verificar possíveis alterações na expressão dos receptores de acetilcolina, bem como realizar uma análise morfológica e morfométrica das JNMs. Neste estudo foram utilizados ratos Wistar, machos, divididos em grupos controle e experimental e a Insuficiência cardíaca (IC) foi induzida pela injeção de monocrotalina intra-peritoneal.Quando os sintomas de IC foram visualizados (após 22 dias) os animais foram sacrificados pentobarbital sódico i.p. (50 mg/Kg). A seguir foram mensurados o peso corporal (PC) dos ratos, bem como outros parâmetros. O músculo sóleo de ambos os antímeros foram dissecados e preparados para: avaliação da expressão gênica das subunidades ε, γ e α dos receptores de acetilcolina por PCR em Tempo Real; para análise morfológica e morfométrica da Junção Neuromuscular através da técnica de Esterase inespecífica; para análise ultra-estrutural da JN. Os resultados indicam que não houveram alterações morfológicas e morfométricas na JN, mas houve um aumento... (Resumo completo, clicar acesso eletrônico abaixo)

A influência do alongamento prévio no pico de torque e na taxa de desenvolvimento de força

The objective of this study was to investigate the influence of previous active static stretch on the peak torque (PT) and rate of force development (TDF) during isokinetic concentric contractions at 60 and 180.s-1 in active individuals. Twelve active subjects with ages between 18 and 30 years participated of this study. The individuals were submitted in different days to the following tests: 1) Familiarization session to the isokinetic dynamometer; 2) Five maximal isokinetic concentric contractions for knee extensors at each angular velocity (60 and 180.s-1) to determine PT and TDF (Control), and; 3) Two active static stretching exercises for the dominant leg extensors (10 x 30 s for each exercise, with 20 s of rest). After the stretching, the isokinetic test was repeated (Post-Stretching). The conditions 2 and 3 were performed in random order. There was no significant modification after the stretch exercises on the PT, angle and time at which the PT was attained, at 60 and 180º.s-1. In the same way, there was no significant modification on the TDF and angle at which the maximal TDF was attained in both angular speeds. In other way, the time to attain maximal TDF (TTDF) at 180º.s-1 was significantly lower after the stretching (Pre - 98.3 ± 27.5 ms and Post - 86.6 ± 30.2 ms). There was significant modification on the torque (60 and 180º.s-1) and time (60º.s-1) at different delta of angle variations, obtained at 60º.s-1 at Control and Post-Stretching conditions. However, there was significant reduction of time after the stretching exercises on delta of angle variations of 90-88º (Pre - 46.6 ± 6.5 ms and Post - 44.1 ± 5.1 ms), 88-85º (Pre - 65.8 ± 7.9 ms and Post - 63.3 ± 4.9 ms) and 85-80º (Pre - 93.3 ± 7.7 ms and Post - 90.0 ± 4.2 ms) at 180º.s-1. With base on these data, it is possible to conclude that PT and TDF do not modify after static stretching, irrespectively on the speed...(Complete abstract click electronic access below)