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The purpose of this study is to determine if there is a positive relationship between full-range leadership and employees' effort, efficiency, and satisfaction. A questionnaire was administered to 577 executives from Colombian companies, and the data was analyzed using a partial least squares structural equation modeling (PLS-SEM) approach. The results show that both transformational and transactional leadership have a direct and significant impact on extra effort, effectiveness, and satisfaction, with transformational leadership having the greatest impact on these factors. Conversely, passive-avoidant leadership has negative effects on these three constructs. This study validates the effectiveness of the MLQ 5X in a South American country, a geographical region where such studies are in their early stages. Finally, the whole range of leadership styles-transformational, transactional, and passive-avoidant-is looked at. These styles are seen as second-order constructs that challenge latent multidimensional models as they emerge.

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El proceso de envejecimiento está marcado por el sedentarismo y la escasa actividad física, lo que se asocia a la disminución rápida y continua de las capacidades funcionales, la dependencia y la fragilidad. El objetivo del trabajo se orienta a valorar, mediante el test de repeticiones máximas con pesos no extremos, el efecto de la aplicación de ejercicios con pesas para la atención de la sarcopenia. Se aplicaron métodos de los niveles teóricos y empíricos como el analítico, sintético, inductivo, deductivo, revisión documental, análisis documental, observación, encuesta y entrevista. Se aplicó, como instrumento de trabajo, una batería de ejercicios físicos de resistencia a la fuerza, y aeróbicos que permitieron utilizar el método de medición en siete adultos mayores con sarcopenia, atendidos en el Centro de Actividad Física y Salud de la Universidad de las Ciencias de la Cultura Física y Deportes ¨ Manuel Fajardo. Se evaluó el trabajo de fuerza muscular mediante el test mencionado, lo que permitió identificar el peso real de la carga física con la que deben entrenar y, sobre esa base, se elaboró la batería de ejercicios con pesas. En los resultados preliminares registrados, mediante la aplicación del test, se constató que la integración del trabajo con pesas y el aeróbico influyen de manera favorable en la ganancia de fuerza en el adulto mayor.

O processo de envelhecimento é marcado por um estilo de vida sedentário e pouca atividade física, o que está associado ao declínio rápido e contínuo das capacidades funcionais, à dependência e à fragilidade. O objetivo do trabalho visa avaliar, por meio do teste de repetições máximas com pesos não extremos, o efeito da aplicação de exercícios com carga no tratamento da sarcopenia. Foram aplicados métodos dos níveis teórico e empírico como analítico, sintético, indutivo, dedutivo, revisão documental, análise documental, observação, levantamento e entrevista. Como instrumento de trabalho foi aplicada uma bateria de exercícios físicos resistidos de força e aeróbios que permitiu a utilização do método de mensuração em sete idosos com sarcopenia atendidos no Centro de Atividade Física e Saúde da Universidade de Ciências da Cultura Física e. Desporto ¨ Manuel Fajardo. O trabalho de força muscular foi avaliado por meio do referido teste, que possibilitou identificar o real peso da carga física com a qual devem treinar e, com base nisso, foi desenvolvida a bateria de exercícios com pesos. Nos resultados preliminares registrados, por meio da aplicação do teste, foi confirmado que a integração do trabalho com pesos e do trabalho aeróbio influencia favoravelmente o ganho de força em idosos.

The aging process is marked by a sedentary lifestyle and little physical activity, which is associated with the rapid and continuous decline in functional capacities, dependency and fragility. The objective of the work is aimed at assessing, through the test of maximum repetitions with non-extreme weights, the effect of the application of exercises with weights for the care of sarcopenia. Methods from the theoretical and empirical levels such as synthetic analytical, inductive-deductive, documentary review, documentary analysis, observation, survey and interview were applied. As a working instrument, a set of strength endurance and aerobic physical exercises was applied that allowed the measurement method to be used in seven older adults with sarcopenia, treated at the Center for Physical Activity and Health of the University of Sciences. of Physical Culture and Sports ¨Manuel Fajardo¨. The muscular strength work was evaluated using the aforementioned test, which made it possible to identify the real weight of the physical load with which they must train and, on that basis, the set of exercises with weights was developed. In the preliminary results recorded, through the application of the test, it was confirmed that the integration of weight work and aerobic work favorably influences strength gain in the older adults.

