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Long-distance race car drivers are classified as athletes. The sport is physically and mentally demanding, requiring long hours of practice. Therefore, optimal dietary intake is essential for health and performance of the athlete. The aim of the study was to evaluate dietary intake and to compare the data with dietary recommendations for athletes and for the general adult population according to the German Nutrition Society (DGE). A 24-h dietary recall during a competition preparation phase was obtained from 16 male race car drivers (28.3 ± 6.1 years, body mass index (BMI) of 22.9 ± 2.3 kg/m2). The mean intake of energy, nutrients, water and alcohol was recorded. The mean energy, vitamin B2, vitamin E, folate, fiber, calcium, water and alcohol intake were 2124 ± 814 kcal/day, 1.3 ± 0.5 mg/day, 12.5 ± 9.5 mg/day, 231.0 ± 90.9 ug/day, 21.4 ± 9.4 g/day, 1104 ± 764 mg/day, 3309 ± 1522 mL/day and 0.8 ± 2.5 mL/day respectively. Our study indicated that many of the nutrients studied, including energy and carbohydrate, were below the recommended dietary intake for both athletes and the DGE.
Farber disease (FD) is a rare lysosomal storage disorder resulting from acid ceramidase deficiency and subsequent ceramide accumulation. No treatments are clinically available and affected patients have a severely shortened lifespan. Due to the low incidence, the pathogenesis of FD is still poorly understood. Here, we report a novel acid ceramidase mutant mouse model that enables the study of pathogenic mechanisms of FD and ceramide accumulation. Asah1(tmEx1) mice were generated by deletion of the acid ceramidase signal peptide sequence. The effects on lysosomal targeting and activity of the enzyme were assessed. Ceramide and sphingomyelin levels were quantified by liquid chromatography tandem-mass spectrometry (LC-MS/MS) and disease manifestations in several organ systems were analyzed by histology and biochemistry. We show that deletion of the signal peptide sequence disrupts lysosomal targeting and enzyme activity, resulting in ceramide and sphingomyelin accumulation. The affected mice fail to thrive and die early. Histiocytic infiltrations were observed in many tissues, as well as lung inflammation, liver fibrosis, muscular disease manifestations and mild kidney injury. Our new mouse model mirrors human FD and thus offers further insights into the pathogenesis of this disease. In the future, it may also facilitate the development of urgently needed therapies.
Change of direction speed
(2018)
There is growing evidence that eccentric strength training appears to have benefits over traditional strength training (i.e., strength training with combined concentric and eccentric muscle actions) from muscular, neuromuscular, tendinous, and metabolic perspectives. Eccentric muscle strength is particularly needed to decelerate and stabilize the body during the braking phase of a jump exercise or during rapid changes of direction (CoD) tasks. However, surprisingly little research has been conducted to elucidate the effects of eccentric strength training or strength training with accentuated eccentric muscle actions on CoD speed performance. In this current opinion article, we present findings from cross-sectional studies on the relationship between measures of eccentric muscle strength and CoD speed performance. In addition, we summarize the few available studies on the effects of strength training with accentuated eccentric muscle actions on CoD speed performance in athletic populations. Finally, we propose strength training with accentuated eccentric muscle actions as a promising element in strength and conditioning programs of sports with high CoD speed demands. Our findings from five cross-sectional studies revealed statistically significant moderate-to large-sized correlations (r = 0.45-0.89) between measures of eccentric muscle strength and CoD speed performance in athletic populations. The identified three intervention studies were of limited methodological quality and reported small-to large-sized effects (d = 0.46-1.31) of strength training with accentuated eccentric muscle actions on CoD speed performance in athletes. With reference to the available but preliminary literature and from a performance-related point of view, we recommend strength and conditioning coaches to include strength training with accentuated eccentric muscle actions in training routines of sports with high CoD speed demands (e.g., soccer, handball, basketball, hockey) to enhance sport-specific performance. Future comparative studies are needed to deepen our knowledge of the effects of strength training with accentuated eccentric muscle actions on CoD speed performance in athletes.
Birth weights of newborns and pregnancy outcomes of environmentally boron-exposed females in Turkey
(2018)
Boric acid and sodium borates are currently classified as being toxic to reproduction under "Category 1B" with the hazard statement of "H360 FD" in the European CLP regulation. This has prompted studies on boron-mediated reprotoxic effects in male workers in boron mining areas and boric acid production plants. By contrast, studies on boron-mediated developmental effects in females are scarce. The present study was designed to fill this gap. Hundred and ninety nine females residing in Bandirma and Bigadic participated in this study investigating pregnancy outcomes. The participants constituted a study group covering blood boron from low (< 100 ng B/g blood, n = 143) to high (> 150 ng B/g blood, n = 27) concentrations. The mean blood boron concentration and the mean estimated daily boron exposure of the high exposure group was 274.58 (151.81-975.66) ng B/g blood and 24.67 (10.47-57.86) mg B/day, respectively. In spite of the high level of daily boron exposure, boron-mediated adverse effects on induced abortion, spontaneous abortion (miscarriage), stillbirth, infant death, neonatal death, early neonatal death, preterm birth, congenital anomalies, sex ratio and birth weight of newborns were not observed.
The aim of the study was to determine pre-interventional predictors for all-cause mortality in patients after transcatheter aortic valve implantation (TAVI) with a 12-month follow-up. From 10/2013 to 07/2015, 344 patients (80.9 +/- 5.0 years, 44.5% male) with an elective TAVI were consecutively enrolled prospectively in a multicentre cohort study. Prior to the intervention, sociodemographic parameters, echocardiographic data and comorbidities were documented. All patients performed a 6-min walk test, Short Form 12 and a Frailty Index (score consisting of activities of daily living, cognition, nutrition and mobility). Peri-interventional complications were documented. Vital status was assessed over telephone 12 months after TAVI. Predictors for all-cause mortality were identified using a multivariate regression model. At discharge, 333 patients were alive (in-hospital mortality 3.2%; n = 11). During a follow-up of 381.0 +/- 41.9 days, 46 patients (13.8%) died. The non-survivors were older (82.3 +/- 5.0 vs. 80.6 +/- 5.1 years; p = 0.035), had a higher number of comorbidities (2.6 +/- 1.3 vs. 2.1 +/- 1.3; p = 0.026) and a lower left ventricular ejection fraction (51.0 +/- 13.6 vs. 54.6 +/- 10.6%; p = 0.048). Additionally, more suffered from diabetes mellitus (60.9 vs. 44.6%; p = 0.040). While the global Frailty Index had no predictive power, its individual components, particularly nutrition (OR 0.83 per 1 pt., CI 0.72-0.95; p = 0.006) and mobility (OR 5.12, CI 1.64-16.01; p = 0.005) had a prognostic impact. Likewise, diabetes mellitus (OR 2.18, CI 1.10-4.32; p = 0.026) and EuroSCORE (OR 1.21 per 5%, CI 1.07-1.36; p = 0.002) were associated with a higher risk of all-cause mortality. Besides EuroSCORE and diabetes mellitus, nutrition status and mobility of patients scheduled for TAVI offer prognostic information for 1-year all-cause mortality and should be advocated in the creation of contemporary TAVI risk scores.
This study aimed at examining physiological responses (i.e., oxygen uptake [VO2] and heart rate [HR]) to a semi-contact 3 x 3-min format, amateur boxing combat simulation in elite level male boxers. Eleven boxers aged 21.4 +/- 2.1 years (body height 173.4 +/- 3.7, body mass 74.9 +/- 8.6 kg, body fat 12.1 +/- 1.9, training experience 5.7 +/- 1.3 years) volunteered to participate in this study. They performed a maximal graded aerobic test on a motor-driven treadmill to determine maximum oxygen uptake (VO2max), oxygen uptake (VO2AT) and heart rate (HRAT) at the anaerobic threshold, and maximal heart rate (HRmax). Additionally, VO2 and peak HR (HRpeak) were recorded following each boxing round. Results showed no significant differences between VO2max values derived from the treadmill running test and VO2 outcomes of the simulated boxing contest (p > 0.05, d = 0.02 to 0.39). However, HRmax and HRpeak recorded from the treadmill running test and the simulated amateur boxing contest, respectively, displayed significant differences regardless of the boxing round (p < 0.01, d = 1.60 to 3.00). In terms of VO2 outcomes during the simulated contest, no significant between-round differences were observed (p = 0.19, d = 0.17 to 0.73). Irrespective of the boxing round, the recorded VO2 was >90% of the VO2max. Likewise, HRpeak observed across the three boxing rounds were >= 90% of the HRmax. In summary, the simulated 3 x 3-min amateur boxing contest is highly demanding from a physiological standpoint. Thus, coaches are advised to systematically monitor internal training load for instance through rating of perceived exertion to optimize training-related adaptations and to prevent boxers from overreaching and/or overtraining.
