Metabolic and mechanical changes in ultra-endurance running races and the effects of a specific training on energy cost of running

The present thesis is divided into two parts. Part I: The objectives of the first part were to examine the factors affecting the ultra-endurance performance and in particular which aspects influence the cost of running (Cr). Consequently, we defined how the Cr and running mechanics changed during different types (i.e. level and uphill) of ultra-endurance races. Finally, we proposed a specific training protocol for improving the Cr in high-level ultra-marathoners. We assessed the Cr by measuring the oxygen consumption at one (or more) fixed speeds using a metabolic unit. Further, for the running mechanics measurement and the spring-mass model parameters computation we used video analysis. Other parameters such as maximal muscle power of the lower limbs (MMP), morphological properties of the gastrocnemius medialis and Achilles tendon stiffness were also measured. Our studies showed that the maximal oxygen uptake, the fraction of it maintained throughout the race and the Cr are the main physiological parameters affecting the ultra-endurance performance, both in level and uphill competitions. Moreover, low Cr values were related to high MMP, vertical stiffness (kvert), low foot print index (FPI), Achilles tendon stiffness and external work. These results indicate that MMP, kvert and FPI are important factors in determining ultra-endurance performance. Also, our studies reported that during ultra-endurance competitions athletes tend to change their running mechanics after a certain time (~4 hours) rather than after a certain distance covered. Then, by adding strength, explosive and power training to the usual endurance training it is possible to lower the cost of running leading to a better performance. From these conclusions we suggest new training protocol for the ultra-marathoners including strength, explosive and power training which maintain a correct and less expensive running technique during ultra-endurance events. Part II: The aim of the second part was to develop and validate a customized thermoplastic polyurethane insole shoe sensor for collecting data about the ground reaction forces (GRF), contact and aerial times. This prototype allowed us to collect vertical GRF and contact time by using piezoresistive force sensors (RFS). Our final model was composed by a rubber insole, five RFSs, an s-beam load cell, an acquisition device (NI myRIO) and a battery case. By using this device we can collect data on field, avoiding the restrictions imposed by the laboratory environmen

Feasibility and Accuracy of Transduodenal Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Solid Lesions Using a 19-Gauge Flexible Needle: A Multicenter Study

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A circular RNA map for human induced pluripotent stem cells of foetal origin

Background Adult skin fibroblasts represent the most common starting cell type used to generate human induced pluripotent stem cells (F-hiPSC) for clinical studies. Yet, a foetal source would offer unique advantages, primarily the absence of accumulated somatic mutations. Herein, we generated hiPSC from cord blood multipotent mesenchymal stromal cells (MSC-hiPSC) and compared them with F-hiPSC. Assessment of the full activation of the pluripotency gene regulatory network (PGRN) focused on circular RNA (circRNA), recently proposed to participate in the control of pluripotency. Methods Reprogramming was achieved by a footprint-free strategy. Self-renewal and pluripotency of cord blood MSC-hiPSC were investigated in vitro and in vivo, compared to parental MSC, to embryonic stem cells and to F-hiPSC. High-throughput array-based approaches and bioinformatics analyses were applied to address the PGRN. • View related content for this article Findings Cord blood MSC-hiPSC successfully acquired a complete pluripotent identity. Functional comparison with F-hiPSC showed no differences in terms of i) generation of mesenchymal-like derivatives, ii) their subsequent adipogenic, osteogenic and chondrogenic commitment, and iii) their hematopoietic support ability. At the transcriptional level, specific subsets of mRNA, miRNA and circRNA (n = 4,429) were evidenced, casting a further layer of complexity on the PGRN regulatory crosstalk. Interpretation A circRNA map of transcripts associated to naïve and primed pluripotency is provided for hiPSC of clinical-grade foetal origin, offering insights on still unreported regulatory circuits of the PGRN to consider for the optimization and development of efficient differentiation protocols for clinical translation

