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PURPOSE: To investigate the effects of prehabilitation on the perioperative functional capacity of patients awaiting oncological resections. METHODS: A systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist and within the databases Cochrane Library, EBSCOhost, Google Scholar, MEDLINE PubMed, and Web of Science. The eligibility criteria were set to include peer-reviewed randomised control trials including only adult (≥ 18 years old) patients undergoing any type of prehabilitation (PREHAB) prior to any type of oncological resection. The studies had to feature at least one control group undergoing standard care (SC) and had to assess functional capacity by means of a 6-min walk distance (6MWD) or peak oxygen uptake (VO2Peak) at different stages pre- and post- operatively. RESULTS: Twenty-seven randomised controlled trials involving 1994 patients were included. After processing the data, the number of patients was 1889. Studies featured different cancer specialties: lung (11), colorectal (5), urological (4), abdominal (3), esophagogastric (2), liver (1), and gastrointestinal (1). Overall, PREHAB enhanced both 6MWD (g = 0.273, 95% CI 0.174 to 0.371, Z = 5.406, p < 0.001) and VO2Peak (g = 0.615, 95% CI 0.243 to 0.987, Z = 3.240, p = 0.001) compared with SC. The 6MWD subgroup analysis revealed a small mean effect size favouring both unimodal and multimodal PREHAB interventions. CONCLUSION: These findings support that prehabilitation, whether implemented as unimodal or multimodal format, elicits small preoperative improvements in functional capacity in patients awaiting oncological resections. PROSPERO registration number CRD42023428676.

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The COVID-19 pandemic forced changes in the educational response, which involved the intensive use of Information and Communication Technology (ICT) skills, among other interventions. The circumstances required both families and teachers to make an extra effort to adapt to a reality that was expected to last for a long time. These changes had a special impact on students with Specific Needs of Educational Support (SNES) and Special Educational Needs (SEN). This study aimed to design and validate a questionnaire to assess the impact of the online training model used during the pandemic on teachers of students with SNES and SEN. We used qualitative, exploratory, and confirmatory factor analyses. The final 16-item scale was composed of three factors. Factor1, was labeled as "Educational Response.", factor2 was labeled "ICT Usage and Online Teaching," and Factor 3 was labeled "Impact." The questionnaire demonstrated good validity and reliability. This short questionnaire is recommended for assessing or monitoring the impact of changes in educational interventions involving ICT competencies due to COVID-19. However, they can also be easily adapted to similar circumstances or educational settings.

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Antecedentes y objetivo Desde el inicio de la pandemia de la COVID-19 la población mayor ha presentado las tasas más elevadas de complicaciones y mortalidad. El objetivo de este estudio fue determinar la influencia de distintos factores de riesgo sobre los fallecimientos por la variante ómicron en Canarias. Materiales y método Estudio observacional retrospectivo de 16.998 casos de COVID-19 en mayores de 40 años confirmados en Canarias entre el 1 agosto de 2022 y el 31 enero de 2023. Se extrajeron datos sociodemográficos (edad y sexo), clínicos (fallecimiento, vacunación, ingreso hospitalario, enfermedades previas y tratamientos). Resultados Entre los fallecidos hubo mayor proporción de varones, con edad superior a los 70 años, diabetes, enfermedad cardiovascular, renal, respiratoria y sistémica, y de residentes en centros sociosanitarios. También se encontraron diferencias significativas en cuanto al número de dosis de la vacuna. En el modelo de regresión múltiple encontramos: varón (OR [IC 95%]=1,92 [1,42-2,58]), edad (70-79 años, 9,11 [4,27-19,43]; 80-89 años 21,72 [10,40-45,36]; 90-99 años 66,24 [31,03-141,38]; 100 años o más 69,22[12,97-369,33]) y no vacunados (6,96 [4,01-12,08]) o cuya última dosis fue administrada al menos 12 meses antes del diagnóstico (2,38 [1,48-3,81]) mostraron una asociación significativa con la mortalidad. Conclusiones Existen múltiples posibles factores que pueden incrementar el riesgo de mortalidad por la COVID-19 en población mayor. En nuestro estudio se ha encontrado que solo 3 predictores pueden explicar prácticamente la misma variabilidad: una edad más avanzada, el sexo varón y no estar vacunado o que la última fecha de vacunación fuese anterior a un año (AU)

