Intensity Domain Research Articles

Efficacy, Safety, and Health-Related Quality of Life (HRQOL) in Patients with Sickle Cell Disease (SCD) Who Have Received Lovotibeglogene Autotemcel (Lovo-cel) Gene Therapy: Up to 60 Months of Follow-up

Introduction: Lovo-cel gene therapy uses autologous transplantation of hematopoietic stem and progenitor cells (HSPC) transduced with the BB305 lentiviral vector encoding a modified β-globin gene, which produces an anti-sickling hemoglobin (Hb), HbA T87Q. The phase 1/2 HGB-206 (NCT02140554) and phase 3 HGB-210 (NCT04293185) studies of lovo-cel are the largest clinical trials of gene therapy in SCD to date. We report efficacy and safety from these studies, including the first data from adult and pediatric patients (age 12 to <18 years) in HGB-210, and HRQOL data from HGB-206. Methods: This analysis includes patients from HGB-206 Group C and HGB-210 who received lovo-cel using the current HSPC mobilization and manufacturing process. Patients with SCD and recurrent severe vaso-occlusive events (VOEs) or history of overt stroke underwent plerixafor mobilization and apheresis followed by myeloablative busulfan conditioning and lovo-cel infusion. After 24 months of follow-up post lovo-cel infusion, patients enrolled in the long-term study LTF-307 (NCT04628585). Lab evaluations, SCD-related outcomes (eg, resolution of VOEs), globin response (a composite endpoint evaluating HbA T87Q percentage and total Hb), and safety are reported up to 60 months. An independent Event Adjudication Committee confirmed VOEs met protocol criteria. HRQOL data from Patient-Reported Outcomes Measurement Information System (PROMIS)-57 domains of pain interference, fatigue, and pain intensity are reported up to 48 months. Results:This analysis includes47 patients (HGB-206 Group C, n=36; HGB-210, n=11; male, 59.6%; median [range] age, 23 y [12-38]) who received a lovo-cel infusion as of Feb 13, 2023. Median (range) follow-up was 35.5 months (0.3-61.0). Median (range) time to neutrophil and platelet engraftment was 20 days (12-35) and 35 days (19-136). Peripheral blood vector copy number remained stable (median >1 c/dg through follow-up). Median HbA T87Q levels were ≥4.5 g/dL from 6 months post infusion to last study visit. Median (range) total Hb level increased from 8.7 g/dL (6.1-12.5) at relative baseline to 11.8 g/dL (8.4-15.0) at last visit; median percent HbA T87Q of nontransfused total Hb was ≈40% or more ( Figure). Of 33 evaluable patients (ie, ≥18 months follow-up and ≥4 VOEs in the 2 years before enrollment), 30 (90.9%) and 32 (97.0%) had complete resolution of VOEs and severe VOEs during the 6-18 months post infusion, vs a median (range) of 3.5 (1.5-16.5) and 3.0 (0.5-13.0) events/year in the 2 years before enrollment. Additional efficacy analyses in subgroups (eg, stroke history, α-globin genotype) will be presented. Among patients who had globin response or who had ≥18 months follow-up (n=38), 33 (86.8%) achieved globin response. Hemolysis markers (eg, reticulocytes, total bilirubin, lactate dehydrogenase) approached normal levels. Among all 47 patients, 44 (93.6%) had ≥1 AE of grade ≥3 after lovo-cel infusion; the most common of which were stomatitis (33 [70.2%] patients) and thrombocytopenia (28 [59.6%]). Serious AEs were reported for 26 (55.3%) patients, the most common of which was chronic pain/acute exacerbation of chronic pain (3 [6.4%]; 2 chronic neuropathic pain and 1 chronic pain associated with anxiety). One patient with -α3.7/-α3.7 genotype was diagnosed with myelodysplastic syndrome with stable complete blood counts 30 months post infusion; updated data to be presented. No veno-occlusive liver disease, graft failure, replication-competent lentivirus, or vector-mediated insertional oncogenesis was observed. Lovo-cel treatment regimen largely reflected known side effects of HSPC collection and busulfan conditioning regimen. A total of 25 patients (all from HGB-206 Group C; age ≥18 y) had evaluable HRQOL data. Mean scores for PROMIS-57 domains of pain intensity, pain interference, and fatigue improved (ie, decreased) over time up to 48 months ( Table). Conclusion: One-time treatment with lovo-cel resulted in sustained HbA T87Q production and near-complete resolution of VOEs and severe VOEs up to 18 months post treatment; the safety profile was consistent with underlying SCD and myeloablative conditioning. Patients reported sustained improvements in pain intensity, pain interference, and fatigue. Ongoing long-term follow-up will continue to provide important information on efficacy, safety, and patient experience post lovo-cel treatment.

