Capturing artificial intelligence applications' value proposition in healthcare - a qualitative research study.

Artificial intelligence (AI) applications pave the way for innovations in the healthcare (HC) industry. However, their adoption in HC organizations is still nascent as organizations often face a fragmented and incomplete picture of how they can capture the value of AI applications on a managerial level. To overcome adoption hurdles, HC organizations would benefit from understanding how they can capture AI applications' potential.We conduct a comprehensive systematic literature review and 11 semi-structured expert interviews to identify, systematize, and describe 15 business objectives that translate into six value propositions of AI applications in HC.Our results demonstrate that AI applications can have several business objectives converging into risk-reduced patient care, advanced patient care, self-management, process acceleration, resource optimization, and knowledge discovery.We contribute to the literature by extending research on value creation mechanisms of AI to the HC context and guiding HC organizations in evaluating their AI applications or those of the competition on a managerial level, to assess AI investment decisions, and to align their AI application portfolio towards an overarching strategy.

Impact of a 4-week intensive track and field training intervention on glycaemia in adolescents with type 1 diabetes: The ChilDFiT1 study.

AIM: To investigate the safety and efficacy of track and field training compared with intensification of insulin treatment only in adolescents with type 1 diabetes (T1D). MATERIALS AND METHODS: Eighteen adolescents (seven females) with T1D were included (age 15.1 ± 1.1 years, HbA1c 7.3% ± 1.0% [56.3 ± 10.9 mmol/mol]). After a 4-week observational control phase, participants were randomized to either stand-alone intensive glycaemic management (IT; telemedicine or on-site visits, three times/week) or additionally performed track and field exercise (EX; three 60-minute sessions/week) for 4 weeks. Glycaemia was assessed via continuous glucose monitoring during observational control and intervention phases. RESULTS: Time in range (70-180 mg/dL; 3.9-10.0 mmol/L) significantly improved from the observational control phase to the exercise intervention phase in EX (69% ± 13% vs. 72% ± 11%, P = .049), but not in IT (59% ± 22% vs. 62% ± 16%, P = .399). Time below range 1 (54-69 mg/dL; < 3.9 mmol/L) improved in IT (3.1% ± 1.9% vs. 2.0% ± 0.8%, P = .017) and remained stable in EX (2.0% ± 1.7 vs. 1.9% ± 1.1%, P = .999). The EX group's HbA1c ameliorated preintervention to postintervention (mean difference: ΔHbA1c -0.19% ± 0.17%, P = .042), which was not seen within the IT group (ΔHbA1c -0.16% ± 0.37%, P = .40). Glucose standard deviation was reduced significantly in EX (55 ± 11 vs. 51 ± 10 mg/dL [3.1 ± 0.6 vs. 2.8 ± 0.6 mmol/L], P = .011), but not in IT (70 ± 24 vs. 63 ± 18 mg/dL [3.9 ± 1.3 vs. 3.5 ± 1.0 mmol/L], P = .186). CONCLUSION: Track and field training combined with intensive glycaemic management improved glycaemia in adolescents with T1D, which was not observed in the non-exercise group.

A lipidomic and metabolomic signature of a very low-carbohydrate high-fat diet and high-intensity interval training: an additional analysis of a randomized controlled clinical trial.

INTRODUCTION: Regular physical activity and dietary variety are modifiable and influential factors of health outcomes. However, the cumulative effects of these behaviors are not well understood. Metabolomics may have a promising research potential to extend our knowledge and use it in the attempts to find a long-term and sustainable personalized approach in exercise and diet recommendations. OBJECTIVE: The main aim was to investigate the effect of the 12 week very low carbohydrate high fat (VLCHF) diet and high-intensity interval training (HIIT) on lipidomic and metabolomic profiles in individuals with overweight and obesity. METHODS: The participants (N = 91) were randomly allocated to HIIT (N = 22), VLCHF (N = 25), VLCHF + HIIT (N = 25) or control (N = 19) groups for 12 weeks. Fasting plasma samples were collected before the intervention and after 4, 8 and 12 weeks. The samples were then subjected to untargeted lipidomic and metabolomic analyses using reversed phase ultra-high-performance liquid chromatography coupled to high-resolution mass spectrometry. RESULTS: The VLCHF diet affected plasma lipids considerably while the effect of HIIT was unremarkable. Already after 4 weeks of intervention substantial changes of plasma lipids were found in both VLCHF diet groups. The changes persisted throughout the entire 12 weeks of the VLCHF diet. Specifically, acyl carnitines, plasmalogens, fatty acyl esters of hydroxy fatty acid, sphingomyelin, ceramides, cholesterol esters, fatty acids and 4-hydroxybutyric were identified as lipid families that increased in the VLCHF diet groups whereas lipid families of triglycerides and glycerophospholipids decreased. Additionally, metabolomic analysis showed a decrease of theobromine. CONCLUSIONS: This study deciphers the specific responses to a VLCHF diet, HIIT and their combination by analysing untargeted lipidomic and metabolomic profile. VLCHF diet caused divergent changes of plasma lipids and other metabolites when compared to the exercise and control group which may contribute to a better understanding of metabolic changes and the appraisal of VLCHF diet benefits and harms. CLINICAL TRIAL REGISTRY NUMBER: NCT03934476, registered 1st May 2019 https://clinicaltrials.gov/ct2/show/NCT03934476?term=NCT03934476&draw=2&rank=1 .

