Load In Women Research Articles

Predicting Athlete Workload in Women's Rugby Sevens Using GNSS Sensor Data, Contact Count and Mass.

The use of session rating of perceived exertion (sRPE) as a measure of workload is a popular athlete load monitoring tool. However, the nature of sRPE means the contribution of salient, sport-specific factors to athlete load in field sports is challenging to isolate and quantify. In rugby sevens, drivers of load include high-speed running and physical contact. In soccer and men's rugby, union acceleration/deceleration also influences load. These metrics are evaluated using data from global navigation satellite system (GNSS) sensors worn by athletes. Research suggests that sensor data methods for identifying load in men's rugby do not accurately quantify female athlete loads. This investigation examined how mass, contact, and accelerations and decelerations at different speeds contribute to load in women's rugby sevens. The study evaluated 99 international matches, using data from 19 full-time athletes. GNSS measures, RPE, athlete mass, and contact count were evaluated using a linear mixed-model regression. The model demonstrated significant effects for low decelerations at low and high speeds, mass, distance, and contact count explaining 48.7% of the global variance of sRPE. The use of acceleration/deceleration and speed from GNSS sensors alongside mass, as well as contact count, presents a novel approach to quantifying load.

Is Match Playing Time a Potential Tool for Managing Load in Women's Handball?

García-Sánchez, C, Navarro, RM, Nieto-Acevedo, R, and de la Rubia, A. Is match playing time a potential tool for managing load in women's handball? J Strength Cond Res XX(X): 000-000, 2024-The aim of this study was to explore the external load experienced by female handball players according to the time played in official matches (≥40, <40, and ≤20 minutes) and in relation to playing positions (backs, pivots, and wings). Twenty-two female players from the Spanish second Division were monitored across 13 matches. Total distance covered, high-speed running distance (HSR), accelerations, decelerations, and PlayerLoad were collected in absolute and relative values using a local positioning system (WIMU PRO, Realtrack Systems SL, Almería, Spain). One-way ANOVA with partial eta-squared and Cohen's d were used to determine the differences between playing time groups and between playing positions. This study revealed that players with more match playing time had a higher absolute values in all external load variables (p < 0.001; very large effects), except in HSR where only wings showed higher values according to the time played (p < 0.001; very large effects). However, these differences between playing time groups disappear when the external load values were normalized according to the effective playing time (p > 0.05). In relation to playing positions, wings covered more HSR/minutes than the other playing positions regardless of the playing time (p < 0.05; large effects). In addition, backs performed more ACC/minutes than wings in the high playing time group and more than pivots in the low playing time group (p < 0.05, moderate effects). In addition, backs performed more DEC/minutes than wings in the low playing time group (p < 0.05, moderate effects). Therefore, handball coaches should consider the playing time as an effective tool to optimize the weekly load distribution.

Breast arterial calcification and carotid arteries atherosclerotic load in women

Breast arterial calcification and carotid arteries atherosclerotic load in women

PAX1/JAM3 Methylation and HPV Viral Load in Women with Persistent HPV Infection.

The relationship of PAX1/JAM3 methylation as well as HPV viral load (VL) with cervical lesions has been reported, but their role in persistent HPV infection without cervical high-grade lesions has not been fully elucidated. A total of 231 females diagnosed with persistent HPV infection and pathologically confirmed absence of high-grade cervical lesions were selected from the Colposcopy Outpatient Clinic of Peking University People's Hospital, from March 2023 to December 2023. They were categorized into two groups based on the duration of HPV infection: the HPV persistent less than 3 years group and the more than 3 years group. PAX1/JAM3 methylation and HPV VL were determined by real-time PCR and BioPerfectus Multiplex Real-Time (BMRT)-HPV reports type-specific VL/10,000 cells, respectively. The average age of individuals with HPV infection lasting more than 3 years was higher compared to those with less than 3 years (48.9 vs. 45.1 years), with a statistically significant difference. Among the participants, 81.8% (189/231) had no previous screening. The methylation levels of JAM3 and PAX1 were significantly higher in individuals with HPV infection persisting for more than 3 years compared to those with less than 3 years, with a statistically significant difference (p < 0.05). There was a significant correlation between PAX1 and JAM3 methylation (p < 0.001), which could be used as cumulative evidence of HPV infection duration before the occurrence of precancerous lesions. The incidence of vaginal intraepithelial lesions was higher in individuals with HPV infection persisting for more than 3 years compared to those with less than 3 years, and HPV VL can be used as an indicative biomarker for concurrent cervical-vaginal lesions, especially for HPV other than 16/18 genotypes.

