Application of artificial intelligence to eyewitness identification.

Artificial intelligence is already all around us, and its usage will only increase. Knowing its capabilities is critical. A facial recognition system (FRS) is a tool for law enforcement during suspect searches and when presenting photos to eyewitnesses for identification. However, there are no comparisons between eyewitness and FRS accuracy using video, so it is unknown whether FRS face matches are more accurate than eyewitness memory when identifying a perpetrator. Ours is the first application of artificial intelligence to an eyewitness experience, using a comparative psychology approach. As a first step to test system accuracy relative to eyewitness accuracy, participants and an open-source FRS (FaceNet) attempted perpetrator identification/match from lineup photos (target-present, target-absent) after exposure to real crime videos with varied clarity and perpetrator race. FRS used video probe images of each perpetrator to achieve similarity ratings for each corresponding lineup member. Using receiver operating characteristic analysis to measure discriminability, FRS performance was superior to eyewitness performance, regardless of video clarity or perpetrator race. Video clarity impacted participant performance, with the unclear videos yielding lower performance than the clear videos. Using confidence-accuracy characteristic analysis to measure reliability (i.e., the likelihood the identified suspect is the actual perpetrator), when the FRS identified faces with the highest similarity values, they were accurate. The results suggest FaceNet, or similarly performing systems, may supplement eyewitness memory for suspect searches and subsequent lineup construction and knowing the system's strengths and weaknesses is critical.

Chlorella Supplementation Reduces Blood Lactate Concentration and Increases O2 Pulse during Submaximal and Maximal Cycling in Young Healthy Adults.

Chlorella supplementation is reported to improve V˙O2max following extended supplementation periods (~3 weeks). However, there is little research on its impact over submaximal exercise intensities and following shorter supplementation regimens. This study aimed to investigate the efficacy of 6 g/day 2-day chlorella supplementation on exercise performance in healthy young adults. Twenty young healthy adults (Males = 16, Females = 4) (Age 22 ± 6 years, V˙O2max 42.7 ± 9.6 mL/(kg·min)) were recruited for this double-blinded, randomised cross-over study. Participants ingested 6 g/day of chlorella or a placebo for 2 days, with a one-week washout period between trials. Exercise testing consisted of a 20 min submaximal cycle at 40% of their work rate max (WRmax) (watts), followed by an incremental V˙O2max test. Lactate (mmol/L), heart rate (b/min), oxygen consumption (mL/(kg·min)), O2 pulse (mL/beat), respiratory exchange ratio (RER), and WRmax were compared across conditions. Following chlorella supplementation, blood lactate levels were significantly lower (p < 0.05) during submaximal exercise (3.05 ± 0.92 mmol/L vs. 2.67 ± 0.79 mmol/L) and following V˙O2max tests (12.79 ± 2.61 mmol/L vs. 11.56 ± 3.43 mmol/L). The O2 pulse was significantly higher (p < 0.05) following chlorella supplementation during submaximal (12.6 ± 3.5 mL/beat vs. 13.1 ± 3.5 mL/beat) and maximal exercise intensity (16.7 ± 4.6 mL/beat vs. 17.2 ± 4.5 mL/beat). No differences existed between conditions for oxygen consumption, RER, V˙O2max, or WRmax. A total of 2 days of 6 g/day chlorella supplementation appears to lower the blood lactate response and increase O2 pulse during both submaximal and maximal intensity exercise but did not lead to any improvements in V˙O2max.

Effect of Acute Sodium Bicarbonate and Caffeine Coingestion on Repeated-Sprint Performance in Recreationally Trained Individuals: A Randomized Controlled Trial.

