Effect of strength training on resting metabolic rate and physical activity: age and gender comparisons.
Med Sci Sports Exerc. 2001 Apr ;33(4):532-41. PMID: 11283427
J T Lemmer, F M Ivey, A S Ryan, G F Martel, D E Hurlbut, J E Metter, J L Fozard, J L Fleg, B F Hurley
Department of Kinesiology, College of Health and Human Performance, University of Maryland, College Park, MD 20742, USA.
PURPOSE: The purpose of this study was to compare age and gender effects of strength training (ST) on resting metabolic rate (RMR), energy expenditure of physical activity (EEPA), and body composition.
METHODS: RMR and EEPA were measured before and after 24 wk of ST in 10 young men (20-30 yr), 9 young women (20-30 yr), 11 older men (65-75 yr), and 10 older women (65-75 yr).
RESULTS: When all subjects were pooled together, absolute RMR significantly increased by 7% (5928 +/- 1225 vs 6328 +/- 1336 kJ.d-1, P<0.001). Furthermore, ST increased absolute RMR by 7% in both young (6302 +/- 1458 vs 6719 +/- 1617 kJ x d(-1), P<0.01) and older (5614 +/- 916 vs 5999 +/- 973 kJ x d(-1), P<0.05) subjects, with no significant interaction between the two age groups. In contrast, there was a significant gender x time interaction (P<0.05) for absolute RMR with men increasing RMR by 9% (6645 +/- 1073 vs 7237 +/- 1150 kJ x d(-1), P<0.001), whereas women showed no significant increase (5170 +/- 884 vs 5366 +/- 692 kJ x d(-1), P = 0.108). When RMR was adjusted for fat-free mass (FFM) using ANCOVA, with all subjects pooled together, there was still a significant increase in RMR with ST. Additionally, there was still a gender effect (P<0.05) and no significant age effect (P = NS), with only the men still showing a significant elevation in RMR. Moreover, EEPA and TEE estimated with a Tritrac accelerometer and TEE estimated by the Stanford Seven-Day Physical Activity Recall Questionnaire did not change in response to ST for any group.
CONCLUSIONS: In conclusion, changes in absolute and relative RMR in response to ST are influenced by gender but not age. In contrast to what has been suggested previously, changes in body composition in response to ST are not due to changes in physical activity outside of training.
Article Published Date : Mar 31, 2001
Effects of exercise therapy on painful temporomandibular disorders.
J Oral Rehabil. 2019 Jan 21;:
Authors: Shimada A, Ishigaki S, Matsuka Y, Komiyama O, Torisu T, Oono Y, Sato H, Naganawa T, Mine A, Yamazaki Y, Okura K, Sakuma Y, Sasaki K
Temporomanbular disorders (TMD) are common chronic musculoskeletal pain conditions among orofacial pain. Painful temporomandibular disorders (TMD) condition such as myalgia and arthralgia can be managed by exercise therapy. However, as it is hard to access actual effect of each modality that is included in an exercise therapy program due to multiple choice of the management modality, their efficacy remains controversial. Therefore, this review focused on the effects of exercise therapy for the management of painful TMD. The aims of this review were to summarize the effects of exercise therapy for major symptoms of painful TMD and to establish a guideline for the management of painful TMD, resulting in higher quality and reliability of dental treatment. In this review, exercise modalities are clearly defined as follows: mobilization exercise, muscle-strengthening exercise (resistance training), coordination exercise, and postural exercise. Furthermore, pain intensity and range of movements were focused as outcome parameters in this review. Mobilization exercise including manual therapy, passive jaw mobilization with oral appliances, and voluntary jaw exercise appeared to be a promising option for painful TMD conditions such as myalgia and arthralgia. This review addressed not only the effects of exercise therapy on various clinical conditions of painful TMD shown in the past, but also an urgent need for consensus among dentists and clinicians in terms of the management of each condition, as well as terminology. This article is protected by copyright. All rights reserved.
PMID: 30664815 [PubMed - as supplied by publisher]
Dribble Deficit Enables Measurement of Dribbling Speed Independent of Sprinting Speed in Collegiate, Male, Basketball Players.
