Aerobic Function Research Articles

The use of digital health interventions to deliver prehabilitation in solid organ transplant recipients: are we there yet?

Prehabilitation, defined as preparing the body physically and psychologically for upcoming surgery is of increasing prominence in presurgical care. The aim of this review is to discuss the evidence base around prehabilitation in solid organ transplantation, the use of digital health as a tool to deliver these interventions, and consider future directions. Prehabilitation is of increasing interest as an adjunct to pretransplant care for individuals working up for solid organ transplantation. To date, research has shown that prehabilitation is acceptable and feasible; however, the literature base remains small. The majority of research has been delivered using in-person rehabilitation programmes, and the evidence base utilizing digital health as a means to deliver prehabilitation is limited. To date, the research evidence base in prehabilitation for solid organ transplantation is limited. Evidence in other surgical populations has demonstrated promising results, particularly in aerobic capacity, physical function and postoperative complications. Further high-quality randomized controlled clinical trials are required to strengthen the evidence base, understand how digital health can be harnessed and utilized to deliver multimodal prehabilitation with an aim to see how this may form part of routine care in the solid organ transplantation pathway.

Progressive overload in cardiorespiratory exercise training for young and old: Is increasing duration or intensity of exercise more important?

People undertake endurance training to improve their health and cardio-respiratory fitness. Subsequent cardio-respiratory and skeletal muscle aerobic metabolic adaptations are gauged by improvements in maximum or peak oxygen uptake (V̇O2peak) and the blood lactate inflection point or threshold during incremental exercise – (LIP). To further improve physiological capability, subsequent homoeostatic disturbances from exercise should be progressively greater in succeeding exercise sessions. Therefore, exercise duration, frequency or intensity should be progressively increased during a training regimen to ensure adaptation potential is realized. A progressive increase in training workload is termed “progressive overload”. Despite the universal acknowledgment of the importance of progressive overload, it is unclear if systematically progressing altering either exercise intensity or duration (or distance covered) affect cardio-respiratory gains differently in young and older populations. As running faster results in higher heart rates and greater skeletal muscle metabolic stress than running the same distance at a lower speed, in this hypothesis we postulate that progressively increasing exercise run intensity will result in greater mean and higher incidence of V̇O2peak and LIP gains in young adults (<50 years). However, the mechanisms that initiate improvements in cardio-respiratory fitness and skeletal muscle aerobic function may be different in older adults due to the inevitable aging decline in cardio-vascular function and mechanical and morphological properties of muscle–tendon units. In older adults (>60 years) we hypothesize progressively increasing run distance while maintaining the same speed will just be as effective as to progressively increasing speed to improve V̇O2peak and LIP. To test these hypotheses, we propose a study that compares progressively increasing run intensity to a treatment of progressive matched run distance where speed remains constant in young and old adults.

RESULTS OF THE ECHO-R TRIAL – A PRAGMATIC, TELEHEALTH-DELIVERED EXERCISE INTERVENTION FOR WOMEN WITH RECURRENT OVARIAN CANCER

