Training Period Research Articles

Effects of high-intensity interval training on physical performance, systolic blood pressure, oxidative stress and inflammatory markers in skeletal muscle of spontaneously hypertensive rats.

To investigate whether high-intensity interval training (HIIT) improves physical performance, systolic blood pressure, and markers of oxidative stress and inflammation in skeletal muscle of spontaneously hypertensive rats (SHR). Nineteen male SHR rats were randomly assigned to two groups: sedentary (SHRC) and trained (SHR+T). The SHR+T group trained five times a week for eight weeks on a treadmill, while the SHR group remained without any exercise stimulus throughout the experimental period. Maximum physical performance and systolic blood pressure (SBP) were assessed before and after the training period. The following variables were measured in the tibialis anterior (TA) muscle: gene expression of the NADPH oxidase complex (NOX2, NOX4, p22phox, p47phox) and the NF-kB pathway (NF-kB and Ik-B), lipid peroxidation (malonaldehyde; MDA), protein carbonylation, hydrophilic antioxidant capacity (HAC) and pro-inflammatory cytokines (IL-6 and TNF-α). SHR+T rats showed higher physical performance and levels of IL-6, and lower SBP and protein carbonylation (p<0.05), compared with SHRC rats. No significant differences (p>0.05) were observed in the other variables. Our results indicate that HIIT is an effective non-pharmacologic strategy to improve physical performance, reduce SBP, and modulate the skeletal muscle oxidative damage and inflammation in hypertensive rats.

Challenges and opportunities in pediatric surgery training in Germany: a view from the trenches.

Pediatric surgery training in Germany faces significant challenges related to structural issues and resource limitations, including variability in training sites and a lack of standardized oversight. This study aims to assess the current state of pediatric surgery training including its structure, quality, and resident satisfaction and identify areas for improvement. We conducted an online survey between May 2022 and November 2023 using single-choice, multiple-choice and open-ended questions. Additionally, information was gathered via analysis of available statistics and through direct contact with the State Chambers of Physicians. 75 pediatric surgery residents and 15 young specialists participated in the survey. 12 of 17 state medical chambers responded to our inquiry, but only 4 maintain detailed statistics. Training often extends beyond the planned six years, mainly (75%) due to insufficient surgical exposure. Residents reported a predominant role of attendings in surgical training and other residents in clinical training. They desired more involvement from chiefs in their education. A significant proportion (58.9%) noted a lack of dedicated scientific education. Nearly half (44.4%) of the respondents had changed training sites, primarily due to clinical rotations (26,7%) and dissatisfaction with training conditions (30,0%). Pediatric surgery residents in Germany face inconsistent training quality and extended training periods, mainly due to insufficient surgical exposure. They report that some chiefs do not meet their obligations as trainers adequately. To address these issues, there is a need for enhanced oversight, standardized curricula, more surgical exposure and improved collaboration among training institutions.

Models behaving badly: The limits of data-driven lending

Abstract Data-driven lending relies on the calibration of models using training periods. We find that this type of lending is not resilient in the presence of economic conditions that are materially different from those experienced during the training period. Using data from a small business fintech lending platform, we document that the small business credit supply collapsed during the COVID-19 crisis of March 2020 even though the demand for loans doubled relative to pre-pandemic levels. As the month progressed, most lenders significantly reduced or halted their lending activities, likely due to the heightened risk of model miscalibration under the new economic conditions.

Effects of 6-Week Whole-Body Vibration Training on Isokinetic Trunk Muscle Strength, Postural Stability, and Jump Performance in Female Adults – A Randomized Controlled Trial

ABSTRACT Current evidence regarding the benefits of Whole-Body Vibration (WBV) on postural stability and jump performance remains inconsistent and to the best of our knowledge, there is no study comparing the effectiveness of different vibration frequencies on trunk muscle strength. This study was conducted to determine the effect of whole-body vibration training with different vibration frequency on isokinetic trunk muscle strength, postural stability and jump performance in physically inactive and minimally active healthy female adults. Forty-five females were randomly assigned to 45 hz WBV group (n = 15), 25 hz WBV (n = 15) group and control exercise group without WBV (0 hz group, n = 15). Individuals in each group completed a 6-week trunk-based exercise program at the specified vibration frequency. Concentric and eccentric strength of trunk flexor and extensor muscles, postural stability and jump performance were assessed before and after the training period. There were significant group by time interactions in concentric and eccentric trunk muscle strength. Interaction effects showed no significant differences in postural stability and vertical jump performance. However, post hoc analyses revealed that all three groups significantly improved vertical jump height. These findings suggest that WBV combined with exercise training were effective to enhance the strength of trunk muscles in physically inactive and minimally active women. Nevertheless, WBV exercise training performed in this study had no significant impact on postural stability and jump performance.Clinical Trials Number: NCT05014958 (Pre-registired)

Workforce Diversity in Sports Medicine: Analysis of Recent Trends Relative to the US Population.

