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Survivin is reexpressed in most human breast cancers, where its expression has been associated with tumor aggressiveness, poor prognosis, and poor response to therapy. Survivin expression was evaluated in 41 malignant canine mammary tumors (CMTs) by immunohistochemistry, in relation to histological grade and stage, and correlated with that of some related molecules (β-catenin, caspase 3, heat shock proteins) to understand their possible role in canine mammary tumorigenesis. An increase in nuclear survivin expression, compared with healthy mammary glands, was observed in CMTs, where nuclear immunolabeling was related to the presence of necrosis. No statistically significant relation was found between the expression of the investigated molecules and the histological grade or stage. The present study may suggest an important involvement of survivin in CMT tumorigenesis. Its overexpression in most of the cases evaluated might suggest that targeting survivin in CMTs may be a valid anticancer therapy. [ABSTRACT FROM PUBLISHER]

Objective: To evaluate the effect of strenuous exercise on bone metabolism and related hormones in elderly subjects. Methods: Twenty one active elderly subjects (11 men and 10 women; mean age 73.3 years) showing a mean theoretical Vo2max of 151.4% participated. Concentrations of plasma ionised calcium (iCa), serum intact parathyroid hormone (iPTH), 25-hydroxyvitamin D (25(OH)D), and 1 .25-dihydroxy-vitamin D3 (1.25(OH)₂D3), as well as the bone biochemical markers type l collagen C-telopeptide for bone resorption and osteocalcin and bone alkaline phosphatase for bone formation, were analysed before and after a maximal incremental exercise test. Results: At basal level, iPTH was positively correlated with age (r =0.56, p<0.01) and negatively correlated with 25(OH)D (r= -0.50; p<0.01) and 1.25(OH)₂D3 (r= -0.47; p<0.05). Moreover, 25(OH)D and 1.25(OH)₂D3 levels were negatively correlated with age (r = -0.50, p<0.01 and r = -0.53, pc<.01, respectively). After exercise, iCa and 25(OH)D decreased (p<0.001 and p = 0.01, respectively) while iPTH increased (p<0.00l). The levels of 1.25(OH)₂D3, bone biochemical markers, haematocrit, and haemoglobin were unchanged. The variations in iCa and 25(OH)D were not related to age and/or sex. The iPTH variation was directly related to basal iPTH levels (p<0.01) and indirectly related to age. Conclusions: In active elderly subjects, strenuous exercise disturbed calcium homeostasis and bone related hormones without immediate measurable effect on bone turnover. Although an increase in iPTH could have an anabolic action on bone tissue, our findings from our short term study did not allow us to conclude that such action occurred. [ABSTRACT FROM AUTHOR]

Aims – Define the effects of long cycling exercise on the maximal anaerobic power (Wmax).Methods and results – Sixteen cyclists performed a force–velocity on a friction-loaded cycle ergometer prior and one hour after the end of a 140 km cycling race Wmax (582.1 ± 82.2 W versus 579.5 ± 95.8 W) and the force associated to Wmax (64.4 ± 5.0 N versus 63.2 ± 5 N) were not different between the two measures.Conclusions – The type of muscular contraction, essentially concentric in cycling, and the duration of the recovery between the end of the race and the test allowed the subjects to reinstate their maximal anaerobic power, and probably their intramuscular stock of phosphocreatine. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Progressive recruitment of muscle fibers is not necessary for the slow component of VO2 kinetics," by J.A. Zoladz and colleagues.

