Effects of Eccentric Speed during Front Squat Conditioning Activity on Post-activation Performance Enhancement of Hip and Thigh Muscles

The phenomenon of post-activation performance enhancement plays an unidentified role in movement eccentric speed and individual muscle group responses. Therefore, this study aimed to determine whether the loaded front squat (FSq) speed of the eccentric phase would influence the post-activation performance enhancement effect and whether the FSq would elicit similar performance enhancement of knee flexion, knee extension, hip flexion, and hip extension muscles. Twenty resistance-trained handball players performed the FSq under maximum eccentric-concentric speed and 2-s eccentric speed (only the eccentric phase performed), while pre- and post-front squat countermovement jump, knee, and hip isokinetic flexion/extension performance were tested. The FSq conditioning activity was performed in a single set of three repetitions with either 90% (maximum eccentric-concentric speed) or 120% (2-s eccentric speed) of one repetition maximum, and post-performance was measured 4-12 min after the FSq. Athletes randomly changed the FSq eccentric speed and tested the hip or knee isokinetic flexion/extension strength at 180°/s. ANOVA showed that the rate of force development during the jump increased (Cohen d = 0.59-0.77) with no differences between 2-s eccentric and maximum speed eccentric protocols. Isokinetic strength increased after the 2-s eccentric FSq in hip extension (d = 0.76-0.86), knee flexion (d = 0.74-0.88), and hip flexion (d = 0.82), with no differences in knee extension strength. After maximum eccentric-concentric speed, isokinetic strength increased in hip extension (d = 1.25). In conclusion, the FSq conditioning activity enhances hip extensors' performance more than knee extensors' performance. Different eccentric types of muscle action during a conditioning activity alter the level of local muscle enhancement.

Prevalence and factors associated with professional burnout in Polish oncologists-results of a nationwide survey

BACKGROUND

High rates of burnout are observed among health care professionals worldwide, which could have negative consequences on personal and organizational levels. We aimed to evaluate the burnout prevalence and factors associated with burnout among oncologists in Poland.

MATERIALS AND METHODS

An online survey was conducted using the validated Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and additional work/lifestyle questions. Descriptive statistics, parametric and nonparametric tests, and multivariate logistic regression were used to identify factors associated with burnout.

RESULTS

A total of 228 physicians participated in the survey, including 168 medical oncologists, 43 radiation oncologists, and 17 from other specialties. Data collected from 211 medical and radiation oncologists were included in the final analyses. Most participants were female (71.6%) and ≤40 years of age (70.1%). A self-reported feeling of burnout was present in 65.9% of participants. Based on the MBI-HSS, 74.9% showed evidence of burnout with burnout subdomains as follows: depersonalization 37.0%; emotional exhaustion 64.5%; low accomplishment 43.1%. There were no differences in burnout rates based on specialization (oncology/haematology-75.6%, radiotherapy-72.1%), career stage, gender, or age groups. Lack of work-life balance was the only significant factor associated with the risk of burnout in the logistic regression (relative risk 2.6, 95% confidence interval 1.3-5.4). Only 20.9% of physicians had access to psychological support in their workplace; however, 70.1% desired such support. Three main factors impacting burnout in cancer care workers were: bureaucracy and administrative duties overload, admissions of many patients, and poor work culture.

CONCLUSIONS

Burnout is common among medical and radiation oncologists in Poland. There is a high demand for psychological support and organizational changes in the workplace to reduce risk and mitigate the adverse effects of burnout among health care professionals.

Acute Effects of Isometric Conditioning Activity on the Viscoelastic Properties of Muscles and Sprint and Jumping Performance in Handball Players

ABSTRACT

Krzysztofik, M, Spieszny, M, Trybulski, R, Wilk, M, Pisz, A, Kolinger, D, Filip-Stachnik, A, and Stastny, P. Acute effects of isometric conditioning activity on the viscoelastic properties of muscles and sprint and jumping performance in handball players. J Strength Cond Res 37(7): 1486-1494, 2023-The effects of conditioning activity (CA) on muscle stiffness are currently unknown, suggesting that maximum CA effort can increase or decrease the stiffness of involved muscle groups. Therefore, this study aimed to investigate the effect of maximal isometric half-squats on the viscoelastic properties of muscles and postactivation performance enhancement (PAPE) in sprints and jumps. Twelve handball players underwent a standard warm-up and baseline assessment of muscle stiffness and tone of vastus lateralis and gastrocnemius medialis muscle, followed by 20-m sprint with intermediate measures at 5 and 10 m and countermovement jump. The PAPE was assessed by repeating the tests (at 4th, 8th, and 12th minute post-CA) after a CA protocol consisting of 3 sets of 3-second maximal isometric half-squats (EXP) or a control condition (CTRL) without any CA. The vastus lateralis stiffness in the 4th and 12th minute and muscle tone in the 4th minute post-CA significantly decreased compared with baseline ( p = 0.041, ES = 0.57; p = 0.013, ES = 0.52; p = 0.004, ES = 0.81, respectively) in the EXP condition. The 20-m sprint time significantly decreased at all post-CA time points compared with the baseline for the EXP condition ( p < 0.033) and the after values in the CTRL condition ( p < 0.036). In comparison to baseline, the 10-m sprint time decreased in the eighth minute post-CA ( p = 0.021; ES = 0.82) in the EXP condition. Moreover, it was significantly lower at the 8th and 12th minute post-CA ( p = 0.038; ES = 0.71 and p = 0.005; ES = 1.26) compared with that time points in the CTRL condition. The maximal isometric half-squats effectively improved sprint performance and significantly decreased vastus lateralis tone and stiffness. These findings offer new insights into the assessment of viscoelastic properties for evaluating the fatigue or potentiation state, which requires further investigation.

Acute Effects of Varied Back Squat Activation Protocols on Muscle-Tendon Stiffness and Jumping Performance

ABSTRACT

Krzysztofik, M, Wilk, M, Pisz, A, Kolinger, D, Tsoukos, A, Zając, A, Stastny, P, and Bogdanis, GC. Acute effects of varied back squat activation protocols on muscle-tendon stiffness and jumping performance. J Strength Cond Res 37(7): 1419-1427, 2023-Intensity, movement velocity, and volume are the principal factors to successfully use postactivation performance enhancement. Therefore, 15 resistance-trained volleyball players completed 3 different back squat configurations as a conditioning activity (CA) in randomized order: (a) 3 sets of 3 repetitions at 85% 1RM (HL); (b) a single set of back squats at 60% 1RM until 10% mean velocity loss (VB); (c) and 2 sets of back squats at 60% 1RM until 10% mean velocity loss (2VB) on subsequent countermovement jump performance, Achilles tendon, and vastus lateralis stiffness with concomitant front thigh skin surface temperature assessment. The measurements were performed 5 minutes before the CA and at 2, 4, 6, 8, and 10 minutes. The jump height was significantly increased in the second minute and at peak, post-CA compared with baseline for all conditions ( p = 0.049; ES = 0.23 and p < 0.001; ES = 0.37). Skin surface temperature was significantly increased for all post-CA time points compared with baseline in the 2VB condition ( p from <0.001-0.023; ES = 0.39-1.04) and in the fourth minute and at peak post-CA in HL condition ( p = 0.023; ES = 0.69 and p = 0.04; ES = 0.46), whereas for the VB condition, a significant decrease in peak post-CA was found ( p = 0.004; ES = -0.54). Achilles tendon stiffness was significantly decreased for second, fourth, eighth, 10th, and peak post-CA in comparison to baseline for all conditions ( p from p = 0.004-0.038; ES = -0.47 to -0.69). Vastus lateralis stiffness was significantly decreased for peak post-CA compared with baseline for all conditions ( p = 0.017; ES = -0.42). We recommend using a single set of barbell squats with a 10% velocity loss as a mechanism of fatigue control to acutely improve jump height performance and avoid unnecessary increases in training volume.

