Development and Validation of Nosocomial Bacterial Infection Prediction Models for Patients With Systemic Lupus Erythematosus.

BACKGROUND: Hospital-acquired bacterial infections are associated with high morbidity and mortality rates in patients with systemic lupus erythematosus (SLE). This study aimed to develop and validate predictive models for the risk of hospital-acquired bacterial infections in patients with SLE. METHODS: A historical cohort study was designed for development, and another bidirectional cohort study was used for external validation. The risk of bacterial infection was assessed upon admission and after 5 days of hospitalization. Predictor selection employed the least absolute shrinkage and selection operator (LASSO) techniques. Multiple imputations were used to handle missing data. Logistic regression models were applied, and the properties of discrimination, calibration, and decision curve analysis were evaluated. RESULTS: The development cohort comprised 1686 patients and 237 events (14.1%) from 3 tertiary hospitals. The external validation cohort included 531 patients and 84 infection outcomes (15.8%) from 10 hospital centers in Colombia (secondary and tertiary level). The models applied at admission and after 120 hours of stay exhibited good discrimination (AUC > 0.74). External validation demonstrated good performance among patients from the same tertiary institutions where the models were developed. However, geographic validation at other institutions has been suboptimal. CONCLUSIONS: Two predictive models for nosocomial bacterial infections in patients with SLE are presented. All infection prevention recommendations should be maximized in patients at moderate/high risk. Further validation studies in diverse contexts, as well as clinical impact trials, are necessary before potential applications in research and clinical care.

Off- and On-Bike Resistance Training in Cyclists: A Randomized Controlled Trial.

PURPOSE: This study compared the effects of off- and on-bike resistance training (RT) on endurance cycling performance as well as muscle strength, power and structure. METHODS: Well-trained male cyclists were randomly assigned to incorporate two sessions/week of off- (full squats, n = 12) or on-bike (all-out efforts performed against very high resistances and thus at very low cadences, n = 12) RT during 10 weeks, with all RT-related variables [number of sessions, sets, and repetitions, duration of recovery periods, and relative loads (70% of one-repetition maximum)] matched between the two groups. A third, control group (n = 13) did not receive any RT stimulus but all groups completed a cycling training regime of the same volume and intensity. Outcomes included maximum oxygen uptake (V̇O2max), off-bike muscle strength (full squat) and on-bike ('pedaling') muscle strength and peak power capacity (Wingate test), dual-energy X-ray absorptiometry-determined body composition (muscle/fat mass), and muscle structure (cross-sectional area, pennation angle). RESULTS: No significant within/between-group effect was found for V̇O2max. Both the off- (mean Δ = 2.6-5.8%) and on-bike (4.5-7.3%) RT groups increased squat and pedaling-specific strength parameters after the intervention compared to the control group (-5.8--3.9%) (p < 0.05) with no significant differences between them. The two RT groups also increased Wingate performance (4.1% and 4.3%, respectively, vs. -4.9% in the control group, p ≤ 0.018), with similar results for muscle cross-sectional area (2.5% and 2.2%, vs. -2.3% in the control group, p ≤ 0.008). No significant within/between-group effect was found for body composition. ConclusionsThe new proposed on-bike RT could be an effective alternative to conventional off-bike RT training for improving overall and pedaling-specific muscle strength, power, and muscle mass.

Exercise Intolerance in McArdle Disease: A Role for Cardiac Impairment? A Preliminary Study in Humans and Mice.