INTRODUCTION &amp; AIMS Wide-spread and equitable uptake of exercise into standard cancer care will require evidence of safety and efficacy across all cancer and treatment types. People with rarer cancers, lower survival prospects, and higher morbidity have been under-represented in exercise oncology trials. The ECHO-R trial for women with recurrent ovarian cancer aimed to address this research gap, evaluating the efficacy of a 6-month telephone-delivered, exercise intervention consistent with ESSA exercise oncology prescription guidelines. METHODS 50 women scheduled to receive chemotherapy for recurrent ovarian cancer were recruited to the pre-post exercise trial with assessments at baseline and post-intervention (6 months post-baseline). The intervention was delivered via 12 telephone sessions, with the option of five additional study-funded, in-person sessions with a community-based AEP. The intervention had a global target of 150 minutes of moderate-intensity multimodal exercise per week, with actual volume and prescription individualised at each session, dependent on functional capacity, goals, and barriers. Outcomes included feasibility (volume of exercise completed) and harms profile (occurrence of adverse outcomes) of the intervention, changes in patient-reported outcomes (quality of life [QoL; FACT-O], fatigue [FACT-Fatigue] and neurotoxicity [FACT-GOG-NTX]), and objective assessment of aerobic function (6-minute-walk test), muscular endurance (30-second sit-to-stand) and strength (hand grip). RESULTS The average volume of exercise completed did not meet the target (median 100 min/week, min: 0; max 527). QoL, fatigue, neurotoxicity, aerobic function, muscular endurance, and strength remained stable between the pre and post-intervention assessments. There were no serious adverse events. CONCLUSION Recurrent ovarian cancer is an incurable disease, characterised by declining QoL and physical capacity. Findings from this study suggest that maintenance of QoL and physical function is possible through participation in an exercise intervention, even if exercise targets are not met. Physical activity guidelines may need to reflect this.

Re-evaluating the Need for Routine Maximal Aerobic Capacity Testing within Fighter Pilots.

INTRODUCTION: There is a current belief in aviation suggesting that aerobic training may reduce G-tolerance due to potential negative impacts on arterial pressure response. Studies indicate that increasing maximal aerobic capacity (<mml:math id="ie1" display="inline"><mml:mrow><mml:mover><mml:mtext>V</mml:mtext><mml:mo>˙</mml:mo></mml:mover></mml:mrow></mml:math>o₂ max) through aerobic training does not hinder G-tolerance. Moreover, sustained centrifuge training programs revealed no instances where excessive aerobic exercise compromised a trainee's ability to complete target profiles. The purpose of this review article is to examine the current research in the hope of establishing the need for routine <mml:math id="ie2" display="inline"><mml:mrow><mml:mover><mml:mtext>V</mml:mtext><mml:mo>˙</mml:mo></mml:mover></mml:mrow></mml:math>o₂-max testing in air force pilot protocols.METHODS: A systematic search of electronic databases including Google Scholar, PubMed, the Aerospace Medical Association, and Military Medicine was conducted. Keywords related to "human performance," "Air Force fighter pilots," "aerobic function," and "maximal aerobic capacity" were used in various combinations. Articles addressing exercise physiology, G-tolerance, physical training, and fighter pilot maneuvers related to human performance were considered. No primary data collection involving human subjects was conducted; therefore, ethical approval was not required.RESULTS: The <mml:math id="ie3" display="inline"><mml:mrow><mml:mover><mml:mtext>V</mml:mtext><mml:mo>˙</mml:mo></mml:mover></mml:mrow></mml:math>o₂-max test provides essential information regarding a pilot's ability to handle increased Gz-load. It assists in predicting G-induced loss of consciousness by assessing anti-G straining maneuver performance and heart rate variables during increased G-load.DISCUSSION: <mml:math id="ie4" display="inline"><mml:mrow><mml:mover><mml:mtext>V</mml:mtext><mml:mo>˙</mml:mo></mml:mover></mml:mrow></mml:math>o₂-max testing guides tailored exercise plans, optimizes cardiovascular health, and disproves the notion that aerobic training hampers G-tolerance. Its inclusion in air force protocols could boost readiness, reduce health risks, and refine training for fighter pilots' safety and performance. This evidence-backed approach supports integrating <mml:math id="ie5" display="inline"><mml:mrow><mml:mover><mml:mtext>V</mml:mtext><mml:mo>˙</mml:mo></mml:mover></mml:mrow></mml:math>o₂-max testing for insights into fitness, risks, and tailored exercise.Zeigler Z, Acevedo AM. Re-evaluating the need for routine maximal aerobic capacity testing within fighter pilots. Aerosp Med Hum Perform. 2024; 95(5):273-277.