Acute Effects of High-Load vs. Plyometric Conditioning Activity on Jumping Performance and the Muscle-Tendon Mechanical Properties

ABSTRACT

Krzysztofik, M, Wilk, M, Pisz, A, Kolinger, D, Bichowska, M, Zajac, A, and Stastny, P. Acute effects of high-load versus plyometric conditioning activity on jumping performance and the muscle-tendon mechanical properties. J Strength Cond Res 37(7): 1397-1403, 2023-The effectiveness of high-load and plyometric exercises as conditioning activity (CA) is not well described in the level of performance enhancement and muscle-tendon properties. Therefore, this study aimed to compare the effectiveness of high-loaded back squats and body mass tuck jumps among amateur soccer players on the height of countermovement jump performed without (CMJ) and with arm swing (CMJa) and to verify the usefulness of the myotonometry in assessing the level of CA-induced fatigue. Therefore, 16 male amateur soccer players (resistance training experience: 2 ± 1 year, relative 1 repetition maximum back squat strength: 1.41 ± 0.12 kg·body mass-1) performed 3 experimental sessions to compare the acute effects of 3 sets of 3 repetitions at 85% one repetition maximum of half back squats (HL), 3 sets of 5 repetitions of tuck jump exercises (PLY), and no CA (CTRL) on CMJ and CMJa height. Moreover, the gastrocnemius medialis and Achilles tendon tone and stiffness were examined. Measurements were performed 5 minutes before CA and in the third, sixth, and ninth minutes after CA. The CMJ height significantly increased from pre-CA to post-CA in the CTRL (p = 0.005; effect size [ES] = 0.36; Δ = +3.4%) and PLY (p = 0.001; ES = 0.83; Δ = +8.8%) conditions. Moreover, post-CA jump height was significantly higher in PLY than in the HL condition (p = 0.024; ES = 0.6; Δ = +5.9%). No significant differences were found for CMJa height, tone, and stiffness of gastrocnemius medialis and Achilles tendon. The low-volume plyometric CA (i.e., 3 sets of 5 repetitions) is recommended instead of high-loaded CA (≥85% one repetition maximum) for amateur athletes. In addition, it has been established that the performance improvement was independent of changes in the mechanical properties of the gastrocnemius medialis and Achilles tendon. Furthermore, it seems that the complexity of the post-CA task may affect the magnitude of the postactivation performance enhancement.

Real-life data of abiraterone acetate and enzalutamide treatment in post-chemotherapy metastatic castration-resistant prostate cancer in Poland

Background

Abiraterone acetate (ABI) and Enzalutamide (ENZA) are second-generation hormone drugs that show breakthrough activity in post-chemotherapy, metastatic castration-resistant prostate cancer (mCRPC). The leading oncological and urological guidelines indicate both drugs with the same strong recommendation. There is a lack of randomized trials which compare the efficacy of ABI and ENZA. The current study aimed to compare the effectiveness of the drugs with an analysis of prognostic factors related to those drugs.

Patients and methods

The study included 420 patients with docetaxel (DXL) pretreated mCRPC from seven Polish cancer centers. Patients were treated according to inclusion and exclusion criteria in the Polish national drug program (1000 mg ABI and 10 mg prednisone, n=76.2%; ENZA, 160 mg; n=23.8%). The study retrospectively analyzed the overall survival (OS), time to treatment failure (TTF), PSA 50% decline rate (PSA 50%) and selected clinic-pathological data.

Results

In the study group, the median OS was 17 months (95% CI: 15.6-18.3). The median OS (26.1 vs. 15.7 mo.; p&lt;0.001), TTF (14.2 vs. 7.6 mo.; p&lt;0.001) and PSA 50% (87.5 vs. 56%; p&lt;0.001) were higher in ENZA than in ABI treatment. Multivariate analysis shows that ENZA treatment and PSA nadir &lt;17.35 ng/mL during or after DXL treatment were related to longer TTF. ENZA treatment, DXL dose ≥750 mg, PSA nadir &lt;17.35 ng/mL during or after DXL treatment was related to longer OS.

Conclusions

ENZA treatment may be related to more favorable oncological outcomes than ABI treatment in the studied Polish population of patients. A 50% decline in PSA is an indicator of longer TTF and OS. Due to the non-randomized and retrospective nature of the analysis, the current results require prospective validation.

Antagonist activation exercises elicit similar post-activation performance enhancement as agonist activities on throwing performance

BACKGROUND

This study aimed to determine the acute effect of agonist and antagonist conditioning activities (CA) on medicine ball throw performance among female softball players.

METHODS

Thirteen national-level female softball players (age 22.2 ± 3.1 years; body mass 68.3 ± 11.3 kg; softball experience 7.3 ± 2.4 years) performed 3 medicine ball chest throws before conditioning activity (CA) and after CA respectively in 3rd, 6th, and 9th minute. CA was the bench press and bent-over barbell row with 2 sets of 4 repetitions at 60% and 80% of one-repetition maximum, and 2 sets of 4 repetition bodyweight push up.

RESULTS

Two-way ANOVA revealed an increase in throwing distance (p < 0.001) after bent over barbell row and push-up exercise, and an increase in throwing speed (p < 0.001) after bench press and push-up. All performance increases were in moderate effect size (Cohen d 0.33-0.41), and no differences were found between the experimental CA.

CONCLUSIONS

We conclude that upper body throwing performance is similar after antagonist exercise and agonist CA, both agonist and antagonist CA increase muscle power. In the resistance training practice, we recommend the interchange of agonist and antagonist CA using bodyweight push-up or submaximal intensity (80% of 1RM) bench press and bent over barbell row to succeed post-activation performance enhancement in upper limbs.

Effects of Unilateral Conditioning Activity on Acute Performance Enhancement: A Systematic Review

This review aimed to summarize the reported effects of unilateral conditioning activity (CA) on unilateral performance, bilateral performance, and the contribution of activated body limb to bilateral performance. A systematic search on MEDLINE, SPORTDiscus, Scopus, and Google Scholar was conducted on February 2022. Twenty-three studies met the inclusion criteria. Throwing, jumping, swimming, change of direction, and isokinetic performance were used as outcome measures to assess the impact of unilateral CAs on inducing post-activation performance enhancement. Eleven studies examined the effectiveness of resistance exercises as a CA, seven investigated plyometric exercises, and five used isokinetic muscle actions as CAs. Notably, only three studies directly compared the effects of bilateral and unilateral CA, and no study reported possible changes in the contribution of each limb during bilateral exercises executed following unilateral CA. Split squats were the most often studied CA (7), and it was shown that multiple sets of high-loaded split squats (85% one-repetition maximum) executed as CA, improve vertical jumping and change of direction after 4 to 8 min of recovery. At the same time, multiple sets of alternate leg bounds performed with ~10% body weight or without any external load result in an improvement of sprint performance, 2 and 8 min later, with the effect being greater when loaded jumps are used. The unilateral CAs such as split squats, alternate leg bounds, and drop jumps can be effectively used to acutely improve a wide variety of athletic tasks, including jumping, sprinting, change of direction, and swimming performance.

Acute Effects of Percussive Massage Treatment on Drop Jump Performance and Achilles Tendon Stiffness

This study aimed to investigate the impact of Achilles tendon (AT) mechanical percussion massage (PM) on the passive stiffness of that tendon and subsequent drop jump kinematics. Eleven physically active participants performed two conditions in random order: (i) 60 s of PM applied to each AT (EXP) and (ii) no PM (CTRL). Measurements were performed 5 min before, immediately after, and 5 min following the completion of the PM. In the CTRL, measurements were performed at the same time point but no massage was applied. The two-way ANOVA indicated that there was no statistically significant interaction effect on contact time (p = 0.786), reactive strength index (p = 0.914), and relative peak power (p = 0.896). However, a statistically significant interaction on peak velocity (p = 0.046) and jump height (p = 0.03) was found. Despite that, there was no significant post-hoc comparisons for jump height, it slightly decreased 5 min post-PM (p = 0.136; ES = -0.25; Δ = -3.1%) compared with the CTRL condition (p = 1.00; ES = 0.11; Δ = +1.5%). Friedman's test did not show significant differences in dominant (p = 0.073) and non-dominant limb (p = 0.091) AT stiffness. Although not significant, numerically, the dominant limb AT (p = 0.126; ES = -0.64; Δ = -7.8%) had a larger reduction in stiffness immediately post-PM compared with the non-dominant limb (p = 0.294; ES = -0.26; Δ = -3.6%). The results of this study indicated the temporary effect of PM on the reduction in tissue stiffness. Moreover, these findings show that a mechanical PM might slightly hinder subsequent explosive athletic performance.

