Large inter-individual variability in force-velocity profile changes in response to acute high-load resistance training.

Background: While the acute effects of high-load resistance training on the force generating capacity of muscles have been widely examined, limited data exist on the relationship with the force-velocity profile (FV). Evidence suggests high sensitivity of the vertical FV profile to monitor changes in the muscle's mechanical properties according to the type of the exercise protocol. However, the interpretation of the findings seems not as straightforward. Therefore, the purpose of this study was to examine the effects of a high-load resistance training protocol on the muscle's mechanical properties during loaded jumps and on the vertical force-velocity profile (FV) in relation to maximal strength. Methods: 29 resistance-trained male (mean age±SD: 35.4 ± 7.8 years) and 29 female athletes (mean age±SD: 32.5 ± 7.0 years) participated in the study. Five-repetition maximum (5RM) in back squat, unloaded countermovement jump (CMJ) and FV profile were assessed. Loaded jumps were performed against 25, 50, 75, and 100 percent of body mass. Participants performed exercise protocols corresponding to their 5RM. Immediately after, unloaded CMJ and FV profile measurements were repeated. Results: A significant decrease in CMJ height (∼5-6%) and in average power (∼4%) was recorded for both men and women. The FV profile did not change after the exercise protocol; however, there was a significant decrease in theoretical maximal power (from 4 to 5%) and in theoretical maximal velocity (∼3%). Maximal strength was not associated with the changes in FV profile. Conclusions: Findings suggest that an acute high-load exercise decreased vertical jump performance and maximal power output, but without a concomitant change in FV profile. The large interindividual variability in FV measures indicates a less straightforward connection of the applied exercise with the acute response in the FV profile, highlighting the complexity of the FV profile to monitor changes in response to an acute training load.

The Acute Effect of Dynamic vs. Proprioceptive Neuromuscular Facilitation Stretching on Sprint and Jump Performance.

Participating in sports has been shown to promote overall wellness and, at the same time, reduce health risks. As more people are participating in sports, competitions have increased, and every aspect of the game has been focused by coaches and athletes in order to improve performance. One of these aspects is the warm-up session. The purpose of this study was to investigate the acute effect of a dynamic warm-up versus a proprioceptive neuromuscular facilitation (PNF) warm-up on the sprint and jump performance of recreationally active men. Thirty (n = 30) males were randomly assigned to undergo three sessions of different warm-up types, 72 h apart, involving either proprioceptive neuromuscular facilitation (PNF), dynamic stretching (DS), or no stretching session (control). The PNF and dynamic modes of stretching improved vertical jump performance, F (2.58) = 5.49, p = 0.046, to a certain extent (mean + 3.32% vs. control, p = 0.002 for dynamic and mean + 1.53% vs. control, p = 0.048 for PNF stretching). Dynamic stretching is best used to get a better vertical jump height. Sprint performance was also increased to a greater extent following the stretching session, F (2.58) = 5.60, p = 0.01. Sprint time was +1.05% faster vs. the control, with a value of p = 0.002 after dynamic stretching, while PNF stretching demonstrated a sprint time of +0.35% vs. the control, with a value of p = 0.049. Dynamic stretching showed a better sprint performance and also vertical jump height performance in this study. PNF and dynamic stretching prove to be equally efficacious in flexibility conditioning depending on the type of movement involved. This type of stretching should be utilized to help preserve or improve the performance output of physical activity, especially in sprinting and jumping events.

Dynamics and Mechanisms of ERK Activation after Different Protocols that Induce Long-Term Synaptic Facilitation in Aplysia.

