Preparation for an Half-Ironmantm Triathlon amongst Amateur Athlete: Finishing rate and physiological adaptation.

International Journal of Exercise Science 13(6): 766-777, 2020. Long distance triathlon has gained in popularity amongst the general population. Coaches establish training programs based upon their knowledge, personal experience and on current training principles. The goal was to observe the effect of a triathlon training program for a half Ironman event in neophyte amateur athletes. A specific triathlon training program was followed from February to June 2016 by a group preparing for their first half ironman. Out of the 32 participants (19 Males and 13 Females; mean age of 39 ± 9.9 years old; body weight of 72.7 ± 13.4 kg and a height of 171.5 ± 10.2 cm), only one did not complete the event. A mean training volume of 410 ± 201 min per week led to a mean finishing time of 6 hours 28 minutes. The training program significantly increased the maximal oxygen consumption (45.9 ± 8.2 to 48.6 ± 7.5 ml/kg/min, p =0.002) and the maximal power output (293.1 ± 63.7 to 307.8 ± 58.7 W, p \u3c 0.001). The absolute oxygen consumption and power output at both ventilatory thresholds also significantly increased (VT1: 2.2 ± 0.4 to 2.5 ± 0.5 L, p = 0.001; 157.8 ± 41.8 to 176.7 ± 41.1 W p = 0.009 and VT2: 2.9 ± 0.4 to 3.0 ± 0.4 L, p = 0.017; 229.3 ± 62.0 to 244.8± 55.2 W, p = 0.022 ). A significant diminution of waist circumference was observed (83.2 ± 10.0 to 81.8 ± 9.5 cm, p = 0.032) with no significant changes in body weight. Thus, a 24-week specific training program appears to be safe and efficient for amateur athletes aiming to finish their first half- Ironman event

Atraumatic (pencil-point) versus conventional needles for lumbar puncture:a clinical practice guideline

Is the needle tip configuration important when performing a lumbar puncture for any indication? A systematic review published in the Lancet in December 2017 suggests that it is. The review found that using atraumatic (pencil-point) lumbar puncture needles instead of conventional lumbar puncture needles reduced the risk of post-dural-puncture headache and of return to hospital for additional pain control.1 This guideline recommendation aims to promptly and transparently translate this evidence to a clinical recommendation, following standards for GRADE methodology and trustworthy guidelines.2 The BMJ Rapid Recommendations panel makes a strong recommendation for the use of atraumatic needles for lumbar puncture in all patients regardless of age (adults and children) or indication instead of conventional needles.3 4 Box 1 shows the article and evidence linked to this Rapid Recommendation. The main infographic provides an overview of the absolute benefits and harms (although none were present here) of atraumatic needles. Table 1 below shows any evidence that has emerged since the publication of this guideline.publishedVersio

Intact Fish Skin Graft vs. Standard of Care in Patients with Neuroischaemic Diabetic Foot Ulcers (KereFish Study) : An International, Multicentre, Double-Blind, Randomised, Controlled Trial Study Design and Rationale

Publisher Copyright: © 2022 by the authors.Background: Cell and/or tissue-based wound care products have slowly advanced in the treatment of non-healing ulcers, however, few studies have evaluated the effectiveness of these devices in the management of severe diabetic foot ulcers. Method: This study (KereFish) is part of a multi-national, multi-centre, randomised, controlled clinical investigation (Odin) with patients suffering from deep diabetic wounds, allowing peripheral artery disease as evaluated by an ankle brachial index equal or higher than 0.6. The study has parallel treatment groups: Group 1 treatment with Kerecis® Omega3 Wound™ versus Group 2 treatment with standard of care. The primary objective is to test the hypothesis that a larger number of severe diabetic ulcers and amputation wounds, including those with moderate arterial disease, will heal in 16 weeks when treated with Kerecis® Omega3 Wound™ than with standard of care. Conclusion: This study has received the ethics committee approval of each participating country. Inclusion of participants began in March 2020 and ended in July 2022. The first results will be presented in March 2023. The study is registered in ClinicalTrials.gov as Identifier: NCT04537520.Peer reviewe

Defining the burden of febrile illness in rural South and Southeast Asia: an open letter to announce the launch of the Rural Febrile Illness project.

In rural areas of South and Southeast Asia malaria is declining but febrile illnesses still account for substantial morbidity and mortality. Village health workers (VHWs) are often the first point of contact with the formal health system, and for patients with febrile illnesses they can provide early diagnosis and treatment of malaria. However, for the majority of febrile patients, VHWs lack the training, support and resources to provide further care. Consequently, treatable bacterial illnesses are missed, antibiotics are overused and poorly targeted, and patient attendance wanes along with declining malaria. This announces the start of a new initiative, the Rural Febrile Illness (RFI) project, the first in a series of projects to be implemented as part of the South and Southeast Asian Community-based Trials Network (SEACTN) research programme. This multi-country, multi-site project will begin in Bangladesh, Cambodia, Lao PDR, and Myanmar and will define the epidemiological baseline of febrile illness in five remote and underserved areas of Asia where malaria endemicity is declining and access to health services is limited. The RFI project aims to determine the incidence, causes and outcomes of febrile illness; understand the opportunities, barriers and appetite for adjustment of the role of VHWs to include management of non-malarial febrile illnesses; and establish a network of community healthcare providers and facilities capable of implementing interventions designed to triage, diagnose and treat patients presenting with febrile illnesses within these communities in the future. [Abstract copyright: Copyright: © 2021 Chandna A et al.