Impact of informal care on the mental health of caregivers during the COVID-19 pandemic.

Informal care can affect the mental health of caregivers. The COVID-19 pandemic precipitated many people into informal care. Little is known about the longitudinal effect of informal care throughout the pandemic. We investigate changes in mental health in relation to changes in informal care between July 2020 and September 2021. Using data from Understanding Society, we applied fixed-effects modelling to assess mental health variations associated with changes in caregiving among 13557 participants (50430 observations). Hours of weekly care were categorized as 0, 1-19, ≥20. Mental health was measured using the General Health Questionnaire (GHQ-12) as a continuous score and a binary indicator. Main analyses were stratified by gender. Compared to when delivering 0hours care/week, the GHQ-12 scores of women providing care for 1-19hours/week were 0.46 points higher (95%CI: -0.11, 1.09), while their mental health scores were 0.99 higher (95%: 0.08, 1.90) when caring for ≥20hours/week. Changes on the binary GHQ-12 measure were only evident for women when providing ≥20hours of weekly care. These changes were not substantial among men. Informal care adversely impacted the mental health of women carers during the COVID-19 pandemic. Support programmes for informal carers should focus on alleviating caregiving loads in women.

Training and Competition Loads in Women's Rugby Sevens Athletes: Are There Implications for Cardiovascular Health?

National- and international-level rugby sevens athletes are exposed to high training and competition loads over the course of a competitive season. Research on load monitoring and body-system responses is widespread; however, the primary focus has been on optimizing performance rather than investigating or improving cardiovascular health. There is a degree of cardiovascular remodeling, as well as local and systemic inflammation, in response to excessive exercise. These responses are moderated by many factors including previous exercise exposure, current exercise intensity and duration, age, race, and gender, as well as sport-specific physiology. For these reasons, high-performing female rugby sevens athletes may have a unique cardiovascular risk profile different from males and other rugby codes. This review aimed to characterize the training and competition loads, as well as the anthropometric and physiological profiles, of female rugby sevens athletes; discuss the potential impacts these may have on the cardiovascular system; and provide recommendations on future research regarding the relationship between rugby sevens training and competition loads and cardiovascular health. Movement demands, competition formatting, and training routines could all contribute to adverse cardiovascular adaptations. Anthropometric data and physiological characteristics may also increase the risk of cardiovascular disease. Future research needs to adopt measures of cardiovascular health to obtain a greater understanding of cardiovascular profiles and risk factors in female rugby sevens athletes.

Relationships Between Sprint, Acceleration, and Deceleration Metrics with Training Load in Division I Collegiate Women's Soccer Players.