Sequencing Effects of Neuromuscular Training on Physical Fitness in Youth Elite Tennis Players
(2018)
Fernandez-Fernandez, J, Granacher, U, Sanz-Rivas, D, Sarabia Marin, JM, Hernandez-Davo, JL, and Moya, M. Sequencing effects of neuromuscular training on physical fitness in youth elite tennis players. J Strength Cond Res 32(3): 849-856, 2018-The aim of this study was to analyze the effects of a 5-week neuromuscular training (NMT) implemented before or after a tennis session in prepubertal players on selected components of physical fitness. Sixteen high-level tennis players with a mean age of 12.9 +/- 0.4 years participated in this study, and were assigned to either a training group performing NMT before tennis-specific training (BT; n = 8) or a group that conducted NMT after tennis-specific training (AT; n = 8). Pretest and posttest included: speed (5, 10, and 20 m); modified 5-0-5 agility test; countermovement jump (CMJ); overhead medicine ball throw (MBT); and serve velocity (SV). Results showed that the BT group achieved positive effects from pretest to posttest measures in speed (d = 0.52, 0.32, and 1.08 for 5, 10, and 20 m respectively), 5-0-5 (d = 0.22), CMJ (d = 0.29), MBT (d = 0.51), and SV (d = 0.32), whereas trivial (10 m, 20 m, CMJ, SV, and MBT) or negative effects (d = -0.19 and -0.24 for 5 m and 5-0-5, respectively) were reported for the AT group. The inclusion of an NMT session before the regular tennis training led to positive effects from pretest to posttest measures in performance-related variables (i.e., jump, sprint, change of direction capacity, as well as upper-body power), whereas conducting the same exercise sessions after the regular tennis training was not accompanied by the same improvements.
Purpose:
To test whether the negative relationship between perceived stress and quality of life (Hypothesis 1) can be buffered by perceived social support in patients with dementia as well as in caregivers individually (Hypothesis 2: actor effects) and across partners (Hypothesis 3: partner effects and actor-partner effects).
Method:
A total of 108 couples (N = 216 individuals) comprised of one individual with early-stage dementia and one caregiving partner were assessed at baseline and one month apart. Moderation effects were investigated by applying linear mixed models and actor-partner interdependence models.
Results:
Although the stress-quality of life association was more pronounced in caregivers (beta = -.63, p<.001) compared to patients (beta= -.31, p<.001), this association was equally moderated by social support in patients (beta = .14, p<.05) and in the caregivers (beta =.13, p<.05). From one partner to his or her counterpart, the partner buffering and actor-partner-buffering effect were not present.
Conclusion:
The stress-buffering effect has been replicated in individuals with dementia and caregivers but not across partners. Interventions to improve quality of life through perceived social support should not only focus on caregivers, but should incorporate both partners.
The current body of evidence suggests that in healthy participants, implicit attitudes towards physical activity explain variance in exercise behaviour beyond explicit cognitive processes. However, such relationships have not been examined in psychiatric patients, although this may contribute to a better understanding of the motivational and volitional resources needed to self-regulate their exercise behaviour. Therefore, the present cross-sectional study aimed to assess implicit attitudes towards exercise among psychiatric in-patients, and to correlate these implicit attitudes with their physical activity levels. Patients (N = 101) showing a psychiatric disorder, but no severe cognitive impairment, were directly recruited from psychiatric clinics. Their physical activity levels were assessed using both accelerometers and self-reports. Additionally, patients reported psychiatric symptoms and performed a single-target implicit association test (ST-IAT) with exercise employed as the target category. Of all patients, 39% showed a preference for exercise, whereas 13% showed an aversion towards exercise. The implicit attitudes of the remaining participants were equally strong for both concepts. Based on correlational analysis (correcting for age, sex, psychiatric symptoms severity, and ST-IAT sequence), no association was found between ST-IAT score, or self-reported and objectively assessed physical activity. Consequently, the link between exercise behaviour and implicit attitudes towards physical activity found in healthy participants could not be observed in psychiatric patients.
Grabow, L, Young, JD, Alcock, LR, Quigley, PJ, Byrne, JM, Granacher, U, Škarabot, J, and Behm, DG. Higher quadriceps roller massage forces do not amplify range-of-motion increases nor impair strength and jump performance. J Strength Cond Res 32(11): 3059–3069, 2018—Roller massage (RM) has been reported to increase range of motion (ROM) without subsequent performance decrements. However, the effects of different rolling forces have not been examined. The purpose of this study was to compare the effects of sham (RMsham), moderate (RMmod), and high (RMhigh) RM forces, calculated relative to the individuals' pain perception, on ROM, strength, and jump parameters. Sixteen healthy individuals (27 ± 4 years) participated in this study. The intervention involved three 60-second quadriceps RM bouts with RMlow (3.9/10 ± 0.64 rating of perceived pain [RPP]), RMmod (6.2/10 ± 0.64 RPP), and RMhigh (8.2/10 ± 0.44 RPP) pain conditions, respectively. A within-subject design was used to assess dependent variables (active and passive knee flexion ROM, single-leg drop jump [DJ] height, DJ contact time, DJ performance index, maximum voluntary isometric contraction [MVIC] force, and force produced in the first 200 milliseconds [F200] of the knee extensors and flexors). A 2-way repeated measures analysis of variance showed a main effect of testing time in active (p < 0.001, d = 2.54) and passive (p < 0.001, d = 3.22) ROM. Independent of the RM forces, active and passive ROM increased by 7.0% (p = 0.03, d = 2.25) and 15.4% (p < 0.001, d = 3.73) from premeasure to postmeasure, respectively. Drop jump and MVIC parameters were unaffected from pretest to posttest (p > 0.05, d = 0.33–0.84). Roller massage can be efficiently used to increase ROM without substantial pain and without subsequent performance impairments.
Remodeling of the extracellular matrix is a key component of the metabolic adaptations of adipose tissue in response to dietary and physiological challenges. Disruption of its integrity is a well-known aspect of adipose tissue dysfunction, for instance, during aging and obesity. Adipocyte regeneration from a tissue-resident pool of mesenchymal stem cells is part of normal tissue homeostasis. Among the pathophysiological consequences of adipogenic stem cell aging, characteristic changes in the secretory phenotype, which includes matrix-modifying proteins, have been described. Here, we show that the expression of the matricellular protein periostin, a component of the extracellular matrix produced and secreted by adipose tissue-resident interstitial cells, is markedly decreased in aged brown and white adipose tissue depots. Using a mouse model, we demonstrate that the adaptation of adipose tissue to adrenergic stimulation and high-fat diet feeding is impaired in animals with systemic ablation of the gene encoding for periostin. Our data suggest that loss of periostin attenuates lipid metabolism in adipose tissue, thus recapitulating one aspect of age-related metabolic dysfunction. In human white adipose tissue, periostin expression showed an unexpected positive correlation with age of study participants. This correlation, however, was no longer evident after adjusting for BMI or plasma lipid and liver function biomarkers. These findings taken together suggest that age-related alterations of the adipose tissue extracellular matrix may contribute to the development of metabolic disease by negatively affecting nutrient homeostasis.
Background: In the course of neurological early rehabilitation, decannulation is attempted in tracheotomized patients after weaning due to its considerable prognostic significance. We aimed to identify predictors of a successful tracheostomy decannulation. Methods: From 09/2014 to 03/2016, 831 tracheotomized and weaned patients (65.4 +/- 12.9 years, 68% male) were included consecutively in a prospective multicentric observation study. At admission, sociodemographic and clinical data (e.g. relevant neurological and internistic diseases, duration of mechanical ventilation, tracheotomy technique, and nutrition) as well as functional assessments (Coma Recovery Scale-Revised (CRS-R), Early Rehabilitation Barthel Index, Bogenhausener Dysphagia Score) were collected. Complications and the success of the decannulation procedure were documented at discharge. Results: Four hundred seventy patients (57%) were decannulated. The probability of decannulation was significantly negatively associated with increasing age (OR 0.68 per SD = 12.9 years, p < 0.001), prolonged duration of mechanical ventilation (OR 0.57 per 33.2 days, p < 0.001) and complications. An oral diet (OR 3.80; p < 0.001) and a higher alertness at admission (OR 3.07 per 7.18 CRS-R points; p < 0.001) were positively associated. Conclusions: This study identified practically measurable predictors of decannulation, which in the future can be used for a decannulation prognosis and supply optimization at admission in the neurological early rehabilitation clinic.