BENEFICIAL EFFECTS OF A COMBINED AEROBIC AND STRENGTH TRAINING PROGRAM IN PATIENTS WITH MOTOR NEURON DISEASE

INTRODUCTION &amp; AIMS Motor Neuron Disease (MND) is a neurodegenerative disease characterised by the progressive degeneration and death of motor neurons, which leads to a reduction in muscle strength and physical function. Although “Exercise as Medicine” is accepted for many diseases, the role of exercise in individuals with MND is still debated. The aim of this study was to evaluate the effect of a combined, moderate-intensity, aerobic and strength training program on aerobic capacities, strength and physical function in individuals with MND. METHODS Fifteen individuals with MND were randomly assigned to either a training (3 times/week for 12 weeks; TRAIN, n=8) or a control (continued their usual standard of care; CTRL, n=7) group. The peak aerobic capacity (VO2peak) and the maximal capacity of oxygen extraction (via Near-Infrared Spectroscopy) were evaluated during an incremental test to exhaustion on a cycle ergometer. The strength of both the lower- and upper-limb muscles was evaluated with a 1-Repetition Maximum (1RM) test on the leg press, leg extension, biceps curl, and vertical chest press. Participants also performed the “Timed Up and Go” test (TUG) and the 6-min walking test (6MWT). RESULTS The adherence to training was 86 ± 6%, and the satisfaction with the exercise program was 9.6 out of 10. VO2peak did not change significantly in both groups, but the maximal capacity of O2 extraction improved significantly in TRAIN (from 44 ± 3 to 67 ± 4%). In TRAIN, the 1RM for the leg press and leg extension increased significantly by 47 ± 8% and 50 ± 13%, respectively, while this parameter did not change in CTRL. While the 6MWT increased by 5% in TRAIN and decreased by 3% in CTRL, the change was not significant. CONCLUSION These preliminary results support the beneficial role of a combined aerobic and strength training program in individuals with MND.

COMPARING THE EFFECTS OF AROMATASE INHIBITORS AND SELECTIVE OESTROGEN RECEPTOR MODULATORS ON BODY COMPOSITION, EXERCISE TOLERANCE AND MARKERS OF CARDIOVASCULAR RISK IN FEMALES WITH BREAST CANCER

INTRODUCTION Adjuvant endocrine therapy (AET) blocks the action of estrogens and is commonly prescribed in hormone receptor-positive breast cancer. Given the putative cardioprotective role of estrogens in females, AET may exacerbate the negative metabolic side-effects of anthracycline chemotherapy. This study examined the early effects of combined anthracycline chemotherapy and AET on body composition, exercise tolerance and markers of cardiovascular risk in a cohort of females with breast cancer. METHODS This was a secondary analysis of the BReast cancer EXercise InTervention (BREXIT) Trial. Females with breast cancer (n=105, aged 51 ± 8 years, BMI 27.4 ± 5.1, mean ± SD) scheduled for anthracycline chemotherapy participated in this study. Aerobic exercise capacity, body composition, physical function, and blood pressure were measured before anthracycline treatment and after 4- and 12-months follow-up. Linear mixed models assessed whether aromatase inhibitors (AI) or selective estrogen receptor modulators (SERMS) affected exercise tolerance, body composition and markers of cardiovascular risk compared to non-endocrine breast cancer treatments. RESULTS Twelve months of anthracycline treatment combined with AI or SERMs decreased total body lean mass by 1.4 kg (2%; interaction p=0.01) and 1kg (1%; interaction p=0.16) respectively, when compared to non-endocrine therapies. There were trends for AET to decrease total fat (-1.5%, interaction p=0.05) and android fat (-2.3%, interaction p=0.07) mass compared to non-endocrine therapy after 12 months. AIs significantly increased both systolic (5.8mmHg, interaction p=0.05) and diastolic (4.0mmHg, interaction p=0.05) blood pressure after 12 months of treatment compared to SERMs or non-endocrine therapies. There was no effect of either AET or SERMS on VO2peak, leg press or seated row 1RM, 30 second sit to stand or handgrip strength. DISCUSSION AND CONCLUSION Short-term treatment with adjuvant endocrine therapies may accelerate muscle loss and increase blood pressure compared to non-endocrine therapies. However, these changes were not associated with worsening of physical function.