INTRODUCTION: Whether cardiac impairment can be fully discarded in McArdle disease-the paradigm of 'exercise intolerance', caused by inherited deficiency of the skeletal muscle-specific glycogen phosphorylase isoform ('myophosphorylase')-remains to be determined. METHODS: Eight patients with McArdle disease and seven age/sex-matched controls performed a 15-minute moderate, constant-load cycle-ergometer exercise bout followed by a maximal ramp test. Electrocardiographic and two-dimensional transthoracic (for cardiac dimension's assessment) and speckle tracking [for left-ventricle global longitudinal (GLS) assessments] echocardiographic evaluations were performed at baseline. Electrocardiographic and GLS assessments were also performed during constant-load exercise and immediately upon maximal exertion. Four human heart biopsies were obtained in individuals without McArdle disease, and in-depth histological/molecular analyses were performed in McArdle and wild-type mouse hearts. RESULTS: Exercise intolerance was confirmed in patients ('second wind' during constant-load exercise, -55% peak power output vs controls). As opposed to controls, patients showed a decrease in GLS during constant-load exercise, especially upon second wind occurrence, but with no other between-group difference in cardiac structure/function. Human cardiac biopsies showed that all three glycogen phosphorylase-myophosphorylase, but also liver and especially brain-isoforms are expressed in the normal adult heart, thereby theoretically compensating for eventual myophosphorylase deficiency. No overall histological (including glycogen depots), cytoskeleton, metabolic or mitochondrial (morphology/network/distribution) differences were found between McArdle and wild-type mouse hearts, except for lower levels of pyruvate kinase M2 and translocase of outer membrane 20 kDa subunit in the former. CONCLUSIONS: This study provides preliminary evidence that cardiac structure and function seem to be preserved in patients with McArdle disease. However, the role for an impaired cardiac contractility associated with the second wind phenomenon should be further explored.

Intensity Matters: Effect of Different Work-Matched Efforts on Subsequent Performance in Cyclists.

PURPOSE: To assess the effect of 2 work-matched efforts of different intensities on subsequent performance in well-trained cyclists. METHODS: The present study followed a randomized controlled crossover design. Twelve competitive junior cyclists volunteered to participate (age, 17 [1] y; maximum oxygen uptake, 71.0 [4.7] mL·kg-1·min-1). The power-duration relationship was assessed through 2-minute, 5-minute, and 12-minute field tests under fresh conditions (control). On subsequent days and following a randomized order, participants repeated the aforementioned tests after 2 training sessions matched for mechanical work (∼15 kJ/kg) of different intensities (ie, a moderate-intensity continuous-training [60%-70% of critical power; CP] session or a session including high-intensity intervals [3-min repetition bouts at 110%-120% of the CP interspersed by 3-min rest periods]). RESULTS: A significantly lower power output was found in the 2-minute test after the high-intensity training session compared not only with the control condition (-8%, P < .001) but also with the moderate-intensity continuous-training session (-7%, P = .003), with no significant differences between the latter conditions. No significant differences between conditions were found for the remaining tests. As a consequence, the high-intensity training session resulted in significantly lower W' values compared to both the control condition (-27%, P = .001) and the moderate-intensity continuous-training session (-26%, P = .012), with no differences between the 2 latter conditions and with no differences for CP. CONCLUSION: A session including high-intensity intermittent efforts induces a greater fatigue, particularly in short-duration efforts and W', than a work-matched continuous-training session of moderate intensity.

Relative pedaling forces are low during cycling.

We quantified and compared the mechanical force demands relative to the maximum dynamic force (MDF) of 11 cyclists when pedaling at different intensities (ventilatory threshold, maximum lactate steady state, respiratory compensation point, and maximal aerobic power), cadences (free, 40, 60 and 80 rpm), and all-out resisted sprints. Relative force demands (expressed as %MDF) progressively increased with higher intensities (p < 0.001) and lower cadences (p < 0.001). Notwithstanding, relative force demands were low (<54 % MDF) for all conditions, even during the so-called 'torque training'. These results might be useful when programming on-bike resistance training to improve torque production capacity.

CGeNArate: a sequence-dependent coarse-grained model of DNA for accurate atomistic MD simulations of kb-long duplexes.

We present CGeNArate, a new model for molecular dynamics simulations of very long segments of B-DNA in the context of biotechnological or chromatin studies. The developed method uses a coarse-grained Hamiltonian with trajectories that are back-mapped to the atomistic resolution level with extreme accuracy by means of Machine Learning Approaches. The method is sequence-dependent and reproduces very well not only local, but also global physical properties of DNA. The efficiency of the method allows us to recover with a reduced computational effort high-quality atomic-resolution ensembles of segments containing many kilobases of DNA, entering into the gene range or even the entire DNA of certain cellular organelles.

Sensing technologies and machine learning methods for emotion recognition in autism: Systematic review.

