Repeated-sprint training in hypoxia boosts up team-sport-specific repeated-sprint ability: 2-week vs 5-week training regimen.

PURPOSE: To investigate (1) the boosting effects immediately and 4 weeks following 2-week, 6-session repeated-sprint training in hypoxia (RSH2-wk, n = 10) on the ability of team-sport players in performing repeated sprints (RSA) during a team-sport-specific intermittent exercise protocol (RSAIEP) by comparing with normoxic counterpart (CON2-wk, n = 12), and (2) the dose effects of the RSH by comparing the RSA alterations in RSH2-wk with those resulting from a 5-week, 15-session regimen (RSH5-wk, n = 10). METHODS: Repeated-sprint training protocol consisted of 3 sets, 5 × 5-s all-out sprints on non-motorized treadmill interspersed with 25-s passive recovery under the hypoxia of 13.5% and normoxia, respectively. The within- (pre-, post-, 4-week post-intervention) and between- (RSH2-wk, RSH5-wk, CON2-wk) group differences in the performance of four sets of RSA tests held during the RSAIEP on the same treadmill were assessed. RESULTS: In comparison with pre-intervention, RSA variables, particularly the mean velocity, horizontal force, and power output during the RSAIEP enhanced significantly immediate post RSH in RSH2-wk (5.1-13.7%), while trivially in CON2-wk (2.1-6.2%). Nevertheless, the enhanced RSA in RSH2-wk diminished 4 weeks after the RSH (- 3.17-0.37%). For the RSH5-wk, the enhancement of RSA immediately following the 5-week RSH (4.2-16.3%) did not differ from that of RSH2-wk, yet the enhanced RSA was well-maintained 4-week post-RSH (0.12-1.14%). CONCLUSIONS: Two-week and five-week RSH regimens could comparably boost up the effects of repeated-sprint training in normoxia, while dose effect detected on the RSA enhancement was minimal. Nevertheless, superior residual effects of the RSH on RSA appear to be associated with prolonged regimen.

Cardiac autonomic disturbance following resistance and sprint-interval exercises in non-obese and obese young men.

This study examined the alterations of heart rate variability (HRV) following iso-duration resistance (RES) and sprint-interval exercises (SIE) by comparing with that of non-exercise control (CON) in 14 non-obese (NOB) and 15 obese (OB) young men. Time and frequency domain measures as well as nonlinear metrics of HRV were assessed before and immediately after exercise, and during every 20 min until 120 min post-exercise. The variables during the first 4 h of actual sleep time at night, and the period of 12-14 h post-exercise were also measured. All trials were scheduled at 20:00. It was found that RES and SIE attenuated the HRV in both NOB and OB (P < 0.05), and the attenuated HRV restored progressively during subsequent recovery. Although the changes in HRV indices among various time points during the recovery period and its interaction across RES, SIE, and CON were not different between NOB and OB, the restoration of the declined HRV indices to corresponding CON level in the 2 exercise trials in OB appeared to be sluggish in relative to NOB. Notwithstanding, post-exercise HRV that recorded during actual sleep at night and during 12-14 h apart from exercise were unvaried among the 3 trials in both groups (P > 0.05). These findings suggest that obesity is likely to be a factor hindering the removal of exercise-induced cardiac autonomic disturbance in young men. Nonetheless, the declined HRV following both the RES and SIE protocols was well restored after a resting period of ∼10 h regardless of obesity. The study was registered at ISRCTN as https://doi.org/10.1186/ISRCTN88544091.

The Physiological and Psychological Benefits of Dance and its Effects on Children and Adolescents: A Systematic Review.

Background: The aim of this review was to examine the physiological and psychological benefits of dance and its effects on children and adolescents. We consider the therapeutic benefits of dance and outline the potential of dance as an alternative therapy for certain pathologies and medical disorders. Secondly, we summarize the types of dances used in physical interventions, and comment on the methodologies used. Finally, we consider the use of dance as a different exercise modality that may have benefits for increased physical activity generally, and for increased physical education provision in schools. Methods: A structured search strategy was conducted using the databases of PubMed, MEDLINE, Web of science, PsycARTICLES, and Social Science database. This review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews. Studies that were published in the past 20 years were considered for inclusion. All written publications were searched for in English, and all articles included in this review were peer reviewed full papers. Conclusion: The key findings from this review indicate that dance is a feasible alternative to traditional physical activity. The findings also indicate that dance provides physiological and psychological benefits to healthy and medically compromised populations. Implementation of dance programs in schools and society generally needs serious consideration by policy makers. We hope that the results of this review stimulate debate and provide the necessary evidence to profile dance as a viable alternative medium of physical activity. Comprehensive and integrated changes will be needed including economical and legislative support from politicians and associated governmental agencies. The findings reported here are important and have implications for health policy change, reconfiguration, and implementation.

