Miracle-dz/UniFAR-FTUs huggingface dataset:
Validity of Lactate Thresholds in Inline Speed Skating

Abstract Hecksteden, A, Heinze, T, Faude, O, Kindermann, W, and Meyer, T. Validity of lactate thresholds in inline speed skating. J Strength Cond Res 29(9): 2497–2502, 2015—Lactate thresholds are commonly used as estimates of the highest workload where lactate production and elimination are in equilibrium (maximum lactate steady state [MLSS]). However, because of the high static load on propulsive muscles, lactate kinetics in inline speed skating may differ significantly from other endurance exercise modes. Therefore, the discipline-specific validity of lactate thresholds has to be verified. Sixteen competitive inline-speed skaters (age: 30 ± 10 years; training per week: 10 ± 4 hours) completed an exhaustive stepwise incremental exercise test (start 24 km·h−1, step duration 3 minutes, increment 2 km·h−1) to determine individual anaerobic threshold (IAT) and the workload corresponding to a blood lactate concentration of 4 mmol·L−1 (LT4) and 2–5 continuous load tests of (up to) 30 minutes to determine MLSS. The IAT and LT4 correlated significantly with MLSS, and the mean differences were almost negligible (MLSS 29.5 ± 2.5 km·h−1; IAT 29.2 ± 2.0 km·h−1; LT4 29.6 ± 2.3 km·h−1; p > 0.1 for all differences). However, the variability of differences was considerable resulting in 95% limits of agreement in the upper range of values known from other endurance disciplines (2.6 km·h−1 [8.8%] for IAT and 3.1 km·h−1 [10.3%] for LT4). Consequently, IAT and LT4 may be considered as valid estimates of the MLSS in inline speed skating, but verification by means of a constant load test should be considered in cases of doubt or when optimal accuracy is needed (e.g., in elite athletes or scientific studies).
CIRCULATING THYROID-STIMULATING HORMONE RECEPTOR MESSENGER RNA AS A MARKER OF TUMOR AGGRESSIVENESS IN PATIENTS WITH PAPILLARY THYROID MICROCARCINOMA.

BACKGROUND We have previously shown that thyroid-stimulating hormone receptor messenger RNA (TSHR mRNA) is detectable in the peripheral blood of patients with papillary thyroid microcarcinoma (PTmC). The aim of this study was to analyze the utility of TSHR mRNA status as a marker of tumor aggressiveness in patients with PTmC. METHODS Preoperative TSHR mRNA values were obtained in 152 patients who underwent thyroidectomy and were found to have PTmC on final pathology. Clinical parameters were analyzed from an institutional review board-approved database using χ(2) and t tests. RESULTS Preoperatively, TSHR mRNA was detected in the peripheral blood in 46% of patients, which was less than that for macroscopic papillary thyroid carcinoma (PTC) (80%) but higher than for benign thyroid disease (18%) (P<.001). The focus of cancer was larger in the TSHR mRNA-positive group compared to the negative group (0.41 vs. 0.30 cm, respectively, P = .015). The prevalence of tall-cell variant was higher in the TSHR mRNA positive group. The rates of lymph node (LN) metastasis (16% vs. 10%), multifocality (46% vs. 49%), and extra-thyroidal extension (10% vs. 5%) were similar between the TSHR mRNA-positive and-negative groups, respectively. In patients 45 years or older, rate of LN metastasis was higher in those who were TSHR mRNA positive (10%) versus negative (2%) (P = .039). TSHR mRNA positivity predicted a higher likelihood of radioactive iodine treatment (36% vs. 17%, P = .009) postoperatively. CONCLUSION This study shows that TSHR mRNA, which is a marker of circulating thyroid cancer cells, is detectable in about half of patients with PTmC. The positivity of this marker predicts a higher likelihood of LN involvement in patients with PTmC who are 45 years or older.
HOW PATIENTS WITH TYPE 1 DIABETES TRANSLATE CONTINUOUS GLUCOSE MONITORING DATA INTO DIABETES MANAGEMENT DECISIONS.