Day-to-day variability in euvolemic body mass.

Short-term variability in body mass is a common, everyday phenomenon; however, data on body mass variability are scarce. While the physiological variability of body mass is negligible in healthy individuals, it could have implications for therapy in patients with impaired volume homeostasis, for example, patients with kidney failure undergoing kidney replacement therapy. We analyzed a long-term dataset comprising 9521 days of standardized body mass measurements from one healthy male individual and assessed the variability in body mass as a positive or negative relative difference in body mass measured on subsequent days. The average and median relative differences were zero, with a standard deviation (SD) of 0.53% for the one-day interval, increasing to 0.69% for the 7-day interval, and this variability was constant throughout the observation period. A body mass variability of approximately 0.6% (±450 mL in a 75-kg patient) should be taken into consideration when weight-dependent treatment prescriptions, e.g. the ultrafiltration rates in patients on hemodialysis, are being set. Consequently, a "soft target weight", considering the longitudinal variation of volume markers, such as body mass, might improve treatment quality.

Accelerometer-Derived Intensity Thresholds Are Equivalent to Standard Ventilatory Thresholds in Incremental Running Exercise.

Accelerometer cut-points are commonly used to prescribe the amount of physical activity, but this approach includes no individual performance measures. As running kinetics change with intensity, acceleration measurements may provide more individual information. Therefore, the aim was to determine two intensity thresholds from accelerometer measures. A total of 33 participants performed a maximal incremental running test with spirometric and acceleration (Axivity AX3) measures at the left and right tibia. Ventilatory equivalents (VE/VO2, VE/VCO2) were used to determine a first and second ventilatory threshold (VT1/VT2). A first and second accelerometer threshold (ACT1/ACT2) were determined within the same regions of interest from vector magnitude (|v| = √(ax2 + ay2 + az2). Accelerometer data from the tibia presented a three-phase increase with increasing speed. Speed at VT1/VT2 (7.82 ± 0.39/10.91 ± 0.87 km/h) was slightly but significantly lower compared to the speed at ACT1/ACT2 from the left (7.71 ± 0.35/10.62 ± 0.72 km/h) and right leg (7.79 ± 0.33/10.74 ± 0.77 km/h). Correlation analysis revealed a strong relationship between speed at thresholds determined from spriometric data or accelerations (r = 0.98; p < 0.001). It is therefore possible to determine accelerometer thresholds from tibia placement during a maximal incremental running test comparable to standard ventilatory thresholds.

Whole Body Substrate Metabolism during Different Exercise Intensities with Special Emphasis on Blood Protein Changes in Trained Subjects-A Pilot Study.

Contrary to carbohydrate and fat metabolism, the influence of a single exercise dose on protein metabolism has not been adequately explored yet. We assessed the effects of different exercise intensities and durations on blood protein changes and their association with carbohydrate (CHO) and fat metabolism in six eligible trained subjects. Subjects performed maximal incremental (IE100: at 100%VO2max) and submaximal continuous exercise (CE) at 75%VO2max for 30 min (CE75) and at 50%VO2max for 90 min (CE50). Blood samples were collected at rest (R), end of exercise (EE), and 1 h after recovery to assess blood urea nitrogen (BUN), plasma amino acids (AA), glucose, lactate, FFA, and glycerol. In IE100 blood lactate, CHO-oxidation (g/min), energy expenditure (kcal/min), and RER were significantly increased during rest (p < 0.05). CE50 induced significantly higher BUN, FFA, glycerol, and fat oxidation (g/min) (p < 0.05). At recovery, the mean sum of the free AA pool (µmol/L) reduced by 8% (p < 0.03) during CE50. Values for CE75 were between IE100 and CE50. Beside lipolysis, also proteolysis (BUN) was an important source of fuel for low-to-moderate intensity CE50. An increased uptake of AA from the plasma bed during CE50 suggests the importance for oxidation and synthesis of other metabolic sources such as gluconeogenesis necessary for recovery. Therefore, one needs to be cautious of protein diet following prolonged cycle exercise training.