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Introduction Permanent education in health aims to ensure that professionals are constantly learning in the workplace and in the last few years institutions resorted to the technology-mediated education modality and new teaching possibilities were explored. In Brazil, between 2017 and 2021, only six articles and five monographs were published about listening effort. Objective The objective of this study was to develop a website with scientific content on the topic listening effort for Speech -Language Therapist and Audiologist with free online access. Methods The study was carried out in five stages: Analysis, contemplating the search for scientific materials to prepare the material. Design, in which the writing and design of the website was carried out. Development, carrying out the adequacy of the online material. Implementation, a stage in which professionals in the area evaluated the quality of the material after consenting to participation through a free and informed consent term. Review, stage in which the researcher analyzed the evaluators' responses. Results The five stages of elaboration of the website were carried out, which was evaluated by professionals in the area. The average of responses to all applied questions rated the website as "superior". Conclusion The website development was validated for online availability.

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This study aimed to verify whether peripheral perception, tactical behaviour, and physical performance are influenced by acute physical fatigue in soccer players. The study included 24 trained soccer players (18.6 ± 1.5 years) from two Brazilian clubs. The TSAFT90 test was used to induce acute physical fatigue. The results showed that physical fatigue did not affect peripheral perception (p = 0.360). Regarding tactical behaviour, improved efficiency was observed for the principles of offensive coverage (p = 0.029), width and length with the ball (p = 0.044), and concentration (p = 0.008). On the other hand, a reduction was observed in the number of tactical actions of offensive coverage (p = 0.020) and recovery balance (p = 0.042). Also, improved accuracy in the principles of defensive balance (p = 0.009), recovery balance (p = 0.021) and defensive unity (p = 0.003) occurred under physical fatigue. A reduction in the physical performance outcomes total distance covered (p < 0.001), average speed (p < 0.001), sprints (p = 0.029), number of accelerations (p = 0.008) and decelerations (p = 0.008) were also detected. The internal (p < 0.01) and external (p < 0.01) workload was higher under physical fatigue. Overall, acute physical fatigue did not influence peripheral perception. However, physical performance was reduced under fatigue, the perceived effort increased, and tactical behaviours were affected by decreasing tactical actions performed near the ball, increasing errors in defensive movements in the lateral corridors and the last defensive line, and improving offensive tactical actions performance.

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This study aimed to analyze the validity and reliability of a smartphone app (i.e., Encephalapp Stroop) to measure cognitive performance. Ten physically active individuals (mean age: 25.2 ± 4.3 years) participated in three laboratory visits. In a randomized sequence, subjects completed cognitive assessments using the app and a computer separately. The response times from 100 measurements for congruent and incongruent stimuli were compared between the two devices (app and computer) using the intraclass correlation coefficient, Pearson product-moment correlation coefficient (r), Cronbach's alpha (α), and Bland-Altman plots. There was excellent agreement between the computerized Stroop and the app version for response times for congruent (ICC = 0.806, p < 0.001; Bland-Altman bias = 41.3 ± 56.4 ms, p < 0.001) and incongruent stimuli (ICC = 0.755, p < 0.001; Bland-Altman bias = 76.4 ± 75.1 ms, p < 0.001). In comparison to the computerized version, the app demonstrated a moderate correlation for response times of congruent (r = 0.678, p < 0.001) and incongruent (r = 0.623, p < 0.001) stimuli. The results of the present study indicate that the response times of congruent and incongruent stimuli can be easily, accurately, and reliably evaluated using a mobile app.