Association between heart rate variability and cardiorespiratory fitness in individuals with type 2 diabetes mellitus

Background: Type 2 Diabetes Mellitus (T2DM) is associated with cardiovascular risk, which is partly due to autonomic dysfunction and decreased cardiorespiratory fitness. This study examines the relationship between heart rate variability (HRV) and maximal oxygen uptake (VO2max) in T2DM patients to understand their interconnected impacts on autonomic and aerobic functions. Methods: In a cross-sectional study, 77 T2DM patients underwent HRV and VO2max assessments using standard protocols. HRV metrics were analysed in conjunction with VO2max, measured through direct breath-by-breath analysis. Pearson's correlation coefficient was used to investigate the relationships between HRV indices and VO2max. Results: VO2max showed strong positive correlations with RMSSD (r = 0.89, p &lt; .001), HF (r = 0.54, p &lt; .001), and pNN50% (r = 0.52, p &lt; .001), indicating higher parasympathetic activity with improved cardiorespiratory fitness. Negative correlations with LF (r = -0.60, p &lt; .001) and the LF/HF ratio (r = -0.39, p &lt; .001) suggested that better fitness levels lead to sympathetic withdrawal and a more favourable autonomic balance. Moderate positive correlations with SDNN (r = 0.46, p &lt; .001) and TP (r = 0.58, p &lt; .001) further suggested that overall autonomic modulation is enhanced with increased cardiorespiratory fitness. Conclusion: This study substantiates a significant correlation between HRV and VO2max in individuals with T2DM, highlighting the intricate relationship between autonomic function and aerobic capacity. These findings suggest that enhancing cardiorespiratory fitness may improve autonomic balance, offering potential avenues for mitigating cardiovascular risk in the T2DM population.

Characteristics of soil nitrogen and phosphorus fractions and microbial traits with increasing stand age in two-layered Cunninghumia lanceolata + Phoebe bournei plantations.

Soil nitrogen and phosphorus are two key elements limiting tree growth in subtropical areas. Understanding the regulation of soil microorganisms on nitrogen and phosphorus nutrition is beneficial to reveal maintenance mechanism of soil fertility in plantations. We analyzed the characteristics of soil nitrogen and phosphorus fractions, soil microbial community composition and function, and their relationship across three stands of two-layered Cunninghumia lanceolata + Phoebe bournei with different ages (4, 7 and 11 a) and the pure C. lanceolata plantation. The results showed that the contents of most soil phosphorus fractions increased with increasing two-layered stand age. The increase in active phosphorus fractions with increasing stand age was dominated by the inorganic phosphorus (9.9%-159.0%), while the stable phosphorus was dominated by the organic phosphorus (7.1%-328.4%). The content of soil inorganic and organic nitrogen also increased with increasing two-layered stand age, with NH4+-N and acid hydrolyzed ammonium N contents showing the strongest enhancement, by 152.9% and 80.2%, respectively. With the increase of stand age, the composition and functional groups of bacterial and fungal communities were significantly different, and the relative abundance of some dominant microbial genera (such as Acidothermus, Saitozyma and Mortierella) increased. The relative abundance of phosphorus solubilization and mineralization function genes, nitrogen nitrification function and aerobic ammonia oxidation function genes tended to increase. The functional taxa of fungi explained 48.9% variation of different phosphorus fractions. The conversion of pure plantations to two-layered mixed plantation affected soil phosphorus fractions transformation via changing the functional groups of saprophytes (litter saprophytes and soil saprophytes). Changes in fungal community composition explained 45.0% variation of different nitrogen fractions. Some key genera (e.g., Saitozyma and Mortierella) play a key role in promoting soil nitrogen transformation and accumulation. Therefore, the conversion of pure C. lanceolata plantation to two-layered C. lanceolata + P. bournei plantation was conducive to improving soil nitrogen and phosphorus availability. Bacteria and fungi played important roles in the transformation process of soil nitrogen and phosphorus forms, with greater contribution of soil fungi.

