Physiological profile comparison between high intensity functional training, endurance and power athletes.

INTRODUCTION: High intensity functional trainings (HIFT), a recent development of high intensity trainings, includes in the same training session components of endurance exercises, elements of Olympic weightlifting and powerlifting, gymnastics, plyometrics and calisthenics exercises. Therefore, subjects practicing this type of activity are supposed to show physiological features that represent a combination of both endurance and power athletes. The aim of this study was to compare the physiological profile of three groups of age-matched endurance, HIFT and power athletes. METHODS: A total of 30 participants, 18 to 38-year-old men were enrolled in the study. Participants were divided in three groups: HIFT (n = 10), endurance (END, n = 10), and power (POW, weightlifters, n = 10) athletes. All were evaluated for anthropometric characteristics, VO2peak, handgrip, lower limb maximal isometric and isokinetic strength, countermovement vertical jump and anaerobic power through a shuttle run test on the field. RESULTS: VO2peak/kg was higher in END and HIFT than POW athletes (p = 0.001 and p = 0.007, respectively), but there were no significant differences between the first two. POW and HIFT athletes showed significant greater strength at the handgrip, countermovement jump and leg extension/flexion tests than END athletes. HIFT athletes showed highest results at the dynamic isokinetic test, while there were no significant differences at the shuttle run test among groups. CONCLUSIONS: As HIFT reach aerobic levels similar to END athletes and power and strength output similar to POW athletes, it appears that HIFT programs are effective to improve both endurance-related and power-related physical fitness components.

Association between seasonal flu vaccination and COVID-19 among healthcare workers.

BACKGROUND: In next fall and winter, SARS-CoV-2 could circulate in parallel with seasonal influenza. The dual epidemics will result in considerable morbidity and mortality; therefore, influenza vaccination may be essential. Recent studies found increased risk of coronavirus in individuals receiving influenza vaccination. AIMS: Our aim is to analyse the association between influenza vaccination and COVID-19 in a population of healthcare workers (HCWs). METHODS: IgG antibodies against SARS-CoV-2 were detected in 3520 HCWs at a large hospital in Northern Italy. For each participant, we collected data on flu immunization status for the last five flu seasons. Logistic regression was used to test associations between seasonal flu vaccination status and a positive serology tests for COVID-19. RESULTS: During the last five flu seasons, 2492 vaccinations were administered. Serology tests were negative for 3196 (91%) HCWs and residents and only 21 (1%) people had an equivocal test (12.0-15.0 AU/mL). Only 128 (4%) people received a diagnosis of COVID-19, with a positive swab test. No flu vaccinations for the last five flu seasons were specifically associated with diagnosis of COVID-19 or with positive results of serology tests. CONCLUSIONS: Flu vaccinations did not appear to be associated with SARS-CoV-2 infection. Influenza vaccination should continue to be recommended for HCWs and for individuals at increased risk for severe illness from respiratory infection.

Direct activation of zebrafish neurons by ultrasonic stimulation revealed by whole CNS calcium imaging.

OBJECTIVE: Ultrasounds (US) use in neural engineering is so far mainly limited to ablation through high intensity focused ultrasound, but interesting preliminary results show that low intensity low frequency ultrasound could be used instead to modulate neural activity. However, the extent of this modulatory ability of US is still unclear, as in in vivo studies it is hard to disentangle the contribution to neural responses of direct activation of the neuron by US stimulation and indirect activation due either to sensory response to mechanical stimulation associated to US, or to propagation of activity from neighboring areas. Here, we aim to show how to separate the three effects and assess the presence of direct response to US stimulation in zebrafish. APPROACH: We observed in zebrafish larvae brain-wide US-induced activity patterns through calcium imaging microscopy. Sensory response to mechanical stimulation was assessed with a US shield. Activity propagation was assessed with inter-area latency evaluation. MAIN RESULTS: We prove that in selected brain regions the zebrafish's neural response is mainly due to direct activation, later spreading to the other regions. Shielding the neurons from direct US stimulation resulted in a significantly attenuated response, showing that sensory stimulation does not play a prominent role. SIGNIFICANCE: US non-invasive neuromodulatory approach might lead to novel ways to test and control neural activity, and hence to novel neuromodulatory therapies. Future studies will focus on the biophysical structure of directly responsive neurons to capture the mechanisms of US induced activity.

