Effect of ACTN3 R577X Genotype on Injury Epidemiology in Elite Endurance Runners.

The p.R577X polymorphism (rs1815739) in the ACTN3 gene causes individuals with the ACTN3 XX genotype to be deficient in functional α-actinin-3. Previous investigations have found that XX athletes are more prone to suffer non-contact muscle injuries. This investigation aimed to determine the influence of the ACTN3 R577X polymorphism in the injury epidemiology of elite endurance athletes. Using a cross-sectional experiment, the epidemiology of running-related injuries was recorded for one season in a group of 89 Spanish elite endurance runners. ACTN3 R577X genotype was obtained for each athlete using genomic DNA samples. From the study sample, 42.7% of athletes had the RR genotype, 39.3% had the RX genotype, and 18.0% had the XX genotype. A total of 96 injuries were recorded in 57 athletes. Injury incidence was higher in RR runners (3.2 injuries/1000 h of running) than in RX (2.0 injuries/1000 h) and XX (2.2 injuries/1000 h; p = 0.030) runners. RR runners had a higher proportion of injuries located in the Achilles tendon, RX runners had a higher proportion of injuries located in the knee, and XX runners had a higher proportion of injuries located in the groin (p = 0.025). The ACTN3 genotype did not affect the mode of onset, the severity, or the type of injury. The ACTN3 genotype slightly affected the injury epidemiology of elite endurance athletes with a higher injury rate in RR athletes and differences in injury location. However, elite ACTN3 XX endurance runners were not more prone to muscle-type injuries.

Concurrent Exercise Interventions in Breast Cancer Survivors with Cancer-related Fatigue.

This study compared the effects of two supervised concurrent training interventions in breast cancer survivors with cancer-related fatigue at baseline. Twenty-three female breast cancer survivors (50±8 years) were randomized to a high- (n=13) or a moderate-intensity (n=10) training program. Both interventions lasted 16 weeks and included the same resistance exercises, but the aerobic component was supervised and more intense in the former (i.e., rating of perceived exertion of 7-8 vs. 6 on a 1-10 scale for the high and moderate-intensity intervention, respectively). The primary endpoint was fatigue perception. Endpoints were assessed at baseline and after 16 weeks. The p-value for statistical significance was set at 0.004 after Bonferroni correction for multiple comparisons. The high-intensity training program increased lower-limb muscle strength significantly (p=0.002) and tended to improve fatigue perception (p=0.006), waist circumference (p=0.013), neutrophil-to-lymphocyte ratio (p=0.028) and some quality of life items (p=0.011). Although the moderate-intensity training program did not provide such benefits in general (i.e., higher p-values for pre vs post-intervention comparisons), no significant differences were found between interventions (all p>0.004). Further research is needed to elucidate if the benefits provided by high-intensity concurrent training are superior to those elicited by moderate-intensity training in breast cancer survivors.

[Local public health services: a descriptive study of the municipalities of Catalonia in 2016]. / Los servicios locales de salud pública: estudio descriptivo de los municipios de Catalunya en 2016.

OBJECTIVE: The health system in Spain rests mostly in the Autonomous Communities (similar to the states in the US). The public health activities of many local governments are little studied. The objective of this work was to bring knowledge about the public health activities of the municipalities, providing information obtained from a recent survey in Catalonia. METHODS: Descriptive study based on a survey to public health officers in the 119 municipalities above 10,000 population in Catalonia, excluding the city of Barcelona. The survey was conducted between May and October 2016, with 103 municipalities (86.6%) reporting on their services in 2015, prior to the survey. Data were collected and descriptive analyses performed. RESULTS: A consolidation of both political and professional public health structures of the municipalities was observed. Most frequent activities in health protection were related to legionella control, the control of urban pests and the management of complaints and requests by citizens. Most frequent activities in the field of health promotion were related to physical activity and health, prevention in tobacco and alcohol, food and nutrition. There were relatively few changes reported in public health structures and their officers, as well as in human resources. CONCLUSIONS: In Catalonia, municipalities above 10,000 population have a remarkable level of activity in public health. Both the areas of health protection (with mandatory minimum services for local governments) and of health promotion show high levels of activity. The system seems stable regarding political changes and budget constraints. There are opportunities for improvement in the training of professionals and service accreditation. It would be desirable to find ways to improve coordination among these services.

