Effect of Vitamin D Supplementation on Muscle Status in Old Patients Recovering from COVID-19 Infection.

Background and Objectives: Vitamin D, in addition to its effect on mineral homeostasis, plays a key role in muscle metabolism. Vitamin D supplementation is involved in muscle recovery after damage as a consequence of either pathology or after high-intensity exercise. In this context, the aim of this study was to analyze the effect of vitamin D on muscle fitness in elderly patients in the recovery phase after SARS-CoV-2 (COVID-19) infection. Materials and Methods: This pilot study was conducted at the Soria Norte Health Center. The study consisted of a double-blind trial with two groups of men (placebo and vitamin D-supplemented) (n = 15/group). Treatment with vitamin D (cholecalciferol: 2000 IU/day) and placebo was carried out for 6 weeks. Circulating hematological and biochemical parameters (total protein, glucose, vitamin D, urea, uric acid, aspartate aminotransferase/glutamic-oxaloacetic transaminase, alanine aminotransferase/glutamic-pyruvic transaminase, creatine kinase, lactate dehydrogenase, aldolase, gamma-glutamyl transferase and myoglobin) and the hormones cortisol and testosterone were determined. As for respiratory function tests, FEV1 and respiratory flow were also studied. For physical fitness tests, the "six-minute walk test" (6MWT) was used. Results: After vitamin D supplementation, we observed that serum creatine kinase levels returned to optimal values. This change suggests a protective role of vitamin D against muscle catabolism compared to placebo. In terms of physical test results, we observed only slight non-significant improvements, although patients reported feeling better. Conclusions: Vitamin D supplementation produces decreases in indicators of muscle damage, which may ultimately contribute to improving the health status and quality of life of patients who have suffered from COVID-19, during the recovery process.

Cold Water Immersion as a Strategy for Muscle Recovery in Professional Basketball Players During the Competitive Season.

CONTEXT: Despite prior studies that have addressed the recovery effects of cold-water immersion (CWI) in different sports, there is a lack of knowledge about longitudinal studies across a full season of competition assessing these effects. OBJECTIVE: To analyze the CWI effects, as a muscle recovery strategy, in professional basketball players throughout a competitive season. DESIGN: A prospective cohort design. SETTING: Elite basketball teams. PARTICIPANTS: A total of 28 professional male basketball players divided into 2 groups: CWI (n = 12) and control (n = 16) groups. MAIN OUTCOME MEASURES: Muscle metabolism serum markers were measured during the season in September-T1, November-T2, March-T3, and April-T4. Isokinetic peak torque strength and ratings of perceived exertion were measured at the beginning and at the end of the season. CWI was applied immediately after every match and after every training session before matches. RESULTS: All serum muscular markers, except myoglobin, were higher in the CWI group than the control group (P < .05). The time course of changes in muscle markers over the season also differed between the groups (P < .05). In the CWI group, ratings of perceived exertion decreased significantly from the beginning (T1-T2) to the end (T3-T4). Isokinetic torque differed between groups at the end of the season (60°/s peak torque: P < .001 and ηp2=.884; and 180°/s peak torque: P < .001 and ηp2=.898) and had changed significantly over the season in the CWI group (P < .05). CONCLUSIONS: CWI may improve recovery from muscle damage in professional basketball players during a regular season.

Higher Inpatient Mortality for Women after Intervention for Lifestyle Limiting Claudication.