Mineral rich algae with pine bark improved pain, physical function and analgesic use in mild-knee joint osteoarthritis, compared to Glucosamine: A randomized controlled pilot trial.

INTRODUCTION: Osteoarthritis (OA) is characterised by synovial joint pain, functional disability and affects ∼13 % of people worldwide, of which ∼16-27 % report Knee-OA (KOA). Glucosamine (Glu) is the most widely used nutraceutical treatment for OA despite a lack of scientific consensus, therefore alternative nutraceutical treatments are required. The aim of this study was to investigate the effect of Lithothamnion species, seawater-derived magnesium and pine bark (Aq+) on pain, symptoms and improve physical function in symptomatic (sKOA), compared to Glu. METHODS: 358 participants were screened. In a double-blinded crossover pilot-trial, sKOA participant (n = 30) were randomly assigned to either the Glu group (2000 mg day-1) or Aq+ (3056 mg day-1) for 12 weeks (clinicaltrials.gov:NCT03106584). The Knee Injury and Osteoarthritis Outcome Score was used to assess subjective pain and symptoms. Timed-up-and-Go (TuG) and Six minute walking distance were used to assess functional change and analgesic use was recorded. RESULTS: Aq+ improved pain, with a large effect (P < 0.01, d' = 0.73, 95 %CI 0.201-1.265) and no change for Glu (d' = 0.38, P = 0.06). Only Aq+ improved pain (P < 0.05) for males (d' = 0.91, 95 %CI 0.162-1.667) and females (d' = 0.55, 95 %CI 0.210-1.299). In females, Aq+ improved TuG by -7.02 % (d' = 0.92, 95 %CI 1.699-0.141) while Glu worsened performance by 4.18 % (P = 0.04). Aq+ reduced analgesia by 71.6 %, compared to Glu (P = 0.02; d' = 0.82, 95 %CI 1.524-0.123). Aq+ was superior to Glu at improving pain, KOOS subscales, physical function and analgesia use in mild-sKOA. Given these data, Aq+ should be considered as a supplementary treatment for early-stage-KOA and may have the potential to reduce use of pain medication, although larger replication studies are required.

Self-reported prevalence of sleep disorders among medical and nursing students.

BACKGROUND: Sleep disorders are highly prevalent among university students. In particular, the symptoms of sleep disorders are more prevalent among healthcare students. AIMS: To assess the prevalence of risk factors of insomnia and sleep disorders and to examine the correlations between them among nursing and medical students. We also compared the effects of shift work during internship. METHODS: The sample was 417 healthcare students; 202 of them were nursing students, and the remaining 215 were medical students. We used a self-administered questionnaire to assess the risk factors for insomnia (i.e. age, BMI, tobacco consumption, physical activity and perceived stress, using the General Health Questionnaire-12). We also used the Sleep and Daytime Habits Questionnaire and Epworth Sleepiness Scale to assess the prevalence of sleep disorders and daytime sleepiness. RESULTS: A higher percentage of nursing students than medical students were aged 25 years or older, engaged in inadequate levels of physical activity and consumed tobacco. With the exception of tobacco consumption among nursing students, high scores on the GHQ-12 were the only risk factor associated with daytime and nighttime symptoms and poor sleep quality. There was no significant association between the symptoms of sleep disorders and shift work including night shifts. CONCLUSIONS: Since sleep disorders are highly prevalent among healthcare students, early detection and management is recommended. This will decrease the risk of harm to students and patients, due to medical mistakes.

Effects of a Six-Month Multi-Ingredient Nutrition Supplement Intervention of Omega-3 Polyunsaturated Fatty Acids, vitamin D, Resveratrol, and Whey Protein on Cognitive Function in Older Adults: A Randomised, Double-Blind, Controlled Trial.

