Digital technologies in the public-health response to COVID-19.

Digital technologies are being harnessed to support the public-health response to COVID-19 worldwide, including population surveillance, case identification, contact tracing and evaluation of interventions on the basis of mobility data and communication with the public. These rapid responses leverage billions of mobile phones, large online datasets, connected devices, relatively low-cost computing resources and advances in machine learning and natural language processing. This Review aims to capture the breadth of digital innovations for the public-health response to COVID-19 worldwide and their limitations, and barriers to their implementation, including legal, ethical and privacy barriers, as well as organizational and workforce barriers. The future of public health is likely to become increasingly digital, and we review the need for the alignment of international strategies for the regulation, evaluation and use of digital technologies to strengthen pandemic management, and future preparedness for COVID-19 and other infectious diseases.

Cytokine mRNA expression responses to resistance, aerobic, and concurrent exercise in sedentary middle-aged men.

Concurrent resistance and aerobic exercise (CE) is recommended to ageing populations, though is postulated to induce diminished acute molecular responses. Given that contraction-induced cytokine mRNA expression reportedly mediates remunerative postexercise molecular responses, it is necessary to determine whether cytokine mRNA expression may be diminished after CE. Eight middle-aged men (age, 53.3 ±1.8 years; body mass index, 29.4 ± 1.4 kg·m(-2)) randomly completed (balanced for completion order) 8 × 8 leg extensions at 70% maximal strength (RE), 40 min of cycling at 55% of peak aerobic workload (AE), or (workload-matched) 50% RE and 50% AE (CE). Muscle (vastus lateralis) was obtained pre-exercise, and at 1 h and 4 h postexercise, and analyzed for changes of glycogen concentration, tumor necrosis factor (TNF)α, TNF receptor-1 and -2 (TNF-R1 and TNF-R2, respectively), interleukin (IL)-6, IL-6R, IL-1ß, and IL-1 receptor-antagonist (IL-1ra). All exercise modes upregulated cytokine mRNA expression at 1 h postexercise comparably (TNFα, TNF-R1, TNF-R2, IL-1ß, IL-6) (p < 0.05). Expression remained elevated at 4 h after RE and AE (p < 0.05), though returned to pre-exercise levels after CE (p > 0.05). Moreover, AE and RE upregulated IL-1ß and IL-1ra expression, whereas CE upregulated IL-1ß expression only (p < 0.05). Only AE reduced muscle glycogen concentration (p < 0.05), whilst upregulating receptor expression the greatest; though, IL-6R expression remained unchanged after all modes (p > 0.05). In conclusion, in middle-aged men, all modes induced commensurate cytokine mRNA expression at 1 h postexercise; however, only CE resulted in ameliorated expression at 4 h postexercise. Whether the RE or AE components of CE are independently or cumulatively sufficient to upregulate cytokine responses, or whether they collectively inhibit cytokine mRNA expression, remains to be determined.

Concurrent resistance and aerobic exercise stimulates both myofibrillar and mitochondrial protein synthesis in sedentary middle-aged men.

We determined myofibrillar and mitochondrial protein fractional synthesis rates (FSR), intramuscular signaling protein phosphorylation, and mRNA expression responses after isolated bouts of resistance exercise (RE), aerobic exercise (AE), or in combination [termed concurrent exercise (CE)] in sedentary middle-aged men. Eight subjects (age = 53.3 ± 1.8 yr; body mass index = 29.4 ± 1.4 kg·m(2)) randomly completed 8 × 8 leg extension repetitions at 70% of one repetition-maximum, 40 min of cycling at 55% peak aerobic power output (AE), or (consecutively) 50% of the RE and AE trials (CE). Biopsies were obtained (during a primed, constant infusion of l-[ring-(13)C(6)]phenylalanine) while fasted, and at 1 and 4 h following postexercise ingestion of 20 g of protein. All trials increased mitochondrial FSR above fasted rates (RE = 1.3-fold; AE = 1.5; CE = 1.4; P < 0.05), although only CE (2.2) and RE (1.8) increased myofibrillar FSR (P < 0.05). At 1 h postexercise, phosphorylation of Akt on Ser(473) (CE = 7.7; RE = 4.6) and Thr(308) (CE = 4.4; RE = 2.9), and PRAS40 on Thr(246) (CE = 3.8; AE = 2.5) increased (P < 0.05), with CE greater than AE for Akt Ser(473)-Thr(308) and greater than RE for PRAS40 (P < 0.05). Despite increased phosphorylation of Akt-PRAS40, phosphorylation of mammalian target of rapamycin (Ser(2448)) remained unchanged (P > 0.05), while rpS6 (Ser(235/236)) increased only in RE (10.4) (P < 0.05). CE and AE both resulted in increased peroxisome proliferator receptor-γ coactivator 1-α (PGC1α) expression at 1 h (CE = 2.9; AE = 2.8; P < 0.05) and 4 h (CE = 2.6; AE = 2.4) and PGC1ß expression at 4 h (CE = 2.1; AE = 2.6; P < 0.05). These data suggest that CE-induced acute stimulation of myofibrillar and mitochondrial FSR, protein signaling, and mRNA expression are equivalent to either isolate mode (RE or AE). These results occurred without an interference effect on muscle protein subfractional synthesis rates, protein signaling, or mRNA expression.