BACKGROUND: Sex-related differences in outcomes have been identified in patients with peripheral artery disease (PAD). We hypothesized that women with PAD would have equivalent inpatient mortality with men after vascular intervention. METHODS: Patients with a primary diagnosis of critical limb ischemia (CLI) or lifestyle-limiting claudication (LLC) receiving endovascular (EV) or open surgical repair from 2003-2012 were identified from the Nationwide Inpatient Sample. Demographics, comorbidities, and inpatient mortality were analyzed by chi-squared tests of independence and independent-samples t-tests. Logistic regression analysis was performed to identify predictors of inpatient mortality. SPSS 24 software was used with P < 0.05 considered statistically significant. RESULTS: We identified 139,435 (59,432 women and 80,003 men) individuals meeting the aforementioned criteria. Women were older than men (71.5 years vs. 68.2, P < 0.001). There were no differences in racial distribution but women had lower rates of diabetes (38.6% vs. 39.7%, P < 0.001), chronic obstructive pulmonary disease (17.9% vs. 19.5%, P < 0.001), and coronary artery disease (38.6% vs. 47.4%, P < 0.001), while having a higher rate of hypertension (60.0% vs. 56.1%, P < 0.001). There was no sex-related difference in the rate of chronic renal failure. Women had higher inpatient mortality than men after vascular intervention (1.3% vs. 1.1%, P < 0.001). When stratified by surgical technique, women also had higher inpatient mortality after EV repair (1.0% vs. 0.8%, P < 0.05) and open repair (1.9% vs 1.3%, P < 0.001). When separated by admitting diagnosis, women with CLI had higher inpatient mortality than men after open surgery (2.3% vs. 1.9%, P < 0.05) but not after EV intervention. Women with LLC had higher inpatient mortality after both open (0.6% vs. 0.3%, P < 0.05) and EV surgery (0.3% vs. 0.1%, P < 0.05). Regression analysis revealed female sex as an independent predictor of inpatient mortality in patients with LLC (OR, 1.74; 95% CI 1.30-2.32, P < 0.001) but not CLI. CONCLUSIONS: Women had higher inpatient mortality than men after vascular intervention for PAD. Women were also older and more likely to have EV intervention than men. Subgroup analysis suggests that these sex-related differences in inpatient mortality are more pronounced in patients with LLC than with CLI. Furthermore, regression analysis shows that sex is a significant predictor for patients diagnosed with LLC but not with CLI. Treatment guidelines should include consideration of sex in their indications for revascularization, particularly for patients diagnosed with LLC.

Adherence to treatment and related factors among patients with chronic conditions in primary care: a cross-sectional study.

BACKGROUND: Adherence to treatment, a public health issue, is of particular importance in chronic disease therapies. Primary care practices offer ideal venues for the effective care and management of these conditions. The aim of this study is to assess adherence to treatment and related-factors among patients with chronic conditions in primary care settings. METHODS: A cross-sectional study was conducted among 299 adult patients with ≥1 chronic condition(s) and prescribed medication in primary healthcare centers of Spain. The Morisky-Green-Levine questionnaire was used to assess medication adherence via face-to-face interviews. Crude and adjusted multivariable logistic regression models were used to analyze factors associated with adherence using the Multidimensional Model proposed by the World Health Organization - social and economic, healthcare team and system-related, condition-related, therapy-related, and patient-related factors. RESULTS: The proportion of adherent patients to treatment was 55.5%. Older age (adjusted odds ratio 1.31 per 10-year increment, 95% CI 1.01-1.70), lower number of pharmacies used for medication refills (0.65, 95% CI 0.47-0.90), having received complete treatment information (3.89, 95% CI 2.09-7.21), having adequate knowledge about medication regimen (4.17, 95% CI 2.23-7.80), and self-perception of a good quality of life (2.17, 95% CI 1.18-4.02) were independent factors associated with adherence. CONCLUSIONS: Adherence to treatment for chronic conditions remained low in primary care. Optimal achievement of appropriate levels of adherence through tailored multifaceted interventions will require attention to the multidimensional factors found in this study, particularly those related to patients' education and their information needs.

Limitations of Spectral Electromyogramic Analysis to Determine the Onset of Neuromuscular Fatigue Threshold during Incremental Ergometer Cycling.