Pattern of the heart rate performance curve in maximal graded treadmill running from 1100 healthy 18-65 Years old men and women: the 4HAIE study.

Introduction: The heart rate performance curve (HRPC) in maximal incremental cycle ergometer exercise demonstrated three different patterns such as downward, linear or inverse versions. The downward pattern was found to be the most common and therefore termed regular. These patterns were shown to differently influence exercise prescription, but no data are available for running. This study investigated the deflection of the HRPC in maximal graded treadmill tests (GXT) of the 4HAIE study. Methods: Additional to maximal values, the first and second ventilatory thresholds as well as the degree and the direction of the HRPC deflection (kHR) were determined from 1,100 individuals (489 women) GXTs. HRPC deflection was categorized as downward (kHR < -0.1), linear (-0.1 ≤ kHR ≤ 0.1) or inverse (kHR > 0.1) curves. Four (even split) age- and two (median split) performance-groups were used to investigate the effects of age and performance on the distribution of regular (= downward deflection) and non-regular (= linear or inverse course) HR curves for male and female subjects. Results: Men (age: 36.8 ± 11.9 years, BMI: 25.0 ± 3.3 kg m-2, VO2max: 46.4 ± 9.4 mL min-1. kg-1) and women (age: 36.2 ± 11.9 years, BMI: 23.3 ± 3.7 kg m-2, VO2max: 37.4 ± 7.8 mL min-1. kg-1) presented 556/449 (91/92%) downward deflecting, 10/8 (2/2%) linear and 45/32 (7/6%) inverse HRPC´s. Chi-squared analysis revealed a significantly higher number of non-regular HRPC´s in the low-performance group and with increasing age. Binary logistic regression revealed that the odds ratio (OR) to show a non-regular HRPC is significantly affected by maximum performance (OR = 0.840, 95% CI = 0.754-0.936, p = 0.002) and age (OR = 1.042, 95% CI = 1.020-1.064, p < 0.001) but not sex. Discussion: As in cycle ergometer exercise, three different patterns for the HRPC were identified from the maximal graded treadmill exercise with the highest frequency of regular downward deflecting curves. Older subjects and subjects with a lower performance level had a higher probability to show a non-regular linear or inverted curve which needs to be considered for exercise prescription.

Session Rating of Perceived Exertion Is Different for Similar Intensity and Duration Prescribed Low-Intensity Sessions and Has a Different Effect on Performance in Young Cross-Country Skiers.

ABSTRACT: Pind, R, Purge, P, Mäestu, E, Vahtra, E, Hofmann, P, and Mäestu, J. Session rating of perceived exertion is different for similar intensity and duration prescribed low-intensity sessions and has a different effect on performance in young cross-country skiers. J Strength Cond Res 37(1): 187-193, 2023-The aim of this study was to analyze whether the rating of perceived exertion (RPE) and the resulting internal load (sRPE) could differ among subjects when volume and intensity are matched in young cross-country (XC) skiers. Second, we analyzed whether subjects with a high or low RPE response and sRPE have different adaptation after a 1-week low-intensity high-volume training period. Well-trained national level XC skiers (n = 13) aged 13.4 ± 1.9 years took part in a 1-week training period with double poling performance tested pretraining and after 1-week training. All subjects trained under a similar training program. Rating of perceived exertion was measured after each training session on a 10-point scale, and the total training load was calculated by the sRPE method by multiplying training session's duration and the RPE. Subjects were divided into Glow (n = 6) or Ghigh (n = 7) groups based on median rating of RPE (3.78 ± 1.24) in low-intensity trainings. Total training load in low-intensity trainings was higher in Ghigh compared with Glow (4,010 ± 765 vs. 2,499 ± 193 arbitrary units, respectively), although total training time with (16.3 ± 0.8 hours vs. 16.0 ± 0.6 hours) or without (13.1 ± 0.9 hours vs. 13.3 ± 0.7 hours, p > 0.05, respectively to Glow and Ghigh) high-intensity sessions was not different. No significant differences were found for time spent in different heart rate zones between the 2 groups. Increases in performance were significant for both groups (p< 0.05), while the effect was large in Ghigh (+12.5%; ES = 0.74), and medium in Glow (+10.7%; ES = 0.34). Differences in the internal load and the further quantification of training load for different target intensity sessions could provide important practical information to stimulate expected adaptation in young endurance athletes.