This was a cross-sectional study of sports medicine fellows from previous (2010-2015) and contemporary (2016-2021) training periods. There were 2315 trainees from family medicine (FM, 85%), 261 trainees from physical medicine and rehabilitation (PMR, 10%), and 133 trainees from emergency medicine (EM, 5%). PMR had the highest female and Asian trainee representation while FM had the highest Black trainee representation. There was no difference in female representation between training periods (30% vs 30%, P = 0.714). White trainee representation decreased between training periods (72% vs 65%, P < 0.001). Black (6% vs 6%, P = 0.894), Asian (15% vs 15%, P = 0.970), and Hispanic (6% vs 7%, P = 0.130) trainee representation was consistent between training periods. Female (participation-to-prevalence ratio, PPR = 0.59), Black (PPR = 0.48), Hispanic (PPR = 0.35), and American Indian/Alaskan Native (PPR = 0.17) trainees were underrepresented in sports medicine relative to the US population. Efforts to recruit underrepresented groups in sports medicine fellowship training may help create a more diverse workforce.

Self-regulation of slow cortical potential and seizure suppression by scalp electroencephalography: Early prediction of therapeutic efficacy.

Seizure suppression using the neurofeedback (NFB) method by self-regulation of scalp-recorded slow cortical potential (SCP) is effective for patients with refractory focal epilepsy. However, the prolonged training period required prevents it from wider implementation as the standard treatment in clinical practice. Therefore, we examined whether it would be appropriate to shorten the training period, in spite of the small number of patients. 12 patients participated the NFB training. 1 course of NFB training consisted of 35 sessions divided into 2 phases. After each phase we evaluated whether each patient acquired NFB control, and seizure reduction was assessed compared to that before training. Of 11 patients who completed the first training phase, 4 showed reduced post-training seizure frequency, of whom 3 could regulate the SCP polarity (NFB control). Of the remaining 7, 2 acquired NFB control during the second training phase but seizure frequency did not decrease. Furthermore, the other 5 did not acquire NFB control, and seizure frequency did not decrease. Patients who acquired NFB control within a short period, i.e., 3weeks, were more likely to exhibit a lower post-training seizure frequency. SCP self-regulation can be acquired within a short period and is associated with seizure reduction.

Psychosocial effects of a humanoid robot on informal caregivers of people with dementia: A randomised controlled trial with nested interviews

BackgroundDementia rates are rising globally, impacting healthcare systems and society. The care of people with dementia is largely provided by informal caregivers (e.g., family, friends), which can present significant challenges and increase caregivers' burden. New technologies, such as humanoid socially assistive robots, show promise in reducing this burden, as such robots were considered to be supportive devices for both informal caregivers and people with dementia. ObjectiveTo explore the psychosocial effects of the humanoid social assistive robot Coach Pepper (equipped with functions like tablet-based multimodal training for people with dementia) compared to exclusively tablet-based multimodal training for people with dementia on informal caregivers. Additionally, informal caregivers' attitudes and experiences with Coach Pepper were examined. DesignA randomised controlled parallel two-arm trial with a nested qualitative study was conducted. SettingThe study took place in the home setting (i.e. private households). ParticipantsThirty-two informal caregivers of people with dementia participated in the study. MethodsInformal caregivers (and their loved one with dementia) were randomly assigned to Coach Pepper (n = 16) or a solely tablet-based multimodal training (n = 16) for a three-week period. Data for caregivers were collected at baseline and after the intervention by standardised questionnaires for caregiver burden (primary outcome), quality of life, depressive symptoms and affect. Additionally, acceptance was measured in both groups and semi-structured interviews were conducted in the Coach Pepper group post-interventionally. ResultsNo significant differences in mean changes between groups were identified in the outcomes, except that two domains of acceptance (usefulness and accessibility) were rated significantly higher for the control group. Qualitative findings showed mostly positive attitudes towards Coach Pepper in dementia care and neutral feelings on caregiver burden. Caregivers reported usefulness of Coach Pepper on being assistive in six components of human needs: ‘learning ability’, ‘recreational activities’, ‘contact with others’, ‘mobility/body posture’, ‘communication’ and ‘avoiding danger’. However, they recommended further improvement in all fourteen components of human needs. ConclusionsCoach Pepper had no significant psychosocial effects on informal caregivers of people with dementia. Qualitative findings demonstrated the participants' positive attitudes but highlighted a need for improvements regarding Coach Pepper's usability. RegistrationNCT03818217 (date of registration: 09.01.2019; date of first recruitment: 04.02.2019).