INTRODUCTION: The acute and isolated ingestion of sodium bicarbonate (NaHCO3) and caffeine (CAF) improves performance and delays fatigue in high-intensity tasks. However, it remains to be elucidated if the coingestion of both dietary supplements stimulates a summative ergogenic effect. This study aimed to examine the effect of the acute coingestion of NaHCO3 and CAF on repeated-sprint performance. METHODS: Twenty-five trained participants (age: 23.3 [4.0] y; sex [female/male]: 12/13; body mass: 69.6 [12.5] kg) participated in a randomized, double-blind, placebo (PLA) -controlled, crossover study. Participants were assigned to 4 conditions: (1) NaHCO3 + CAF, (2) NaHCO3, (3) CAF, or (4) PLA. Thus, they ingested 0.3 g/kg of NaHCO3, 3 mg/kg of CAF, or PLA. Then, participants performed 4 Wingate tests (Wt), consisting of a 30-second all-out sprint against an individualized resisted load, interspersed by a 1.5-minute rest period between sprints. RESULTS: Peak (Wpeak) and mean (Wmean) power output revealed a supplement and sprint interaction effect (P = .009 and P = .049, respectively). Compared with PLA, NaHCO3 + CAF and NaHCO3 increased Wpeak performance in Wt 3 (3%, P = .021) and Wt 4 (4.5%, P = .047), while NaHCO3 supplementation increased mean power performance in Wt 3 (4.2%, P = .001). In Wt 1, CAF increased Wpeak (3.2%, P = .054) and reduced time to Wpeak (-8.5%; P = .008). Plasma lactate showed a supplement plus sprint interaction (P < .001) when NaHCO3 was compared with CAF (13%, P = .031) and PLA (23%, P = .021). CONCLUSION: To summarize, although the isolated ingestion of CAF and NaHCO3 improved repeated-sprint performance, the coingestion of both supplements did not stimulate a synergic ergogenic effect.

Evidence of Implicit and Explicit Motor Learning during Gait Training with Distorted Rhythmic Auditory Cues.

Gait training with rhythmic auditory cues contains motor learning mechanisms that are weighted more explicitly than implicitly. However, various clinical populations may benefit from a shift to gait training with greater implicit motor learning mechanisms. To investigate the ability to incorporate more implicit-weighted motor learning processes during rhythmic auditory cueing, we attempted to induce error-based recalibration using a subtly varying metronome cue for naïve unimpaired young adults. We assessed the extent of implicit and explicit retention after both an isochronous metronome and subtly varying metronome frequency during treadmill and overground walking. Despite 90% of participants remaining unaware of the changing metronome frequency, participants adjusted their cadence and step length to the subtly changing metronome, both on a treadmill and overground (p < 0.05). However, despite evidence of both implicit and explicit processes involved with each metronome (i.e., isochronous and varying), there were no between-condition differences in implicit or explicit retention for cadence, step length, or gait speed, and thus no increased implicit learning advantage with the addition of error-based recalibration for young, unimpaired adults.

The effect of time of day on Special Judo Fitness Test in active judokas: Evaluation in terms of chronotype.

The present cross-sectional study aims to examine the effect of time of day on the judo-specific performance in judokas, considering their chronotypes. Twenty-four male judokas participated in the study where the Morningness-Eveningness Questionnaire was administered, and on it, they were divided into morning-type (MT:12-judokas) and evening-type groups (ET:12-judokas). Afterwards, the Special Judo Fitness Test (SJFT) was applied to both groups at three different times (morning: 09:00 h, afternoon: 13:00 h and evening: 17:00 h) with body temperature measured before and after every SJFT performance. As a result, the Group*Test Time interaction significantly affected overall throwing performance during SJFT [F(2,44) = 29.437, p = 0.001, η2p: .572]. Furthermore, a significant time effect was found for the SJFT index [F(2,44) = 5.118, p = 0.010, η2p: .189] and for the Group*Test Time interaction with the mean value of the index [F(2,44) = 24.424, p < 0.001, η2p: .526]. Furthermore, body temperature had a significant time effect [F(2,44) = 301.454, p < 0.001, η2p: .932] and the Group*Test Time interaction [F(2,44) = 5.802, p = 0.006, η2p: .209]. In conclusion, coaches and exercise experts should consider judo athletes' chronotype when planning special training programs to improve judo-specific anaerobic capacity. Furthermore, to minimize the impact of time of day and chronotype on athletes' performance in competitions, it is recommended that MT athletes develop their judo-specific anaerobic capacity in the evening hours, when their performance is lower, while ET athletes should do so in the morning hours when their performance is lower via randori training.