Background and aims Since the beginning of the COVID-19 pandemic, the elderly population has had the highest rates of complications and mortality. This study aimed to determine the influence of different risk factors on deaths due to the Omicron variant in the Canary Islands. Materials and methods A retrospective observational study of 16,998 cases of COVID-19 over 40 years of age was conducted in the Canary Islands between August 1, 2022, and January 31, 2023. We extracted sociodemographic data (age and sex) and clinical data (death, vaccination history, hospital admission, previous diseases, and treatments). Results Among the deaths, there was a higher proportion of males aged over 70 years, with diabetes, cardiovascular, renal, respiratory, and systemic diseases, and nursing home residents. Significant differences were observed in the number of doses of the vaccine. The multiple regression model showed that male sex (OR [95% CI]=1.92 [1.42–2.58]), age (70–79 years, 9.11 [4.27–19.43]; 80–89 years, 21.72 [10.40–45.36]; 90–99 years, 66.24 [31.03–141.38]; 100 years or older, 69.22 [12.97–369.33]), being unvaccinated (6.96, [4.01–12.08]), or having the last dose administered at least 12 months before the diagnosis (2.38, [1.48–3.81]) were significantly associated with mortality. Conclusions Multiple factors may increase the risk of mortality due to COVID-19 in the elderly population. In our study, we found that only three predictors can effectively explain the variability: older age, male sex, and not being vaccinated or last vaccination date prior to one year (AU)

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BACKGROUND AND AIMS: Since the beginning of the COVID-19 pandemic, the elderly population has had the highest rates of complications and mortality. This study aimed to determine the influence of different risk factors on deaths due to the Omicron variant in the Canary Islands. MATERIALS AND METHODS: A retrospective observational study of 16,998 cases of COVID-19 over 40 years of age was conducted in the Canary Islands between August 1, 2022, and January 31, 2023. We extracted sociodemographic data (age and sex) and clinical data (death, vaccination history, hospital admission, previous diseases, and treatments). RESULTS: Among the deaths, there was a higher proportion of males aged over 70 years, with diabetes, cardiovascular, renal, respiratory, and systemic diseases, and nursing home residents. Significant differences were observed in the number of doses of the vaccine. The multiple regression model showed that male sex (OR [95% CI]=1.92 [1.42-2.58]), age (70-79 years, 9.11 [4.27-19.43]; 80-89 years, 21.72 [10.40-45.36]; 90-99 years, 66.24 [31.03-141.38]; 100 years or older, 69.22 [12.97-369.33]), being unvaccinated (6.96, [4.01-12.08]), or having the last dose administered at least 12 months before the diagnosis (2.38, [1.48-3.81]) were significantly associated with mortality. CONCLUSIONS: Multiple factors may increase the risk of mortality due to COVID-19 in the elderly population. In our study, we found that only three predictors can effectively explain the variability: older age, male sex, and not being vaccinated or last vaccination date prior to one year.

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Fundamentos: Desde mayo de 2022, países no endémicos notificaron la aparición de casos no importados de viruela del simio(Mpox), siendo España uno de los más afectados. El objetivo del estudio fue describir las características clínico-epidemiológicas delos casos confirmados de Mpox en las Islas Canarias y las principales dificultades en el rastreo de contactos.Métodos: Se realizó un estudio retrospectivo observacional descriptivo con casos confirmados de Mpox y sus contactos estrechos en la Comunidad Autónoma de Canarias. Se realizó un análisis descriptivo, indicando frecuencias y porcentajes para variablescualitativas y mediana (rango intercuartílico) para cuantitativas.Resultados: Se notificaron ciento setenta y siete casos de Mpox en las Islas Canarias, con una mediana de edad de 39 años(32,8-48,3), un 46,6% de seropositivos por VIH, y un 6,8% de extranjeros. La manifestación clínica más frecuente fue exantemaanogenital (68,8 %), y en estadio de pústulas (61,4%). Ciento tres declararon conductas sexuales de riesgo. Solo cincuenta y tres(30%) colaboraron en la identificación de contactos estrechos. Se produjeron dificultades al establecer comunicación con los casos,al comunicar las medidas de aislamiento, en la solicitud de pruebas y, finalmente, debido al procesamiento de muestras con retraso.Conclusiones: La manifestación clínica más frecuente al diagnóstico es el exantema anogenital en estadio de pústulas. Lamayoría de los casos reportan relaciones sexuales de riesgo. Las principales barreras en el rastreo de contactos resultan la dificultadpara contactar con los casos, la falta de datos de identificación y la inexperiencia de los profesionales sanitarios en relación con Mpox.(AU)