Phosphorylation of the MAPK family member extracellular signal-regulated kinase (ERK) is required to induce long-term synaptic plasticity, but little is known about its persistence. We examined ERK activation by three protocols that induce long-term synaptic facilitation (LTF) of the Aplysia sensorimotor synapse - the standard protocol (five 5-min pulses of 5-HT with interstimulus intervals (ISIs) of 20 min), the enhanced protocol (five pulses with irregular ISIs, which induces greater and longer-lasting LTF) and the two-pulse protocol (two pulses with ISI 45 min). Immunofluorescence revealed complex ERK activation. The standard and two-pulse protocols immediately increased active, phosphorylated ERK (pERK), which decayed within 5 h. A second wave of increased pERK was detected 18 h post-treatment for all protocols. This late phase was blocked by inhibitors of protein kinase A, TrkB and TGF-ß. These results suggest that complex interactions among kinase pathways and growth factors contribute to the late increase of pERK. ERK activity returned to basal 24 h after the standard or two-pulse protocols, but remained elevated 24 h for the enhanced protocol. This 24-h elevation was also dependent on PKA and TGF-ß, and partly on TrkB. These results begin to characterize long-lasting ERK activation, plausibly maintained by positive feedback involving growth factors and PKA, that appears essential to maintain LTF and LTM. Because many processes involved in LTF and late LTP are conserved among Aplysia and mammals, these findings highlight the importance of examining the dynamics of kinase cascades involved in vertebrate long-term memory.

Co-creation of a training for community health workers to enhance skills in serving LGBTQIA+ communities.

This paper describes creating and implementing a 30-h LGBTQIA+ specialty training for community health workers (CHWs). The training was co-developed by CHW training facilitators (themselves CHWs), researchers with expertise in LGBTQIA+ populations and health information, and a cohort of 11 LGBTQIA+ CHWs who theater tested and piloted the course. The research and training team collected cohort feedback through focus groups and an evaluative survey. Findings stress the importance of a curriculum designed to elicit lived experiences and informed by a pedagogical framework centered on achieving LGBTQIA+ visibilities. This training is a vital tool for CHWs to foster cultural humility for LGBTQIA+ populations and identify opportunities to support their health promotion, especially considering their limited and sometimes absent access to affirming and preventative healthcare. Future directions include revising the training content based on cohort feedback and adapting it to other contexts, such as cultural humility training for medical and nursing professionals and staff.

Commercial device-based hand rehabilitation systems for stroke patients: State of the art and future prospects.

Various hand rehabilitation systems have recently been developed for stroke patients, particularly commercial devices. Articles from 10 electronic databases from 2010 to 2022 were extracted to conduct a systematic review to explore the existing commercial training systems (hardware and software) and evaluate their clinical effectiveness. This review divided the rehabilitation equipment into contact and non-contact types. Game-based training protocols were further classified into two types: immersion and non-immersion. The results of the review indicated that the majority of the devices included were effective in improving hand function. Users who underwent rehabilitation training with these devices reported improvements in their hand function. Game-based training protocols were particularly appealing as they helped reduce boredom during rehabilitation training sessions. However, the review also identified some common technical drawbacks in the devices, particularly in non-contact devices, such as their vulnerability to the effects of light. Additionally, it was found that currently, there is no commercially available game-based training protocol that specifically targets hand rehabilitation. Given the ongoing COVID-19 pandemic, there is a need to develop safer non-contact rehabilitation equipment and more engaging training protocols for community and home-based rehabilitation. Additionally, the review suggests the need for revisions or the development of new clinical scales for hand rehabilitation evaluation that consider the current scenario, where in-person interactions might be limited.

Development and optimization of an effective method for evaluating habituation learning behavior in larval zebrafish.

BACKGROUND: Habituation learning is a simple and conserved behavior in all organisms which could be induced by repeated stimuli. However, no standard and universal methods for training and evaluating the habituation learning behavior in larval zebrafish were available. NEW METHOD: This study aims to establish effective training and detection protocols for habituation learning behavior in larval zebrafish by using the ViewPoint system. For this purpose, the detection threshold of velocity-a parameter for distinguishing the escape reaction and the spontaneous motion, the detection sensitivity-a parameter for determining the size of the identified object, the number of stimuli, and the age of larvae were optimized to obtain the best performance. RESULTS: In this study, the optimized parameters were as follows: the detection threshold of velocity at 13, the luminous intensity at 8 %, the detection sensitivity at 32, the number of stimuli at 150, and the age of larvae at 6 dpf. Furthermore, we validated the utility of the established protocol by showing a consistent memory impairment induced by cycloheximide (CHX). COMPARISON WITH EXISTING METHOD: A similar method was reported previously. However, the equipment used in those assays, including the hardware and software, were neither standard nor universal, which might impede the extensive application of the habituation learning assays. Here, we developed an alternative method for studying the habituation learning behavior in larval zebrafish using the ViewPoint system. CONCLUSIONS: Our study provided an alternative method for studying the habituation learning behavior in larval zebrafish.