Classifying Intensity Domains From Arm Cycle Ergometry Differs Versus Leg Cycling Ergometry.

Astorino, TA, Robson, T, and McMillan, DW. Classifying intensity domains from arm cycle ergometry differs versus leg cycling ergometry. J Strength Cond Res 37(11): 2192-2199, 2023-This study compared the distribution of exercise intensity domains in response to progressive leg cycle ergometry (LCE) and arm cycle ergometry (ACE). Seventeen active men and women (age and body fat = 26 ± 7 years and 18 ± 3%) initially performed graded exercise on each modality to assess maximal oxygen uptake (V̇o2max) and peak power output (PPO). Using a randomized crossover design, they subsequently performed moderate intensity continuous exercise consisting of three 15-minute bouts at 20, 40, and 60% PPO on each modality. Gas exchange data (V̇o2, V̇co2, and VE), respiratory exchange ratio, heart rate (HR), blood lactate concentration (BLa), and perceptual responses were acquired. Only 2 subjects were classified in the same intensity domains across modalities, with LCE eliciting more subjects exercising at "vigorous" and "near-maximal" intensities than ACE. Time spent above 70 (22 ± 7 vs. 15 ± 8 minutes, d = 1.03) and 80 %HRmax (15 ± 6 vs. 9 ± 6 minutes, d = 1.04) was significantly greater with LCE vs. ACE. Compared with ACE, LCE revealed significantly higher (p < 0.05) peak (94 ± 6 vs. 88 ± 9 %HRmax, d = 0.81) and mean HR (73 ± 6 vs. 66 ± 6 %HRmax, d = 1.20), V̇o2 (54 ± 5 vs. 50 ± 7 %V̇o2max, d = 0.68), and BLa (5.5 ± 2.0 vs. 4.7 ± 1.5 mM, d = 0.48). The results exhibit that progressive leg cycling at identical intensities elicits a greater cardiometabolic stimulus than ACE.

Defining the Patient Acceptable Symptom State (PASS) for PROMIS After Total Ankle Replacement

Category: Ankle Arthritis; Other Introduction/Purpose: Patient-reported outcomes (PROs), such as PROMIS, are a key element of evaluating success after total ankle replacement (TAR). To date, most PROs are described using absolute values or parameters like the minimum clinically important difference. However, these interpretations do not explicitly tell the surgeon the most important factor of postoperative success: is the patient satisfied with their outcome after TAR? The patient acceptable symptom state (PASS) is a novel PRO metric that attempts to bridge this gap. PASS represents the symptom threshold above which patients consider themselves well. This study aimed to establish the PROMIS thresholds for PASS in a primary cohort of TAR patients. We hypothesized that TAR patients would meet PASS and that PASS would vary with demographic variables. Methods: This is a single-institution retrospective cohort study of primary TAR patients (n=127; mean age 63.2 years; mean BMI 29.0 kg/m2; 58% male) with preoperative and 2-year postoperative PROMIS scores (domains: Physical Function, Pain Interference, Pain Intensity, Global Mental Health, Global Physical Health, &amp; Depression). At 2 years postoperatively, patients also answered 2 PASS anchor questions with Likert-scale responses: 1) Are you satisfied with the results of your surgery?; and 2) the Delighted- Terrible symptom scale. PASS thresholds with 95% confidence intervals (CI) were calculated using the anchors “Very satisfied” or “Satisfied” for question 1 and “Delighted,” “Pleased,” or “Mostly Satisfied” for question 2. Using bootstrapping technique with 1000 iterations, the Youden Index was then calculated to determine the best coordinates of specificity and sensitivity to maximize the Area Under the Curve (AUC). Finally, we analyzed preoperative variables (demographics, clinical/surgical data, and preoperative PROMIS scores) on the likelihood of achieving PASS. Results: There was a strong association between PASS thresholds and PROMIS domains, especially Physical Function (PASS threshold &gt;44.7, AUC 0.883), Pain Interference (&lt; 56.0, AUC 0.940), and Pain Intensity (&lt; 48.4, AUC 0.936). Covariate stratification demonstrated that the likelihood of achieving PASS was not affected by age, race, gender, ASA score, or BMI. PASS was less likely to be achieved by patients who had undergone prior orthopaedic surgery (P=0.013). Patients with diabetes mellitus and peripheral vascular disease were less likely to meet PASS for Physical Function (P=0.010, P=0.037), but did meet PASS for Pain domains. Patients with worse preoperative Physical Function and Depression scores were less likely to meet PASS for Physical Function postoperatively (P=0.028, P=0.041), but achieved similar PASS for Pain Interference and Pain Intensity domains. Conclusion: After TAR, the ability to reach the postoperative PASS was most strongly associated with postoperative pain scores, as evidenced by the Pain Interference and Pain Intensity domains. However, the thresholds for PASS were generally lower than population means. This demonstrates that TAR patients do not need to reach normal pain or physical function levels in order to have an acceptable symptom state postoperatively. Moreover, the ability to achieve PASS was not affected by demographic variables. Further research on PASS is warranted, and may shift how surgeons and researchers evaluate TAR patients pre- and post-operatively.