J Strength Cond Res. 2019 Jan 17;:
Authors: Ramirez-Campillo R, Gentil P, Moran J, Dalbo VJ, Scanlan AT
Ramirez-Campillo, R, Gentil, P, Moran, J, Dalbo, VJ, and Scanlan, AT. Dribble Deficit enables measurement of dribbling speed independent of sprinting speed in collegiate, male, basketball players. J Strength Cond Res XX(X): 000-000, 2019-The aim of this study was to determine the relationships between sprinting and dribbling speed in basketball during linear and change-of-direction (COD) sprints using total dribbling time and Dribble Deficit. Collegiate, male, basketball players (n = 10; 21.0 ± 1.6 years) performed linear and COD sprints with and without dribbling a ball. Linear dribbling sprints were measured for the dominant and nondominant hands, whereas COD dribbling sprints involved bilateral use of hands. Dribble Deficit was determined as the difference between total time (second) during each dribbling trial and the equivalent nondribbling trial for linear and COD sprints. Simple linear regression analyses were performed during linear and COD sprints to determine the relationship (R) and shared variance (R) between (a) sprinting times and total dribbling times and (b) sprinting times and Dribble Deficit. Large to very large, significant relationships were evident between linear sprinting and dribbling time for dominant (R = 0.86; R = 0.74, p = 0.001) and nondominant hands (R = 0.80; R = 0.65, p = 0.005). Trivial relationships were apparent between linear sprinting time and Dribble Deficit with dominant (R = 0.10; R = 0.01, p = 0.778) and nondominant hands (R = 0.03; R = 0.00, p = 0.940). A very large relationship was evident between COD sprinting and dribbling time (R = 0.91; R = 0.82, p < 0.001), whereas a trivial relationship was observed between COD sprinting time and COD Dribble Deficit (R = -0.23; R = 0.05, p = 0.530). Dribble Deficit eliminates the strong influence of sprinting speed on outcome measures typically seen when using tests predicated on total dribbling time. Consequently, Dribble Deficit may be of added use in basketball test batteries to measure dribbling speed across linear and multidirectional movement paths.
PMID: 30664115 [PubMed - as supplied by publisher]
Reduction of T Cells and Hsa-miR150-5p in Female Canoeing Athletes: Preliminary Evidence Between Exercise Training and Immune.
J Strength Cond Res. 2019 Jan 17;:
Authors: Xiao F, Yang Y, Xiao L, Xia Z, Wang L, Yang K, Wang S
Xiao, F, Yang, Y, Xiao, L, Xia, Z, Wang, L, Yang, K, and Wang, S. Reduction of T cells and hsa-miR150-5p in female canoeing athletes: Preliminary evidence between exercise training and immune. J Strength Cond Res XX(X): 000-000, 2018-This article aims to reveal the alteration of immune profile in teenage canoeing athletes, by which applies a clue for regulation of exercise on human immune. Thirty-one teenagers of female canoeing athletes and age-matched subjects participated in this research. Peripheral leukocytes' microRNAs (miRNAs) were analyzed using Agilent human microRNA 2.0 and gene software. The miRNA candidates were quantified by reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR). The percentages of various lymphocytes were tested using flow cytometry. There were 6 miRNAs (hsa-miR150-5p, 31-5p, 3659, 4419a, 650, and 8485) lower in canoeing athletes, and the reduction of miR-150 was identified by RT-qPCR (p = 0.021). Canoeing athletes had lower percent of CD3 T cells than the subjects with no exercise training had (p < 0.001), but the ratio of CD4 to CD8 and the percent of CD4 T cells and CD8 T cells showed no significant difference between these 2 groups. T cells and hsa-miR150-5p are sensitive to the long-time heavy exercise training, and the exercise for winning competition regulates the immune system by inhibiting T cells and hsa-miR150-5p.
PMID: 30664110 [PubMed - as supplied by publisher]
Does the addition of single joint exercises to a resistance training program improve changes in performance and anthropometric measures in untrained men?