Effect of Online Home-Based Training on Functional Capacity and Strength in Two CKD Patients: A Case Study.

Chronic kidney disease (CKD) is a clinical condition characterized by the loss of kidney function over time, as well as several complications affecting gastrointestinal, cardiovascular, and musculoskeletal systems. Physical exercise seems to induce positive adaptations in CKD patients, without side effects. Usually, these patients show a reduced physical activity and physical performance. The aim of this case-report was to evaluate the effects of an online training protocol on functional capacity and on muscle mass, in CKD stage III patients. Methods: Two CKD (stage III according to KDIGO guidelines) participants (1 female, Patient A; 1 male, Patient B) were enrolled and they performed an online tailored-supervised combined training lasting 12 weeks, including multi-joint strength exercises using TheraBand and an aerobic session at 65-70% of the patients' heart rate reserve. Results: Both patients showed an improving trend on functional capacity (6 min walking test: Patient A = +3%; Patient B = +5.3%) and on strength of the upper arms (handgrip strength test-right: Patient A = +13.4%; Patient B = +19.1%; handgrip strength test-left: Patient A = +42.8%; Patient B= +12.9%), as well as a reduction in inflammation and oxidative stress biomarkers. The protocol was feasible, and no side effects were evidenced. These case studies suggest that the online combined training can produce beneficial effects in CKD patients under conservative therapy, by reducing the CKD-related complications and improving the adherence to exercise of this population of patients, overcoming logistic barriers such as transportation, availability of facilities, and working and personal-life schedule.

Mejora del razonamiento analógico en ancianos / Improving Analog Reasoning in the Elderly

Analogical reasoning is perhaps the core element of intelligent behavior and it has been related to successful aging. The present study aimed to impact the analogical reasoning of the elderly individuals through the application of an analogies protocol based on promoting fluency and flexibility (FFA) in relational responding. The FFA protocol was designed specifically for this study and according to the available information on relational behavior. A pre-post design with two conditions, five participants each ranged of 69 to 89 years old. At pre-test, participants responded to two WAIS subscales as well as to three analogies tasks specifically designed for the study. Then, fluency and flexibility analogies protocol (FFA) was applied to the participants of the experimental condition throughout a week. Subsequently, in post-test, the same measures used in the pre-test were applied. The FFA protocol had a significant impact on three of the five measures. The sensitivity of the tests was discussed as well as different ways to improve the protocol impact were all discussed. The relevant effect produced for most of the participants are discussed and highlighted (AU)

Can the training regimen influence night time physical activity in racehorses?

Physical activity has been widely investigated in horses to elucidate locomotion characteristics and behavior. However, research in real environment of training stables is limited. The objective of this study was to evaluate the effect of training regimen on night time physical activity of racehorses. Physical activities of twenty animals were monitored during the night time using accelerometers. The animals were compared in terms of training regimen: horses subjected to training on continual days, and horses subjected to training on intermittent days; age and sex were also considered. The variables analyzed were: counts per minute, percentage of time in (sedentary, light, moderate and vigorous) physical activity. Statistical analysis was performed by the PROCGLM procedure (ANOVA) and the means were calculated by Tukey's test. The training regimen impacts the physical activity of thoroughbreds. The mean counts per minute showed a higher physical activity in the intermittent trained animals in relation with continuously trained animals. The continuously trained animals presented a greater percentage of time in sedentary physical activity than those intermittent trained. However, intermittently trained horses spent a larger percentage of time in moderate and vigorous physical activity, in comparison with continuously trained animals. In conclusion, racehorses subject to training on continual days have lower physical activity in the night time than those that train on intermittent days.