Background: Since May 2022, non-endemic countries reported the appearance of non-imported cases of monkeypox (Mpox).Spain was one of the most affected countries. The objective of the study was to describe the clinical-epidemiological characteristicsof the first confirmed cases of Mpox in the Canary Islands and the main difficulties in contact tracing.Methods: Retrospective observational descriptive study with confirmed cases of Mpox and their close contacts in the AutonomousCommunity of the Canary Islands. We conducted a descriptive analysis, using frequencies and percentages for qualitative variables, andmedian (interquartile range) for quantitative variables.Results: One hundred and seventy-seven cases of Mpox were reported in the Canary Islands, with a median age of 39 years(32.8-48.3); 46.6% were HIV seropositive, and 6.8% were foreign. The most frequent clinical symptom was anogenital rash (68.8%),and at pustules stage (61.4%). One hundred and three declared risky sexual behaviors. Only fifty-three (30%) collaborated in theidentification of close contacts. There were difficulties in: establishing communication with the cases, communicating the isolationmeasures, requesting tests, and due to delayed sample processing.Conclusions: Most common clinical symptom at diagnosis is anogenital rash in pustule stage. Most of the cases report riskysexual relations. The main barriers in contact tracing are the difficulty in contacting cases, the lack of identification data and the lackof experience of health professionals regarding Mpox.(AU)

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OBJECTIVE: Since May 2022, non-endemic countries reported the appearance of non-imported cases of monkeypox (Mpox). Spain was one of the most affected countries. The objective of the study was to describe the clinical-epidemiological characteristics of the first confirmed cases of Mpox in the Canary Islands and the main difficulties in contact tracing. METHODS: Retrospective observational descriptive study with confirmed cases of Mpox and their close contacts in the Autonomous Community of the Canary Islands. We conducted a descriptive analysis, using frequencies and percentages for qualitative variables, and median (interquartile range) for quantitative variables. RESULTS: One hundred and seventy-seven cases of Mpox were reported in the Canary Islands, with a median age of 39 years (32.8-48.3); 46.6% were HIV seropositive, and 6.8% were foreign. The most frequent clinical symptom was anogenital rash (68.8%), and at pustules stage (61.4%). One hundred and three declared risky sexual behaviors. Only fifty-three (30%) collaborated in the identification of close contacts. There were difficulties in: establishing communication with the cases, communicating the isolation measures, requesting tests, and due to delayed sample processing. CONCLUSIONS: Most common clinical symptom at diagnosis is anogenital rash in pustule stage. Most of the cases report risky sexual relations. The main barriers in contact tracing are the difficulty in contacting cases, the lack of identification data and the lack of experience of health professionals regarding Mpox.

OBJETIVO: Desde mayo de 2022, países no endémicos notificaron la aparición de casos no importados de viruela del simio (Mpox), siendo España uno de los más afectados. El objetivo del estudio fue describir las características clínico-epidemiológicas de los casos confirmados de Mpox en las Islas Canarias y las principales dificultades en el rastreo de contactos. METODOS: Se realizó un estudio retrospectivo observacional descriptivo con casos confirmados de Mpox y sus contactos estrechos en la Comunidad Autónoma de Canarias. Se realizó un análisis descriptivo, indicando frecuencias y porcentajes para variables cualitativas y mediana (rango intercuartílico) para cuantitativas. RESULTADOS: Se notificaron ciento setenta y siete casos de Mpox en las Islas Canarias, con una mediana de edad de 39 años (32,8-48,3), un 46,6% de seropositivos por VIH, y un 6,8% de extranjeros. La manifestación clínica más frecuente fue exantema anogenital (68,8 %), y en estadio de pústulas (61,4%). Ciento tres declararon conductas sexuales de riesgo. Solo cincuenta y tres (30%) colaboraron en la identificación de contactos estrechos. Se produjeron dificultades al establecer comunicación con los casos, al comunicar las medidas de aislamiento, en la solicitud de pruebas y, finalmente, debido al procesamiento de muestras con retraso. CONCLUSIONES: La manifestación clínica más frecuente al diagnóstico es el exantema anogenital en estadio de pústulas. La mayoría de los casos reportan relaciones sexuales de riesgo. Las principales barreras en el rastreo de contactos resultan la dificultad para contactar con los casos, la falta de datos de identificación y la inexperiencia de los profesionales sanitarios en relación con Mpox.