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Background: Despite decades of advancement to support interventions for managing work-related stress, mental health issues have significantly escalated among healthcare professionals. Effort-reward imbalance (ERI) and overcommitment in the workplace are linked to several psychiatric disorders. However, the underlying biological mechanisms remain unclear. This study investigated whether ERI and overcommitment among healthcare professionals were linked to Allostatic Load (AL) and whether AL mediates the relationship between ERI, overcommitment and mental health issues. Methods: One hundred forty-two nursing workers (n = 142; 90.1 % female, mean age: 39.5 ± 9.6) were randomly recruited from a university hospital in Sao Paulo, Brazil, and applied the ERI scale that assesses work effort, reward, and overcommitment. The Perceived Stress Scale (PSS), The Beck Depression Inventory (BDI), and the Self-Report Questionnaire for psychiatric symptoms (SRQ-20) evaluated the mental health outcomes. Ten neuroendocrine, metabolic, immunologic and cardiovascular biomarkers were analyzed, and values were transformed into an AL index using clinical reference cutoffs. Results: Linear regression adjusted for covariates showed that higher scores for overcommitment were associated with higher AL indexes, which in turn were associated with higher SRQ-20, but not with PSS and DBI scores. As expected, higher scores for effort, lower for reward, and higher ERI were associated with higher scores for PSS, SRQ-20, and DBI, but not with AL index. Direct effect estimates showed that overcommitment was directly associated with higher SRQ-20 scores, and indirectly via AL. Conclusion: Our study reveals that overcommitment, rather than ERI, was linked to increased AL in healthcare workers. Additionally, AL mediates the relationship between overcommitment and higher psychiatric symptoms, highlighting a key mechanism by which work stress can lead to mental health problems. Individual's responses to high work demands need to be considered when designing predictive models and interventions for mental health issues.

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Behavioral momentum theory (BMT) provides a theoretical and methodological framework for understanding how differentially maintained operant responding resists disruption. A common way to test operant resistance involves contingencies with suppressive effects, such as extinction or prefeeding. Other contingencies with known suppressive effects, such as response-cost procedures arranged as point-loss or increases in response force, remain untested as disruptive events within the BMT framework. In the present set of three experiments, responding of humans was maintained by point accumulation programmed according to a multiple variable-interval (VI) VI schedule with different reinforcement rates in either of two components. Subsequently, subtracting a point following each response (Experiment 1) or increasing the force required for the response to be registered (Experiments 2 and 3 decreased response rates, but responding was less disrupted in the component associated with the higher reinforcement rate. The point-loss contingency and increased response force similarly affected response rates by suppressing responding and human persistence, replicating previous findings with humans and nonhuman animals when other types of disruptive events (e.g., extinction and prefeeding) were investigated. The present findings moreover extend the generality of the effects of reinforcement rate on persistence, and thus BMT, extending the analysis of resistance to two well-known manipulations used to reduce responding in the experimental analysis of behavior.

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The use of rating of perceived exertion (RPE) has grown substantially, providing a valuable alternative for exercise intensity monitoring, especially for older adults. However, some challenges, such as cross-cultural validity, age-related differences, and reliability issues, necessitate the development of a concise and user-friendly RPE instrument, particularly for strength training in this population. This study aimed to validate the Subjective Effort Induction Scale (SEIS-3), a simplified tool for measuring effort during strength training. SEIS-3 is a graded instrument with three exertion levels: 1) Light effort, 2) Moderate effort, and 3) Strong effort. Twenty seniors, aged 71±7 years, of both genders participated in the study (CEP/Unimontes 2,741,071/2018). We collected maximal isometric voluntary contraction (MIVC) data using a digital dynamometer. Subsequently, participants underwent the initial test, following the three SEIS-3 categories in a randomly assigned order of induced subjective effort. SEIS-3 instrument was evaluated by the approaches:•Linear regression analysis: employed to assess the validity of the instrument.•Intraclass Correlation Coefficient (ICC): employed to assess the reliability of the instrument.SEIS-3 effort categories correlated with MIVC in both hands (R2=0.80, F = 25.596, df=3, p < 0.01 for right hand; R2=0.56, F = 9.132, p < 0.01 for left hand). Test-retest reliability for grip strength across effort categories was excellent (ICC > 0.9). SEIS-3 is a valid and reliable user-friendly tool for accurately assessing and regulating exercise intensity in older adults during strength tasks, benefiting their health, functional capacity, and overall quality of life. This low-cost instrument can help health professionals in their activities.

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Obstructive Sleep Apnea (OSA) is a respiratory disorder characterized by frequent breathing pauses during sleep. The apnea-hypopnea index is a measure used to assess the severity of sleep apnea and the hourly rate of respiratory events. Despite numerous commercial devices available for apnea diagnosis and early detection, accessibility remains challenging for the general population, leading to lengthy wait times in sleep clinics. Consequently, research on monitoring and predicting OSA has surged. This comprehensive paper reviews devices, emphasizing distinctions among representative apnea devices and technologies for home detection of OSA. The collected articles are analyzed to present a clear discussion. Each article is evaluated according to diagnostic elements, the implemented automation level, and the derived level of evidence and quality rating. The findings indicate that the critical variables for monitoring sleep behavior include oxygen saturation (oximetry), body position, respiratory effort, and respiratory flow. Also, the prevalent trend is the development of level IV devices, measuring one or two signals and supported by prediction software. Noteworthy methods showcasing optimal results involve neural networks, deep learning, and regression modeling, achieving an accuracy of approximately 99%.

