Recreational soccer is an effective health-promoting activity for untrained men

Copyright BMJ publishing GroupTo examine the effects of regular participation in recreational soccer on health profile, 36 healthy untrained Danish men aged 20-43 years were randomised into a soccer group (SO; n=13), a running group (RU; n=12) and a control group (CO; n=11). Training was performed for 1 h two or three times per week for 12 weeks; at an average heart rate of 82% (SEM 2%) and 82% (1%) of HRmax for SO and RU, respectively. During the 12 week period, maximal oxygen uptake increased (p < 0.05) by 13% (3%) and 8% (3%) in SO and RU, respectively. In SO, systolic and diastolic blood pressure were reduced (p < 0.05) from 130 (2) to 122 (2) mm Hg and from 77 (2) to 72 (2) mm Hg, respectively, after 12 weeks, with similar decreases observed for RU. After the 12 weeks of training, fat mass was 3.0% (2.7 (0.6) kg) and 1.8% (1.8 (0.4) kg) lower (p < 0.05) for SO and RU, respectively. Only SO had an increase in lean body mass (1.7 (0.4) kg, p < 0.05), an increase in lower extremity bone mass (41 (8) g, p < 0.05), a decrease in LDL-cholesterol (2.7 (0.2) to 2.3 (0.2) mmol/l; p < 0.05) and an increase (p < 0.05) in fat oxidation during running at 9.5 km/h. The number of capillaries per muscle fibre was 23% (4%) and 16% (7%) higher (p < 0.05) in SO and RU, respectively, after 12 weeks. No changes in any of the measured variables were observed for CO. In conclusion, participation in regular recreational soccer training, organised as small-sided drills, has significant beneficial effects on health profile and physical capacity for untrained men, and in some aspects it is superior to frequent moderate-intensity running

Outcome in patients perceived as receiving excessive care across different ethical climates: a prospective study in 68 intensive care units in Europe and the USA

Purpose: Whether the quality of the ethical climate in the intensive care unit (ICU) improves the identification of patients receiving excessive care and affects patient outcomes is unknown. Methods: In this prospective observational study, perceptions of excessive care (PECs) by clinicians working in 68 ICUs in Europe and the USA were collected daily during a 28-day period. The quality of the ethical climate in the ICUs was assessed via a validated questionnaire. We compared the combined endpoint (death, not at home or poor quality of life at 1 year) of patients with PECs and the time from PECs until written treatment-limitation decisions (TLDs) and death across the four climates defined via cluster analysis. Results: Of the 4747 eligible clinicians, 2992 (63%) evaluated the ethical climate in their ICU. Of the 321 and 623 patients not admitted for monitoring only in ICUs with a good (n = 12, 18%) and poor (n = 24, 35%) climate, 36 (11%) and 74 (12%), respectively were identified with PECs by at least two clinicians. Of the 35 and 71 identified patients with an available combined endpoint, 100% (95% CI 90.0–1.00) and 85.9% (75.4–92.0) (P = 0.02) attained that endpoint. The risk of death (HR 1.88, 95% CI 1.20–2.92) or receiving a written TLD (HR 2.32, CI 1.11–4.85) in patients with PECs by at least two clinicians was higher in ICUs with a good climate than in those with a poor one. The differences between ICUs with an average climate, with (n = 12, 18%) or without (n = 20, 29%) nursing involvement at the end of life, and ICUs with a poor climate were less obvious but still in favour of the former. Conclusion: Enhancing the quality of the ethical climate in the ICU may improve both the identification of patients receiving excessive care and the decision-making process at the end of life

Circulating microRNAs in sera correlate with soluble biomarkers of immune activation but do not predict mortality in ART treated individuals with HIV-1 infection: A case control study

Introduction: The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods: A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results: None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR- 145 correlated with nadir CD4+ T cell count. Discussion: No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection

The Barents and Chukchi Seas: Comparison of two Arctic shelf ecosystems

This paper compares and contrasts the ecosystems of the Barents and Chukchi Seas. Despite their similarity in a number of features, the Barents Sea supports a vast biomass of commercially important fish, but the Chukchi does not. Here we examine a number of aspects of these two seas to ascertain how they are similar and how they differ. We then indentify processes and mechanisms that may be responsible for their similarities and differences.Both the Barents and Chukchi Seas are high latitude, seasonally ice covered, Arctic shelf-seas. Both have strongly advective regimes, and receive water from the south. Water entering the Barents comes from the deep, ice-free and "warm" Norwegian Sea, and contains not only heat, but also a rich supply of zooplankton that supports larval fish in spring. In contrast, Bering Sea water entering the Chukchi in spring and early summer is cold. In spring, this Bering Sea water is depleted of large, lipid-rich zooplankton, thus likely resulting in a relatively low availability of zooplankton for fish. Although primary production on average is similar in the two seas, fish biomass density is an order of magnitude greater in the Barents than in the Chukchi Sea. The Barents Sea supports immense fisheries, whereas the Chukchi Sea does not. The density of cetaceans in the Barents Sea is about double that in the Chukchi Sea, as is the density of nesting seabirds, whereas, the density of pinnipeds in the Chukchi is about double that in the Barents Sea. In the Chukchi Sea, export of carbon to the benthos and benthic biomass may be greater. We hypothesize that the difference in fish abundance in the two seas is driven by differences in the heat and plankton advected into them, and the amount of primary production consumed in the upper water column. However, we suggest that the critical difference between the Chukchi and Barents Seas is the pre-cooled water entering the Chukchi Sea from the south. This cold water, and the winter mixing of the Chukchi Sea as it becomes ice covered, result in water temperatures below the physiological limits of the commercially valuable fish that thrive in the southeastern Bering Sea. If climate change warms the Barents Sea, thereby increasing the open water area via reducing ice cover, productivity at most trophic levels is likely to increase. In the Chukchi, warming should also reduce sea ice cover, permitting a longer production season. However, the shallow northern Bering and Chukchi Seas are expected to continue to be ice-covered in winter, so water there will continue to be cold in winter and spring, and is likely to continue to be a barrier to the movement of temperate fish into the Chukchi Sea. Thus, it is unlikely that large populations of boreal fish species will become established in this Arctic marginal sea. © 2012 Elsevier B.V

The benefits of strength training on musculoskeletal system health: practical applications for interdisciplinary care

Global health organizations have provided recommendations regarding exercise for the general population. Strength training has been included in several position statements due to its multi-systemic benefits. In this narrative review, we examine the available literature, first explaining how specific mechanical loading is converted into positive cellular responses. Secondly, benefits related to specific musculoskeletal tissues are discussed, with practical applications and training programmes clearly outlined for both common musculoskeletal disorders and primary prevention strategies