Acute effects of combined isometric and plyometric conditioning activities on sports performance and tendon stiffness in female volleyball players

This study aimed to compare the effects of bilateral and unilateral conditioning activities (CA; combined isometric and plyometric) on countermovement jump performance, modified t-agility test, Achilles tendon stiffness and skin surface temperature. Thirteen female semi-professional volleyball players performed two CAs in random order: 1) bilateral isometric half back squats followed by bilateral drop jumps (BI-CA); and 2) unilateral isometric half back squats followed by unilateral drop jumps (UNI-CA). To assess the effects of CAs, countermovement jump, modified t-agility test, Achilles tendon stiffness and skin surface temperature measurements were performed 5 min before and 6 min after the CA. Both CAs significantly increased thigh skin surface temperature from pre- to post-CA (BI-CA, p < 0.001; effect size [ES] = 1.41 and UNI-CA, p = 0.001; ES = 1.39) but none of them influenced modified t-agility test time (interaction: p = 0.338, main effect of time: p = 0.121 and condition: p = 0.819). The countermovement jump height and modified reactive strength index significantly increased from pre-to post-CA during the BI-CA condition (p = 0.003, ES = 0.45, and p = 0.008, ES = 0.48) but not for UNI-CA (p = 0.061, ES = 0.18 and p = 0.065, ES = 0.26). No significant impact has been found for countermovement depth (interaction: p = 0.054, main effect of time: 0.097, and condition: p = 0.41) as well as for contraction time (interaction: p = 0.536, main effect of time: p = 0.224, and condition: p = 0.807). Moreover, stronger and weaker limb CMJ relative peak force significantly decreased from pre-to post-CA (p = 0.014, ES = −0.31, and p = 0.027, ES = −0.26; respectively) during UNI-CA condition but not for BI-CA (p = 0.096, ES = 0.23, and p = 1.41, ES = 0.18). The stronger and weaker limb Achilles tendon stiffness significantly increased from pre-to post-CA during the UNI-CA condition (p = 0.013, ES = 0.60 and p < 0.001, ES = 0.79; respectively) but not for BI-CA (p = 0.66; ES = 0.15 and p = 0.265; ES = 0.42). Furthermore, the post-CA stronger limb Achilles tendon stiffness during the UNI-CA was significantly higher than that noted during the BI-CA (p = 0.006, ES = 0.7). The present study showed that combined isometric and plyometric bilateral CA effectively improved the countermovement jump but did not enhance the t-agility test performance. These findings indicate that exercise combinations could effectively produce a post-activation performance enhancement effect but should replicate the following explosive task as much as possible.

Hydrothermal carbonization of the wet fraction from mixed municipal solid waste: Hydrochar characteristics and energy balance

Mixed municipal solid waste (MSW) may be pre-treated in a mechanical-biological treatment (MBT) plant to produce an exiting stream with improved combustible characteristics. The process also produces a second waste stream, which is generally separated on a size basis by industrial sieving equipment. It contains fractions with a high moisture content such as residual food waste, soiled paper and cardboard, and small fragments of other materials. Samples of this stream, collected at an existing plant, were characterized and processed by hydrothermal carbonization (HTC) at laboratory scale, at various temperatures (180, 200 and 220 °C), reaction times (1, 4 and 8 h) and solid to water ratios (0.15 and 0.07). The primary energy balance, on a hypothetical industrial scale, was performed. In brief, the results confirmed that the produced hydrochar was a brittle, hydrophobic, solid carbonaceous product which gave a better combustion performance as the residence time of the HTC process was increased. Moreover, the dewaterability of the carbonized waste was greatly improved when compared to raw, wet samples. The results of the primary energy balance confirmed that the energy contained in the produced hydrochar was higher than the energy consumption for the process itself, under all the HTC working conditions. The energy consumed in the process was in the range of 40-70 % of the energy content of the produced hydrochar.

Resistance Training with Blood Flow Restriction and Ocular Health: A Brief Review

Despite the many health benefits of resistance training, it has been suggested that high-intensity resistance exercise is associated with acute increases in intraocular pressure which is a significant risk factor for the development of glaucomatous optic nerve damage. Therefore, resistance training using a variety of forms (e.g., resistance bands, free weights, weight machines, and bodyweight) may be harmful to patients with or at risk of glaucoma. An appropriate solution for such people may involve the combination of resistance training and blood flow restriction (BFR). During the last decade, the BFR (a.k.a. occlusion or KAATSU training) method has drawn great interest among health and sports professionals because of the possibility for individuals to improve various areas of fitness and performance at lower exercise intensities. In comparison to studies evaluating the efficiency of BFR in terms of physical performance and body composition changes, there is still a paucity of empirical studies concerning safety, especially regarding ocular health. Although the use of BFR during resistance training seems feasible for glaucoma patients or those at risk of glaucoma, some issues must be investigated and resolved. Therefore, this review provides an overview of the available scientific data describing the influence of resistance training combined with BFR on ocular physiology and points to further directions of research.

AB0937 Improvement in clinical disease activity and no deterioration in quality of life in psoriatic arthritis patients followed for 5 years in a Norwegian outpatient clinic

Background

Recent years of progress in conventional and biologic disease-modifying anti-rheumatic drugs development and improved treatment strategies (treat to target) have yield in improved outcome in psoriatic arthritis (PsA) patients. [1,2]. Still, despite modern treatment and clinical monitoring methods, we might miss dimensions of disease burden outside our main focus including quality of life (QoL), which are of high importance from patients’ perspective.

Objectives

Main objective of this study was to explore how clinical aspects of disease activity and QoL measures will change in PsA patients in an ordinary outpatient clinic in Norway, followed for 5 years, in the biological treatment era.

Methods

PsA patients fulfilling the CASPAR criteria visiting an outpatient clinic in Norway between January 2013 and February 2020 were consecutively included in the study. Data collection included variables for demographics, treatment, laboratory assessment of ESR and CRP, joint counts, disease activity score in psoriatic arthritis (DAPSA), global assessments – patient’s (PGA) and investigator’s (IGA), reported joint and global pain, patient reported outcomes (PROMs) regarding different aspects of quality of life (QoL), (MHAQ, RAID, QoL15D and reported fatigue level). Patients were analyzed at baseline and after 5-year follow-up period. Statistics included paired sample t test and McNemar test.

Results

Among 140 PsA patients included at baseline, 114 (81.4%) were re-examined after 5 years. Mean age at baseline was 52 years (95%CI 50.3-53.7) and percentage of women was 50.7%. Proportion of patients treated with biologics increased from 32.9% to 39.5%, but the difference wasn’t statistically significant. During the 5 year follow up period most clinical disease activity measures decreased and QoL was maintained (Table 1).

Table 1.

Demographic data, clinical activity measures and patient reported outcomes regarding quality of life in PsA patients followed for 5 years. Values are mean (95CI) or number (%).

Baseline (140)5-years follow up (114)pAge (years)52.0 (50.3, 53.7)56.3 (54.4, 58.3)Women71 (50.7%)56 (49.1%)Exercise >1h week62 (44.3%)59 (51.8%)0.28BMI (kg/m2)28.4 (27.5, 29.2)28.2 (27.3, 29.1)0.89Current smoker24 (17.1%)17 (14.9%)0.90Current bDMARD treatment46 (32.9%)45 (39.5%)0.65DAPSA18.6 (16.2, 21.0)12.8 (10.8, 14.8)<0.01TJC684.1 (3.2, 5.0)1.8 (1.3, 2.4)<0.01SJC660.7 (0.5, 0.9)0.3 (0.2, 0.4)<0.01ESR15.9 (13.9, 18.0)10.7 (7.8, 13.5)<0.01CRP4.9 (3.5, 6.3)5.3 (2.5, 8.2)0.41IGA (VAS 0-100)4.1 (3.2, 5.0)1.8 (1.3, 2.4)<0.01PGA (VAS 0-100)36.6 (32.5, 40.8)29.3 (25.0, 33.6)0.12Global pain (VAS 0-100)35.1 (31.2, 39.0)28.9 (24.4, 33.5)0.42Joint pain (VAS 0-100)33.8 (29.9, 37.8)27.5 (23.2, 31.9)0.31MHAQ (0-3)0.4 (0.4, 0.5)0.3 (0.3, 0.4)0.72RAID (0-10)3.5 (3.1, 3.9)3.2 (2.9, 3.6)0.41QoL15D (15-75)24.2 (23.1, 25.2)22.7 (21.6, 23.9)0.85Fatigue (VAS 0-100)47.8 (41.5, 54.2)39.1 (32.8, 45.4)0.16

Conclusion

In our cohort of PsA patients after 5 years follow up disease activity was reduced and QoL maintained. Our data adds to the evidence that the burden of disease in PsA patients has decreased in the biologic treatment era however is still significant. Further improvement in pharmacological and non-pharmacological treatments in PsA patients is still needed.