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The most important fisheries are recording catches below their historical averages despite increased effort. This level of overfishing is worrying and requires the establishment of feasible and precise measures to prevent a continuing decrease in biomass. Determining the factors that lead to changes in the abundance and distribution of overfished resources would allow us to identify the strengths and weaknesses of management schemes; this approach would also make it possible to estimate more accurate parameters for their evaluation. We hypothesize that environmental, temporal, spatial, and operational components contribute to the variation in the relative abundance. Thus, we analyzed the red grouper fishery, the most important demersal fishery in the southeastern Gulf of Mexico (SGM); it is locally known as escama. We employed the catch per unit effort (CPUE) as an index of relative abundance recorded by the semi-industrial fleet (kilogram per effective fishing day) and the small-scale fleet (kilogram per effective fishing hour) during the overexploitation phase (from 1996 to 2019). We fitted several variables of the components using generalized additive models (GAM) and used multi-model inference to determine the best GAM for each fleet. For both fleets, the operational and temporal components (fishing gear and year) have had a greater impact on the distribution and abundance of red grouper in the SGM than the spatial and environmental components (the place of origin and sea surface temperature). These findings encourage the exploration of métier schemes for more efficient fishery management. In addition, we have identified several strategies that would support the recovery of the resource, such as restricting fishing in the quadrants located to the northeast or regulating scuba diving. We recommend that in the future, researchers use the indices we have generated in the present study to evaluate the red grouper fishery.

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Different investigations lead to the urgent need to generate validated clinical protocols as a tool for medical doctors to orientate patients under risk for a preventive approach to control Alzheimer's disease. Moreover, there is consensus that the combined effects of risk factors for the disease can be modified according to lifestyle, thus controlling at least 40% of cases. The other fraction of cases are derived from candidate genes and epigenetic components as a relevant factor in AD pathogenesis. At this point, it appears to be of critical relevance the search for molecular biomarkers that may provide information on probable pathological events and alert about early detectable risks to prevent symptomatic events of the disease. These precocious detection markers will then allow early interventions of non-symptomatic subjects at risk. Here, we summarize the status and potential avenues of prevention and highlight the usefulness of biological and reliable markers for AD.

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We aimed to analyze the effect of brain endurance training on maximum oxygen consumption (VO2máx ), time-to-exhaustion, and inhibitory control in amateur trained runners. We employed a mixed experimental design, with the group as the between-participant factor and time as the within-participant factor. 45 participants attended 36 training sessions over 12 weeks. The cognitive training group (CT) performed the Stroop word-color task [trials of each type (congruent, incongruent, and neutral) were randomly presented during each training session], the endurance training group (ET) participated in a running training program (intensity was 60%Δ of maximal aerobic velocity and performed on a motor-driven treadmill), and the brain endurance training group (BET) make cognitive and endurance training simultaneously over 12 weeks. The total time of each session (i.e., 20-40 min) was identical in the experimental groups. VO2máx , time-to-exhaustion, and inhibitory control tests were measured before (baseline) and after (post-experiment) the 12-week intervention. A significant effect of interaction (group × time) for VO2máx (p < 0.05) was found. A post-hoc test showed an increase in VO2máx from baseline to post-experiment only for ET (Δ% = 2.98) and BET (Δ% = 3.78) groups (p < 0.05). Also, the analyses showed a significant interaction (group × time) for time-to-exhaustion (p < 0.05), and a post-hoc test revealed an improvement in time-to-exhaustion for ET (Δ% = 8.81) and BET (Δ% = 11.01) (p < 0.05). No group × time interaction was found for accuracy and response time in the inhibitory control task (p > 0.05). The results conclude that BET was not superior to ET for improving VO2máx and time-to-exhaustion. Also, the findings conclude that BET improved inhibitory control similar to CT.

