High-Intensity Functional Training Induces Superior Training Adaptations Compared With Traditional Military Physical Training

This study examined the effectiveness of concurrent strength and endurance training with an emphasis on high-intensity functional training (HIFT) during military service. Voluntary male conscripts (aged 18-28 years) were placed in either an experimental (EXP: n = 50-66) or a control (CON: n = 50-67) group. The training for the EXP group included HIFT using body mass, sandbags, and kettlebells. The CON group trained according to the current practice. Physical performance and body composition were assessed at baseline (PRE), at week 10 (MID), and after (POST) the 19-week training period. Significance was set at p < 0.05. The total distance covered in a 12-minute running test increased in both groups, but the change in EXP was superior to the change in CON (11.6%, ES: 0.79 vs. 5.7%, ES: 0.33; p = 0.027). Maximal strength and power characteristics increased in EXP (3.1-5.0%), whereas no improvements were observed in CON. Conscripts with the highest initial fitness showed no improvements in physical performance in either group. Body mass and waist circumference decreased in EXP, whereas CON showed an increase in muscle mass. These findings suggest that HIFT is an effective and time-efficient approach to improve soldiers' aerobic fitness during military service. For the optimal development of strength, the training equipment used may not have provided sufficient and progressive loading to yield considerable strength adaptations. More focus should be placed on sufficient intensity and volume in both strength and endurance training, especially for the most fit soldiers

Glioomien diagnoosi ja ennuste - molekyylidiagnostiikan mahdollisuudet

Glioomat ovat aivojen tukisolukasvaimia ja primaarisista aivokasvaimista yleisimpiä. Diffuusien glioomien hoito perustuu kasvaimen kirurgiseen poistoon sekä säde- ja solunsalpaajahoitoon. Diagnoosi tehdään kasvaimen histopatologisesta tutkimuksesta, jota voidaan nykyisin täydentää molekyylidiagnostisilla tutkimuksilla. Esitämme Tampereen yliopistollisessa sairaalassa vuosina 1983-2009 hoidettujen glioomapotilaiden ennustetta kuvaavia uusia menetelmiä, joista tärkeimpiä ovat IDH-mutaation ja 1p/19q-kodeleetion osoitukset. Tulevaisuudessa voi olla mahdollista räätälöidä hoitoa potilaskohtaisesti glioomien profiloinnin perusteella

Impact of Timing of Surgery and Adjuvant Treatment on Survival of Adult IDH–wild-type Glioblastoma : A Single-center Study of 392 Patients

Background: The purpose of our study was to analyze the impact of time interval from referral to surgery and from surgery to adjuvant treatment on survival of adult isocitrate dehydrogenase–wild-type (IDH-wt) glioblastomas. Methods: Data on 392 IDH-wt glioblastomas diagnosed at the Tampere University Hospital in 2004–2016 were obtained from the electronic patient record system. Piecewise Cox regression was used to calculate hazard ratios for different time intervals between referral and surgery, as well as between surgery and adjuvant treatments. Results: The median survival time from primary surgery was 9.5 months (interquartile range: 3.8–16.0). Survival among patients with an interval exceeding 4 weeks from referral to surgery was no worse compared to <2 weeks (hazard ratio: 0.78, 95% confidence interval: 0.54–1.14). We found indications of poorer outcome when the interval from surgery to radiotherapy exceeded 30 days (hazard ratio: 1.42, 95% confidence interval: 0.91–2.21 for 31–44 days; and 1.59, 0.94–2.67 for over 45 days). Conclusions: Interval from referral to surgery in the range of 4–10 weeks was not associated with decreased survivals in IDH-wt glioblastomas. In contrast, delay exceeding 30 days from surgery to adjuvant treatment may decrease long-term survival.Peer reviewe