Interventions for health-related physical fitness and overweight and obesity in children with intellectual disability: Systematic review and meta-analysis.

BACKGROUND: Poor health-related physical fitness (HRPF) and overweight and obesity are common health problems for children with intellectual disability. This study aimed to review existing lifestyle intervention studies, and identify effective strategies for this population. METHODS: A systematic search was undertaken in three databases. The random-effects model was used to pool the weighted results by inverse variance methods, and the I2 statistic was applied to assess heterogeneity among the included studies. RESULTS: Most of the identified interventions (27/29) adopted physical activity (PA). For obesity-related outcomes, the results showed no significant effect of PA studies on reducing obesity. For HRPF outcomes, significant effects were found on 6-min walk distance (51.86 m, 95% CI [16.49, 87.22], p < .05). CONCLUSIONS: PA is the predominant intervention component adopted and may contribute to improving cardiopulmonary fitness; but the lack of research limits our ability to draw any confirmed conclusion on obesity-related outcomes and other HRPF outcomes.

Cardiac autonomic disturbance following sprint-interval exercise in untrained young males: Does exercise volume matter?

OBJECTIVES: This study examined the influences of the volume of all-out sprint-interval exercise (SIE) on acute post-exercise heart rate variability (HRV) recovery. METHODS: HRV recovery following a session of (i) 2 × 30-s SIE (SIE2), (ii) 4 × 30-s SIE (SIE4), and (iii) non-exercising control (CON) were compared in 15 untrained young males. Time domain [standard deviation of normal-to-normal intervals, root mean square of successive R-R differences] and frequency domain [low frequency (0.04-0.14 Hz), high frequency (0.15-0.40 Hz)] measures of HRV were assessed every 20 min for 140 min after the exercise, and every hour during the first 4 h of actual sleep time at immediate night. All trials were scheduled at 19:00. RESULTS: In comparison to CON, both SIE2 and SIE4 attenuated the HRV markedly (p < 0.05), while the declined HRV restored progressively during recovery. Although the sprint repetitions of SIE4 was twice as that of SIE2, the declined HRV indices at corresponding time points during recovery were not different between the two trials (p > 0.05). Nevertheless, the post-exercise HRV restoration in SIE2 appeared to be faster than that in SIE4. Regardless, nocturnal HRV measured within 10 h following the exercise was not different among the SIE and CON trials (p > 0.05). CONCLUSION: Such findings suggest that the exercise volume of the SIE protocol may be a factor affecting the rate of removal of the cardiac autonomic disturbance following the exercise. In addition, rest for ∼10 h following either session of the SIE protocol appears to be appropriate for the cardiovascular system to recover.

Acute performance responses to repeated treadmill sprints in hypoxia with varying inspired oxygen fractions, exercise-to-recovery ratios and recovery modalities.

PURPOSE: For optimizing the quality of repeated-sprint training in hypoxia, the differences in the acute performance responses to a single session of repeated-sprint exercise with various (i) inspired oxygen fractions; (ii) exercise-to-recovery (E:R) ratios and (iii) recovery modalities were examined. METHODS: Ten male participants performed three sets, 5 × 5-s all-out treadmill sprints, E:R ratio of 1:5, passive recovery, in seven trials randomly. In four of the seven trials, hypoxic levels were set corresponding to sea level (SL1:5P), 1500 (1.5K1:5P), 2500 (2.5K1:5P), and 3500 m (3.5K1:5P), respectively. In a further two trials, the hypoxic level of 3.5K1:5P was maintained, while the E:R ratio was reduced to 1:4 (3.5K1:4P) and 1:3 (3.5K1:3P), respectively. In the last trial, the passive recovery mode of 3.5K1:5P was changed to active (3.5K1:5A). RESULTS: In comparison to SL1:5P, the averaged peak velocity (P-Vel), mean velocity (M-Vel), and velocity decrement score (Sdec) of the sprints, and the cumulative HR-based training impulse (cTRIMP) in 1.5K1:5P and 2.5K1:5P were well maintained. Minor decrement in the M-Vel was found in 3.5K1:5P. Conversely, lowered E:R ratio in 3.5K1:4P and 3.5K1:3P significantly reduced the P-Vel (≥ -2.3%, Cohen's d ≥ 0.43) and M-Vel (≥ -2.4%, ≥ 0.49), and in 3.5K1:3P altered the Sdec (107%, ≥ 0.96), and cTRIMP (-16%, 1.39), when compared to 3.5K1:5P. Furthermore, mild reductions in M-Vel (-2.6%, 0.5) was observed in 3.5K1:5A using the active recovery mode. Other variables did not change. CONCLUSION: The findings suggest that a 3.5K1:5P marginally maintained sea-level training loads, and as a result, could maximally optimize the training stress of hypoxia.