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BACKGROUND: The study aimed to assess the association between three predominant SARS-CoV-2 variants (Alpha, Delta, and Omicron) and the risk of developing long COVID (persistence of physical, medical, and cognitive symptoms more than 4 weeks after infection), post-COVID-19 syndrome (symptoms extending beyond 12 weeks), and viral persistence (testing positive beyond 4 weeks despite clinical resolution). METHODS: Retrospective study of 325 patients hospitalized for COVID-19 with genomic sequencing information. For each SARS-CoV-2 variant, sample characteristics, frequency of symptoms, and long-term sequelae were compared using Chi-squared test, Fisher's exact test, Kruskal-Wallis test, and Dunn's test as appropriate. Odds ratios (OR) were calculated using logistic regression models to assess the association of risk factors and sequelae. RESULTS: The adjusted model showed that the Omicron (vs Alpha) variant (OR, 0.30; 95% CI 0.16-0.56), admission to ICU (OR, 1.14; 95% CI 1.05-1.23), and being treated with antiviral or immunomodulatory drugs (OR, 2.01; 95% CI 1.23-3.27) predicted long COVID and post-COVID-19 syndrome. Viral persistence showed no difference between variants. CONCLUSIONS: The Omicron variant was associated with significantly lower odds of developing long-term sequelae from COVID-19 compared with previous variants, while severity of illness indicators increased the risk. Vaccination status, age, sex, and comorbidities were not found to predict sequelae development. This information has implications for both health managers and clinicians when deciding on the appropriate clinical management and subsequent outpatient follow-up of these patients. More studies with non-hospitalized patients are still necessary.

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PURPOSE: The impact of ingesting carbohydrates alone or combined with proteins to support exercise immune adaptation in endurance athletes is scarcely investigated. The present study compares the effect of ingesting a combined protein-carbohydrate supplement vs. a carbohydrate-only supplement post-workout on immune inflammation markers following a 10 week periodized endurance training program in well-trained athletes. METHODS: Twenty-five men completed the study after being randomly assigned to one of the following intervention groups: combined protein-carbohydrate (PRO-CHO n = 12, 31 ± 9 years, [Formula: see text]O2peak 61.0 ± 5.6 ml.kg-1.min-1) or non-protein isoenergetic carbohydrate (CHO, n = 13, 33 ± 8 years, [Formula: see text]O2peak 60.6 ± 6.9 ml.kg-1.min-1). Treatment consisted of ingesting 24 g of assigned supplement, mixed with 250 ml of orange juice, once a day for 10 weeks immediately post-workout (or before breakfast on non-training days). Measurements were conducted pre- and post-intervention on total leukocytes, leukocyte subsets (i.e., neutrophils, eosinophils, basophils, monocytes, and lymphocytes), and platelets. The inflammatory status was assessed by the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the systemic-immune inflammation index (SII). RESULTS: Post-intervention, significant increases were observed for CHO group only for the three inflammatory markers: NLR (p = 0.050, d = 0.58), PLR (p = 0.041, d = 0.60), and SII (p = 0.004, d = 0.81) but not for PRO-CHO (p > 0.05). CONCLUSION: Ingesting a post-workout protein-carbohydrate combined beverage promoted a more favourable immune status than carbohydrate-only ingestion by attenuating cellular inflammation over a 10 week training period in endurance male athletes. TRIAL REGISTRATION: The study was registered in ClinicalTrials.gov with the following ID: NCT02954367. The study was registered by 3 November 2016.