Our experimental approach included two studies to determine discriminative validity and test-retest reliability (study 1) as well as ecological validity (study 2) of a judo ergometer system while performing judo-specific movements. Sixteen elite (age: 23 +/- 3 years) and 11 sub-elite (age: 16 +/- 1 years) athletes participated in study 1 and 14 male sub-elite judo athletes participated in study 2. Discriminative validity and test-retest reliability of sport-specific parameters (mechanical work, maximal force) were assessed during pulling movements with and without tsukuri (kuzushi). Ecological validity of muscle activity was determined by performing pulling movements using the ergometer without tsukuri and during the same movements against an opponent. In both conditions, electromyographic activity of trunk (e.g., m. erector spinae) and upper limb muscles (e.g., m. biceps brachii) were assessed separately for the lifting and pulling arm. Elite athletes showed mostly better mechanical work, maximal force, and power (0.12 <= d <= 1.80) compared with sub-elite athletes. The receiver operating characteristic analysis revealed acceptable validity of the JERGo(C) system to discriminate athletes of different performance levels predominantly during kuzushi without tsukuri (area under the curve = 0.27-0.90). Moreover, small-to-medium discriminative validity was found to detect meaningful performance changes for mechanical work and maximal force. The JERGo(C) system showed small-to-high relative (ICC = 0.37-0.92) and absolute reliability (SEM = 10.8-18.8%). Finally, our analyses revealed acceptable correlations (r = 0.41-0.88) between muscle activity during kuzushi performed with the JERGo(C) system compared with a judo opponent. Our findings indicate that the JERGo(C) system is a valid and reliable test instrument for the assessment and training of judo-specific pulling kinetics particularly during kuzushi movement without tsukuri.
Hintergrund Schnellkräftige Wurfeingangsbewegungen stellen im Judo entscheidende Voraussetzungen für den Wettkampferfolg dar, weshalb das Training der Anrissbewegung ein zentrales Element des judospezifischen Trainings darstellt. Das Ziel der Studie bestand darin, die Effekte eines Anrisstrainings mit einem Judoergometer-System (ATJ) gegenüber einem tradierten Anrisstraining mit Partner (ATP) auf kinetische und elektromyografische Parameter des Anreißens bei Wurfeingangsbewegungen von Judoka zu untersuchen. Methode Männliche leistungsorientierte Judoka (N = 24, Alter: 22 ± 4 Jahre; Trainingserfahrung: 15 ± 3 Jahre) wurden randomisiert in zwei Gruppen aufgeteilt. Im Crossover-Design absolvierte die erste Gruppe über vier Wochen ein ATJ gefolgt von vier Wochen ATP (je 3x/ Woche). Die zweite Gruppe führte beide Trainingsvarianten in umgekehrter Reihenfolge durch. ATJ und ATP wurden zusätzlich zum bestehenden Training absolviert. Vor dem Training sowie nach vier und nach acht Wochen Training wurden Tests zur Erfassung kinetischer Parameter (dynamisch-realisierte Maximalkraft, Explosivkraft, mechanische Arbeit) und elektromyografischer (EMG) Schulter-/ Rumpfmuskelaktivitäten (M. biceps brachii, M. deltoideus, M. trapezius, M. erector spinae) für die Hub- und Zugarmseite bei Wurfeingangsbewegungen am Judoergometer sowie sportartunspezifische Krafttests (d. h. Liegend-Anreißen, Klimmziehen) durchgeführt.
Ergebnisse Die Ergebnisse der statistischen Analyse ergaben über den gesamten Interventionszeitraum (8 Wochen) für beide Trainingsgruppen signifikante Verbesserungen der kinetischen Parameter (p <,05; 0,83 ≤d≤ 1,77) und EMG-Aktivitäten (p <,05; 1,07 ≤d≤ 2,25). Darüber hinaus zeigten sich größere Zuwachsraten in der Explosivkraft, der mechanischen Arbeit und den Schulter-/Rumpfmuskelaktivitäten (M. deltoideus, M. erector spinae, M. trapezius) zugunsten von ATJ im Vergleich zu ATP (p <,05; 1,25 ≤d≤ 2,79). Für die sportartunspezifischen Kraftwerte wurden keine signifikanten Veränderungen festgestellt.
Schlussfolgerung Die vorliegenden Ergebnisse zeigen, dass ATJ gegenüber ATP größere Steigerungsraten von kinetischen und elektromyografischen Parametern des Anreißens bei Wurfeingangsbewegungen von Judoka bewirkt. Die trainingsbedingten Leistungssteigerungen scheinen zumindest teilweise auf neuronalen Anpassungen zu beruhen.
In a subset of patients, non-alcoholic fatty liver disease (NAFLD) is complicated by cell death and inflammation resulting in non-alcoholic steatohepatitis (NASH), which may progress to fibrosis and subsequent organ failure. Apart from cytokines, prostaglandins, in particular prostaglandin E-2 (PGE(2)), play a pivotal role during inflammatory processes. Expression of the key enzymes of PGE(2) synthesis, cyclooxygenase 2 and microsomal PGE synthase 1 (mPGES-1), was increased in human NASH livers in comparison to controls and correlated with the NASH activity score. Both enzymes were also induced in NASH-diet-fed wild-type mice, resulting in an increase in hepatic PGE(2) concentration that was completely abrogated in mPGES-1-deficient mice. PGE(2) is known to inhibit TNF-alpha synthesis in macrophages. A strong infiltration of monocyte-derived macrophages was observed in NASH-diet-fed mice, which was accompanied with an increase in hepatic TNF-alpha expression. Due to the impaired PGE(2) production, TNF-alpha expression increased much more in livers of mPGES-1-deficient mice or in the peritoneal macrophages of these mice. The increased levels of TNF-alpha resulted in an enhanced IL-1 beta production, primarily in hepatocytes, and augmented hepatocyte apoptosis. In conclusion, attenuation of PGE(2) production by mPGES-1 ablation enhanced the TNF-alpha-triggered inflammatory response and hepatocyte apoptosis in diet-induced NASH.
Background: Dynamic balance keeps the vertical projection of the center of mass within the base of support while walking. Dynamic balance tests are used to predict the risks of falls and eventual falls. The psychometric properties of most dynamic balance tests are unsatisfactory and do not comprise an actual loss of balance while walking. Objectives: Using beam walking distance as a measure of dynamic balance, the BEAM consortium will determine the psychometric properties, lifespan and patient reference values, the relationship with selected “dynamic balance tests,” and the accuracy of beam walking distance to predict falls. Methods: This cross-sectional observational study will examine healthy adults in 7 decades (n = 432) at 4 centers. Center 5 will examine patients (n = 100) diagnosed with Parkinson’s disease, multiple sclerosis, stroke, and balance disorders. In test 1, all participants will be measured for demographics, medical history, muscle strength, gait, static balance, dynamic balance using beam walking under single (beam walking only) and dual task conditions (beam walking while concurrently performing an arithmetic task), and several cognitive functions. Patients and healthy participants age 50 years or older will be additionally measured for fear of falling, history of falls, miniBESTest, functional reach on a force platform, timed up and go, and reactive balance. All participants age 50 years or older will be recalled to report fear of falling and fall history 6 and 12 months after test 1. In test 2, seven to ten days after test 1, healthy young adults and age 50 years or older (n = 40) will be retested for reliability of beam walking performance. Conclusion: We expect to find that beam walking performance vis-à-vis the traditionally used balance outcomes predicts more accurately fall risks and falls. Clinical Trial Registration Number: NCT03532984.
Physiological mechanisms of an anti-depressive effect of physical exercise in major depressive disorder (MDD) seem to involve alterations in brain-derived neurotrophic factor (BDNF) level. However, previous studies which investigated this effect in a single bout of exercise, did not control for confounding peripheral factors that contribute to BDNF-alterations. Therefore, the underlying cause of exercise-induced BDNF-changes remains unclear. The current study aims to investigate serum BDNF (sBDNF)-changes due to a single-bout of graded aerobic exercise in a group of 30 outpatients with MDD, suggesting a more precise analysis method by taking plasma volume shift and number of platelets into account. Results show that exercise-induced increases in sBDNF remain significant (p<.001) when adjusting for plasma volume shift and controlling for number of platelets. The interaction of sBDNF change and number of platelets was also significant (p=.001) indicating larger sBDNF-increase in participants with smaller number of platelets. Thus, findings of this study suggest an involvement of peripheral as well as additional possibly brain-derived mechanisms explaining exercise-related BDNF release in MDD. For future studies in the field of exercise-related BDNF research, the importance of controlling for peripheral parameters is emphasized.
Background: Retinol binding protein 4 (RBP4), a protein secreted by adipocytes and bound in plasma to transthyretin (TTR), has been associated with obesity, the early phase of insulin resistance, metabolic syndrome, and type 2 diabetes mellitus. The objective of this study was to elucidate the relationship between RBP4, TTR, triglyceride (TG) and type 2 diabetes risk in rural Thailand. Results: RBP4 and TTR levels, as well as homeostatic model assessment of insulin resistance (HOMA-IR) values, were significantly elevated among subjects with high triglyceride levels (p < 0.01, p < 0.05, p < 0.05, respectively). Triglyceride levels correlated with RBP4 (r = 0.34, p < 0.001) and TTR (r= 0.26, p < 0.01) levels, as well as HOMA-IR values (r= 0.16, p < 0.05). After adjustment for age and gender, the risk of hypertriglyceridemia was 3.7 times greater (95% Cl =1.42 -9.73, p = 0.008) in the highest RBP4 tertile as compared to the lowest tertile. Similarly, the highest TTR and HOMA-IR tertiles had greater risk of hypertriglyceridemia at 3.5 (95% Cl = 1.30-9.20, p = 0.01) and 3.6 (95% CI = 1.33- 9.58, p = 0.01) times higher than the respective lowest tertiles. The correlation between TTR and blood glucose was statistically significant (r 0.18, p < 0.05), but not found this relationship in RBP4. Conclusions: The associations of RBP4 and TTR with hypertriglyceridemia and insulin resistance may have important implications for the risk of heart disease and stroke.