This study aimed to investigate the feasibility of a peripheral artery disease (PAD)-adapted 30-20-10 Nordic walking session in patients with symptomatic PAD and to compare the cardiovascular response of this new training session to a traditional walking (TW) and 4 × 4 minutes Nordic walking session. This is a prospective observational study. Patients with Fontaine stage II PAD were included. Patients participated in Nordic walking sessions, which were randomly assigned as TW, 4 × 4 minute intervals, and peripheral artery disease adapted 30-20-10 exercise session (PAD-adapted 30-20-10 sessions). PAD-adapted 30-20-10 and 4 × 4 minutes sessions consisted of 4 repetitions of 4 minutes of effort followed by 3 minutes of passive recovery. PAD-adapted 30-20-10 session was characterized by 4 continuous 1-min repetitions at 3 different walking speeds [high (30 seconds), moderate (20 seconds) and low (10 seconds)]. During the 4 × 4 minutes session, patients were asked to cover the maximal distance at a constant speed. During TW session, patients were asked to walk at a speed inducing moderate-to-severe claudication pain. Heart rate, rating of perceived exertion (RPE) and claudication pain intensity using a visual analog scale were assessed. The perceived enjoyment of each session was assessed using a visual analog scale ranging from 0 (not enjoyable) to 10 (very enjoyable). Eleven patients with chronic symptomatic PAD were included (62 ± 13 years; 54% women). The mean heart rate during the time of effort was significantly higher in PAD-adapted 30-20-10 group than in 4 × 4 minutes and TW groups (127 ± 12, 122 ± 12, 114 ± 11 bpm, respectively; P ≤ .001). The mean rating of perceived exertion (16 ± 1, 15 ± 1, 13 ± 1; P ≤ .001) and claudication pain intensity (8 ± 1, 7 ± 1; 7 ± 1 mm; P ≤ .019) were significantly higher during PAD-adapted 30-20-10 sessions than during 4 × 4 minutes and TW sessions. The perceived enjoyment was similar among sessions (8.7 ± 1.6 for TW, 8.6 ± 1.7 for 4 × 4 minutes, and 8.8 ± 1.8 mm for PAD-adapted 30-20-10 sessions; P = .935). The PAD-adapted 30-20-10 session is feasible and induces higher cardiovascular stimulation and claudication pain than 4 × 4 minutes and TW procedures in patients with symptomatic PAD. Despite these different responses, a similar perceived enjoyment among the sessions has been shown. Future investigations are needed to examine the effects of this new training session in these patients., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

All guidelines worldwide strongly recommend exercise as a pillar of the management of patients affected by lower extremity peripheral artery disease (PAD). Exercise therapy in this setting presents different modalities, and a structured programme provides optimal results. This clinical consensus paper is intended for clinicians to promote and assist for the set-up of comprehensive exercise programmes to best advice in patients with symptomatic chronic PAD. Different exercise training protocols specific for patients with PAD are presented. Data on patient assessment and outcome measures are narratively described based on the current best evidence. The document ends by highlighting disparities in access to supervised exercise programmes across Europe and the series of gaps for evidence requiring further research., (© 2024 the European Society of Cardiology, the European Society of Vascular Medicine, and the European Society for Vascular Surgery. Published by Oxford University Press on behalf of the European Society of Cardiology, by Hogrefe AG on behalf of European Society of Vascular Medicine and by Elsevier B.V on behalf of European Society for Vascular Surgery. All rights reserved. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when citing this article.)