References

[1]Coates LC, Moverley AR, McParland L, et al. Effect of tight control of inflammation in early psoriatic arthritis (TICOPA): a UK multicentre, open-label, randomised controlled trial. Lancet. 2015;386(10012):2489-2498. doi:10.1016/S0140-6736(15)00347-5

[2]Coates LC, Helliwell PS. Treating to target in psoriatic arthritis: how to implement in clinical practice. Ann Rheum Dis. 2016;75(4):640-643. doi:10.1136/annrheumdis-2015-208617

Acknowledgements

Nurses and doctors from Division of Rheumatology at Sørlandet Hospital in Kristiansand, Norway contributed to data collection.

Disclosure of Interests

None declared

Cardiac Biomarkers and Geriatric Assessment in Metastatic Castrate-Resistant Prostate Cancer During Abiraterone Acetate Therapy – A Cardio-Oncology Study

Background

Abiraterone acetate (AA) is a drug used in advanced prostate cancer. However, known clinical factors with predictive and prognostic value are scarce. This study evaluated cardiovascular (CV) factors and geriatric scales as potential markers of superior response during AA therapy.

Methods

This is a prospective observational study. Serum levels of high sensitivity troponin T (hsTnT), D-dimer, NT-proBNP and left ventricle ejection fraction (LVEF) were used for CV evaluation. Questionnaires of G8, VES-13, Activities of Daily Living (ADL), Instrumental Activities of Daily Living (iADL), and Geriatric Depression Scale (GDS) were included in the geriatric screening assessment. All measures were taken before AA initiation. Survival curves and Cox proportional hazard models (univariate and multivariate) were used to determine the predictors for a longer time to treatment failure (TTF).

Results

Forty nine patients were included in the study. Overall median TTF was 7.9 months (95% CI: 5.9-12.4). In univariate analysis, factors associated with inferior TTF were ( P-value < .05): visceral metastases - HR 2.34; 95% CI: 1.24-4.45, history of coronary artery disease - HR 3.02; 95% CI: 1.19-7.66; LVEF < 50% - HR 2.53; 95% CI: 1.03-6.17; P = .041; age-adjusted D-dimer > upper reference limit (URL) - HR 3.53; 95% CI: 1.81-6.85; P < .001; hsTnT > URL - HR 2.17; 95% CI: 1.13-4.16; P = .016; NT-proBNP ≥ 300 pg/mL - HR 2.3; 95% CI: 1.22-4.34; P = .01; G8 score ≤14 points - HR 2.47; 95% CI: 1.29-4.74; P = .007. In multivariate analysis, age-adjusted D-dimer > URL, G8 score ≤ 14 points and visceral metastases remained statistically significant in prediction of inferior TTF. The number of these factors was associated with shorter median TTF: 0-1 factor – 14.1 months; 2 factors – 5.9 months; 3 factors – 2.7 months; P < .001, log-rank).

Conclusions

Age-adjusted D-dimer, and geriatric G8 scores may predict TTF in men with metastatic castration-resistant prostate cancer during AA therapy. These observations require further study in a larger population.

Range of motion of resistance exercise affects the number of performed repetitions but not a time under tension

The resistance training volume along with the exercise range of motion has a significant impact on the training outcomes. Therefore, this study aimed to examine differences in training volume assessed by a number of performed repetitions, time under tension, and load-displacement as well as peak barbell velocity between the cambered and standard barbell bench press training session. The participants performed 3 sets to muscular failure of bench press exercise with the cambered or standard barbell at 50% of one-repetition maximum (1RM). Eighteen healthy men volunteered for the study (age = 25 ± 2 years; body mass = 92.1 ± 9.9 kg; experience in resistance training 7.3 ± 2.1 years; standard and cambered barbell bench press 1RM > 120% body mass). The t-test indicated a significantly higher mean range of motion for the cambered barbell in comparison to the standard (p < 0.0001; ES =  -2.24). Moreover, there was a significantly greater number of performed repetitions during the standard barbell bench press than cambered barbell (p < 0.0001) in a whole training session, while no difference was found in total time under tension (p = 0.22) and total load-displacement (p = 0.913). The two-way repeated-measures ANOVA indicated a significant barbell × set interaction effect for peak velocity (p = 0.01) and a number of repetitions (p = 0.015). The post-hoc analysis showed a significantly higher number of repetitions for standard than cambered barbell bench press in set 1 (p < 0.0001), set 3 (p < 0.0001) but not in set 2 (p = 0.066). Moreover, there was a significantly higher peak velocity during the cambered than standard barbell bench press in set 1 (p < 0.0001), and set 2 (p = 0.049), but not in set 3 (p = 0.063). No significant differences between corresponding sets of the standard and cambered barbell bench press in time under tension and load-displacement were found. However, concentric time under tension was significantly higher during cambered barbell bench press in all sets (p < 0.05) when compared to the standard barbell bench press, while eccentric time under tension was significantly lower during the cambered than standard barbell bench presses only in the set 3 (p = 0.001). In summary, this study briefly showed that measuring training volume by the number of performed repetitions is not reliable when different exercise range of motion is used.

Fast Eccentric Movement Tempo Elicits Higher Physiological Responses than Medium Eccentric Tempo in Ice-Hockey Players

BACKGROUND

Resistance training is a significant part of ice-hockey players' conditioning, where optimal loading should ensure strength development and proper recovery. Therefore, this study aimed to compare the acute physiological responses to fast and medium movement tempo resistance exercises in ice-hockey players.

METHODS

Fourteen ice-hockey players (26.2 ± 4.2 years; 86.4 ± 10.2 kg; squat one repetition maximum (1RM) = 130.5 ± 18.5) performed five sets of the barbell squat and barbell bench press at 80% 1RM until failure in a crossover design one week apart using either 2/0/2/0 or 6/0/2/0 (eccentric/isometric/concentric/isometric) tempo of movement. The blood samples to evaluate the concentration of cortisol, testosterone, insulin-like growth factor 1 (IGF-1), and growth hormone (hGH) were taken before exercise, 3 min after the last set of the squat exercise, 3 min after the last set of the bench press exercise, and after 30 min of recovery.

RESULTS

The 2/0/2/0 tempo resulted in a higher number of repetitions (p < 0.001) and lower time under tension (p < 0.001) in the squat and bench press exercises compared to the 6/0/2/0 movement tempo. The endocrine responses to exercise were significantly higher during the 2/0/2/0 compared to the 6/0/2/0 movement tempo protocol for IGF-1, hGH, and cortisol (p < 0.01). There were no differences in testosterone responses between exercises performed with fast and medium movement tempos.

CONCLUSION

Fast eccentric tempo induced higher cortisol, IGF-1, and hGH responses compared to the medium tempo. Therefore, fast eccentric movement tempo seems to be more useful in eliciting training stimulus than medium eccentric tempo during resistance training in ice-hockey players. However, future studies are needed to confirm our findings.

OP0089 DO PAIN CATASTROPHIZING REDUCE THE LIKELIHOOD OF REMISSION IN PATIENTS WITH CHRONIC INFLAMMATORY JOINT DISORDERS?

Background:

Rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (ax-SpA) may have a devastating impact on patients’ lives, including chronic and relapsing pain. One factor contributing to bio-psycho-social model of pain in these diseases, is pain catastrophizing (PC) defined as tendency to report pain experience in exaggerated terms, to ruminate more or to feel helpless about it. In one RA study PC has been shown to be associated with patient reported outcomes e.g. reduced likelihood of remission using composite measures.[1]

Objectives:

Main objective of this study was to explore if pain catastrophizing score is associated with remission rates in the chronic inflammatory joint disorders RA, PsA and ax-SpA.

Methods:

Patients were recruited during routine assessment at an outpatient clinic in Norway. Variables collected included demographics, treatment, disease duration, global pain VAS, pain catastrophizing score (PCS), and disease activity scores: DAS28-CRP for RA, BASDAI for ax-SpA and DAPSA for PsA. Cut off definitions of remission was for DAS28 <2.6, for BASDAI <4.0 and for DAPSA ≤4.0. Two questions from Coping Strategies Questionnaire as recommended by Jensen et al [2] were used to describe PC, range PC total score (PCS) 0–6. Patients with PCS ≥ 4 were defined as high pain catastrophizers. Statistics included Chi-Square test and adjusted logistic regression (enter procedure).