Morphological assessments of the oropharyngeal isthmus in professional singing.

and Aims We conducted this research motivated by the incomplete knowledge of the changes made by resonance and harmonic filtering processes made by articulatory gestures in the supralar-yngeal level of the vocal tract. Aim of research The goal of the study is to evaluate the adaptive changes taking place at the oropharyngeal isthmus during sustained phonation. Methods We focused on exploring the dynamics of the oropharyngeal pavilion in voice professionals using Cone-Beam Computed Tomogra-phy (CBCT). Our study included 14 women with soprano vocals and 12 tenor men in 3 different situations: mimed phonation in a neutral position, sustained phonation on vowel /i/, which brings the larynx in a high position and sustained phonation on the vowel /ä/ which brings the larynx in a low position. Resutlts We observed particular traits of the professional soprano voice, developing as a series of motor patterns that allows the singers to emit high-pitched sound and to maintain them for a long period of time. Our results show that the lateral wall of the isthmic space addapts differently to phonation requirement after adequate and prolonged vocal training. s Vocal training seems to play a determining role in the functional synergy between the pillars of the palatine veil, which can be observed as a motor pattern. Conclusions All the linear and volumetric differences we highlighted show important anatomical and functional diffe-rences among opera singers, which depend both on the gender of the subject and on their respective trai-ning period. The results of our study have direct applicability in practice, addressed to the field of otorhi-nolaryngology, anatomy, physiology, radiology, canto and phoniatry.

P-328. Compliance of Hand Hygiene Practice among Health Care Workers in Tertiary Care Military Hospitals of Bangladesh

Abstract Background Hospital-acquired infection is still a major cause of morbidity and mortality in hospitals. Healthcare workers’ (HCWs) hands become progressively colonized with potential pathogens during their patient care and act as a vehicle for transmission of microorganisms to other patients. Hand hygiene (HH) is undisputedly one of the most effective infection control measures. Military hospitals in Bangladesh are known for better compliance of health system practice. This study aimed to evaluate HH compliance and associated factors among HCWs in two tertiary level military hospitals in Bangladesh.Table 1HH practice of Physicans Methods We conducted non-participatory observations at 02 tertiary Combined Military hospitals (CMH) at Dhaka (1650 bedded) and Jashore (500 bedded) during Oct to Dec 2021. We used the WHO’s ‘5 moments of Hand Hygiene tools’ to record HH compliance among physicians, nurses and cleaning staff. We also performed semi-structured interviews to determine the key barriers to complying with HH.Table 2HH practice of Nurses Results We observed total 172 HH opportunities. The overall HH compliance was 30.9%, highest among physicians (34.5%), followed by Nurses (25.2%). Physicians’ performance (49%) on HH practice before touching a patient was higher than the nurses (46%) but poorer (44.5%) after touching the patient than same practice of nurses (58%). Study also observed that only 24% physicians and 18% nurses practiced HH Before and after handling patient file. Responded opined that workload, shortage of time, lack of facility, distance of hand washing station, inadequate supply were the key hand hygiene barriers with soap. Insufficient supply, skin reaction, cost of product, lack of knowledge appeared. Qualitative assessment revealed that Inadequate handwashing station at wards (distance), insufficient training &amp; orientation for HCWs, irregular monitoring and audit and lack of enforcement of IPC guidelines were key challenges at both study sites.Table 3HH practice barrier with soap Conclusion HH compliance among HCWs of study hospital was short of standard for safe patient care. Periodical training and motivation, ensuring HH supplies and enforcement of IPC guideline is needed to improve the situation.Table 4HH practice barrier of sanitizer Disclosures All Authors: No reported disclosures