A realização de supersérie em uma sessão completa de treinamento impacta no volume e percepção subjetiva de esforço de praticantes de musculação / La realización de una superserie en una sesión completa de entrenamiento influye en el volumen y percepción subjetiva de esfuerzo de practicantes de musculación / Performing a superset in a complete training session impact on volume and rate of perceived exertion of resistance training practitioners

Objetivo: Comparar os protocolos tradicional e supersérie, com intervalo de recuperação equiparado, quanto ao volume total de treinamento (número de repetições x peso), número total de repetições por exercício e percepção subjetiva de esforço em uma sessão de treinamento.Método: Dezesseis homens treinados realizaram de forma randomizada os protocolos. No protocolo tradicional foram executadas três séries com intervalos de dois minutos entre séries e três minutos entre exercícios. No protocolo supersérie, 30 segundos após o término de cada série, o voluntário realizava o outro exercício. Depois de finalizado o segundo exercício da supersérie, o voluntário aguardava o término do intervalo (dois minutos) para reiniciar o primeiro exercício da supersérie.Resultados: Verificou-se maior volume total de treinamento no protocolo tradicional em comparação ao supersérie (p = 0.003). Adicionalmente, no protocolo tradicional os voluntários realizaram maior número de repetições (p < 0.05) em cinco dos oito exercícios. Com relação à percepção subjetiva de esforço, os participantes relataram maiores valores de esforço no protocolo supersérie quando comparado ao protocolo tradicional (p = 0.017).Conclusão: Foi observada redução no volume total de treinamento com a utilização do protocolo supersérie, comparado ao protocolo tradicional, em uma sessão de treinamento na musculação. Adicionalmente, houve uma maior percepção subjetiva de esforço dos sujeitos no protocolo supersérie. Sendo assim, a aplicação do protocolo tradicional torna-se uma alternativa eficiente quando o objetivo é priorizar o volume de treinamento. (AU)

Objetivo: Comparar el protocolo tradicional y el de superserie, con pausa equiparada, en cuanto al volumen total de entrenamiento (número de repeticiones x peso), número total de repeticiones por ejercicio y percepción subjetiva de esfuerzo, en una sesión de entrenamiento.Método: Dieciséis hombres entrenados realizaron de forma aleatorizada los protocolos. En el protocolo tradicional se realizaron tres series con intervalos de dos minutos entre las series y tres minutos entre los ejercicios. En el protocolo de superserie, 30 segundos después de finalizada cada serie, el voluntario realizaba el otro ejercicio. Después de finalizado el segundo ejercicio de la superserie, el voluntario aguardaba el final del intervalo (dos minutos) para reiniciar el primer ejercicio de la superserie.Resultados: Se verificó mayor volumen total de entrenamiento en el protocolo tradicional en comparación con el protocolo superserie (p = 0.003). Adicionalmente, en el protocolo tradicional, los voluntarios realizaron mayor número de repeticiones (p < 0.05) en cinco de los ocho ejercicios de la sesión de entrenamiento. En cuanto a la percepción subjetiva de esfuerzo los participantes reportaron mayores valores de esfuerzo en el protocolo superserie comparado con el protocolo tradicional (p = 0.017).Conclusión: Se observó reducción en el volumen total de entrenamiento con la utilización del protocolo superserie, comparado al protocolo tradicional, en una sesión completa de entrenamiento de musculación. Adicionalmente, hubo una mayor percepción subjetiva de esfuerzo de los sujetos en el protocolo superserie. Por lo tanto, la aplicación del protocolo tradicional se convierte en una alternativa eficiente cuando el objetivo es priorizar el volumen de entrenamiento. (AU)

Objective: To compare the traditional protocol and supersets, with equal rest interval, on volume load (number of repetitions x load), total number of repetitions per exercise, and rating of perceived exertion in a training session.Method: Sixteen resistance trained men randomly performed the protocols. In traditional protocol, three sets were performed with rest intervals of two minutes between sets and three minutes between exercises. In the superset protocol, 30 seconds after the end of each set, the subject performed the other exercise. After completing the second exercise of the superset, the volunteer waited for the end of the rest intervals (two minutes) to restart the first exercise of the superset.Results: There was a higher total training volume in traditional protocol compared to superset protocol (p = 0.003). Additionally, in traditional protocol, the volunteers performed a greater number of repetitions (p < 0.05) in five of the eight exercises of the training session. Regarding the median rating of perceived exertion of the training session, it was verified that the participants reported higher effort values in the superset protocol when compared to the traditional protocol (p = 0.017).Conclusion: A reduction in the total volume of training was observed with the use of the superset protocol alternated by body segment, compared to the traditional protocol, in a complete resistance training session. Additionally, there was a higher rating of perceived exertion of the subjects in the superset protocol. Thus, the application of the traditional protocol becomes an efficient alternative when the goal is to prioritize the training volume. (AU)

Treadmill training based on the overload principle promotes locomotor recovery in a mouse model of chronic spinal cord injury.