Recently, a new method has been proposed to detect the onset of neuromuscular fatigue during an incremental cycling test by assessing the changes in spectral electromyographic (sEMG) frequencies within individual exercise periods of the test. The method consists on determining the highest power output that can be sustained without a significant decrease in spectral frequencies. This study evaluated the validity of the new approach by assessing the changes in spectral indicators both throughout the whole test and within individual exercise periods of the test. Fourteen cyclists performed incremental cycle ergometer rides to exhaustion with bipolar surface EMG signals recorded from the vastus lateralis. The mean and median frequencies (Fmean and Fmedian, respectively) of the sEMG power spectrum were calculated. The main findings were: (1) Examination of spectral indicators within individual exercise periods of the test showed that neither Fmean nor Fmedian decreased significantly during the last (most fatiguing) exercise periods. (2) Examination of the whole incremental test showed that the behaviour of Fmean and Fmedian with increasing power output was highly inconsistent and varied greatly among subjects. (3) Over the whole incremental test, half of the participants exhibited a positive relation between spectral indicators and workload, whereas the other half demonstrated the opposite behavior. Collectively, these findings indicate that spectral sEMG indexes do not provide a reliable measure of the fatigue state of the muscle during an incremental cycling test. Moreover, it is concluded that it is not possible to determine the onset of neuromuscular fatigue during an incremental cycling test by examining spectral indicators within individual exercise periods of the test. Key pointsThe behaviour of spectral EMG indicators during the incremental test exhibited a high heterogeneity among individuals, with approximately half of the participants showing a positive relation between spectral indicators and workload and the other half showing the opposite behaviour.None of the spectral EMG indicators examined (Fmean nor Fmedian) decreased significantly between the ventilatory threshold and the highest power output.Examination of spectral indicators within individual exercise periods of the test showed that neither Fmean nor Fmedian decreased significantly during the last (most fatiguing) exercise periods.

Oxidative stress markers after a race in professional cyclists.

The aim was to determine the levels and activities of the oxidative stress markers in erythrocytes, plasma, and urine after a flat cyclist stage. Eight voluntary male professional trained-cyclists participated in the study. Exercise significantly increased erythrocyte, leukocyte, platelet, and reticulocyte counts. The exercise induced significant increases in the erythrocyte activities of catalase (19.8%) and glutathione reductase (19.2%), while glutathione peroxidase activity decreased significantly (29.3%). Erythrocyte GSSG concentration was significantly increased after exercise (21.4%), whereas GSH was significantly diminished (20.4%). Erythrocyte malondialdehyde levels evidenced a significant decrease 3 h after finishing the stage (44.3%). Plasma malondialdehyde, GSH and GSSG levels significantly decreased after 3 hr recovery (26.8%, 48.6%, and 31.1%, respectively). The exercise significantly increased the F2-isoprostane concentration in urine from 359 ± 71 pg/mg creatinine to 686 ± 139 pg/mg creatinine. In conclusion, a flat cycling stage induced changes in oxidative stress markers in erythrocytes, plasma, and urine of professional cyclists. Urine F2-isoprostane is a more useful biomarker for assessing the effects of acute exercise than the traditional malondialdehyde measurement.

Scuba diving induces nitric oxide synthesis and the expression of inflammatory and regulatory genes of the immune response in neutrophils.

OBJECTIVE: Scuba diving, characterized by hyperoxia and hyperbaria, could increase reactive oxygen species production which acts as signaling molecules to induce adaptation against oxidative stress. The aim was to study the effects of scuba diving immersion on neutrophil inflammatory response, the induction of oxidative damage, and the NO synthesis. DESIGN: Nine male divers performed a dive at 50 m depth for a total time of 35 min. Blood samples were obtained at rest before the dive, after the dive, and 3 h after the diving session. MEASUREMENTS: Markers of oxidative and nitrosative damage, nitrite, and the gene expression of genes related with the synthesis of nitric oxide and lipid mediators, cytokine synthesis, and inflammation were determined in neutrophils. RESULTS: The mRNA levels of genes related with the inflammatory and immune response of neutrophils, except TNF-α, myeloperoxidase, and toll-like receptor (TLR) 2, significantly increased after the recovery period respect to predive and postdive levels. NF-κB, IL-6, and TLR4 gene expression reported significant differences immediately after diving respect to the predive values. Protein nitrotyrosine levels significantly rose after diving and remained high during recovery, whereas no significant differences were reported in malondialdehyde. Neutrophil nitrite levels as indicative of inducible nitric oxide synthase (iNOS) activity progressively increased after diving and recovery. The iNOS protein levels maintained the basal values in all situations. CONCLUSION: Scuba diving which combines hyperoxia, hyperbaria, and acute exercise induces nitrosative damage with increased nitrotyrosine levels and an inflammatory response in neutrophils.