BACKGROUND: Human Emotion Recognition (HER) has been a popular field of study in the past years. Despite the great progresses made so far, relatively little attention has been paid to the use of HER in autism. People with autism are known to face problems with daily social communication and the prototypical interpretation of emotional responses, which are most frequently exerted via facial expressions. This poses significant practical challenges to the application of regular HER systems, which are normally developed for and by neurotypical people. OBJECTIVE: This study reviews the literature on the use of HER systems in autism, particularly with respect to sensing technologies and machine learning methods, as to identify existing barriers and possible future directions. METHODS: We conducted a systematic review of articles published between January 2011 and June 2023 according to the 2020 PRISMA guidelines. Manuscripts were identified through searching Web of Science and Scopus databases. Manuscripts were included when related to emotion recognition, used sensors and machine learning techniques, and involved children with autism, young, or adults. RESULTS: The search yielded 346 articles. A total of 65 publications met the eligibility criteria and were included in the review. CONCLUSIONS: Studies predominantly used facial expression techniques as the emotion recognition method. Consequently, video cameras were the most widely used devices across studies, although a growing trend in the use of physiological sensors was observed lately. Happiness, sadness, anger, fear, disgust, and surprise were most frequently addressed. Classical supervised machine learning techniques were primarily used at the expense of unsupervised approaches or more recent deep learning models. Studies focused on autism in a broad sense but limited efforts have been directed towards more specific disorders of the spectrum. Privacy or security issues were seldom addressed, and if so, at a rather insufficient level of detail.

EFFECT OF PULMONARY ARTERY CATHETERIZATION IN PATIENTS WITH NONISCHEMIC CARDIOGENIC SHOCK: A NATIONWIDE ANALYSIS.

ABSTRACT: Background: Pulmonary artery catheterization (PAC) has been widely used in critically ill patients, yielding mixed results. Prior studies on cardiogenic shock (CS) predominantly included patients with acute myocardial infarction. This study aims to examine the effect of PAC use in patients with nonischemic CS. Methods: This retrospective cohort study employed data from the National Inpatient Sample database, including weighted hospitalizations of adult patients with nonischemic CS during 2017 to 2019. In-hospital outcomes were compared between groups using inverse probability of treatment weighting. Results: A total of 303,970 patients with nonischemic CS were included, of whom 17.5% received a PAC during their hospitalization. The median age was 67 years (interquartile range: 57-77) and 61% were male. After inverse probability of treatment weighting, patients in the PAC group had significantly lower in-hospital mortality (24.8% vs. 35.3%, P < 0.001), renal replacement therapy (10.7% vs. 12.4%, P = 0.002), in-hospital cardiac arrest (7.1% vs. 9.6%, P < 0.001), and mechanical ventilation (44.6% vs. 50.4%, P < 0.001) compared to non-PAC group. In contrast, the PAC group had higher use of intra-aortic balloon pump (15.4% vs. 3.4%, P < 0.001), percutaneous ventricular assist devices (12.6% vs. 2.6%, P < 0.001), extracorporeal membrane oxygenation (3.9% vs. 2.5%, P < 0.001), and heart transplantation (2.1% vs. 0.4%, P < 0.001). Conclusion: In the real-world setting, invasive hemodynamic monitoring with PAC in patients with nonischemic CS is associated with survival benefits and a reduction in adverse events, including reduced need for renal replacement therapy, mechanical ventilation and risk of in-hospital cardiac arrest.

Is all work the same? Performance after accumulated work of differing intensities in male professional cyclists.

OBJECTIVES: Although the ability to attenuate power output (PO) declines after accumulated work (i.e., 'durability') is increasingly recognized as a major determinant of cycling performance, the potential role of the intensity of the previous work is unclear. We assessed the effect of work-matched levels of accumulated work at different intensities on performance in male professional cyclists. DESIGN: Observational field-based study. METHODS: PO data was registered in 17 cyclists during a competition season, and the critical power (CP) was repeatedly determined every 4 weeks from training sessions and competitions. Participants' maximum mean power (MMP) for different durations (5 s, 5 min, 10 min, and 20 min) and the CP were determined under 'fresh' conditions (0 kJ·kg-1) and after varying levels of accumulated work (2.5, 5.0 and 7.5 kJ·kg-1) at intensities below and above the CP. RESULTS: A significant decline was found for all MMP values following all levels of accumulated work above the CP (-4.0 %, -1.7 %, -1.8 %, and -3.2 % for 30s, 5 min, 10 min and 20 min-MMP, respectively; all p < 0.001), versus no change after any level of accumulated work below the CP (all p > 0.05). Similar results were observed for the CP, which decreased after all levels of accumulated work above (-2.2 %, -6.1 %, and -16.2 %, after 2.5, 5.0 and 7.5 kJ·kg-1, p < 0.001) but not below this indicator (p > 0.05). CONCLUSIONS: In male professional cyclists, accumulated work above the CP impairs performance compared with work-matched, albeit less intense efforts. This raises concerns on the use of mechanical work per se as a single fatigue/stress indicator in these athletes.