OBJETIVO: El sistema sanitario en España pivota sobre las Comunidades Autónomas. La salud pública gestionada por muchos gobiernos locales está poco estudiada. El objetivo de este trabajo fue contribuir al conocimiento de las actividades de salud pública de los municipios con una encuesta reciente. METODOS: Estudio descriptivo basado en cuestionario a los responsables de salud pública de los 119 municipios mayores de 10,000 habitantes de Catalunya, excluyendo la ciudad de Barcelona. Se realizó entre mayo y octubre de 2016, respondiendo 103 municipios (86,6 %) sobre la situación en 2015, anterior a la encuesta. Los datos se tabularon y sometieron a análisis descriptivos. RESULTADOS: Se apreció una consolidación de las estructuras políticas y técnicas de los municipios en salud pública. Las actuaciones más frecuentes en protección de la salud eran las referidas a la legionelosis, el control de plagas urbanas y la gestión de quejas y denuncias de la ciudadanía; en el ámbito de la promoción de la salud fueron actividad física y salud, prevención en tabaco y alcohol, alimentación y nutrición. Se refirieron relativamente pocos cambios recientes en las estructuras de salud pública, de sus responsables, y de los recursos humanos. CONCLUSIONES: Los municipios catalanes de más de 10.000 habitantes tienen un notable nivel de actividad en salud pública. Tanto los ámbitos de protección de la salud (con servicios mínimos obligatorios para los gobiernos locales) como los de promoción de la salud muestran niveles altos de actividad. El sistema parece estable respecto a cambios políticos y restricciones presupuestarias. Hay oportunidades de mejora en formación de profesionales y acreditación de servicios. Sería deseable mejorar la coordinación entre estos servicios.

Los servicios locales de salud pública: estudio descriptivo de los municipios de Catalunya en 2016 / Local public health services: a descriptive study of the municipalities of Catalonia in 2016

OBJETIVO: El sistema sanitario en España pivota sobre las Comunidades Autónomas. La salud pública gestionada por muchos gobiernos locales está poco estudiada. El objetivo de este trabajo fue contribuir al conocimiento de las actividades de salud pública de los municipios con una encuesta reciente. MÉTODOS: Estudio descriptivo basado en cuestionario a los responsables de salud pública de los 119 municipios mayores de 10,000 habitantes de Catalunya, excluyendo la ciudad de Barcelona. Se realizó entre mayo y octubre de 2016, respondiendo 103 municipios (86,6 %) sobre la situación en 2015, anterior a la encuesta. Los datos se tabularon y sometieron a análisis descriptivos. RESULTADOS: Se apreció una consolidación de las estructuras políticas y técnicas de los municipios en salud pública. Las actuaciones más frecuentes en protección de la salud eran las referidas a la legionelosis, el control de plagas urbanas y la gestión de quejas y denuncias de la ciudadanía; en el ámbito de la promoción de la salud fueron actividad física y salud, prevención en tabaco y alcohol, alimentación y nutrición. Se refirieron relativamente pocos cambios recientes en las estructuras de salud pública, de sus responsables, y de los recursos humanos. CONCLUSIONES: Los municipios catalanes de más de 10.000 habitantes tienen un notable nivel de actividad en salud pública. Tanto los ámbitos de protección de la salud (con servicios mínimos obligatorios para los gobiernos locales) como los de promoción de la salud muestran niveles altos de actividad. El sistema parece estable respecto a cambios políticos y restricciones presupuestarias. Hay oportunidades de mejora en formación de profesionales y acreditación de servicios. Sería deseable mejorar la coordinación entre estos servicios

OBJECTIVE: The health system in Spain rests mostly in the Autonomous Communities (similar to the states in the US). The public health activities of many local governments are little studied. The objective of this work was to bring knowledge about the public health activities of the municipalities, providing information obtained from a recent survey in Catalonia. METHODS: Descriptive study based on a survey to public health officers in the 119 municipalities above 10,000 population in Catalonia, excluding the city of Barcelona. The survey was conducted between May and October 2016, with 103 municipalities (86.6%) reporting on their services in 2015, prior to the survey. Data were collected and descriptive analyses performed. RESULTS: A consolidation of both political and professional public health structures of the municipalities was observed. Most frequent activities in health protection were related to legionella control, the control of urban pests and the management of complaints and requests by citizens. Most frequent activities in the field of health promotion were related to physical activity and health, prevention in tobacco and alcohol, food and nutrition. There were relatively few changes reported in public health structures and their officers, as well as in human resources. CONCLUSIONS: In Catalonia, municipalities above 10,000 population have a remarkable level of activity in public health. Both the areas of health protection (with mandatory minimum services for local governments) and of health promotion show high levels of activity. The system seems stable regarding political changes and budget constraints. There are opportunities for improvement in the training of professionals and service accreditation. It would be desirable to find ways to improve coordination among these services

Gait-cycle characteristics and running economy in elite Eritrean and European runners.