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We aimed to analyze the effect of a head-to-head virtual race on 20-km time trial performance in well-trained mentally fatigued cyclists. A total of 24 male professional cyclists participated in the present study, which was conducted in a within-factors design [four experimental conditions × four times (throughout 20-km time trial cycling)]. An avatar representing the participant on the racecourse was visible during the time trials. Then, a second virtual avatar representing the opponent was projected onto the screen in the mental fatigue head-to-head and control head-to-head experimental conditions. Measurements [rating of perceived exertion, heart rate, and eye-tracking measures (i.e., pupil diameter)] were performed every 5-km throughout the 20-km time trial. As a result, impaired total time, power output, and cadence throughout the 20-km cycling time trial were found for mental fatigue compared to mental fatigue head-to-head, control head-to-head, and control conditions (p < 0.05). Also, impaired 20-km time trial performance (total time, power output, and cadence) was found for mental fatigue head-to-head compared to control head-to-head (p < 0.05). Moreover, lower RPE was found for the control and control head-to-head conditions than mental fatigue head-to-head and mental fatigue experimental conditions (p < 0.05). Higher pupil diameter was also found for mental fatigue head-to-head, control head-to-head, and control than the mental fatigue experimental condition (p < 0.05). In summary, the overall performance throughout the 20-km cycling time trial was improved by the presence of a virtual opponent for the mentally fatigued cyclists.

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In this longitudinal, observational study, following 883 adolescents (aged 11-15 years, grades 6th - 8th) we tracked changes in perceived school motivation and effort across four time points during the two years of remote education in Perú as a consequence of COVID-19 (retrospective reports before the pandemic, May 2020, July 2021, and November 2021). Compared to before the pandemic, levels of perceived school motivation and effort dropped sharply in May 2020 and continued to decrease across 2 years. Perceived school motivation was positively associated with perceived school effort at almost all time points. Furthermore, students with lower levels of perceived school motivation had a steeper decline in perceived school effort. In a subsample of 380 students in 8th grade, perceived school effort in July 2021 predicted objective math performance in November 2021. Our findings suggest that COVID-19 has further compounded decreases in subjective and objective indices of school engagement and performance that are typically observed in early adolescence. Our results from a large sample of low- to middle-class Peruvian adolescents highlight the experiences of youth in a country that had particularly long school closures, and that is under-represented in the literature.

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The effects of voluntary running on the skeletal muscle of rats with pulmonary arterial hypertension (PAH) were tested in the present study. PAH was induced in rats by a single injection of monocrotaline (MCT, 60 mg/kg). Rats in the sedentary hypertension (HS) group had their tolerance to physical exertion reduced throughout the experiment, while those in the sedentary control (SC), exercise control (EC), exercise hypertension (EH) and median exercise (EM) groups maintained or increased. Despite that, the muscular citrate synthase activity was not different between groups. The survival time was higher in the EH (32 days) than in the SH (28 days) (p = 0.0032). SH and EH groups showed a lower percentage of muscle fiber and a higher percentage of extracellular matrix compared to control groups (p < 0.0001). However, the EM and EH groups presented higher percentage of muscle fiber and lower percentage of extracellular matrix than SH group (p < 0.0001). Regarding muscular gene expression, the SH and EM groups showed a lower expression of PGC1-α (p = 0.0024) and a higher expression of VEGF (p = 0.0033) compared to SC, while PGC1-α was elevated in the EH. No difference between groups was found for the carbonylated protein levels (p > 0.05), while the TNF-α/IL-10 ratio was augmented in the EH (p = 0.0277). In conclusion, voluntary running augments the proportion of fiber and affects the gene expression of inflammatory and mitochondrial biogenesis' markers in the skeletal muscle of rats with MCT-induced PAH, which benefits their survival and tolerance to physical effort.

