Prevalence of Computer Vision Syndrome and Its Risk Factors in a Spanish University Population.

OBJECTIVES: To determine the prevalence of digital eye strain or computer vision syndrome (CVS) and its risk factors in a university population (University of Valladolid, Spain). METHODS: An anonymous cross-sectional online survey was conducted in a university population [staff (lecturers and administrative employees) and students (undergraduate, master's, and PhD)], including two validated questionnaires (Ocular Surface Disease Index [OSDI] and the 17-item Computer-Vision Symptom Scale questionnaire [CVSS17]) and questions about sociodemographic data and visual display terminal use. The prevalence and risk factors for CVS (CVSS17≥29) (multivariate logistic regression model) were calculated. RESULTS: One thousand nine participants responded to the survey (35.2±15.2 years; 64.1% women). The mean OSDI and CVSS17 questionnaire scores were 18.9±15.6 and 31.5±6.4, respectively, and 35.4% of the respondents had dry eye symptoms (OSDI>22). The total prevalence of CVS was 65.4% (95% CI 62.1-68.3). Undergraduate students showed the highest CVS prevalence (72.6%; P <0.01), which was significant. In addition, women, participants younger than 36 years old, contact lens wearers, and subjects with dry eye symptoms reported a statistically higher CVSS17 score ( P ≤0.01). In the multivariate model, significant factors associated with the presence of CVS ( P ≤0.03) were female sex (OR=2.10; 95% CI 1.54-2.88), dry eye symptoms (OSDI>22) (OR=16.98; 95% CI 10.36-27.84), VTD use ≥6 hr daily (OR=1.96; 95% CI 1.09-3.52), and being an undergraduate student (OR=2.23; 95% CI 1.54-3.24). CONCLUSION: A high prevalence (65.4%) of CVS was found among the Spanish university population, with the undergraduate student group having the highest prevalence (72.6%). Female sex, more than 6 hr/day of visual display terminal use, being an undergraduate student, and dry eye symptoms significantly increased the risk of CVS in the university population.

T3-T4 index as a prognostic marker of response to biological treatments in elderly patients with inflammatory bowel disease.

Following the growing trend of trying to individualise treatment in inflammatory bowel disease and in view of the challenge posed by elderly patients requiring biologic treatments, we have conducted a study in our centre to assess the T3/T4 index as a predictor of response to biologic treatments in elderly patients.

Effectiveness and safety of ustekinumab dose escalation in Crohn's disease: a multicenter observational study.

BACKGROUND: ustekinumab has proven effective in Crohn's disease (CD). However, some patients will partially respond or lose response over time. Data supporting the effectiveness of dose escalation in this scenario is scarce. AIM: to evaluate the effectiveness of ustekinumab dose escalation in CD. METHODS: patients with active CD (Harvey-Bradshaw ≥ 5) who had received intravenous (IV) induction and at least a subcutaneous (SC) dose were included in this retrospective observational study. Ustekinumab dose was escalated, either via shortening of the interval to six or four weeks or IV reinduction plus shortening to every four weeks. RESULTS: ninety-one patients were included, and ustekinumab dose was escalated after a median of 35 weeks of treatment. At week 16 after intensification, steroid-free clinical response and remission were observed in 62.6 % and 25.3 % of patients, respectively. Systemic corticosteroids were discontinued in 46.7 % of patients who were on corticosteroids at baseline. Follow-up data beyond week 16 were available for 78 % of patients; at the last visit, 66.2 % and 43.7 % were in steroid-free clinical response and remission, respectively. After a median follow-up of 64 weeks, 81 % of patients were still treated with ustekinumab. Adverse events were reported in 4.3 % of patients; these were all mild and did not lead to hospitalization or discontinuation of treatment. Five patients (5.5 %) underwent surgical resection, with no immediate postsurgical complications. CONCLUSION: ustekinumab dose escalation was effective in recapturing response in over half of the patients. These findings suggest that dose escalation should be considered in patients who experience loss or partial response to the standard maintenance.

Experience with ustekinumab in reservoir Crohn's disease.

Crohn's disease of the reservoir is a pathology of difficult diagnosis and complex approach due to the scarce documented evidence on it. Recently, studies have been published on the treatment strategies available for this entity. Based on the above, we have analyzed the experience of our center in the treatment of reservoir Crohn's disease with one of the new biologic agents, ustekinumab.

Efficacy and safety of tofacitinib in the treatment of ulcerative colitis: real-life experience in Andalusia.