Results:

For RA (N=580), PsA (N=394) and ax-SpA (N=225) mean age (SD) was 61.5 (13.1), 54.4 (12.9) and 47.5 (12.9) years, mean disease duration 12.6 (10.9), 10.2 (8.4) and 12.2 (10.7) years and percentage of women 66.7%, 47.0% and 38.4%. Mean (SD) DAS28-CRP in RA was 2.3 (1.0), BASDAI for ax-SpA 3.7 (2.3) and DAPSA for PsA 10.8 (8.5). Mean (SD) global pain (VAS 0-100mm) was for RA 32.0 (25.6), for PsA 35.5 (25.4) and for ax-SpA 39.4 (25.4) mm. Conventional synthetic DMARDs were used by 65.0% of RA patients, 54.8% by PsA and 9.8% in ax-SpA and for biologic DMARDs the corresponding numbers were 36.7%, 43.9%, 65.9%, respectively.

Percentage of patients in remission was significantly lower in high pain catastrophizers compared with low pain catastrophizers in RA (34.1% vs 70.3%, p<0.01) and ax-SpA patients (17.9% vs 64.5%, p<0.01) but not in PsA (10.3% vs 26.7%, p=0.06).

In analysis adjusting for age, gender, disease duration and global pain (Tab. 1), PC was independently associated with lower remission rate in RA (OR 0.79 (95% CI 0.63, 0.99), p=0.04) and in ax-SpA (OR 0.65 (95% CI 0.46, 0.93), p=0.02) but not in PsA (OR 0.83 (95% CI 0.55, 1.25), p=0.37)

Conclusion:

Our data indicates that high level of patient’s PC may reduce likelihood of achieving remission in RA and ax-SpA. Interestingly, this was not shown in PsA patients. Further studies are needed to reveal the importance of PC and its influence on composite disease activity measures used to define disease status e.g. remission.

Table 1.

Variables and their associations with remission rates in RA, PsA, ax-SpA in logistic regression analysis.

RA remissionPsA remissionax-SpA remissionOR (95%CI)pOR (95%CI)pOR (95%CI)pPCS0.79 (0.63, 0.99)0.040.83 (0.55, 1.25)0.370.65 (0.46, 0.93)0.02Age0.99 (0.97, 1.01)0.171.00 (0.96, 1.04)0.850.98 (0.94, 1.02)0.27Gender0.87 (0.52, 1.45)0.590.37 (0.15, 0.93)0.030.92 (0.40, 2.14)0.85Disease duration1.03 (1.00, 1.05)0.030.95 (0.90, 1.00)0.061.04 (0.99, 1.09)0.09Global pain (VAS)0.96 (0.95, 0.97)<0.010.85 (0.81, 0.89)<0.010.90 (0.88, 0.92)<0.01

References:

[1]Hammer HB et al Pain Catastrophizing, Subjective Outcomes, and Inflammatory Assessments Including Ultrasound: Results From a Longitudinal Study of Rheumatoid Arthritis Patients. Arthritis Care Res. 2018;70:703-12.

[2]Jensen MP, et al. One- and two-item measures of pain beliefs and coping strategies. Pain 2003;104:453-69.

Acknowledgements:

Nurses and doctors from Division of Rheumatology at Sørlandet Hospital in Kristiansand, Norway contributed to data collection.

Disclosure of Interests:

None declared

AB0219 EXPLORING LONG-TERM DRUG EFFECTIVENESS AND DRUG SURVIVAL FOR RITUXIMAB REFERENCE DRUG IN TREATMENT OF RHEUMATOID ARTHRITIS PATIENTS IN ORDINARY OUTPATIENT CLINIC

Background:

In randomized controlled trials (RCTs) rituximab (RTX) has been shown to effectively suppress inflammation and reduce structural joint damage in rheumatoid arthritis (RA) patients [1]. There is a lack of RA data on RTX effectiveness and drug survival when used in real life practice.

Objectives:

To explore long-term drug effectiveness and drug survival for RTX used to treat RA patients in ordinary clinical practice.

Methods:

The study population included RA patients treated between 2006 and 2020 with RTX at an outpatient clinic in Norway. Patients were monitored using recommended measures for disease activity and patient reported outcomes (PROs). Drug effectiveness was assessed with random intercept linear mixed models. Drug survival was described using Kaplan-Meier survival analysis. Baseline predictors of drug survival were assessed with multivariable Cox proportional hazard models.

Results:

In database a total of 246 RA patients (females 74.8%) were identified to have been treated with RTX. At baseline mean (SD) age was 59.1 (13.5) years, disease duration 13.0 (10.2) years, RF positive 88.8%, ACPA positive 92.1%. Majority of patients had first cycle RTX dosage of 2000 mg (82.9%). At baseline patients currently using conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) were 51.5% (methotrexate 39.4%), prednisolone 73.6% and a total of 17.1% were biologic DMARDs (bDMARDs) naïve. In table 1 mean (SE) values for disease activity and PROs are shown for baseline and subsequent years after baseline for 5 years follow up.

Table 1.

Changes in disease activity and PROs at baseline and subsequent 1-year periods

BaselineN=2461 yearN=2462 yearN=2043 yearN=1634 yearN=1305 yearN=111CRP (mg/L)23.1 (2.1)21.3 (1.6)11.7 (0.9)8.6 (1.4)6.2 (0.7)6.7 (0.9)ESR (mm/hr)32.1 (1.4)31.1 (1.3)22.3 (1.1)17.6 (1.2)14.3 (1.0)13.6 (1.2)SJC28 (0-28)6.3 (0.4)5.4 (0.3)3.2 (0.3)2.2 (0.2)1.6 (0.2)1.5 (0.2)TJC28 (0-28)7.1 (0.4)6.6 (0.3)3.6 (0.3)2.6 (0.3)2.2 (0.3)1.8 (0.3)DAS284.9 (0.1)4.7 (0.1)3.6 (0.1)3.1 (0.1)2.8 (0.1)2.7 (0.1)CDAI22.9 (0.9)20.7 (0.7)12.3 (0.7)9.4 (0.7)8.5 (0.6)7.7 (0.7)PGA (0-100mm)57.2 (1.7)53.7 (1.4)38.1 (1.6)33.7 (1.9)35.0 (2.1)32.8 (2.2)MHAQ (0-3)1.0 (0.0)0.9 (0.0)0.7 (0.0)0.6 (0.0)0.5 (0.0)0.5 (0.0)

During follow up all disease activity and PRO measures improved significantly (p <0.001). Least improvement was seen in first year and a more substantial improvement progressed since second year. Percentage of patients with no, moderate and good treatment response defined according to EULAR response criteria [2] is shown in figure 1.

Figure 1.

No, moderate and good response to RTX treatment

No significant difference during the 5-year follow-up was found regarding previous use of bDMARD or not and for concomitant use of csDMARDs or not for variables listed in the table 1.

Drug survival for the RTX was 83% (95CI 77-87%) after 1 year, 66% (95CI 60-72%) after 2 years, 53% (95CI 46-59%) after 3 years, 46% (95CI 39-52%) after 4 years and 34% (95CI 28-40%) after 5 years of follow up.

No significant difference in drug survival was found between bDMARD naïve and previous users of bDMARDs or between concomitant and non-concomitant users of csDMARDs. RF positive patients had a better drug survival.

In prediction analysis RF positive status, high baseline DAS28, low baseline CRP, previous bDMARDs use, short disease duration and low MHAQ were found to be independently associated with better drug survival.

Conclusion:

Our real life data shows that RTX treated RA patients had a satisfactory treatment response and drug survival declines rather linearly over time. However, a significant treatment response was achieved primary in the second year indicating that at least 2 twin infusions should be given before identifying treatment failure.

References:

[1]Mok CC. Rituximab for the treatment of rheumatoid arthritis: An update. Drug Des Devel Ther 2013;8:87-100.

[2]Fransen J, van Riel PL. The Disease Activity Score and the EULAR response criteria. Rheum Dis Clin North Am. 2009;35:745-viii.

Acknowledgements:

Nurses and doctors from Division of Rheumatology at Sørlandet Hospital in Kristiansand, Norway contributed to data collection.

Disclosure of Interests:

None declared

Angiotensin System Inhibitors May Improve Outcomes of Patients With Castration-Resistant Prostate Cancer During Abiraterone Acetate Treatment-A Cardio-Oncology Study

Background

Abiraterone acetate (ABI) therapy improves overall survival in metastatic prostate cancer (PC) patients; however, this effect may be diminished by concurrent comorbidities. We aimed to evaluate the influence of pre-existing chronic diseases and concomitant medications on the course of ABI treatment among post-chemotherapy patients with metastatic castration-resistant prostate cancer patients (mCRPC).