Rehabilitative treatment, including treadmill training, is considered an important strategy for restoring motor function after spinal cord injury (SCI). However, many unexplained problems persist regarding the appropriate rehabilitative method and the mechanism underlying the beneficial effects of rehabilitation. Moreover, only a few preclinical studies have been performed on rehabilitative interventions for chronic SCI, although most patients have chronic injuries. In fact, several preclinical studies reported that rehabilitative training was less effective when applied during the chronic phase than when applied sooner. While numerous studies have examined the effects of treadmill training during the subacute phase, the training conditions vary considerably among preclinical reports. Therefore, establishing a standard training protocol is essential for achieving beneficial rehabilitation effects at the chronic stage. Since the difficulty of applying an appropriate training load hinders training at constant speeds, it is important to adjust the training intensity in accordance with the exercise tolerance of an individual animal to provide further functional recovery benefits. Here, we created a novel quadrupedal treadmill training protocol based on the overload principle for mice with incomplete thoracic SCI. We subjected SCI model mice to rehabilitative training according to the protocol for two consecutive weeks starting at 42 days after injury. We examined the treadmill speeds at which the mice were able to run based on the severity of paresis and investigated the impact of the protocol on functional recovery. Assessment of running speed changes during the treadmill training period revealed faster treadmill speeds for mice with mild paresis than for those with severe paresis. The training parameters, including the speed and distance traveled, were positively correlated with the changes in motor function. These results suggest that the most suitable running speed during treadmill training differs according to the level of motor dysfunction and that running longer distances has a positive impact on motor functional recovery. Based on this established protocol, we compared functional and histological results between the chronic SCI groups with and without rehabilitation. The gait analyses showed significantly better functional improvement in the rehabilitation group than in the nonrehabilitation group. Histological analyses revealed that the BDNF- and VGLUT1-positive areas of lumbar enlargement were significantly increased in the rehabilitation group. These findings implied that rehabilitation promoted not only motor performance but also motor control, including forelimb-hindlimb coordination, even in chronic SCI, resulting in functional improvement by treadmill training alone. Therefore, rehabilitative training based on the overload principle appears to be one of the appropriate treatment options for incomplete thoracic SCI, and evidence of its efficacy exists in actual clinical settings.

A case for mandatory ultrasound training for rural general practitioners: a commentary.

CONTEXT: Point-of-care ultrasound is a rapidly evolving technology that enables rapid diagnostic imaging to be performed at a patient's bedside, reducing time to diagnosis and minimising the need for patient transfers. This has significant applications for rural emergency and general practice, and could potentially prevent unnecessary transfers of patients from rural communities to more urban centres for the purpose of diagnostic imaging, reducing costs and preventing disruption to patients' lives. Meta-analyses on point-of-care ultrasound have reported extremely high sensitivity and specificity when detecting lung pathology, and the potential applications of the technology are substantial. A significant application of the technology is in the care of rural paediatric patients, where acute lower respiratory pathology is the most common cause of preventable deaths, hospitalisations, and emergency medical retrievals from remote communities for children under five. ISSUES: Although widely available, point-of-care ultrasound technology is not widely utilised in Australian emergency departments and general practices. Issues with comprehensive training, maintenance of skills, upskilling and quality assurance programs prevent physicians from feeling confident when utilising the technology. In Canada, point-of-care ultrasound training is part of the core competency training in the Royal College of Physicians of Canada emergency medicine fellowship program. Point-of-care ultrasound is widely used in rural practice, although lack of training, funding, maintenance of skills and quality assurance were still listed as barriers to use. LESSONS LEARNED: Point-of-care ultrasound is a highly sensitive and specific technology with wide potential applications. Issues with quality control and maintenance of skills are preventing widespread use. Coupling point-of-care ultrasound with telemedicine could help increase the usability and accessibility of the technology by reducing the issues associated with maintenance of skills and quality assurance.

An Online Data Visualization Feedback Protocol for Motor Imagery-Based BCI Training.