Critical power is a key threshold determining the magnitude of post-exercise hypotension in non-hypertensive young males.

The effect of different exercise intensities on the magnitude of post-exercise hypotension has not been rigorously clarified with respect to the metabolic thresholds that partition discrete exercise intensity domains (i.e., critical power and the gas exchange threshold (GET)). We hypothesized that the magnitude of post-exercise hypotension would be greater following isocaloric exercise performed above versus below critical power. Twelve non-hypertensive men completed a ramp incremental exercise test to determine maximal oxygen uptake and the GET, followed by five exhaustive constant load trials to determine critical power and W' (work available above critical power). Subsequently, criterion trials were performed at four discrete intensities matched for total work performed (i.e., isocaloric) to determine the impact of exercise intensity on post-exercise hypotension: 10% above critical power (10%>CP), 10% below critical power (10%<CP), 10% above GET (10%>GET) and 10% below GET (10%<GET). The post-exercise decrease (i.e., the minimum post-exercise values) in mean arterial (10%>CP: -12.7±8.3 vs. 10%<CP: v3.5±2.9mmHg), diastolic (10%>CP: -9.6±9.8 vs. 10%<CP: -1.4±5.0mmHg) and systolic (10%>CP: -23.8±7.0 vs. 10%<CP: -9.9±4.3mmHg) blood pressures were greater following exercise performed 10%>CP compared to all other trials (all P<0.01). No effects of exercise intensity on the magnitude of post-exercise hypotension were observed during exercise performed below critical power (all P>0.05). Critical power represents a threshold above which the magnitude of post-exercise hypotension is greatly augmented. NEW FINDINGS: What is the central questions of this study? What is the influence of exercise intensity on the magnitude of post-exercise hypotension with respect to metabolic thresholds? What is the main finding and its importance? The magnitude of post-exercise hypotension is greatly increased following exercise performed above critical power. However, below critical power, there was no clear effect of exercise intensity on the magnitude of post-exercise hypotension.

Sodium-Bismuth-Titanium glass–ceramic network: A high capacity anode network for Na+ ion storage

This article discusses 95[35Na2O-65Bi2O3]: 5TiO2 (mol%) glass-ceramic anode material system (abbreviated as GC-NBT5.0) in order to overcome major issues with Na-ion battery technology, such as inadequate reversible capacity, rate capability, electrical conductivity, and safety. After heat treatment for different heat treating regimes, the production of intense intermediate domains Na3Bi and Na3Ti results in flexible active centers with which heavier Na+ ions may react very easily for Na+ ion storage in the glass-ceramic anode network. As evaluated at 50mA/g over a longer cycle life of up to 3000 cycles, the GC-NBT5.0-8h glass ceramic anode beats both glass anode and traditional graphite anodes with a specific discharge capacity of 801mAh/g. However, the cell design is still backed by the best electrical conductivity because of the good interfacial contact between the glass-ceramic anode and electrolyte, and the lowest cycle-dependent complex impedance characteristics (Rct and Zw), which guarantee consistent capacity retention and the highest Columbic efficiency over longer cycle durations.

Prediction of Exercise Tolerance in the Severe and Extreme Intensity Domains by a Critical Power Model.