Background: Life events (LEs) are associated with future physical and mental health. They are crucial for understanding the pathways to mental disorders as well as the interactions with biological parameters. However, deeper insight is needed into the complex interplay between the type of LE, its subjective evaluation and accompanying factors such as social support. The "Stralsund Life Event List" (SEL) was developed to facilitate this research.
Methods: The SEL is a standardized interview that assesses the time of occurrence and frequency of 81 LEs, their subjective emotional valence, the perceived social support during the LE experience and the impact of past LEs on present life. Data from 2265 subjects from the general population-based cohort study "Study of Health in Pomerania" (SHIP) were analysed. Based on the mean emotional valence ratings of the whole sample, LEs were categorized as "positive" or "negative". For verification, the SEL was related to lifetime major depressive disorder (MDD; Munich Composite International Diagnostic Interview), childhood trauma (Childhood Trauma Questionnaire), resilience (Resilience Scale) and subjective health (SF-12 Health Survey).
Conclusions: The SEL is a valid instrument that enables the analysis of the number and frequency of LEs, their emotional valence, perceived social support and current impact on life on a global score and on an individual item level. Thus, we can recommend its use in research settings that require the assessment and analysis of the relationship between the occurrence and subjective evaluation of LEs as well as the complex balance between distressing and stabilizing life experiences.
The purpose of this study was to examine sex-specific effects of different footwear properties vs. barefoot condition during the performance of drop jumps (DJs) on stable and unstable surfaces on measures of jump performance, electromyographic (EMG) activity, and knee joint kinematics. Drop jump performance, EMG activity of lower-extremity muscles, as well as sagittal and frontal knee joint kinematics were tested in 28 healthy male (n = 14) and female (n = 14) physically active sports science students (23 6 2 years) during the performance of DJs on stable and unstable surfaces using different footwear properties (elastic vs. minimal shoes) vs. barefoot condition. Analysis revealed a significantly lower jump height and performance index (Delta 7-12%; p < 0.001; 2.22 <= d = 2.90) during DJs on unstable compared with stable surfaces. This was accompanied by lower thigh/shank muscle activities (Delta 11-28%; p < 0.05; 0.99 <= d = 2.16) and knee flexion angles (Delta 5-8%; p < 0.05; 1.02 <= d = 2.09). Furthermore, knee valgus angles during DJs were significantly lower when wearing shoes compared with barefoot condition (Delta 22-32%; p < 0.01; 1.38 <= d = 3.31). Sex-specific analyses indicated higher knee flexion angles in females compared with males during DJs, irrespective of the examined surface and footwear conditions (Delta 29%; p < 0.05; d = 0.92). Finally, hardly any significant footwear-surface interactions were detected. Our findings revealed that surface instability had an impact on DJ performance, thigh/shank muscle activity, and knee joint kinematics. In addition, the single factors "footwear" and "sex" modulated knee joint kinematics during DJs. However, hardly any significant interaction effects were found. Thus, additional footwear-related effects can be neglected when performing DJs during training on different surfaces.
Aims/hypothesis Paternal high-fat diet prior to mating programmes impaired glucose tolerance in female offspring. We examined whether the metabolic consequences in offspring could be abolished by folate treatment of either the male rats before mating or the corresponding female rats during pregnancy. Methods Male F0 rats were fed either control diet or high-fat, high-sucrose and high-salt diet (HFSSD), with or without folate, before mating. Male rats were mated with control-diet-fed dams. After mating, the F0 dams were fed control diet with or without folate during pregnancy.
The present study aimed to identify new key genes as potential biomarkers for the diagnosis, prognosis or targeted therapy of clear cell renal cell carcinoma (ccRCC). Three expression profiles (GSE36895, GSE46699 and GSE71963) were collected from Gene Expression Omnibus. GEO2R was used to identify differentially expressed genes (DEGs) in ccRCC tissues and normal samples. The Database for Annotation, Visualization and Integrated Discovery was utilized for functional and pathway enrichment analysis. STRING v10.5 and Molecular Complex Detection were used for protein-protein interaction (PPI) network construction and module analysis, respectively. Regulation network analyses were performed with the WebGestal tool. UALCAN web-portal was used for expression validation and survival analysis of hub genes in ccRCC patients from The Cancer Genome Atlas (TCGA). A total of 65 up- and 164 downregulated genes were identified as DEGs. DEGs were enriched with functional terms and pathways compactly related to ccRCC pathogenesis. Seventeen hub genes and one significant module were filtered out and selected from the PPI network. The differential expression of hub genes was verified in TCGA patients. Kaplan-Meier plot showed that high mRNA expression of enolase 2 (ENO2) was associated with short overall survival in ccRCC patients (P=0.023). High mRNA expression of cyclin D1 (CCND1) (P<0.001), fms related tyrosine kinase 1 (FLT1) (P=0.004), plasminogen (PLG) (P<0.001) and von Willebrand factor (VWF) (P=0.008) appeared to serve as favorable factors in survival. These findings indicate that the DEGs may be key genes in ccRCC pathogenesis and five genes, including ENO2, CCND1, PLT1, PLG and VWF, may serve as potential prognostic biomarkers in ccRCC.
Wild rodents are important hosts for tick larvae but co-infestations with other mites and insects are largely neglected. Small rodents were trapped at four study sites in Berlin, Germany, to quantify their ectoparasite diversity. Host-specific, spatial and temporal occurrence of ectoparasites was determined to assess their influence on direct and indirect zoonotic risk due to mice and voles in an urban agglomeration. Rodent-associated arthropods were diverse, including 63 species observed on six host species with an overall prevalence of 99%. The tick Ixodes ricinus was the most prevalent species, found on 56% of the rodents. The trapping location clearly affected the presence of different rodent species and, therefore, the occurrence of particular host-specific parasites. In Berlin, fewer temporary and periodic parasite species as well as non-parasitic species (fleas, chiggers and nidicolous Gamasina) were detected than reported from rural areas. In addition, abundance of parasites with low host-specificity (ticks, fleas and chiggers) apparently decreased with increasing landscape fragmentation associated with a gradient of urbanisation. In contrast, stationary ectoparasites, closely adapted to the rodent host, such as the fur mites Myobiidae and Listrophoridae, were most abundant at the two urban sites. A direct zoonotic risk of infection for people may only be posed by Nosopsyllus fasciatus fleas, which were prevalent even in the city centre. More importantly, peridomestic rodents clearly supported the life cycle of ticks in the city as hosts for their subadult stages. In addition to trapping location, season, host species, body condition and host sex, infestation with fleas, gamasid Laelapidae mites and prostigmatic Myobiidae mites were associated with significantly altered abundance of I. ricinus larvae on mice and voles. Whether this is caused by predation, grooming behaviour or interaction with the host immune system is unclear. The present study constitutes a basis to identify interactions and vector function of rodent-associated arthropods and their potential impact on zoonotic diseases.
The use of functional music in gait training termed rhythmic auditory stimulation (RAS) and treadmill training (TT) have both been shown to be effective in stroke patients (SP). The combination of RAS and treadmill training (RAS-TT) has not been clinically evaluated to date. The aim of the study was to evaluate the efficacy of RAS-TT on functional gait in SR The protocol followed the design of an explorative study with a rater-blinded three arm prospective randomized controlled parallel group design. Forty-five independently walking SP with a hemiparesis of the lower limb or an unsafe and asymmetrical walking pattern were recruited. RAS-TT was carried out over 4 weeks with TT and neurodevelopmental treatment based on Bobath approach (NDT) serving as control interventions. For RAS-TT functional music was adjusted individually while walking on the treadmill. Pre and post-assessments consisted of the fast gait speed test (FGS), a gait analysis with the locometre (LOC), 3 min walking time test (3MWT), and an instrumental evaluation of balance (IEB). Raters were blinded to group assignments. An analysis of covariance (ANCOVA) was performed with affiliated measures from pre-assessment and time between stroke and start of study as covariates. Thirty-five participants (mean age 63.6 +/- 8.6 years, mean time between stroke and start of study 42.1 +/- 23.7 days) completed the study (11 RAS-TT, 13 TT, 11 NDT). Significant group differences occurred in the FGS for adjusted post-measures in gait velocity [F-(2,F- (34)) = 3.864, p = 0.032; partial eta(2) = 0.205] and cadence [F-(2,F- 34) = 7.656, p = 0.002; partial eta(2) = 0.338]. Group contrasts showed significantly higher values for RAS-TT. Stride length results did not vary between the groups. LOC, 3MWT, and IEB did not indicate group differences. One patient was withdrawn from TT because of pain in one arm. The study provides first evidence for a higher efficacy of RAS-TT in comparison to the standard approaches TT and NDT in restoring functional gait in SP. The results support the implementation of functional music in neurological gait rehabilitation and its use in combination with treadmill training.