Sodium L-Aspartate Supplementation Improves Repeated-Sprint Performance.

Aspartate supplementation has been reported to improve endurance performance by facilitating the tricarboxylic acid cycle flux. The present study was performed to investigate the effects of aspartate supplementation on repeated-sprint performance and blood pH. Following an overnight fast, fourteen healthy males completed three sets of 10 × 6 s maximal sprints after consuming sodium L-aspartate (ASP) or placebo (PLA), in a double-blind manner. Both supplements were taken twice on each test day (2 × 4.5 g). Exercise performance (e.g., cadence and power output) and blood variables (e.g., pH and plasma amino acid levels) were measured. The ASP trial evidenced significantly higher plasma aspartate concentration during the first (ASP, 45.3 ± 9.2 µM; PLA, 6.1 ± 0.8 µM) and the second exercise sets (ASP, 24.2 ± 4.5 µM; PLA, 6.6 ± 0.9 µM) and peak cadence during the second set (ASP, 153 ± 3 rpm; PLA, 152 ± 3 rpm) compared with the PLA trial (all p < 0.05). The peak power output during the second exercise set (ASP, 743 ± 32 W; PLA, 734 ± 31 W; p = 0.060) and the blood pH immediately before (ASP, 7.280 ± 0.020; PLA, 7.248 ± 0.016; p = 0.087) and after the third exercise set (ASP, 7.274 ± 0.019; PLA, 7.242 ± 0.018; p = 0.093) tended to be higher in the ASP than in the PLA trial. In conclusion, ASP supplementation partially improved repeated-sprint performance (peak cadence during the second exercise set). However, it did not affect the mean power output.

Effectiveness of Shenshu Guanxin recipe granules for improving exercise tolerance in patients with stable angina pectoris: a randomized, double-blind, placebo-controlled trial.

OBJECTIVE: To assess the effectivess of Shenshu Guanxin recipe granules (, SGR) in improving exercise tolerance and the quality of life in patients with Stable Angina Pectoris (SAP). METHODS: A total of 189 patients were consecutively enrolled between December 2012 and December 2014. The included patients were randomly assigned to SGR and placebo groups. The primary endpoints included mainly the results of treadmill exercise test and Seattle Angina Questionnaire (SAQ) during 12 weeks of treatment. RESULTS: After 12 weeks of treatment, SGR extended the time of exercise-induced ST-segment depression of 0.1 MV, lowered the maximum ST-segment depression, and shortened the duration of ST-segment depression in patients with SAP in southern China. Besides, the study also proved that SGR could improve the quality of life and functional status of patients with SAP. CONCLUSIONS: SGR showed a positive effect on exercise tolerance compared with the placebo besides optimal medical therapy. Also, the study proved that SGR could improve the SAQ score of the patients.

The cardiopulmonary exercise test in the prognostic evaluation of patients with heart failure and cardiomyopathies: the long history of making a one-size-fits-all suit.

Cardiopulmonary exercise test (CPET) has become pivotal in the functional evaluation of patients with chronic heart failure (HF), supplying a holistic evaluation both in terms of exercise impairment degree and possible underlying mechanisms. Conversely, there is growing interest in investigating possible multiparametric approaches in order to improve the overall HF risk stratification. In such a context, in 2013, a group of 13 Italian centres skilled in HF management and CPET analysis built the Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score, based on the dynamic assessment of HF patients and on some other instrumental and laboratory parameters. Subsequently, the MECKI score, initially developed on a cohort of 2716 HF patients, has been extensively validated as well as challenged with the other multiparametric scores, achieving optimal results. Meanwhile, the MECKI score research group has grown over time, involving up to now a total of 27 centres with an available database accounting for nearly 8000 HF patients. This exciting joint effort from multiple HF Italian centres allowed to investigate different HF research field in order to deepen the mechanisms underlying HF, to improve the ability to identify patients at the highest risk as well as to analyse particular HF categories. Most recently, some of the participants of the MECKI score group started to join the forces in investigating a possible additive role of CPET assessment in the cardiomyopathy setting too. The present study tells the ten-year history of the MECKI score presenting the most important results achieved as well as those projects in the pipeline, this exciting journey being far to be concluded.