Response of TCE biodegradation to elevated H2 and O2: Implication for electrokinetic-enhanced bioremediation

The study investigated the influences of pure H2 and O2 introduction, simulating gases produced from the electrokinetic-enhanced bioremediation (EK-Bio), on TCE degradation, and the dynamic changes of the indigenous microbial communities. The dissolved hydrogen (DH) and oxygen (DO) concentrations ranged from 0.2 to 0.7 mg/L and 2.6 to 6.6 mg/L, respectively. The biological analysis was conducted by 16S rRNA sequencing and functional gene analyses. The results showed that the H2 introduction enhanced TCE degradation, causing a 90.4% TCE removal in the first 4 weeks, and 131.1 μM was reduced eventually. Accordingly, cis-dichloroethylene (cis-DCE) was produced as the only product. The following three ways should be responsible for this promoted TCE degradation. Firstly, the high DH rapidly reduced the oxidation-reduction potential (ORP) value to around −500 mV, beneficial to TCE microbial dechlorination. Secondly, the high DH significantly changed the community and promoted the enrichment of TCE anaerobic dechlorinators, such as Sulfuricurvum, Sulfurospirillum, Shewanella, Geobacter, and Desulfitobacterium, and increased the abundance of dechlorination gene pceA. Thirdly, the high DH promoted preferential TCE dechlorination and subsequent sulfate reduction. However, TCE bio-remediation did not occur in a high DO environment due to the reduced aerobic function or lack of functional bacteria or co-metabolic substrate. The competitive dissolved organic carbon (DOC) consumption and unfriendly microbe-microbe interactions also interpreted the non-degradation of TCE in the high DO environment. These results provided evidence for the mechanism of EK-Bio. Providing anaerobic obligate dechlorinators, and aerobic metabolic bacteria around the electrochemical cathodes and anodes, respectively, or co-metabolic substrates to the anode can be feasible methods to promote remediation of TCE-contaminated shallow aquifer under EK-Bio technology.

Exosomal miRNA-146a-5p Derived from Senescent Hepatocellular Carcinoma Cells Promotes Aging and Inhibits Aerobic Glycolysis in Liver Cells via Targeting IRF7.

Hepatocellular carcinoma (HCC) is a major global health challenge. Chemotherapy can cause HCC cells to become senescent. Senescent HCC cells play an important role in inhibiting or promoting cancer by producing extracellular vesicles with a senescence-associated secretory phenotype (EV-SASP). miRNA can be strongly upregulated in EV-SASP during the aging process and can substantially alter the phenotypic characteristics of cells. MiRNA microarray analysis revealed that miRNA-146a-5p was highly expressed in oxaliplatin- and H2O2-induced senescent Huh7 cells, and RT‒PCR confirmed its significant upregulation in exosomes. The transcriptome sequencing results of Huh7 cells overexpressing miRNA-146a-5p suggested that miRNA-146a-5p could regulate HCC cell glycolysis. Subsequently, a dual luciferase assay was used to verify whether miRNA-146a-5p can interact with IRF7 to promote aging. The key functions of miRNA-146a-5p and IRF7 in aerobic glycolysis in liver cancer cells were determined through experiments analyzing glucose uptake, lactate production, the oxygen consumption rate (OCR) and the proton efflux rate (PER). Subsequently, the regulatory effect of IRF7 on the key glycolytic gene PFKL was confirmed through luciferase reporter assays. The western blot experiment results showed that miR-146a-5p can activate CHK2 and p53 phosphorylated proteins by targeting IRF7, and upregulate p21 protein. Overexpression of miRNA-146a-5p effectively inhibited the aerobic glycolytic function of HCC cells. Moreover, silencing IRF7 effectively inhibited aerobic glycolysis. MiR-146a-5p. MiR-146a-5p can activate the phosphorylation of CHK2 phosphorylation protein and its downstream protein p53 by targeting IRF7, and the activated p53 upregulates the expression of p21. Our study revealed that exosomal miRNA-146a-5p produced by aging HCC cells, can inhibit HCC cell proliferation through inhibiting aerobic glycolysis and promote HCC cell aging by activating CHK2/p53/p21 signaling way by targeting IRF7.