Purpose Moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) are associated with different adjustments in motor output. Changes in motor unit (MU) peripheral properties may contribute to these adjustments, but this is yet to be elucidated. This study evaluated early changes in MU conduction velocity (MUCV) and MU action potential amplitude after 2 wk of either HIIT or MICT. Methods Sixteen men were assigned to either an MICT group or HIIT group (n = 8 each), and participated in six training sessions over 14 d. HIIT: 8 to 12 x 60-s intervals at 100% peak power output. Moderate-intensity continuous training: 90 to 120 min continuous cycling at similar to 65% VO2peak. Preintervention and postintervention, participants performed maximal voluntary contractions (MVC) and submaximal (10%, 30%, 50%, and 70% of MVC) isometric knee extensions while high-density EMG was recorded from the vastus medialis (VM) and vastus lateralis (VL) muscles. The high-density EMG was decomposed into individual MU by convolutive blind-source separation and tracked preintervention and postintervention. Results Both training interventions induced changes in MUCV, but these changes depended on the type of training (P < 0.001). The HIIT group showed higher values of MUCV after training at all torque levels (P < 0.05), MICT only displayed changes in MUCV at low torque levels (10%-30% MVC, P < 0.002). There were no changes in MU action potential amplitude for either group (P = 0.2). Conclusions Two weeks of HIIT or MICT elicit differential changes in MUCV, likely due to the contrasting load and volume used in such training regimes. This new knowledge on the neuromuscular adaptations to training has implications for exercise prescription.
Surface electromyographic (EMG) signal amplitude is typically used to compare the neural drive to muscles. We experimentally investigated this association by studying the motor unit (MU) behavior and action potentials in the vastus medialis (VM) and vastus lateralis (VL) muscles. Eighteen participants performed isometric knee extensions at four target torques [10. 30. 50, and 70% of the maximum torque (MVC)] while high-density EMG signals were recorded from the VM and VL. The absolute EMG amplitude was greater for VM than VL (P < 0.001), whereas the EMG amplitude normalized with respect to MVC was greater for VL than VM (P < 0.04). Because differences in EMG amplitude can be due to both differences in the neural drive and in the size of the MU action potentials, we indirectly inferred the neural drives received by the two muscles by estimating the synaptic inputs received by the corresponding motor neuron pools. For this purpose. we analyzed the increase in discharge rate from recruitment to target torque for motor units matched by recruitment threshold in the two muscles. This analysis indicated that the two muscles received similar levels of neural drive. Nonetheless, the size of the MU action potentials was greater for VM than VL (P < 0.001), and this difference explained most of the differences in EMG amplitude between the two muscles (similar to 63% of explained variance). These results indicate that EMG amplitude, even following normalization, does not reflect the neural drive to synergistic muscles. Moreover, absolute EMG amplitude is mainly explained by the size of MU action potentials. NEW & NOTEWORTHY Electromyographic (EMG) amplitude is widely used to compare indirectly the strength of neural drive received by synergistic muscles. However, there are no studies validating this approach with motor unit data. Here, we compared between-muscles differences in surface EMG amplitude and motor unit behavior. The results clarify the limitations of surface EMG to interpret differences in neural drive between muscles.
Background and objective Optimisation of hydrocortisone replacement therapy in children is challenging as there is currently no licensed formulation and dose in Europe for children under 6 years of age. In addition, hydrocortisone has non-linear pharmacokinetics caused by saturable plasma protein binding. A paediatric hydrocortisone formulation, Infacort (R) oral hydrocortisone granules with taste masking, has therefore been developed. The objective of this study was to establish a population pharmacokinetic model based on studies in healthy adult volunteers to predict hydrocortisone exposure in paediatric patients with adrenal insufficiency. Methods Cortisol and binding protein concentrations were evaluated in the absence and presence of dexamethasone in healthy volunteers (n = 30). Dexamethasone was used to suppress endogenous cortisol concentrations prior to and after single doses of 0.5, 2, 5 and 10 mg of Infacort (R) or 20 mg of Infacort (R)/hydrocortisone tablet/hydrocortisone intravenously. A plasma protein binding model was established using unbound and total cortisol concentrations, and sequentially integrated into the pharmacokinetic model. Results Both specific (non-linear) and non-specific (linear) protein binding were included in the cortisol binding model. A two-compartment disposition model with saturable absorption and constant endogenous cortisol baseline (Baseline (cort),15.5 nmol/L) described the data accurately. The predicted cortisol exposure for a given dose varied considerably within a small body weight range in individuals weighing < 20 kg. Conclusions Our semi-mechanistic population pharmacokinetic model for hydrocortisone captures the complex pharmacokinetics of hydrocortisone in a simplified but comprehensive framework. The predicted cortisol exposure indicated the importance of defining an accurate hydrocortisone dose to mimic physiological concentrations for neonates and infants weighing < 20 kg.
Background: Optimal antibiotic exposure is a vital but challenging prerequisite for achieving clinical success in ICU patients. Objectives: To develop and externally validate a population pharmacokinetic model for continuous-infusion meropenem in critically ill patients and to establish a nomogram based on a routinely available marker of renal function. Methods: A population pharmacokinetic model was developed in NONMEM (R) 7.3 based on steady-state meropenem concentrations (C-ss) collected during therapeutic drug monitoring. Different serum creatinine-based markers of renal function were compared for their influence on meropenem clearance (the Cockcroft-Gault creatinine clearance CLCRcG, the CLCR bedside estimate according to Jelliffe, the Chronic Kidney Disease Epidemiology Collaboration equation and the four-variable Modification of Diet in Renal Disease equation). After validation of the pharmacokinetic model with independent data, a dosing nomogram was developed, relating renal function to the daily doses required to achieve selected target concentrations (4/8/16 mg/L) in 90% of the patients. Probability of target attainment was determined for efficacy (C-ss >= 8 mg/L) and potentially increased likelihood of adverse drug reactions (C-ss >32 mg/L). Results: In total, 433 plasma concentrations (3.20-48.0 mg/L) from 195 patients (median/P-0.05 - P-0.95 at baseline: weight 77.0/55.0-114 kg, CLCRCG 63.0/19.6-168 mL/min) were used for model building. We found that CLCRCG best described meropenem clearance (CL = 7.71 L/h, CLCRCG = 80 mL/min). The developed model was successfully validated with external data (n = 171, 73 patients). According to the nomogram, daily doses of 910/1480/2050/2800/ 3940 mg were required to reach a target C-ss = 8 mg/L in 90% of patients with CLCRCG = 20/50/80/120/180 mL/min, respectively. A low probability of adverse drug reactions (<0.5%) was associated with these doses. Conclusions: A dosing nomogram was developed for continuous-infusion meropenem based on renal function in a critically ill population.
Differences in neuromuscular activity of ankle stabilizing muscles during postural disturbances
(2018)
The purpose was to examine gender differences in ankle stabilizing muscle activation during postural disturbances. Seventeen participants (9 females: 27 +/- 2yrs., 1.69 +/- 0.1 m, 63 +/- 7 kg; 8 males: 29 +/- 2yrs., 1.81 +/- 0.1 m; 83 +/- 7 kg) were included in the study. After familiarization on a split-belt-treadmill, participants walked (1 m/s) while 15 right-sided perturbations were randomly applied 200 ms after initial heel contact. Muscle activity of M. tibialis anterior (TA), peroneus longus (PL) and gastrocnemius medialis (GM) was recorded during unperturbed and perturbed walking. The root mean square (RMS; [%]) was analyzed within 200 ms after perturbation. Co-activation was quantified as ratio of antagonist (GM)/agonist (TA) EMG-RMS during unperturbed and perturbed walking. Time to onset was calculated (ms). Data were analyzed descriptively (mean +/- SD) followed by three-way-ANOVA (gender/condition/muscle; alpha= 0.05). Perturbed walking elicited higher EMG activity compared to normal walking for TA and PL in both genders (p < 0.000). RMS amplitude gender comparisons revealed an interaction between gender and condition (F = 4.6, p = 0.049) and, a triple interaction among gender, condition and muscle (F = 4.7, p = 0.02). Women presented significantly higher EMG-RMS [%] PL amplitude than men during perturbed walking (mean difference = 209.6%, 95% confidence interval = -367.0 to -52.2%, p < 0.000). Co-activation showed significant lower values for perturbed compared to normal walking (p < 0.000), without significant gender differences for both walking conditions. GM activated significantly earlier than TA and PL (p < 0.01) without significant differences between the muscle activation onsets of men and women (p = 0.7). The results reflect that activation strategies of the ankle encompassing muscles differ between genders. In provoked stumbling, higher PL EMG activity in women compared to men is present. Future studies should aim to elucidate if this specific behavior has any relationship with ankle injury occurrence between genders.