Player load is a variable derived from GPS technology that quantifies external load demands. Sprints and change-of-direction movements are high-intensity activities that place stress on the body. Research is needed to determine which sprint metrics may relate to and predict player load during practice sessions in collegiate women's soccer players, as coaches could manipulate the most impactful variables. This study analyzed which sprint metrics related to GPS player load in women's soccer players from one Division I team. Data from 19 practice sessions for 18 field players were analyzed. Players wore GPS sensors during all training sessions, and the variables assessed were player load, sprint count, sprint volume, sprint distance, average top speed, maximum top speed, and the number of accelerations and decelerations in different speed zones (±1, ±2, ±3, ±4, ±5 m/s2). Pearson's correlations (p < 0.05) analyzed relationships between the sprint variables and player load. Stepwise regression analyses (p < 0.05) determined if any metrics predicted player load. The results indicated significant relationships between player load and sprint count, maximum top speed, sprint distance, sprint volume, number of decelerations at -1, -2, and -3 m/s2, and accelerations at 1, 2, and 5 m/s2(r = 0.512-0.861, p ≤ 0.025). Sprint distance and decelerations at 1 m/s2predicted player load (p = 0.001, r2= 0.867). Maximal sprinting and decelerations and accelerations at different speeds were significant contributors to player load in collegiate women's soccer players. Sprint distance, decelerations, and accelerations could be targeted in training drills via dimension and movement manipulation to adjust training intensity for collegiate women's soccer players.

Exercise volume load in women with breast cancer: Study protocol for the ABRACE randomized clinical trial

BackgroundAn increased number of breast cancer patients are challenged by acute and persistent treatment side effects. Oncology guidelines have been establishing physical exercise to counteract several treatment-related toxicities throughout cancer care. However, evidence regarding the optimal dose-response, feasibility, and the minimal resistance exercise volume and/or intensity remains unclear. The ABRACE Study will assess the impact of different resistance training volumes (i.e., single or multiple sets) combined with aerobic exercise on physical and psychological outcomes of breast cancer patients undergoing primary treatment. MethodsThis study is a randomized, controlled, three-armed parallel trial. A total of 84 participants, aged ≥18 years, with breast cancer stages I-III, initiating adjuvant or neoadjuvant chemotherapy (≤50% of sessions completed) will be randomized to multiple sets resistance training plus aerobic training group, single set resistance training plus aerobic training group or control group. Neuromuscular and cancer-related fatigue (primary outcomes), muscle strength, muscle thickness, muscle quality by echo intensity, body composition, cardiorespiratory capacity, functional performance, upper-body endurance and quality of life will be measured before and after the 12-week intervention. Our analysis will follow the intention-to-treat approach and per-protocol criteria, with additional sub-group analysis. DiscussionFindings support prescribing exercise during chemotherapy for breast cancer and elucidate the potential role of different resistance training volumes as a management strategy for physical and psychological impairments in women with early-stage breast cancer. Our main hypothesis is for superiority in physical and psychological outcomes for both training groups compared to the control group, with no difference between single or multiple sets groups. Trial registrationClinical trials NCT03314168.

Load-Specific Performance Fatigability, Coactivation, and Neuromuscular Responses to Fatiguing Forearm Flexion Muscle Actions in Women.

Benitez, B, Dinyer-McNeeley, TK, McCallum, L, Kwak, M, Succi, PJ, and Bergstrom, HC. Load-specific performance fatigability, coactivation, and neuromuscular responses to fatiguing forearm flexion muscle actions in women. J Strength Cond Res 37(4): 769-779, 2023-This study examined the effects of fatiguing, bilateral, dynamic constant external resistance (DCER) forearm flexion on performance fatigability, coactivation, and neuromuscular responses of the biceps brachii (BB) and triceps brachii (TB) at high (80% 1 repetition maximum [1RM]) and low (30% 1RM) relative loads in women. Ten women completed 1RM testing and repetitions to failure (RTF) at 30 and 80% 1RM. Maximal voluntary isometric force was measured before and after RTF. Electromyographic (EMG) and mechanomyographic (MMG) amplitude (AMP) and mean power frequency (MPF) signals were measured from the BB and TB. Performance fatigability was greater (p < 0.05) after RTF at 30% (%∆ = 41.56 ± 18.61%) than 80% (%∆ = 19.65 ± 8.47%) 1RM. There was an increase in the coactivation ratio (less coactivation) between the initial and final repetitions at 30%, which may reflect greater increases in agonist muscle excitation (EMG AMP) relative to the antagonist for RTF at 30% than 80% 1RM. The initial repetitions EMG AMP was greater for 80% than 30% 1RM, but there was no difference between loads for the final repetitions. For both loads, there were increases in EMG MPF and MMG AMP and decreases in MMG MPF that may suggest fatigue-dependent recruitment of higher-threshold motor units. Thus, RTF at 30 and 80% 1RM during DCER forearm flexion may not necessitate additional muscle excitation to the antagonist muscle despite greater fatigability after RTF at 30% 1RM. These specific acute performance and neuromuscular responses may provide insight into the unique mechanism underlying adaptations to training performed at varying relative loads.