Aerobic bimetallic catalysis for oxy-alkynylation of allenes

An aerobic double functionalization of 2,3-allenoic acids with terminal alkynes has been achieved affording versatile 4-alkynylfuran-2(5H)-one derivatives, which have been demonstrated as platform molecules for synthesis of useful natural products.

Quantifying Improvement in V˙ o2peak and Exercise Thresholds in Cardiovascular Disease Using Reliable Change Indices.

Improving aerobic fitness through exercise training is recommended for the treatment of cardiovascular disease (CVD). However, strong justifications for the criteria of assessing improvement in key parameters of aerobic function including estimated lactate threshold (θ LT ), respiratory compensation point (RCP), and peak oxygen uptake (V˙ o2peak ) at the individual level are not established. We applied reliable change index (RCI) statistics to determine minimal meaningful change (MMC RCI ) cutoffs of θ LT , RCP, and V˙ o2peak for individual patients with CVD. Sixty-six stable patients post-cardiac event performed three exhaustive treadmill-based incremental exercise tests (modified Bruce) ∼1 wk apart (T1-T3). Breath-by-breath gas exchange and ventilatory variables were measured by metabolic cart and used to identify θ LT , RCP, and V˙ o2peak . Using test-retest reliability and mean difference scores to estimate error and test practice/exposure, respectively, MMC RCI values were calculated for V˙ o2 (mL·min -1. kg -1 ) at θ LT , RCP, and V˙ o2peak . There were no significant between-trial differences in V˙ o2 at θ LT ( P = .78), RCP ( P = .08), or V˙ o2peak ( P = .74) and each variable exhibited excellent test-retest variability (intraclass correlation: 0.97, 0.98, and 0.99; coefficient of variation: 6.5, 5.4, and 4.9% for θ LT , RCP, and V˙ o2peak , respectively). Derived from comparing T1-T2, T1-T3, and T2-T3, the MMC RCI for θ LT were 3.91, 3.56, and 2.64 mL·min -1. kg -1 ; 4.01, 2.80, and 2.79 mL·min -1. kg -1 for RCP; and 3.61, 3.83, and 2.81 mL·min -1. kg -1 for V˙ o2peak . For each variable, MMC RCI scores were lowest for T2-T3 comparisons. These MMC RCI scores may be used to establish cutoff criteria for determining meaningful changes for interventions designed to improve aerobic function in individuals with CVD.

Flight muscle size reductions and functional changes following long-distance flight under variable humidity conditions in a migratory warbler.

Bird flight muscle can lose as much as 20% of its mass during a migratory flight due to protein catabolism, and catabolism can be further exacerbated under dehydrating conditions. However, the functional consequences of exercise and environment induced protein catabolism on muscle has not been examined. We hypothesized that prolonged flight would cause a decline in muscle mass, aerobic capacity, and contractile performance. This decline would be heightened for birds placed under dehydrating environmental conditions, which typically increases lean mass losses. Yellow-rumped warblers (Setophaga coronata) were exposed to dry or humid (12 or 80% relative humidity at 18°C) conditions for up to 6 h while at rest or undergoing flight. The pectoralis muscle was sampled after flight/rest or after 24 h of recovery, and contractile properties and enzymatic capacity for aerobic metabolism was measured. There was no change in lipid catabolism or force generation of the muscle due to flight or humidity, despite reductions in pectoralis dry mass immediately post-flight. However, there was a slowing of myosin-actin crossbridge kinetics under dry compared to humid conditions. Aerobic and contractile function is largely preserved after 6 h of exercise, suggesting that migratory birds preserve energy pathways and function in the muscle.