Physiological Responses during Cycling With Oval Chainrings (Q-Ring) and Circular Chainrings.

The aim of this study was to compare the physiological responses of cyclists using round (C-ring) or oval (Q-ring) chainrings during an incremental test until exhaustion. Following a randomized design, twelve male elite cyclists [age (mean ± SD): 21.1 ± 2.1 yr; VO2max: 78.1 ± 5.3 mL·kg(-1)min(-1)] performed two incremental maximal tests separated by 48 h (one with C-rings, the other with Q-rings). Starting at 100 W, the workload was increased by 25 W every 3 min until volitional exhaustion. Maximal heart rate, power output and oxygen consumption were compared. Blood lactate was monitored throughout the test. After the incremental test, 4 intermittent 20-s maximal sprints with a 60-s recovery period in between were performed. Maximal isometric voluntary contractions were performed at rest and immediately after each 20-s maximal sprint, and the force and EMG RMS amplitude were recorded from the vastus medialis and vastus lateralis muscles. For the incremental exercise test, no significant differences were found in the maximal power output (P=0.12), oxygen consumption (P=0.39), and heart rate (P=0.32) between Q-rings and C-rings. Throughout the incremental test, lactate levels were comparable when using both the C-rings and Q-rings (P=0.47). During the short sprints, power output was 2.5-6.5% greater for Q-rings than for C-rings (P=0.22). The decline in EMG RMS amplitude observed during the incremental tests was comparable for Q-rings and C-rings (0.42). These findings indicate that the oval chainring design, presented here as "Q-rings", did not significantly influence the physiological response to an incremental exercise test as compared to a conventional chainring. Key pointsDuring the incremental exercise test, no significant differences were found in power output, oxygen consumption or heart rate between oval "Q-rings" and conventional chainrings.Over the course of the incremental test, blood lactate levels were comparable for the oval "Q-rings" and conventional chainrings.During the short sprints performed after the incremental test, there were no statistical differences in power production between oval "Q-rings" and conventional chainrings.

Maximizing wound coverage in full-thickness skin defects: A randomized-controlled trial of autologous skin cell suspension and widely meshed autograft versus standard autografting.