Effects of Different Durations at Fixed Intensity Exercise on Internal Load and Recovery-A Feasibility Pilot Study on Duration as an Independent Variable for Exercise Prescription.

Duration is a rarely investigated marker of exercise prescription. The aim of this study was to test the feasibility of the methodological approach, assessing effects of different duration constant-load exercise (CLE) on physiological responses (internal load) and recovery kinetics. Seven subjects performed an incremental exercise (IE) test, one maximal duration CLE at 77.6 ± 4.8% V˙O2max, and CLE's at 20%, 40%, and 70% of maximum duration. Heart rate (HR), blood lactate (La), and glucose (Glu) concentrations were measured. Before, 4, 24, and 48 h after CLE's, submaximal IE tests were performed. HR variability (HRV) was assessed in orthostatic tests (OT). Rating of perceived exertion (RPE) was obtained during all tests. CLE's were performed at 182 ± 27 W. HRpeak, Lapeak, V˙Epeak, and RPEpeak were significantly higher in CLE's with longer duration. No significant differences were found between CLE's for recovery kinetics for HR, La, and Glu in the submaximal IE and for HRV or OT. Despite no significant differences, recovery kinetics were found as expected, indicating the feasibility of the applied methods. Maximum tests and recovery tests closer to CLE's termination are suggested to better display recovery kinetics. These findings are a first step to prescription of exercise by both intensity and duration on an individual basis.

Very Low-Carbohydrate High-Fat Diet Improves Risk Markers for Cardiometabolic Health More Than Exercise in Men and Women With Overfat Constitution: Secondary Analysis of a Randomized Controlled Clinical Trial.

Purpose: This randomized controlled parallel-group study examined the effects of a very low-carbohydrate high-fat (VLCHF) diet and high-intensity interval training (HIIT) program over 12-weeks on cardiometabolic risk factors in individuals with overfat constitution. Methods: Ninety-one participants out of 109 completed the study. The participants were randomly allocated to the HIIT (N = 22), VLCHF (N = 25), VLCHF+HIIT (N = 25), or control (N = 19) groups for 12 weeks. Fasting plasma samples were collected before the intervention and after 4 and 12 weeks. The analyzed outcomes included complete blood count, glucose, insulin, glycated hemoglobin, triglycerides (TG), cholesterol, high- and low-density lipoprotein (HDL-C and LDL-C), lipoprotein(a), adiponectin (Adpn), leptin (Lep), tumor necrosis factor α (TNF-α), other interleukins (hs-IL-6, IL-1ß, and IL-10), and IL-1RA. The homeostasis model assessment of insulin resistance (HOMA-IR), Adpn/Lep ratio, TG/HDL-C ratio, and TyG index were calculated and analyzed. Blood pressure was measured before the intervention, after 4, 8, and 12 weeks (ClinicalTrials.gov: NCT03934476). Results: Absolute changes in HOMA-IR, Adpn/Lep ratio, LDL-C, and diastolic blood pressure after 12 weeks differed by study groups (p < 0.05). The most pronounced changes were revealed in the VLCHF (ΔM [95% CI]; HOMA-IR: -0.75 [-1.13; -0.55]; Adpn/Lep: 9.34 [6.33; 37.39]; LDL-C: 0.06 [-0.12; 0.50] mmol/l) and VLCHF+HIIT (HOMA-IR: -0.44 [-1.14; 0.12]; Adpn/Lep: 4.26 [2.24; 13.16]; LDL-C: 0.25 [-0.04; 0.50] mmol/l) groups. Conclusions: A 12-week VLCHF diet intervention in individuals with overfat constitution is effective for favorable changes in HOMA-IR (compared to HIIT), Adpn/Lep ratio, and diastolic blood pressure. HIIT, or HIIT combined with the VLCHF diet, had no additional benefits for the analyzed variables. No adverse side effects were observed.