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BACKGROUND: Protein-based multi-ingredient (MTN) supplements have been suggested as a safe and effective way of enhancing exercise outcomes. However, their effectiveness remains controversial when compared to isocaloric and single-nutrient supplements. This review aims to systematically summarise the current knowledge of multi-ingredient supplementation to optimise body composition and physical performance in middle-aged and older adults. MATERIAL AND METHODS: A systematic review with meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search of the literature was conducted using PubMed, EBSCOhost, Google Scholar, Web of Science, and SPORTDiscus from June to October 2021. Every publication identified from the outset to October 2021 was considered. The main inclusion criteria comprised randomized controlled trial (RCT) studies conducted in adults (≥45 years old), following resistance- or endurance-based training programmes for a period of 6 weeks or longer, combined with MTN supplementation and a calorie equivalent comparator (COMP) supplement (e.g., carbohydrates). Continuous data on body composition [fat-free mass (FFM) or lean body mass], strength, and functional capacity as markers of physical performance were pooled using a random-effects model. RESULTS: Initially, 3329 publications were identified. Data from nine RCTs were ultimately included, involving 476 participants. The overall quality of the included studies was high, demonstrating a low risk of bias. Compared to COMP, no significant further benefits of ingesting MTN were identified for FFM (kg) (g = 0.044, 95 % CI -0.14 to 0.22), upper-body strength (kg) (g = 0.046, 95 % CI -0.24 to 0.33), lower-body strength, leg press exercise (kg) (g = 0.025, 95 % CI -0.26 to 0.31), leg extension exercise (kg) (g = 0.106, 95 % CI -0.15 to 0.36) and functional capacity (time in seconds) (g = 0.079, 95 % CI -0.12 to 0.27). CONCLUSIONS: No additional benefits of ingesting MTN vs. COMP to maximise exercise-induced outcomes on body composition and physical performance in healthy physically active middle-aged and older adults have been identified.

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Objetivo: En Canarias, desde el inicio de la pandemia, se han notificado 466.443 casos confirmados y 2.285 fallecidos por COVID-19. Objetivo: Comparar las tasas de mortalidad y letalidad por COVID-19 en Canarias con los de España desde el 1 de marzo de 2020 hasta el 31 de diciembre de 2022. Materiales y métodos: Se analizaron los datos recogidos por el Centro Nacional de Epidemiología, mediante un análisis descriptivo para el que se generaron tablas de población, fallecimientos, hospitalizaciones e ingresos en UCI por grupo de edad decenal para 2020, 2021 y 2022, excluyéndose los datos de enero de 2023. Se calculó el porcentaje de fallecimientos por grupo de edad y año. Se comparó la suma total con los subgrupos de 60-69 años, 70-79 años y 80 o más años. Resultados: Durante los años 2020, 2021 y 2022 fallecieron 2.174 personas por COVID-19 en Canarias, siguiendo un patrón de sucesivas oleadas. La Comunidad Autónoma de Canarias ha presentado menor incidencia y tasas de mortalidad por COVID-19 en comparación con la media nacional durante todo el periodo de estudio. Conclusiones: Este estudio retrospectivo muestra cómo la Comunidad Autónoma de Canarias ha presentado menor incidencia y tasas de mortalidad en comparación con la media nacional. Estas diferencias entre los casos notificados por Canarias y los casos notificados por todo el territorio nacional, han ido variando a lo largo de las 7 ondas de la pandemia de COVID-19, pudiendo ser atribuibles a diferentes causas.(AU)

Objective: Since the beginning of the pandemic of COVID-19, 466,443 confirmed cases and 2,285 deaths have been reported in the Canary Islands. Objective: to compare mortality and case fatality rates from COVID-19 in the Canary Islands with those in Spain, from March 1, 2020 to December 31, 2022. Methodology: A descriptive analysis was performed on the data collected by the National Epidemiology Center. Tables of population, deaths, hospitalizations, and ICU admissions were generated by decennial age group for 2020, 2021, and 2022, excluding data from January 2023. The percentage of deaths by age group and year was calculated. Total sum was compared with subgroups of 60-69 years, 70-79 years, and 80 or more years. Results: During the years 2020, 2021 and 2022, 2,174 people died from COVID-19 in the Canary Islands, following a pattern of successive waves. The Canary Islands have shown lower incidence and mortality rates for COVID-19 compared with the national average during the entire study period. Conclusion: This retrospective study shows how the Autonomous Community of the Canary Islands has presented lower incidence and mortality rates compared to the national average. These differences between the cases reported by the Canary Islands and the cases reported in the national territory have varied throughout the 7 waves of the COVID-19 pandemic, being attributable to different causes.(AU)