Effects of a School-Based Physical Activity Intervention for Obesity and Health-Related Physical Fitness in Adolescents With Intellectual Disability: Protocol for a Randomized Controlled Trial.

BACKGROUND: Childhood obesity accompanied by lower levels of health-related physical fitness (HRPF) is a major threat to public health both internationally and locally. Children with intellectual disability, especially adolescents, have a higher risk of being overweight/obese and having poor HRPF levels. Therefore, more interventions are needed to help this population attain their optimal health levels. However, there has been relatively limited research on this population compared with on their typically developing peers. OBJECTIVE: The proposed study aims to fill this knowledge gap by developing and examining the success of a physical activity (PA) intervention for the target population. METHODS: The proposed study will be a 12-week, school-based randomized controlled trial. The participants (N=48) will be recruited from special schools for students with mild intellectual disability and then randomly allocated to either the intervention group (IG) or the wait-list control group (CG). During the intervention period, the participants in the IG will receive a fun game-based moderate-to-vigorous PA (MVPA) training program (2 sessions/week, 60 minutes/session, for a total of 24 sessions). The intensity of the activities will increase in a progressive manner. Participants in the CG will receive no program during the study period, but the same PA program will be provided to them after the completion of the study. To observe and evaluate the sustaining effects of the intervention, follow-up testing will be scheduled for the participants 12 weeks after the intervention concludes. The study outcomes will include primary outcomes (obesity- and fitness-related outcomes) and a secondary outcome (blood pressure). All of the measurements will be taken at 3 time points. After the follow-up tests, the same PA training program will be provided to the participants in the CG. RESULTS: This study is ongoing. The participants were recruited from October 2020 to November 2020. The total duration of the study is 13 months. Study results are expected at the end of 2021. CONCLUSIONS: The proposed study is expected to reduce obesity and improve HRPF levels in children with intellectual disability. If proven effective, the intervention will be made accessible to more special schools and mainstream schools with students with intellectual disability. Furthermore, the study can serve as an example for international researchers, policy makers, and members of the public who are seeking to tackle the problem of obesity and poor HRPF among children with intellectual disability. TRIAL REGISTRATION: ClinicalTrials.gov NCT04554355; https://www.clinicaltrials.gov/ct2/show/NCT04554355. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/25838.

A Combined Approach for Health Assessment in Adolescent Endurance Runners.

BACKGROUND: It has been shown that prolonged exhaustive exercise, such as half-marathon running, could lead to transient post-exercise elevation of cardiac troponins, increase in oxidative stress, and mild decline in renal function in adolescent athletes. With increases in sports participation involving young people, there has been much interest in pre and post health evaluations following exercise. Evaluations can be used to identify pre-existing health confounders and to examine any detrimental responses that may occur post exercise. Study purpose & Methods: The purpose of this study was to evaluate pre and post exercise measures of cardiac function, serum albumin, systemic immunoglobulin (Serum IgA and IgG), cortisol and testosterone in adolescent (age: 16.2 ± 0.6) male endurance runners performing in 21-km maximal run. RESULTS: Results revealed that cortisol, IgA and IgG levels significantly decreased 2, 4, and 24 h post exercise compared to pre-exercise levels (p < 0.05). Testosterone levels reduced 4 h post exercise (p < 0.05) but were restored to baseline values following 24 h. There were no changes recorded for albumin levels post exercise (p > 0.05). ECG assessments did not show any abnormalities at the T wave axis, ST segments and Q wave pre or post exercise. CONCLUSIONS: The findings from this study suggest that a single bout of prolonged maximum running is not likely to induce abnormal electrical activity in the heart, but does decrease serum immunoglobulin, and homeostasis of anabolic and catabolic hormones in trained adolescent endurance runners.