P-745. Skin and Soft-tissue Infections among Military Recruits

Abstract Background Skin and soft-tissue infections (SSTIs), commonly Staphylococcus aureus, are an important cause of morbidity in congregate military populations with high rates among military recruits. We characterized SSTI epidemiology over an ∼10-year period at a military training facility in GA (largest U.S. training facility; ∼30,000 recruits per year). Methods SSTI data were collected from US Army Infantry recruits during basic training, through four studies (2 observational and 2 interventional studies spanning 2010-2019) and pooled into a single resource for retrospective research. SSTI characteristics (syndromes and diagnosis timing) and microbiology are described. Results The study population includes 3288 recruits who developed SSTIs during the training period for a total of 3690 SSTIs. Median age was 19 years and median time for initial SSTI development was 7 (IQR 4 -11) weeks of training. Cellulitis (N=1600, 43%) and abscesses (N=1098, 30%) were most common and median time to diagnosis was 7 (IQR 4-11) and 8 (IQR 4-11) weeks of training, respectively. Cultures were collected from 1620 (44%) SSTIs, including 77% of abscesses. Methicillin-resistant and methicillin-susceptible S. aureus (MRSA and MSSA) were identified in 784 (48%) and 610 (38%) cultures, respectively (Table). Other findings include coagulase-negative staphylococci (4%), group A streptococci (0.2%), and group B streptococci (0.4%). A total of 373 recruits had ≥ 2 SSTIs and 55% of the subsequent 402 SSTIs were abscesses. Median time to 2nd and 3rd SSTIs was 10 (IQR 7.5-12) and 12 (IQR 10-13) weeks of training, respectively. There was a significant difference among the bacterial distribution for abscesses (p&amp;lt; 0.001) with MRSA contributing the highest proportion (62%), followed by MSSA (28%). MRSA was also identified with 64% of the 166 subsequent SSTIs with cultures. Conclusion Cellulitis and abscesses are frequent infections affecting military recruits during high-intensity congregate training. The most common bacteria with purulent infections (i.e., abscesses), as well as subsequent infections, was MRSA. Pooling data from multiple studies allows for examination of syndromes and etiology to inform targeted interventions. Disclosures David Tribble, MD, DrPH, AstraZeneca: The IDCRP and HJF were funded to conduct an unrelated phase III COVID-19 monoclonal antibody immunoprophylaxis trial as part of US Govt COVID Response

P-1399. Impact of Positive Chlamydia and Gonorrhea Testing Among Male Military Trainees

Abstract Background All females trainees entering the U.S. Air Force basic military training (BMT) are tested for chlamydia (CT) and gonorrhea (GC) and account for the vast majority of cases in this population. Recent studies have demonstrated that, when universally tested, BMT males had similar overall rates of CT and GC as compared to females, as most cases are asymptomatic. This study evaluates the incidence of CT and GC in male BMT trainees and follow-up. Methods Over 30,000 BMT recruits train at Joint Base San Antonio-Lackland each year. This study included all male trainees who tested positive for CT or GC during their 8-week training period between 2017-2023. Information was obtained regarding patient’s age, indication for testing, facility-type performing testing, date of test, follow-up testing, and occurrence of STIs within three years of diagnosis. Male trainees were then matched with female trainees based on age, date of diagnosis, and pathogen type to determine sex-based differences in follow-up. Results 50 (0.03%) of the 182,726 males who attended BMT between 2017-2023 tested positive for CT or GC during their training. Most cases (88%) were detected in primary care and the median time in training until diagnosis was 12.5 [IQR: 8-27] days. (56%) of male trainees had symptoms on presentation for STI testing, with dysuria (40%) and penile discharge (35%) being the most common. When compared to matched-females, male trainees had significantly less follow-up testing within one year as compared to female trainees (56% vs. 75%, p=0.05). Despite the difference in follow-up testing, there was no difference in STIs diagnosed in the next three years (18% vs. 24%, p=0.5). Conclusion Despite universal access to care, only slightly more than half of male BMT trainees with CT or GC received guideline-directed follow-up within one year. Additionally, approximately one in five men who tested positive for CT or GC during BMT developed a subsequent STI in the next three years, at rates similar to women who tested positive, despite less frequent testing. More work is needed to improve follow-up testing services for those who test positive for CT or GC. Disclosures All Authors: No reported disclosures