PTPRD and CNTNAP2 as markers of tumor aggressiveness in oligodendrogliomas

Oligodendrogliomas are typically associated with the most favorable prognosis among diffuse gliomas. However, many of the tumors progress, eventually leading to patient death. To characterize the changes associated with oligodendroglioma recurrence and progression, we analyzed two recurrent oligodendroglioma tumors upon diagnosis and after tumor relapse based on whole-genome and RNA sequencing. Relapsed tumors were diagnosed as glioblastomas with an oligodendroglioma component before the World Health Organization classification update in 2016. Both patients died within 12 months after relapse. One patient carried an inactivating POLE mutation leading to a clearly hypermutated progressed tumor. Strikingly, both relapsed tumors carried focal chromosomal rearrangements in PTPRD and CNTNAP2 genes with associated decreased gene expression. TP53 mutation was also detected in both patients after tumor relapse. In The Cancer Genome Atlas (TCGA) diffuse glioma cohort, PTPRD and CNTNAP2 expression decreased by tumor grade in oligodendrogliomas and PTPRD expression also in IDH-mutant astrocytomas. Low expression of the genes was associated with poor overall survival. Our analysis provides information about aggressive oligodendrogliomas with worse prognosis and suggests that PTPRD and CNTNAP2 expression could represent an informative marker for their stratification.publishedVersionPeer reviewe

Genomic characterization of IDH-mutant astrocytoma progression to grade 4 in the treatment setting

As the progression of low-grade diffuse astrocytomas into grade 4 tumors significantly impacts patient prognosis, a better understanding of this process is of paramount importance for improved patient care. In this project, we analyzed matched IDH-mutant astrocytomas before and after progression to grade 4 from six patients (discovery cohort) with genome-wide sequencing, 21 additional patients with targeted sequencing, and 33 patients from Glioma Longitudinal AnalySiS cohort for validation. The Cancer Genome Atlas data from 595 diffuse gliomas provided supportive information. All patients in our discovery cohort received radiation, all but one underwent chemotherapy, and no patient received temozolomide (TMZ) before progression to grade 4 disease. One case in the discovery cohort exhibited a hypermutation signature associated with the inactivation of the MSH2 and DNMT3A genes. In other patients, the number of chromosomal rearrangements and deletions increased in grade 4 tumors. The cell cycle checkpoint gene CDKN2A, or less frequently RB1, was most commonly inactivated after receiving both chemo- and radiotherapy when compared to other treatment groups. Concomitant activating PDGFRA/MET alterations were detected in tumors that acquired a homozygous CDKN2A deletion. NRG3 gene was significantly downregulated and recurrently altered in progressed tumors. Its decreased expression was associated with poorer overall survival in both univariate and multivariate analysis. We also detected progression-related alterations in RAD51B and other DNA repair pathway genes associated with the promotion of error-prone DNA repair, potentially facilitating tumor progression. In our retrospective analysis of patient treatment and survival timelines (n = 75), the combination of postoperative radiation and chemotherapy (mainly TMZ) outperformed radiation, especially in the grade 3 tumor cohort, in which it was typically given after primary surgery. Our results provide further insight into the contribution of treatment and genetic alterations in cell cycle, growth factor signaling, and DNA repair-related genes to tumor evolution and progression.Peer reviewe

Reliability, validity and performance determinants of the military simulation test for the assessment of anaerobic performance in soldiers

Introduction: Measurements of physical fitness have been identified as one of the most important research priorities in the military. Currently, the physical fitness tests of The Finnish Defence Forces (FDF) do not include a valid and reliable anaerobic test. In order to develop job-related task simulation tests, the purpose of the study was to determine the reliability and validity of a high-intensity military simulation test (MST), which is designed to assess the task-specific anaerobic performance of soldiers. The MST includes typical combat-related maneuvers while wearing a 20 kg combat load. Methods: 22 male cadets (22.5 ± 0.8 years) volunteered to participate. The MST was performed three times with a minimum of 48 hours of recovery between trials to determine reliability. To study the validity and the contribution of different physical characteristics on performance, the MST was compared with measurements of body composition, muscular strength and endurance, maximal oxygen uptake (VO2max), and anaerobic performance. Results: The mean MST times for the first, second, and third trial were 108.5 ± 8.6, 103.3 ± 6.6 and 98.4 ± 6.5 s, respectively. Repeated measures ANOVA showed significant improvement in the MST time between every trial (p < 0.05 for both). The intraclass correlation coefficient was 0.58 (95 % CI: 0.03–0.84) between the first and second trial and 0.74 (95 % CI: −0.06–0.94) between the second and third trial. The MST performance was significantly correlated with several measured variables. The strongest relationships were observed with mean and peak power in the 60-second Bosco jump test (r = −0.65, p < 0.01; r = −0.68, p < 0.01, respectively), maximal isometric strength of the upper body (r = −0.67, p < 0.01), standing long jump (r = −0.66, p < 0.01), sit-ups (r = −0.69, p < 0.01), and VO2max (r = −0.63, p < 0.01). Discussion: The improvement in MST time in every trial suggested a significant learning effect, especially between the first and second trials. Due to the complex nature of MST, several familiarization trials are required to reach statistically stable results. In addition, the MST may not be considered as a valid task-specific anaerobic test for soldiers, as the performance in MST relies on the simultaneous participation of all three energy pathways, and a combination of neuromuscular, anaerobic, and anaerobic performance characteristics