OBJECTIVE To understand how patients use continuous glucose monitoring (CGM) data in their diabetes management. METHODS We surveyed patients who regularly used CGM (>6 days per week), using 70 questions, many scenario-based. The survey had 6 sections: patient characteristics, general CGM use, hypoglycemia prevention and management, hyperglycemia prevention and management, insulin dosing adjustments (both for incidental hyperglycemia not at meals and at mealtimes), and real-time use versus retrospective analysis. RESULTS The survey was completed by 222 patients with type 1 diabetes. In response to a glucose of 220 mg/dL, the average correction dose adjustment based on rate of change arrows varied dramatically. Specifically, when the CGM device showed 2 arrows up (glucose increasing >3 mg/dL/minute), respondents stated they would increase their correction bolus, on average, by 140% (range, 0 to 600%). Conversely, 2 arrows down (glucose decreasing >3 mg/dL/minute) caused respondents to reduce their dose by 42%, with 24% omitting their dose entirely. Furthermore, 59% of respondents stated they would delay a meal in response to rapidly rising glucose, whereas 60% would wait until after a meal to bolus in response to falling glucose levels. With a glucose value of 120 mg/dL and a falling glucose trend, 70% of respondents would prophylactically consume carbohydrates to avoid hypoglycemia. CONCLUSION CGM users utilize CGM data to alter multiple aspects of their diabetes care, including insulin dose timing, dose adjustments, and in hypoglycemia prevention. The insulin adjustments are much larger than common recommendations. Additional studies are needed to determine appropriate insulin adjustments based on glucose trend data.
BONE MINERAL DENSITY IN PATIENTS WITH ADDISON DISEASE ON REPLACEMENT THERAPY WITH PREDNISOLONE.

OBJECTIVE In primary adrenal insufficiency (PAI), replacement with prednisolone may result in lower bone mineral density (BMD) compared with hydrocortisone therapy. However, the number of patients studied on prednisolone is small and the results are conflicting. We conducted a cross-sectional study to determine BMD and its relation with therapy in patients on physiologic doses of prednisolone replacement. METHODS Forty-one consecutive patients (31 males, age [mean ± SD] 50.9 ± 13.0 years), receiving prednisolone (hydrocortisone equivalent [HCE] 13.0 ± 3.0 mg/m(2)) for 104 ± 95 months were studied. BMD was evaluated by dual-energy X-ray absorptiometry and compared with an age- and sex-matched reference group of healthy Indian subjects (n = 677). RESULTS Among males, BMD Z-scores (mean [95% confidence interval {CI}]) at lumbar spine (-0.42 [-0.80, -0.04]), femoral neck (-0.50 [-0.95, -0.06]) and total hip (-0.58 [-0.90, -0.26]) were significantly lower than the reference population. Z-scores in female patients did not differ from controls. Among postmenopausal females and males >50 years, 43% had osteoporosis (T-score ≤-2.5), as compared with 25% in the reference group (P = .04). There was no correlation between BMD Z-scores and HCE dose or duration of therapy. On multivariate regression analysis, body mass index was the only significant predictor of BMD. A high proportion of males (45%) had low serum testosterone (<300 ng/dL), but there was no correlation between testosterone and BMD. CONCLUSIONS Male patients with PAI receiving physiologic prednisolone replacement had a small but significant diminution in BMD at all sites.
Slower Recovery Rate of Muscle Oxygenation After Sprint Exercise in Long-Distance Runners Compared With That in Sprinters and Healthy Controls