Improving the aerobic possibilities of qualified athletes

Improving the aerobic possibilities of qualified athletes

ThTP6.4 A systematic review of the impact of postoperative aerobic exercise training in patients undergoing surgery for intra-abdominal cancers

Abstract Introduction Enhanced recovery after surgery (ERAS) programmes which advocate early mobility after surgery have improved immediate clinical outcomes for patients undergoing abdominal cancer resections with curative intent. However, the impact of continued physical activity on patient-related outcomes and functional recovery is not well-defined. This review aims to assess the impact of postoperative aerobic exercise training, either alone or in conjunction with another exercise modality, on patients who have had surgery for intra-abdominal cancer. Methods A literature search was performed of electronic journal databases. Eligible papers needed to report an outcome of aerobic capacity in patients &amp;gt;18 years of age, who underwent cancer surgery with curative intent and participated in an exercise programme (not solely ERAS) that included an aerobic exercise component starting at any point in the postoperative pathway up to twelve weeks. Results Ten studies were deemed eligible for inclusion consisting of one inpatient, one mixed inpatient/outpatient and eight outpatient studies. Meta-analysis of 4 outpatient studies, each reporting change in 6-minute walk test (6MWT), showed a significant improvement in 6MWT with exercise (MD: 74.92 m, 95% CI: 48.52 to 101.31m). The impact on health-related quality of life was variable across studies. Conclusion Postoperative exercise confers benefits in improving aerobic function post-surgery and can be safely delivered in various formats (home-based or group/supervised).

Exercise Training in Non-Hospitalized Patients with Post-COVID-19 Syndrome-A Narrative Review.

Post COVID-19 Syndrome (PCS) is the persistence of symptoms after an infection with SARS-CoV-2 in both hospitalized and non-hospitalized COVID-19 survivors. Exercise was proposed as a rehabilitation measure for PCS and early studies focused on patients post-hospital discharge. The objective of this review is to summarize the results of trials investigating exercise interventions in non-hospitalized subjects with PCS and propose practical recommendations concerning safe exercise programming. A literature search in the databases MEDLINE and Scopus was conducted until 26 July 2023 and resulted in seven studies that met the criteria. In total, 935 subjects with PCS were investigated. Exercise enhanced aerobic fitness and physical function and relieved symptoms of dyspnea, fatigue and depression. Participants reported lower Post COVID-19 Functional Status scores post-intervention. The exercise programs were well tolerated with no adverse events. To ensure safety, medical examinations should take place in advance and there should be a regular evaluation of the individual responses to the training. Caution is advised when working with patients suffering from post-exertional malaise or diagnosed with myalgic encephalomyelitis/chronic fatigue syndrome. There is a growing need for additional randomized controlled trials to investigate the effectiveness and safety of exercise in individuals with PCS.

Guidance and standard operating procedures for functional exercise testing in cystic fibrosis.

Regular exercise testing is recommended for all people with cystic fibrosis (PwCF). A range of validated tests, which integrate both strength and aerobic function, are available and increasingly being used. Together, these tests offer the ability for comprehensive exercise evaluation. Extensive research and expert consensus over recent years has enabled the adaptation and standardisation of a range of exercise tests to aid the understanding of the pathophysiology related to exercise limitation in PwCF and has led to the development of novel exercise tests which may be applied to PwCF. This article provides expert, opinion-based clinical practice guidance, along with test instructions, for a selection of commonly used valid tests which have documented clinimetric properties for PwCF. Importantly, this document also highlights previously used tests that are no longer suggested for PwCF and areas where research is mandated. This collaboration, on behalf of the European Cystic Fibrosis Society Exercise Working Group, represents expert consensus by a multidisciplinary panel of physiotherapists, exercise scientists and clinicians and aims to improve global standardisation of functional exercise testing of PwCF. In short, the standardised use of a small selection of tests performed to a high standard is advocated.