Sotilaan fyysisen toimintakyvyn ja kehon koostumuksen muutosten yhteydet tehtäväsimulaatioradan suorituksen muutokseen kuuden kuukauden kriisinhallintaoperaation aikana

Fyysisen toimintakyvyn tehtäväkohtaiset vaatimukset ja niiden mittaaminen ovat tällä hetkellä tärkeimmät tutkimuskohteet sotilaan terveyden ja toimintakyvyn alalla. Viime vuosina eri asevoimissa on tutkittu ja otettu käyttöön sotilastehtävissä tyypillisiä suorituksia mittaavia simulaatiotestejä. Tämän tutkimuksen tarkoitus oli selvittää, miten kehon koostumuksen ja fyysisen toimintakyvyn muutokset ovat yhteydessä sotilaan lajinomaista suorituskykyä arvioivan tehtäväsimulaatioradan ajan muutokseen. Toisena tavoitteena oli selvittää, minkälaisia vasteita radan suorittaminen aiheuttaa alaraajojen lihasaktiivisuudessa, veren laktaatissa sekä kuormitustuntemuksessa ja pohtia niiden yhteyttä suoritusaikaan. Tutkimukseen osallistui 58 vapaaehtoista rauhanturvaajaa (29,2 ± 8,3 vuotta, 78,1 ± 7,9 kg, 179,9 ± 6,4 cm), joilta mitattiin 6 kuukautta kestäneen kriisinhallintapalveluksen alussa ja lopussa 1) kehon koostumus: paino, lihasmassa, rasvamassa, rasvaprosentti ja vyötärönym-pärys sekä 2) fyysinen toimintakyky: 3 000 metrin juoksu, ala- ja yläraajojen isometrinen maksimivoima, vauhditon pituushyppy, istumaannousu, etunojapunnerrus ja käsinkohonta. Tehtäväsimulaatioradan yhteydessä mitattiin alaraajojen lihasten sähköinen aktiivisuus (EMG) shortseihin integroiduilla tekstiilielektrodeilla. Ennen ja jälkeen radan suoritusta mitattiin veren laktaatti (La) ja kuormitustuntemus (RPE). Tuloksia tarkasteltiin alku- ja loppumittausten keskiarvoina sekä mittausten välissä tapahtuneena prosentuaalisena muutoksena. Yhteyksiä tutkittiin Spearmanin korrelaatioanalyysillä ja lineaarisella askeltavalla regressioanalyysillä. Tehtäväsimulaatioradan suoritusaika parani (−11,3 ± 6,7 %, p < 0,001). Suorituksen aikana mitattu EMG nousi radan kaikissa vaiheissa. Suorituksen jälkeen mitattu LaPOST nousi mittausjaksojen vertailussa (62,7 ± 55,1 %, p < 0,001). LaPRE ja RPE eivät muuttuneet. Kehon koostumuksen ja fyysisen toimintakyvyn muutosten ja tehtäväsimulaatioradan ajan muutok-sen välillä havaittiin vain keskinkertaisia yhteyksiä. Voimakkain yhteys oli 3 000 metrin juoksuajan muutoksella (r = 0,462, p < 0,01). Regressioanalyysissä selittäjiksi nousivat 3 000 metrin juoksun, lihasmassan ja vyötärönympäryksen muutos, mutta mallien selitysasteet olivat heikkoja (R2 adj. = 0,262–0,365). Tässä tutkimuksessa ei löydetty vahvoja selittäjiä tehtäväsimulaatioradan ajan muutokselle. Valtaosa muutoksesta selittyi muilla, tuntemattomilla tekijöillä. Oppimisvaikutuksella ja motivaatiolla saattoi olla suuri merkitys. Eri energiantuottomekanismien yhteyksistä suoritusajan muutokseen ei saatu riittävän tarkkaa tietoa. Erityisesti anaerobisen kapasiteetin merkityksestä sotilaan fyysiselle toimintakyvylle on saatava lisää tutkimustietoa. Sotilaiden tehtäväsimulaatiotestien kehittämistä Puolustusvoimissa on jatkettava