Brain-computer interface (BCI) has developed rapidly over the past two decades, mainly due to advancements in machine learning. Subjects must learn to modulate their brain activities to ensure a successful BCI. Feedback training is a practical approach to this learning process; however, the commonly used classifier-dependent approaches have inherent limitations such as the need for calibration and a lack of continuous feedback over long periods of time. This paper proposes an online data visualization feedback protocol that intuitively reflects the EEG distribution in Riemannian geometry in real time. Rather than learning a hyperplane, the Riemannian geometry formulation allows iterative learning of prototypical covariance matrices that are translated into visualized feedback through diffusion map process. Ten subjects were recruited for MI-BCI (motor imagery-BCI) training experiments. The subjects learned to modulate their sensorimotor rhythm to centralize the points within one category and to separate points belonging to different categories. The results show favorable overall training effects in terms of the class distinctiveness and EEG feature discriminancy over a 3-day training with 30% learners. A steadily increased class distinctiveness in the last three sessions suggests that the advanced training protocol is effective. The optimal frequency band was consistent during the 3-day training, and the difference between subjects with good or low MI-BCI performance could be clearly observed. We believe that the proposed feedback protocol has promising application prospect.

Evaluation of the training program for p16/ Ki-67 dual immunocytochemical staining interpretation for laboratory staff without experience in cervical cytology and immunocytochemistry.

Background p16/Ki-67 dual immunocytochemical staining (DS) is considered easy to interpret if evaluators are properly trained, however, there is no consensus on what constitutes proper training. In the present study we evaluated a protocol for teaching DS evaluation on students inexperienced in cervical cytology. Methods Initial training on 40 DS conventional smears was provided by a senior cytotechnologist experienced in such evaluation. Afterwards, two students evaluated 118 cases. Additional training consisted mainly of discussing discrepant cases from the first evaluation and was followed by evaluation of new 383 cases. Agreement and accuracy of students' results were compared among the participants and to the results of the reference after both evaluations. We also noted time needed for evaluation of one slide as well as intra-observer variability of the teacher's results. Results At the end of the study, agreement between students and reference was higher compared to those after initial training (overall percent agreement [OPA] 81.4% for each student, kappa 0.512 and 0.527 vs. OPA 78.3% and 87.2%, kappa 0.556 and 0.713, respectively). However, accuracy results differed between the two students. After initial training sensitivity was 4.3% points and 2.9% points higher, respectively compared to the reference, while specificity was 30.6% points and 24.4% points lower, respectively, compared to the reference. At the end of the study, the sensitivity reached by one student was the same as that of the reference, while it was 2.6% points lower for the other student. There was a statistically significant difference in specificity between one student and the reference and also between students (16.7 and 15.1% points). Towards the end of the study, one student needed 5.2 min for evaluating one slide while the other needed 8.2 min. The intra-observer variability of the senior cytotechnologist was in the range of "very good" in both arms of the study. Conclusions In teaching DS evaluation, the students' progress has to be monitored using several criteria like agreement, accuracy and time needed for evaluating one slide. The monitoring process has to continue for a while after students reach satisfactory results in order to assure a continuous good performance. Monitoring of teacher's performance is also advisable.

The combined treatment with lentil protein hydrolysate and a mixed training protocol is an efficient lifestyle intervention to manage cardiovascular and renal alterations in obese Zucker rats.

PURPOSE: Functional and structural changes in cardiovascular and renal systems resulting from obesity and metabolic syndrome represent a severe risk to human health. Lifestyle interventions such as combining healthy diet with adequate physical exercise protocols are good strategies to manage these pathologies. In this research, the effects of lentil protein hydrolysate administration, combined or not with a mixed training protocol, on insulin resistance, cardiovascular and renal functionality were studied in the obese Zucker rat experimental model. METHODS: Thirty-two rats (16 lean and 16 obese subdivided in sedentary and trained animals) were administered lentil protein hydrolysate, whereas another 32 subdivided in the same experimental design were administered placebo. The experiment lasted for 8 weeks. At the end of the experimental period, insulin resistance and different parameters of cardiovascular and renal functionality were measured. RESULTS: The individual or combined interventions with lentil protein hydrolysate and mixed training protocol were efficient at counteracting some of the metabolic, cardiovascular and renal alterations characterizing the obese Zucker rat. Specifically, lentil protein hydrolysate decreased hyperphagia, amplitude of QRS complex, plasma ACE and selectin E expression in aorta, while increasing urinary volume and pH. Exercise showed beneficial actions on HOMA-IR, QRS amplitude, QTc interval, urinary volume, kidney weight and Mn-SOD activity. Interestingly, most of the mentioned benefits of exercise were more consistent when protein hydrolysate was also administered. CONCLUSION: The interesting synergies between the two interventions assessed qualify them as alternative therapeutic strategies to treat cardiovascular and kidney diseases associated to the metabolic syndrome.