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A retrospective review of the electronic medical records of patients presenting to the University Medical Center in Lubbock, Texas with orbital wall fractures. Clinical data such as associated ocular injuries and different management approaches are analyzed and discussed to help clarify the specific indications for, and timing of, a formal ophthalmologic examination. All patients who presented to the emergency department for an orbital fracture after suffering various types of traumas between 2008 and 2017 were included. The study reviewed 451 patients with orbital wall fractures with a wide variety of presentations as well as demographics. There were 411 cases of adults presenting with an average age of 34 years and 40 pediatric presentations with an average age of 14 years. The average age of the combined study population was 30 years. Only 16.9% of patients required surgical correction for their orbital fractures and assault accounted for nearly 50% of all the orbital fractures reviewed in this study. In this large retrospective review, no notable relationship was found between orbital wall fractured and ocular injury. Alarm symptoms for more visual threatening injuries such as retinal tears, detachments, open globe injury, and extraocular muscle entrapment are all reasonable indications to consult ophthalmology emergently. Most orbital fractures are not vision threatening, do not usually require surgical correction, and typically occur in the setting of assault.

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INTRODUCTION: Empathy from healthcare providers is associated with improved patient care and satisfaction, resulting in increased emphasis on empathy in pharmacy school curricula. Previous studies showed improvement in pharmacy student empathy after older adult-specific simulation activities in the didactic setting, but no such data exist for the practice environment. This study's purpose was to evaluate the impact of a geriatrics advanced pharmacy practice experience (APPE) on pharmacy student empathy toward older adults. METHODS: All fourth-year pharmacy students in a geriatrics APPE at one of four participating sites were offered to participate in the study at the beginning of the rotation. Empathy was measured at baseline and end of the rotation using the Kiersma-Chen Empathy Scale (KCES). Wilcoxon matched-pairs signed-ranks test was used to test differences from pre- to post-rotation. RESULTS: Fifty-four of the 110 eligible students opted to participate in the study, and 46 completed both the pre- and post-surveys. Most students were female (55.6%), and the average age was 27.3 years. Mean empathy scores for all students increased significantly by 4.89 points (z = 4.17, P < .001, d = 0.97). Specific KCES items related to handling other's feelings and viewing another person's perspective also significantly improved. CONCLUSIONS: Empathy is a key component to professional development in healthcare students, and a geriatrics APPE provides an opportunity for students to grow this soft skill. Although further study is warranted, older adult focused rotations may be considered by schools of pharmacy to aid in preparing "graduate-ready" pharmacists.

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BACKGROUND: Typically, skin lesions caused by monkeypox (MPX) begin as a monomorphic exanthema with centrifugal distribution, and can be found at different sequential stages in different regions of the body. The aim of this study is to present an atypical case of MPX infection that simultaneously presented exanthema at three stages of evolution in the same location. METHODS: This is a descriptive study of a confirmed case of MPX by detection of the virus genome in clinical sample by polymerase chain reaction. RESULTS: We describe a 40-year-old male patient with an unusual clinical presentation. One week after having multiple risky MSM sexual intercourses, the patient developed skin eruption on the penis. During the following 10 days, he progressively developed new lesions on the same area. These lesions simultaneously showed different stages of evolution (vesicles, pustules and crust). CONCLUSIONS: Contrary to expected clinical presentation of the disease, the patient developed lesions at different stages in the same location. Attending physicians must be aware of atypical initial presentation and evolution of the lesions, and conduct a comprehensive epidemiological survey.