This study aimed to assess the predictive capability of different critical power (CP) models on cycling exercise tolerance in the severe- and extreme-intensity domains. Nineteen cyclists (age: 23.0 ± 2.7 y) performed several time-to-exhaustion tests (Tlim) to determine CP, finite work above CP (W'), and the highest constant work rate at which maximal oxygen consumption was attained (IHIGH). Hyperbolic power-time, linear power-inverse of time, and work-time models with three predictive trials were used to determine CP and W'. Modeling with two predictive trials of the CP work-time model was also used to determine CP and W'. Actual exercise tolerance of IHIGH and intensity 5% above IHIGH (IHIGH+5%) were compared to those predicted by all CP models. Actual IHIGH (155 ± 30 s) and IHIGH+5% (120 ± 26 s) performances were not different from those predicted by all models with three predictive trials. Modeling with two predictive trials overestimated Tlim at IHIGH+5% (129 ± 33 s; p = 0.04). Bland-Altman plots of IHIGH+5% presented significant heteroscedasticity by all CP predictions, but not for IHIGH. Exercise tolerance in the severe and extreme domains can be predicted by CP derived from three predictive trials. However, this ability is impaired within the extreme domain.

Wavelet and Earth Mover’s Distance Coupling Denoising Techniques

The widely used wavelet-thresholding techniques (DWT-H and DWT-S) have a near-optimal behavior that cannot be enhanced by any local denoising filter, but they cannot utilize the similarity of small-size image patches to enhance the denoising performance. Two of the latest improvements (WNLM and NLMW) introduced the Euclidean distance to measure the similarity of image patches, and then used the non-local meaning of similar patches for further denoising. Since the Euclidean distance is not a good similarity measurement, these two improvements are limited. In this study, we introduced the earth mover’s distance (EMD) as the similarity measure of small-scale patches within the wavelet sub-bands of noisy images. Moreover, at higher noise levels, we further incorporated joint bilateral filtering, which can filter both the spatial domain and the intensity domain of images. Denoising simulation experiments on BSDS500 demonstrated that our algorithm outperformed the DWT-H, DWT-S, WNLM, and NLMW algorithms by 4.197 dB, 3.326 dB, 2.097 dB, and 1.162 dB in terms of the average PSNR, and by 0.230, 0.213, 0.132, and 0.085 in terms of the average SSIM.

The High Arctic Large Igneous Province: first seismic-stratigraphic evidence for multiple Mesozoic volcanic pulses on the Lomonosov Ridge, central Arctic Ocean

We use seismic reflection data acquired by an over-winter expedition on drifting sea ice in the central Arctic Ocean to explore a possible spatial and temporal magmatic relation between the sub-bottom geology of part of the deep Arctic Ocean and the Mesozoic volcanic rocks found on the islands and the bordering continental shelf of Franz Josef Land and Svalbard. The new dataset from the North American segment (85–90°N) of the Lomonosov Ridge, central Arctic Ocean documents several Mesozoic volcanic pulses over a distance of c. 600 km along the ridge. This volcanism borders a domain of high magnetic field intensity over the adjacent Alpha Ridge in the deep basin where the magnetic source rocks and recent seismic reflection data indicate extensive Mesozoic magmatism. We suggest that the Mesozoic volcanism on the Lomonosov Ridge in its palaeo-position at the former continental margin north of Franz Josef Land and Svalbard spatially links the Mesozoic magmatic pulses of the continental High Arctic Large Igneous Province (HALIP) of polar Europe to volcanism on the adjacent Alpha Ridge in the deep Arctic Ocean. Increased input of heat to the upper crust on the Lomonosov Ridge enhanced maturation of hydrocarbon source rocks as manifested by the presence of gas or fluid escape pipes restricted to the area of volcanism.

Exercise Physiology and Cardiopulmonary Exercise Testing.