A two-phase stochastic dynamic model for COVID-19 mid-term policy recommendations in Greece: a pathway towards mass vaccination

From November 7th, 2020, Greece adopted a second nationwide lockdown policy to mitigate the transmission of SARS-CoV-2 (the first took place from March 23rd till May 4th, 2020), just as the second wave of COVID-19 was advancing, as did other European countries. In the light of the very promising voluntary mass vaccination, which will start in January 2021, it is of utmost importance for the country to plan to complement vaccination with mid-term Non-Pharmaceutical Interventions (NPIs). The objective is to minimize human losses and to limit social and economic costs. In this paper a two-phase stochastic dynamic network compartmental model (a pre-vaccination SEIR until February 15th, 2021 and a post-vaccination SVEIR from February 15th, 2021 to June 30th, 2021) is developed. Three scenarios are assessed in the first phase: (a) a baseline scenario, which lifts the national lockdown and all NPIs on January 2021, (b) a "semi-lockdown" scenario with school opening, partial retail sector operation, universal mask wearing and social distancing/teleworking on January 2021 and (c) a "rolling lockdown" scenario combining a partial lifting of measures in January 2021 followed by a third imposed nationwide lockdown in February 2021. In the second phase three scenarios with different vaccination rates are assessed. Publicly available data along with some preliminary first results of the SHARE COVID-19 survey conducted in Greece are used as input. The results regarding the first phase indicate that the "semi-lockdown" scenario outperforms the third lockdown scenario (5.7% less expected fatalities), whereas in the second phase it is of great importance to ensure a sufficient vaccine supply and high vaccination rates.

Exercise training-induced visceral fat loss in obese women: The role of training intensity and modality.

Visceral fat loss in response to four-cycle ergometer training regimens with explicit differences in exercise intensity and modality was compared. Fifty-nine obese young women (body fat percentage ≥ 30%) were randomized to a 12-week intervention consisting of either all-out sprint interval training (SITall-out , n = 11); supramaximal SIT (SIT120 , 120% V ˙ O2peak , n = 12); high-intensity interval training (HIIT90 , 90% V ˙ O2peak , n = 12), moderate-intensity continuous training (MICT, 60% V ˙ O2peak , n = 11), or no training (CON, n = 13). The total work done per training session in SIT120 , HIIT90 , and MICT was confined to 200 kJ, while it was deliberately lower in SITall-out . The abdominal visceral fat area (AVFA) was measured through computed tomography scans. The whole-body and regional fat mass were assessed through dual-energy X-ray absorptiometry. Pre-, post-, and 3-hour post-exercise serum growth hormone (GH), and epinephrine (EPI) were measured during selected training sessions. Following the intervention, similar reductions in whole-body and regional fat mass were found in all intervention groups, while the reductions in AVFA resulting from SITall-out , SIT120 , and HIIT90 (>15 cm2 ) were greater in comparison with MICT (<3.5 cm2 , P < .05). The AVFA reductions among the SITs and HIIT groups were similar, and it was concomitant with the similar exercise-induced releases of serum GH and EPI. CON variables were unchanged. These findings suggest that visceral fat loss induced by interval training at or above 90% V ˙ O2peak appeared unresponsive to the change in training intensity. Nonetheless, SITall-out is still the most time-efficient strategy among the four exercise-training regimes for controlling visceral obesity.

Short-Term Ketogenic Diet Improves Abdominal Obesity in Overweight/Obese Chinese Young Females.