Linguistic correlates of societal variation: A quantitative analysis.

Traditionally, many researchers have supported a uniformitarian view whereby all languages are of roughly equal complexity, facilitated by internal trade-offs between complexity at different levels, such as morphology and syntax. The extent to which the speakers' societies influence the trade-offs has not been well studied. In this paper, we focus on morphology and syntax, and report significant correlations between specific linguistic and societal features, in particular those relating to exoteric (open) vs. esoteric (close-knit) society types, characterizable in terms of population size, mobility, communication across distances, etc. We conduct an exhaustive quantitative analysis drawing upon WALS, D-Place, Ethnologue and Glottolog, finding some support for our hypothesis that languages spoken by exoteric societies tend towards more complex syntaxes, while languages spoken by esoteric societies tend towards more complex morphologies.

High-dose short-term creatine supplementation without beneficial effects in professional cyclists: a randomized controlled trial.

BACKGROUND: Growing evidence supports the ergogenic effects of creatine supplementation on muscle power/strength, but its effects on endurance performance remain unclear. We assessed the effects of high-dose short-term creatine supplementation in professional cyclists during a training camp. METHODS: The study followed a double-blind, randomized parallel design. Twenty-three professional U23 cyclists (19 ± 1 years, maximum oxygen uptake: 73.0 ± 4.6 mL/kg/min) participated in a 6-day training camp. Participants were randomized to consume daily either a recovery drink (containing carbohydrates and protein) with a 20-g creatine supplement (creatine group, n = 11) or just the recovery drink (placebo group, n = 12). Training loads and dietary intake were monitored, and indicators of fatigue/recovery (Hooper index, countermovement jump height), body composition, and performance (10-second sprint, 3-, 6-, and 12-minute time trials, respectively, as well as critical power and W') were assessed as study outcomes. RESULTS: The training camp resulted in a significant (p < 0.001) increase of training loads (+50% for total training time and + 61% for training stress score, compared with the preceding month) that in turn induced an increase in fatigue indicators (significant time effect [p < 0.001] for delayed-onset muscle soreness, fatigue, and total Hooper index) and a decrease in performance (significant time effect [p = 0.020] for critical power, which decreased by -3.8%). However, no significant group-by-time interaction effect was found for any of the study outcomes (all p > 0.05). CONCLUSIONS: High-dose short-term creatine supplementation seems to exert no consistent beneficial effects on recovery, body composition or performance indicators during a strenuous training period in professional cyclists.

CuentosIE: can a chatbot about "tales with a message" help to teach emotional intelligence?

In this article, we present CuentosIE (TalesEI: chatbot of tales with a message to develop Emotional Intelligence), an educational chatbot on emotions that also provides teachers and psychologists with a tool to monitor their students/patients through indicators and data compiled by CuentosIE. The use of "tales with a message" is justified by their simplicity and easy understanding, thanks to their moral or associated metaphors. The main contributions of CuentosIE are the selection, collection, and classification of a set of highly specialized tales, as well as the provision of tools (searching, reading comprehension, chatting, recommending, and classifying) that are useful for both educating users about emotions and monitoring their emotional development. The preliminary evaluation of the tool has obtained encouraging results, which provides an affirmative answer to the question posed in the title of the article.

The Influence of High-Intensity Work on the Record Power Profile of Under-23, Pro Team, and World Tour Cyclists.