Validation of the endoscopic stone treatment step 1 (EST-s1): a novel EAU training and assessment tool for basic endoscopic stone treatment skills-a collaborative work by ESU, ESUT and EULIS.

INTRODUCTION: The endoscopic stone treatment step 1 (EST s1) protocol has been developed after 2 years of collaborative work between different European Association of Urology (EAU) sections. OBJECTIVES: In this study, we added construct validity evidence to the EST s1 curriculum. MATERIALS AND METHODS: The EST-s1 curriculum includes four standardized tasks: flexible cystoscopy, rigid cystoscopy, semi-rigid URS and flexible URS. Validation was performed during the annual 2016 EUREP meeting in Prague. 124 participants provided information on their endoscopic logbook and carried out these 4 tasks during a DVD recorded session. Recordings were anonymized and blindly assessed independently by five proctors. Inter-rater reliability was checked on a sample of five videos by the calculation of intra-class correlation coefficient. Task-specific clinical background of participants was correlated with their personal performance on the simulator. Breakpoint analysis was used to define the minimum number of performed cases, to be considered "proficient". "Proficient" and "Non-proficient" groups were compared for construct validity assessment. Likert scale-based questionnaires were used to test content and to comment on when the EST-s1 exams should be undertaken within the residency program. RESULTS: 124 participants (105 final-year residents and 19 faculty members) took part in this study. The breakpoint analysis showed a significant change in performance curve at 36, 41, 67 and 206 s, respectively, corresponding to 30, 60, 25 and 120 clinical cases for each of the 4 tasks. EST-s1 was scored as a valid training tool, correctly representing the procedures performed in each task. Experts felt that this curriculum is best used during the third year of residency training. CONCLUSION: Our validation study successfully demonstrated correlation between clinical expertise and EST-s1 tasks, adding construct validity evidence to it. Our work also demonstrates the successful collaboration established within various EAU sections.

Utilising an Accelerated Delphi Process to Develop Guidance and Protocols for Telepresence Applications in Remote Robotic Surgery Training.

CONTEXT: The role of robot-assisted surgery continues to expand at a time when trainers and proctors have travel restrictions during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE: To provide guidance on setting up and running an optimised telementoring service that can be integrated into current validated curricula. We define a standardised approach to training candidates in skill acquisition via telepresence technologies. We aim to describe an approach based on the current evidence and available technologies, and define the key elements within optimised telepresence services, by seeking consensus from an expert committee comprising key opinion leaders in training. EVIDENCE ACQUISITION: This project was carried out in phases: a systematic review of the current literature, a teleconference meeting, and then an initial survey were conducted based on the current evidence and expert opinion, and sent to the committee. Twenty-four experts in training, including clinicians, academics, and industry, contributed to the Delphi process. An accelerated Delphi process underwent three rounds and was completed within 72 h. Additions to the second- and third-round surveys were formulated based on the answers and comments from the previous rounds. Consensus opinion was defined as ≥80% agreement. EVIDENCE SYNTHESIS: There was 100% consensus regarding an urgent need for international agreement on guidance for optimised telepresence. Consensus was reached in multiple areas, including (1) infrastructure and functionality; (2) definitions and terminology; (3) protocols for training, communication, and safety issues; and (4) accountability including ethical and legal issues. The resulting formulated guidance showed good internal consistency among experts, with a Cronbach alpha of 0.90. CONCLUSIONS: Using the Delphi methodology, we achieved international consensus among experts for development and content validation of optimised telepresence services for robotic surgery training. This guidance lays the foundation for launching telepresence services in robotic surgery. This guidance will require further validation. PATIENT SUMMARY: Owing to travel restrictions during the coronavirus disease 2019 (COVID-19) pandemic, development of remote training and support via telemedicine is becoming increasingly important. We report a key opinion leader consensus view on a standardised approach to telepresence.

Myofibrillar protein synthesis and muscle hypertrophy individualized responses to systematically changing resistance training variables in trained young men.