22 Sotilaan fyysinen toimintakyky

Tässä jaksossa keskustellaan sotilaan fyysisen toimintakyvyn ylläpitämisestä ja kehittämisestä sotilaskoulutuksessa sekä erilaisista fyysisistä rasitteista ja vaatimuksista tosi tilanteessa. Keskustelemassa ovat kapteeni, liikuntatieteiden maisteri Joonas Helén ja apulaisprofessori, liikuntatieteiden tohtori Jani Vaara

High-Intensity Functional Training Induces Superior Training Adaptations Compared With Traditional Military Physical Training

Helén, J, Kyröläinen, H, Ojanen, T, Pihlainen, K, Santtila, M, Heikkinen, R, and Vaara, JP. High-intensity functional training induces superior training adaptations compared with traditional military physical training. J Strength Cond Res XX(X): 000–000, 2023—This study examined the effectiveness of concurrent strength and endurance training with an emphasis on high-intensity functional training (HIFT) during military service. Voluntary male conscripts (aged 18–28 years) were placed in either an experimental (EXP: n = 50–66) or a control (CON: n = 50–67) group. The training for the EXP group included HIFT using body mass, sandbags, and kettlebells. The CON group trained according to the current practice. Physical performance and body composition were assessed at baseline (PRE), at week 10 (MID), and after (POST) the 19-week training period. Significance was set at p < 0.05. The total distance covered in a 12-minute running test increased in both groups, but the change in EXP was superior to the change in CON (11.6%, ES: 0.79 vs. 5.7%, ES: 0.33; p = 0.027). Maximal strength and power characteristics increased in EXP (3.1–5.0%), whereas no improvements were observed in CON. Conscripts with the highest initial fitness showed no improvements in physical performance in either group. Body mass and waist circumference decreased in EXP, whereas CON showed an increase in muscle mass. These findings suggest that HIFT is an effective and time-efficient approach to improve soldiers' aerobic fitness during military service. For the optimal development of strength, the training equipment used may not have provided sufficient and progressive loading to yield considerable strength adaptations. More focus should be placed on sufficient intensity and volume in both strength and endurance training, especially for the most fit soldiers.peerReviewe

Whole-exome sequencing identifies germline mutation in TP53 and ATRX in a child with genomically aberrant AT/RT and her mother with anaplastic astrocytoma

Brain tumors typically arise sporadically and do not affect several family members simultaneously. In the present study, we describe clinical and genetic data from two patients, a mother and her daughter, with familial brain tumors. Exome sequencing revealed a germline missense mutation in the TP53 and ATRX genes in both cases, and a somatic copy-neutral loss of heterozygosity (LOH) in TP53 in both atypical teratoid/rhabdoid tumor (AT/RT) and astrocytoma tumors. ATRX mutation was associated with the loss of ATRX protein expression. In the astrocytoma case, R132C missense mutation was found in the known hotspot site in isocitrate dehydrogenase 1 (IDH1) and LOH was detected in TP53. The mother carried few other somatic alterations, suggesting that the IDH1 mutation and LOH in TP53 were sufficient to drive tumor development. The genome in the AT/RT tumor was atypically aneuploid: Most chromosomes had experienced copy-neutral LOH or whole-chromosome gains. Only Chromosome 18 had normal diploid status. INI1/hSNF5/SMARCB1 was homozygously deleted in the AT/RT tumor. This report provides further information about tumor development in a predisposed genetic background and describes two special Li–Fraumeni cases with a familial brain tumor.</jats:p