Comparison of in vivo visco-hyperelastic properties of uterine suspensory tissue in women with and without pelvic organ prolapse

The uterine suspensory tissue (UST) complex includes the cardinal (CL) and uterosacral “ligaments” (USL), which are mesentery-like structures that play a role in resisting pelvic organ prolapse (POP). Since there is no information on the time-dependent material properties of the whole structure in situ and in vivo, we developed and tested an intraoperative technique to quantify in vivo whether there is a significant difference in visco-hyperelastic behavior of the CL and USL between women with and without POP. Thirteen women with POP (cases) and four controls scheduled for surgery were selected from an ongoing POP study. Immediately prior to surgery, a computer-controlled linear servo-actuator with a series force transducer applied a continuous, caudally directed traction force while simultaneously recording the resulting cervical displacement in the same direction. After applying an initial 1.1 N preload, a ramp rate of 4 mm/s was used to apply a maximum force of 17.8 N in three “ramp-and-hold” test trials. A simplified bilateral four-cable biomechanical model was used to identify the material behavior of each ligament. For this, the initial cross-section areas of the CL and USL were measured on 3-T magnetic resonance image-based 3D models from each subject. The time-dependent strain energy function of CL/USL was defined with a three-parameter hyperelastic Mooney–Rivlin material model and a two-term Prony series in relaxation form. When cases were compared with controls, the estimated time-dependent material constants of CL and USL did not differ significantly. These are the first measurements that compare the in vivo and in situ visco-hyperelastic response of the tissues comprising the CL and USL to loading in women with and without prolapse. Larger sample sizes would help improve the precision of intergroup differences.

Digital phenotyping in transmission constrained, military operational environments

Introduction: Stress fracture injuries affect defence forces worldwide. The sudden onset of high-impact exercise, insufficient recovery, and suboptimal conditions (e.g., energy and sleep restriction) elicit injuries in 5 to 10% of military recruits. Women are three times more likely to develop stress fractures than men1, and this risk of injury is projected to increase further in women employed in ground close combat roles2. Oestrogens have two distinct roles in women’s bone biology. 1. Oestrogens influence the size and shape of bone during puberty, promoting endosteal contraction, and resulting in a smaller cross-sectional area than men. A smaller bone size contributes to the increased risk of stress injuries under loading in women. 2. Oestrogens prevent excessive bone resorption by suppressing RANKL expression. Low oestrogen caused by suppression of the hypothalamic-pituitary-ovarian axis—indicated by a loss of menstrual periods—is highly prevalent during arduous exercise3 and demineralises bone. Cessation of menstrual periods, amenorrhoea, is a risk factor for stress fracture injury4. Ovulation is a key event in the menstrual cycle, preceded by a peak in oestrogen concentration, and followed by increased progesterone concentration. Anovulatory cycles are characterised by low, non-cyclical oestrogen and progesterone. Ovulation is a sign of menstrual health and informs women of their reproductive hormonal status. Non-invasive, innovative methods of detecting ovulation are disrupted approaches to mitigating injury risk in women. Methods: This presentation will provide an overview of the epidemiology of stress fracture injuries in military personnel, reporting the prevalence and patterns of injuries observed during basic military training. The role of the sex steroid hormones on bone health will be described, and the utility of wearables to detect ovulation appraised. Primary evidence will be obtained from open-source, peer-reviewed literature, and wearable data will be drawn from both published studies and preliminary data from the British Army’s EMPOWER study. Conclusions: A high proportion of women experience menstrual disturbances during arduous training and suffer a high incidence of stress fractures. The validity of wearable technology for women to detect ovulation during arduous military training, characterised by high physical demands, stress, and restricted energy and sleep, is under investigation. Acknowledgements: This work was funded by the British Army. References 1O’Leary TJ, Wardle SL, Rawcliff AJ, et al. Understanding the musculoskeletal injury risk of women in combat: the effect of infantry training and sex on musculoskeletal injury incidence during British Army basic training. BMJ Mil Health. 2020; 0:1-5. https://doi.org/10.1136/jramc-2019-001347 2Ministry of Defence. Women in Ground Close Combat Roles - Interim Health Report 2016. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/536381/20160706_ADR006101_Report_Women_in_Combat_WEB-FINAL.PDF Accessed 31 Aug 2021. 3Gifford RM, O’Leary TJ, Wardle SL, et al. Reproductive and metabolic adaptation to multistressor training in women. Am J Physiol Endoc-M 2021; 321(2):E281-E291. https://doi.org/10.1152/ajpendo.00019.2021 4Ackerman KE, Sokoloff NC, Maffazioli GDN, et al. Fractures in relation to menstrual status and bone parameters in young athletes. Med Sci Sports Exerc 2015; 47(8):1577-1586. https://doi.org/10.1249/MSS.0000000000000574