Physiology of exercise and heart failure treatments: cardiopulmonary exercise testing as a tool for choosing the optimal therapeutic strategy.

In the last decades, the pharmacological treatment of heart failure (HF) become more complex due to the availability of new highly effective drugs. Although the cardiovascular effects of HF therapies have been extensively described, less known are their effects on cardiopulmonary function considered as a whole, both at rest and in response to exercise. This is a 'holistic' approach to disease treatment that can be accurately evaluated by a cardiopulmonary exercise test. The aim of this paper is to assess the main differences in the effects of different drugs [angiotensin-converting enzyme (ACE)-inhibitors, Angiotensin II receptor blockers, ß-blockers, Angiotensin receptor-neprilysin inhibitors, renal sodium-glucose co-transporter 2 inhibitors, iron supplementation] on cardiopulmonary function in patients with HF, both at rest and during exercise, and to understand how these differences can be taken into account when choosing the most appropriate treatment protocol for each individual patient leading to a precision medicine approach.

Effects of fitness on self-reported physical and mental quality of life in professional firefighters: An exploratory study.

BACKGROUND: The work-related stress experienced by firefighters is associated with numerous health issues. In the general population, improving physical fitness is associated with improvements in both mental and physical quality of life. OBJECTIVE: The purpose of the study was to examine whether fitter professional firefighters report greater physical and mental quality of life. METHODS: Twenty-three professional firefighters (males = 21, females = 2; age: 36.78±7.12yrs; height: 176.96±5.67 cm; weight: 88.20±16.02 kg; years of service: 8.70±6.62years) volunteered for the study. Participants completed a fitness protocol that included the wall sit and reach, Y-balance test, vertical jump, 1 repetition maximum bench press, pull-ups to failure, push-ups to failure, a plank hold and 1-mile run. The short form 36 questionnaire was used to assess overall quality of life. Firefighters were divided into "high" and "low" groups for physical and mental quality of life. Group differences in fitness parameters were assessed using a multivariate analysis of covariance with gender, age, years of service, height, and body mass as co-variates. RESULTS: Firefighters with lower mental quality of life had lower body fat percentages (p = 0.003), fat mass (p = 0.036), greater fat free mass (p = 0.015), vertical jump height (p = 0.024) and performed more pull-ups (p = 0.003). There were no significant differences in any of the fitness measures between high and low physical quality of life groups. CONCLUSION: The findings indicate that physical fitness of firefighters is not indicative of overall health. Firefighters might use exercise to cope for psychological stress and a holistic approach to improve firefighter quality of life is recommended.

Anxiolytic-like effects of an mGluR 5 antagonist and a mGluR 2/3 agonist, and antidepressant-like effects of an mGluR 7 agonist in the chick social separation stress test, a dual-drug screening model of treatment-resistant depression.

Modulation of glutamate receptors has demonstrated anxiolytic and/or antidepressant effects in rodent stress models. The chick social-separation stress paradigm exposes socially raised aves to an isolation stressor which elicits distress vocalizations (DVocs) in an attempt to re-establish contact. The model presents a state of panic during the first 5 min followed by a state of behavioral despair during the last 60 to 90 min. Making it useful as a dual anxiolytic/antidepressant screening assay. Further research has identified the Black Australorp strain as a stress-vulnerable, treatment-resistant, and ketamine-sensitive genetic line. Utilizing this genetic line, we sought to evaluate modulation of glutamatergic receptors for potential anxiolytic and/or antidepressant effects. Separate dose-response studies were conducted for the following drugs: the AMPA PAM LY392098, the mGluR 5 antagonist MPEP, the mGluR 2/3 agonist LY404039, the mGluR 2/3 antagonist LY341495, and the mGluR 7 agonist AMN082. The norepinephrine α2 agonist clonidine and the NMDA antagonist ketamine were included as comparison for anxiolytic (anti-panic) and antidepressant effects, respectively. As in previous studies, clonidine reduced DVoc rates during the first 5 min (attenuation of panic) and ketamine elevated DVoc rates (attenuation of behavioral despair) during the last 60 min of isolation. The mGluR 2/3 agonist LY404039 and the mGluR 5 antagonist MPEP decreased DVoc rates during the first 5 min of isolation indicative of anxiolytic effects like that of clonidine while the mGluR 7 agonist AMN082 elevated DVoc rates in the later hour of isolation, representative of antidepressant effects like that of ketamine. Collectively, these findings suggest that certain glutamate targets may be clinically useful in treating panic disorder and/or treatment-resistant depression.