Abstract Nagasawa, T. Slower recovery rate of muscle oxygenation after sprint exercise in long-distance runners compared with that in sprinters and healthy controls. J Strength Cond Res 27(12): 3360–3366, 2013—The purpose of this study was to examine whether differences in aerobic capacity and training status influence muscle reoxygenation after sprint exercise. We hypothesized that the muscle reoxygenation rate after sprint exercise is slower in long-distance runners with a high aerobic capacity. Five male long-distance runners, 5 male sprinters, and 6 healthy male controls performed a 30-second sprint exercise on a cycle ergometer. Oxygen saturation in muscle tissue (StO2) in the vastus lateralis muscles was measured by near-infrared spectroscopy. The muscle reoxygenation rate after the exercise was evaluated at half the time required for StO2 recovery (T1/2 StO2). Aerobic capacity was evaluated by measuring maximal oxygen consumption (V[Combining Dot Above]O2max). The T1/2 StO2 in the long-distance runners (25.0 ± 4.5 seconds) was significantly longer than that in the controls (15.9 ± 1.6 seconds; p < 0.01) and in the sprinters (18.0 ± 4.6 seconds; p < 0.05). In all the subjects (long-distance runners, sprinters, and controls), the T1/2 StO2 had a significant positive correlation with the V[Combining Dot Above]O2max (r = 0.75; p < 0.01) and was longer in subjects with a higher V[Combining Dot Above]O2max. These results suggest that reoxygenation after sprint exercise is influenced by aerobic capacity and training status, and that the subjects with a higher aerobic capacity have delayed muscle reoxygenation after sprint exercise.
ASSOCIATION BETWEEN HYPOGLYCEMIA AND FALL-RELATED FRACTURES AND HEALTH CARE UTILIZATION IN OLDER VETERANS WITH TYPE 2 DIABETES.

OBJECTIVE To examine the association between hypoglycemia and fall-related outcomes in older patients with type 2 diabetes mellitus (T2DM). METHODS This retrospective cohort study used electronic medical records of T2DM patients (≥65 years) from the Veterans Integrated Service Network 16 (VISN 16) data warehouse (01/01/2004-06/30/2010). Patients in nonhypoglycemia group (non-HG) were 1:1 randomly matched with patients in hypoglycemia group (HG) by age (±5 years), sex, race, and medical center location. Fall-related events (i.e., fractures and head injuries) were identified, with a fall being the external cause within ±2 days. McNemar tests and generalized estimating equation (GEE) models were used to compare fall-related events in the 1-year outcome period after the index date (i.e., date of first hypoglycemic episode). We also examined fall-related healthcare utilization. RESULTS A total of 4,215 patients in each group were studied, with the mean age of 76.5 years (SD: 5.85). The mean Charlson comorbidity index (CCI) scores were 5.73 (SD: 2.95) in the HG and 4.34 (SD: 2.40) in the non-HG. The HG had significantly higher rates of fall-related events than non-HG, 27 (0.64%) versus 1 (0.02%) and 89 (2.11%) versus 21 (0.50%) events within 30 days and 1 year, respectively. GEE models confirmed the elevated risk of fall-related events after controlling for sociodemographic and clinical characteristics, comorbidities, and medication use (adjusted odds ratio [aOR]: 2.70; 95% confidence interval [CI]: 1.64-4.47). The HG patients were more likely to have emergency department (ED) visits, hospital admissions, and long-term care placement compared to their counterparts. CONCLUSION Hypoglycemia is associated with worse fall-related outcomes among the elderly veterans.
Effect of an Aerodynamic Helmet on Head Temperature, Core Temperature, and Cycling Power Compared With a Traditional Helmet