PURPOSE: This study aimed to determine whether biomechanical characteristics such as ground-contact time, swing time, and stride length and frequency contribute to the exceptional running economy of East African runners. METHODS: Seventeen elite long-distance runners (9 Eritrean, 8 European) performed an incremental maximal running test and 3 submaximal running bouts at 17, 19, and 21 km/h. During the tests, gas-exchange parameters were measured to determine maximal oxygen uptake (VO2max) and running economy (RE). In addition, ground-contact time, swing time, stride length, and stride frequency were measured. RESULTS: The European runners had higher VO2max values than the Eritrean runners (77.2 ± 5.2 vs 73.5 ± 6.0 mL · kg-1 · min-1, P = .011, effect sizes [ES] = 0.65), although Eritrean runners were more economical at 19 km/h (191.4 ± 10.4 vs 205.9 ± 13.3 mL · kg-1 · min-1, P = .026, ES = 1.21). There were no differences between groups for ground-contact time, swing time, stride length, or stride frequency at any speed. Swing time was associated with running economy at 21 km/h in the Eritrean runners (r = .71, P = .033), but no other significant association was found between RE and biomechanical variables. Finally, best 10-km performance was significantly correlated with RE (r = -.57; P = .013). CONCLUSIONS: Eritrean runners have superior RE compared with elite European runners. This appears to offset their inferior VO2max. However, the current data suggest that their better RE does not have a biomechanical basis. Other factors, not measured in the current study, may contribute to this RE advantage.

Acyl coenzyme A synthetase long-chain 1 (ACSL1) gene polymorphism (rs6552828) and elite endurance athletic status: a replication study.

The aim of this study was to determine the association between the rs6552828 polymorphism in acyl coenzyme A synthetase (ACSL1) and elite endurance athletic status. We studied 82 Caucasian (Spanish) World/Olympic-class endurance male athletes, and a group of sex and ethnically matched healthy young adults (controls, n=197). The analyses were replicated in a cohort of a different ethnic origin (Chinese of the Han ethnic group), composed of elite endurance athletes (runners) [cases, n=241 (128 male)] and healthy sedentary adults [controls, n=504 (267 male)]. In the Spanish cohort, genotype (P=0.591) and minor allele (A) frequencies were similar in cases and controls (P=0.978). In the Chinese cohort, genotype (P=0.973) and minor allele (G) frequencies were comparable in female endurance athletes and sedentary controls (P=0.881), whereas in males the frequency of the G allele was higher in endurance athletes (0.40) compared with their controls (0.32, P=0.040). The odds ratio (95%CI) for an elite endurance Chinese athlete to carry the G allele compared with ethnically matched controls was 1.381 (1.015-1.880) (P-value=0.04). Our findings suggest that the ACSL1 gene polymorphism rs6552828 is not associated with elite endurance athletic status in Caucasians, yet a marginal association seems to exist for the Chinese (Han) male population.

C34T mutation of the AMPD1 gene in an elite white runner.

The case is reported of an elite, male, white endurance runner (28 years of age), who is one of the best non-African runners in the world despite carrying the C34T mutation in the gene (AMPD1) that encodes the skeletal muscle specific isoform of AMP deaminase, an enzyme important in muscle metabolism. The frequency of the mutant allele in sedentary white people is 8-11%. Previous research has shown that this mutation, at least in homozygotes, can impair the exercise capacity of untrained people and their trainability. The maximum oxygen uptake (VO(2MAX)) of the study subject was exceptionally high (83.6 mlO(2)/kg/min), whereas his ammonia and lactate concentrations at high submaximal running speeds were lower than those of other world class runners who are not carriers of the mutation. The partial metabolic deficiency of the study subject is possibly compensated for by his exceptionally favourable anthropometric characteristics (body mass index 18.2 kg/m(2)).

Citius and longius (faster and longer) with no alpha-actinin-3 in skeletal muscles?