Here we investigated the virulence properties of a unique cell-adapted SARS-CoV-2 mutant showing a ten-amino acid deletion encompassing the furin cleavage site of the spike protein (Δ 680 SPRAARSVAS 689 ; Δ680-689-B.1) in comparison to its parental strain (wt-B.1) and two Delta variants (AY.122 and AY.21) of concern. After intranasal inoculation, transgenic K18-hACE2 mice were monitored for 14 days for weight change, lethality, and clinical score; oral swabs were daily collected and tested for the presence of N protein subgenomic RNA. At 3 and 7 dpi mice were also sacrificed and organs collected for molecular, histopathological, and immune response profile investigations. The Δ680-689-B.1-infected mice exhibited reduced shedding, lower virulence at the lung level, and milder pulmonary lesions. In the lung, infection with Δ680-689-B.1 was associated with a significant lower expression of some cytokines at 3 dpi (IL-4, IL-27, and IL-28) and 7 dpi (IL-4, IL-27, IL-28, IFN-γ and IL-1α)., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Mention of trade names or commercial products in this article is solely for the purpose of providing specific information and does not imply recommendation or endorsement by the IZSAM., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The (patho-)physiological responses to hypoxia are highly heterogeneous between individuals. In this review, we focused on the roles of sex differences, which emerge as important factors in the regulation of the body's reaction to hypoxia. Several aspects should be considered for future research on hypoxia-related sex differences, particularly altitude training and clinical applications of hypoxia, as these will affect the selection of the optimal dose regarding safety and efficiency. There are several implications, but there are no practical recommendations if/how women should behave differently from men to optimise the benefits or minimise the risks of these hypoxia-related practices. Here, we evaluate the scarce scientific evidence of distinct (patho)physiological responses and adaptations to high altitude/hypoxia, biomechanical/anatomical differences in uphill/downhill locomotion, which is highly relevant for exercising in mountainous environments, and potentially differential effects of altitude training in women. Based on these factors, we derive sex-specific recommendations for mountain sports and intermittent hypoxia conditioning: (1) Although higher vulnerabilities of women to acute mountain sickness have not been unambiguously shown, sex-dependent physiological reactions to hypoxia may contribute to an increased acute mountain sickness vulnerability in some women. Adequate acclimatisation, slow ascent speed and/or preventive medication (e.g. acetazolamide) are solutions. (2) Targeted training of the respiratory musculature could be a valuable preparation for altitude training in women. (3) Sex hormones influence hypoxia responses and hormonal-cycle and/or menstrual-cycle phases therefore may be factors in acclimatisation to altitude and efficiency of altitude training. As many of the recommendations or observations of the present work remain partly speculative, we join previous calls for further quality research on female athletes in sports to be extended to the field of altitude and hypoxia., (© 2023. The Author(s).)

Background: Efficient gait assistance by augmentative exoskeletons depends on reliable control strategies. While numerous control methods and their effects on the metabolic cost of walking have been explored in the literature, the use of different exoskeletons and dissimilar protocols limit direct comparisons. In this article, we present and compare two controllers for hip exoskeletons with different synchronization paradigms. Methods: The implicit-synchronization-based approach, termed the Simple Reflex Controller (SRC), determines the assistance as a function of the relative loading of the feet, resulting in an emerging torque profile continuously assisting extension during stance and flexion during swing. On the other hand, the Hip-Phase-based Torque profile controller (HPT) uses explicit synchronization and estimates the gait cycle percentage based on the hip angle, applying a predefined torque profile consisting of two shorter bursts of assistance during stance and swing. We tested the controllers with 23 naïve healthy participants walking on a treadmill at 4 km ⋅ h -1 , without any substantial familiarization. Results: Both controllers significantly reduced the metabolic rate compared to walking with the exoskeleton in passive mode, by 18.0% (SRC, p < 0.001) and 11.6% (HPT, p < 0.001). However, only the SRC led to a significant reduction compared to walking without the exoskeleton (8.8%, p = 0.004). The SRC also provided more mechanical power and led to bigger changes in the hip joint kinematics and walking cadence. Our analysis of mechanical powers based on a whole-body analysis suggested a reduce in ankle push-off under this controller. There was a strong correlation (Pearson's r = 0.778, p < 0.001) between the metabolic savings achieved by each participant with the two controllers. Conclusion: The extended assistance duration provided by the implicitly synchronized SRC enabled greater metabolic reductions compared to the more targeted assistance of the explicitly synchronized HPT. Despite the different assistance profiles and metabolic outcomes, the correlation between the metabolic reductions with the two controllers suggests a difference in individual responsiveness to assistance, prompting more investigations to explore the person-specific factors affecting assistance receptivity., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Manzoori, Malatesta, Primavesi, Ijspeert and Bouri.)

All guidelines worldwide strongly recommend exercise as a pillar in the management of patients affected by lower extremity peripheral artery disease (PAD). Exercise therapy in this setting presents different modalities, and a structured programme provides optimal results. This clinical consensus paper is intended to promote and assist the set up of comprehensive exercise programmes and best advice for patients with symptomatic chronic PAD. Different exercise training protocols specific for patients with PAD are presented. Data on patient assessment and outcome measures are described based on the current best evidence. The document ends by highlighting supervised exercise programme access disparities across Europe and the evidence gaps requiring further research., (Copyright © 2024 European Society for Vascular Surgery, The European Society of Cardiology, The European Society of Vascular Medicine. Published by Elsevier B.V. All rights reserved.)

