Loads and Movement Speeds Dictate Differences in Power Output During Circuit Training.

Power training has become a common exercise intervention for improving muscle strength, power, and physical function while reducing injury risk. Few studies, however, have evaluated acute load changes on power output during traditional resistance training protocols. Therefore, the aim of this study was to quantify the effects of different loading patterns on power output during a single session of circuit resistance training (CRT). Nine male (age = 19.4 ± 0.9 years) and 11 female participants (age = 20.6 ± 1.6 years) completed 3 CRT protocols during separate testing sessions using 7 pneumatic exercises. Protocols included heavy load explosive contraction (HLEC: 80% one repetition maximum [1RM], maximum speed concentric-2 seconds eccentric), heavy load controlled contraction (HLCC: 80% 1RM, 2 seconds concentric-2 seconds eccentric), and moderate load explosive contraction (MLEC: 50% 1RM, maximum speed concentric-2 seconds eccentric). Protocols were assigned randomly using a counterbalanced design. Power for each repetition and set were determined using computerized software interfaced with each machine. Blood lactate was measured at rest and immediately postexercise. For male and female participants, average power was significantly greater during all exercises for HLEC and MLEC than HLCC. Average power was greatest during the HLEC for leg press (LP), hip adduction (ADD), and hip abduction (ABD) (p ≤ 0.05), whereas male participants alone produced their greatest power during HLEC for leg curl (LC) (p < 0.001). For male and female participants, significantly greater power was detected by set for LP, lat pull-down (LAT), ADD, LC, and ABD for the MLEC protocol (p < 0.02) and for LP, LAT, CP, and LC for the HLEC protocol (p < 0.03). A condition × sex interaction was seen for blood lactate changes ((Equation is included in full-text article.)= 0.249; p = 0.024), with female participants producing a significantly greater change for MLEC than HLEC (Mdiff = 1.61 ± 0.35 mmol·L; p = 0.011), whereas male participants showed no significant differences among conditions. Performing a CRT protocol using explosive training patterns, especially at high loads for lower-body exercises and moderate loads for upper-body exercises, produces significantly higher power than controlled speed training in most exercises. These results provide exercisers, personal trainers, and strength coaches with information that can assist in the design of training protocols to maximize power output during CRT.

Hemodynamic profiles by non-invasive monitoring of cardiac index and vascular tone in acute heart failure patients in the emergency department: External validation and clinical outcomes.

BACKGROUND: Non-invasive finger-cuff monitors measuring cardiac index and vascular tone (SVRI) classify emergency department (ED) patients with acute heart failure (AHF) into three otherwise-indistinguishable subgroups. Our goals were to validate these "hemodynamic profiles" in an external cohort and assess their association with clinical outcomes. METHODS: AHF patients (n = 257) from five EDs were prospectively enrolled in the validation cohort (VC). Cardiac index and SVRI were measured with a ClearSight finger-cuff monitor (formerly NexFin, Edwards Lifesciences) as in a previous study (derivation cohort, DC, n = 127). A control cohort (CC, n = 127) of ED patients with sepsis was drawn from the same study as the DC. K-means cluster analysis previously derived two-dimensional (cardiac index and SVRI) hemodynamic profiles in the DC and CC (k = 3 profiles each). The VC was subgrouped de novo into three analogous profiles by unsupervised K-means consensus clustering. PERMANOVA tested whether VC profiles 1-3 differed from profiles 1-3 in the DC and CC, by multivariate group composition of cardiac index and vascular tone. Profiles in the VC were compared by a primary outcome of 90-day mortality and a 30-day ranked composite secondary outcome (death, mechanical cardiac support, intubation, new/emergent dialysis, coronary intervention/surgery) as time-to-event (survival analysis) and binary events (odds ratio, OR). Descriptive statistics were used to compare profiles by two validated risk scores for the primary outcome, and one validated score for the secondary outcome. RESULTS: The VC had median age 60 years (interquartile range {49-67}), and was 45% (n = 116) female. Multivariate profile composition by cardiac index and vascular tone differed significantly between VC profiles 1-3 and CC profiles 1-3 (p = 0.001, R2 = 0.159). A difference was not detected between profiles in the VC vs. the DC (p = 0.59, R2 = 0.016). VC profile 3 had worse 90-day survival than profiles 1 or 2 (HR = 4.8, 95%CI 1.4-17.1). The ranked secondary outcome was more likely in profile 1 (OR = 10.0, 1.2-81.2) and profile 3 (12.8, 1.7-97.9) compared to profile 2. Diabetes prevalence and blood urea nitrogen were lower in the high-risk profile 3 (p<0.05). No significant differences between profiles were observed for other clinical variables or the 3 clinical risk scores. CONCLUSIONS: Hemodynamic profiles in ED patients with AHF, by non-invasive finger-cuff monitoring of cardiac index and vascular tone, were replicated de novo in an external cohort. Profiles showed significantly different risks of clinically-important adverse patient outcomes.