OBJECTIVES: To investigate the impact of a six-month multi-ingredient nutrition supplement intervention (Smartfish®), containing omega-3 polyunsaturated fatty acids (PUFAs), vitamin D, resveratrol, and whey protein, on cognitive function in Irish older adults. DESIGN: Double-blind, randomised controlled trial (ClinicalTrials.gov: NCT02001831). A quantitative, mixed-model design was employed in which the dependent variable (cognitive function) was analysed with a between-subjects factor of group (placebo, intervention) and within-subjects factor of testing occasion (baseline, three-months, six-months). SETTING: Community-based intervention including assessments conducted at University College Dublin, Ireland. PARTICIPANTS: Thirty-seven community-dwelling older adults (68-83 years; mean (x̄)= 75.14 years; standard deviation (SD)= 3.64; 18 males) with normal cognitive function (>24 on the Mini Mental State Examination) were assigned to the placebo (n= 17) or intervention (n= 20) via a block randomisation procedure. INTERVENTION: Daily consumption for six-months of a 200mL liquid juice intervention comprising 3000mg omega-3 PUFAs [1500mg docosahexaenoic acid (DHA) and 1500mg eicosapentaenoic acid (EPA)], 10µg vitamin D3, 150mg resveratrol and 8g whey protein isolate. The placebo contained 200mL juice only. MEASUREMENTS: A standardised cognitive assessment battery was conducted at baseline and follow-ups. Individual test scores were z-transformed to generate composite scores grouped into cognitive domains: executive function, memory, attention and sensorimotor speed. Motor imagery accuracy and subjective awareness of cognitive failures variables were computed from raw scores. RESULTS: A hierarchical statistical approach was used to analyse the data; first, by examining overall cognitive function, then by domain, and then by individual test scores. Using mixed between-within subjects, analyses of variance (ANOVAs), no significant differences in overall cognitive function or composite cognitive domains were observed between groups over time. The only significant interaction was for Stroop Color-Word Time (p< 0.05). The intervention group demonstrated reduced task completion time at three- and six-month follow-ups, indicating enhanced performance. CONCLUSION: The present nutrition intervention encompassed a multi-ingredient approach targeted towards improving cognitive function, but overall had only a limited beneficial impact in the older adult sample investigated. Future investigations should seek to establish any potential clinical applications of such targeted interventions with longer durations of supplementation, or in populations with defined cognitive deficits.

The Body Fat-Cognition Relationship in Healthy Older Individuals: Does Gynoid vs Android Distribution Matter?

OBJECTIVE: To examine the relationship between regional and whole body fat accumulation and core cognitive executive functions. DESIGN: Cross-sectional study. SETTINGS AND PARTICIPANTS: 78 healthy men and women aged between 65 and 75 years recruited through consumer's database. MEASUREMENTS: DXA measured percentage total body fat, android, gynoid distribution and android/gynoid ratio; inhibition and working memory updating through Random Number Generation test and cognitive flexibility by Trail Making test. First-order partial correlations between regional body fat and cognitive executive function were computed partialling out the effects of whole body fat. Moderation analysis was performed to verify the effect of gender on the body fat-cognition relationship. RESULTS: Results showed a differentiated pattern of fat-cognition relationship depending on fat localization and type of cognitive function. Statistically significant relationships were observed between working memory updating and: android fat (r = -0.232; p = 0.042), gynoid fat (r = 0.333; p = 0.003) and android/gynoid ratio (r = -0.272; p = 0.017). Separating genders, the only significant relationship was observed in females between working memory updating and gynoid fat (r = 0.280; p = 0.045). In spite of gender differences in both working memory updating and gynoid body fat levels, moderation analysis did not show an effect of gender on the relationship between gynoid fat and working memory updating. CONCLUSIONS: Results suggest a protective effect of gynoid body fat and a deleterious effect of android body fat. Although excessive body fat increases the risk of developing CDV, metabolic and cognitive problems, maintaining a certain proportion of gynoid fat may help prevent cognitive decline, particularly in older women. Guidelines for optimal body composition maintenance for the elderly should not target indiscriminate weight loss, but weight maintenance through body fat/lean mass control based on non-pharmacological tools such as physical exercise, known to have protective effects against CVD risk factors and age-related cognitive deterioration.

Effect of exercise training on neuromuscular function of elbow flexors and knee extensors of type 2 diabetic patients.