Abstract Lee, JF, Brown, SR, Lange, AP, and Brothers, RM. Effect of an aerodynamic helmet on head temperature, core temperature, and cycling power compared with a traditional helmet. J Strength Cond Res 27(12): 3402–3411, 2013—Nonvented “aerodynamic helmets” reduce wind resistance but may increase head (Th) and gastrointestinal (Tgi) temperature and reduce performance when worn in hot conditions. This study tested the hypothesis that Th and Tgi would be greater during low-intensity cycling (LIC) in the heat while wearing an aero helmet (AERO) vs. a traditional vented racing helmet (REG). This study also tested the hypothesis that Th, Tgi, and finish time would be greater, and power output would be reduced during a self-paced time trial in the heat with AERO vs. REG. Ten highly trained heat-acclimated endurance athletes conducted LIC (50% V[Combining Dot Above]O2max, LIC) and a high-intensity 12-km self-paced time trial (12-km TT) on a cycle ergometer in 39° C on 2 different days (AERO and REG), separated by >48 hours. During LIC, Th was higher at minute 7.5 and all time points thereafter in AERO vs. REG (p < 0.05). Similarly, during the 12-km TT, Th was higher at minutes 12.5, 15, and 17.5 in AERO vs. REG (p < 0.05). Heart rate (HR) and Tgi increased during LIC and during 12-km TT (both p < 0.001); however, no significant interaction (helmet × time) existed for HR or Tgi at either intensity (all p > 0.05). No group differences existed for finish time or power output during the 12-km TT (both p > 0.05). In conclusion, Th becomes elevated during cycling in the heat with an aero helmet compared with a traditional vented racing helmet during LIC and high-intensity cycling, yet Tgi and HR responses are similar irrespective of helmet type and Th. Furthermore, the higher Th that develops when an aero helmet is worn during cycling in the heat does not affect power output or cycling performance during short-duration high-intensity events.
Systematic Review of Core Muscle Activity During Physical Fitness Exercises

Abstract Martuscello, JM, Nuzzo, JL, Ashley, CD, Campbell, BI, Orriola, JJ, and Mayer, JM. Systematic review of core muscle activity during physical fitness exercises. J Strength Cond Res 27(6): 1684–1698, 2013—A consensus has not been reached among strength and conditioning specialists regarding what physical fitness exercises are most effective to stimulate activity of the core muscles. Thus, the purpose of this article was to systematically review the literature on the electromyographic (EMG) activity of 3 core muscles (lumbar multifidus, transverse abdominis, quadratus lumborum) during physical fitness exercises in healthy adults. CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, PubMed, SPORTdiscus, and Web of Science databases were searched for relevant articles using a search strategy designed by the investigators. Seventeen studies enrolling 252 participants met the review's inclusion/exclusion criteria. Physical fitness exercises were partitioned into 5 major types: traditional core, core stability, ball/device, free weight, and noncore free weight. Strength of evidence was assessed and summarized for comparisons among exercise types. The major findings of this review with moderate levels of evidence indicate that lumbar multifidus EMG activity is greater during free weight exercises compared with ball/device exercises and is similar during core stability and ball/device exercises. Transverse abdominis EMG activity is similar during core stability and ball/device exercises. No studies were uncovered for quadratus lumborum EMG activity during physical fitness exercises. The available evidence suggests that strength and conditioning specialists should focus on implementing multijoint free weight exercises, rather than core-specific exercises, to adequately train the core muscles in their athletes and clients.
SAFETY AND EFFICACY OF A PERI-OPERATIVE PROTOCOL FOR PATIENTS WITH DIABETES TREATED WITH CONTINUOUS SUBCUTANEOUS INSULIN INFUSION WHO ARE ADMITTED FOR SAME-DAY SURGERY.