The diapause-like colorectal cancer cells induced by SMC4 attenuation are characterized by low proliferation and chemotherapy insensitivity

In response to adverse environmental conditions, embryonic development may reversibly cease, a process termed diapause. Recent reports connect this phenomenon with the non-genetic responses of tumors to chemotherapy, but the mechanisms involved are poorly understood. Here, we establish a multifarious role for SMC4 in the switching of colorectal cancer cells to a diapause-like state. SMC4 attenuation promotes the expression of three investment phase glycolysis enzymes increasing lactate production while also suppressing PGAM1. Resultant high lactate levels increase ABC transporter expression via histone lactylation, rendering tumor cells insensitive to chemotherapy. SMC4 acts as co-activator of PGAM1 transcription, and the coordinate loss of SMC4 and PGAM1 affects F-actin assembly, inducing cytokinesis failure and polyploidy, thereby inhibiting cell proliferation. These insights into the mechanisms underlying non-genetic chemotherapy resistance may have significant implications for the field, advancing our understanding of aerobic glycolysis functions in tumor and potentially informing future therapeutic strategies.

Distinct cortical haemodynamics during squat-stand and continuous aerobic exercise do not influence the magnitude of a postexercise executive function benefit

ABSTRACT A single bout of aerobic exercise benefits executive function (EF). A potential mechanism for this benefit is an exercise-mediated increase in cerebral blood flow (CBF) that elicits vascular endothelial shear-stress improving EF efficiency. Moderate intensity continuous aerobic exercise (MCE) asymptotically increases CBF, whereas continuous body weight squat-stand exercise (SSE) provides a large amplitude oscillatory response. Some work has proposed that an increase in CBF oscillation amplitude provides the optimal shear-stress for improving EF and brain health. We examined whether a large amplitude oscillatory CBF response associated with a single bout of SSE imparts a larger postexercise EF benefit than an MCE cycle ergometer protocol. Exercise changes in middle cerebral artery velocity (MCAv) were measured via transcranial Doppler ultrasound to estimate CBF, and pre- and postexercise EF was assessed via the antisaccade task. MCE produced a steady state increase in MCAv, whereas SSE produced a large amplitude MCAv oscillation. Both conditions produced a postexercise EF benefit that null hypothesis and equivalence tests showed to be comparable in magnitude. Accordingly, we provide a first demonstration that a single bout of SSE benefits EF; however, the condition’s oscillatory CBF response does not impart a larger benefit than a time- and intensity-matched MCE protocol.

Aerobic exercise reverses aging-induced depth-dependent decline in cerebral microcirculation.

Aging is a major risk factor for cognitive impairment. Aerobic exercise benefits brain function and may promote cognitive health in older adults. However, underlying biological mechanisms across cerebral gray and white matter are poorly understood. Selective vulnerability of the white matter to small vessel disease and a link between white matter health and cognitive function suggests a potential role for responses in deep cerebral microcirculation. Here, we tested whether aerobic exercise modulates cerebral microcirculatory changes induced by aging. To this end, we carried out a comprehensive quantitative examination of changes in cerebral microvascular physiology in cortical gray and subcortical white matter in mice (3-6 vs. 19-21 months old), and asked whether and how exercise may rescue age-induced deficits. In the sedentary group, aging caused a more severe decline in cerebral microvascular perfusion and oxygenation in deep (infragranular) cortical layers and subcortical white matter compared with superficial (supragranular) cortical layers. Five months of voluntary aerobic exercise partly renormalized microvascular perfusion and oxygenation in aged mice in a depth-dependent manner, and brought these spatial distributions closer to those of young adult sedentary mice. These microcirculatory effects were accompanied by an improvement in cognitive function. Our work demonstrates the selective vulnerability of the deep cortex and subcortical white matter to aging-induced decline in microcirculation, as well as the responsiveness of these regions to aerobic exercise.