Aerobic, or endurance, exercise is an energy requiring process supported primarily by energy from oxidative adenosine triphosphate synthesis. The consumption of oxygen and production of carbon dioxide in muscle cells are dynamically linked to oxygen uptake (V̇O2) and carbon dioxide output (V̇CO2) at the lung by integrated functions of cardiovascular, pulmonary, hematologic, and neurohumoral systems. Maximum oxygen uptake (V̇O2max) is the standard expression of aerobic capacity and a predictor of outcomes in diverse populations. While commonly limited in young fit individuals by the capacity to deliver oxygen to exercising muscle, (V̇O2max) may become limited by impairment within any of the multiple systems supporting cellular or atmospheric gas exchange. In the range of available power outputs, endurance exercise can be partitioned into different intensity domains representing distinct metabolic profiles and tolerances for sustained activity. Estimates of both V̇O2max and the lactate threshold, which marks the upper limit of moderate-intensity exercise, can be determined from measures of gas exchange from respired breath during whole-body exercise. Cardiopulmonary exercise testing (CPET) includes measurement of V̇O2 and V̇CO2 along with heart rate and other variables reflecting cardiac and pulmonary responses to exercise. Clinical CPET is conducted for persons with known medical conditions to quantify impairment, contribute to prognostic assessments, and help discriminate among proximal causes of symptoms or limitations for an individual. CPET is also conducted in persons without known disease as part of the diagnostic evaluation of unexplained symptoms. Although CPET quantifies a limited sample of the complex functions and interactions underlying exercise performance, both its specific and global findings are uniquely valuable. Some specific findings can aid in individualized diagnosis and treatment decisions. At the same time, CPET provides a holistic summary of an individual's exercise function, including effects not only of the primary diagnosis, but also of secondary and coexisting conditions.

Exercise intensity domains determined by heart rate at the ventilatory thresholds in patients with cardiovascular disease: new insights and comparisons to cardiovascular rehabilitation prescription recommendations

ObjectivesTo compare the elicited exercise responses at ventilatory thresholds (VTs: VT1 and VT2) identified by cardiopulmonary exercise testing (CPET) in patients with cardiovascular disease (CVD) with the guideline-directed exercise intensity...

Polarization-Aware Low-Light Image Enhancement

Polarization-based vision algorithms have found uses in various applications since polarization provides additional physical constraints. However, in low-light conditions, their performance would be severely degenerated since the captured polarized images could be noisy, leading to noticeable degradation in the degree of polarization (DoP) and the angle of polarization (AoP). Existing low-light image enhancement methods cannot handle the polarized images well since they operate in the intensity domain, without effectively exploiting the information provided by polarization. In this paper, we propose a Stokes-domain enhancement pipeline along with a dual-branch neural network to handle the problem in a polarization-aware manner. Two application scenarios (reflection removal and shape from polarization) are presented to show how our enhancement can improve their results.

Responses to Exercise at the Critical Heart Rate vs. the Power Output Associated With the Critical Heart Rate.

Succi, PJ, Dinyer-McNeely, TK, Voskuil, CC, Abel, MG, Clasey, JL, and Bergstrom, HC. Responses to exercise at the critical heart rate vs. the power output associated with the critical heart rate. J Strength Cond Res XX(X): 000-000, 2023-This study examined the physiological (volume of oxygen consumption [V̇o2], heart rate [HR], power output [PO], respiration rate [RR], muscle oxygen saturation [%SmO2]), neuromuscular (electromyographic and mechanomyographic amplitude [EMG AMP and MMG AMP] and mean power frequency [EMG MPF and MMG MPF]), and perceptual (rating of perceived exertion [RPE]) responses during exercise anchored at the critical heart rate (CHR) vs. the PO associated with CHR (PCHR). Nine subjects (mean ± SD; age = 26 ± 3 years) performed a graded exercise test and 4 constant PO trials to exhaustion at 85-100% of peak PO (PP) to derive CHR and PCHR on a cycle ergometer. Responses were recorded during trials at CHR (173 ± 9 b·min-1, time to exhaustion [TLim] = 45.5 ± 20.2 minutes) and PCHR (198 ± 58 W, TLim = 21.0 ± 17.8 minutes) and normalized to their respective values at PP in 10% intervals. There were significant (p ≤ 0.05) mode (CHR vs. PCHR) × time (10%-100% TLim) interactions for all variables (p < 0.001-0.036) except MMG AMP (p > 0.05). Post hoc analyses indicated differences across time for CHR V̇o2 (%change = -22 ± 16%), PCHR V̇o2 (19 ± 5%), CHR RR (24 ± 23%), PCHR RR (45 ± 14%), CHR PO (-33 ± 11%), PCHR HR (22 ± 5%), CHR RPE (22 ± 14%), PCHR RPE (39 ± 6%), CHR %SmO2 (41 ± 33%), PCHR %SmO2 (-18 ± 40%), CHR EMG AMP (-13 ± 15%), PCHR EMG AMP (13 ± 13%), CHR EMG MPF (9 ± 8%), CHR MMG MPF (7 ± 11%), and PCHR MMG MPF (-3 ± 14%). The critical heart rate was more sustainable than PCHR but required adjustments in PO which traversed intensity domains and caused dissociations of the responses previously observed in exercise anchored to PO. These dissociations indicated the demands to exercise varied with anchoring scheme and provides an important consideration for practitioners prescribing endurance exercise.