The purpose of this study was to examine the effects of a short-term ketogenic diet (KD) on body composition and cardiorespiratory fitness (CRF) in overweight/obese Chinese females. Twenty young females [age: 21.0 ± 3.7 years, weight: 65.5 ± 7.7 kg, body mass index (BMI): 24.9 ± 2.7 kg⋅m-2] consumed 4 weeks of a normal diet (ND) as a baseline and then switched to a low-carbohydrate, high-fat, and adequate protein KD for another 4 weeks. With the same daily caloric intake, the proportions of energy intake derived from carbohydrates, proteins, and fats were changed from 44.0 ± 7.6%, 15.4 ± 3.3%, 39.6 ± 5.8% in ND to 9.2 ± 4.8%, 21.9 ± 3.4%, and 69.0 ± 5.4% in KD. The results showed that, without impairing the CRF level, the 4-week KD intervention significantly reduced body weight (-2.9 kg), BMI (-1.1 kg⋅m-2), waist circumference (-4.0 cm), hip circumference (-2.5 cm), and body fat percentage (-2.0%). Moreover, fasting leptin level was lowered significantly, and serum levels of inflammatory markers (i.e., TNF-α and MCP-1) were unchanged following KD. These findings suggest that KD can be used as a rapid and effective approach to lose weight and reduce abdominal adiposity in overweight/obese Chinese females without exacerbating their CRF.

Multiplex real-time PCR assays for the prediction of cephalosporin, ciprofloxacin and azithromycin antimicrobial susceptibility of positive Neisseria gonorrhoeae nucleic acid amplification test samples.

BACKGROUND: The incidence of antimicrobial-resistant Neisseria gonorrhoeae (GC) is rising in Canada; however, antimicrobial resistance (AMR) surveillance data are unavailable for infections diagnosed directly from clinical specimens by nucleic acid amplification tests (NAATs), representing over 80% of diagnoses. We developed a set of 10 improved molecular assays for surveillance of GC-AMR and prediction of susceptibilities in NAAT specimens. METHODS: Multiplex real-time PCR (RT-PCR) assays were developed to detect SNPs associated with cephalosporin (ponA, porB, mtrR -35delA, penA A311V, penA A501, N513Y, G545S), ciprofloxacin (gyrA S91, parC D86/S87/S88) and azithromycin [23S (A2059G, C2611T), mtrR meningitidis-like promoter] resistance. The assays were validated on 127 gonococcal isolates, 51 non-gonococcal isolates and 50 NAATs with matched culture isolates. SNPs determined from the assay were compared with SNPs determined from in silico analysis of WGS data. MICs were determined for culture isolates using the agar dilution method. RESULTS: SNP analysis of the 50 NAAT specimens had 96% agreement with the matched culture RT-PCR analysis. When compared with MICs, presence of penA A311V or penA A501 and two or more other SNPs correlated with decreased susceptibility and presence of three or more other SNPs correlated with intermediate susceptibility to cephalosporins; presence of any associated SNP correlated with ciprofloxacin or azithromycin resistance. NAAT-AMR predictions correlated with matched-culture cephalosporin, ciprofloxacin and azithromycin MICs at 94%, 100% and 98%, respectively. CONCLUSIONS: We expanded molecular tests for N. gonorrhoeae AMR prediction by adding new loci and multiplexing reactions to improve surveillance where culture isolates are unavailable.

Effects of Specific Core Re-Warm-Ups on Core Function, Leg Perfusion and Second-Half Team Sport-Specific Sprint Performance: A Randomized Crossover Study.

This study examined the effects of a specific core exercise program, as a re-warm-up regime during the half-time period, on inspiratory (IM) and core (CM) muscle functions, leg perfusion and the team sport-specific sprint performance in the initial stage of the second half of a simulated exercise task. Nine team-sports players performed a simulated team-sport intermittent exercise protocol (IEP) in two phases, on a non-motorized treadmill, interspersed by a 15-min half-time break. During the half-time period subsequent to the 25-min Phase-1 IEP, the players either rested passively or performed 4-min CM exercise concomitant with inspiratory loaded breathing following 11-min passive recovery. The changes in IM and CM functions, leg perfusion and repeated-sprint ability mediated by the two recovery modes were compared. Following Phase-1 IEP, there was a significant decline in IM and CM functions respectively, revealed by the decreases in maximal inspiratory pressure (PImax: -8.1%) and performance of a sport-specific endurance plank test (SEPT: -29.7%, p < 0.05). With the 15-min passive recovery, the decline in IM and CM functions from pre-exercise levels were not restored satisfactorily (PImax: -6.4%, SEPT: -19.0%, p < 0.05). Moreover, repeated-sprint ability during the Phase-2 IEP tended to decrease (peak velocity: -2.3%, mean velocity: -2.1%) from the levels recorded in Phase-1. In contrast, following the re-warm-up exercises during half-time, the restoration of IM and CM function was accelerated (PImax: -0.9%, SEPT: -3.3%, p <0 .05). This was associated with enhanced repeated-sprint ability (peak velocity: +3.0%, mean velocity: +2.0%, p < 0.05) in Phase-2 IEP. Nevertheless, the changes in the anterior thigh muscle perfusion assessed by near-infrared spectroscopy following the re-warm-up exercises was not different from that of passive recovery (p > 0.05). The findings suggest that a brief inspiratory-loaded CM exercise regime appears to be an effective re-warm-up strategy that optimizes second-half repeated-sprint performance and core function of players in team sports.

