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Contributing to an emerging debate that brings the mobilization of land rent as a financial asset to the heart of urban analysis, this article offers a narrative of land financialization as a ‘lived’ process. Focusing empirically on Bicocca (a post-industrial area north-east of Milan that traditionally hosted the activities of Pirelli, one of Italy’s most successful companies), the paper shifts the focus of enquiry on land financialization from global capital flows and real estate aggregate data to a qualitative analysis of the alliances and struggles between the elites and workers who animated the traditional manufacturing sector. Centring the analysis on these previously neglected actors permits an understanding of land financialization as a ‘lived’ and socially embodied process, and offers a complementary perspective to the discussion on the role of land rent in the making of financialized capitalism. First, it reveals the struggles and alliances between industrial elites, workers’ unions, and local governance as key protagonists in the way land became mobilized as a financial asset, was subsequently embedded in practices of urban renewal, and finally contributed to an epochal change in urban capitalism. Second, it shows how mobilizing industrial land as a financial asset performed not just a coordinating but also a transformative role in the transition from industrial to financial capitalism as it enabled traditional elites to launch into a financialized phase of transnational competition. Third, it reveals changes in urban governance to be as much responses to the needs of local traditional elites as they are responses to the demands of global financial elites. [ABSTRACT FROM AUTHOR]

Interlimb asymmetry (ILA) refers to an anatomical or physiological imbalance between contralateral limbs, which can influence neuromuscular function. Investigating the influence of neuromuscular fatigue on ILA may be critical for optimizing training programs, injury rehabilitation, and sport-specific performance. The purpose of this study was to determine if a single bout of ice hockey-specific exercise creates or exacerbates lower-limb ILA. Before and after an on-ice training session, 33 youth ice-hockey athletes (14.9 [1.7] y; 11 females) performed 3 repetitions of a maximal vertical countermovement jump (CMJ), an eccentric hamstring contraction, and maximal isometric hip adduction and abduction contractions. Force- and power-related variables were analyzed to determine limb-specific neuromuscular function. The on-ice session reduced maximal isometric hip adduction (left: 7.3% [10.3%]; right: 9.5% [9.6%]) and abduction (left: 4.9% [6.9%]; right: 5.0% [8.1%]) force, but did not impair (P ≥ .10) CMJ performance (jump height, relative peak power, braking duration, and total duration). After the on-ice session, ILA was greater for CMJ propulsive impulse (6.3% [2.9%] vs 5.1% [2.6%]), CMJ braking rate of force development (19.3% [7.6%] vs 15.2% [6.4%]), and peak isometric hip adduction force (6.7% [5.5%] vs 6.1% [4.1%]). In conclusion, hockey-specific exercise leads to increased ILA for multiple force-related metrics, which may be a compensatory mechanism to maintain bilateral task performance when fatigued.

Importance: Although active surveillance for patients with low-risk prostate cancer (LRPC) has been recommended for years, its adoption at the population level is often limited., Objective: To make active surveillance available for patients with LRPC using a research framework and to compare patient characteristics and clinical outcomes between those who receive active surveillance vs radical treatments at diagnosis., Design, Setting, and Participants: This population-based, prospective cohort study was designed by a large multidisciplinary group of specialists and patients' representatives. The study was conducted within all 18 urology centers and 7 radiation oncology centers in the Piemonte and Valle d'Aosta Regional Oncology Network in Northwest Italy (approximate population, 4.5 million). Participants included patients with a new diagnosis of LRPC from June 2015 to December 2021. Data were analyzed from January to May 2023., Exposure: At diagnosis, all patients were informed of the available treatment options by the urologist and received an information leaflet describing the benefits and risks of active surveillance compared with active treatments, either radical prostatectomy (RP) or radiation treatment (RT). Patients choosing active surveillance were actively monitored with regular prostate-specific antigen testing, clinical examinations, and a rebiopsy at 12 months., Main Outcomes and Measures: Outcomes of interest were proportion of patients choosing active surveillance or radical treatments, overall survival, and, for patients in active surveillance, treatment-free survival. Comparisons were analyzed with multivariable logistic or Cox models, considering centers as clusters., Results: A total of 852 male patients (median [IQR] age, 70 [64-74] years) were included, and 706 patients (82.9%) chose active surveillance, with an increasing trend over time; 109 patients (12.8%) chose RP, and 37 patients (4.3%) chose RT. Median (IQR) follow-up was 57 (41-76) months. Worse prostate cancer prognostic factors were negatively associated with choosing active surveillance (eg, stage T2a vs T1c: odds ratio [OR], 0.51; 95% CI, 0.28-0.93), while patients who were older (eg, age ≥75 vs <65 years: OR, 4.27; 95% CI, 1.98-9.22), had higher comorbidity (Charlson Comorbidity Index ≥2 vs 0: OR, 1.98; 95% CI, 1.02-3.85), underwent an independent revision of the first prostate biopsy (OR, 2.35; 95% CI, 1.26-4.38) or underwent a multidisciplinary assessment (OR, 2.65; 95% CI, 1.38-5.11) were more likely to choose active surveillance vs active treatment. After adjustment, center at which a patient was treated continued to be an important factor in the choice of treatment (intraclass correlation coefficient, 18.6%). No differences were detected in overall survival between active treatment and active surveillance. Treatment-free survival in the active surveillance cohort was 59.0% (95% CI, 54.8%-62.9%) at 24 months, 54.5% (95% CI, 50.2%-58.6%) at 36 months, and 47.0% (95% CI, 42.2%-51.7%) at 48 months., Conclusions and Relevance: In this population-based cohort study of patients with LRPC, a research framework at system level as well as favorable prognostic factors, a multidisciplinary approach, and an independent review of the first prostate biopsy at patient-level were positively associated with high uptake of active surveillance, a practice largely underused before this study.