The aim of this study was to investigate the effect of a 6-week sensorimotor or resistance training on maximum trunk strength and response to sudden, high-intensity loading in athletes. Interventions showed no significant difference for maximum strength in concentric and eccentric testing (p>0.05). For perturbation compensation, higher peak torque response following SMT (Extension: +24Nm 95%CI +/- 19Nm; Rotation: + 19Nm 95%CI +/- 13Nm) and RT (Extension: +35Nm 95%CI +/- 16Nm; Rotation: +5Nm 95%CI +/- 4Nm) compared to CG (Extension: -4Nm 95%CI +/- 16Nm; Rotation: -2Nm 95%CI +/- 4Nm) was present (p<0.05).
Accuracy of training recommendations based on a treadmill multistage incremental exercise test
(2018)
Competitive runners will occasionally undergo exercise in a laboratory setting to obtain predictive and prescriptive information regarding their performance. The present research aimed to assess whether the physiological demands of lab-based treadmill running (TM) can simulate that of over-ground (OG) running using a commonly used protocol. Fifteen healthy volunteers with a weekly mileage of ≥ 20 km over the past 6 months and treadmill experience participated in this cross-sectional study. Two stepwise incremental tests until volitional exhaustion was performed in a fixed order within one week in an Outpatient Clinic research laboratory and outdoor athletic track. Running velocity (IATspeed), heart rate (IATHR) and lactate concentration at the individual anaerobic threshold (IATbLa) were primary endpoints. Additionally, distance covered (DIST), maximal heart rate (HRmax), maximal blood lactate concentration (bLamax) and rate of perceived exertion (RPE) at IATspeed were analyzed. IATspeed, DIST and HRmax were not statistically significantly different between conditions, whereas bLamax and RPE at IATspeed showed statistical significance (p < 0.05). Apart from RPE at IATspeed, IATspeed, DIST, HRmax and bLamax strongly correlate between conditions (r = 0.815–0.988). High reliability between conditions provides strong evidence to suggest that running on a treadmill are physiologically comparable to that of OG and that training recommendations and be made with assurance.
Background: Core-specific sensorimotor exercises are proven to enhance neuromuscular activity of the trunk, improve athletic performance and prevent back pain. However, the dose-response relationship and, therefore, the dose required to improve trunk function is still under debate. The purpose of the present trial will be to compare four different intervention strategies of sensorimotor exercises that will result in improved trunk function. Discussion: The results of the study will be clinically relevant, not only for researchers but also for (sports) therapists, physicians, coaches, athletes and the general population who have the aim of improving trunk function.
Introduction
To date, several meta-analyses clearly demonstrated that resistance and plyometric training are effective to improve physical fitness in children and adolescents. However, a methodological limitation of meta-analyses is that they synthesize results from different studies and hence ignore important differences across studies (i.e., mixing apples and oranges). Therefore, we aimed at examining comparative intervention studies that assessed the effects of age, sex, maturation, and resistance or plyometric training descriptors (e.g., training intensity, volume etc.) on measures of physical fitness while holding other variables constant.
Methods
To identify relevant studies, we systematically searched multiple electronic databases (e.g., PubMed) from inception to March 2018. We included resistance and plyometric training studies in healthy young athletes and non-athletes aged 6 to 18 years that investigated the effects of moderator variables (e.g., age, maturity, sex, etc.) on components of physical fitness (i.e., muscle strength and power).
Results
Our systematic literature search revealed a total of 75 eligible resistance and plyometric training studies, including 5,138 participants. Mean duration of resistance and plyometric training programs amounted to 8.9 ± 3.6 weeks and 7.1±1.4 weeks, respectively. Our findings showed that maturation affects plyometric and resistance training outcomes differently, with the former eliciting greater adaptations pre-peak height velocity (PHV) and the latter around- and post-PHV. Sex has no major impact on resistance training related outcomes (e.g., maximal strength, 10 repetition maximum). In terms of plyometric training, around-PHV boys appear to respond with larger performance improvements (e.g., jump height, jump distance) compared with girls. Different types of resistance training (e.g., body weight, free weights) are effective in improving measures of muscle strength (e.g., maximum voluntary contraction) in untrained children and adolescents. Effects of plyometric training in untrained youth primarily follow the principle of training specificity. Despite the fact that only 6 out of 75 comparative studies investigated resistance or plyometric training in trained individuals, positive effects were reported in all 6 studies (e.g., maximum strength and vertical jump height, respectively).
Conclusions
The present review article identified research gaps (e.g., training descriptors, modern alternative training modalities) that should be addressed in future comparative studies.
From a health and performance-related perspective, it is crucial to evaluate subjective symptoms and objective signs of acute training-induced immunological responses in young athletes. The limited number of available studies focused on immunological adaptations following aerobic training. Hardly any studies have been conducted on resistance-training induced stress responses. Therefore, the aim of this observational study was to investigate subjective symptoms and objective signs of immunological stress responses following resistance training in young athletes. Fourteen (7 females and 7 males) track and field athletes with a mean age of 16.4 years and without any symptoms of upper or lower respiratory tract infections participated in this study. Over a period of 7 days, subjective symptoms using the Acute Recovery and Stress Scale (ARSS) and objective signs of immunological responses using capillary blood markers were taken each morning and after the last training session. Differences between morning and evening sessions and associations between subjective and objective parameters were analyzed using generalized estimating equations (GEE). In post hoc analyses, daily change-scores of the ARSS dimensions were compared between participants and revealed specific changes in objective capillary blood samples. In the GEE models, recovery (ARSS) was characterized by a significant decrease while stress (ARSS) showed a significant increase between morning and evening-training sessions. A concomitant increase in white blood cell count (WBC), granulocytes (GRAN) and percentage shares of granulocytes (GRAN%) was found between morning and evening sessions. Of note, percentage shares of lymphocytes (LYM%) showed a significant decrease. Furthermore, using multivariate regression analyses, we identified that recovery was significantly associated with LYM%, while stress was significantly associated with WBC and GRAN%. Post hoc analyses revealed significantly larger increases in participants' stress dimensions who showed increases in GRAN%. For recovery, significantly larger decreases were found in participants with decreases in LYM% during recovery. More specifically, daily change-scores of the recovery and stress dimensions of the ARSS were associated with specific changes in objective immunological markers (GRAN%, LYM%) between morning and evening-training sessions. Our results indicate that changes of subjective symptoms of recovery and stress dimensions using the ARSS were associated with specific changes in objectively measured immunological markers.
Ramirez-Campillo, R, Alvarez, C, García-Pinillos, F, Sanchez-Sanchez, J, Yanci, J, Castillo, D, Loturco, I, Chaabene, H, Moran, J, and Izquierdo, M. Optimal reactive strength index: is it an accurate variable to optimize plyometric training effects on measures of physical fitness in young soccer players? J Strength Cond Res 32(4): 885–893, 2018—This study aimed to compare the effects of drop-jump training using a fixed drop-box height (i.e., 30-cm [FIXED]) vs. an optimal (OPT) drop-box height (i.e., 10-cm to 40-cm: generating an OPT reactive strength index [RSI]) in youth soccer players' physical fitness. Athletes were randomly allocated to a control group (n = 24; age = 13.7 years), a fixed drop-box height group (FIXED, n = 25; age = 13.9 years), or an OPT drop-box height group (OPT, n = 24; age = 13.1 years). Before and after 7 weeks of training, tests for the assessment of jumping (countermovement jump [CMJ], 5 multiple bounds), speed (20-m sprint time), change of direction ability (CODA [Illinois test]), strength {RSI and 5 maximal squat repetition test (5 repetition maximum [RM])}, endurance (2.4-km time trial), and kicking ability (maximal kicking distance) were undertaken. Analyses revealed main effects of time for all dependent variables (p < 0.001, d = 0.24–0.72), except for 20-m sprint time. Analyses also revealed group × time interactions for CMJ (p < 0.001, d = 0.51), depth jump (DJ) (p < 0.001, d = 0.30), 20-m sprint time (p < 0.001, d = 0.25), CODA (p < 0.001, d = 0.22), and 5RM (p < 0.01, d = 0.16). Post hoc analyses revealed increases for the FIXED group (CMJ: 7.4%, d = 0.36; DJ: 19.2%, d = 0.49; CODA: −3.1%, d = −0.21; 5RM: 10.5%, d = 0.32) and the OPT group (CMJ: 16.7%, d = 0.76; DJ: 36.1%, d = 0.79; CODA: −4.4%, d = −0.34; 5RM: 18.1%, d = 0.47). Post hoc analyses also revealed increases for the OPT group in 20-m sprint time (−3.7%, d = 0.27). Therefore, to maximize the effects of plyometric training, an OPT approach is recommended. However, using adequate fixed drop-box heights may provide a rational and practical alternative.