PURPOSE: The effects of exercise training on neuromuscular function of arm and leg muscles in type 2 diabetic patients (T2D) was investigated. METHODS: Eight T2D sedentary male patients (61.0±2.3years) and eight sedentary healthy age matched control subjects (H, 63.9±3.8years) underwent a 16-week supervised combined endurance and resistance exercise program. Before and after training, maximal isometric (MVIC), isokinetic (15, 30, 60, 120, 180, 240°s(-1)) torque and muscle endurance of the elbow flexors (EF) and knee extensors (KE) were assessed. Simultaneously, surface electromyographic signals from biceps brachii (BB) and vastus lateralis (VL) muscles were recorded and muscle fiber conduction velocity (MFCV) estimated. RESULTS: Following training, maximal torque of the KE increased during MVIC and isokinetic contractions at 15 and 30°s(-1) in the T2D (+19.1±2.7% on average; p<0.05) but not in the H group (+7±0.9%; p>0.05). MFCV recorded from the VL during MVIC and during isokinetic contractions at 15 and 30°s(-1) increased (+11.2±1.6% on average; p<0.01), but in the diabetic group only. Muscular endurance was lower in T2D (20.1±0.7s) compared to H (26.9±1.3s), with an associated increase in the MFCV slope after training in the KE muscles only. CONCLUSION: The effect of a combined exercise training on muscle torque appears to be angular velocity-specific in diabetic individuals, with a more pronounced effect on KE muscles and at slow contraction velocities, along with an associated increase in the MFCV. MFCV appears to be a more sensitive marker than torque in detecting the early signs of neuromuscular function reconditioning.

A large-field polarisation-resolved laser scanning microscope: applications to CARS imaging.

Laser-scanning imaging techniques are frequently used to probe the molecule spatial orientation in a sample of interest by exploiting selection rules depending on the polarisation of the excitation light. For the successful implementation of these techniques the precise control of the polarisation at the sample level is of fundamental importance. Polarisation distortions induced by the optical elements are often the main limitation factor for the maximum size of the field-of-view in polarisation-resolved (PR) laser-scanning microscopy, since for large scanning angles the polarisation distortions may mask the real sample structure. Here we shall demonstrate the implementation of large-field-of-view PR microscopy and show PR CARS imaging of mouse spinal cord thanks to a careful design of the laser-beam optical path. We shall show that this design leads to strongly suppressed distortions and quantify their effects on the final images. Although the focus of this work is on CARS imaging, we stress that the approaches described here can be successfully applied to a wide range of PR laser-scanning techniques.

[A survey on dental offices: risk assessment and practicable preventive and protective measures]. / Indagine su un campione di studi odontoiatrici: valutazione dei rischi e misure preventive e protettive attuabili.

The survey was aimed at developing a method and providing valuable tools to be used for risk assessment in dental practices and for the implementation of preventive and protective measures. For these purposes general (inspection card for the definition of risk level for health and safety) and specific tools (check-lists) were used. In each dental office chemical and physical hazards (noise and hand-arm vibration) were assessed. Adequate levels of security were achieved, even if workers' training was evidenced as a critical element. In the 90% of cases, rooms for specific use were available and suitable according the law. The risk of work-related stress was acceptable in almost all the analyzed dental offices. Chemical and specific physical hazards appeared to be below the action level. Biological risk doesn't seem to be a critical element, even though its control could be further improved.

[Hepatitis B vaccination coverage and booster dose: results from a survey on healthcare students]. / Copertura vaccinale anti-epatite B e dose di rinforzo: risultati di uno studio su una popolazione universitaria.

This study assessed the immunisation status against hepatitis B in healthcare students and residents, before their hospital internship, as suggested by the "National Immunization Prevention Plan 2012-2014". The concentration of antibodies against hepatitis B was measured in 2,491 subjects (70.90% women), born between 1980 and 1993 and visited between January 1st 2000 and July 15th 2012. Personal and serologic data were collected for each subjects. Individuals with antibody less than 10 mIU/mL (327, 13.3%) were given a booster dose and re-tested 2 months later. The multivariate logistic regression evidenced that immunization is influenced by the gender, the age at first vaccination, the time elapsed between first vaccination and antibody measurement. This study confirms the importance of measuring the concentration of antibodies against hepatitis B among healthcare students, even if they have previously been vaccinated, according to the "National Immunization Prevention Plan 2012-2014".