Introduction: With acclimatization to high altitude (HA), adaptations occur throughout the nervous system and at the level of the muscle, which may affect motor unit (MU) characteristics. However, despite the importance of MUs as the final common pathway for the control of voluntary movement, little is known about their adaptations with acclimatization., Methods: Ten lowlanders and Sherpa participated in this study 7 to 14 d after arrival at HA (5050 m), with seven lowlanders repeating the experiment at sea level (SL), 6 months after the expedition. The maximal compound muscle action potential (M max ) was recorded from relaxed biceps brachii. During isometric elbow flexions at 10% of maximal torque, a needle electrode recorded the MU discharge rate (MUDR) and MU potential (MUP) characteristics of single biceps brachii MUs., Results: Compared with SL, acclimatized lowlanders had ~10% greater MUDR, ~11% longer MUP duration, as well as ~18% lower amplitude and ~6% greater duration of the first phase of the M max (all P < 0.05). No differences were noted between SL and HA for variables related to MUP shape (e.g., jitter, jiggle; P > 0.08). Apart from lower near-fiber MUP area for Sherpa than acclimatized lowlanders ( P < 0.05), no M max or MU data were different between groups ( P > 0.10)., Conclusions: Like other components of the body, MUs in lowlanders adapt with acclimatization to HA. The absence of differences between acclimatized lowlanders and Sherpa suggests that evolutionary adaptations to HA are smaller for MUs than components of the cardiovascular or respiratory systems., (Copyright © 2022 by the American College of Sports Medicine.)

Rocker-profile design shoes are commonly used in clinical settings. Such footwear reduces in-shoe pressure over the forefoot area during the gait, and depending on the rocker-profile type (i.e., toe-only, heel negative, or double rocker), affects lower limb kinematics, kinetics, and muscle electromyographic activity. However, whether wearing rocker-profile shoes influence the dynamics of the body centre of mass (BCoM) is unknown. We used a mathematical procedure combining Lissajous contours and Fourier analysis to describe the 3D trajectory of the BCoM in walking with rocker-profile (RollingSole) and flat (Control) shoes at 0.97, 1.25, and 1.53 m s -1 in 30 participants. Harmonics amplitude and phase were compared using linear and circular statistics, respectively. External (W ext ), kinematic internal (W int,k ) and total (W tot ) mechanical works, and the mechanical energy fraction recovered from a pendular exchange of potential and kinetic energy were also calculated. RollingSole shoes yielded greater W ext (1-9 %; P < 0.05) and fractional pendular energy exchange (1-8 %; P < 0.01), with lower W int,k (2-5 %; P < 0.05) and unchanged W tot (P ≥ 0.30). RollingSole shoes led also to a greater mean height of the BCoM (1-3 %; P < 0.01), and amplitude of the anteroposterior and vertical symmetric, and mediolateral 2nd-to-5th harmonics (1-30 %; P < 0.01). No differences between shoes were found for the harmonics phase (P ≥ 0.14). Our results indicate that RollingSole shoes enhanced an inverted pendulum-like behaviour of the BCoM during walking with no alterations in total mechanical work. This may result from the combination of rocker-profile design and greater BCoM height (through thicker soles) with such shoes, increasing recovery of mechanical energy in step-to-step transitions and mid-stance., 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 © 2022 Elsevier Ltd. All rights reserved.)

The trajectory of the body centre of mass (BCoM) during locomotion differs through speeds, gaits and pathological states; statistical methods are needed to compare it among different conditions. Here, ten participants walked on treadmill at 1.1 and 1.4 m/s; BCoM trajectories were obtained through stereophotogrammetry and expressed as Fourier series. Trajectories were compared among speeds using (i) zero-dimensional (0D) linear and circular tests for difference on amplitudes and phases of Fourier series harmonic, (ii) one-dimensional statistical parametric mapping (1D-SPM) t-tests on the anteroposterior, mediolateral and vertical axial components of the BCoM trajectory and (iii) 1D-SPM Hotelling's T 2 test on the three-dimensional BCoM trajectory. Increasing speed increased the amplitude and decreased the phase of the fundamental (2nd) vertical harmonic. Coherently, the BCoM vertical trajectory featured greater displacement and a forward-shift, combined with greater displacement along the anteroposterior axis. Hotelling's T 2 1D-SPM on the whole trajectory featured supra-threshold clusters at the transition between double and single support, and mid of the single support. 0D and 1D test yielded coherent and complementary results: 1D-SPM Hotelling's T 2 is suitable to compare whole three-dimensional BCoM trajectories; however, when researchers hypothesize that conditions may impact specific harmonics or axial components, 0D or 1D-SPM t-tests are recommended., (© 2022. The Author(s).)