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To investigate the ability of the OMNI-RES (0-10) scale to estimate velocity and loading changes during sets to failure in the hang power clean (HPC) exercise. Eleven recreationally resistance-trained males (28.5 ± 3.5 years) with an average one-repetition maximum (1RM) value of 1.1 ± 0.07 kg body mass-1 in HPC, were assessed on five separate days with 48 hours of rest between sessions. After determining the 1RM value, participants performed four sets to self-determined failure with the following relative loading ranges: 60% < 70%, 70 < 80%, 80 < 90% and > 90%. The peak vertical velocity (PVV), and Rating of Perceived Exertion (RPE) were measured for every repetition of each set. The RPE expressed after the first repetition (RPE-1) and when the highest value of PVV was achieved during the set (RPE-max) were similar and significantly lower than the RPE associated with a 5% (RPE-5%) and 10% (RPE-10%) drop in PVV. In addition, the RPE produced at failure was similar to RPE-5% only for the heaviest range (≥ 90%). Furthermore, RPE-1 was useful to distinguish loading zones between the four assessed ranges (60 < 70%, vs. 70 < 80%, vs. 80 < 90%, vs. ≥ 90%). The RPE seems to be useful to identify PVV changes (maximal, 5% and 10% drop) during continuous sets to self-determined failure and to distinguish 10% loading zone increments, from 60 to 100% of 1RM in the HPC exercise.

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BACKGROUND: and purpose: Exercise has not typically been used as an adjunct in treatment of anorexia nervosa (AN). This study aimed to examine the effects of progressive resistance exercise (PREx) on perceived quality of life (QoL) and body composition in adolescents with AN. MATERIALS AND METHODS: Forty-four adolescents diagnosed with AN were randomly allocated to either PREx or control groups after hospitalization. The PREx group completed twenty-four PREx sessions over two months including three sets of 8-10 repetitions of eight whole-body exercises at a moderate intensity. QoL and body composition were evaluated at baseline and after two months using Health Questionnaire Short-Form 36 (SF-36) and anthropometric measurements. RESULTS: At completion, forty-one participants (n = 19 PREx, and n = 22 controls) with mean age of 12.78 ± 0.88 years and mean body mass index of 18 ± 2.2 kg/m2 were analyzed. Significant group x time effects were found on SF-36 role physical (RP) scores. Significant improvements with large effect sizes (d > 0.72) were found in RP, and arm circumferences in the PREx group. Spearman association analyses between percent change in anthropometric variables and change in QoL scores showed positive associations with moderate-to-large effect sizes in the PREx group among the following variables: mid-thigh-circumference, physical functioning (PF) and general health (GH); calf-circumference relaxed and body pain; biceps skinfold and GH scores; triceps-skinfold, and role physical (RP) and vitality (VT); supraspinale-skinfold and RP and VT; mid-thigh-skinfold and calf-skinfold and VT. CONCLUSION: PREx after hospitalization enables modest positive changes in QoL associated to anthropometric changes in adolescents with AN without adverse effects on weight recovery.

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This study analyzed the effects of physical training programs on heart rate variability, as a measure of sympathovagal balance, in children and adolescents with chronic diseases. Relevant articles were systematically searched in Pubmed, Science Direct, Web of Science, Scopus, Google Scholar and Embase scientific databases. We performed a meta-analysis using an inverse variance heterogeneity model. Effect size calculation was based on the standardized mean differences between pre- and post-intervention assessments, assuring at least a single-group repeated-measures model for each extracted group. Ten studies (252 participants) were included, seven in obese subjects, two in type-1 diabetes, and one in cerebral palsy. When time-domain variables were analyzed, exercise was found to moderately increase RMSSD (SMD=0.478; 95%CI: 0.227 to 0.729; p<0.001), SDNN (SMD=0.367; 95%CI: 0.139 to 0.595; p=0.002) and pNN50 (SMD=0.817; 95%CI: 0.139 to 0.595; p=0.002). As for frequency-domain variables, exercise presented a moderate increasing effect on HF (SMD=0.512; 95%CI: 0.240 to 0.783; p<0.001), a negligible effect for LF (SMD=0.077; 95%CI: -0.259 to 0.412; p<0.001) and a non-significant reduction for LF/HF (SMD=-0.519; 95%CI: -1.162 to 0.124; p=0.114). In conclusion, physical training programs are able to modulate heart rate variability in children and adolescents with chronic diseases, affecting mainly the time-domain variables.