Methods

From the Polish National Health Fund database, we identified 93 post-chemotherapy, mCRPC patients, who were qualified for ABI treatment in our oncology center between 2014 and 2018. Survival curves and Cox proportional hazard models (univariate and multivariate) were used to determine the predictors for longer time to treatment failure (TTF) of ABI therapy.

Results

Median TTF was 9,8 months (IQR: 0,6–56,5) Factors associated with longer TTF were: well controlled hypertension (HR, 0.59; 95% CI. 0.38–0.90; p = 0.02), stable coronary artery disease (HR, 0.56; 95% CI, 0.33–0.95; p=0.03), the use of angiotensin system inhibitor (ASi) (HR, 0.61; 95% CI 0.4–0.94; p = 0,02). Patients who were receiving ASi had median TTF of 12.2 months versus 5.8 months in men who did not receive ASi before ABI initiation. At the start of ABI therapy, the aforementioned groups did not differ in terms of well-known prognostic factors: Gleason score, PSA level, or the number of patients with visceral metastases. In a multivariate analysis, the use of ASi remained statistically significant, even after adjustment for well-known oncological factors (HR, 0.57; 95% CI, 0.34–0.98; p = 0.04).

Conclusions

The use of ASi may enhance and prolong ABI therapy in post-docetaxel mCRPC patients and may potentially be considered a new, non-oncological, predictive factor for longer TTF. This association requires a prospective validation.

The Effects of High Mineral Alkaline Water Consumed Over Three Consecutive Days on Reaction Time Following Anaerobic Exercise - A Randomized Placebo-Controlled Crossover Pilot Study

Drinking alkaline water after intense anaerobic exercise may enhance both cognitive and physical performance. This study aimed to investigate the effect of high mineral alkaline water consumed over three consecutive days on reaction time after anaerobic exercise in twelve healthy young males (aged 21.1 ± 1.3 years) with a valid sports medical examination. Participants were excluded when they took any medications or performance-enhancing supplements for the period of at least four weeks before the study commenced. Participants were randomly divided into two groups in this double-blind, placebo-controlled crossover pilot study. They ingested either alkaline water (AW) or regular table water ( RTW) for three consecutive days before anaerobic exercise. The anaerobic exercise consisted of two 2-min high-intensity step-tests with a passive rest interval of 3 minutes between the two bouts of exercise. Performance in the step-test (W), reaction time for visual and auditory signals, the rate of perceived exertion (RPE), urine specific gravity, and lactate concentration were analysed. No effect of AW was found on reaction time and the other variables except anaerobic performance. An-aerobic performance was significantly higher after ingestion of AW in both step-tests (p < 0.05). The ingestion of AW for three consecutive days before anaerobic exercise seems to positively affect anaerobic performance.

Cardiovascular Complications of Prostate Cancer Treatment

Treatment of prostate cancer (PC) is a rapidly evolving field of pharmacology research. In recent years, numerous novel therapeutics that improve survival and ameliorate disease control have been approved. Currently, the systemic treatment for prostate neoplasm consists of hormonal therapy, chemotherapy, immunotherapy, radiopharmaceuticals, targeted therapy, and supportive agents (e.g., related to bone health). Unfortunately, many of them carry a risk of cardiovascular complications, which occasionally pose a higher mortality threat than cancer itself. This article provides a unique and comprehensive overview of the prevalence and possible mechanisms of cardiovascular toxicities of all PC therapies, including state-of-the-art antineoplastic agents. Additionally, this article summarizes available recommendations regarding screening and prevention of the most common cardiac complications among patients with advanced cancer disease.

In Vitro Investigations of Acetohexamide Binding to Glycated Serum Albumin in the Presence of Fatty Acid

The interaction of drugs with human serum albumin (HSA) is an important element of therapy. Albumin affects the distribution of the drug substance in the body, as well as its pharmacokinetic and pharmacodynamic properties. On the one hand, inflammation and protein glycation, directly associated with many pathological conditions and old age, can cause structural and functional modification of HSA, causing binding disorders. On the other hand, the widespread availability of various dietary supplements that affect the content of fatty acids in the body means that knowledge of the binding activity of transporting proteins, especially in people with chronic diseases, e.g., diabetes, will achieve satisfactory results of the selected therapy. Therefore, the aim of the present study was to evaluate the effect of a mixture of fatty acids (FA) with different saturated and unsaturated acids on the affinity of acetohexamide (AH), a drug with hypoglycaemic activity for glycated albumin, simulating the state of diabetes in the body. Based on fluorescence studies, we can conclude that the presence of both saturated and unsaturated FA disturbs the binding of AH to glycated albumin. Acetohexamide binds more strongly to defatted albumin than to albumin in the presence of fatty acids. The competitive binding of AH and FA to albumin may influence the concentration of free drug fraction and thus its therapeutic effect.

Determinants of Survival After Emergency Intrapericardial Cisplatin Treatment in Cancer Patients with Recurrent Hemodynamic Instability After Pericardiocentesis

BACKGROUND

Pericardial effusion is associated with high mortality in oncology. The etiology of infectious pericarditis and iatrogenic effects of previous radio-/chemotherapy may be always suspected, especially when a subsequent episode is observed.

PATIENTS AND METHODS

The study included 17 hemodynamically-unstable patients with cancer due to recurrent pericardial bloody effusion after previous pericardiocentesis and analyzed survival determinants after intrapericardial chemotherapy with cisplatin.

RESULTS

The mortality rate was not significantly associated with the level of N-terminal pro-B type natriuretic peptide, low hemoglobin (<12 g/dl), elevated white blood cell account (>10⁴/μl), large volume (>1500 ml) and long duration (>8 days) of pericardial drainage, cardiac arrhythmias, positive culture test results nor fever occurring during cisplatin administration. Subsequent systemic anticancer therapy was the strongest factor determining a longer survival (hazard ratio(HR)=0.31, 95% confidence interval(CI)=0.11-0.9; p=0.03).

CONCLUSION

Efficacy of rescue intrapericardial chemotherapy with cisplatin is independent of parameters of hemodynamic instability and levels of inflammatory markers in recurrent pericardial effusion.

Nadciśnienie Płucne w Przebiegu Sarkoidozy Leczone Sildenafilem

Rozwój nadciśnienia płucnego w przebiegu sarkoidozy (SAPH) istotnie pogarsza rokowanie. Niestety, nie ma metody leczenia o udokumentowanym korzystnym działaniu w tej postaci nadciśnienia płucnego. Duże zainteresowanie w tym zakresie budzą leki stosowane w terapii tętniczego nadciśnienia płucnego (PAH). W prezentowanej pracy przedstawiono opis przypadku chorej na sarkoidozę powikłaną ciężkim nadciśnieniem płucnym, która była leczona sildenafilem. Obserwowano istotną, choć zaledwie przejściową poprawę stanu czynnościowego. Pacjentka zmarła z powodu stopniowo postępującej niewydolności krążenia i oddychania, w trakcie oczekiwania na przeszczepienie płuc.

Neuromuscular Control During the Bench Press Movement in an Elite Disabled and Able-Bodied Athlete

The disabled population varies significantly in regard to physical fitness, what is conditioned by the damage to the locomotor system. Recently there has been an increased emphasis on the role of competitive sport in enhancing health and the quality of life of individuals with disability. One of the sport disciplines of Paralympics is the flat bench press. The bench press is one of the most popular resistance exercises used for the upper body in healthy individuals. It is used not only by powerlifters, but also by athletes in most strength-speed oriented sport disciplines. The objective of the study was to compare neuromuscular control for various external loads (from 60 to 100% 1RM) during the flat bench press performed by an elite able-bodied athlete and an athlete with lower limb disability. The research project is a case study of two elite bench press athletes with similar sport results: an able-bodied athlete (M.W., age 34 years, body mass 103 kg, body height 1.72 m, 1RM in the flat bench press 200 kg) and a disabled athlete (M.T., age 31 years, body mass 92 kg, body height 1.70 m, 1RM in the flat bench press 190 kg). The activity was recorded for four muscles: pectoralis major (PM), anterior deltoid (AD), as well as for the lateral and long heads of the triceps brachii (TBlat and TBlong). The T-test revealed statistically significant differences between peak activity of all the considered muscles (AD with p = 0.001; PM with p = 0.001; TBlat with p = 0.0021 and TBlong with p = 0.002) between the 2 athletes. The analysis of peak activity differences of M.W and M.T. in relation to the load revealed statistically significant differences for load changes between: 60 to 100% 1RM (p = 0.007), 70 to 100% 1RM (p = 0.016) and 80 to 100% 1RM (p = 0.032). The flat bench press performed without legs resting firmly on the ground leads to the increased engagement of upper body muscles and to their greater activation. Isolated initial positions can be used to generate greater engagement of muscle groups during the bench press exercise and evoke their higher activation.