Adaptive reactions of the cardiovascular system to health classes with different types of motor activity.

The topicality of research`s subject. In themodern scientific literature, the adaptiveresponses of the cardiovascular system toexercise are studied mainly by the dynamics ofblood pressure at rest. Adaptive responses ofblood pressure during dosed exercise remaininsufficiently studied.The purpose of the study. To establish thefeatures of adaptive reactions of heart rate,blood pressure at rest and after dosed exercisein women 25-35 years of age under theinfluence health classes of different types ofphysical activity.Research methods: pedagogical experiment,pulsometry, sphygmomanometry, methods ofmathematical statistics.Results: Wellness running classes caused a2.2% decrease in resting heart rate and a 2.1%decrease in systolic blood pressure after adosed ergometric load power of 1 ·kg.Wellness swimming helped to reduce heartrate by 1.9% and reduce by 2.5% systolicblood pressure after a load power of 2 W·kg.Сonclusions: We did not find data on theimpact of wellness activities in swimming,running, aqua fitness, fitness on the functionalstate of the cardiovascular system of women ofthe first period of adulthood. To solve thisproblem, a study of adaptive responses ofcardiovascular system to the various types ofphysical activity. Detected decreased heart rateat rest and systolic blood pressure after a dosedergometric load in women engaged in wellnessactivities in swimming, running. Theseprograms were focused on stimulating aerobicenergy supply.

Daily cumulative load and body mass index alter knee cartilage response to running in women.

It is unknown whether a greater accumulation of knee load over a typical day is related to how cartilage responds to an acute bout of loading. This information may clarify the role of habitual activity on cartilage function. Is there a relationship between change in tibial and femoral cartilage thickness, volume, and T2 relaxation time following running with daily cumulative knee load in women? Secondarily, is there a relationship between cartilage change following running and the statistical interaction of body mass index (BMI) and daily steps? Participants (n = 15) completed gait analyses and wore an accelerometer over a week. Daily cumulative knee load was the statistical interaction between tibial compressive joint reaction force (JRF) impulse with the average number of daily steps measured using accelerometry. Magnetic resonance imaging scans were acquired before and immediately after 15-min of treadmill running. Changes in tibial and femoral cartilage thickness, volume, and T2 relaxation time were calculated. Multiple linear regressions tested the associations of cartilage change outcomes with: baseline (thickness, volume, T2), JRF impulse, steps, and the interaction JRF impulse*steps. Secondarily, BMI was substituted for JRF impulse. Tibial volume change was explained by baseline volume, JRF impulse, steps, and JRF impulse*steps (R2 = 0.50, p = 0.013). Additionally, tibial volume change was explained by baseline volume, BMI, steps, and BMI*steps (R2 = 0.43, p = 0.002). Those who were more physically active with lower JRF impulse (or lower BMI) showed less change in tibial cartilage after a running exposure. This may suggest cartilage conditioning.