BACKGROUND: tofacitinib is a Janus kinase inhibitor approved for the treatment of moderate-severe ulcerative colitis (UC). This study aimed to evaluate its efficacy in a real-life setting. METHODS: a retrospective and multicenter observational study was performed with UC patients treated with tofacitinib. Short and long-term treatment effectiveness, treatment survival, need for dose escalation and safety were analyzed. Clinical response and remission were defined in accordance with the partial Mayo score. RESULTS: seventy-four patients were included, 98.3 % had received prior biological treatment, 55.4 % with three or more biologicals and up to 64.9% with two or three different mechanisms of action. Clinical remission and response rates were 37.8 % and 77 % at eight weeks, and 41.8 % and 70.1 % at 16 weeks. With regard to non-responders at eight weeks, 37.5 % achieved a delayed clinical response at 16 weeks. Mean treatment duration was 19 months (95 % CI: 16-22), with a treatment survival of 56 % at 28 months, and remission and response rates at 24 months of 53.8 % and 61.5 %. Twenty-three treatments were withdrawn, most of them (18) during the induction period. There were adverse events in a quarter of the patients; only four were severe and led to treatment discontinuation. CONCLUSION: tofacitinib has a demonstrated efficacy in clinical practice to induce and maintain clinical response in treatment-refractory UC patients, with an acceptable safety profile.

Clinical guidelines for the management of keratoconus patients with gas permeable contact lenses based on expert consensus and available evidence.

PURPOSE OF REVIEW: Fitting rigid gas permeable contact lenses (RGP CLs) in keratoconic patients is the most common visual rehabilitation option to improve patients' quality of life, but require long patient and practitioner chair time. The purpose of this review is to provide evidence-based clinical practice guidelines (CPG) in the management of patients with keratoconus with RGP CLs. RECENT FINDINGS: An extensive literature review from 1990 to 2017 identified 354 potentially relevant publications. Fifty-two articles were reviewed and included in the CPG. An international expert panel of eight contact lens practitioners, with vast experience in keratoconus management reviewed and appraised the CPG following the Appraisal of Guidelines for Research and Evaluation II consortium requirements. The developed CPG clearly outlines a strategy for the successful fitting of RGP CLs in patients with keratoconus. This includes how to calculate parameters of the first diagnostic lens, criteria for assessing good fit and a standardized schedule of wear time and follow-up appointments. SUMMARY: The current evidence and consensus-based CPG helps guide clinicians in a successful strategy for fitting RGP CLs in patients with keratoconus.

COVID-19: ensuring safe clinical teaching at university optometry schools.

The COVID-19 pandemic has been spreading across the globe for several months. The nature of the virus (SARS-CoV-2) with easy person-to-person transmissions and the severe clinical course observed in some people necessitated unprecedented modifications of everyday social interactions. These included the temporary suspension of considerable elements of clinical teaching at optometry schools worldwide. This article describes the challenges optometry schools were facing in early to mid 2020. The paper highlights the experiences of six universities in five countries on four continents. Strategies to minimise the risk of virus transmission, to ensure safe clinical optometric teaching and how to overcome the challenges presented by COVID-19 are described. An outlook on opportunities to further improve optometric education is provided.

Effects of glyphosate on soil fungal communities: A field study.

The driving forces behind many soil processes are microorganisms and they are able to respond immediately to environmental changes. The soil microbial community impacts on many soil properties. More than one-third of the terrestrial ecosystems are semiarid. However, a limited number of studies have been conducted to characterize soil fungal communities in semiarid grasslands, in particular those of agricultural fields. The aim of this study was to explore changes in the diversity and structure of soil fungal communities in semiarid grasslands, after different doses of glyphosate were applied under field conditions. Changes in soil fungal communities were examined using different approaches including culturing, calcofluor white stain and denaturing gradient gel electrophoresis (DGGE). The different approaches complement each other, revealing different aspects of the effect of glyphosate on soil fungal communities. We demonstrated a negative effect of glyphosate on soil fungal biomass at high doses and an early and transitory stimulatory effect on soil fungal biomass. We also found a negative effect of glyphosate on the species richness of cultivable fungi and changes in the molecular structure of soil fungal communities after double doses or long-term glyphosate application. In summary, our findings demonstrate an overall negative effect of glyphosate on soil fungal communities.

Metallation-Induced Heterogeneous Dynamics of DNA Revealed by Single-Molecule FRET.