Physical conditioning in children and adolescents with cerebral palsy: Systematic review and meta-analysis.

INTRODUCTION: Cerebral palsy (CP) can be described as a group of permanent non-progressive disorders that occur in the developing fetal or infant brain. Studies have shown that children and adolescents with CP have low cardiorespiratory fitness and higher energy expenditure during daily activities when compared to typical children. Therefore, interventions focused on the physical conditioning of this population could be critical. OBJECTIVE: To evaluate the effect of physical conditioning training on distance walked and maximum oxygen consumption (VO2 max) in individuals with CP, through a systematic review. METHOD: Two independent researchers performed systematic searches in the PUBMED, SciELO, PEDro, ERIC, and Cochrane databases using the search terms "physical fitness", "aerobic training" or "endurance" combined with "cerebral palsy". INCLUSION CRITERIA: (1) population (children and adolescents with CP between 5 and 18 years old); (2) type of study (experimental studies); (3) type of intervention (physical conditioning protocols); (4) outcome (distance walked in the 6 min walking test - 6MWT, and VO2 max). RESULTS: 386 studies were identified and 5 articles were considered eligible. After physical conditioning training, there was an increase of 46.34 m (p = 0.07) and 5.93. ml. kg-1. min -1 (p < 0.001) in the 6MWT and VO2 max, respectively. CONCLUSION: Physical conditioning training appears to be clinically beneficial to the cardiorespiratory fitness of children and adolescents with CP.

Beneficial effects of oral and topical sodium bicarbonate during a battery of team sport-specific exercise tests in recreationally trained male athletes.

OBJECTIVE: This study examined the effects of oral and topical (PR Lotion; Momentous) sodium bicarbonate (NaHCO3) during a battery of team sport-specific exercise tests. METHOD: In a block randomized, crossover, double-blind, placebo-controlled design, 14 recreationally trained male team sport athletes performed a familiarization visit and three experimental trials receiving: (i) 0.3 g·kg-1 body mass (BM) NaHCO3 in capsules + placebo lotion (SB-ORAL), (ii) placebo capsules +0.9036 g·kg-1 BM PR Lotion (SB-LOTION), or (iii) placebo capsules + placebo lotion (PLA). Supplements were given ~120 min prior to the team sport-specific exercise tests: countermovement jumps (CMJ), 8 × 25 m repeated sprints and Yo-Yo Intermittent Recovery Level 2 (Yo-Yo IR2). Blood acid-base balance (pH, bicarbonate) and electrolytes (sodium, potassium) were measured throughout. Rating of perceived exertion (RPE) was recorded after each sprint and post-Yo-Yo IR2. RESULTS: Distance covered during the Yo-Yo IR2 was 21% greater for SB-ORAL compared with PLA (+94 m; p = 0.009, d = 0.64) whereas performance was only 7% greater for SB-LOTION compared with PLA (480 ± 122 vs. 449 ± 110 m; p = 0.084). Total completion time for the 8 × 25 m repeated sprint test was 1.9% faster for SB-ORAL compared with PLA (-0.61 s; p = 0.020, d = 0.38) and 2.0% faster for SB-LOTION compared with PLA (-0.64 s; p = 0.036, d = 0.34). CMJ performance was similar between treatments (p > 0.05). Blood acid-base balance and electrolytes were significantly improved for SB-ORAL compared with PLA, but no differences were observed for SB-LOTION. Compared to PLA, RPE was lower for SB-LOTION after the fifth (p = 0.036), sixth (p = 0.012), and eighth (p = 0.040) sprints and for SB-ORAL after the sixth (p = 0.039) sprint. CONCLUSIONS: Oral NaHCO3 improved 8 × 25 m repeated sprint (~2%) and Yo-Yo IR2 performance (21%). Similar improvements in repeated sprint times were observed for topical NaHCO3 (~2%), but no significant benefits were reported for Yo-Yo IR2 distance or blood acid-base balance compared to PLA. These findings suggest that PR Lotion might not be an effective delivery system for transporting NaHCO3 molecules across the skin and into systematic circulation, therefore further research is needed to elucidate the physiological mechanisms responsible for the ergogenic effects of PR Lotion.

