The objective of this study was to determine whether the variability in exercise tolerance and physiological responses is lower when exercise is prescribed relative to physiological thresholds (THR) compared to traditional intensity anchors (TRAD).Ten individuals completed a series of maximal exercise tests and a series of moderate (MOD), heavy (HVY) and severe intensity (HIIT) exercise bouts prescribed using THR intensity anchors (critical power and gas exchange threshold) and TRAD intensity anchors (maximum oxygen uptake; VO 2 max ). There were no differences in exercise tolerance or acute response variability between MOD THR and MOD TRAD . All individuals completed HVY THR but only 30% completed HVY TRAD . Compared to HVY THR , where work rates were all below critical power, work rates in HVY TRAD exceeded critical power in 70% of individuals. There was, however, no difference in acute response variability between HVY THR and HVY TRAD . All individuals completed HIIT THR but only 20% completed HIIT TRAD . The variability in peak (F = 0.274) and average (F = 0.318) blood lactate responses was lower in HIIT THR compared to HIIT TRAD . The variability in W′ depletion (the finite work capacity above critical power) after the final interval bout was lower in HIIT THR compared to HIIT TRAD (F = 0.305). Using physiological thresholds to prescribe exercise intensity reduced the heterogeneity in exercise tolerance and physiological responses to exercise spanning the boundary between the heavy and severe intensity domains. To increase the precision of exercise intensity prescription, it is recommended that, where possible, physiological thresholds are used in place of VO 2 max .
K E Y W O R D Scritical power, exercise intensity, exercise prescription, interindividual differences
INTRODUCTIONCardiorespiratory fitness, measured as maximum oxygen uptake ( VO 2 max ), is an important marker of both endurance performanceThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Aims: Treatment strategies for breast cancer continue to evolve. No uniformity exists in the UK for the management of node-positive breast cancer patients. Most centres continue to use conventional histopathology of sampled sentinel lymph nodes (SLNs), which requires delayed axillary clearance in up to 25% of patients. Some use touch imprint cytology or frozen section for intraoperative testing, although both have inherent sensitivity issues. An intraoperative molecular diagnostic approach helps to overcome some of these limitations. The aim of this study was to assess the clinical effectiveness of Metasin, a molecular method for the intraoperative evaluation of SLNs. Methods and results: RNA from 3296 lymph nodes from 1836 patients undergoing SLN assessment was analysed with Metasin. Alternate slices of tissue were examined in parallel by histology. Cases deemed to be discordant were analysed by protein gel electrophoresis. There was concordance between Metasin and histology in 94.1% of cases, with a sensitivity of 92% [95% confidence interval (CI) 88-94%] and a specificity of 97% (95% CI 2016 , 68, 875-887. DOI: 10.1111 95-97%). Positive and negative predictive values were 88% and 98%, respectively. Over half of the discordant cases (4.4%) were ascribed to tissue allocation bias (TAB).Conclusions: Clinical validation of the Metasin assay suggests that it is sufficiently sensitive and specific to make it fit for purpose in the intraoperative setting.
BackgroundIn March 2020, the UK Government enforced its first national 'lockdown' in response to the COVID-19 pandemic. Significant restrictions to the lifestyle and conduct of the public were enforced, including institution of various safety-behaviours such as washing, mask-wearing and physical distancing, aimed at reducing the spread of infection. From July -November 2020, as infection rates dropped, a gradual easing of restrictions occurred in most parts of the country alongside a short-lived restoration of more normal ways of living. In other areas where rates remained high, a partial lockdown was re-enforced, sometimes at very short notice. Similar unpredictable changes in levels of restriction and control continued to be applied over subsequent months and, as a new viral strain emerged in the UK around December 2020, another full lockdown was implemented at a national level. This work is licensed under a CC BY 4.0 International license.
Disease and 10% had an alternative form of IBD (e.g. Proctitis, Lymphocytic Colitis or Collagenous Colitis). The ethnic mix in the responding cohort was 91% Caucasian, 6% Asian, 2% Mixed and 1% was not stated. The sample had a mean score of 7.8 (CI = 7 -8.6). 98 (40%) of patients' scores reflected "no depression"; 64 (26%) reflected "mild depression"; 33 (14%) reflected "moderate depression"; 36 (15%) reflected "moderately severe depression"; 12 (5%) of scores reflected "severe depression". Conclusion 20% of our responding IBD patients were shown to have clinically significant levels of depression (moderately severe + severe), with 5% demonstrating scores suggestive of severe depression (1% expressing suicidal ideation). Relapse rates are known to be closely correlated with the severity of depression, and yet very few are on active treatment or review for this. The prevalence and severity of depression in our cohort of responding IBD patients supports the argument for screening all new IBD patients in order to optimise clinical well-being and treatment efficacy.
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