The metallation of nucleic acids is key to wide-ranging applications, from anticancer medicine to nanomaterials, yet there is a lack of understanding of the molecular-level effects of metallation. Here, we apply single-molecule fluorescence methods to study the reaction of an organo-osmium anticancer complex and DNA. Individual metallated DNA hairpins are characterised using Förster resonance energy transfer (FRET). Although ensemble measurements suggest a simple two-state system, single-molecule experiments reveal an underlying heterogeneity in the oligonucleotide dynamics, attributable to different degrees of metallation of the GC-rich hairpin stem. Metallated hairpins display fast two-state transitions with a two-fold increase in the opening rate to ≈2 s-1 , relative to the unmodified hairpin, and relatively static conformations with long-lived open (and closed) states of 5 to ≥50 s. These studies show that a single-molecule approach can provide new insight into metallation-induced changes in DNA structure and dynamics.

Quality of life in elderly people after a hip fracture: a prospective study.

BACKGROUND: Hip fracture is an important social and medical problem due to its increasing prevalence, the consequences for health and the economic impact on the health care system, but there is no doubt that it also has repercussions on health-related quality of life (HRQoL). Hence the importance of understanding and determining the impact of the condition on everyday life from the perspective of the patient's physical, emotional and social well-being. PURPOSE: To determine the impact of hip fracture on HRQoL of people over the age of 65 1 month after surgery, related factors and the effects on functional ability and mood. METHODS: Prospective observational study conducted in the traumatology units of two university hospitals in the province of Cáceres with consecutive sampling of all patients over the age of 65 admitted for hip fracture surgery during the study period. Sociodemographic and clinical data were recorded at the time of admission and prospectively at the follow-up visit 1 month later. Clinical, social, quality of life (EQ-5D-), basic functional and instrumental capacity (Barthel Index (BI) and Lawton & Brody Scale), and geriatric depression (Yesavage) variables were collected. RESULTS: The study included 224 patients with a median age of 84.6 years (SD ± 6.1), 76.3% were female. Charlson's comorbidity was 5.3 (SD ± 1.2). The EQ-5D index decreased from 0.62 (SD ± 0.35) to 0.16 at 1 month follow up (SD ± 0.20) p <  0.001. The mean Visual Analog Scale (VAS) score of EQ-5D decreased from 72.8 (SD ±15.8) to 48.3 (SD ± 17.2) p <  0.001. All dimensions of EQ-5D showed a significant reduction from the time of pre-fracture status to 1 month after surgery. Independent factors associated with HRQoL 1 month after surgery were pre-fracture status Barthel Index score, Lawton and Brody scale, presence of depression, and type of surgery. CONCLUSIONS: After a hip fracture, patients experience considerable deterioration in their HRQoL, especially in self-care, daily activities, and mobility. There is also a significant decline in functional capacity for both the basic and instrumental activities of daily living. One month after surgery, HRQoL is a long way from pre-fracture levels.

Classification of Keratoconus Based on Anterior Corneal High-order Aberrations: A Cross-validation Study.

SIGNIFICANCE: Placido disc-based videokeratography is one of the most extensively used methods for corneal topographic assessments in keratoconus. Anterior corneal wavefront analysis has been demonstrated to be an effective tool to manage keratoconus eyes. However, currently, there is no clinically adequate classification system for keratoconus. PURPOSE: The aim of this study was to analyze the usefulness of anterior corneal high-order aberrations in keratoconus classification provided by Placido disc-based videokeratography conducting a cross-validation analysis. METHODS: Corneal topography of 70 normal and 77 keratoconic eyes (divided according to the Amsler-Krumeich classification [n = 21, stage 1; n = 30, stage 2; and n = 26, stage 3]) was assessed using Placido disc-based videokeratography (Oculus Keratograph [Oculus Optikgeräte GmbH, Wetzlar, Germany]). Receiver operating characteristic curve analysis was used to compare the mean values of coma, trefoil, tetrafoil, secondary astigmatism, spherical aberration, and coma-like, third-, and fourth-order root mean square (RMS) to calculate cutoff values, sensitivity, and specificity to discriminate between normal and stage 1 keratoconus eyes and between each keratoconus stage after cross-validation analysis. RESULTS: All wavefront aberrations were significantly different between the normal and keratoconus groups (P ≤ .01). The coma and third-order RMS values (cutoff values, 0.367 and 0.359 µm, respectively) provide better sensitivity (99 and 100%, respectively) and specificity (100%) to discriminate keratoconus (stage 1) from healthy eyes compared with trefoil, tetrafoil, secondary astigmatism, spherical aberration, and coma-like and fourth-order RMS values (sensitivity >84% and specificity >57%). The coma and third-order RMS values showed the highest specificity (100%) and great sensitivity (90 and 87%, respectively) to differentiate between stages 1 and 2 and good sensitivity (97 and 100%) and specificity (81 and 88%) to differentiate between stages 2 and 3. CONCLUSIONS: Anterior corneal high-order aberrations, specifically coma and third-order RMS, could be useful in keratoconus diagnosis and topographical classification. These new cutoff values could improve different stages of keratoconus eyes discrimination.