Effects of Sprint Interval and Endurance Respiratory Muscle Training on Postcycling Inspiratory and Quadriceps Fatigue.

PURPOSE: We investigated whether a 4-wk period of respiratory muscle endurance training (RMET) or respiratory muscle sprint interval training (RMSIT) would lead to an attenuation of inspiratory muscle and quadriceps fatigue after a bout of high-intensity cycling compared with a placebo intervention (PLAT), as predicted by the respiratory metaboreflex model. METHODS: Thirty-three active, young healthy adults performed RMET, RMSIT, or PLAT. Changes in inspiratory muscle and quadriceps twitches in response to a cycling test at 90% of peak work capacity were assessed before and after training. EMG activity and deoxyhemoglobin (HHb, via near-infrared spectroscopy) of the quadriceps and inspiratory muscles were also monitored during the cycling test, along with cardiorespiratory and perceptual variables. RESULTS: At pretraining, cycling reduced the twitch force of the inspiratory muscles (86% ± 11% baseline) and quadriceps (66% ± 16% baseline). Training did not attenuate the drop in twitch force of the inspiratory muscles (PLAT, -3.5 ± 4.9 percent-points [p.p.]; RMET, 2.7 ± 11.3 p.p.; RMSIT, 4.1 ± 8.5 p.p.; group-training interaction, P = 0.394) or quadriceps (PLAT, 3.8 ± 18.6 p.p.; RMET, -2.6 ± 14.0 p.p.; RMSIT, 5.2 ± 9.8 p.p.; group-training interaction P = 0.432). EMG activity and HHb levels during cycling did not change after training for either group. Only RMSIT showed a within-group decrease in the perception of respiratory exertion with training. CONCLUSIONS: Four weeks of RMET or RMSIT did not attenuate the development of exercise-induced inspiratory or quadriceps fatigue. The ergogenic effects of respiratory muscle training during whole-body exercise might be related to an attenuation of perceptual responses.

Body Loading during an Intensive Yoga Exercise Routine and a Cycle Ergometer Test.

The present study compared the effects on the cardiovascular, respiratory, and metabolic functions of the practice of an intensive yoga exercise routine called Dynamic Suryanamaskar (DSN) and a cycle ergometer test (CET) of increasing intensity. The study involved 18 middle-aged volunteers who had previously practiced DSN. The study was conducted in two series (i.e., as CET and DSN with similar intensity) until complete exhaustion. At rest (R), at the ventilatory anaerobic threshold (VAT), and at the maximum workload (ML), the variables characterizing cardiovascular, respiratory, and metabolic functions were determined. In addition, the subjective intensity of both efforts was determined using the Borg test. No functional differences were observed in the cardiovascular, respiratory, and metabolic systems at similar CET and DSN intensities. Respondents experienced less subjective workload during DSN than during CET (p < 0.001). Since DSN intensifies the activity of the cardiovascular, respiratory, and metabolic systems to a similar degree to CET both at VAT and ML, but causes less subjective fatigue, this yogic practice can be used as a laboratory exercise test and as an effective training medium.