High-intensity interval exercise lowers postprandial glucose concentrations more in obese adults than lean adults.

AIMS: To compare postprandial glucose responses to high-intensity interval exercise (HIE) between obese and lean individuals. METHODS: Thirty healthy young adult males (15 obese, 15 lean) ate a standardised meal, then performed HIE (4 × 30-s Wingate cycling/4-min rest) or a no-exercise control trial (CON). Blood glucose was measured preprandially and up to 150 min postprandially. RESULTS: Compared to CON, HIE reduced postprandial glucose concentrations at 120-150 min in obese (p < 0.001) and lean men (p < 0.05), with greater reductions in obese than lean subjects at 120 (-27.0% vs. -8.3%), 135 (-31.9% vs. -15.7%), and 150 min (-21.8% vs. -10.6%). The total glucose area under the curve (AUC) for the testing period was lower with HIE than CON among obese men (p < 0.05), but not lean men (p > 0.05). We found moderate correlations between body mass and postprandial glucose changes (r = 0.39-0.44, p < 0.05), and between glucose AUC and body mass and fat free mass (r = 0.39-0.48, p < 0.05). CONCLUSIONS: Our findings suggest that HIE may act as a time-efficient lifestyle intervention strategy for improving obesity-related diabetes risk factors, and might play a role in primary diabetes prevention for the healthy but sedentary population.

Multidrug-resistant and extensively drug-resistant Neisseria gonorrhoeae in Canada, 2012-2016.

BACKGROUND: Neisseria gonorrhoeae have acquired resistance to many antimicrobials, including third generation cephalosporins and azithromycin, which are the current gonococcal combination therapy recommended by the Canadian Guidelines on Sexually Transmitted Infections. OBJECTIVE: To describe antimicrobial susceptibilities for N. gonorrhoeae circulating in Canada between 2012 and 2016. METHODS: Antimicrobial resistance profiles were determined using agar dilution of N. gonorrhoeae isolated in Canada 2012-2016 (n=10,167) following Clinical Laboratory Standards Institute guidelines. Data were analyzed by applying multidrug-resistant gonococci (MDR-GC) and extensively drug-resistant gonococci (XDR-GC) definitions. RESULTS: Between 2012 and 2016, the proportion of MDR-GC increased from 6.2% to 8.9% and a total of 19 cases of XDR-GC were identified in Canada (0.1%, 19/18,768). The proportion of isolates with decreased susceptibility to cephalosporins declined between 2012 and 2016 from 5.9% to 2.0% while azithromycin resistance increased from 0.8% to 7.2% in the same period. CONCLUSION: While XDR-GC are currently rare in Canada, MDR-GC have increased over the last five years. Azithromycin resistance in N. gonorrhoeae is established and spreading in Canada, exceeding the 5% level at which the World Health Organization states an antimicrobial should be reviewed as an appropriate treatment. Continued surveillance of antimicrobial susceptibilities of N. gonorrhoeae is necessary to inform treatment guidelines and mitigate the impact of resistant gonorrhea.

Addressing the rising rates of gonorrhea and drug-resistant gonorrhea: There is no time like the present.