Protocol for the Exercise, Cancer and Cognition - The ECCO-Study: A Randomized Controlled Trial of Simultaneous Exercise During Neo-/Adjuvant Chemotherapy in Breast Cancer Patients and Its Effects on Neurocognition.

Introduction: Epidemiological studies show that increased physical activity is linked to a lower risk of breast cancer and mortality. As a result, physical activity can significantly improve patients' quality of life (QOL) both during and after therapy.Many breast cancer patients demonstrate a decrease in cognitive capacity, referred to as the symptom-complex cancer related cognitive impairment (CRCI). Most frequently reported impairments are mild to moderate deficits in processing speed, attention, memory, and executive functions. Cognitive symptoms persist for months or even years, following medical treatment in roughly 35% of afflicted people, impairing everyday functioning, limiting the ability to return to work, and lowering the overall QOL. Recent studies point toward a key role of inflammatory pathways in the CRCI genesis. Attention to physical activity as a potential supportive care option is therefore increasing. However, evidence for the positive effects of exercise on preventing CRCI is still lacking. Patients and Methods: Against this background, the prospective, two-arm, 1:1 randomized, controlled trial investigates the influence of first line chemotherapy accompanied by exercise training on preventing CRCI in 126 patients with breast cancer at the local University Hospital. The study will evaluate biomarkers and secondary assessments suspected to be involved in the pathogenesis of CRCI in addition to objective (primary outcome) and subjective cognitive function. CRCI is believed to be connected to either functional and/or morphological hippocampal damage due to chemotherapy. Thus, cerebral magnetic resonance imaging (MRI) and hippocampal volume measurements are performed. Furthermore, a specific neuropsychological test battery for breast cancer patients has been developed to detect early signs of cognitive impairments in patients and to be integrated into practice. Discussion: This study will explore how a long-term supervised exercise intervention program might prevent CRCI, enables optimization of supportive care and objectifies limits of psychological and physical resilience in breast cancer patients during and after chemotherapy treatment. Trial Registration: ClinicalTrials.gov: Identifier: NCT04789187. Registered on 09 March 2021.

Effect of Short-Duration High-Intensity Upper-Body Pre-Load Component on Performance among High-Level Cyclists.

The aim of the present study was to evaluate the effects of upper-body high-intensity exercise priming on subsequent leg exercise performance. Specifically, to compare maximal 4000 m cycling performance with upper-body pre-load (MPThigh) and common warm-up (MPTlow). In this case, 15 high-level cyclists (23.3 ± 3.6 years; 181 ± 7 cm; 76.2 ± 10.0 kg; V˙O2max: 65.4 ± 6.7 mL·kg−1·min−1) participated in the study attending three laboratory sessions, completing an incremental test and both experimental protocols. In MPThigh, warm-up was added by a 25 s high-intensity all-out arm crank effort to the traditional 20-min aerobic warm-up. Both 4000 m maximal bouts started with a 12 s all-out start. Heart rate, blood lactate concentration [La) and spirometric data were measured and analyzed. Overall MPThigh time was slower by 5.3 ± 1.2 s (p < 0.05). [La] at the start was 5.5 ± 1.5 mmol·L−1 higher for MPThigh (p < 0.001) reducing anaerobic energy contribution which was higher in MPTlow during the first and third 1000 m split (p < 0.05). Similarly, MPTlow maintained higher total average power during the entire performance (p < 0.05, d = 0.7). Although the MPThigh condition performed less effectively due to decreased anaerobic capacity, pre-load effect may have the potential to enhance performance at longer distances.

Corrigendum: Increases in RPE Rating Predict Fatigue Accumulation Without Changes in Heart Rate Zone Distribution After 4-Week Low-Intensity High-Volume Training Period in High-Level Rowers.

[This corrects the article DOI: 10.3389/fphys.2021.735565.].

Exercise duration: Independent effects on acute physiologic responses and the need for an individualized prescription.