BACKGROUND: Durability (ie, the ability to attenuate the decline in performance after accumulated work) has been identified as a performance determinant in elite cyclists. The aim of the present study was to compare durability in elite cyclists of various performance levels, particularly after high-intensity work, referred to as "high-intensity durability." METHODS: Forty-nine (N = 49) male road cyclists were categorized as either under 23 years of age (U23) (N = 11), Pro Team (N = 13), or World Tour (N = 24). The participants' critical power (CP) was assessed during the preseason. Thereafter, the participants' maximum mean power (MMP) values were determined for efforts of different durations (from 5 s to 30 min) after different levels of accumulated work above CP (from 0 to 7.5 kJ·kg-1). RESULTS: U23 cyclists showed a significant reduction of all relative MMP values for durations ≥1 minute after ≥5 kJ·kg-1 above CP compared with the "fresh" state (0 kJ·kg-1), whereas in Pro Team and World Tour cyclists, a significant reduction was not observed until 7.5 kJ·kg-1 above CP. In the "fresh" state, both Pro Team and particularly World Tour cyclists attained higher MMP values for efforts ≥10 minutes than U23 riders. However, more differences emerged with greater previous work levels, and indeed after 7.5 kJ·kg-1 above CP World Tour cyclists attained higher MMP values than both U23 and Pro Team cyclists for most efforts (≥30 s). CONCLUSION: Pro Team and particularly World Tour cyclists tolerate greater levels of accumulated work at high intensity, which might support the importance of high-intensity durability for performance.

Torque-Cadence Profile and Maximal Dynamic Force in Cyclists: A Novel Approach.

We aimed to determine the feasibility, test-retest reliability and long-term stability of a novel method for assessing the force (torque)-velocity (cadence) profile and maximal dynamic force (MDF) during leg-pedaling using a friction-loaded isoinertial cycle ergometer and a high-precision power-meter device. Fifty-two trained male cyclists completed a progressive loading test up to the one-repetition maximum (1RM) on a cycle ergometer. The MDF was defined as the force attained at the cycle performed with the 1RM-load. To examine the test-retest reliability and long-term stability of torque-cadence values, the progressive test was repeated after 72 h and also after 10 weeks of aerobic and strength training. The participants' MDF averaged 13.4 ± 1.3 N·kg-1, which was attained with an average pedal cadence of 21 ± 3 rpm. Participants' highest power output value was attained with a cadence of 110 ± 16 rpm (52 ± 5% MDF). The relationship between the MDF and cadence proved to be very strong (R2 = 0.978) and independent of the cyclists' MDF (p = 0.66). Cadence values derived from this relationship revealed a very high test-retest repeatability (mean SEM = 4 rpm, 3.3%) and long-term stability (SEM = 3 rpm, 2.3%); despite increases in the MDF following the 10-week period. Our findings support the validity, reliability and long-term stability of this method for the assessment of the torque-cadence profile and MDF in cyclists.

Acute ketone supplementation in the absence of muscle glycogen utilization: Insights from McArdle disease.

BACKGROUND & AIMS: Ketone supplementation is gaining popularity. Yet, its effects on exercise performance when muscle glycogen cannot be used remain to be determined. McArdle disease can provide insight into this question, as these patients are unable to obtain energy from muscle glycogen, presenting a severely impaired physical capacity. We therefore aimed to assess the effects of acute ketone supplementation in the absence of muscle glycogen utilization (McArdle disease). METHODS: In a randomized cross-over design, patients with an inherited block in muscle glycogen breakdown (i.e., McArdle disease, n = 8) and healthy controls (n = 7) underwent a submaximal (constant-load) test that was followed by a maximal ramp test, after the ingestion of a placebo or an exogenous ketone ester supplement (30 g of D-beta hydroxybutyrate/D 1,3 butanediol monoester). Patients were also assessed after carbohydrate (75 g) ingestion, which is currently considered best clinical practice in McArdle disease. RESULTS: Ketone supplementation induced ketosis in all participants (blood [ketones] = 3.7 ± 0.9 mM) and modified some gas-exchange responses (notably increasing respiratory exchange ratio, especially in patients). Patients showed an impaired exercise capacity (-65 % peak power output (PPO) compared to controls, p < 0.001) and ketone supplementation resulted in a further impairment (-11.6 % vs. placebo, p = 0.001), with no effects in controls (p = 0.268). In patients, carbohydrate supplementation resulted in a higher PPO compared to ketones (+21.5 %, p = 0.001) and a similar response was observed vs. placebo (+12.6 %, p = 0.057). CONCLUSIONS: In individuals who cannot utilize muscle glycogen but have a preserved ability to oxidize blood-borne glucose and fat (McArdle disease), acute ketone supplementation impairs exercise capacity, whereas carbohydrate ingestion exerts the opposite, beneficial effect.

The Tour de France, also possible for mortals? A comparison of a recreational and a World Tour cyclist.