Increasing rates of gonococcal (GC) infection and antimicrobial resistant (AMR) GC, are a serious public health concern for Canada and around the world. Previously recommended treatments are ineffective against many of the gonorrhea strains circulating today. The current recommendation for combination therapy is now being threatened by globally emerging and increasingly resistant strains. It is important that coordinated efforts be made now to ensure these new global strains do not become established in Canada. Otherwise, we will be faced with the possibility of persistent GC infection which can lead to pelvic inflammatory disease, infertility and chronic pelvic pain in women; and epididymitis in men. The presence of GC can also increase the risk of HIV acquisition and transmission. There are a number of reasons why we are facing this public health threat. GC infection is often asymptomatic and it is highly transmissible. People may hesitate to seek testing (or to offer testing). Treatment is complex: recommendations vary by site of infection and risk of resistance. Sexual contact during travel is an important source of imported emerging resistant global strains. The new screening and diagnostic Nucleic Acid Amplification Test (NAAT) is excellent but has decreased the number of cultures being done and therefore our capacity to track AMR-GC. There are four key actions that clinicians and front-line public health professionals can take to stem the increase in rates of GC and drug resistant GC. First, normalize and increase GC screening based on risk factors and emphasize the need for safer sex practices. NAAT is useful for screening, but culture is still needed for extra-genital sites. Second, conduct pretravel counselling and include a travel history as part of the risk assessment. Third, use culture along with NAAT to establish the diagnosis and follow up for test-of-cure. Finally, refer to the most current Canadian Guidelines on Sexually Transmitted Infections or provincial/territorial recommendations on combination therapies for patients and their contacts as recommendations may have changed in response to evolving AMR-GC trends.

Preoperative Assessment of Bone Quality in Spine Deformity Surgery: Correlation With Clinical Practice and Published Recommendations.

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The goals of this study were to (A) evaluate preoperative bone quality assessment and intervention practice over time and (B) review the current evidence for bone evaluation in spine fusion surgery. SUMMARY OF BACKGROUND DATA: Deformity spine surgery has demonstrated improved quality of life in patients; however, its cost has made it controversial. If preoperative bone quality can be optimized then potentially these treatments could be more durable; however, at present, no clinical practice guidelines have been published by professional spine surgical organizations. METHODS: A retrospective cohort review was performed on patients who underwent a minimum five-level primary or revision fusion. Preoperative bone quality metrics were evaluated over time from 2012 to 2017 to find potential trends. Subgroup analysis was conducted based on age, sex, preoperative diagnosis, and spine fusion region. RESULTS: Patient characteristics including preoperative rates of pseudarthrosis and junctional failure did not change. An increasing trend of physician bone health documentation was noted (P = 0.045) but changes in other metrics were not significant. A sex bias favored females who had higher rates of preoperative DXA studies (P = 0.001), Vitamin D 25-OH serum labs (P = 0.005), Vitamin D supplementation (P = 0.022), calcium supplementation (P < 0.001), antiresorptive therapy (P = 0.016), and surgeon clinical documentation of bone health (P = 0.008) compared with men. CONCLUSION: Our spine surgeons have increased documentation of bone health discussions but this has not affected bone quality interventions. A discrepancy exists favoring females over males in nearly all preoperative bone quality assessment metrics. Preoperative vitamin D level and BMD assessment should be considered in patients undergoing long fusion constructs; however, the data for bone anabolic and resorptive agents have less support. Clinical practice guidelines on preoperative bone quality assessment spine patients should be defined. LEVEL OF EVIDENCE: 4.

Twelve weeks of low volume sprint interval training improves cardio-metabolic health outcomes in overweight females.

This study compared the effects of 12-week sprint interval training (SIT), high-intensity interval training (HIIT), and moderate-intensity continuous training (MICT) on cardiorespiratory fitness (V̇O2peak), body mass and insulin sensitivity in overweight females. Forty-two overweight women (age 21.2 ± 1.4 years, BMI 26.3 ± 2.5 kg·m-2) were randomized to the groups of SIT (80 × 6-s sprints + 9-s rest), and isoenergetic (300KJ) HIIT (~9 × 4-min cycling at 90% V̇O2peak + 3-min rest) and MICT (cycling at 60% V̇O2peak for ~ 61-min). Training intervention was performed 3 d·week-1 for 12 weeks. After intervention, all three groups induced the same improvement in V̇O2peak (~ +25%, p < 0.001) and a similar reduction in body mass (~ - 5%, p < 0.001). Insulin sensitivity and fasting insulin levels were improved significantly on post-training measures in SIT and HIIT by ~26% and ~39% (p < 0.01), respectively, but remain unchanged in MICT. In contrast, fasting glucose levels were only reduced with MICT (p < 0.01). The three training strategies are equally effective in improving V̇O2peak and reducing body mass, however, the SIT is time-efficient. High-intensity training (i.e. SIT and HIIT) seems to be more beneficial than MICT in improving insulin sensitivity. Abbreviations: BMI: body mass index; CVD: cardiovascular disease; HIEG: hyperinsulinaemic euglycaemic glucose; HIIT: high-intensity interval training; HOMA-IR: homeostasis model assessment of insulin resistance; HR: heart rate; MICT: moderate-intensity continuous training; RPE: ratings of perceived exertion; SIT: sprint interval training; T2D: type 2 diabetes; V̇O2peak: peak oxygen consumption.