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Propósito: la adecuación del esfuerzo terapéutico es una decisión clínica basada en la evidencia que pretende evitar la futilidad médica. Se han señalado diferentes factores que pueden influir en esta toma de decisiones los cuales se relacionan con el paciente, el profesional médico que toma de las decisiones, barreras del sistema, cultura y economía, entre otros. El presente estudio pretende identificar aquellos factores que influyen en los médicos especialistas que laboran en la institución referente del cáncer en Colombia, a fin de planear acciones que mejoren el abordaje de la toma de decisiones con respecto a la adecuación del esfuerzo terapéutico en pacientes con cáncer. Metodología: diseño cualitativo basado en 13 entrevistas en profundidad a médicos especialistas del Instituto Nacional de Cancerología de Colombia. Resultados: participaron 3 mujeres y 10 hombres, con un promedio de edad de 36 años, 7 pertenecientes a la especialidad de oncología de adultos, 2 a oncohematología pediátrica, 1 a cuidados intensivos de adultos y 3 a cuidados intensivos pediátricos. Los factores hallados se agruparon en cuatro categorías: 1) conocimiento, 2) aspectos relacionados con la toma de decisiones, 3) quién decide, 4) tipo de decisión que se toma; a su vez, estas categorías se agruparon en temas que hacen alusión a los factores que influyen en la toma de decisiones de los especialistas para adecuar los esfuerzos terapéuticos. Conclusión: la adecuación de los esfuerzos terapéuticos es importante para evitar procedimientos médicos fútiles que prolonguen el sufrimiento. Se evidenciaron algunos factores que influyen en la toma de decisiones de los especialistas: falta de preparación de los profesionales de salud en el tema de toma de decisiones al final de la vida, uso reducido de escalas que permitan mejorar la información del pronóstico y desconocimiento sobre voluntades anticipadas; estos son algunos de aquellos factores que deben fortalecerse para generar acciones que mejoren el abordaje de esta temática.

Purpose: Adjusting therapeutic efforts is an evidence-based clinical decision that aims to avoid medical futility. Varied factors that can influence this decision-making have been pointed out, related to the patient, the medical professional who makes the decisions, system barriers, culture, and the economy, among others. The present study aims to identify those factors that help the specialists working in a cancer referral institution in Colombia to plan actions that improve the approach to decision-making regarding the adequacy of therapeutic efforts in cancer patients. Methodology: This qualitative design is based on 13 in-depth interviews with Colombia's National Cancer Institute specialists. Results: Three women and ten men participated, with an average age of 36 years; seven belonged to the specialty of adult oncology, two to pediatric oncohematology, one to adult intensive care, and three to pediatric intensive care. The factors found were grouped into four categories: 1) knowledge, 2) aspects related to decision-making, 3) the decision-maker, and 4) the type of decision made. These categories were clustered into themes that allude to the factors swaying specialists' decision-making to adjust therapeutic efforts. Conclusion: Adjusting therapeutic actions is vital to avoid futile medical procedures that prolong suffering. Some factors that influence the specialists' decision-making were noted: lack of preparation of health professionals on end-of-life decision-making, reduced use of scales to improve prognostic information, and ignorance about advance directives. These factors must be strengthened to improve the approach to this issue.

Introdução: a adequação do esforço terapêutico é uma decisão clínica baseada em evidências que pretende evitar a futilidade médica. Diferentes fatores que podem influenciar nessa tomada de decisão vêm sendo identificados e estão relacionados com o paciente, com o profissional médico que toma as decisões, com as barreiras do sistema, com a cultura e a economia, entre outros. Objetivo: este estudo pretende identificar aqueles fatores que influenciam os médicos especialistas que trabalham na instituição referente do câncer na Colômbia, a fim de propor ações que melhorem a abordagem da tomada de decisões a respeito da adequação do esforço terapêutico em pacientes com câncer. Metodologia: desenho qualitativo baseado em 13 entrevistas em profundidade com médicos especialistas do Instituto Nacional de Cancerologia da Colômbia. Resultados: participaram 3 mulheres e 10 homens, com média de idade de 36 anos - 7 pertencentes à especialidade de oncologia de adultos; 2, onco-hematologia pediátrica; 1, terapia intensiva de adultos e 3, terapia intensiva pediátrica. Os fatores achados foram agrupados em quatro categorias: 1) conhecimento; 2) aspectos relacionados com a tomada de decisões; 3) quem decide; 4) tipo de decisão tomada. Por sua vez, essas categorias foram agrupadas em temas que fazem alusão aos fatores que influenciam a toma de decisões dos especialistas para adequar os esforços terapêuticos. Conclusões: a adequação dos esforços terapêuticos é importante para evitar procedimentos médicos fúteis que prolonguem o sofrimento. Foram evidenciados alguns fatores que influenciam a tomada de decisões dos especialistas: falta de preparação dos profissionais de saúde no tema, uso reduzido de escalas que permitam melhorar a informação do prognóstico e desconhecimento sobre vontades antecipadas; estes são alguns dos fatores que devem ser fortalecidos para gerar ações que melhorem a abordagem da temática.