BACKGROUND: Traumatic insults, infection, and surgical procedures can leave skin defects that are not amenable to primary closure. Split-thickness skin grafting (STSG) is frequently used to achieve closure of these wounds. Although effective, STSG can be associated with donor site morbidity, compounding the burden of illness in patients undergoing soft tissue reconstruction procedures. With an expansion ratio of 1:80, autologous skin cell suspension (ASCS) has been demonstrated to significantly decrease donor skin requirements compared with traditional STSG in burn injuries. We hypothesized that the clinical performance of ASCS would be similar for soft tissue reconstruction of nonburn wounds. METHODS: A multicenter, within-patient, evaluator-blinded, randomized-controlled trial was conducted of 65 patients with acute, nonthermal, full-thickness skin defects requiring autografting. For each patient, two treatment areas were randomly assigned to concurrently receive a predefined standard-of-care meshed STSG (control) or ASCS + more widely meshed STSG (ASCS+STSG). Coprimary endpoints were noninferiority of ASCS+STSG for complete treatment area closure by Week 8, and superiority for relative reduction in donor skin area. RESULTS: At 8 weeks, complete closure was observed for 58% of control areas compared with 65% of ASCS+STSG areas (p = 0.005), establishing noninferiority of ASCS+STSG. On average, 27.4% less donor skin was required with ASCS+ STSG, establishing superiority over control (p < 0.001). Clinical healing (≥95% reepithelialization) was achieved in 87% and 85% of Control and ASCS+STSG areas, respectively, at 8 weeks. The treatment approaches had similar long-term scarring outcomes and safety profiles, with no unanticipated events and no serious ASCS device-related events. CONCLUSION: ASCS+STSG represents a clinically effective and safe solution to reduce the amount of skin required to achieve definitive closure of full-thickness defects without compromising healing, scarring, or safety outcomes. This can lead to reduced donor site morbidity and potentially decreased cost associated with patient care.Clincaltrials.gov identifier: NCT04091672. LEVEL OF EVIDENCE: Therapeutic/Care Management; Level I.

Energy consumption, body composition and physical activity levels in 11- to 13-year-old Spanish children.

BACKGROUND/AIMS: The prevalence of overweight and obesity in childhood is increasing markedly. The aim of this study was to evaluate the relationship between physical activity, energy consumption and weight status in a cohort of Spanish children. METHODS: A total of 137 children (11-13 years old) participated in the study voluntarily (with paternal consent). Children were classified into 3 groups according to their physical activity, i.e. sedentary, active and sporty groups. Body composition measures, physical fitness and total caloric and macronutrient intake were determined. RESULTS: Weight, body mass index, waist circumference, skinfold thickness measures and body fat percentage of children were lower in the active children, whereas body water content increased with activity. Nutritional habits were similar in the 3 studied groups. No significant differences in total energy intake or percentage of carbohydrates, fat and proteins were found. All parameters related to caloric expenditure were higher in children carrying out more physical activity. CONCLUSIONS: Children with higher levels of physical activity presented more favorable anthropometric profiles, but there were no differences in respect to their dietary habits. An increase in weekly energy expenditure through physical activity outside school seems essential to prevent overweight and the risk of childhood obesity.

Influence of Stress and Emotions in the Learning Process: The Example of COVID-19 on University Students: A Narrative Review.

Emotional instability and stress are the main disturbances that condition the learning process, affecting both teachers and students. The main objective of this review is to analyze the influence of stress and emotions (as part of stress) on the learning environment. Stress is a physiological mechanism that the organism develops to adapt and survive external and internal challenges. In this context, stress tends to be seen as a negative condition in the learning process when it is chronic. Extreme stress situations, such as the COVID-19 pandemic, can generate anxiety and frustration in students. However, other studies indicate that controlled stress can positively enhance the learning process. On the other hand, the quality and intensity of emotions resulting from stress can influence as well the learning process. Positive emotions are healthy and can promote optimal learning. Emotions lead to sentimental, cognitive, behavioral, and physiological changes, which will have a strong influence on intellectual performance. The activation of coping strategies constitutes a key mechanism for dealing positively with problems and challenges, generating positive emotions essential for the self-regulation of learning. In conclusion, correct management of emotions in stressful situations could promote effective learning through enhanced attention and capacity to solve problems.

Is Curcumine Useful in the Treatment and Prevention of the Tendinopathy and Myotendinous Junction Injury? A Scoping Review.