Comparing Time Efficiency of Sprint vs. High-Intensity Interval Training in Reducing Abdominal Visceral Fat in Obese Young Women: A Randomized, Controlled Trial.

Introduction: High-intensity interval training (HIIT) is an emerging lifestyle intervention strategy for controlling obesity. HIIT consisted of brief all-out supramaximal sprint intervals was termed as sprint interval training (SIT). This study was designed to examine the time-efficient characteristics of SIT in reducing abdominal visceral fat. Methods: A randomized controlled trial was conducted to compare the specific adaptations of SIT (80 × 6 s all-out cycle sprints interspersed with 9 s passive recovery) with those resulting from a HIIT regimen with training volume relatively higher (repeated 4 min bouts of cycling at 90% V˙ O2max alternated with 3 min rest, until the work of 400KJ was achieved), and with those of nonexercising control counterparts (CON). Forty-six obese young women (body fat percentage ≥30) received either SIT (n = 16), HIIT (n = 16), or no training (n = 14), 3-4 sessions per week, for 12 weeks. The abdominal visceral fat area (AVFA) and abdominal subcutaneous fat area (ASFA) of the participants were measured through computed tomography scans pre-intervention and post-intervention. Total fat mass and the fat mass of the android, gynoid, and trunk regions were assessed through dual-energy X-ray absorptiometry. Results: Following the intervention, abdominal visceral and subcutaneous fat were reduced markedly (p < 0.05). The reduction in AVFA (-6.31, -9.7 cm2) was not different between SIT and HIIT (p > 0.05), while the reduction in ASFA (-17.4, -40.7 cm2) in SIT was less than that in HIIT (p < 0.05). Less reduction in the fat mass of the trunk (-1.2, -2.0 kg) region was also found in SIT, while the reductions in fat percentage (-1.9%, -2.0%), total fat mass (-2.0, -2.8 kg), and fat mass of the android (-0.2, -0.2 kg), and gynoid (-0.4, -0.3 kg) regions did not differ between the two regimes (p > 0.05). In contrast, the increase in V˙ O2max was significant greater following the SIT than HIIT (p < 0.01). No variable changed in CON. Conclusion: Such findings suggest that the lower training load and exercise time commitments of the SIT regime could optimize the time-efficiency advantage of the traditional HIIT, facilitating the abdominal visceral fat reduction in obese young women.

Influence of recovery duration during 6-s sprint interval exercise on time spent at high rates of oxygen uptake.

BACKGROUND/OBJECTIVE: This study examined whether time spent at high rates of oxygen consumption (VO2) during 6-s sprint interval exercises (SIE) is a function of recovery interval duration. METHODS: In a randomised crossover study, thirteen male endurance runners performed 40 × 6-s all-out sprints interspersed with 15-s, 30-s and 60-s passive recovery intervals (SIE15, SIE30, and SIE60 trials respectively), and a work duration-matched Wingate-SIE (8 × 30-s all-out sprints with 4-min passive recovery, SIEWin trial). The accumulated exercise time at ≥ 80%, 85%, 90%, 95% and 100% of VO2max, and maximum heart rate (HRmax) in the four trials were compared. RESULTS: During the 6-s SIEs, accumulated time spent at all selected high rates of VO2max increased as recovery time decreased, whilst the SIE work rate decreased (p < .05). In SIEWin, although the exercise lasted longer, the time spent at ≥90% VO2max (74 ±â€¯16 s) was significant less than that in SIE15 (368 ±â€¯63 s, p < .05), yet comparable to that in SIE30 (118 ±â€¯30 s, p > .05), and longer than that in SIE60 (20 ±â€¯14 s, p < .05). The differences between the four trials in accumulated time at high percentages of HRmax were similar to those for VO2, although the temporal characteristics of the increases in HR and VO2 during the SIEs were different. CONCLUSION: In conclusion, the duration of the recovery interval in 6-s SIE protocols appears to be a crucial parameter when sprint interval training is prescribed to enhance aerobic capacity. Further, the SIE15 protocol may represent a potential alternative to 30-s SIEWin in the development of time-efficient aerobic training intervention.