A Linear Periodized Resistance Training Program Is Effective at Reducing Depressive Symptoms but Not Anxiety in Females: A Pilot

Background/Objectives: The purpose of this study was to determine whether a periodized resistance training program would influence self-reported depression and anxiety scores in college-aged females. Methods: Eight participants participated in a six-week periodized resistance training program. The participants completed a 3–5 repetition maximum (3–5 RM) for the sumo deadlift (SDL), bench press (BP), barbell back squat (BBS), and standing shoulder press (SSP). These data were used to estimate the 1 repetition maximum (1RM), which in turn was used to develop the periodization program. Following baseline testing, participants participated in two full-body workouts per week for six weeks. Each individual was retested after they completed the 6-week program, performing 3–5 RM for the SDL, BP, BBS, and SSP. To determine symptoms of depression and anxiety, the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were distributed before and after participating in the resistance training program. A repeated measures 2 × 2 Analysis of Variance (ANOVA) was used to determine the effect of resistance training had on the outcome measures. Results: There was a significant (p = 0.011) decrease in BDI scores after the 6 weeks of resistance training. There was no statistically significant difference in the BAI scores (p = 0.106). There was no correlation between any individual exercise and the outcome scores. Conclusions: The results of the current study indicate that a periodized resistance training program is effective at reducing self-reported measures of depression using the BDI in college-aged females.

РЕАЛІЗАЦІЯ ФІТНЕС-ТЕХНОЛОГІЙ У ТРЕНУВАЛЬНОМУ ПРОЦЕСІ БАР’ЄРИСТІВ-ЮНАКІВ

The relevance of the research topic. Over the past two decades, interest in the organization and construction of the training process of hurdlers of different ages and different skill levels has increased significantly, which due to the growth of results abroad. This determines the study of the features of of the content of the training process of hurdlers at the stage of preliminary basic preparation. A number of authors substantiated the ways of improvement of the educational and training process of track and field athletes, studied the rhythmic and temporal structure of the running. The most effective modern means of training athletes are fitness technologies, as indicated by recent scientific publications. Varieties of fitness are a universal training tool that can be modified and adapted to the needs of any athlete in any training period. The purpose of the research is to substantiate the ways of realization of fitness technologies in the training process of young men hurdlers. Materials and methods of the research. The study was conducted on the basis of the Children and Youth Sports School No. 1 in Vinnytsia. The study involved boys aged 13-14 years old who specialize in 110-meter hurdles. Results. During the analysis of sources of literature it was established that the structure of an annual cycle of preparation of hurdlers can change as the level of physical abilities, physical fitness of an athlete is unstable. The content and structure of training loads change in relation to periods and stages of the annual cycle. In the training of athletes of different levels, different sports the following types of fitness are mainly used: strength training, stretching, functional training, callanetics, step aerobics. Conclusions. The absence of the use of modern training means in training of hurdlers is revealed, that leads to the decrease of indicators of physical fitness of athletes. The prospect of the further researches consists in the study of indicators of fitness of juniors who are engaged in barrier running.

Atención a la diversidad y discursos sobre lecturas en Educación Superior / Attention to diversity and discourses on readings in Higher Education

The educational context demands the training of teachers who respect the individual differences. Based on the need for this training, this study analyzes the knowledge that teachers in training (Master in Teaching, Spanish Language and Literature) have about attention to diversity through readings. Two previous objectives are proposed: the first investigates the memories of Secondary Education school experiences on de subject -quiz without prior knowledge-; the second -after a short training period- offers current readings and didactic proposals. To compile the information for this case study, the mixed, quantitative and interpretive methodology is applied. Their questionnaires offer the analysis over time of a population of 71 university students (10 autonomous communities) during three academic years. The data analyzed express results of the scarce reading experiences and the training deficiencies of the students; Now they compensate for these deficiencies with education in values. This situation poses the need to develop specific training to address diversity with reading itineraries.