OBJECTIVE The number of people with diabetes using continuous subcutaneous insulin infusions (CSII) with an insulin pump has risen dramatically, creating new challenges when these patients are admitted to the hospital for surgical or other procedures. There is limited literature guiding CSII use during surgical procedures. METHODS The study was carried out in a large, urban, tertiary care hospital. We enrolled 49 patients using insulin pump therapy presenting for 57 elective surgeries. We developed a CSII peri-operative glycemic management protocol (PGMP) to standardize insulin pump management in patients admitted to a same-day surgery unit (SDSU). The purpose was evaluate the safety (% capillary blood glucose (CBG) <70 mg/dL and/or pump incidents) and efficacy (first postoperative CBG ≤200 mg/dL) of the CSII PGMP. We determine the contribution of admission CBG, type of anesthesia, surgery length, and peri-operative steroid use on postoperative glycemic control. RESULTS Overall, 63% of patients treated according to the CSII PGMP had a first postoperative CBG ≤200 mg/dL. There were no episodes of intra- or postoperative hypoglycemia. For patients treated with the CSII PGMP, the mean postoperative CBG was lower in patients with anticipated or actual surgical length ≤120 minutes (158.1 ± 53.9 vs. 216 ± 77.7 mg/dL, P<.01). No differences were observed with admission CBG, type of anesthesia, or steroid use. CONCLUSIONS This study demonstrates that a CSII PGMP is both safe and effective for patients admitted for elective surgical procedures and provides an example of a standardized protocol for use in clinical practice.
Retrospective Injury Epidemiology of Strongman Athletes

Abstract Winwood PW, Hume PA, Cronin JB, and Keogh JWL. Retrospective injury epidemiology of strongman athletes. J Strength Cond Res 28(1): 28–42, 2014—This study provides the first empirical evidence of strongman training and competition injury epidemiology. Strongman athletes (n = 213) (mean ± SD: 31.7 ± 8.8 years, 181.3 ± 7.4 cm, 113.0 ± 20.3 kg, 12.8 ± 8.1 years general resistance training, and 4.4 ± 3.4 years strongman implement training) completed a self-reported, 4-page, 1-year retrospective survey of physical injuries that caused a missed or modified training session or competition. Analysis by age (⩽30 and >30 years), body mass (⩽105 and >105 kg), and competitive standard (low and high level) was conducted. Eighty-two percent of strongman athletes reported injuries (1.6 ± 1.5 training injuries per lifter per year, 0.4 ± 0.7 competition injuries per lifter per year, and 5.5 ± 6.5 training injuries per 1,000-hour training). Lower back (24%), shoulder (21%), bicep (11%), knee (11%), and strains and tears of muscle (38%) and tendon (23%) were frequent. The majority of injuries (68%) were acute and were of moderate severity (47%). Strongman athletes used self-treatment (54%) or medical professional treatment (41%) for their injuries. There were significantly more competition injuries for the ⩽30- than the >30-year athletes (0.5 ± 0.8 vs. 0.3 ± 0.6, p = 0.03) and >105-kg athletes compared with the ⩽105-kg athletes (0.5 ± 0.8 vs. 0.3 ± 0.6, p = 0.014). Although 54% injuries resulted from traditional training, strongman athletes were 1.9 times more likely to sustain injury when performing strongman implement training when exposure to type of training was considered. To reduce risk of injury and improve training practices, strongman athletes should monitor technique and progressions for exercises that increase risk of lower back, shoulder, bicep, and knee musculoskeletal injuries. Clinicians should advise athletes who use of strongman resistance training programs can increase injury risk over traditional exercises.
PREDICTORS OF BIOCHEMICAL REMISSION AND RECURRENCE AFTER SURGICAL AND RADIATION TREATMENTS OF CUSHING DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS.