Sex differences in physiological responses to various stressors, including exercise, have been well documented. However, the specific impact of these differences on exposure to hypoxia, both at rest and during exercise, has remained underexplored. Many studies on the physiological responses to hypoxia have either excluded women or included only a limited number without analyzing sex-related differences. To address this gap, this comprehensive review conducted an extensive literature search to examine changes in physiological functions related to oxygen transport and consumption in hypoxic conditions. The review encompasses various aspects, including ventilatory responses, cardiovascular adjustments, hematological alterations, muscle metabolism shifts, and autonomic function modifications. Furthermore, it delves into the influence of sex hormones, which evolve throughout life, encompassing considerations related to the menstrual cycle and menopause. Among these physiological functions, the ventilatory response to exercise emerges as one of the most sex-sensitive factors that may modify reactions to hypoxia. While no significant sex-based differences were observed in cardiac hemodynamic changes during hypoxia, there is evidence of greater vascular reactivity in women, particularly at rest or when combined with exercise. Consequently, a diffusive mechanism appears to be implicated in sex-related variations in responses to hypoxia. Despite well-established sex disparities in hematological parameters, both acute and chronic hematological responses to hypoxia do not seem to differ significantly between sexes. However, it is important to note that these responses are sensitive to fluctuations in sex hormones, and further investigation is needed to elucidate the impact of the menstrual cycle and menopause on physiological responses to hypoxia., (© 2023. The Author(s).)

Cardinal motor symptoms in Parkinson's disease (PD) include bradykinesia, rest tremor and/or rigidity. This symptomatology can additionally encompass abnormal gait, balance and postural patterns at advanced stages of the disease. Besides pharmacological and surgical therapies, physical exercise represents an important strategy for the management of these advanced impairments. Traditionally, diagnosis and classification of such abnormalities have relied on partially subjective evaluations performed by neurologists during short and temporally scattered hospital appointments. Emerging sports medical methods, including wearable sensor-based movement assessment and computational-statistical analysis, are paving the way for more objective and systematic diagnoses in everyday life conditions. These approaches hold promise to facilitate customizing clinical trials to specific PD groups, as well as personalizing neuromodulation therapies and exercise prescriptions for each individual, remotely and regularly, according to disease progression or specific motor symptoms. We aim to summarize exercise benefits for PD with a specific emphasis on gait and balance deficits, and to provide an overview of recent advances in movement analysis approaches, notably from the sports science community, with value for diagnosis and prognosis. Although such techniques are becoming increasingly available, their standardization and optimization for clinical purposes is critically missing, especially in their translation to complex neurodegenerative disorders such as PD. We highlight the importance of integrating state-of-the-art gait and movement analysis approaches, in combination with other motor, electrophysiological or neural biomarkers, to improve the understanding of the diversity of PD phenotypes, their response to therapies and the dynamics of their disease progression., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

The purpose of this investigation was (1) to test the effect of movement restriction of the free leg during unilateral vertical jump on performance and power output comparing 2 different jump techniques: flexed (Classic technique) and straight (FC Luzern technique) free leg, and (2) to test the correlation between performance and power output obtained using these 2 techniques. Twenty elite soccer players performed squat (SJ) and countermovement (CMJ) jumps on each leg. The jump height and peak power output were compared between the 2 techniques for both legs. The jump height and peak power were significantly higher for the classic test for SJ and CMJ (P < .001) with no side effects or interactions. The angular range of motion of the free leg was higher for the Classic test than for the FC Lucerne test (P < .001), with no difference in the angular range of motion of the trunk. A moderate correlation was found between the 2 techniques on peak power (SJ: r = .626; CMJ: r = .649) and jump height (SJ: r = .742; CMJ: r = .891). Consequently, FC Lucerne technique, limiting the contribution of the free leg, is more appropriate to assess lower limb strength capacities during unilateral jump test.