Drug Prescription Pattern of Physicians Using Who Prescribing Indicators: A Cross Sectional Study

Background: Prescriptions are one of the prescribing standards to promote the rational use of drugs. To provide a corrective message to prescribers, it is important to evaluate prescription patterns and identify unreasonable prescribing practices. Keeping these facts in consideration the present study was planned to assess the prescription pattern using WHO prescribing indicators. Methods: The cross-sectional study was conducted at outpatient department of Dhaka Medical College Hospital and Sir Salimullah Medical College Mitford Hospital, Dhaka from January to December, 2022. A systematic random sampling technique was used to select prescriptions and data were collected by observation check list. Data were analyzed by statistical software- SPSS 23 version. Ethical issues were maintained strictly. Results: Around 296 prescriptions were analyzed. Average number of drugs per prescription was 3.5 (optimal value 1.6–1.8). About 1043 drugs were prescribed, from which 24.73% were with their generic name (optimal value 100%), antibiotics and injections were prescribed 57% (optimal value 20.0–26.8%) and 3.37% (optimal value 13.4–24.1%) respectively. About 32.7% drugs were prescribed from the Essential Drug List. During the study period, anti-ulcerant and NSAIDs were highest prescribed drug (69.3%) followed by antibiotics (57.1%). Conclusion: The study result revealed that average number of drugs per encounter, generic formatting, antibiotic prescribing, and the use of Essential Drug List (EDL) of the hospital to prescribe drugs out of the recommended values. Periodic training and initiating the performance evaluation for doctors are effective ways for improving prescription quality. There is a need to standardize the format of prescriptions so that all essential information is included. JOPSOM 2023; 42(2): 23-28

Preparation of an Operational Curriculum Based on Local Wisdom for Students in PAUD

Local wisdom as a cultural heritage owned by a community, including traditions, values, customs, and local knowledge that has been passed down from generation to generation. Within the scope of PAUD, local wisdom has great potential to become an integral part of the learning process, enrich children's learning experiences, and strengthen their cultural identity. This research aims to find out the preparation of an operational curriculum based on local wisdom and to find out the challenges faced in the preparation of an operational curriculum based on local wisdom in PAUD. The research method used is descriptive qualitative research with a descriptive approach. The results of the study show that the process of preparing the curriculum through systematic stages involves analyzing needs, formulating goals, determining the content and structure of the program, and developing learning strategies that integrate elements of local wisdom. Collaboration between the school, community leaders, and parents of students is the key in identifying and integrating relevant local wisdom in the curriculum. Conclusions and suggestions in this study are periodic training to improve teachers' understanding and skills in integrating local wisdom into learning. The Education Office should provide guidance and training for schools in developing an operational curriculum based on local wisdom.

Effect of Six Weeks of Training with Wearable Resistance Attached to the Forearm on Throwing Kinematics, Strength, and Velocity in Female Handball Players

Background: The aim of the study was to investigate the effect of six weeks of training with wearable resistance attached to the forearm on throwing kinematics, strength, and velocity in experienced female handball players. Methods: Twenty-five female handball players (mean age: 24.7 ± 3.8 y, mass: 72.1 ± 17.6 kg, height: 1.69 ± 0.06 m, and training experience: 14.3 ± 4.9 y) participated and were divided into an experimental group (n = 14) or a control group (n = 11). Both groups participated in the same handball sessions, but the experimental group trained with wearable resistance attached to the forearm during the training sessions. Before and after a training period of six weeks, throwing velocity, strength, and kinematics were tested. Results: The throwing velocity was significantly increased in the experimental group but not in the control group (p = 0.006). Only a few significant kinematic changes were observed, mostly around ball release, in which both groups had increased elbow flexion. The experimental group had a larger shoulder flexion at ball release and a more flexed wrist (p ≤ 0.04). Meanwhile, the control group had a lower shoulder abduction after the training period (p ≤ 0.023). No significant effects were found in the maximal angular velocities, timing of joint angles, angular velocities and in the strength test (p &gt; 0.075). Conclusions: Based on the findings in this present study, it was concluded that training with wearable resistance attached to the forearm increases throwing velocity during the competition season compared to normal throwing training, which was probably caused by the changes in maximal elbow angle and extension velocity and the more flexed wrist at ball release.