Eur J Transl Myol. 2018 Nov 02;28(4):7827
Authors: Barbalho M, Coswig VS, Raiol R, Steele J, Fisher JP, Paoli A, Bianco A, Gentil P
The present study compared changes in muscle performance and anthropometric measures in young men performing resistance training (RT) programs composed of only multi joint (MJ) exercises, or with the addition of single joint (SJ) exercises (MJ+SJ). Twenty untrained men were randomized to MJ or MJ+SJ groups for 8 weeks. Both groups performed the same MJ exercises. The difference was that the MJ+SJ group added SJ exercises for upper and lower limbs. Participants were tested for 10 repetitions maximum (10RM), flexed arm circumference, and biceps and triceps skinfolds. Both groups significantly increased 10RM load for the bench press (MJ 38.5%, MJ+SJ 40.1%), elbow extension (MJ 28.7%, MJ+SJ 31.9%), pull down (MJ 34.0% MJ+SJ 38.5%), elbow flexion (MJ 38.2%, MJ+SJ 45.3%), leg press (MJ 40.8%, MJ+SJ 46.8%) and knee extension (MJ 26.9%, MJ+SJ 32.9%), with no significant difference between them. The decreases in biceps (MJ -3.6%, MJ+SJ -3.9%) and triceps (MJ -3.4%, MJ+SJ -3.3%) skinfolds were significant for both groups, with no difference between them. However, the flexed arm circumference increased significantly more for MJ+SJ (5.2%), than for MJ (4.0%). The use of SJ exercises as a complement to a RT program containing MJ exercises brings no additional benefit to untrained men in terms of muscle performance and skinfold reduction, though it promoted higher increases in arm circumference.
PMID: 30662699 [PubMed]
Multidisciplinary approach to obesity: Aerobic or resistance physical exercise?
J Exerc Sci Fit. 2018 Dec;16(3):118-123
Authors: Said MA, Abdelmoneem M, Almaqhawi A, Hamid Kotob AA, Alibrahim MC, Bougmiza I
Background: An integrated treatment based on dieting, physical training and cognitive-behavioural psychotherapy is an effective tool to reduce obesity and its consequences. However, the feasibility of this approach is problematic. This study aims to compare two multidisciplinary programs used to improve weight loss.
Methods: Fifty-two obese individuals were subjected to an Enhanced Lifestyle Counselling associated with, according to their own choice, dieting (N = 11), or dieting + aerobic training (n = 18), or dieting + resistance training program (n = 23). The study experiment spanned 16 weeks divided into two phases. The first phase lasted 04 weeks and was oriented to enhance motivation and establishing changes in behaviours related to dietary and sedentary lifestyle. The second phase lasted 12 weeks and was oriented to add aerobic or resistance training. Body compositions, cardiovascular disease risk factors, and cardio-respiratory fitness were assessed.
Results: Data demonstrated that all obesity treatment programs were able to improve all studied variables. Weight loss levels were -6.03 ± 2.08, -10.5 ± 2.33, and -9.37 ± 1.99 kg in Dieting, DAT and DRT groups, respectively. Our results noted also that exercise training could play an important role in reducing obesity and its consequences. Nevertheless, modifications were more important in DRT at the explosivity and muscle strength and in DAT at fat percentage, aerobic capacity, SA, and CVR factors.
Conclusion: The current evidence noted that both multidisciplinary weight loss programs were efficient in the treatment of obesity and its comorbidity. Moreover, the use of aerobic exercises was more effective in reducing body fat and improving cardiorespiratory fitness. However, using resistance exercises appeared to be more appropriate to enhance the muscle potential.
PMID: 30662505 [PubMed]
Effect of deep oscillation as a recovery method after fatiguing soccer training: A randomized cross-over study.
J Exerc Sci Fit. 2018 Dec;16(3):112-117
Authors: von Stengel S, Teschler M, Weissenfels A, Willert S, Kemmler W
Background/Objective: In soccer the recovery time between matches is often not long enough for complete restoration. Insufficient recovery can result in reduced performance and a higher risk of injuries. The purpose of this study was to evaluate the potential of Deep Oscillation (DO) as a recovery method.
Methods: In a randomized crossover study including 8 male soccer players (22 ± 3.3 years) the following parameters were evaluated directly before and 48 h after a fatiguing soccer-specific exercise: Maximum isokinetic strength of the leg and hip extensors and flexors (Con-Trex® Leg Press, Physiomed, Germany), rating of perceived exertion (RPE) during isokinetic testing (Borg scale 6-20), creatine kinase (CK) serum levels and Delayed Onset Muscle Soreness (DOMS; visual analogue scale 1-10). By random allocation, half of the group performed a DO self-treatment twice daily (4 applications of 15min each), whilst the other half received no intervention. 4 weeks later a cross-over was conducted. Two-way repeated measures analysis of variance was used to compare treatment versus control.