Fatores Nutricionais e Físicos que Interferem na Qualidade de Vida do Idoso

Population aging is a Brazilian reality and a challenging aspect for public health since functional changes that are inherent to such process occur which should be taken into consideration in order to provide the elderly with good quality of life so that they can go through this process healthly. This review article aims to discuss the issue of aging from the perspective of nutrition and physical activity, highlighting the main nutrition and physical factors that affect the quality of human life during the aging process considering the raise in life expectancy and the increasing participation of the elderly in society, especially in developing countries like Brazil. The knowledge of these causes and the intervention of nutritionists and fitness trainers will allow such population to have its dietary needs met according to its needs, physical training tailored to the conditions of their bodies and, consequently, better health and independence to continue performing day-to-day activities.O envelhecimento populacional é uma realidade brasileira e motivo de desafio para a saúde pública, visto que no envelhecimento ocorrem alterações funcionais inerentes ao processo de envelhecer, as quais devem ser consideradas a fim de proporcionar ao idoso qualidade de vida, de forma que o mesmo possa passar por esse processo com saúde. Este artigo de revisão bibliográfica se propõe a discutir a questão do envelhecimento sob a ótica da nutrição e da atividade física, destacando os principais fatores nutricionais e físicos que afetam a qualidade de vida do ser humano durante o envelhecimento, em razão da elevação da expectativa de vida da população e do crescente aumento da participação do idoso na sociedade, principalmente nos países em desenvolvimento como o Brasil. Por meio do conhecimento de tais causas e da intervenção de nutricionistas e educadores físicos, tal população poderá ter alimentação adequada às suas necessidades, treinamentos físicos moldados às condições do seu corpo e, consequentemente, mais saúde e independência para continuar desempenhando as atividades do dia-a-dia

Colorectal cancer after bariatric surgery (Cric-Abs 2020): Sicob (Italian society of obesity surgery) endorsed national survey

Background The published colorectal cancer (CRC) outcomes after bariatric surgery (BS) are conflicting, with some anecdotal studies reporting increased risks. The present nationwide survey CRIC-ABS 2020 (Colo-Rectal Cancer Incidence-After Bariatric Surgery-2020), endorsed by the Italian Society of Obesity Surgery (SICOB), aims to report its incidence in Italy after BS, comparing the two commonest laparoscopic procedures-Sleeve Gastrectomy (SG) and Roux-en-Y gastric bypass (GBP). Methods Two online questionnaires-first having 11 questions on SG/GBP frequency with a follow-up of 5-10 years, and the second containing 15 questions on CRC incidence and management, were administered to 53 referral bariatric, high volume centers. A standardized incidence ratio (SIR-a ratio of the observed number of cases to the expected number) with 95% confidence intervals (CI) was calculated along with CRC incidence risk computation for baseline characteristics. Results Data for 20,571 patients from 34 (63%) centers between 2010 and 2015 were collected, of which 14,431 had SG (70%) and 6140 GBP (30%). 22 patients (0.10%, mean age = 53 +/- 12 years, 13 males), SG: 12 and GBP: 10, developed CRC after 4.3 +/- 2.3 years. Overall incidence was higher among males for both groups (SG: 0.15% vs 0.05%; GBP: 0.35% vs 0.09%) and the GBP cohort having slightly older patients. The right colon was most affected (n = 13) and SIR categorized/sex had fewer values < 1, except for GBP males (SIR = 1.07). Conclusion Low CRC incidence after BS at 10 years (0.10%), and no difference between procedures was seen, suggesting that BS does not trigger the neoplasm development