Sarcoidosis-associated pulmonary hypertension treated with sildenafil - a case report

Development of sarcoidosis-associated pulmonary hypertension (SAPH) significantly worsens prognosis in sarcoidosis patients. Unfortunately, there is no treatment of proven benefit for this condition. Medications used for treatment of pulmonary arterial hypertension are of great interest in this respect. Here, we report a case of a patient with severe SAPH treated with sildenafil. A significant, but only temporary improvement in functional status was observed, and the patient died of gradually progressing heart and respiratory failure while awaiting for lung transplantation.

A systematic review of surface electromyography analyses of the bench press movement task

BACKGROUND

The bench press exercise (BP) plays an important role in recreational and professional training, in which muscle activity is an important multifactorial phenomenon. The objective of this paper is to systematically review electromyography (EMG) studies performed on the barbell BP exercise to answer the following research questions: Which muscles show the greatest activity during the flat BP? Which changes in muscle activity are related to specific conditions under which the BP movement is performed?

STRATEGY

PubMed, Scopus, Web of Science and Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library were searched through June 10, 2016. A combination of the following search terms was used: bench press, chest press, board press, test, measure, assessment, dynamometer, kinematics and biomechanics. Only original, full-text articles were considered.

RESULTS

The search process resulted in 14 relevant studies that were included in the discussion. The triceps brachii (TB) and pectoralis major (PM) muscles were found to have similar activity during the BP, which was significantly higher than the activity of the anterior deltoid. During the BP movement, muscle activity changes with exercise intensity, velocity of movement, fatigue, mental focus, movement phase and stability conditions, such as bar vibration or unstable surfaces. Under these circumstances, TB is the most common object of activity change.

CONCLUSIONS

PM and TB EMG activity is more dominant and shows greater EMG amplitude than anterior deltoid during the BP. There are six factors that can influence muscle activity during the BP; however, the most important factor is exercise intensity, which interacts with all other factors. The research on muscle activity in the BP has several unresolved areas, such as clearly and strongly defined guidelines to perform EMG measurements (e.g., how to elaborate with surface EMG limits) or guidelines for the use of exact muscle models.

Tritium dynamics in soils and plants grown under three irrigation regimes at a tritium processing facility in Canada

The dynamics of tritium released from nuclear facilities as tritiated water (HTO) have been studied extensively with results incorporated into regulatory assessment models. These models typically estimate organically bound tritium (OBT) for calculating public dose as OBT itself is rarely measured. Higher than expected OBT/HTO ratios in plants and soils are an emerging issue that is not well understood. To support the improvement of models, an experimental garden was set up in 2012 at a tritium processing facility in Pembroke, Ontario to characterize the circumstances under which high OBT/HTO ratios may arise. Soils and plants were sampled weekly to coincide with detailed air and stack monitoring. The design included a plot of native grass/soil, contrasted with sod and vegetables grown in barrels with commercial topsoil under natural rain and either low or high tritium irrigation water. Air monitoring indicated that the plume was present infrequently at concentrations of up to about 100 Bq/m(3) (the garden was not in a major wind sector). Mean air concentrations during the day on workdays (HTO 10.3 Bq/m(3), HT 5.8 Bq/m(3)) were higher than at other times (0.7-2.6 Bq/m(3)). Mean Tissue Free Water Tritium (TFWT) in plants and soils and OBT/HTO ratios were only very weakly or not at all correlated with releases on a weekly basis. TFWT was equal in soils and plants and in above and below ground parts of vegetables. OBT/HTO ratios in above ground parts of vegetables were above one when the main source of tritium was from high tritium irrigation water (1.5-1.8). Ratios were below one in below ground parts of vegetables when irrigated with high tritium water (0.4-0.6) and above one in vegetables rain-fed or irrigated with low tritium water (1.3-2.8). In contrast, OBT/HTO ratios were very high (9.0-13.5) when the source of tritium was mainly from the atmosphere. TFWT varied considerably through time as a result of SRBT's operations; OBT/HTO ratios showed no clear temporal pattern in above or below ground plant parts. Native soil after ∼20 years of operations at SRBT had high initial OBT that persisted through the growing season; little OBT formed in garden plot soil during experiments. High OBT in native soil appeared to be a signature of higher past releases at SRBT. This phenomenon was confirmed in soils obtained at another processing facility in Canada with a similar history. The insights into variation in OBT/HTO ratios found here are of regulatory interest and should be incorporated in assessment models to aid in the design of relevant environmental monitoring programs for OBT.

Modelling analysis and prediction of women javelin throw results in the years 1946 - 2013

The main goals of our study of the women’s javelin throw were twofold:. first, to analyse the dynamics of female javelin throw results variability as a function of time (time period 1946-2014), second, to create a predictive model of the results during the upcoming 4 years. The study material consisted of databases covering the female track and field events obtained from the International Association of Athletics Federations. Prior to predicting the magnitude of results change dynamics in the time to follow, the adjustment of trend function to empirical data was tested using the coefficients of convergence. Phase II of the investigation consisted of the construction of predictive models. The greatest decreases in result indexes were noted in 2000 (9.4%), 2005-2006 (8.7%) and 2009 (7.4%). The trend increase was only noted in the years 2006-2008. In general, until 1998 the mean result improved by 54.6% (100% - results of 1946) whereas from 1999 through 2011 the result only increased by 1.3%. Based on data and results variability analysis it might be presumed that, in the nearest future (2015-2018), results variability will increase by approximately 9.7%. Percent improvement of javelin throw distance calculated on the basis of the 1999 raw input data is 1.4% (end of 2014).

Levels of tritium in soils and vegetation near Canadian nuclear facilities releasing tritium to the atmosphere: implications for environmental models

Concentrations of organically bound tritium (OBT) and tritiated water (HTO) were measured over two growing seasons in vegetation and soil samples obtained in the vicinity of four nuclear facilities and two background locations in Canada. At the background locations, with few exceptions, OBT concentrations were higher than HTO concentrations: OBT/HTO ratios in vegetation varied between 0.3 and 20 and values in soil varied between 2.7 and 15. In the vicinity of the four nuclear facilities OBT/HTO ratios in vegetation and soils deviated from the expected mean value of 0.7, which is used as a default value in environmental transfer models. Ratios of the OBT activity concentration in plants ([OBT]plant) to the OBT activity concentration in soils ([OBT]soil) appear to be a good indicator of the long-term behaviour of tritium in soil and vegetation. In general, OBT activity concentrations in soils were nearly equal to OBT activity concentrations in plants in the vicinity of the two nuclear power plants. [OBT]plant/[OBT]soil ratios considerably below unity observed at one nuclear processing facility represents historically higher levels of tritium in the environment. The results of our study reflect the dynamic nature of HTO retention and OBT formation in vegetation and soil during the growing season. Our data support the mounting evidence suggesting that some parameters used in environmental transfer models approved for regulatory assessments should be revisited to better account for the behavior of HTO and OBT in the environment and to ensure that modelled estimates (e.g., plant OBT) are appropriately conservative.

Mesenchymal stem cell therapy promotes corneal allograft survival in rats by local and systemic immunomodulation

Mesenchymal stem cells (MSCs) are being investigated extensively due to their ability to dampen immune responses. Here, we tested the ability of MSCs from three distinct sources to prolong rat corneal allograft survival. A fully allogeneic rat cornea transplant model (DA to LEW) was used. Recipient rats received 1 × 10(6) MSCs (syn [LEW], allo [DA] or third-party [Wistar Furth]) intravenously 7 days before transplantation and again on the day of transplantation (day 0). A high percentage of untreated and syn-MSC treated allografts were rejected (80% and 100%, respectively). Preactivation of syn-MSCs with interferon gamma also failed to prolong allograft survival. Conversely, corneal allograft survival was significantly prolonged in allo-MSC treated (90%) and third-party MSC treated (80%) allograft recipients. Flow cytometric analysis revealed less infiltrating natural killer T cells in corneas of both allo- and third-party MSC treated animals, coupled with a higher proportion of splenic CD4+Foxp3+ regulatory T cells, compared to controls. In the case of allo- and third-party MSCs, results from a delayed-type hypersensitivity assay clearly showed that hypo-responsiveness was specific for corneal donor-associated allo-antigens. Thus, allo- and third-party MSC treatment prolongs corneal allograft survival by suppressing peripheral immune responses and promoting an intragraft immunoregulatory milieu.

