Feasibility and safety of Heavy Lifting Strength Training in Head and Neck Cancer survivors post-surgical neck dissection (the LIFTING trial).

BACKGROUND: Light-to-moderate intensity strength training (LMST) improves muscular strength, physical functioning, and some side effects in head and neck cancer survivors (HNCS). Heavy lifting strength training (HLST) may further improve these outcomes; however, it has not been studied in HNCS. The primary aim of the LIFTING trial was to examine the feasibility and safety of a HLST program in HNCS ≥1-year post-surgical neck dissection. METHODS: In this single-arm feasibility study, HNCS were asked to complete a twice weekly, 12-week, supervised HLST program, gradually progressing to lifting heavy loads of 80-90% of 1 repetition maximum (1RM) for barbell squat, bench press, and deadlift. The feasibility outcomes included recruitment rate, 1RM completion rate, program adherence, barriers, and motivation. The preliminary efficacy outcomes included changes in upper and lower body strength. RESULTS: Nine HNCS were recruited over an 8-month period during the COVID-19 pandemic. All 9 (100%) completed the 1RM tests and successfully progressed to heavy loads at approximately 5 weeks. The median attendance was 95.8% (range 71-100%), and few barriers were reported. Weight lifted increased for squat/leg press (median change: +34kg; 95% CI +25 to +47), bench press (median change: +6kg; 95% CI +2 to +10), and deadlift (median change: +12kg; 95% CI +7 to +24). No adverse events were reported and participants were motivated to continue HLST after the study. CONCLUSIONS: HLST appears feasible and safe for HNCS and may result in meaningful improvements in muscular strength. Future research should consider additional recruitment strategies and compare HLST to LMST in this understudied survivor population. TRIAL REGISTRATION: NCT04554667.

Impact of Implementing and Lifting COVID-19 Lockdown on Study and Physical Activity Patterns Among Youths in China.

OBJECTIVE: The youths' study and physical activity (PA) patterns may have been affected by lockdown measures due to COVID-19. This study aimed to reveal how youths' study and PA patterns had changed after implementing and lifting COVID-19 lockdown in China. METHODS: The COVID-19 Impact on Lifestyle Change Survey (COINLICS) was used, where 10082 youth participants voluntarily reported their study and PA patterns in the 3 periods before, during, and after COVID-19 lockdown. PA was measured as the weekly frequency of engaging in active transport for commuting/errands, leisure-time walking, leisure-time moderate-/vigorous-intensity physical activity (MVPA), and moderate-/vigorous-intensity housework (MVH); study patterns were measured as the daily average study time and the major study modes. We assessed differences of these variables across educational levels, sex, and periods. RESULTS: The significant decreases were generally observed during lockdown in the frequency of active transport for commuting/ errands (1.3 to 0.2 days/ week), leisure-time walking (1.0 to 0.2 days/ week), leisure-time MVPA (0.7 to 0.3 days/ week), and MVH (2.3 to 2.0 days/ week), with heterogeneities existing between sexes and across educational levels, except for the increase in MVH engagement among graduate students, especially female (1.5 to 2.4 days/ week). Rebounds were observed in the frequency of all activities except MVH after lifting lockdown (2.0 to 1.9 days/ week). The average study time generally increased during lockdown, with more youths studying for 1 - 4 hours/ day and less studying for < 1 hour/ day, and further increased after lockdown. A main shift of study modes has been from in-class to online study after implementing lockdown. CONCLUSIONS: The youths' PA level have generally decreased, and study patterns significantly changed during and after lockdown in China. Our results would inform policymakers and educational administrators of the declined PA levels and changed study patterns among youths during COVID-19 lockdown for better policy making. In - class and/ or extracurricular PA programs could be designed to counteract those effects under cooperation of youths' parents.

Decline in reported measles cases in Italy in the COVID-19 era, January 2020 - July 2022: The need to prevent a resurgence upon lifting non-pharmaceutical pandemic measures.

From January 2020 to July 2022, 120 measles cases were reported to the Italian national surveillance system, of which 105 had symptom onset in 2020, nine in 2021 and six in the first seven months of 2022. This represents a sharp decline compared to the time period immediately preceding the COVID-19 pandemic, most likely due to the non-pharmaceutical interventions implemented to prevent SARS-CoV2 transmission. Of 105 cases reported in 2020, 103 acquired the infection before a national lockdown was instituted on 9 March 2020. Overall, one quarter of cases reported at least one complication. As non-pharmaceutical pandemic measures are being eased worldwide, and considering measles seasonality, infectiousness, and its potential severity, it is important that countries ensure high vaccination coverage and close immunity gaps, to avoid risk of future outbreaks.

Evaluation of the HeroWear Apex back-assist exosuit during multiple brief tasks.

Trunk exoskeletons are wearable devices that support humans during physically demanding tasks by reducing biomechanical loads on the back. While most trunk exoskeletons are rigid devices, more lightweight soft exoskeletons (exosuits) have recently been developed. One such exosuit is the HeroWear Apex, which achieved promising results in the developers' own work but has not been independently evaluated. This paper thus presents an evaluation of the Apex with 20 adult participants during multiple brief tasks: standing up from a stool with a symmetric or asymmetric load, lifting a unilateral or bilateral load from the floor to waist level, lifting the same bilateral load with a 90-degree turn to the right, lowering a bilateral load from waist level to floor, and walking while carrying a bilateral load. The tasks were performed in an ABA-style protocol: first with exosuit assistance disengaged, then with it engaged, then disengaged again. Four measurement types were taken: electromyography (of the erector spinae, rectus abdominis, and middle trapezius), trunk kinematics, self-report ratings, and heart rate. The exosuit decreased the erector spinae electromyogram by about 15% during object lifting and lowering tasks; furthermore, participants found the exosuit mildly to moderately helpful. No adverse effects on other muscles or during non-lifting tasks were noted, and a decrease in middle trapezius electromyogram was observed for one task. This confirms that the HeroWear Apex could reduce muscle demand and fatigue. The results may transfer to other exoskeletons with similar design principles, and may inform researchers working with other wearable devices.

Resumption of the treatment of non-COVID-19 gynecologic patients after lifting lockdown: Triage and infection prevention experiences from Wuhan.

AIM: To share our experiences of resuming the treatments for gynecologic patients after lifting the lockdown in a hotspot area for the Coronavirus Disease 2019 (COVID-19) pandemic. METHODS: The triage process used to resume medical activities for gynecologic patients at the Wuhan Union Hospital after a 76-day lockdown of the city is described, and its effectiveness in preventing COVID-19 nosocomial transmission is shown. RESULTS: Nonemergency patients were pretriaged based on their contact history and body temperature at an outpatient clinic, and negative COVID-19 screening test results were required for admission to the buffering rooms at the gynecologic department. The buffering lasted at least 3 days for symptom monitoring, and a second round of COVID-19 testing was required before patients could be transferred to the regular gynecologic wards. For patients who needed emergency surgery, the first screening was completed at the isolation wards after surgery, followed by buffering at the gynecologic department. We received 19 298 outpatient visits, admitted 326 patients, and performed 223 operations in the first 2 months after the lockdown was lifted. No COVID-19 cases occurred in the hospitalized patients, while the proportion of potentially high-risk patients with cancer and severe anemia was increased in comparison to that observed during the same period in 2019 and the first 2 months of 2020 before the lockdown. CONCLUSIONS: We provide an effective triage system with buffering at two levels to guarantee safe and timely treatment for non-COVID-19 gynecologic patients in the postlockdown phase.