Physical activity in general and sports in particular, is a mechanism that produces stress and generates great force in the tendon and in the muscle-tendon unit, which increases the risk of injury (tendinopathies). Eccentric and repetitive contraction of the muscle precipitates persistent microtraumatism in the tendon unit. In the development of tendinopathies, the cellular process includes inflammation, apoptosis, vascular, and neuronal changes. Currently, treatments with oral supplements are frequently used. Curcumin seems to preserve, and even repair, damaged tendons. In this systematic review, we focus more especially on the benefits of curcumin. The biological actions of curcumin are diverse, but act around three systems: (a) inflammatory, (b) nuclear factor B (NF-κB) related apoptosis pathways, and (c) oxidative stress systems. A bibliographic search is conducted under the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) as a basis for reporting reliable systematic reviews to perform a Scoping review. After analysing the manuscripts, we can conclude that curcumin is a product that demonstrates a significant biological antialgic, anti-inflammatory, and antioxidant power. Therefore, supplementation has a positive effect on the inflammatory and regenerative response in tendinopathies. In addition, curcumin decreases and modulates the cell infiltration, activation, and maturation of leukocytes, as well as the production of pro-inflammatory mediators at the site of inflammation.

Inflammatory Process on Knee Osteoarthritis in Cyclists.

Osteoarthritis is a disorder affecting the joints and is characterized by cellular stress and degradation of the extracellular matrix cartilage. It begins with the presence of micro- and macro-lesions that fail to repair properly, which can be initiated by multiple factors: genetic, developmental, metabolic, and traumatic. In the case of the knee, osteoarthritis affects the tissues of the diarthrodial joint, manifested by morphological, biochemical, and biomechanical modifications of the cells and the extracellular matrix. All this leads to remodeling, fissuring, ulceration, and loss of articular cartilage, as well as sclerosis of the subchondral bone with the production of osteophytes and subchondral cysts. The symptomatology appears at different time points and is accompanied by pain, deformation, disability, and varying degrees of local inflammation. Repetitive concentric movements, such as while cycling, can produce the microtrauma that leads to osteoarthritis. Aggravation of the gradual lesion in the cartilage matrix can evolve to an irreversible injury. The objective of the present review is to explain the evolution of knee osteoarthritis in cyclists, to show the scarce research performed in this particular field and extract recommendations to propose future therapeutic strategies.

Effects of L-Carnitine Intake on Exercise-Induced Muscle Damage and Oxidative Stress: A Narrative Scoping Review.

Exercise-induced muscle damage results in decreased physical performance that is accompanied by an inflammatory response in muscle tissue. The inflammation process occurs with the infiltration of phagocytes (neutrophils and macrophages) that play a key role in the repair and regeneration of muscle tissue. In this context, high intensity or long-lasting exercise results in the breakdown of cell structures. The removal of cellular debris is performed by infiltrated phagocytes, but with the release of free radicals as collateral products. L-carnitine is a key metabolite in cellular energy metabolism, but at the same time, it exerts antioxidant actions in the neuromuscular system. L-carnitine eliminates reactive oxygen and nitrogen species that, in excess, alter DNA, lipids and proteins, disturbing cell function. Supplementation using L-carnitine results in an increase in serum L-carnitine levels that correlates positively with the decrease in cell alterations induced by oxidative stress situations, such as hypoxia. The present narrative scoping review focuses on the critical evaluation of the efficacy of L-carnitine supplementation on exercise-induced muscle damage, particularly in postexercise inflammatory and oxidative damage. Although both concepts appear associated, only in two studies were evaluated together. In addition, other studies explored the effect of L-carnitine in perception of fatigue and delayed onset of muscle soreness. In view of the studies analyzed and considering the role of L-carnitine in muscle bioenergetics and its antioxidant potential, this supplement could help in postexercise recovery. However, further studies are needed to conclusively clarify the mechanisms underlying these protective effects.

Clinical and Radiological Outcomes of Computer-Assisted versus Conventional Total Knee Arthroplasty at 5-Year Follow-Up: Is There Any Benefit?