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OBJECTIVE: Chronic neurological disorders (CNDs) generally produce deleterious effects on the musculoskeletal system and can affect physical activity and increase sedentary behavior in children, hindering the execution of training programs and the attainment of a correct dose of exercise. The purpose of this systematic review was to analyze the effect of neuromuscular electrical stimulation (NMES) on skeletal muscle and then on biomechanics of movement, functional mobility, strength, spasticity, muscle architecture, and body composition of children and adolescents with CNDs and chronic diseases. METHODS: The search was conducted in April 2020 in PubMed, MEDLINE, Scopus, the Cochrane Library, and Web of Science, without publication period restriction. Publications investigating the effect of NMES on children and adolescents with CNDs and other chronic diseases were independently selected by 2 researchers. One author independently extracted data from the studies selected, and a second author cross-checked. RESULTS: Eighteen studies with 595 participants aged between 3 and 14 years were included. Quality assessment showed that 50% of the studies presented a low risk of bias. The pooled effect of NMES on gross motor functional measure, calculated as a standardized mean difference using a random effects model, was 0.41 (95% CI = 0.19-0.64). CONCLUSION: The use of NMES programs for children diagnosed with cerebral palsy, spinal muscular atrophy, and obstetric injury of the brachial plexus was effective in improving muscle strength, biomechanics of movement, and functional mobility. IMPACT: NMES can be a useful tool to prevent the reduction of mobility that results from CNDs.

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Background: Cystic fibrosis (CF) affects the autonomic nervous system (ANS) and exercise in healthy children modulates the interaction between sympathetic and parasympathetic activity. This study aimed to evaluate the effects of a short-term resistance exercise program on heart rate variability (HRV) in children and adolescents with CF. Methods: A randomized controlled trial was carried out in children diagnosed with CF aged 6-18 years. Individuals were divided into two groups: control (CON) and resistance-training (EX). Individuals in the EX group completed an individualized guided resistance program (5-RM-60-80%) for 8 weeks (3 sessions of 60 min/week). Upper and lower limbs exercises (seated bench press, seated lateral row, and leg press) were used. HRV was measured using a Suunto watch with subjects in lying position. Results: Nineteen subjects (13 boys) were included (CON = 11; and EX = 8). Mean age was 12.2 ± 3.3, FEV1 (forced expiratory volume in the first second) z-score was 1.72 ± 1.54 and peak oxygen consumption (VO2peak) 42.7 ± 7.4 mL.Kg-1.min-1. Exercise induced significant changes in the frequency-domain variables, including a decrease in LF power (p = 0.001, d = 0.98) and LF/HF ratio (p = 0.020, d = 0.92), and an increase in HF power (p = 0.001, d = -0.97), compared to the CON group. No significant changes were found for time-domain variables, although increases with a moderate effect size were seen for SDNN (p = 0.152, d = -0.41) and RMSSD (p = 0.059, d = -0.49) compared to the CON group. Conclusion: A short-term resistance exercise-training program was able to modulate HRV in children and adolescents with CF presenting mild to moderate lung function impairment and good physical condition. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT04293926.

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ABSTRACT: Chapman, M, Larumbe-Zabala, E, Triplett, NT, and Naclerio, F. Velocity change estimation by subjective measures over a wide-load spectrum in squat and bench press. J Strength Cond Res 35(2S): S51-S56, 2021-This study compared whether the perception of effort measured on a repetition-by-repetition basis during continuous sets to failure is different between squat (SQ) and bench press (BP). After determining the one repetition maximum (1RM) value in both SQ and BP, 18 subjects (28.2 ± 5 years, 50% women) performed 7 sets to failure per exercise, separated by 24-48 hours, alternating SQ and BP, using the following relative load ranges: 30 < 40%, 40 < 50%, 50 < 60%, 60% < 70%, 70 < 80%, 80 < 90%, and >90%. The mean accelerative velocity (MAV) and rating of perceived exertion (RPE) using the OMNI-RES (0-10) scale were measured for every repetition of each set. The ability of the OMNI-RES (0-10) scale to identify velocity changes during continuous sets to volitional failure and to distinguish loading zones divided into 10% slots, from 30 to 100% of 1RM was confirmed for both SQ and BP. The RPE values measured at (a) the first repetition; (b) the repetition where MAV peaks; (c) the repetition where MAV drops by ≤10% compared the maximum and (d) the last repetition, showed no differences (p > 0.05, d < 0.2) between exercises. In conclusion, the same RPE scores can be applied to both exercises, for either estimating the relative load or monitoring changes in MAV during continuous sets to failure.

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