An individualization of exercise prescription is implemented mainly in terms of intensity but not for duration. To survey the need for an individualized exercise duration prescription, we investigated acute physiologic responses during constant-load exercise of maximal duration (tmax ) and determined so-called duration thresholds. Differences between absolute (min) and relative terms (% tmax ) of exercise duration were analyzed. Healthy young and trained male and female participants (n = 11) performed an incremental exercise test and one tmax constant-load exercise test at a target intensity of 10% of maximal power output below the second lactate turn point (LTP2 ). Blood lactate, heart rate, and spirometric data were measured during all tests. tmax was markedly different across subjects (69.6 ± 14.8 min; range: 40-90 min). However, distinct duration phases separated by duration thresholds (DTh) were found in most measured variables. These duration thresholds (except DTh1) were significantly related to tmax (DTh2: r2  = 0.90, p < 0.0001; DTh3: r2  = 0.98, p < 0.0001) and showed substantial interindividual differences if expressed in absolute terms (DTh2: 24.8 ± 6.0 min; DTh3: 47.4 ± 10.6 min) but not in relative terms (DTh2: 35.4 ± 2.7% tmax ; DTh3: 67.9 ± 2.4% tmax ). Our data showed that (1) maximal duration was individually different despite the same relative intensity, (2) duration thresholds that were related to tmax could be determined in most measured variables, and (3) duration thresholds were comparable between subjects if expressed in relative terms. We therefore conclude that duration needs to be concerned as an independent variable of exercise prescription.

Electromyographic and Systemic Physiological Thresholds in Single-Joint Elbow Flexion Movements.

PURPOSE: Reported relationships between electromyographic (EMG) thresholds and systemic thresholds based on lactate, ventilation, or heart rate are contradictory. This might be related to the complexity of the investigated whole-body movements involving many muscles with different activation patterns. Therefore, the aim of the study was to investigate these relationships during an incremental single-joint exercise. METHODS: Eighteen male subjects (29.7 [4.4] y) performed single-arm elbow flexions on a biceps curl machine with loads increasing every minute until exhaustion. EMG signals of the main elbow flexors (short and long head of the biceps brachii, flexor carpi radialis, and brachioradialis) as well as gas exchange variables, blood lactate concentration, and heart rate were measured, and 2 turn points based on a 3-phase model of metabolism were determined for each variable. RESULTS: The first and second turn points for EMG were determined at 32.0% to 33.1% and 64.4% to 66.5% of maximal achieved performance (maximum weight), respectively. Systemic turn points were determined at 33.3% to 34.4% and 65.9% to 66.7% of maximum weight and were not significantly different from EMG turn points. Furthermore, systemic and EMG turn points showed a strong or very strong relationship at the first (ρ = .54-.93, P < .05) and second turn point (ρ = .76-.93, P < .01). CONCLUSIONS: A close relationship between EMG and systemic turn points could be confirmed for the applied movement of a small muscle group. The determination of local single muscle thresholds using EMG provides additional muscle-specific information about performance-limiting properties of muscles involved in endurance-type incremental exercise.

Can We Improve the Functional Threshold Power Test by Adding High-Intensity Priming Arm-Crank?

The aim of the present study was to evaluate the effects of arm-crank induced priming on subsequent 20 min Functional Threshold Power Test among 11 well-trained male cyclists (18.8 ± 0.9 years; 182 ± 5 cm; 73.0 ± 6.6 kg; V˙O2max 67.9 ± 5.1 mL·kg-1·min-1). Participants completed an incremental test and two maximal performance tests (MPTs) in a randomized order. Warm-up prior to MPTlow consisted of 20 min aerobic exercise and 25 s high-intensity all-out arm crank effort was added to warm-up in MPThigh. Constant intensities for the first 17 min of MPT were targeting to achieve a similar relative fatigue according to participants' physiological capacity before the last 3 min all-out spurt. Final 3 min all-out spurt power was 4.94 ± 0.27 W·kg-1 and 4.85 ± 0.39 W·kg-1 in MPTlow and MPThigh, respectively (not statistically different: p = 0.116; d = 0.5). Blood lactate [La] levels just before the start were higher (p < 0.001; d = 2.6) in MPThigh (5.6 ± 0.5 mmol·L-1) compared to MPTlow (1.1 ± 0.1 mmol·L-1). According to V˙CO2 and net [La] data, significantly higher anaerobic energy production was detected among MPTlow condition. In conclusion, priming significantly reduced anaerobic energy contribution but did neither improve nor decrease group mean performance although effects were variable. We suggest priming to have beneficial effects based on previous studies; however, the effects are individual and additional studies are needed to distinguish such detailed effects in single athletes.

Observational study of an inpatient program for musculoskeletal disorders: The effects of gender and physical activity.