Intervertebral disc (IVD) cells are naturally exposed to high osmolarity and complex mechanical loading, which drive microenvironmental osmotic changes. Age- and degeneration-induced degradation of the IVD’s extracellular matrix causes osmotic imbalance, which, together with an altered function of cellular receptors and signalling pathways, instigates local osmotic stress. Cellular responses to osmotic stress include osmoadaptation and activation of pro-inflammatory pathways. This review summarises the current knowledge on how IVD cells sense local osmotic changes and translate these signals into physiological or pathophysiological responses, with a focus on inflammation. Furthermore, it discusses the expression and function of putative membrane osmosensors (e.g. solute carrier transporters, transient receptor potential channels, aquaporins and acid-sensing ion channels) and osmosignalling mediators [e.g. tonicity response-element-binding protein/nuclear factor of activated T-cells 5 (TonEBP/NFAT5), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB)] in healthy and degenerated IVDs. Finally, an overview of the potential therapeutic targets for modifying osmosensing and osmosignalling in degenerated IVDs is provided.
Ziel der Studie Die vorliegende Untersuchung beinhaltete die explorative Erfassung potenzieller Indikatoren der Ergebnisqualität der kardiologischen Rehabilitation (CR) für Patienten unter 65 Jahren.
Methoden In einer 4-stufigen webbasierten Delphi-Befragung (04-07/2016) von in der CR tätigen Ärzten[2] , Psychologen und Sport-/Physiotherapeuten wurden Parameter der körperlichen Leistungsfähigkeit, der Sozialmedizin, der subjektiven Gesundheit und kardiovaskuläre Risikofaktoren hinsichtlich ihrer Eignung als Qualitätsindikator bewertet.
Ergebnisse Von 44 vorgegebenen wie auch von den Teilnehmern vorgeschlagenen Parametern wurden 21 Parameter (48%), die Hälfte davon psychosoziale Faktoren, als potenzielle Qualitätsindikatoren ausgewählt, wobei lediglich für das Rauchverhalten, den Blutdruck, das LDL-Cholesterin und die max. Belastbarkeit im Belastungs-EKG ein Konsens (Zustimmung>75% der Befragten) erzielt wurde.
Schlussfolgerung Die Wahl der Qualitätsindikatoren durch die Experten erfolgte mehrheitlich mit nur geringer Einigkeit. Eine klinische und wissenschaftliche Evaluierung der gewählten Parameter ist daher zwingend erforderlich.
Hintergrund
Einem Großteil der Bevölkerung gelingt es trotz ausreichenden Wissens um die protektiven Effekte nicht, ausreichende körperliche Aktivität in den Alltag zu integrieren. Digitale Assistenzsysteme könnten hierbei unterstützend eingesetzt werden. Dies setzt jedoch das Interesse potentieller Nutzer voraus.
Methode
In einer Online-Befragung wurden im Juni/Juli 2015 Mitarbeiter und Studierende der Universität Potsdam zum individuellen Ausmaß der sportlichen Aktivität, dem Interesse an elektronischer Trainingsunterstützung und weiteren Parametern befragt.
Ergebnis 1217 Studierende und 485 Mitarbeiter (67,3 bzw. 67,5% Frauen, 26±4,9 bzw. 42,7±11,7 Jahre) nahmen an der Studie teil. Die empfohlene sportliche Aktivität (≥3 Tage bzw. 150 min/Woche) wurde von 70,1% der Mitarbeiter und 52,7% der Studierenden nicht erreicht. Innerhalb dieser Gruppen zeigten 53,2% (Studierende) bzw. 44,2% (Mitarbeiter), unabhängig von Alter, Geschlecht, BMI bzw. Bildungsniveau, Interesse an einer elektronischen Trainingsunterstützung.
Schlussfolgerung
Auch in jüngeren Bevölkerungsgruppen mit hohem Bildungsniveau ist die Mehrzahl der Personen unzureichend körperlich aktiv. Ein Interesse an Trainingsunterstützung besteht in etwa der Hälfte dieser sportlich inaktiven Gruppe. Dies legt den Schluss nahe, dass der personalisierte Einsatz mobiler Assistenzsysteme für die positive Beeinflussung des Lebensstils zunehmend an Bedeutung gewinnen könnte.
Hintergrund In den letzten Jahrzehnten führte die leitliniengerechte Therapie des akuten Myokardinfarktes (MI) zu einer Mortalitätsreduktion in Deutschland, wobei zwischen einzelnen Bundesländern erhebliche Unterschiede beschrieben werden. Ziel war es daher, die aktuelle Versorgungssituation von Patienten mit MI in der Region Nordost-Deutschland (Berlin, Brandenburg [BRB] und Mecklenburg-Vorpommern [MV]) zu untersuchen und Prädiktoren der 1-Jahresmortalität unter Berücksichtigung der regionalen Zuordnung zu identifizieren.
Methode Auf Basis pseudonymisierter Abrechnungsdaten einer gesetzlichen Krankenversicherung wurden für das Jahr 2012 anhand des ICD 10-Codes I21 und I22 von 1 387 084 Versicherten insgesamt 6733 Patienten mit stationärer Aufnahme bei MI gefiltert. Neben der Krankenhaus- und 1-Jahresmortalität wurden potenzielle Prognoseprädiktoren unter Berücksichtigung von Komorbiditäten, periinfarziellen Prozeduren und sekundärpräventiver Pharmakotherapie erfasst und im Ländervergleich analysiert.
Ergebnisse Sowohl die Krankenhaus- als auch die 1-Jahresmortalitätsrate der einzelnen Länder (Berlin 13,6 resp. 27,5 %, BRB 13,9 resp. 27,9 %, MV 14,4 resp. 29,0 %) war vergleichbar zur Gesamtrate (13,9 % resp. 28,0 %) und im Ländervergleich weitgehend identisch. Die multiple Analyse der Einflussfaktoren auf die 1-Jahresmortalität identifizierte vor allem die Koronarangiografie (OR 0,42, 95 % KI 0,35 – 0,51, p < 0,001) und die Umsetzung der pharmakologischen Leitlinienempfehlungen (OR 0,14, 95 % KI 0,12 – 0,17, p < 0,001) als wesentliche Maßnahmen zur Risikoreduktion. Bei beiden Einflussfaktoren lagen univariat keine statistischen Unterschiede zwischen den drei Bundesländern vor.
Schlussfolgerung Die vorliegenden Daten lassen auf eine vergleichbare stationäre und poststationäre Versorgung und 1-Jahresprognose von Patienten mit akutem MI in den Bundesländern Berlin, Brandenburg und Mecklenburg-Vorpommern in der untersuchten Population schließen, wobei insbesondere der Durchführung einer Koronarangiografie und der adäquaten Umsetzung einer leitliniengerechten Pharmakotherapie prognostische Bedeutung zukommt.
The purpose of this study was to estimate the optimal body size, limb-segment length, girth or breadth ratios for 100-m backstroke mean speed performance in young swimmers. Sixty-three young swimmers (boys [n = 30; age: 13.98 ± 0.58 years]; girls [n = 33; age: 13.02 ± 1.20 years]) participated in this study. To identify the optimal body size and body composition components associated with 100-m backstroke speed performance, we adopted a multiplicative allometric log-linear regression model, which was refined using backward elimination. The multiplicative allometric model exploring the association between 100-m backstroke mean speed performance and the different somatic measurements estimated that biological age, sitting height, leg length for the lower-limbs, and two girths (forearm and arm relaxed girth) are the key predictors. Stature and body mass did not contribute to the model, suggesting that the advantage of longer levers was limb-specific rather than a general whole-body advantage. In fact, it is only by adopting multiplicative allometric models that the abovementioned ratios could have been derived. These findings highlighted the importance of considering somatic characteristics of young backstroke swimmers and can help swimming coaches to classify their swimmers and enable them to suggest what might be the swimmers’ most appropriate stroke (talent identification).
The influence of Pavlovian conditioned stimuli on ongoing behavior may contribute to explaining how alcohol cues stimulate drug seeking and intake. Using a Pavlovian-instrumental transfer task, we investigated the effects of alcohol-related cues on approach behavior (i.e., instrumental response behavior) and its neural correlates, and related both to the relapse after detoxification in alcohol-dependent patients. Thirty-one recently detoxified alcohol-dependent patients and 24 healthy controls underwent instrumental training, where approach or non-approach towards initially neutral stimuli was reinforced by monetary incentives. Approach behavior was tested during extinction with either alcohol-related or neutral stimuli (as Pavlovian cues) presented in the background during functional magnetic resonance imaging (fMRI). Patients were subsequently followed up for 6 months. We observed that alcohol-related background stimuli inhibited the approach behavior in detoxified alcohol-dependent patients (t = -3.86, p < .001), but not in healthy controls (t = -0.92, p = .36). This behavioral inhibition was associated with neural activation in the nucleus accumbens (NAcc) (t((30)) = 2.06, p < .05). Interestingly, both the effects were only present in subsequent abstainers, but not relapsers and in those with mild but not severe dependence. Our data show that alcohol-related cues can acquire inhibitory behavioral features typical of aversive stimuli despite being accompanied by a stronger NAcc activation, suggesting salience attribution. The fact that these findings are restricted to abstinence and milder illness suggests that they may be potential resilience factors.