The muscle protein alpha-actinin-3 (ACTN3) is normally thought to be expressed in type II muscle fibres and to be necessary for high-power, high-velocity muscle contractions, such as those typically seen in speed/power athletes. The authors report the case of a Spanish elite long jumper (two times Olympian, personal best of 8.26 m) whose genotype for the ACTN3 gene is 577XX (ACTN3 deficient). These data suggest that there might be notable exceptions to the concept that ACTN3 is the "gene for speed".

Physiological characteristics of the best Eritrean runners-exceptional running economy.

Despite their young age, limited training history, and lack of running tradition compared with other East African endurance athletes (e.g., Kenyans and Ethiopians), male endurance runners from Eritrea have recently attained important running successes. The purposes of our study were (i) to document the main physical and physiological characteristics of elite black Eritrean distance runners (n = 7; age: 22 +/- 3 years) and (ii) to compare them with those of their elite white Spanish counterparts. For this second purpose we selected a control group of elite Spanish runners (n = 9; 24 +/- 2 years), owing to the traditionally high success of Spanish athletes in long-distance running compared with other white runners, especially in cross-country competitions. The subjects' main anthropometric characteristics were determined, together with their maximum oxygen uptake (VO2 max) and VO2 (mL.kg(-1).min(-1)), blood lactate, and ammonia concentrations while running at 17, 19, or 21 km.h(-1). The body mass index (18.9 +/- 1.5 kg.m(-2)) and maximal calf circumference (30.9 +/- 1.5 cm) was lower in Eritreans than in Spaniards (20.5 +/- 1.7 kg.m(-2) and 33.9 +/- 2.0 cm, respectively) (p < 0.05 and p < 0.01, respectively) and their lower leg (shank) length was longer (44.1 +/- 3.0 cm vs. 40.6 +/- 2.7 cm, respectively) (p < 0.05). VO2 max did not differ significantly between Eritreans and Spaniards (73.8 +/- 5.6 mL.kg(-1).min(-1) vs. 77.8 +/- 5.7 mL.kg(-1).min(-1), respectively), whereas the VO2 cost of running was lower (p < 0.01) in the former (e.g., 65.9 +/- 6.8 mL.kg(-1).min(-1) vs. 74.8 +/- 5.0 mL.kg(-1).min(-1) when running at 21 km.h(-1)). Our data suggest that the excellent running economy of Eritreans is associated, at least partly, with anthropometric variables. Comparison of their submaximal running cost with other published data suggests that superior running economy, rather than enhanced aerobic capacity, may be the common denominator in the success of black endurance runners of East African origin.

Easy listening to sleep recordings: tools and examples.

BACKGROUND AND PURPOSE: To specify a simple conversion of neurophysiological signals contained in sleep recordings into standard audio files and to illustrate how our cerebral audio processor can then detect specific signal characteristics. METHODS: A software package (freely accessible from the Internet) has been developed that converts signals from standard EDF (or EDF+) format to standard audio (WAV) format, a process usually called audification. The software has been applied to sleep EEG, EOG and ECG. The software is easy to apply. RESULTS: A wide range of audified signals is described, stressing the analogy with familiar sounds. Audio properties of EEG in different sleep stages, EOG, ECG and respiration signals are discussed. Auditive presentation of the signals invokes brain processes that differ essentially from the commonly applied visual interpretation, including physiological frequency analysis. CONCLUSIONS: Such auditive interpretation may complement the visual one. The widespread use of EDF+ and multimedia computers makes such audification simple and straightforward.

European data format 'plus' (EDF+), an EDF alike standard format for the exchange of physiological data.

The European data format (EDF) is a widely accepted standard for exchange of electroencephalogram and polysomnogram data between different equipment and labs. But it hardly accommodates other investigations. EDF+ is a more flexible but still simple format which is compatible to EDF except that an EDF+ file may contain interrupted recordings. Also, EDF+ supports time-stamped annotations for the storage of events such as text annotations, stimuli, averaged signals, electrocardiogram parameters, apnoeas and so on. When compared to EDF, EDF+ can not only store annotations but also electromyography, evoked potentials, electroneurography, electrocardiography and many more types of investigations. Further improvements over EDF include the use of standard electrode names. EDF+ is so much like EDF that existing EDF viewers still display the signals in EDF+ files. Software development is limited mainly to implementing the annotations. EDF+ offers a format for a wide range of neurophysiological investigations which can become a standard within a few years.