Results: A significant treatment effect was observed for maximum leg flexion strength (p = 0.03; DO: 125 ± 206 N vs. CG: -115 ± 194; p = 0.03) and for RPE (DO: -0.13 ± 0.64; vs. CG: +1.13 ± 1.36; p = 0.03). There was a trend to better recovery for maximum leg extension strength (DO: -31 ± 165 N vs. CG: -138 ± 212; p = 0.028), CK values (DO: 72 ± 331 U/ml vs. CG: 535 ± 797 U/ml; p = 0.15) and DOMS (DO: 3.4 ± 1.5 vs. CG: 4.1 ± 2.6; p = 0.49).
Conclusion: In the present study we found significant effects of DO on maximum leg flexion strength and perceived rate of exertion. Other variables showed a consistent trend in favour of DO compared with the control without significance. DO seems to be a promising method to accelerate the time-course of peripheral recovery of muscle which should be addressed in larger studies in future.
Trial registration: ClinicalTrials.gov; NCT03411278, 18.01.2018 (during the study).
PMID: 30662504 [PubMed]
The effect of a 12-week combinational exercise program on CD4 count and mental health among HIV infected women: A randomized control trial.
J Exerc Sci Fit. 2018 Apr;16(1):21-25
Authors: Dianatinasab M, Fararouei M, Padehban V, Dianatinasab A, Alimohamadi Y, Beheshti S, AminiLari Z, AminiLari M
Background/objective: There are conflicting results regarding the effects of exercise on immune function of HIV positive patients. Exercise can also be beneficial to psychological functioning of the patients. The purpose of this study was to determine the impact of a 12-week aerobic and resistance exercise training program on mental health and CD4 counts among female HIV+ patients.
Methods: This clinical trial was conducted between September and December 2013. Forty participants (women age range 20-40) were carefully selected from 240 HIV-positive women referred to Voluntary Counseling and Treatment Center (VCT) and randomly assigned to either exercise (80 min of aerobic and strength training while receiving the VCT's routine services) group (n = 20) or control (received the VCT's routine services only) group (n = 20). To assess their mental health status, all participants completed GHQ28 questionnaire. Blood samples were collected to measure CD4 and T-cell counts at baseline and at the end of the 12-week intervention.
Results: From a sample of 40 women with HIV infection, the data of 30 participants [experimental group (14) and control group (16)] were analyzed (participation rate 75%). The results indicated that after the intervention program, a significant difference in CD4 cell counts was found between the two groups (P = 0.01). With regard to mental health, after performing intervention, significant improvement in all subscales including anxiety disorder, social function, depression and mental health's total score was observed in the exercise compared to the control groups (P < 0.001).
Conclusion: Exercise training can be included in health care services in order to improve the mental health status of women with HIV infection. No effect on CD4 count was detected.
PMID: 30662488 [PubMed]
Post-operative rehabilitation of a distal biceps brachii tendon reattachment in a weightlifter: a case report.
J Can Chiropr Assoc. 2018 Dec;62(3):193-201
Authors: Wentzell M
Objective: To describe the successful rehabilitation of a distal biceps brachii tendon reattachment following an acute traumatic tendon rupture.
Clinical Features: A 30-year-old weightlifter presented five days post-op after a left distal biceps tendon repair. A three month one pound weight-restriction was recommended by the attending surgeon. Active and passive elbow and wrist range of motion were markedly reduced with profuse post-operative swelling and bruising noted upon initial inspection.
Intervention and Outcome: An accelerated treatment program was prescribed that included soft tissue therapy, scar mobilization, laser therapy, kinesiology tape and rehabilitative exercise. A novel training method known as blood flow restriction (BFR) training was utilized throughout the rehabilitative process to maximize recovery and retain muscle mass and strength. The weightlifter returned to near pre-injury activity level after 3.5 months. Treatment, exercise and BFR protocols are provided.
PMID: 30662074 [PubMed]
The potential therapeutic effects of creatine supplementation on body composition and muscle function in cancer.