Objective: The aim of the present study was to examine the effect of Cold Water Immersion (CWI) on the recovery of physical performance, hematological stress markers and perceived wellness (i.e., Hooper scores) following a simulated Mixed Martial Arts (MMA) competition. Methods: Participants completed two experimental sessions in a counter-balanced order (CWI or passive recovery for control condition: CON), after a simulated MMAs competition (3 x 5-min MMA rounds separated by 1-min of passive rest). During CWI, athletes were required to submerge their bodies, except the trunk, neck and head, in the seated position in a temperature-controlled bath (similar to 10 degrees C) for 15-min. During CON, athletes were required to be in a seated position for 15-min in same room ambient temperature. Venous blood samples (creatine kinase, cortisol, and testosterone concentrations) were collected at rest (PRE-EX, i.e., before MMAs), immediately following MMAs (POST-EX), immediately following recovery (POST-R) and 24 h post MMAs (POST-24), whilst physical fitness (squat jump, countermovement-jump and 5- and 10-m sprints) and perceptual measures (well-being Hooper index: fatigue, stress, delayed onset muscle soreness (DOMS), and sleep) were collected at PRE-EX, POST-R and POST-24, and at PRE-EX and POST-24, respectively. Conclusion: The use of CWI resulted in an enhanced recovery of 10-m sprint performance, as well as improved perceived wellness 24-h following simulated MMA competition.
Background Previous studies found evidence that dispositional optimism is related to lower pain sensitivity. Recent findings suggest that temporarily increasing optimism by means of imagining a positive future may also have pain-alleviating effects. Objectives The present experiment was designed to investigate conditioned pain modulation (CPM) as a potential underlying mechanism of this pain-alleviating effect of induced optimism. Methods For this purpose, 45 healthy participants were randomized into an optimistic or neutral imagery condition. Additionally, participants completed questionnaires on dispositional optimism, pain catastrophizing and pain expectations. CPM was assessed by delivering a series of five heat pain stimuli on the nondominant hand before and during immersion of the dominant hand in water of 5 degrees C for 70 s. Results A clear CPM effect was found, that is heat pain reports were lower during simultaneous cold water stimulation. Although the optimism manipulation successfully increased optimism, it did not affect pain ratings or CPM. Post hoc analyses indicated that dispositional optimism was not associated with the magnitude of CPM, but pain catastrophizing and pain expectations did significantly correlate with the CPM effect. Conclusion Pain-specific but not general cognitions appear to influence endogenous pain modulation. Significance Conditioned pain modulation is not the underlying mechanism of the pain-alleviating effects of induced optimism. However, pain-specific cognitions including pain catastrophizing and pain expectations affect endogenous pain modulation which should be taken into account in treatment and CPM research.
Vitamin D, either in its D-2 or D-3 form, is essential for normal human development during intrauterine life, kidney function and bone health. Vitamin D deficiency has also been linked to cancer development and some auto immune diseases. Given this huge impact of vitamin Don human health, it is important for daily clinical practice and clinical research to have reliable tools to judge on the vitamin D status. The major circulating form of vitamin D is 25-hydroxyvitamin D (25(OH)D), although it is not the most active metabolite, the concentrations of total 25-hydroxyvitamin D in the serum are currently routinely used in clinical practice to assess vitamin D status. In the circulation, vitamin D - like other steroid hormones - is bound tightly to a special carrier - vitamin D-binding protein (DBP). Smaller amounts are bound to blood proteins - albumin and lipoproteins. Only very tiny amounts of the total vitamin D are free and potentially biologically active. Currently used vitamin D assays do not distinguish between the three forms of vitamin D - DBP-bound vitamin D, albumin-bound vitamin D and free, biologically active vitamin D. Diseases or conditions that affect the synthesis of DBP or albumin thus have a huge impact on the amount of circulating total vitamin D. DBP and albumin are synthesized in the liver, hence all patients with an impairment of liver function have alterations in their total vitamin D blood concentrations, while free vitamin D levels remain mostly constant. Sex steroids, in particular estrogens, stimulate the synthesis of DBP. This explains why total vitamin D concentrations are higher during pregnancy as compared to nonpregnant women, while the concentrations of free vitamin D remain similar in both groups of women. The vitamin D-DBP as well as vitamin D-albumin complexes are filtered through the glomeruli and re-uptaken by megalin in the proximal tubule. Therefore, all acute and chronic kidney diseases that are characterized by a tubular damage, are associated with a loss of vitamin D-DBP complexes in the urine. Finally, the gene encoding DBP protein is highly polymorphic in different human racial groups. In the current review, we will discuss how liver function, estrogens, kidney function and the genetic background might influence total circulating vitamin D levels and will discuss what vitamin D metabolite is more appropriate to measure under these conditions: free vitamin D or total vitamin D.
Research question: This study aimed to establish reference values in 1-14 year old healthy children and to implement FPA-percentile curves for daily clinical use. Methods: 5910 healthy children performed at least 3 repetitions of barefoot walking over an instrumented walkway using a pressure measurement platform. The FPA [degrees] was extracted and analyzed by age and gender (mean +/- standard deviation; median with percentiles, MANOVA (age, gender) and Wilcoxon-Signed-Rank test for intra-individual side differences (alpha = 0.05). Results: FPA maximum was observed in 2-year-old children and diminished significant until the age of 4 to moderate out-toeing. For ages 5-14, no statistically significant differences in FPA values were present (p > 0.05). MANOVA confirmed age (p < 0.001) and gender (p < 0.001) as significant FPA influencing factors, without combined effect (p > 0.05). In every age group, right feet showed significantly greater out-toeing (p < 0.05). Significance: Percentile values indicate a wide FPA range in children. FPA development in young children shows a spontaneous shift towards moderate external rotation (age 2-4), whereby in-toeing <= 1-5 degrees can be present, but can return to normal. Bilateral in-toeing after the age of four and unilateral in-toeing after the age of seven should be monitored.
Symptoms of anxiety and depression in young athletes using the hospital anxiety and depression scale
(2018)
Elite young athletes have to cope with multiple psychological demands such as training volume, mental and physical fatigue, spatial separation of family and friends or time management problems may lead to reduced mental and physical recovery. While normative data regarding symptoms of anxiety and depression for the general population is available (Hinz and Brahler, 2011), hardly any information exists for adolescents in general and young athletes in particular. Therefore, the aim of this study was to assess overall symptoms of anxiety and depression in young athletes as well as possible sex differences. The survey was carried out within the scope of the study "Resistance Training in Young Athletes" (KINGS-Study). Between August 2015 and September 2016, 326 young athletes aged (mean +/- SD) 14.3 +/- 1.6 years completed the Hospital Anxiety and Depression Scale (HAD Scale). Regarding the analysis of age on the anxiety and depression subscales, age groups were classified as follows: late childhood (12-14 years) and late adolescence (15-18 years). The participating young athletes were recruited from Olympic weight lifting, handball, judo, track and field athletics, boxing, soccer, gymnastics, ice speed skating, volleyball, and rowing. Anxiety and depression scores were (mean +/- SD) 4.3 +/- 3.0 and 2.8 +/- 2.9, respectively. In the subscale anxiety, 22 cases (6.7%) showed subclinical scores and 11 cases (3.4%) showed clinical relevant score values. When analyzing the depression subscale, 31 cases (9.5%) showed subclinical score values and 12 cases (3.7%) showed clinically important values. No significant differences were found between male and female athletes (p >= 0.05). No statistically significant differences in the HADS scores were found between male athletes of late childhood and late adolescents (p >= 0.05). To the best of our knowledge, this is the first report describing questionnaire based indicators of symptoms of anxiety and depression in young athletes. Our data implies the need for sports medical as well as sports psychiatric support for young athletes. In addition, our results demonstrated that the chronological classification concerning age did not influence HAD Scale outcomes. Future research should focus on sports medical and sports psychiatric interventional approaches with the goal to prevent anxiety and depression as well as teaching coping strategies to young athletes.
Aims Anterior lumbar interbody fusion procedures (ALIF) and total disc replacement (TDR) with anterior exposure of the lumbar spine entail a risk of a vascular injury and dysfunction of the sympathetic and parasympathetic nerves due to disturbance of the inferior and superior hypogastric plexus. While retrograde ejaculation is a known complication of the anterior spinal approach in males, post-operative sexual as well as urinary function in females has not yet been thoroughly investigated and was hence the aim of this study. Methods Fifteen female patients documented their sexual and urinary function preoperatively, 3 months and 6 months postoperatively, using the validated questionnaires FSFI (Female Sexual Function Index) and ICIQ (International Consultation of Incontinence Questionnaire). Randomization tests were used to statistically analyze expectation values over time (two-sided, P < 0.05). Results While no statistically significant change in the total FSFI score occurred over time, a significant increase in FSFI desire score was noted between preoperative (2.95 +/- 0.8) and 6 months follow-up (3.51 +/- 0.6, P = 0.02). Urinary continence remained unchanged over time. Conclusion In summary, ALIF and lumbar TDR do not seem to negatively influence sexual and urinary function in females. In contrast, increased sexual desire was noted, likely secondary to post-surgical pain relief.