Intermittent-sprint performance and muscle glycogen after 30 h of sleep deprivation.

PURPOSE: The aim of this study was to determine the effects of 30 h of sleep deprivation on consecutive-day intermittent-sprint performance and muscle glycogen content. METHODS: Ten male, team-sport athletes performed a single-day "baseline" session and two consecutive-day experimental trials separated either by a normal night's sleep (CONT1 and CONT2) or no sleep (SDEP1 and SDEP2). Each session included a 30-min graded exercise run and 50-min intermittent-sprint exercise protocol, including a 15-m maximal sprint every minute and self-paced exercise bouts of varying intensities. Muscle biopsies were extracted before and after exercise during the baseline session and before exercise on day 2 during experimental trials. Voluntary force and activation of the right quadriceps, nude mass, HR, core temperature, capillary blood lactate and glucose, RPE, and a modified POMS were recorded before, after, and during the exercise protocols. RESULTS: Mean sprint times were slower on SDEP2 (2.78±0.17 s) compared with SDEP1 (2.70±0.16 s) and CONT2 (2.74±0.15 s, P<0.05). Distance covered during self-paced exercise was reduced during SDEP2 during the initial 10 min compared with SDEP1 and during the final 10 min compared with CONT2 (P<0.05). Muscle glycogen concentration was lower before exercise on SDEP2 (209±60 mmol·kg dry weight) compared with CONT2 (274±54 mmol·kg dry weight, P=0.05). Voluntary force and activation were reduced on day 2 of both conditions; however, both were lower in SDEP2 compared with CONT2 (P<0.05). Sleep loss did not affect RPE but negatively affected POMS ratings (P<0.05). CONCLUSIONS: Sleep loss and associated reductions in muscle glycogen and perceptual stress reduced sprint performance and slowed pacing strategies during intermittent-sprint exercise for male team-sport athletes.

Early time course of Akt phosphorylation after endurance and resistance exercise.

PURPOSE: The aim of this study was to determine the early time course of exercise-induced signaling after divergent contractile activity associated with resistance and endurance exercise. METHODS: Sixteen male subjects were randomly assigned to either a cycling (CYC; n = 8, 60 min, 70% V˙O2peak) or resistance (REX; n = 8, 8 x 5 leg extension, 80% one-repetition maximum, 3-min recovery) exercise group. Serial muscle biopsies were obtained from vastus lateralis at rest before, immediately after, and after 15, 30, and 60 min of passive recovery to determine early signaling responses after exercise. RESULTS: There were comparable increases from rest in Akt(Thr308/Ser473) and mTOR(Ser2448) phosphorylation during the postexercise time course that peaked 30-60 min after both CYC and REX (P < 0.05). There were also similar patterns in p70S6K(Thr389) and 4E-BP1(Thr37/46) phosphorylation, but a greater magnitude of effect was observed for REX and CYC, respectively (P < 0.05). However, AMPK(Thr172) phosphorylation was only significantly elevated after CYC (P < 0.05), and we observed divergent responses for glycogen synthase(Ser641) and AS160 phosphorylation that were enhanced after CYC but not REX (P < 0.05). CONCLUSIONS: We show a similar time course for Akt-mTOR-S6K phosphorylation during the initial 60-min recovery period after divergent contractile stimuli. Conversely, enhanced phosphorylation status of proteins that promote glucose transport and glycogen synthesis only occurred after endurance exercise. Our results indicate that endurance and resistance exercise initiate translational signaling, but high-load, low-repetition contractile activity failed to promote phosphorylation of pathways regulating glucose metabolism.