ANALYSIS AND COMPARISON OF TRAINING LOAD BETWEEN TWO GROUPS OF WOMEN’S ARTISTIC GYMNASTS RELATED TO THE PERCEPTION OF EFFORT AND THE RATING OF THE PERCEIVED EFFORT SESSION

The aim of this study was to assess the internal training load in female artisticgymnastics through subjective perception of effort (PSE) by calculating the sRPE variableand different associated variables. Ten gymnasts participated (age: 14.4 ± 2.9 years; height:1.5 ± 0.1 m; mass: 43.3 ± 12.2 kg) and were divided into two groups according to theircompetitive level and weekly training volume: High Level Gymnasts (HLG) and MediumLevel Gymnasts (MLG). The PSE of each gymnast was recorded daily for four weeks after theend of each training block. The HLG group recorded a significantly higher RPE and sRPEvalue in the specific physical preparation (SST) and in the parallel technical training (UB)contents (p &lt; 0.05) compared to MLG. Statistically significant differences were also obtainedfrom the registered mean values of RPE and sRPE when comparing training content.Furthermore, a direct relationship between volume and workload was observed. Finally, thevariables associated with injury risk control provided relevant information to determine thatthe HLG group had a higher risk of injury than the MLG group. Therefore, the sRPE hasbeen a useful tool to assess the internal training load in women's artistic gymnastics. Suchinformation may help quantify the load in this sport in the future.

Pre Extension Demonstration of Improved Milk Churner at Sidama Region and Gedio Zone SNNPR

Dairy industry is one of the major industries in Ethiopia which can improve the livelihood of the farmer. Butter making process is the one and the most tedious and time consuming operations in dairy industry especially for small holder farmers. It can be made by churning either cream or soar milk. The research activity carried out support of AGP2 Sidama region in Burisa district and SNNPR in Gedio zone Bule district with objectives of to demonstration and popularization of improved milk churners, to evaluate the efficiency both milk churner in time consuming and better yield and to collect farmers’ preference. From these districts two peasant associations were purposively selected from list of peasant associations based on their potential of dairy production. Then, two groups which have fifteen members in each of women farmers were organized in the selected peasant associations to undertake demonstration and popularization of plastic milk churner. The training was given to farmers, DAs and districts’ dairy experts focusing on how to use the technology, advantages of technology over the traditional ones. A total of 2 FREGs (30 women farmers in two district) member farmers of which around 100% females have been participated on training and demonstration activities. The result reveals that use of plastic milk-churner reduces time of milk churning by half in relative to traditional one i.e. from 60 minutes to 30 minutes, significantly higher quantity of butter (0.39kg/5liter) was obtained from improved churner than traditional clay pot (0.27kg/5liter) and highly reduces work load in women so that, improved milk churner was preferred by two FREG members. Thus, Promotion of this technology should be expanded in other dairy cattle populated areas. Also, sealing of improved milk churner is not tight well, so there was continues dropping of milk, thus sealing part needs further improvement.

Effect of Foot-Planting Strategy on Anterior Cruciate Ligament Loading in Women During a Direction Diversion Maneuver: A Musculoskeletal Modeling Approach.