Advances in the treatment of prolactinomas

Prolactinomas account for approximately 40% of all pituitary adenomas and are an important cause of hypogonadism and infertility. The ultimate goal of therapy for prolactinomas is restoration or achievement of eugonadism through the normalization of hyperprolactinemia and control of tumor mass. Medical therapy with dopamine agonists is highly effective in the majority of cases and represents the mainstay of therapy. Recent data indicating successful withdrawal of these agents in a subset of patients challenge the previously held concept that medical therapy is a lifelong requirement. Complicated situations, such as those encountered in resistance to dopamine agonists, pregnancy, and giant or malignant prolactinomas, may require multimodal therapy involving surgery, radiotherapy, or both. Progress in elucidating the mechanisms underlying the pathogenesis of prolactinomas may enable future development of novel molecular therapies for treatment-resistant cases. This review provides a critical analysis of the efficacy and safety of the various modes of therapy available for the treatment of patients with prolactinomas with an emphasis on challenging situations, a discussion of the data regarding withdrawal of medical therapy, and a foreshadowing of novel approaches to therapy that may become available in the future

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Changes in running mechanics during a 6-hour running race

3nonenoneGiovanelli, Nicola; Taboga, Paolo; Lazzer, StefanoGiovanelli, Nicola; Taboga, Paolo; Lazzer, Stefan

Energetics and Mechanics of Steep Treadmill Versus Overground Pole Walking: A Pilot Study

Purpose: To compare energetics and spatiotemporal parameters of steep uphill pole walking on a treadmill and overground. Methods: First, the authors evaluated 6 male trail runners during an incremental graded test on a treadmill. Then, they performed a maximal overground test with poles and an overground test at 80% (OG(80)) of vertical velocity of maximal overground test with poles on an uphill mountain path (length = 1.3 km, elevation gain = 433 m). Finally, they covered the same elevation gain using poles on a customized treadmill at the average vertical velocity of the OG(80). During all the tests, the authors measured oxygen uptake, carbon dioxide production, heart rate, blood lactate concentration, and rate of perceived exertion. Results: Treadmills required lower metabolic power (15.3 [1.9] vs 16.6 [2.0] W/kg, P = .002) and vertical cost of transport (49.6 [2.7] vs 53.7 [2.1] J/kg.m, P < .001) compared with OG(80). Also, oxygen uptake was lower on a treadmill (41.7 [5.0] vs 46.2 [5.0] mL/kg.min, P = .001). Conversely, respiratory quotient was higher on TR80 compared with OG(80) (0.98 [0.02] vs 0.89 [0.04], P= .032). In addition, rate of perceived exertion was higher on a treadmill and increased with elevation (P < .001). The authors did not detect any differences in other physiological measurements or in spatiotemporal parameters. Conclusions: Researchers, coaches, and athletes should be aware that steep treadmill pole walking requires lower energy consumption but same heart rate and rate of perceived exertion than overground pole walking at the same average intensity

Pole Walking Is Faster but Not Cheaper During Steep Uphill Walking

Purpose: The aim of this study was to compare pole walking (PW) and walking without poles (W) on a steep uphill mountain path (1.3 km, 433 m of elevation gain) at 2 different intensities: a maximal effort that would simulate a vertical kilometer intensity and a lower intensity (80% of maximal) simulating an ultratrail race. Methods: On the first day, we tested the participants in the laboratory to determine their maximal physiological parameters, respiratory compensation point, and gas exchange threshold. Then, they completed 4 uphill tests along a mountain path on 4 separate days, 2 at their maximum effort (PWmaxand Wmax, randomized order) and 2 at 80% of the mean vertical velocity maintained during the first 2 trials (PW80 and W80, randomized order). We collected metabolic data, heart rate, blood lactate concentration, and rating of perceived exertion at the end of each trial. We also collected rating of perceived exertion at every 100 m of elevation gain during PW80 and W80. Results: Participants completed the maximal effort faster with poles versus without poles (18:51 [03:12] vs 19:19 [03:01] in min:s, P=.013, d=0.08, small). Twelve of the 15 participants (80%) improved their performance when they used poles. During PW80 and W80, none of the physiological or biomechanical parameters were different. Conclusion: In the examined condition, athletes should use poles during steep uphill maximal efforts to obtain the best performance. Conversely, during submaximal effort, the use of poles does not provide advantages in uphill PW