Intrasession Repeatability of the Contact Angle Measured Using the Captive Bubble Method and Agreement Assessed Between Different Analysis Software Programs.

OBJECTIVES: The material biocompatibility of hydrogel and silicone hydrogel (SiHy) contact lens (CL) is of paramount importance in CL wear because a decrease in CL wettability reduces wearer comfort and increases wearer dropout. The aim of this study is to report on the repeatability and agreement between two different software programs that measure the contact angle with the captive bubble method in marketed CLs, which will help to translate this information into clinical practice. METHODS: The contact angle of 23 different CLs was measured with the captive bubble method using 2 software programs: FTÅ200 and ImageJ. Three consecutive measurements were conducted for each CL. Reproducibility, repeatability, and agreement values were calculated according to the British Standards Institute and the International Organization for Standardization. RESULTS: All methods showed good repeatability values in both CL materials (coefficient of variation <1.51%, Sw <2.26°, intraclass correlation coefficient >0.89, and the range of limits of agreement was between 7.22° and 7.57°). Higher concordance was achieved between the spherical and nonspherical options when using FTÅ200 software than when using ImageJ software. Statistically significant differences (P<0.05) between the 2 software programs were found, and they ranged between 5° and 10°. CONCLUSIONS: The captive bubble method showed great repeatability in measuring the contact angle in marketed CLs with both software programs (FTÅ200 and ImageJ) assessed in this study. However, differences in the measured contact angles suggest that these techniques are not interchangeable. Therefore, standardization is recommended for contact angle measurement in hydrogel CL materials to facilitate comparisons, to improve clinical use of this information, and to analyze their impact in CL user comfort.

Wrist Vascular Biometric Recognition Using a Portable Contactless System.

Human wrist vein biometric recognition is one of the least used vascular biometric modalities. Nevertheless, it has similar usability and is as safe as the two most common vascular variants in the commercial and research worlds: hand palm vein and finger vein modalities. Besides, the wrist vein variant, with wider veins, provides a clearer and better visualization and definition of the unique vein patterns. In this paper, a novel vein wrist non-contact system has been designed, implemented, and tested. For this purpose, a new contactless database has been collected with the software algorithm TGS-CVBR®. The database, called UC3M-CV1, consists of 1200 near-infrared contactless images of 100 different users, collected in two separate sessions, from the wrists of 50 subjects (25 females and 25 males). Environmental light conditions for the different subjects and sessions have been not controlled: different daytimes and different places (outdoor/indoor). The software algorithm created for the recognition task is PIS-CVBR®. The results obtained by combining these three elements, TGS-CVBR®, PIS-CVBR®, and UC3M-CV1 dataset, are compared using two other different wrist contact databases, PUT and UC3M (best value of Equal Error Rate (EER) = 0.08%), taken into account and measured the computing time, demonstrating the viability of obtaining a contactless real-time-processing wrist system.

Vitamin D and inflammatory bowel disease: what do we know so far?

In the last years,several studies have focused on the involement of vitamin D in different physiological and pathological processes. One of the most interesting actions occurs in the Inflammatory bowel disease, where a higher prevalence of vitamin D deficiency has been observed. This study aimed to review the literature in order to explain its relationship with the disease, the risk factors, measuring the importance of sun exposure, describing how treatments are affected or observing the effect of vitamin supplementation in this type of patients.

Extended Alkenyl and Alkynyl Benzotriazoles with Enhanced Two-Photon Absorption Properties as a Promising Alternative to Benzothiadiazoles.