Über die Wirkung polycyclischer, aromatischer Kohlenwasserstoffe auf isolierte Mitochondrien der Mäuseleber

In wäßrig gepufferten Mitochondrien-Suspensionen konnte ein selektives Lösungsvermögen für carcinogene Kohlenwasserstoffe mit Hilfe fluoreszenz-spektroskopischer Messungen festgestellt werden. Gleichzeitig wird eine starke Verminderung der Atmung der Mitochondrien durch die Einwirkung der gelösten, polycyclischen Aromaten beobachtet. Nicht carcinogene Kohlenwasserstoffe werden weder gelöst, noch zeigen sie einen Einfluß auf die Atmung. Sehr schwer lösliche Carcinogene und schwächer wirksame Kohlenwasserstoffe werden in den angewandten Versuchszeiten weder gelöst, noch vermindern sie die Geschwindigkeit des Sauerstoffverbrauchs.

Mitochondrien älterer, oder mit Vitamin B2-Mangel behafteter Tiere zeigen erhöhte Depression der Atmung bei Zugabe von DMBA bzw. 3.4-Benzpyren.

Es wird versucht, diese Effekte einer reinen Promotor-Aktivität der polycyclischen, aromatischen Kohlenwasserstoffe zuzuschreiben, die an den Strukturelementen der Zellatmung (Mitochondrien) einsetzt.

Effects of growth hormone and testosterone therapy on aerobic and anaerobic fitness, body composition and lipoprotein profile in middle-aged men

INTRODUCTION

Andropause and aging are associated with neuroendocrine dysfunctions. Growth hormone and testosterone play a significant role in several processes affecting adaptation and thereby also everyday functioning. The aim of this research project was to evaluate the effects of recombinant human growth hormone and testosterone enanthate injections on body mass and body composition, aerobic and anaerobic fitness and lipid profile in middle-aged men.

MATERIALS AND METHOD

The research group was comprised of 14 men aged 45 - 60 years. Two series of laboratory analyses were performed. Independent tests were carried out at baseline and after 12 weeks of the experiment. The data were analyzed using Statistica 9.1 software.

RESULTS

A two-way repeated measures ANOVA revealed a statistically significant effect of the intervention programme on fat-free mass (η(2)=0.34), total body fat (η(2)=0.79), total cholesterol (η(2)=0.30), high-density lipoprotein cholesterol (η(2)=0.31), low-density lipoprotein cholesterol (η(2)=0.42), triglyceride (η(2)=0.28), testosterone (η(2)=0.52), insulin-like growth factor 1 (η(2)=0.47) and growth hormone (η(2)=0.63). Furthermore, ANOVA revealed a statistically significant effect of the rhGH and T treatment on maximal oxygen uptake (η(2)=0.63), anaerobic threshold (η(2)=0.61) and maximal work rate (η(2)=0.53).

CONCLUSION

It should be emphasized that the lipid profile was affected not only by rhGH+T replacement therapy, but also by the prescribed physical activity programme. The strength and endurance fitness programme alone did not cause significant changes in body mass and composition, nor the anaerobic and aerobic capacity. On the other hand, the rhGH=T treatment stimulated these changes significantly.

Fungal Planet description sheets: 154-213

Novel species of microfungi described in the present study include the following from South Africa: Camarosporium aloes, Phaeococcomyces aloes and Phoma aloes from Aloe, C. psoraleae, Diaporthe psoraleae and D. psoraleae-pinnatae from Psoralea, Colletotrichum euphorbiae from Euphorbia, Coniothyrium prosopidis and Peyronellaea prosopidis from Prosopis, Diaporthe cassines from Cassine, D. diospyricola from Diospyros, Diaporthe maytenicola from Maytenus, Harknessia proteae from Protea, Neofusicoccum ursorum and N. cryptoaustrale from Eucalyptus, Ochrocladosporium adansoniae from Adansonia, Pilidium pseudoconcavum from Greyia radlkoferi, Stagonospora pseudopaludosa from Phragmites and Toxicocladosporium ficiniae from Ficinia. Several species were also described from Thailand, namely: Chaetopsina pini and C. pinicola from Pinus spp., Myrmecridium thailandicum from reed litter, Passalora pseudotithoniae from Tithonia, Pallidocercospora ventilago from Ventilago, Pyricularia bothriochloae from Bothriochloa and Sphaerulina rhododendricola from Rhododendron. Novelties from Spain include Cladophialophora multiseptata, Knufia tsunedae and Pleuroascus rectipilus from soil and Cyphellophora catalaunica from river sediments. Species from the USA include Bipolaris drechsleri from Microstegium, Calonectria blephiliae from Blephilia, Kellermania macrospora (epitype) and K. pseudoyuccigena from Yucca. Three new species are described from Mexico, namely Neophaeosphaeria agaves and K. agaves from Agave and Phytophthora ipomoeae from Ipomoea. Other African species include Calonectria mossambicensis from Eucalyptus (Mozambique), Harzia cameroonensis from an unknown creeper (Cameroon), Mastigosporella anisophylleae from Anisophyllea (Zambia) and Teratosphaeria terminaliae from Terminalia (Zimbabwe). Species from Europe include Auxarthron longisporum from forest soil (Portugal), Discosia pseudoartocreas from Tilia (Austria), Paraconiothyrium polonense and P. lycopodinum from Lycopodium (Poland) and Stachybotrys oleronensis from Iris (France). Two species of Chrysosporium are described from Antarctica, namely C. magnasporum and C. oceanitesii. Finally, Licea xanthospora is described from Australia, Hypochnicium huinayensis from Chile and Custingophora blanchettei from Uruguay. Novel genera of Ascomycetes include Neomycosphaerella from Pseudopentameris macrantha (South Africa), and Paramycosphaerella from Brachystegia sp. (Zimbabwe). Novel hyphomycete genera include Pseudocatenomycopsis from Rothmannia (Zambia), Neopseudocercospora from Terminalia (Zambia) and Neodeightoniella from Phragmites (South Africa), while Dimorphiopsis from Brachystegia (Zambia) represents a novel coelomycetous genus. Furthermore, Alanphillipsia is introduced as a new genus in the Botryosphaeriaceae with four species, A. aloes, A. aloeigena and A. aloetica from Aloe spp. and A. euphorbiae from Euphorbia sp. (South Africa). A new combination is also proposed for Brachysporium torulosum (Deightoniella black tip of banana) as Corynespora torulosa. Morphological and culture characteristics along with ITS DNA barcodes are provided for all taxa.

Role of lentivirus-mediated overexpression of programmed death-ligand 1 on corneal allograft survival

To investigate the role of lentivirus-mediated overexpression of programmed death-ligand 1 (PD-L1) on rat corneal allograft survival. A fully allogeneic rat cornea transplant model was used for in vivo studies. Lentiviral (LV) vectors are efficient tools for ex vivo genetic modification of cultured corneas. LV vector encoding for PD-L1 (LV.PD-L1) and LV vector encoding for eGFP (LV.eGFP, as control) were constructed and tested. PD-L1 or eGFP expression was increased on corneal cells upon LV.PD-L1 and LV.eGFP transduction, respectively. Both allogeneic controls and allogeneic LV.eGFP transduced corneas were uniformly rejected (MST: 13.8 ± 1.7 days and 12.3 ± 1.9 days, respectively). In contrast, allogeneic LV.PD-L1 transduced corneas showed a high percentage (83%) of graft survival (MST > 30 days, n = 5, 15 days, n = 1). Graft opacity of PD-L1 transduced corneas was present but was significantly reduced compared to control or eGFP expressing corneas. Flow cytometric analysis revealed that percentages of CD3(+) CD8(+) CD161(+) and CD3(+) CD8(+) CD161(-) lymphocytes were decreased in animals receiving LV.PD-L1 transduced corneas compared to animals grafted with LV.eGFP transduced corneas. Moreover, reduced expression of proinflammatory cytokines (IFN-γ and IL-6) in PD-L1 transduced corneas compared to allogeneic controls was also observed. Local PD-L1 gene transfer in cultured corneas is a promising approach for the prolongation of corneal allograft survival and attenuation of graft rejection.