Effects of exercise intensity on nutritional status, body composition, and energy balance in patients with COPD: a randomized controlled trial

BackgroundHigh-intensity exercise is recommended for the pulmonary rehabilitation of patients with chronic obstructive pulmonary disease (COPD); however, it can cause an energy imbalance due to increased energy expenditure. Here, we aimed to explore the effect of reducing exercise intensity on energy balance in patients with COPD experiencing high-intensity training-induced weight loss.MethodsAll participants underwent high-intensity endurance and resistance training for a 2-week preliminary period. Those who lost more than 1% of their weight were then randomized to either continue high-intensity exercise (AA group) or switch to low-intensity exercise (AB group) for another 2 weeks (experimental period).ResultsThe analysis included 30 participants (AA, n = 15; AB, n = 15). The AA group showed significant increases in body composition, dietary intake, nutritional status, muscle strength, and exercise capacity at week 4 than at week 2, with no significant changes in the AB group. After the experimental period, a greater proportion of the AA group had energy intake exceeding expenditure than did the AB group (80% vs. 40%).ConclusionsIn patients with COPD who lost body weight during pulmonary rehabilitation with high-intensity exercise, continuing this exercise had a more positive effect on body composition, nutritional status, physical function, and energy balance than did reducing exercise intensity. These results suggest the importance of continuing high-intensity exercise, while taking into consideration energy intake and nutritional therapy, even when body weight loss occurs during pulmonary rehabilitation in patients with COPD.Trial registrationThis study was retrospectively registered on the UMIN-CTR as UMIN000050976 on May 5, 2023.

Comparative Study of Device Lifecycles in Different Healthcare Settings

This research targets the performances and lifetime of medical devices with regard to preventive maintenance (PM) practices in large and small health settings. A new maintenance effectiveness metric (MEM) has been developed and applied in this research for quantifying effectiveness due to PM activities using a synthetic data set. Descriptive and comparative analyses can show that larger hospitals tend to have higher values of MEM and longer lifespans for devices, probably because of more frequent and organized schedules for maintenance. On the other hand, clinics tend to present lower MEM values and longer device downtime, which may indicate a lack of proper practices for maintenance. Regression analysis indicates that the major factors contributing to the longevity of a device are PM schedules and duration, while the number of repairs and the amount of device usage rate are minor. The inference that seems to emerge is that, in many cases, clinics can be helped more by a more regular and predictive approach, taking proper maintenance strategies like periodic training for staff and resource allocation. The study emphasizes the fact that effective PM practices are of high relevance for the performance and operational efficiency of devices within healthcare facilities. Future recommendations proposed for this study included continuing to research advanced predictive maintenance technologies and performing, based on real-world data, a cost-benefit analysis of enhanced PM protocols.

Effect of Different Reduced Training Frequencies After 12 Weeks of Concurrent Ballistic and Aerobic Training on Muscle Power and Triceps Brachii Muscle Architecture.

Background/Objectives: The aim of the present study was to investigate the effect of two long-term reduced concurrent training frequencies (incorporating power training for the upper and high-intensity interval aerobic training for the lower extremities), in which participants performed one training session every either 7 or 14 days, after 12 weeks of systematic concurrent training on upper extremities' muscle strength, power, and morphology in young females. Methods: After a 12-week concurrent resistance and aerobic training period, participants were assigned into three groups and performed either one training session every 7 days (G7), or once every 14 days (G14), or detraining (GD) for 12 weeks, followed by 12 additional weeks of detraining. Results: Performance and muscle mass increased after the initial 12-week training period. After the reduced training frequency period, bench press 1-RM and aerobic power remained unchanged in G7 and decreased significantly in G14 (-5.9 ± 4.9%; -1.4 ± 4.5%). Muscle power and muscle thickness of the triceps branchii long head decreased significantly in G7 (-9.8 ± 7.7%; -0.9 ± 0.6%; respectively, p < 0.05) and G14 (-10.9 ± 7.6%; -2.8 ± 2.7%, respectively, p < 0.05), without significant differences between groups (p > 0.05). Conclusions: In conclusion, 12 weeks of systematic concurrent resistance (upper extremities) and aerobic training (lower extremities) induced significant improvements in upper extremities muscle power/strength and muscle architecture characteristics. Both reduced training frequencies led to significant reductions in power performance. Thus, performing one training session every 2 weeks for 3 months may preserve 90 to 95% of the muscle power/strength, aerobic power and 72% of muscle mass adaptations achieved with systematic concurrent training. However, greater preservations in the above parameters could be observed if the training frequency is one training session per week.