Heavy Resistance Training Versus Plyometric Training for Improving Running Economy and Running Time Trial Performance: A Systematic Review and Meta-analysis.

BACKGROUND: As an adjunct to running training, heavy resistance and plyometric training have recently drawn attention as potential training modalities that improve running economy and running time trial performance. However, the comparative effectiveness is unknown. The present systematic review and meta-analysis aimed to determine if there are different effects of heavy resistance training versus plyometric training as an adjunct to running training on running economy and running time trial performance in long-distance runners. METHODS: Electronic databases of PubMed, Web of Science, and SPORTDiscus were searched. Twenty-two studies completely satisfied the selection criteria. Data on running economy and running time trial performance were extracted for the meta-analysis. Subgroup analyses were performed with selected potential moderators. RESULTS: The pooled effect size for running economy in heavy resistance training was greater (g = - 0.32 [95% confidence intervals [CIs] - 0.55 to - 0.10]: effect size = small) than that in plyometric training (g = -0.13 [95% CIs - 0.47 to 0.21]: trivial). The effect on running time trial performance was also larger in heavy resistance training (g = - 0.24 [95% CIs - 1.04 to - 0.55]: small) than that in plyometric training (g = - 0.17 [95% CIs - 0.27 to - 0.06]: trivial). Heavy resistance training with nearly maximal loads (≥ 90% of 1 repetition maximum [1RM], g = - 0.31 [95% CIs - 0.61 to - 0.02]: small) provided greater effects than those with lower loads (< 90% 1RM, g = - 0.17 [95% CIs - 1.05 to 0.70]: trivial). Greater effects were evident when training was performed for a longer period in both heavy resistance (10-14 weeks, g = - 0.45 [95% CIs - 0.83 to - 0.08]: small vs. 6-8 weeks, g = - 0.21 [95% CIs - 0.56 to 0.15]: small) and plyometric training (8-10 weeks, g = 0.26 [95% CIs - 0.67 to 0.15]: small vs. 4-6 weeks, g = - 0.06 [95% CIs 0.67 to 0.55]: trivial). CONCLUSIONS: Heavy resistance training, especially with nearly maximal loads, may be superior to plyometric training in improving running economy and running time trial performance. In addition, running economy appears to be improved better when training is performed for a longer period in both heavy resistance and plyometric training.

Diabetes Care Providers' Manual for Disaster Diabetes Care.

To ensure that experiences and lessons learned from the unprecedented 2011 Great East Japan Earthquake are used to improve future disaster planning, the Japan Diabetes Society (JDS) launched the "Research and Survey Committee for Establishing Disaster Diabetes Care Systems Based on Relevant Findings from the Great East Japan Earthquake" under the supervision of the Chairman of the JDS. The Committee conducted a questionnaire survey among patients with diabetes, physicians, disaster medical assistance teams (DMATs), nurses, pharmacists, and nutritionists in disaster areas about the events they saw happening, the situations they found difficult to handle, and the needs that they felt required to be met during the 2011 Great East Japan Earthquake. A total of 3,481 completed questionnaires were received. Based on these and other experiences and lessons reported following the 2011 Great East Japan Earthquake and the 2004 Niigata-Chuetsu Earthquakes, the current "Manual for Disaster Diabetes Care" has been developed by the members of the Committee and other invited authors from relevant specialties. To our knowledge, the current Manual is the world's first to focus on emergency diabetes care, with this digest English version translated from the Japanese original. It is sincerely hoped that patients with diabetes and healthcare providers around the world will find this manual helpful in promoting disaster preparedness and implementing disaster relief.

Difference in the prevalence of gestational diabetes mellitus according to gestational age at 75-g oral glucose tolerance test in Japan: The Japan Assessment of Gestational Diabetes Mellitus Screening trial.

AIMS/INTRODUCTION: To evaluate the differences in the results of 75-g oral glucose tolerance tests (OGTTs) according to gestational age in Japan. MATERIALS AND METHODS: In this prospective cohort study, 2,578 pregnant women were divided into three categories based on their gestational age during the 75-g OGTT: <14 weeks' gestation, 14-23 weeks' gestation and 24-32 weeks' gestation. The association between gestational age and the results of the 75-g OGTT were evaluated using multivariable analysis. RESULTS: Early gestational age was associated with high fasting plasma glucose levels at the time of the 75-g OGTT, and low corresponding 1-h and 2-h plasma glucose levels. Compared with women with a gestational age of 24-32 weeks, women who had undergone the 75-g OGTT at <14 weeks' gestation had significantly higher odds of gestational diabetes mellitus diagnosis based on the currently used criteria in Japan (adjusted odds ratio 1.42, 95% confidence interval 1.07-1.90). CONCLUSIONS: The results of the 75-g OGTT varied by gestational age. The use of the same 75-g OGTT cut-off values for the diagnosis of gestational diabetes mellitus, regardless of gestational age, might lead to increases in the prevalence of gestational diabetes mellitus diagnosis in Japan.