Heart failure with preserved ejection fraction: relevance of a dedicated dyspnoea clinic.

BACKGROUND AND AIMS: Heart failure with preserved ejection fraction (HFpEF) is a syndrome with a heterogeneous presentation. This study provides an in-;depth description of haemodynamic and metabolic alterations revealed by systematic assessment through cardiopulmonary exercise testing combined with exercise echocardiography (CPETecho) within a dedicated dyspnoea clinic. METHODS AND RESULTS: Consecutive patients (n = 297), referred to a dedicated dyspnoea clinic using a standardized workup including CPETecho, with HFpEF diagnosed through a H2FPEF score ≥6 or HFA-PEFF score ≥5, were evaluated. A median of four haemodynamic/metabolic alterations was uncovered per patient: impaired stroke volume reserve (73%), impaired chronotropic reserve (72%), exercise pulmonary hypertension (65%), and impaired diastolic reserve (64%) were the most frequent cardiac alterations. Impaired peripheral oxygen extraction and a ventilatory limitation were present in 40% and 39%, respectively. In 267 patients (90%), 575 further diagnostic examinations were recommended (median of two tests per patient). Cardiac magnetic resonance imaging, coronary or amyloidosis workup, ventilation-perfusion scanning, and pulmonology referral were each recommended in approximately one out of three patients. In 293 patients (99%), 929 cardiovascular drug optimizations were performed (median of 3 modifications per patient). In 110 patients (37%), 132 cardiovascular interventions were performed, with ablation as the most frequent procedure. CONCLUSION: Holistic workup of HFpEF patients within a multidisciplinary, dedicated dyspnoea clinic, including systematic implementation of CPETecho reveals various haemodynamic/metabolic alterations, leading to further diagnostic testing and potential treatment changes in the majority of cases.

Primary mitochondrial disease as a rare cause of unclear breathlessness and distinctive performance degradation - a case report.

BACKGROUND: Primary muscular disorders (metabolic myopathies, including mitochondrial disorders) are a rare cause of dyspnea. We report a case of dyspnea caused by a mitochondrial disorder with a pattern of clinical findings that can be classified in the known pathologies of mitochondrial deletion syndrome. CASE PRESENTATION: The patient presented to us at 29 years of age, having had tachycardia, dyspnea, and functional impairment since childhood. She had been diagnosed with bronchial asthma and mild left ventricular hypertrophy and treated accordingly, but her symptoms had worsened. After more than 20 years of progressive physical and social limitations was a mitochondrial disease suspected in the exercise testing. We performed cardiopulmonary exercise testing (CPET) with right heart catheterization showed typical signs of mitochondrial myopathy. Genetic testing confirmed the presence of a ~ 13 kb deletion in mitochondrial DNA from the muscle. The patient was treated with dietary supplements for 1 year. In the course of time, the patient gave birth to a healthy child, which is developing normally. CONCLUSION: CPET and lung function data over 5 years demonstrated stable disease. We conclude that CPET and lung function analysis should be used consistently to evaluate the cause of dyspnea and for long-term observation.

Effect of Ischemic Preconditioning on Acute Recovery in Elite Judo Athletes: A Randomized, Single-Blind, Crossover Trial.

PURPOSE: The ischemic preconditioning (IPC) method has been shown to aid the recovery processes; however, no studies have been done to assess its acute recovery use in judo. This study aimed to examine IPC of lower limbs effects on recovery after a judo-specific performance in highly trained male judokas and its applicability during a competition day. METHODS: A single-blind, placebo-randomized crossover study was carried out on a sample of 13 elite male judo athletes. They undertook measurements of body composition, judo-specific task (Special Judo Fitness Test), jump performance, handgrip strength, lactate, blood pressure, perceived exertion, and delayed-onset muscle soreness. IPC was applied on the legs and inflated 50 mm Hg above the systolic blood pressure for 5 minutes and repeated 3 times for each leg, with 5 minutes of reperfusion. Two-way analysis of variance with repeated measurements was used to determine changes between interventions and measurement times. Paired-sample t test and 1-way repeated-measures analysis of variance was used to determine the difference among measurement times. Statistical significance was set at P < .05. RESULTS: The IPC intervention resulted in (1) decreased heart rate at 30 and 60 minutes during recovery (P = .002; P = .001), (2) better countermovement jump performance at 60 minutes (P = .05), (3) lower perceived-muscle-soreness scores (P = .006), and (4) maintained handgrip strength compared with placebo. CONCLUSIONS: The present study revealed that IPC applied to judo athletes following judo-specific exercise resulted in better cardiovascular and neuromuscular recovery and could be a useful tool to enhance recovery during judo competition breaks between preliminaries and final block.