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We compared the effects of resistance training (ResisT) to pyramidal and traditional weightlifting sets on men's psychophysiological responses. In a randomized crossover design, 24 resistance-trained males performed drop-set, descending pyramid, and traditional ResisT in the barbell back squat, 45° leg press, and seated knee extension. We assessed participants' rating of perceived exertion (RPE) and feelings of pleasure/displeasure (FPD) at the end of each set and at 10, 15, 20, and 30 minutes post-session. No differences were detected across ResisT Methods in total training volume (p = 0.180). Post hoc comparisons revealed that drop-set training elicited higher RPE (M 8.8 SD 0.7 arbitrary units) and lower FPD (M -1.4 SD 1.5 arbitrary units) values compared to descending pyramid (M Set RPE 8.0 SD 0.9 arbitrary units and M Set FPD 0.4 SD 1.6 arbitrary units) and traditional set (M Set RPE 7.5 SD 1.1 arbitrary units and M Set FPD 1.3 SD 1.2 arbitrary units) schemes (p < 0.05). In addition, drop-set training elicited higher session RPE (M 8.1 SD 0.8 arbitrary units) and lower session FPD (M 0.2 SD 1.4 arbitrary units) values than descending pyramid and traditional ResisT (p < 0.001). Similarly, descending pyramid training elicited higher session RPE (M 6.6 SD 0.9 arbitrary units) and lower session FPD (M 1.2 SD 1.4 arbitrary units) than traditional set (M Session RPE 5.9 SD 0.8 arbitrary units and M Session FPD 1.5 SD 1.2 arbitrary units) training (p = 0.015). No differences were found in the temporality of post-session metrics, suggesting that testing 10 and 15 minutes post-ResisT was sufficient to assess session RPE (p = 0.480) and session FPD (p = 0.855), respectively. In conclusion, even with similar total training volume, drop-set training elicited more pronounced psychophysiological responses than either pyramidal or traditional ResisT in resistance-trained males.

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Pulmonary arterial hypertension is associated with skeletal muscle myopathy and atrophy and impaired exercise tolerance. Aerobic exercise training has been recommended as a non-pharmacological therapy for deleterious effects imposed by pulmonary arterial hypertension. Aerobic physical training induces skeletal muscle adaptations via reduced inflammation, improved anabolic processes, decreased hypoxia and regulation of mitochondrial function. These benefits improve physical exertion tolerance and quality of life in patients with pulmonary arterial hypertension. However, the mechanisms underlying the therapeutic potential of aerobic exercise to skeletal muscle disfunctions in patients with pulmonary arterial hypertension are not well understood yet. This minireview highlights the pathways involved in skeletal muscle adaptations to aerobic exercise training in patients with pulmonary arterial hypertension.

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Mechanical ventilation (MV) is a life-saving respiratory support therapy, but MV can lead to diaphragm muscle injury (myotrauma) and induce diaphragmatic dysfunction (DD). DD is relevant because it is highly prevalent and associated with significant adverse outcomes, including prolonged ventilation, weaning failures, and mortality. The main mechanisms involved in the occurrence of myotrauma are associated with inadequate MV support in adapting to the patient's respiratory effort (over- and under-assistance) and as a result of patient-ventilator asynchrony (PVA). The recognition of these mechanisms associated with myotrauma forced the development of myotrauma prevention strategies (MV with diaphragm protection), mainly based on titration of appropriate levels of inspiratory effort (to avoid over- and under-assistance) and to avoid PVA. Protecting the diaphragm during MV therefore requires the use of tools to monitor diaphragmatic effort and detect PVA. Diaphragm ultrasound is a non-invasive technique that can be used to monitor diaphragm function, to assess PVA, and potentially help to define diaphragmatic effort with protective ventilation. This review aims to provide clinicians with an overview of the relevance of DD and the main mechanisms underlying myotrauma, as well as the most current strategies aimed at minimizing the occurrence of myotrauma with special emphasis on the role of ultrasound in monitoring diaphragm function.