Crit Rev Oncol Hematol. 2019 Jan;133:46-57
Authors: Fairman CM, Kendall KL, Hart NH, Taaffe DR, Galvão DA, Newton RU
Low muscle mass in individuals with cancer has a profound impact on quality of life and independence and is associated with greater treatment toxicity and poorer prognosis. Exercise interventions are regularly being investigated as a means to ameliorate treatment-related adverse effects, and nutritional/supplementation strategies to augment adaptations to exercise are highly valuable. Creatine (Cr) is a naturally-occurring substance in the human body that plays a critical role in energy provision during muscle contraction. Given the beneficial effects of Cr supplementation on lean body mass, strength, and physical function in a variety of clinical populations, there is therapeutic potential in individuals with cancer at heightened risk for muscle loss. Here, we provide an overview of Cr physiology, summarize the evidence on the use of Cr supplementation in various aging/clinical populations, explore mechanisms of action, and provide perspectives on the potential therapeutic role of Cr in the exercise oncology setting.
PMID: 30661658 [PubMed - in process]
Effects of nine weeks L-Carnitine supplementation on exercise performance, anaerobic power, and exercise-induced oxidative stress in resistance-trained males.
J Exerc Nutrition Biochem. 2018 Dec 31;22(4):7-19
Authors: Koozehchian MS, Daneshfar A, Fallah E, Agha-Alinejad H, Samadi M, Kaviani M, Kaveh B M, Jung YP, Sablouei MH, Moradi N, Earnest CP, Chandler TJ, Kreider RB
PURPOSE: Studies of L-carnitine in healthy athletic populations have yielded equivocal results. Further scientific-based knowledge is needed to clarify the ability of L-carnitine to improve exercise capacity and expedite the recovery process by reducing oxidative stress. This study aimed to examine the 9-week effects of L-carnitine supplementation on exercise performance, anaerobic capacity, and exercise-induced oxidative stress markers in resistance-trained males.
METHODS: In a double-blind, randomized, and placebo-controlled treatment, 23 men (age, 25±2y; weight, 81.2±8.31 kg; body fat, 17.1±5.9%) ingested either a placebo (2 g/d, n=11) or L-carnitine (2 g/d, n=12) for 9 weeks in conjunction with resistance training. Primary outcome measurements were analyzed at baseline and at weeks 3, 6, and 9. Participants underwent a similar resistance training (4 d/w, upper/lower body split) for a 9-week period. Two-way ANOVA with repeated measures was used for statistical analysis.
RESULTS: There were significant increases in bench press lifting volume at wk-6 (146 kg, 95% CI 21.1, 272) and wk-9 (245 kg, 95% CI 127, 362) with L-carnitine. A similar trend was observed for leg press. In the L-carnitine group, at wk-9, there were significant increases in mean power (63.4 W, 95% CI 32.0, 94.8) and peak power (239 W, 95% CI 86.6, 392), reduction in post-exercise blood lactate levels (-1.60 mmol/L, 95% CI -2.44, -0.75) and beneficial changes in total antioxidant capacity (0.18 mmol/L, 95% CI 0.07, 0.28).
CONCLUSION: L-carnitine supplementation enhances exercise performance while attenuating blood lactate and oxidative stress responses to resistance training.
PMID: 30661327 [PubMed]
Differences in elbow extensor muscle characteristics between resistance-trained men and women.
Eur J Appl Physiol. 2018 Nov;118(11):2359-2366
Authors: Merrigan JJ, White JB, Hu YE, Stone JD, Oliver JM, Jones MT
PURPOSE: Muscular strength is suggested to be dependent upon muscle characteristics. Yet, sex-specific relationships of muscle characteristics to strength in the resistance-trained require investigation. Therefore, the purpose was to evaluate sex differences in muscle characteristics and isometric strength in the elbow extensors, as well as their respective associations.
METHODS: Resistance-trained men (n = 15, mean ± SD 22 ± 4 years, 87.5 ± 12.8 kg, 16.9 ± 2.9% body fat) and women (n = 15, mean ± SD 25 ± 5 years, 59.3 ± 7.3 kg, 22.4 ± 4.2% body fat) were tested. B-mode ultrasound images assessed muscle thickness, pennation angle, and echo intensity. Muscle volume and fascicle length were estimated from previously validated equations. Maximal voluntary isometric contraction measured elbow extensors isometric strength. Independent samples t-tests and Fisher's r-to-z test examined differences between sexes.