Assessment of laparoscopic training for gynecological malignancies using Thiel-embalmed human cadavers.

The introduction of laparoscopic surgery has also been beneficial for patients with gynecological malignancies. In this respect, surgeons should receive related training in the context of human resource development. Hands-on training was introduced using Thiel-embalmed human cadavers (THCs) in 2014. To determine the usefulness of THCs, they were evaluated in terms of tissue color, consistency and operative tactility, among others, compared with in vivo laparoscopic training for gynecological malignancies. Hands-on training sessions using THCs were held for a total of 11 times at Ehime University Graduate School of Medicine between March 2014 and October 2017. Training on THCs included advanced laparoscopic procedures for radical hysterectomy type III. At the end of each training session, data were collected using a standardized, anonymous questionnaire termed the Likert scale. THCs ensured flexibility and plasticity of tissues and organs; therefore, the working space was similar to that in the living body under pneumoperitoneum. After analyzing the quality and consistency of tissue and organ color compared with in vivo conditions, most of the participants agreed or strongly agreed regarding the uterus, adnexa and ureter, but not regarding the large blood vessels. The highest scores were observed in the authenticity of the anatomical condition of each organ. Most participants strongly agreed that training using THCs would help improve their laparoscopic skills with a high level of satisfaction. Furthermore, most participants reported that they would recommend this training to other obstetrician-gynecologists. Laparoscopic training for gynecological malignancies using THCs was comparable to the in vivo conditions in terms of surgical view and operative tactility. Therefore, THCs may be an excellent training tool for improving laparoscopic surgical skills for gynecological malignancies.

Magnetic resonance assessment of fetal lung maturity: comparison between signal intensity and volume measurement.

PURPOSE: We evaluated the associations between gestational age (GA) and lung-to-liver signal intensity ratio (LLSIR) and fetal lung volume (FLV) using magnetic resonance imaging (MRI). Moreover, we evaluated the reproducibility of these measurements. MATERIALS AND METHODS: LLSIR and FLV were measured using single-shot fast spin-echo MRI in 88 consecutive fetuses. The Spearman test was used to assess the relationships between (1) LLSIR and GA, and (2) FLV and GA in 81 fetuses without lung abnormalities. Intra- and inter-observer reliabilities were assessed using intra-class correlation coefficients (ICCs). RESULTS: Overall, GA and LLSIR were significantly correlated (r = 0.62, p < 0.001). However, GA and LLSIR were only significantly correlated during the third trimester (before third trimester: r = 0.39, p = 0.08; during third trimester: r = 0.46, p < 0.001). Overall, GA and FLV were significantly correlated (r = 0.72, p < 0.001). FLV was significantly correlated with GA before (r = 0.86, p < 0.001) and during the third trimester (r = 0.47, p < 0.001). All ICCs were above 0.90. CONCLUSIONS: LLSIR and FLV are useful for the assessment of fetal lung maturity and are highly reproducible. Before the third trimester, FLV is more suitable than LLSIR for the evaluation of fetal lung maturity.

Assessment of the cardioankle vascular index in pregnant women complicated with hypertensive disorders.

It was previously reported that the brachial-ankle pulse wave velocity (baPWV) is elevated in preeclamptic women. However, baPWV is strongly affected by blood pressure. Recently, a new index of vascular stiffness, the cardioankle vascular index (CAVI), was developed. CAVI is thought to be an index independent of blood pressure. We assessed CAVI in normotensive and hypertensive pregnant women. We studied a total of 109 Japanese women consisting of 23 nonpregnant healthy women (group A), 45 normotensive pregnant women (group B), 28 pregnant women complicated with established preeclampsia (group C), and 13 pregnant women with chronic hypertension (group D). The subject remained supine while the blood pressure, baPWV, and CAVI were recorded. No significant difference in baPWV was present between groups C and D, but the difference in CAVI was significantly high in group D. We believe that we can distinguish the vessel structural change between chronic hypertension and preeclampsia through simultaneous baPWV and CAVI measurements.