Computer-assisted total knee arthroplasty (CAS) remains controversial. Some authors defend that its improvement in knee alignment and positioning positively impacts arthroplasty survival rates, while others have stated that there is minimal or no difference compared to the conventional technique (cTKA). This paper features a retrospective, single-center, single-surgeon study, evaluating CAS surgery vs. regular cTKA in patients who consecutively underwent surgery between 2015 and 2017 (60 CAS patients vs. 59 cTKA). Data collection includes surgery duration, length of stay, blood loss and both preoperative and postoperative clinical outcome evaluation using WOMAC, SF-12, Forgotten Joint Score and VAS. Radiograph evaluation includes the tibiofemoral angle, posterior condylar offset and its ratio, and notching frequency and measurement. A total of 119 patients were included: 60 in the CAS group and 59 in the cTKA. Mean follow-up was 5.61 years (Max 7.83-Min 5.02 years). No clinically relevant preoperative differences were observed between the groups. Postoperatively, both groups showed similar functional results (WOMAC, SF-12, FJS, KSS, and VAS) with similar complication rates. The CAS group had an increased surgery time by a mean of 12 min (107.02 ± 15.22 vs. 95.32 + 13.87; p = 0.00) as well as a higher notching frequency and size (40% vs. 13.60%; p = 0.013; 1.239 mm ± 1.7604 vs. 0.501 mm ± 1.4179; p = 0.031). CAS obtained similar functional, radiological, and complication rates to cTKA at the expense of increasing surgery time and notching frequency and size.

Reproduction of Sheep through Nuclear Transfer of Somatic Cells: A Bibliometric Approach.

Somatic cell nuclear transfer (SCNT) is a reproductive biotechnology with great potential in the reproduction of different species of zootechnical interest, including sheep. This study aimed to carry out a bibliometric analysis of scientific papers published on the application of SCNT in sheep reproduction during the period 1997-2023. The search involved the Science Citation Index Expanded and Social Sciences Citation Index databases of the main collection of the Web of Sciences with different descriptors. A total of 124 scientific papers were analyzed for different bibliometric indicators using the VOSviewer software. Since 2001, the number of SCNT-related papers that have been published concerning sheep reproduction has increased and it has fluctuated in ensuing years. The main authors, research groups, institutions, countries, papers, and journals with the highest number of papers related to the application of SCNT in sheep reproduction were identified, as well as the topics that address the research papers according to the terms: somatic cell, embryo, oocyte, gene expression, SCNT, and sheep.

Current use of the National Surgical Quality Improvement Program surgical risk calculator in academic surgery: a mixed-methods study.

Background: This study aims to quantitatively assess use of the NSQIP surgical risk calculator (NSRC) in contemporary surgical practice and to identify barriers to use and potential interventions that might increase use. Materials and methods: We performed a cross-sectional study of surgeons at seven institutions. The primary outcomes were self-reported application of the calculator in general clinical practice and specific clinical scenarios as well as reported barriers to use. Results: In our sample of 99 surgeons (49.7% response rate), 73.7% reported use of the NSRC in the past month. Approximately half (51.9%) of respondents reported infrequent NSRC use (<20% of preoperative discussions), while 14.3% used it in ≥40% of preoperative assessments. Reported use was higher in nonelective cases (30.2% vs 11.1%) and in patients who were ≥65 years old (37.1% vs 13.0%), functionally dependent (41.2% vs 6.6%), or with surrogate consent (39.9% vs 20.4%). NSRC use was not associated with training status or years in practice. Respondents identified a lack of influence on the decision to pursue surgery as well as concerns regarding the calculator's accuracy as barriers to use. Surgeons suggested improving integration to workflow and better education as strategies to increase NSRC use. Conclusions: Many surgeons reported use of the NSRC, but few used it frequently. Surgeons reported more frequent use in nonelective cases and frail patients, suggesting the calculator is of greater utility for high-risk patients. Surgeons raised concerns about perceived accuracy and suggested additional education as well as integration of the calculator into the electronic health record.

Association between sedentary behaviour and socioeconomic factors, diet and lifestyle among the Balearic Islands adolescents.