ABSTRACT: A new inpatient secondary preventive program for patients with musculoskeletal health problems was introduced throughout Austria. The aim of the current work was to evaluate this "Health Prevention Active" program and its possible influences on the quality of medical results upon hospital discharge.This observational study presents monocentric data for 7448 patients (48.99 ±â€Š6.15 years; 53.7% women) with chronic musculoskeletal disorders who completed a 3-week health program. The focus was placed on measuring medical quality outcomes such as BMI, blood pressure, heart rate, pain, subjective ratings, and achieved power output in cycle ergometer exercise testing. We describe pre-post changes before and after the inpatient program and the results of a follow-up survey conducted after 1 year to identify moderating factors related to health outcomes.The medical baseline showed obvious deficits regarding obesity, hypertension, and subjective symptoms. Of all patients, 36.5% were completely inactive. The patient's gender and physical activity had a high impact on the medical baseline status. In total, the majority of patients (86.2%; SMD = -0.78 ±â€Š0.59) responded well to the health prevention program, independent of their ages and lifestyles.Requirements for secondary prevention programs are high. The results of the study reflect the general problems presented by inactivity, obesity, and subjective symptoms like pain. Physical activity was specifically identified as a major factor for the observed medical baseline status.

Increases in RPE Rating Predict Fatigue Accumulation Without Changes in Heart Rate Zone Distribution After 4-Week Low-Intensity High-Volume Training Period in High-Level Rowers.

Purpose: The aim of this study was to investigate the interaction of training load quantification using heart rate (HR) and rating of perceived exertion (RPE)-based methodology, and the relationship between internal training load parameters and subjective training status (Fatigue) in high-level rowers during volume increased low-intensity training period. Methods: Training data from 19 high-level rowers (age 23.5 ± 5.9 years; maximal oxygen uptake 58.9 ± 5.8 ml·min-1·kg-1) were collected during a 4-week volume increased training period. All individual training sessions were analyzed to quantify training intensity distribution based on the HR time-in-zone method (i.e., HR Z1, HR Z2, and HR Z3) determined by the first and second ventilatory thresholds (VT1/VT2). Internal training load was calculated using session RPE (sRPE) to categorize training load by effort (i.e., sRPE1, sRPE2, and sRPE3). The Recovery-Stress Questionnaire for Athletes (RESTQ-Sport) questionnaire was implemented after every week of the study period. Results: No differences were found between the respective HR and effort-based zone distributions during the baseline week (p > 0.05). Compared to HR Z1, sRPE1 was significantly lower in weeks 2-4 (p < 0.05), while sRPE2 was higher in weeks 2-3 compared to HR Z2 (p < 0.05) and, in week 4, the tendency (p = 0.06) of the higher amount of sRPE3 compared to HR Z3 was found. There were significant increases in RESTQ-Sport stress scales and decreases in recovery scales mostly during weeks 3 and 4. Increases in the Fatigue scale were associated with the amounts of sRPE2 and sRPE3 (p = 0.011 and p = 0.008, respectively), while no associations with Fatigue were found for HR-based session quantification with internal or external training load variables. Conclusion: During a low-intensity 4-week training period with increasing volume, RPE-based training quantification indicated a shift toward the harder rating of sessions with unchanged HR zone distributions. Moderate and Hard rated sessions were related to increases in Fatigue. Session rating of perceived exertion and effort-based training load could be practical measures in combination with HR to monitor adaptation during increased volume, low-intensity training period in endurance athletes.

Impact of global cooling on Early Cretaceous high pCO2 world during the Weissert Event.

The Weissert Event ~133 million years ago marked a profound global cooling that punctuated the Early Cretaceous greenhouse. We present modelling, high-resolution bulk organic carbon isotopes and chronostratigraphically calibrated sea surface temperature (SSTs) based on an organic paleothermometer (the TEX86 proxy), which capture the Weissert Event in the semi-enclosed Weddell Sea basin, offshore Antarctica (paleolatitude ~54 °S; paleowater depth ~500 meters). We document a ~3-4 °C drop in SST coinciding with the Weissert cold end, and converge the Weddell Sea data, climate simulations and available worldwide multi-proxy based temperature data towards one unifying solution providing a best-fit between all lines of evidence. The outcome confirms a 3.0 °C ( ±1.7 °C) global mean surface cooling across the Weissert Event, which translates into a ~40% drop in atmospheric pCO2 over a period of ~700 thousand years. Consistent with geologic evidence, this pCO2 drop favoured the potential build-up of local polar ice.