Cycling Grand Tours are arguably the epitome of strenuous endurance exercise, and they have been reported to represent the ceiling of sustained energy expenditure for humans. It remains unknown, however, if an average recreational athlete could endure such an event. Through the analysis of power output (PO), we compared data from the 2023 Tour de France (21 stages, total distance = 3,405 km, elevation gain = 51,815 m) in a recreational (male, age = 58 yr; height = 191 cm; body mass = 96.1 kg; estimated maximum oxygen uptake = 45.4 mL·kg-1·min-1) and a sex-matched professional (World-Tour) cyclist (28 yr; 180 cm; 67.0 kg; 80.5 mL·kg-1·min-1). The recreational and professional cyclist completed the event in 191 and 87 h, respectively (average PO of 1.50 and 3.45 W·kg-1), with the latter spending a greater proportion of time in high-intensity zones. The recreational cyclist showed an estimated total daily energy expenditure (TDEE) of 35.9 MJ [or 8,580 kcal, or ∼4.3× his daily basal metabolic rate (BMR)], whereas lower absolute values were estimated for the professional cyclist (29.7 MJ, 7,098 kcal, ∼3.8× his BMR). Despite such high TDEE values, both individuals lost minimal body mass during the event (0-2 kg). The present report therefore suggests that, partly due to differences in exercise intensity and duration, not only professional cyclists but also recreational athletes can reach currently known ceilings of TDEE for humans.NEW & NOTEWORTHY This case report indicates that a recreationally trained 58-year-old man can reach similar or even higher values of energy expenditure (∼4 times their basal metabolic rate) than professional cyclists, who are likely near the ceiling of sustained energy expenditure for humans. This was possible owing to a total longer exercise time coupled with a lower absolute and relative intensity in the recreational athlete.

Time-course Changes of Field- and Laboratory-based Performance Indicators in Junior Cyclists Through a Season.

This study aimed to assess the seasonal evolution of field-based and laboratory-based performance indicators in cyclists. Thirteen Junior male road cyclists (age 17.4±0.5 years) were followed up during a season, which was divided in three phases: early season (involving mainly training sessions), mid-season (including the first competitions), and late season (including the major competitions of the season). During each phase, field-based power output data were registered for the assessment of maximum mean power values, and laboratory-based endurance (ramp test and simulated 8-minute time trial), muscle strength/power (squat, lunge, hip thrust) and body composition indicators (dual-energy X-ray absorptiometry) were also assessed. A progressive (p<0.01) increase in maximum mean power values (e.g., 3.8±0.3 and 4.5±0.4 watts/kg in early and late season, respectively, for 60-minute efforts) and on 8-minute time trial performance (i.e., 5.3±0.3 and 5.6±0.4 watts/kg, respectively) was observed through the season. Yet, more "traditional" endurance indicators (i.e., ventilatory threshold, respiratory compensation point, or maximum oxygen uptake) seemed to show a ceiling effect beyond the mid-season. In addition, neither peak power output, body composition, nor muscle strength indicators followed a similar pattern to the aforementioned field-based indicators. In summary, in Junior cyclists field-based indicators seem more sensitive to monitor endurance cyclists' changes in actual fitness and performance capacity than more "traditional" laboratory-based markers in Junior cyclists.

Dose-response effect of pre-exercise carbohydrates under muscle glycogen unavailability: Insights from McArdle disease.

BACKGROUND: This study aimed to determine the effect of different carbohydrate (CHO) doses on exercise capacity in patients with McArdle disease-the paradigm of "exercise intolerance", characterized by complete muscle glycogen unavailability-and to determine whether higher exogenous glucose levels affect metabolic responses at the McArdle muscle cell (in vitro) level. METHODS: Patients with McArdle disease (n = 8) and healthy controls (n = 9) underwent a 12-min submaximal cycling constant-load bout followed by a maximal ramp test 15 min after ingesting a non-caloric placebo. In a randomized, double-blinded, cross-over design, patients repeated the tests after consuming either 75 g or 150 g of CHO (glucose:fructose = 2:1). Cardiorespiratory, biochemical, perceptual, and electromyographic (EMG) variables were assessed. Additionally, glucose uptake and lactate appearance were studied in vitro in wild-type and McArdle mouse myotubes cultured with increasing glucose concentrations (0.35, 1.00, 4.50, and 10.00 g/L). RESULTS: Compared with controls, patients showed the "classical" second-wind phenomenon (after prior disproportionate tachycardia, myalgia, and excess electromyographic activity during submaximal exercise, all p < 0.05) and an impaired endurance exercise capacity (-51% ventilatory threshold and -55% peak power output, both p < 0.001). Regardless of the CHO dose (p < 0.05 for both doses compared with the placebo), CHO intake increased blood glucose and lactate levels, decreased fat oxidation rates, and attenuated the second wind in the patients. However, only the higher dose increased ventilatory threshold (+27%, p = 0.010) and peak power output (+18%, p = 0.007). In vitro analyses revealed no differences in lactate levels across glucose concentrations in wild-type myotubes, whereas a dose-response effect was observed in McArdle myotubes. CONCLUSION: CHO intake exerts beneficial effects on exercise capacity in McArdle disease, a condition associated with total muscle glycogen unavailability. Some of these benefits were dose dependent.