Relationships between biventricular myocardial function and oxygen uptake during exercise in healthy adolescent male athletes

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): UK Research and Innovation Medical Research Council Doctoral Training Programme Grant Work supported as part of a research partnership between the University of Bristol and Canon Medical Systems UK that determines the independence of the research from either parties. Background Biventricular cardiac function improves with increasing work-rate during exercise in healthy elite athletes, but how it relates to concomitantly measured oxygen uptake (VO2) is not well known. Assessing cardiac determinants of cardiorespiratory fitness through multimodal evaluations may lead to improvements in clinical stress testing protocols and better understanding of exercise physiology. Purpose The aim of this study was to investigate whether left and right ventricular (LV and RV) systolic function measured by speckle tracking echocardiography (STE) at submaximal exercise (moderate and high intensity domains) is associated with concomitantly measured VO2 in healthy adolescent male athletes. Methods Elite male football players &amp;lt;16 years-old underwent cardiopulmonary exercise testing with concomitant STE at 50 W steps. Exercise intensity domains were defined based on the gas exchange threshold (GET). LV and RV free wall (FW) peak systolic longitudinal strain (Sl), strain rate (SRl) and LV average (12 mid and basal segments) circumferential strain (Sc) and strain rate (SRc) were measured. Cardiac function relation to peak VO2 was evaluated using linear regression, and its relationships to VO2 within each exercise intensity domain using repeated measures mixed linear models, before and after adjusting for heart rate (HR). Results A total of n=94 athletes were included (mean age 14.7 ± 1 years). Mean peak VO2 and work-rate were 43 ± 7 mL·min-1·kg-1 and 215 ± 40 W, respectively. Relationships between cardiac function and VO2, by exercise intensity domain are shown in Figure 1 with all regression coefficients shown in Table 1. Only LV Sl at high intensity was correlated to peak VO2 (p = 0.04). Within exercise intensity domains higher LV Sl (Figure 1A) and SRl (Figure 1B) were associated with higher concomitantly measured VO2 at both moderate and high intensity. Higher SRc (Figure 1C) and RV FW SRl (Figure 1F) were associated with higher VO2 only at moderate intensity. LV Sc (Figure 1C) and RV FW Sl (Figure 1E) were not associated with concomitant VO2 during exercise at moderate or high intensity. Only LV Sl and SRl at moderate and high intensity remained significantly associated to concomitantly measured VO2 after further adjusting by HR (Table 1). Conclusions In healthy adolescent athletes, only LV longitudinal strain and strain rate measured at moderate and high intensity were associated with VO2 independent of HR response. There were differences in myocardial response to exercise both between the two ventricles, and between the longitudinal and circumferential components of LV function. These require further research, both in healthy and disease groups, especially in RV pathology, where components of myocardial function could play different roles in limiting exercise capacity.

Cardiopulmonary exercise testing in cardiac rehabilitation: From the reporting form to structured exercise prescription. A proposal from the Italian alliance for cardiovascular rehabilitation and prevention (Itacare-P)

The cardiopulmonary exercise test (CPET) is the gold standard for the diagnostic evaluation of exercise intolerance, as for individualized prescription of structured physical training. Exercise is a core component of cardiovascular prevention and rehabilitation activites, but unfortunately the limited availability of CPET-derived informations often leads to unpowered program's prescription in real life. The Italian Alliance for Cardiovascular Rehabilitation and Prevention (ITACARE-P) has developed a CPET reporting form specifically oriented to exercise prescription, in order to facilitate interventions on lifestyle and during phase II/phase III cardiac rehabilitation programmes. The ITACARE-P CPET reporting form includes a limited number of key variables for clinical practice and individual domains of exercise intensity, suitable both for threshold-based and range-based aerobic training protocols. The adoption of the ITACARE-P CPET reporting form could improve non-pharmacological intervention in preventive cardioloy and facilitate collaborative research on physical training within the network of cardiac rehabilitation facilities.