[Work-related stress risk assessment in a home care agency]. / La valutazione del rischio stress lavoro-correlato in una cooperativa di assistenza domiciliare.

The workload, the quality of professional relationships and emotional involvement have a significant impact on distress and burnout in health care-workers; this impact has an hight variability among the different environments and different care facilities (hospital, erderly nursing homes, home care). The risk assessment of work-related stress performed in 2010 in a homecare agency highlighted organizational problems related to the content/context of work and risk factors for health and safety. High turn-over is evidenced as critical among the "sentinel events". The level of job-strain was moderate, even if some critical issues were evidenced especially in the group of physiotherapists; nurses were configured as a homogeneous group with a low level of job-strain. In informative meetings the workers identified the discomfort related to the time for transferring patients from their homes in a high-traffic metropolitan area was identified as the most critical aspect.

The disease of the moon: the linguistic and pathological evolution of the English term "lunatic".

The public opinion and the scientific community incorrectly believe that the English term "lunatic" was originally related only to insanity, but it also referred to epileptic people. The aim of this article is to clarify the original meaning of the English word "lunatic" by analyzing the evolution of the relationship between psychiatric and neurological diseases and by pointing out the influence of the moon in the history of medicine, in popular traditions, and in English literature. The article also contains a detailed and accurate review of the modern scientific literature on the relationship between moon and epilepsy/psychiatric disorders.

[EMG and forces during manoeuvring of ceiling-based and floor-based patient transfer devices]. / EMG e forze applicate durante l'utilizzo dei sollevatori per pazienti di tipo carrellato e a soffitto.

A laboratory and on-the-field study was conducted to compare Floor-Based (FB) and Ceiling-Based (CB) patients transfer devices. Pushing and pulling forces were measured by means of computer assisted dynamometer. EMG signals were measured. Standardized patient transfers were setup in the room (bed-chair-door-return). FB devices showed pushing and pulling forces higher than CB ones. CB paths were the smoothest and EMG data related to upper arms and trunk muscles showed stable lower loads for CB. The study suggests that CB patient transfer devices reduced the load. CBs seem the best tools for patient handling.

[Sentinel events for work-related stress in hospital and their monitoring in the decade 2001-2010]. / Eventi sentinella stress lavoro-correlati in ambito ospedaliero e lore monitoraggio nel decennio 2001-2010.

This survey was aimed at showing the relationship between some working organizational indicators--work-related stress "sentinel events" such as sick leaves and work accident--and some sociodemographic (gender, age) and organizational (homogeneous tasks, departmental areas) parameters. In the decade 2001-2010 a progressive decrease of the absenteeism and work accident rates was evidenced. The absenteeism rate was inversely related to job-qualification and it was higher among female workers. The highest requests of medical visits by auxiliary personnel showed a lower adaptation to job content, looked upon as low-rewarding in this homogeneous task.

Mesothelioma and asbestos, fifty years of evidence: Chris Wagner and the contribution of the Italian occupational medicine community.

BACKGROUND: One of the first studies that "convincingly" described the relationship between pleural mesothelioma and asbestos was made by Wagner, Sleggs and Marchard in 1960. This article, published fifty years ago, contains much of what we still know to-day about malignant mesothelioma. OBJECTIVES: The aims of this article were to analyze the historical and scientific developments that led to the publication of Wagner's paper, to critically examine its contents and to consider the contribution to the initernational debate on the carcinogenesis of asbestos fibres made by occupational medicine in Italy in that period. METHODS: A thorough analysis ofscientific and historical literature on the relationship between asbestos exposure and tumours was conducted, with special regard to the articles by Italian authors in the 1960's. RESULTS: The decisive role of Wagner's paper in understanding the aetiopathogenetic mechanisms of asbestos-related tumours is inconfutable. In particular, his article clearly demonstrated the existence of a typical cancer of the mesothelium, expressing three fundamental principles of the epidemiology of occupational cancer: association with the carcinogen, latency and individual susceptibility. Enrico Vigliani, then director of the "Clinica del Lavoro" in Milan, made important contributions to this debate, also through the collection of data regarding mortality among Italian asbestos workers. CONCLUSIONS: Wagner's 1960 paper can be considered as a milestone not only in the history of occupational and environmental health, but also in the evolution of other medical disciplines such as epidemiology, pathology and oncology. A re-appraisal of the Italian contributions to the international debate on this subject should be considered.