Accurate real-time estimation of the gait phase (GP) is crucial for many control methods in exoskeletons and prostheses. A class of approaches to GP estimation construct the phase portrait of a segment or joint angle, and use the normalized polar angle of this diagram to estimate the GP. Although several studies have investigated such methods, quantitative information regarding their performance is sparse. In this work, we assess the performance of 3 portrait-based methods in flat and inclined steady walking conditions, using quantitative metrics of accuracy, repeatability and linearity. Two methods use portraits of the hip angle versus angular velocity (AVP), and hip angle versus integral of the angle (IAP). In a novel third method, a linear transformation is applied to the portrait to improve its circularity (CSP). An independent heel-strike (HS) detection algorithm is employed in all algorithms, rather than assuming HSs to occur at a constant point on the portrait. The novel method shows improvements in all metrics, notably significant root-mean-square error reductions compared to IAP (-3%, p < 0.001) and AVP (-2.4%, p < 0.001) in slope, and AVP (-1.61%, p = 0.0015) in flat walking. A non-negligible inter-subject variability is observed between phase angles at HS (equivalent to up to 8.4% of error in the GP), highlighting the importance of explicit HS detection for portrait-based methods.

Background: The gait pattern of adults with class I obesity [30 ≤ body mass index < 35kg/m 2 ] was characterized by altered three-dimensional ground reaction force signals compared to lean adults (18.5 ≤ body mass index < 25 kg/m 2 ). However, results might not be generalizable to adults with severe obesity (class II and III; body mass index ≥ 35 kg/m 2 ). Hence, the purpose of the present study was to investigate the differences in relative ground reaction force signals, i.e., normalized by body weight, between adults with severe obesity and lean adults using functional principal component analysis., Methods: Thirteen lean and eighteen sedentary adults with severe obesity performed a 5-min walking trial (1.11 m/s) on an instrumented treadmill. The first five functional principal components of the relative force signals (mediolateral, anterior-posterior, and vertical directions) were obtained using functional principal component analysis. Functional principal component scores were compared between groups using an analysis of covariance with age as covariable., Findings: Functional principal component analysis reported a statistically significant group effect for first functional principal component score for mediolateral (P = 0.004), and second and fifth functional principal component scores for anterior-posterior (P ≤ 0.02) force signals. Adults with severe obesity displayed a greater mediolateral force during most of the stance but similar magnitudes of the anterior-posterior and vertical forces compared to lean adults., Interpretation: Therefore, increasing the obesity level accentuates differences in mediolateral force but promotes no specific changes in anterior-posterior force likely due to chronic loading adaptation., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The aim of this study was to examine how running biomechanics (spatiotemporal and kinetic variables) adapt with exhaustion during treadmill runs at 90, 100, 110, and 120% of the peak aerobic speed (PS) of a maximal incremental aerobic test. Thirteen male runners performed a maximal incremental aerobic test on an instrumented treadmill to determine their PS. Biomechanical variables were evaluated at the start, mid, and end of each run until volitional exhaustion. The change of running biomechanics with fatigue was similar among the four tested speeds. Duty factor and contact and propulsion times increased with exhaustion (P ≤ 0.004; F ≥ 10.32) while flight time decreased (P = 0.02; F = 6.67) and stride frequency stayed unchanged (P = 0.97; F = 0.00). A decrease in vertical and propulsive peak forces were obtained with exhaustion (P ≤ 0.002; F ≥ 11.52). There was no change in the impact peak with exhaustion (P = 0.41; F = 1.05). For runners showing impact peaks, the number of impact peaks increased (P ≤ 0.04; [Formula: see text] ≥ 6.40) together with the vertical loading rate (P = 0.005; F = 9.61). No changes in total, external, and internal positive mechanical work was reported with exhaustion (P ≥ 0.12; F ≤ 2.32). Results suggest a tendency towards a "smoother" vertical and horizontal running pattern with exhaustion. A smoother running pattern refers to the development of protective adjustments, leading to a reduction of the load applied to the musculoskeletal system at each running step. This transition seemed continuous between the start and end of the running trials and could be adopted by the runners to decrease the muscle force level during the propulsion phase. Despite these changes with exhaustion, there were no changes in either gesture speed (no alteration of stride frequency) or positive mechanical work, advocating that runners unconsciously organize themselves to maintain a constant whole-body mechanical work output., (© 2023. The Author(s).)