Laboratory-based determinants of simulated time trial performance in cyclists.

Different laboratory-based variables are individually associated with cycling performance, but scarce evidence exists on which of them, when all assessed in combination, could best explain cycling performance. The present study aimed to examine the combined association between laboratory-based endurance, strength/power and body composition indicators with time trial performance in high-level cyclists. Ninety-four male cyclists were recruited (age: 20 ± 3.5 years, maximum oxygen uptake [V̇O2max]: 77.7 ± 5.4 ml · kg-1 · min-1). Participants performed a maximal incremental cycling test for the assessment of endurance indicators (peak power output [PPO], V̇O2max, ventilatory threshold [VT] and respiratory compensation point [RCP]), and an incremental loading test to assess muscle strength and power-related outcomes (1-repetition maximum, mean maximal power) in the squat, lunge and hip-thrust exercises. Body composition was assessed by dual energy X-ray absorptiometry. On a separate visit, participants performed a simulated 8-minute time trial to assess cycling performance (determined as the mean power output attained). Strong-to-very-strong correlations were found between all endurance indicators and time trial performance (most r-values ranging between 0.68-0.92), whereas weaker correlations were found for strength/power (r-values < 0.5) or body composition (r-values < 0.7) indicators. Multivariate regression analyses revealed that VT, RCP and PPO explained together 92% of the variance in time trial performance (p < 0.001), with no significant contribution of the remaining variables. Although different endurance, strength/power and body composition individually correlate with simulated time trial performance in high-level cyclists, the former (and particularly VT, RCP and PPO) show the strongest association when all studied in combination. These findings underscore the importance of endurance capabilities (above strength/power or body composition) for maximizing time trial performance.

What Does It Take to Become a Professional Cyclist? A Laboratory-Based Longitudinal Analysis in Competitive Young Riders.

PURPOSE: Laboratory-based indicators are commonly used for performance assessment in young cyclists. However, evidence supporting the use of these indicators mostly comes from cross-sectional research, and their validity as predictors of potential future performance remains unclear. We aimed to assess the role of laboratory variables for predicting transition from U23 (under 23 y) to professional category in young cyclists. METHODS: Sixty-five U23 male road cyclists (19.6 [1.5] y) were studied. Endurance (maximal graded test and simulated 8-min time trial [TT]), muscle strength/power (squat, lunge, and hip thrust), and body composition (assessed with dual-energy X-ray absorptiometry) indicators were determined. Participants were subsequently followed and categorized attending to whether they had transitioned ("Pro") or not ("Non-Pro") to the professional category during the study period. RESULTS: The median follow-up period was 3 years. Pro cyclists (n = 16) showed significantly higher values than Non-Pro riders (n = 49) for ventilatory thresholds, peak power output, peak oxygen uptake, and TT performance (all P < .05, effect size > 0.69) and lower levels of fat mass and bone mineral content/density (P < .05, effect size > 0.63). However, no significant differences were found for muscle strength/power indicators (P > .05, effect size < 49). The most accurate individual predictor was TT performance (overall predictive value = 76% for a cutoff value of 5.6 W·kg-1). However, some variables that did not reach statistical significance in univariate analyses contributed significantly to a multivariate model (R2 = .79, overall predictive value = 94%). CONCLUSIONS: Although different "classic" laboratory-based endurance indicators can predict the potential of reaching the professional category in U23 cyclists, a practical indicator such as 8-minute TT performance showed the highest prediction accuracy.