BACKGROUND: Many different factors influenced food habits and physical activity patterns of adolescents in a complex interactive way. The aim of this study was to assess association between sedentary behaviour and socioeconomic factors, diet and lifestyle among the Balearic Islands adolescents. METHODS: A cross-sectional survey (n = 1961; 12-17 years old) was carried out. Physical activity was assessed using the International Physical Activity Questionnaire for adolescents (IPAQ-A). Sedentary behaviour was defined as <300 min/week of moderate and vigorous physical activity. Anthropometric measurements, body image, socio-economic and lifestyle determinants, food consumption, and adherence to the Mediterranean diet were assessed. RESULTS: The prevalence of sedentary behaviour was 37.1% (22.0% boys, 50.8% girls). Active boys consumed frequently breakfast cereals and fresh fruit; active girls yogurt, cheese, breakfast cereals, and fresh fruit; and sedentary girls high fat foods and soft drinks. Sedentary behaviour of girls was directly associated to age, and time spent on media screen and homework, and inversely related to adherence to Mediterranean diet, and body composition. Sedentary behaviour of boys was inversely related to adherence to the Mediterranean diet, and the desire to remain the same weight. CONCLUSIONS: The prevalence of sedentary behaviour among Balearic Islands adolescents is high, mainly among girls. Age, sex, parental educational and profession levels, body size dissatisfaction, and poor quality diet are important factors of physical activity practice among adolescents.

Coenzyme Q10 Supplementation and Its Impact on Exercise and Sport Performance in Humans: A Recovery or a Performance-Enhancing Molecule?

Evidence exists to suggest that ROS induce muscular injury with a subsequent decrease in physical performance. Supplementation with certain antioxidants is important for physically active individuals to hasten recovery from fatigue and to prevent exercise damage. The use of nutritional supplements associated with exercise, with the aim of improving health, optimizing training or improving sports performance, is a scientific concern that not only drives many research projects but also generates great expectations in the field of their application in pathology. Since its discovery in the 1970s, coenzyme Q10 (CoQ10) has been one of the most controversial molecules. The interest in determining its true value as a bioenergetic supplement in muscle contraction, antioxidant or in the inflammatory process as a muscle protector in relation to exercise has been studied at different population levels of age, level of physical fitness or sporting aptitude, using different methodologies of effort and with the contribution of data corresponding to very diverse variables. Overall, in the papers reviewed, although the data are inconclusive, they suggest that CoQ10 supplementation may be an interesting molecule in health or disease in individuals without a pathological deficiency and when used for optimising exercise performance. Considering the results observed in the literature, and as a conclusion of this systematic review, we could say that it is an interesting molecule in sports performance. However, clear approaches should be considered when conducting future research.

Nitric-Oxide-Inducing Factors on Vitamin D Changes in Older People Susceptible to Suffer from Sarcopenia.

Calcium and magnesium, together with vitamin D and the hormones testosterone and cortisol, are key elements in muscle function, to maintain physical fitness. This study aims to analyze if supplementation with NO precursors (L-arginine, L-citrulline and beetroot extract) modulates the circulating levels of calcium, magnesium, vitamin D and steroid hormones in elders. Sixty-one volunteers (65.1 years old, 164.6 cm of height and 71.2 kg of weight) susceptible to develop sarcopenia participated in a physical activity program for 6 weeks. Participants were divided into four groups: one placebo and three taking one of the indicated supplements. Physical capacity was assessed through the following tests: (a) distance covered in 6 min by walking (endurance indicator); (b) hand grip (upper-body strength indicator); (c) time to cover 4 m by walking (speed indicator); and (d) time to perform five full squats (lower-body strength indicator). We concluded that there is a disparity in the association of steroid hormones, vitamin D levels and physical fitness. However, a significant inverse correlation between speed and endurance indicators was observed. Higher circulating vitamin D levels were observed in the L-arginine- and beetroot-supplemented groups. In conclusion, vasodilators increase vitamin D circulating levels that, in the long term, could maintain mineral homeostasis, improving muscular function.