The manipulation of resistance training (RT) variables is used among athletes, recreational exercisers, and compromised populations (e.g., elderly) attempting to potentiate muscle hypertrophy. However, it is unknown whether an individual's inherent predisposition dictates the RT-induced muscle hypertrophic response. Resistance-trained young [26 (3) y] men (n = 20) performed 8 wk unilateral RT (2 times/wk), with 1 leg randomly assigned to a standard progressive RT [control (CON)] and the contralateral leg to a variable RT (VAR; modulating exercise load, volume, contraction type, and interset rest interval). The VAR leg completed all 4 RT variations every 2 wk. Bilateral vastus lateralis cross-sectional area (CSA) was measured, pre- and post-RT and acute integrated myofibrillar protein synthesis (MyoPS) rates were assessed at rest and over 48 h following the final RT session. Muscle CSA increase was similar between CON and VAR (P > 0.05), despite higher total training volume (TTV) in VAR (P < 0.05). The 0-48-h integrated MyoPS increase postexercise was slightly greater for VAR than CON (P < 0.05). All participants were considered "responders" to RT, although none benefited to a greater extent from a specific protocol. Between-subjects variability (MyoPS, 3.30%; CSA, 37.8%) was 40-fold greater than the intrasubject (between legs) variability (MyoPS, 0.08%; CSA, 0.9%). The higher TTV and greater MyoPS response in VAR did not translate to a greater muscle hypertrophic response. Manipulating common RT variables elicited similar muscle hypertrophy than a standard progressive RT program in trained young men. Intrinsic individual factors are key determinants of the MyoPS and change in muscle CSA compared with extrinsic manipulation of common RT variables.NEW & NOTEWORTHY Systematically manipulating resistance training (RT) variables during RT augments the stimulation of myofibrillar protein synthesis (MyoPS) and training volume but fails to potentiate muscle hypertrophy compared with a standard progressive RT. Any modest further MyoPS increase and higher training volumes do not reflect in a greater hypertrophic response. Between-subject variability was 40-fold greater than the variability promoted by extrinsic manipulation of RT variables, indicating that individual intrinsic factors are stronger determinants of the hypertrophic response.

Therapeutic Approaches to Nonalcoholic Fatty Liver Disease: Exercise Intervention and Related Mechanisms.

Exercise training ameliorates nonalcoholic fatty liver disease (NAFLD) as well as obesity and metabolic syndrome. Although it is difficult to eliminate the effects of body weight reduction and increased energy expenditure-some pleiotropic effects of exercise training-a number of studies involving either aerobic exercise training or resistance training programs showed ameliorations in NAFLD that are independent of the improvements in obesity and insulin resistance. In vivo studies have identified effects of exercise training on the liver, which may help to explain the "direct" or "independent" effect of exercise training on NAFLD. Exercise training increases peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1α) expression, improves mitochondrial function and leads to reduced hepatic steatosis, inflammation, fibrosis, and tumor genesis. Crosstalk between the liver and adipose tissue, skeletal muscle and the microbiome is also a possible mechanism for the effect of exercise training on NAFLD. Although numerous studies have reported benefits of exercise training on NAFLD, the optimal duration and intensity of exercise for the prevention or treatment of NAFLD have not been established. Maintaining adherence of patients with NAFLD to exercise training regimes is another issue to be resolved. The use of comprehensive analytical approaches to identify biomarkers such as hepatokines that specifically reflect the effect of exercise training on liver functions might help to monitor the effect of exercise on NAFLD, and thereby improve adherence of these patients to exercise training. Exercise training is a robust approach for alleviating the pathogenesis of NAFLD, although further clinical and experimental studies are required.

Designing Guiding Systems for Brain-Computer Interfaces.

Brain-Computer Interface (BCI) community has focused the majority of its research efforts on signal processing and machine learning, mostly neglecting the human in the loop. Guiding users on how to use a BCI is crucial in order to teach them to produce stable brain patterns. In this work, we explore the instructions and feedback for BCIs in order to provide a systematic taxonomy to describe the BCI guiding systems. The purpose of our work is to give necessary clues to the researchers and designers in Human-Computer Interaction (HCI) in making the fusion between BCIs and HCI more fruitful but also to better understand the possibilities BCIs can provide to them.