Light pollution spatial impact assessment in Hong Kong: Measurement and numerical modelling on commercial lights at street level.

With rapid urbanization, the use of external lighting to illuminate cities for night-time activity is on the rise worldwide. Many studies have suggested the excessive use of external lighting causes light pollution, which harms human health and leads to energy wastage. Although more awareness has been raised, there are not many regulations and guidelines available. As one of the cities most affected by light pollution in the world, Hong Kong has started exploring this issue within the general and business communities. However, studies that quantitatively evaluate the problem of light pollution in this city are lacking. This study aimed to assess light pollution quantitatively through measurement and numerical modelling. To achieve this, measurement protocols were developed, and site measurements were carried out in one of the known problem areas, Sai Yeung Choi Street in Mong Kok district. Through this exercise, both vertical and horizontal illuminances on the street level and the light distribution along the street were determined. An average level of 250 lx for the vertical illuminance was found, which was 3-4 times higher than the recommended brightness for normal activity. The light environment of the measured area was also modelled with the simulation program DIALux. This effort complemented the measurements by providing a means to increase the resolution on the light variation and to visualize light pollution in a 3D environment. The simulation results were verified by correlating the numerical model with measurements. The correlated model was exercised in a subsequent sensitivity study to predict possible outcomes with changing lighting pattern and lighting lumen level. This study serves to quantify this issue, which helps with the further development of effective solutions.

Assessment of mammographic breast density after sleeve gastrectomy.

BACKGROUND: Mammographic breast density (BD) is an independent risk factor for breast cancer. The effects of bariatric surgery on BD are unknown. OBJECTIVES: To investigate BD changes after sleeve gastrectomy (SG). SETTING: University hospital, United States. METHODS: Fifty women with mammograms before and after SG performed from 2009 to 2015 were identified after excluding patients with a history of breast cancer, hormone replacement, and/or breast surgery. Patient age, menopausal status, co-morbidities, hemoglobin A1C, and body mass index were collected. Craniocaudal mammographic views before and after SG were interpreted by a blinded radiologist and analyzed by software to obtain breast imaging reporting and data system density categories, breast area, BD, and absolute dense breast area (ADA). Analyses were performed using χ2, McNemar's test, t test, and linear regressions. RESULTS: Radiologist interpretation revealed a significant increase in breast imaging reporting and data system B+C category (68% versus 54%; P = .0095) and BD (9.8 ± 7.4% versus 8.3 ± 6.4%; P = .0006) after SG. Software analyses showed a postoperative decrease in breast area (75,398.9 ± 22,941.2 versus 90,655.9 ± 25,621.0 pixels; P < .0001) and ADA (7287.1 ± 3951.3 versus 8204.6 ± 4769.9 pixels; P = .0314) with no significant change in BD. Reduction in ADA was accentuated in postmenopausal patients. Declining breast area was directly correlated with body mass index reduction (R2 = .4495; P < 0.0001). Changes in breast rather than whole body adiposity better explained ADA reduction. Neither diabetes status nor changes in hemoglobin A1C correlated with changes in ADA. CONCLUSIONS: ADA decreases after SG, particularly in postmenopausal patients. Software-generated ADA may be more accurate than radiologist-estimated BD or breast imaging reporting and data system for capturing changes in dense breast tissue after SG.

Loads and movement speed affect energy expenditure during circuit resistance exercise.

Circuit resistance training (CT) constitutes a high-intensity interval program commonly used to target weight loss; however, the loads and exercise patterns that maximize energy expenditure (EE) remain undetermined. We examined differences in EE among CT protocols using varying loads and contraction speeds in recreationally trained males and females. Seven males (age, 21.1 ± 0.5 years) and 8 females (age, 20.0 ± 0.9 years) performed 3 randomized CT protocols incorporating 3 circuits using heavy-load (80% 1-repetition maximum (1RM)) explosive (HLEC), heavy-load, controlled (2 s) (HLCC), and moderate-load (50% 1RM) explosive contractions (MLEC). Expired air was collected continuously before, during, and after exercise. Blood lactate was collected at rest, immediately postexercise, and 5 min postexercise. No significant differences were detected for resting EE; however, there was a significant difference among conditions during exercise (p = 0.034, ηp2 = 0.229). Post hoc analysis revealed that MLEC produced significantly higher EE than HLCC, but not HLEC (p = 0.023). There was a significant difference among conditions for rate of EE during exercise (p = 0.003, ηp2 = 0.361). Post hoc analysis revealed that HLEC produced a significantly higher EE rate than HLCC (p = 0.012) or MLEC (p = 0.001). A condition × sex interaction was seen for blood lactate changes (ηp2 = 0.249; p = 0.024). Females produced significantly greater change for MLEC than HLEC (p = 0.011), while males showed no significant differences. Our results favor CT using MLEC for a higher EE during a full workout; however, the rate of EE was highest when using HLEC.