OBJECTIVE We conducted a systematic review and meta-analysis to synthesize the evidence about predictors that may affect biochemical remission and recurrence after transsphenoidal surgery (TSS), radiosurgery (RS), and radiotherapy (RT) in Cushing disease. METHODS We searched multiple databases through December 2014 including original controlled and uncontrolled studies that enrolled patients with Cushing disease who received TSS (first-line), RS, or RT. We extracted data independently, in duplicates. Outcomes of interest were biochemical remission and recurrence. A meta-analysis was conducted using the random-effects model to estimate event rates with 95% confidence intervals (CIs). RESULTS First-line TSS was associated with high remission (76% [95% CI, 72 to 79%]) and low recurrence rates (10% [95% CI, 6 to 16%]). Remission after TSS was higher in patients with microadenomas or positive-adrenocorticotropic hormone tumor histology. RT was associated with a high remission rate (RS, 68% [95% CI, 61 to 77%]; RT, 66% [95% CI, 58 to 75%]) but also with a high recurrence rate (RS, 32% [95% CI, 16 to 60%]; RT, 26% [95% CI, 14 to 48%]). Remission after RS was higher at short-term follow-up (≤2 years) and with high-dose radiation, while recurrence was higher in women and with lower-dose radiation. Remission was after RT in adults who received TSS prior to RT, and with lower radiation doses. There was heterogeneity (nonstandardization) in the criteria and cutoff points used to define biochemical remission and recurrence. CONCLUSION First-line TSS is associated with high remission and low recurrence, while RS and RT are associated with reasonable remission rates but important recurrence rates. The current evidence warrants low confidence due to the noncomparative nature of the studies, high heterogeneity, and imprecision.
Immune effects of Lactobacillus casei Shirota

Verkennend onderzoek naar de effecten van probiotica geeft aan dat er een mogelijk risico bestaat voor het ontwikkelen van auto-immuunziekten. Probiotica worden in reclameboodschappen ook wel aangeduid als 'goede bacterien'. Fabrikanten claimen een positief effect op darmflora, weerstand en mogelijk preventie van allergieen. Momenteel is er nog geen regelgeving op het gebied van probiotica en worden deze producten als veilig beschouwd. Om inzicht te verkrijgen in de effecten van probiotica op het immuunsysteem zijn verschillende proefdiermodellen gebruikt. De studies tonen aan dat toediening van probiotica zowel positieve als negatieve effecten kan hebben, afhankelijk van het model dat werd gebruikt. De effecten op deze immunologische responsen zijn gering. In een studie met proefdieren werd een vermindering van ontsteking in de longen waargenomen, terwijl in een auto-immuniteit model de symptomen verergerden. Verder onderzoek om de betekenis hiervan voor de mens vast te stellen is nog nodig.
Fluid and Electrolyte Balance During Two Different Preseason Training Sessions in Elite Rugby Union Players

Abstract Cosgrove, SD, Love, TD, Brown, RC, Baker, DF, Howe, AS, and Black, KE. Fluid and electrolyte balance during two different preseason training sessions in elite rugby union players. J Strength Cond Res 28(2): 520–527, 2014—The purpose of this study was to compare fluid balance between a resistance and an aerobic training sessions, in elite rugby players. It is hypothesized that resistance exercise will result in a higher prevalence of overdrinking, whereas during the aerobic session, underdrinking will be more prevalent. As with previous fluid balance studies, this was an observational study. Twenty-six players completed the resistance training session, and 20 players completed the aerobic training session. All players were members of an elite rugby union squad competing in the southern hemisphere's premier competition. For both sessions, players provided a preexercise urine sample to determine hydration status, pre- and postexercise measures of body mass, and blood sodium concentration were taken, and the weight of drink bottles were recorded to calculate sweat rates and fluid intake rates. Sweat patches were positioned on the shoulder of the players, and these remained in place throughout each training session and were later analyzed for sodium concentration. The percentage of sweat loss replaced was higher in the resistance (196 ± 130%) than the aerobic training session (56 ± 17%; p = 0.002). Despite this, no cases of hyponatremia were detected. The results also indicated that more than 80% of players started training in a hypohydrated state. Fluid intake seems to differ depending on the nature of the exercise session. In this group of athletes, players did not match their fluid intakes with their sweat loss, resulting in overdrinking during resistance training and underdrinking in aerobic training. Therefore, hydration strategies and education need to be tailored to the exercise session. Furthermore, given the large number of players arriving at training hypohydrated, improved hydration strategies away from the training venue are required.