RESULTS: Sex differences existed in all muscle characteristics (p < 0.05). Men's absolute strength (27.86 ± 3.55 kg) was significantly greater than women (16.15 ± 3.15 kg), but no differences were noted when controlling for muscle volume (men 0.069 ± 0.017, women 0.077 ± 0.022 kg/cm3). Sex differences did not exist in the relationships of muscle characteristics to strength with muscle size having the largest correlations. However, the relationship between echo intensity and body fat was different in men (r = - 0.311) and women (r = 0.541, p = 0.0143).
CONCLUSIONS: Sex differences in isometric elbow extensor strength are eliminated when expressed relative to muscle volume. Relationships of echo intensity and body fat were different between men and women and may be indicative of greater adipose infiltration in women.
PMID: 30097710 [PubMed - indexed for MEDLINE]
Aortic stiffness, central pulse pressure and cognitive function following acute resistance exercise.
Eur J Appl Physiol. 2018 Oct;118(10):2203-2211
Authors: Palmiere S, Wade M, DeBlois JP, Lefferts WK, Heffernan KS
INTRODUCTION: While resistance exercise (RE) is known to be beneficial for overall health, one bout of RE acutely increases aortic stiffness and pulse pressure (PP). Increases in aortic stiffness and PP in a setting of aging has been shown to detrimentally impact cognitive function. This study examined whether increased aortic stiffness and PP from an acute bout of RE is associated with cognitive function.
METHODS: Thirty-five participants (21 ± 2 years) underwent cognitive testing before and after either an acute bout of RE or a non-exercise time-control condition. Cognitive function was assessed as reaction time and accuracy during memory recognition, attention (Flanker) and working memory (N-back) tasks. Aortic stiffness and PP were measured via pulse wave velocity (PWV) and pulse wave analysis, respectively, using a brachial oscillometric device.
RESULTS: There were significant increases in aortic PWV and aortic PP following RE (p < 0.05) with no change in PWV or PP following the non-exercise control condition (p > 0.05). There was no change in accuracy metrics (% hits) across conditions for any cognitive task (p > 0.05). There was a condition-by-time interaction for reaction time for the memory task (p < 0.05) driven by a significant decrease in reaction times following RE (p < 0.05) with no change in reaction time following the non-exercise control (p > 0.05).
CONCLUSION: Functional increases in aortic stiffness and pulse pressure following acute RE occur in the absence of detrimental changes in cognitive function in young, healthy adults.
PMID: 30056548 [PubMed - indexed for MEDLINE]
Treatment of stress urinary incontinence with a mobile app: factors associated with success.
Int Urogynecol J. 2018 09;29(9):1325-1333
Authors: Nyström E, Asklund I, Sjöström M, Stenlund H, Samuelsson E
INTRODUCTION AND HYPOTHESIS: Stress urinary incontinence is common among women. First-line treatment includes pelvic floor muscle training (PFMT) and lifestyle advice, which can be provided via a mobile app. The efficacy of app-based treatment has been demonstrated in a randomized controlled trial (RCT). In this study, we aimed to analyze factors associated with successful treatment.
METHODS: Secondary analysis of data from the RCT. At baseline and 3-month follow-up, participants (n = 61) answered questions about symptoms, quality of life, background, and PFMT. Success was defined as rating the condition as much or very much better according to the validated Patient Global Impression of Improvement questionnaire. Factors possibly associated with success were analyzed with univariate logistic regression; if p < 0.20, the factor was entered into a multivariate model that was adjusted for age. Variables were then removed stepwise.
RESULTS: At follow-up, 34 out of 61 (56%) of participants stated that their condition was much or very much better. Three factors were significantly associated with success: higher expectations for treatment (odds ratio [OR] 11.38, 95% confidence interval [CI] 2.02-64.19), weight control (OR 0.44 per kg gained, 95% CI 0.25-0.79), and self-rated improvement of pelvic floor muscle strength (OR 35.54, 95% CI 4.96-254.61). Together, these factors accounted for 61.4% (Nagelkerke R2) of the variability in success.
CONCLUSION: These results indicate that app-based treatment effects are better in women who are interested in and have high expectations of such treatment. Also, the findings underline the importance of strengthening the pelvic floor muscles and offering lifestyle advice.
PMID: 29222718 [PubMed - indexed for MEDLINE]