Muscle fibre conduction velocity and cardiorespiratory response during incremental cycling exercise in young and older individuals with different training status.

We investigated the effect of ageing and training on muscle fibre conduction velocity (MFCV) and cardiorespiratory response during incremental cycling exercise. Eight young (YT; 24+/-5 yrs) and eight older (OT; 64+/-3 yrs) cyclists, together with eight young (YU; 27+/-4 yrs) and eight older (OU; 63+/-2 yrs) untrained individuals underwent to an incremental maximal test on a cycle ergometer. Ventilatory threshold (VT), respiratory compensation point (RCP) and maximal oxygen uptake (VO(2)max) were identified and MFCV recorded from the vastus lateralis muscle using surface electromyography with linear arrays electrodes. In YT MFCV increased with the exercise intensity, reaching a peak of 4.99+/-1.02 [m/s] at VT. Thereafter, and up to VO(2)max, MFCV declined. In YU MFCV showed a similar trend although the peak [4.55+/-0.53m/s] was observed, at 75% of VO(2)max an intensity higher than VT (66% of VO(2)max). In both YT and YU MFCV did not decline until RPC, which occurred at 78% VO(2)max in YU and at 92% VO(2)max (P<0.01) in YT. Differently from young individuals, MFCV in older subjects did not increase with exercise intensity. Moreover, maximal MFCV in OU was significantly lower [3.53+/-0.40 m/s;] than that of YT (P<0.005) and YU (P<0.05). The present study shows that, especially in young individuals, MFCV reflects cardiorespiratory response during incremental dynamic cyclic exercise and hence can be used to investigate motor unit recruitment strategies.

[Ageing and work: technical standards]. / Invecchiamento e lavoro: la normativa tecnica.

Over the last few years, studies on the relationship between ageing and work have attracted growing interest due to the increased probability among workers of developing major health problems as a consequence of ageing of the working population. Negative outcomes for health are possible when an age-related imbalance appears between physical workload and physical work capacity. Interventions based on workload reductions should help to keep workers on the job for as long as allowed by law. Reference masses by age and sex are suggested by the technical standards of the ISO 11228 series, which are also quoted by Italian law D.Lgs. 81/2008, and EN 1005 series, which recommend limits valid also for manual material handling, and pushing and pulling. Decreasing low back pain prevalence or recurrence, in an ageing population with high prevalence of back disorders, could be more effective than many other approaches to enhance workers' quality of life and consequently maintain and improve workers' performance.

The cardiovascular response to underwater pedaling at different intensities: a comparison of 4 different water stationary bikes.

AIM: Among the fitness activities, cycling in water immersion performed with water stationary bikes (WSB) has become very popular. However, there is a lack of information concerning their physiological demand. The aim of the present study was to assess the cardiovascular responses to four WSBs. METHODS: Twenty-two healthy participants underwent a graded exercise test on a cycle ergometer. Sixteen of them, 8 males (age 31.5 + or - 8.2 years) and 8 females (age 31.9 + or - 5.8 years) with the same level of peak oxygen consumption (VO(2peak)) were chosen and submitted, in random order, to four incremental testing sessions performed with four different models of WSB, one with no resistance (WSB1), two with resistance added to the bottom bracket axle (WSB2 and WSB3), one with resistance added to the pedals (WSB4). The VO(2peak) and heart rate peak (HR(peak)) were measured in all five conditions. RESULTS: Since no significant main effect for gender was detected, the data were grouped and analyzed all together. No significant differences were found in VO(2peak) and HR(peak) within the five testing conditions, whilst time to exhaustion (P<0.01) and pedaling frequency (RPM) at volitional exhaustion (P<0.01) were both significantly different across the four WSBs. When pedaling at 70 RPM, the oxygen consumption and heart rate response (as % of VO(2peak) and HR(peak)) were approximately 45% and 60% for WSB1, 60% and 70% for WSB3, 90% and 90% for WSB2 and WSB4, respectively. CONCLUSIONS: The present results provide useful information for instructors and practitioners because they demonstrate that different models of WSBs could elicit very different cardiovascular responses.