Robust binary fringe pattern optimization for optical three-dimensional shape measurement

Current studies show that binary fringe patterns can be optimized in the phase or intensity domain. The problem with the former is the poor sensitivity to defocusing levels and the problem with the latter is that phase errors can not be restricted efficiently. In this paper, a binary fringe pattern optimization technology, combining intensity similarity and phase similarity, is proposed to improve fringe pattern structure similarity and defocusing robustness. Moreover, a binary patch optimization framework is also proposed to solve the time-consuming problem. Simulation and experiment results show that the proposed optimization can produce binary fringe patterns with high phase quality and defocusing robustness.

"I just had the feeling that the interval training is more beneficial": young adults' subjective experiences of physical fitness and the role of training modes.

Compelling evidence has shown that high-intensity interval training (HIIT) is associated with substantial increases in physical fitness. However, little is known about whether and how individuals experience these adaptations over time. The purpose of this study is, therefore, to explore how physically inactive young adults subjectively experience physical fitness and its development as they start to exercise and how these experiences relate to different intensity domains (i.e., moderate and severe) as well as to training modes [i.e., HIIT and moderate intensity continuous training (MICT)] and their sequential administration (i.e., HIIT-MICT and MICT-HIIT). Thirty-one inactive participants completed a 15-week two-period sequential exercise intervention in which they first trained for six weeks in a HIIT or a MICT group and subsequently switched training modes. Interviews using the biographical mapping method were conducted at the end of the intervention to assess participants' exercise- and fitness-related experiences over the past weeks. To assess experiential patterns, we conducted a reflexive thematic analysis. We developed three themes that represent the temporal and processual character of starting to exercise after a prolonged period of inactivity: (1) Inactive young adults are not all the same when starting to exercise; (2) Developing physical fitness is a multi-faceted and individual experience; and (3) Feeling physically fit (or not) fosters large-scale effects. Our results show that, in retrospect, participants mostly deemed HIIT to be more effective than MICT. Our findings also emphasize that physical fitness is a complex and subjective experience that manifests in various ways over time. The idiosyncrasy of physical fitness experiences reiterates the necessity for individually tailored exercise prescriptions instead of one-size-fits-all approaches.

Pulse Lidar imaging algorithm based on adaptive triangle window-width centroid discrimination

The pulse light detecting and ranging (Lidar) can obtain rich environmental information of the target, and the centroid algorithm can obtain the distance and intensity information of the target from the echo pulse. However, there are problems of sensitivity to noise and fixed window width. Therefore, this paper proposes an adaptive triangle window-width centroid algorithm (ATWC) to improve the ranging accuracy and robustness of Lidar. This algorithm combines the characteristics of the steep front and slow back of the pulse echo waveform. The centroid calculation point is selected by an isosceles triangle envelope in the time domain and a non-isosceles triangle envelope in the intensity domain with a longer front and a shorter back. Further combined with intensity weighting, the distance and intensity values of ATWC are obtained. On the one hand, the simulation verifies the influence of window width selection on the accuracy of the centroid algorithm. On the other hand, real environment comparison experiments are conducted with traditional waveform centroid (TWC), peak ranging (PR), and adaptive threshold methods (ATM) under a pulse Lidar system constructed by our method, and our method achieves significant improvements. At different distances, when the peak signal-to-noise ratio (PSNR) is above 20 dB, the ranging error of ATWC is below 0.3 ns, which is much better than the compared algorithms. When the target is at a distance of 25 m, which is a weak echo signal environment with a PSNR of 15.6 dB, our algorithm can still achieve a ranging error of 0.56 ns, and the detection success rate can still reach 88.8%. In addition, our method can obtain a clearer intensity image, which further demonstrates the research potential and practical utility of the proposed method.

Associations of Physical Activity With Breast Cancer Risk: Findings From the UK Biobank Prospective Cohort Study.

Although physical activity (PA) has been consistently associated with breast cancer, existing evidence is limited to self-reported physical activity, which is prone to dilution bias. Therefore, this aims to examine the associations of device-measured PA domains with breast cancer risk and whether it differs by menopausal status. Prospective cohort study. Data from 48,286 women from the UK Biobank cohort were analyzed. A wrist triaxial accelerometer was used to collect physical activity data for light, moderate, vigorous, moderate to vigorous, and total PA. Cox proportional models were performed to examine the association between PA domains, menopausal status, and breast cancer risk. Eight hundred thirty-six breast cancer cases were diagnosed during a median of 5.4years (interquartile range: 4.7-5.9). For total PA, those in the most active quartile had a 26% lower risk of breast cancer (Hazard ratio [HR]: 0.74; 95% confidence interval [CI], 0.61-0.91) compared with those least active. Similar results were observed for light PA (HR: 0.79; 95% CI, 0.64-0.96), and moderate to vigorous PA (HR: 0.78; 95% CI, 0.64-0.96). However, moderate PA (HR: 0.73; 95% CI, 0.44-1.19) and vigorous PA (HR: 0.77; 95% CI, 0.56-1.05) was nonsignificant. No evidence of interaction between PA domains and menopause status was found (P > .10). High levels of PA are associated with a lower risk of breast cancer with similar magnitude of associations observed across different intensity domains.