Five Days of Tart Cherry Supplementation Improves Exercise Performance in Normobaric Hypoxia.

Previous studies have shown tart cherry (TC) to improve exercise performance in normoxia. The effect of TC on hypoxic exercise performance is unknown. This study investigated the effects of 5 days of tart cherry (TC) or placebo (PL) supplementation on hypoxic exercise performance. Thirteen healthy participants completed an incremental cycle exercise test to exhaustion (TTE) under two conditions: (i) hypoxia (13% O2) with PL and (ii) hypoxia with TC (200 mg anthocyanin per day for 4 days and 100 mg on day 5). Pulmonary gas exchange variables, peripheral arterial oxygen saturation (SpO2), deoxygenated hemoglobin (HHb), and tissue oxygen saturation (StO2) assessed by near-infrared spectroscopy in the vastus lateralis muscle were measured at rest and during exercise. Urinary 8-hydro-2' deoxyguanosine (8-OHdG) excretion was evaluated pre-exercise and 1 and 5 h post-exercise. The TTE after TC (940 ± 84 s, mean ± standard deviation) was longer than after PL (912 ± 63 s, p < 0.05). During submaximal hypoxic exercise, HHb was lower and StO2 and SpO2 were higher after TC than PL. Moreover, a significant interaction (supplements × time) in urinary 8-OHdG excretion was found (p < 0.05), whereby 1 h post-exercise increases in urinary 8-OHdG excretion tended to be attenuated after TC. These findings indicate that short-term dietary TC supplementation improved hypoxic exercise tolerance, perhaps due to lower HHb and higher StO2 in the working muscles during submaximal exercise.

The importance of re-evaluating the risk score in heart failure patients: An analysis from the Metabolic Exercise Cardiac Kidney Indexes (MECKI) score database.

BACKGROUND: The role of risk scores in heart failure (HF) management has been highlighted by international guidelines. In contrast with HF, which is intrinsically a dynamic and unstable syndrome, all its prognostic studies have been based on a single evaluation. We investigated whether time-related changes of a well-recognized risk score, the MECKI score, added prognostic value. MECKI score is based on peak VO2, VE/VCO2 slope, Na+, LVEF, MDRD and Hb. METHODS: A multi-centre retrospective study was conducted involving 660 patients who performed MECKI re-evaluation at least 6 months apart. Based on the difference between II and I evaluation of MECKI values (MECKI II - MECKI I = ∆ MECKI) the study population was divided in 2 groups: those presenting a score reduction (∆ MECKI <0, i.e. clinical improvement), vs. patients presenting an increase (∆ MECKI >0, clinical deterioration). RESULTS: The prognostic value of MECKI score is confirmed also when re-assessed during follow-up. The group with improved MECKI (366 patients) showed a better prognosis compared to patients with worsened MECKI (294 patients) (p < 0.0001). At 1st evaluation, the two groups differentiated by LVEF, VE/VCO2 slope and blood Na+ concentration, while at 2nd evaluation they differentiated in all 6 parameters considered in the score. The patients who improved MECKI score, improved in all components of the score but hemoglobin, while patients who worsened the score, worsened all parameters. CONCLUSIONS: This study shows that re-assessment of MECKI score identifies HF subjects at higher risk and that score improvement or deterioration regards several MECKI score generating parameters confirming the holistic background of HF.