Background:Although there is a higher prevalence of noncontact anterior cruciate ligament (ACL) injuries during a direction diversion maneuver (DDM), no previous studies have reported how foot-planting strategies affect ACL loading.Purpose:To investigate the effect of foot-planting strategies on ACL loading in women during a DDM task using a musculoskeletal modeling approach.Study Design:Descriptive laboratory study.Methods:A total of 13 female participants performed a DDM task, which involved running at 4.5 ± 0.2 m/s and turning left at 35° to 55° under a foot-planting strategy in 3 directions: neutral, toe-in, and toe-out. Kinematic and kinetic data were measured with the use of a 3-dimensional motion capture system and force platform to calculate variables such as joint angle, shear force, and moment. Anterior ACL and posterior ACL forces were extracted using musculoskeletal modeling.Results:The peak anterior ACL force was significantly larger for the toe-out condition (31.29 ± 4.02 N/body weight [BW]) compared with the toe-in condition (25.43 ± 5.68 N/BW) (P = .047), with no significant difference in the neutral condition. The toe-out condition had a higher knee valgus angle (2.98° ± 4.20°; P = .041), knee shear force (10.20 ± 1.69 N/BW; P = .009), and knee internal rotation moment (–0.18 ± 0.16 N·m/BW×height; P = .012) than the toe-in and neutral conditions.Conclusion:Through musculoskeletal modeling, we were able to conclude that the toe-out condition during the DDM might result in a higher risk of ACL injuries. Athletes and sports practitioners should avoid the toe-out foot-planting strategy when participating in a sporting activity.Clinical Relevance:Based on these findings, medical professionals and athletic coaches can gain knowledge on how foot-planting strategy affects ACL loading. Understanding the actual cause of an ACL injury can be useful for designing preventive training programs or strategies to decrease the risk of such injuries.

Relating Bone Strain to Local Changes in Radius Microstructure Following 12 Months of Axial Forearm Loading in Women.

Work in animal models suggests that bone structure adapts to local bone strain, but this relationship has not been comprehensively studied in humans. Here, we quantified the influence of strain magnitude and gradient on bone adaptation in the forearm of premenopausal women performing compressive forearm loading (n = 11) and nonloading controls (n = 10). High resolution peripheral quantitative computed tomography (HRpQCT) scans of the distal radius acquired at baseline and 12 months of a randomized controlled experiment were used to identify local sites of bone formation and resorption. Bone strain was estimated using validated finite element (FE) models. Trabecular strain magnitude and gradient were higher near (within 200 μm) formation versus resorption (p < 0.05). Trabecular formation and resorption occurred preferentially near very high (>95th percentile) versus low (<5th percentile) strain magnitude and gradient elements, and very low strain elements were more likely to be near resorption than formation (p < 0.05). In the cortical compartment, strain gradient was higher near formation versus resorption (p < 0.05), and both formation and resorption occurred preferentially near very high versus low strain gradient elements (p < 0.05). At most, 54% of very high and low strain elements were near formation or resorption only, and similar trends were observed in the control and load groups. These findings suggest that strain, likely in combination with other physiological factors, influences adaptation under normal loads and in response to a novel loading intervention, and represents an important step toward defining exercise interventions to maximize bone strength.

Short-course Benznidazole treatment to reduce Trypanosoma cruzi parasitic load in women of reproductive age (BETTY): a non-inferiority randomized controlled trial study protocol

BackgroundRetrospective observational studies suggest that transmission of Trypanosoma cruzi does not occur in treated women when pregnant later in life. The level of parasitemia is a known risk factor for congenital transmission. Benznidazole (BZN) is the drug of choice for preconceptional treatment to reduce parasitic load.The fear of treatment-related side effects limits the implementation of the Argentine guideline recommending BZN 60d/300 mg (or equivalent) treatment of T. cruzi seropositive women during the postpartum period to prevent transmission in a future pregnancy. A short and low dose BZN treatment might reduce major side effects and increase compliance, but its efficacy to reduce T. cruzi parasitic load compared to the standard 60d/300 mg course is not yet established. Clinical trials testing alternative BZN courses among women of reproductive age are urgently needed.Methods and designWe are proposing to perform a double-blinded, non-inferiority randomized controlled trial comparing a short low dose 30-day treatment with BZN 150 mg/day (30d/150 mg) vs. BZN 60d/300 mg. We will recruit not previously treated T. cruzi seropositive women with a live birth during the postpartum period in Argentina, randomize them at 6 months postpartum, and follow them up with the following specific aims:Specific aim 1: to measure the effect of BZN 30d/150 mg compared to 60d/300 mg preconceptional treatment on parasitic load measured by the frequency of positive Polymerase Chain Reaction (PCR) (primary outcome) and by real-time quantitative PCR (qPCR), immediately and 10 months after treatment.Specific aim 2: to measure the frequency of serious adverse events and/or any adverse event leading to treatment interruption.Trial registrationClinicalTrials.gov. Identifier: NCT03672487. Registered 14 September 2018