Acute ventilatory responses to swimming at increasing intensities.

Physical exercise is a source of stress to the human body, triggering different ventilatory responses through different regulatory mechanisms and the aquatic environment imposes several restrictions to the swimmer, particularly regarding the restricted ventilation. Thus, we aimed to assess the acute ventilatory responses and to characterize the adopted breathing patterns when swimming front crawl at increasing intensity domains. Eighteen well-trained swimmers performed 7 × 200 m front crawl (0.05 m∙s-1 velocity increments) and a maximal 100 m (30 s rest intervals). Pulmonary gas exchange and ventilation were continuously measured (breath-by-breath) and capillary blood samples for lactate concentration ([La-]) analysis were collected at rest, during intervals and at the end of the protocol, allowing the identification of the low, moderate, heavy, severe and extreme intensity domains. With the swimming velocity rise, respiratory frequency (f R), [La-] and stroke rate (SR) increased ([29.1-49.7] breaths∙min-1, [2.7-11.4] mmol∙L-1, [26.23-40.85] cycles; respectively) and stroke length (SL) decreased ([2.43-2.04] m∙min-1; respectively). Oxygen uptake (VO2), minute ventilation (VE), carbon dioxide production (VCO2) and heart rate (HR) increased until severe ([37.5-53.5] mL∙kg-1∙min-1, [55.8-96.3] L∙min-1, [32.2-51.5] mL∙kg-1∙min-1 and [152-182] bpm; respectively) and stabilized from severe to extreme (53.1 ± 8.4, mL∙kg-1∙min-1, 99.5 ± 19.1 L∙min-1, 49.7 ± 8.3 mL∙kg-1∙min-1 and 186 ± 11 bpm; respectively) while tidal volume (VT) was similar from low to severe ([2.02-2.18] L) and decreased at extreme intensities (2.08 ± 0.56 L). Lastly, the f R/SR ratio increased from low to heavy and decreased from severe to the extreme intensity domains (1.12 ± 0.24, 1.19 ± 0.25, 1.26 ± 0.26, 1.32 ± 0.26 and 1.23 ± 0.26). Our findings confirm a different ventilatory response pattern at extreme intensities when compared to the usually evaluated exertions. This novel insight helps to understand and characterize the maximal efforts in swimming and reinforces the importance to include extreme efforts in future swimming evaluations.

A novel deep learning-based approach for malware detection

Malware detection approaches can be classified into two classes, including static analysis and dynamic analysis. Conventional approaches of the two classes have their respective advantages and disadvantages. For example, static analysis is faster but cannot detect the malware variants generated through code obfuscation, whereas dynamic analysis can effectively detect variants generated through code obfuscation but is slower and requires intensive resources. This paper proposes a novel deep learning-based approach for malware detection. It delivers better performance than conventional approaches by combining static and dynamic analysis advantages. First, it visualises a portable executable (PE) file as a coloured image. Second, it extracts deep features from the colour image using fine-tuned deep learning model. Third, it detects malware based on the deep features using support vector machines (SVM). The proposed method combines deep learning with machine learning and eliminates the need for intensive feature engineering tasks and domain knowledge. The proposed approach is scalable, cost-effective, and efficient. The detection effectiveness of the proposed method is validated through 12 machine learning models and 15 deep learning models. The generalisability of the proposed framework is validated on various benchmark datasets. The proposed approach outperformed with an accuracy of 99.06% on the Malimg dataset. The Wilcoxon signed-rank test is used to show the statistical significance of the proposed framework. The detailed experimental results demonstrate the superiority of the proposed method over the other state-of-the-art approaches, with an average increase in accuracy of 16.56%. Finally, to tackle the problems of imbalanced data and the shortage of publicly available datasets for malware detection, various data augmentation techniques are proposed, which lead to improved performance. It is evident from the results that the proposed framework can be useful to the defence industry, which will be helpful in devising more efficient malware detection solutions.