Pf7: an open dataset of Plasmodium falciparum genome variation in 20,000 worldwide samples

We describe the MalariaGEN Pf7 data resource, the seventh release of Plasmodium falciparum genome variation data from the MalariaGEN network.  It comprises over 20,000 samples from 82 partner studies in 33 countries, including several malaria endemic regions that were previously underrepresented.  For the first time we include dried blood spot samples that were sequenced after selective whole genome amplification, necessitating new methods to genotype copy number variations.  We identify a large number of newly emerging crt mutations in parts of Southeast Asia, and show examples of heterogeneities in patterns of drug resistance within Africa and within the Indian subcontinent.  We describe the profile of variations in the C-terminal of the csp gene and relate this to the sequence used in the RTS,S and R21 malaria vaccines.  Pf7 provides high-quality data on genotype calls for 6 million SNPs and short indels, analysis of large deletions that cause failure of rapid diagnostic tests, and systematic characterisation of six major drug resistance loci, all of which can be freely downloaded from the MalariaGEN website

Psychological Status During and After the Preparation of a Long-distance Triathlon Event in Amateur Athletes

International Journal of Exercise Science 14(5): 134-148, 2021. Preparation for an endurance event among amateur athletes requires a major commitment on their part. Knowing amateur athletes’ psychological characteristics during a training period should be a priority for coaches and athletes. The aim of our longitudinal study was to characterize the psychological profile of amateur athletes over a training period of six months prior to and after a long-distance triathlon. Thirty-two amateur athletes (13 females; 19 males; 1.5±1.3 years of experience) were recruited for this observational study. All participants (39±9.9 years old; weighs 73±12.9 kg; measure 172±10.2 cm) underwent a physical fitness assessment pre- and post 6-months of training, a monthly psychological questionnaire battery assessing mood, positive and negative affect, passion and motivation and, for some participants (n=5), an interview post event. Positive emotions increased until the sixth month, from 38.1±22.0 to 54.3±7.2 (Z=3.49, p\u3c0.001, r=0.80). Participants were more harmonious (29.0±3.0) than obsessive (13.0±1.0) with their triathlon\u27s passion (Z=4.91, p\u3c0.001, r=0.85). Participants felt a high level of intrinsic motivation (15.9±1.76) and a low level of external motivation (4.9±1.08) about their triathlon training (p\u3c0.05). The vigor score is the only sub scale that significantly changed from the 1st to the 6th month of training, and ranged between 21.4±10.6 and 28.1±4.1 (Z=2.0, p=0.046, r=0.46). This longitudinal observational study is the first to have explored athletes\u27 psychological and emotional parameters over a training period of six months prior to a long-distance triathlon event and one month after. Thus, specific interventions and mental training can be structured around these important milestones

Remote Ischemic Preconditioning Does Not Improve the Six Minutes Walk Test Performance in Chronic Heart Failure Patients: a Randomised Pilot Trial

International Journal of Exercise Science 14(2): 1354-1362, 2021. Cycles of ischemia and reperfusion induced with a pressure cuff on a skeletal muscle, also know as remote ischemic preconditioning (RIPC), appears to improve performance in different time-trial events in healthy individuals. Our primary goal was to assess the effect of RIPC in heart failure (HF) patients’ functional capacity using the six-minute walk test (6MWT). A randomized crossover design comparing RIPC (4 x five-minutes of upper arm ischemia) to the SHAM procedure was done in 15 patients prior to a 6MWT. The primary outcome measure was the total distance walked in a standardized 6MWT (20m corridor). Metabolic and hemodynamic responses were measured using gas exchange analysis with a portable metabolic analyzer and peripheral skeletal muscle oxygen saturation (smO2) with near-infrared spectroscopy. The total distance travelled during 6MWT was not significantly different between the RIPC (347 ± 63 m) and the SHAM procedure (352 ± 65 m; p = 0.514). Relative oxygen uptake did not change when comparing interventions: 10.26 ± 2.01 ml/kg/min vs 10.69 ± 2.51 ml/kg/min (RIPC vs SHAM, respectively, p = 0.278). As well, no significant differences were observed for heart rate, respiratory exchange ratio, smO2, and ventilation. Even though HF patients tolerated well the RIPC intervention, it did not provide any significant improvement in functional capacity and other physiological parameters in our sample of patients

Trajectories of sleep duration and timing before dementia: a 14-year follow-up study

BACKGROUND: given the complex relationship between sleep and neurodegenerative processes, it is important to examine whether changes in sleep patterns occur prior or close to dementia onset. OBJECTIVE: to examine the relationship between sleep parameters and dementia incidence and, to characterize trajectories of sleep patterns before dementia diagnosis. DESIGN: a 14-year longitudinal study including a nested case-control study. SETTING: the French Three-City Study. SUBJECTS: overall, 1,749 cognitively healthy participants (>/=65 years) for the longitudinal study and, 182 incident dementia cases and 719 controls matched by sex, age and educational level for the case-control study. METHODS: dementia cases were assessed at each visit and self-reported sleep parameters at baseline, 2, 8, 10, 12 and 14 years. Cox models were used to estimate the risk of dementia associated with baseline sleep parameters (sleep duration, time in bed (TIB), sleep timing, sleepiness and insomnia). Latent-process mixed models were performed to compare sleep trajectories according to the case-control status. RESULTS: long baseline nighttime and 24-h sleep durations (>/=9 h) as well as being persistent or becoming long sleepers during follow-up were associated with dementia incidence. Trajectories of sleep durations and TIB showed faster increases in cases compared with controls up to 12 years before dementia. The mean differences [95%CI] for 24-h sleep duration between cases and controls were: 0.27 h [0.01;0.52], 0.34 [0.09;0.58] and 0.67 [0.44;0.90] at -12, -8 and -2 years, respectively. Bedtime trajectories showed an earlier bedtime in cases up to -8 years. CONCLUSION: long sleep duration and earlier bedtime may impact dementia incidence