A series of donor-π-acceptor-π-donor (D-π-A-π-D) benzoazole dyes with 2H-benzo[d][1,2,3]triazole or BTD cores have been prepared and their photophysical properties characterized. The properties of these compounds display remarkable differences, mainly as a result of the electron-donor substituent. Dyes with the best properties have visible-light absorption over λ=400 nm, large Stokes shifts in the range of about 3500-6400 cm-1 , and good fluorescence emission with quantum yields of up to 0.78. The two-photon absorption properties were also studied to establish the relationship between structure and properties in the different compounds synthesized. These results provided cross sections of up to 1500 GM, with a predominance of S2 ←S0 transitions and a high charge-transfer character. Time-dependent DFT calculations supported the experimental results.

Vitamin D deficiency in outpatients with inflammatory bowel disease: prevalence and association with clinical-biological activity.

INTRODUCTION: there are few data on the prevalence of vitamin D deficiency in patients with inflammatory bowel disease (IBD) in Spain. A deficiency could be associated with a worse course of the disease. AIM: to determine the prevalence of 25-hydroxyvitamin D (25OHD) deficiency in a cohort of outpatients with IBD and assess its association with clinical and biological activity, quality of life and psychological symptoms. METHODS: a cross-sectional, single-center observational study was performed. The study variables were obtained via clinical interviews, medical chart review and validated questionnaires (Hospital Anxiety and Depression Scale and Short Quality of Life in Inflammatory Bowel Disease Questionnaire). 25OHD was measured in the same laboratory by an electro-chemiluminescence immunoassay. RESULTS: the study included 224 patients. The prevalence of vitamin D deficiency in Crohn's disease and ulcerative colitis was 33.3% and 20.3%, respectively. In Crohn's disease, vitamin D deficiency was associated with a higher clinical activity (p < 0.001) and a higher concentration of fecal calprotectin (p = 0.01). In ulcerative colitis, it was associated with clinical activity (p < 0.001), the use of steroids during the last six months (p = 0.001) and hospital admission during the previous year (p = 0.003). A sub-analysis of 149 patients failed to detect an association between vitamin D and quality of life or the scores of the Hospital Anxiety and Depression Scale. CONCLUSIONS: vitamin D deficiency is common in patients with inflammatory bowel disease. An association was found between vitamin D concentration and clinical activity indexes, as well as fecal calprotectin levels in Crohn's disease.

Sunlight exposure in inflammatory bowel disease outpatients: Predictive factors and correlation with serum vitaminD. / Exposición solar en la enfermedad inflamatoria intestinal ambulatoria: factores predictivos y correlación con la concentración sérica de vitamina D.

INTRODUCTION: Sunlight exposure is the main source of vitaminD. Our aim was to describe both sun exposure and sun protection behaviour in a series of patients with inflammatory bowel disease (IBD), and to study their potential association with vitaminD concentration. PATIENTS AND METHODS: A cross sectional, observational study. The clinical-demographic variables were obtained via clinical interviews and medical history review. The sunlight exposure assessment was carried out using the Sun Exposure Questionnaire and the concentration of 25-hydroxy vitaminD (25OHD) was measured by an electro-chemiluminescence immunoassay. Questionnaires were conducted on quality of life, physical activity, weekly vitaminD intake and sun protection behaviour. RESULTS: 149 patients were included. In 69% of patients, deficient or insufficient 25OHD values were recorded. 67% showed low sun exposure. A modest significant correlation was observed between the total score of the solar exposure questionnaire and the 25OHD concentration in the complete series (r=0.226, P=.006) and in the summer (r=0.274, P=.01). The sun protection behaviour questionnaire score did not influence the 25OHD concentration. In the multivariate analysis, only the presence of clinical activity was associated with low sun exposure (OR=3.23). DISCUSSION: Sun exposure according to the questionnaire used was low, was associated with the presence of clinical activity and was weakly correlated with serum 25OHD concentration. More studies are needed to explore the use of individual questionnaires for sun exposure and its relationship with vitaminD in patients with IBD.

Individualized Care Scale-patient: A Spanish validation study.