Better Viral Control despite Higher CD4+ T Cell Activation during Acute HIV-1 Infection in Zambian Women Is Linked to the Sex Hormone Estradiol.

The influence of biological sex on disease progression in HIV-1-infected individuals has been focused on the chronic stage of infection, but little is known about how sex differences influence acute HIV-1 infection. We observed profound differences in viral load and CD4+ T cell activation from the earliest time points in men and women in a Zambian heterosexual acute infection cohort. Women exhibited a >2-fold higher rate of CD4+ T cell loss despite significantly lower viral loads (VL) than men. The importance of studying acute infection was highlighted by the observation that very early in infection, women exhibited significantly higher levels of CD4+ T cell activation, a difference that was lost over the first 3 years of infection as activation in men increased. In women, activation of CD4+ T cells in the acute phase was significantly correlated with plasma levels of 17β-estradiol (E2). However, unlike in men, higher CD4+ T cell activation in women was not associated with higher VL. In contrast, a higher E2 level in early infection was associated with lower early and set-point VL in women. We attribute this to an inhibitory effect of estradiol on virus replication, which we were able to observe with relevant transmitted/founder viruses in vitro Thus, estradiol plays a key role in defining major differences between men and women during early HIV-1 infection by contributing to both viral control and CD4+ T cell loss, an effect that extends into the chronic phase of the disease.IMPORTANCE Previous studies have identified sex-specific differences during chronic HIV-1 infection, but little is known about sex differences in the acute phase, or how disparities in the initial response to the virus may affect disease. We demonstrate that restriction of viral load in women begins during acute infection and is maintained into chronic infection. Despite this, women exhibit more rapid CD4+ T cell loss than men. These profound differences are influenced by 17β-estradiol, which contributes both to T cell activation and to reduced viral replication. Thus, we conclude that estradiol plays a key role in shaping responses to early HIV-1 infection that influence the chronic phase of disease.

Gender-related dynamics of exercise tolerance in patients with acute coronary syndrome undergoing the outpatient phase of rehabilitation

Background. The relevance of the comparative study of exercise tolerance in male and female cardiac patients is due to the need to individualize physical rehabilitation programs.&#x0D; Aims: to study the impact of gender on exercise tolerance in patients with acute coronary syndrome undergoing a course of rehabilitation in a day hospital.&#x0D; Methods. 110 patients with acute coronary syndrome were examined: 81 men (73.6%) aged 34 to 75 years and 29 women (26.4%) aged 44 to 74 years. In accordance with the purpose of the study, all patients were exposed to stress testing before and after the end of the three-week rehabilitation course.&#x0D; Results. According to the analysis of the six-minute walk test and the Bicycle ergometric test, men had better physical endurance than women. Features of hemodynamic indicators during physical activity also correlate with gender: in comparison with men, the maximum physical load in women was accompanied by higher heart rate values. At the end of the rehabilitation course, women had a more pronounced improvement of Bicycle ergometry indicators: a greater increase in maximum power and the percentage of load performed during the test.&#x0D; Conclusions. The gender differences in exercise tolerance in cardiac patients identified in the study should be taken into account when designing rehabilitation programs.