BACKGROUND: I suggest this individualized care is a fundamental principle closely linked to nursing ethics and has important benefits for the patients, however, nurses do not always take into consideration the principles of individualized care. Moreover, there is no validated instrument to assess patients' views of individualized care in Spanish-speaking countries. OBJECTIVES: To assess the validity and reliability of the Spanish version of the Individualized Care Scale-patient. DESIGN: A cross-sectional study design was conducted. A questionnaire survey, including the Individualized Care Scale-patient, was used for data collection. Psychometric properties of reliability and validity were assessed. Fit indices of the overall model were computed. PARTICIPANTS AND RESEARCH CONTEXT: Survey data were collected from a sample of 118 inpatients at a public hospital in Spain. ETHICAL CONSIDERATIONS: Informed consent from participants and ethical approval was obtained from a regional Clinical Research Ethics Committee. FINDINGS: Ordinal Cronbach's alphas were 0.966 for Individualized Care Scale-patient subscale A and 0.969 for Individualized Care Scale-patient subscale B. The polychoric correlation between each item and the subscale ranged between 0.653-0.874 and 0.604-0.916, respectively. The exploratory factor analysis revealed a three-factor solution. Personal life situation explained relatively large amounts of the variance. Goodness of fit index showed a good fit for the model. DISCUSSION: This study confirms three factors underlining the individualized care concept, but some differences were found in the load of the factors, such as the relevance of "personal life situation" subscale, that need further research. CONCLUSION: The Spanish version of the Individualized Care Scale-patient is reliable, valid, user-friendly, and suitable to be used in Spanish-speaking countries showing satisfactory properties. This instrument may help managers better understand and develop areas in which patients perceive lower individualized care received and the factors influencing it. Such key information will help ensure the right of the patient to be respected as an individual.

Intrasession Repeatability and Intersession Reproducibility Measurements Using VX120 Multidiagnostic Unit.

OBJECTIVE: The VX120 multidiagnostic unit is a multidiagnostic instrument that combines several functions: autorefraction, keratometry, corneal topography, aberrometry, pachymetry, and noncontact tonometry. The purpose of this study was to determine the intrasession repeatability and the intersession reproducibility of all parameters measured by the VX120 multidiagnostic unit in a sample of normal healthy eyes. METHODS: Three repeated measurements in the right eye of the volunteers were taken with VX120. Repeatability of the sphere, cylinder, axis, anterior corneal powers (K flat and K steep, 3-mm pupil), high- and low-order aberration root mean square (HOA-RMS and LOA-RMS, 3-mm pupil), eccentricity, white-to-white (WTW), anterior chamber depth (ACD), and central corneal thickness (CCT) (2-mm central) was analyzed. Within-subject SD (Sw), precision, repeatability, coefficient of variation (CV), and the intraclass correlation coefficient (ICC) were calculated. RESULTS: The CV was low for K flat and K steep, WTW, ACD, and CCT with a range from 0.34% to 1.16%. The CV was higher for sphere, cylinder, HOA-RMS, and LOA-RMS and eccentricity with a range among 6.92% to 54.24%. The ICC showed high values in all parameters except in HOA-RMS (0.720-0.776) and eccentricity (0.889) in first session with moderate agreement. Comparing the intrasession repeatability of first and second session, statistically significant differences (P<0.01) were found between both sessions just to the CV for all parameters (except cylinder values) measured with VX120. However, nonstatistically significant differences (P>0.13) were found for Sw, precision, and repeatability values. CONCLUSIONS: The VX120 multidiagnostic unit provides repeatable measurements in anterior corneal power (K flat and K steep), WTW, ACD, and CCT. However sphere, cylinder, HOA-RMS, LOA-RMS, and eccentricity showed worse repeatability. Intersession reproducibility showed good results with little differences between sessions in healthy subjects.

Effects of High-intensity Warm-ups on Running Performance.

The objective of this study was to determine the effects of high-intensity warm-ups (WUs) on performance, physiological, neuromuscular and biomechanical parameters. Three randomized cross-over 105%vVO2max time limit trials (TLimT) were performed by 11 well-trained runners following three different WU protocols. These included two experimental high-intensity variants and one control WU variant: (i) 9x20-sec level strides (105%vVO2max; 1% gradient) with 60 s of recovery (level); (ii) 6x6-sec uphill strides (105%vVO2max; 5% gradient), with the same recovery (uphill) and (iii) 7 min at 60%vVO2max as control condition (control). The uphill and level WUs resulted in a greater performance during TLimT (160.0±6.62 s and 152.64±10.88 s, respectively) compared to control WUs (144.82±6.60 s). All WU conditions reduced the energy cost (EC) of running, respiratory exchange ratio, and step frequency (SF) after the experimental and control phases of WU, while blood lactate (BLC) increased in uphill and level WUs and decreased in control WUs. Changes in kinematic variables were found without differences between WU conditions during TLimT. BLC rose at conclusion of TLimT without differences between WU conditions. Both high-intensity WUs show a longer TLimT. EC is deteriorated after the high-intensity WU exercise due to a change of substrate utilization, increase of BLC and SF. A long transient phase (18 min) is necessary to avoid impairing the performance.