To describe microbiota profiles considering potential influencing factors in pre-school children with recurrent respiratory tract infections (rRTIs) and to evaluate microbiota changes associated with oral bacterial lysate OM-85 treatment, we analyzed gut and nasopharynx (NP) microbiota composition in patients included in the OM-85-pediatric rRTIs (OMPeR) clinical trial (https://www.clinicaltrialsregister.eu/ctr-search/trial/2016-002705-19/IT). Relative percentage abundance was used to describe microbiota profiles in all the available biological specimens, grouped by age, atopy, and rRTIs both at inclusion (T0) and at the end of the study, after treatment with OM-85 or placebo (T1). At T0, Firmicutes and Bacteriodetes were the predominant genera in gut and Proteobacteria , Firmicutes , and Actinobacteria were the predominant genera in NP samples. Gut microbiota relative composition differed with age (<2 vs. ≥2 years) for Firmicutes, Proteobacteria, Actinobacteria (phyla) and Bifidobacterium, Ruminococcus, Lachnospiraceae (genera) ( p < 0.05). Moraxella was more enriched in the NP of patients with a history of up to three RTIs. Intra-group changes in relative percentage abundance were described only for patients with gut and NP microbiota analysis available at both T0 and T1 for each study arm. In this preliminary analysis, the gut microbiota seemed more stable over the 6-month study in the OM-85 group, whose mean age was lower, as compared to the placebo group ( p = 0.004). In this latter group, the relative abundance of Bacteroides decreased significantly in children ≥2 years. Some longitudinal significant differences in genera relative abundance were also detected in children of ≥2 years for NP Actinobacteria , Haemophilus , and Corynebacterium in the placebo group only. Due to the small number of patients in the different sub-populations, we could not identify significant differences in the clinical outcome and therefore no associations with microbiota changes were searched. The use of bacterial lysates might play a role in microbiota rearrangement, but further data and advanced analysis are needed to prove this in less heterogeneous populations with higher numbers of samples considering the multiple influencing factors such as delivery method, age, environment, diet, antibiotic use, and type of infections to ultimately show any associations with prevention of rRTIs., 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 © 2022 Esposito, Ballarini, Argentiero, Ruggiero, Rossi and Principi.)

Purpose: In volleyball, jump execution is critical for the match outcome. Game-play-related neuromuscular impairments may manifest as decreased jump height (JH) or increased jump total duration, both of which are pivotal for performance. To investigate changes in JH and kinetics with game play, the authors conducted a prospective exploratory analysis using minimal-effect testing (MET) and equivalence testing with the 2 one-sided tests procedure, univariate, and bivariate functional principal component analysis, respectively., Methods: Twelve male varsity athletes completed 3-set matches on 2 consecutive days. Countermovement jumps were performed on a force platform immediately prematch and postmatch on days 1 and 2 and once on days 3 and 4., Results: Across sessions, JH was equivalent (P < .022, equivalence test), while total duration reported inconclusive changes (P > .227). After match 2, MET indicated that relative force at zero velocity (P = .036) decreased, while braking duration (P = .040) and time to peak force (P = .048) increased compared with baseline. With the first and second functional principal components, these alterations, together with decreased relative braking rate of force development (P = .092), were already evident after match 1. On day 4, MET indicated that relative peak force (P = .049), relative force at zero velocity (P = .023), and relative braking rate of force development (P = .021) decreased, whereas braking duration (P = .025) increased from baseline., Conclusions: Impairments in jump kinetics were evident from variables related to the countermovement-jump braking phase, while JH was equivalent. In addition to these experimental findings, the present research provides information for the choice of sample size and smallest effect size of interest when using MET and 1- and 2-dimensional analyses for countermovement-jump height and kinetics.

Ascent to high altitude is accompanied by a reduction in partial pressure of inspired oxygen, which leads to interconnected adjustments within the neuromuscular system. This review describes the unique challenge that such an environment poses to neuromuscular fatigability (peripheral, central and supraspinal) for individuals who normally reside near to sea level (SL) (<1000 m; ie, lowlanders) and for native highlanders, who represent the manifestation of high altitude-related heritable adaptations across millennia. Firstly, the effect of acute exposure to high altitude-related hypoxia on neuromuscular fatigability will be examined. Under these conditions, both supraspinal and peripheral fatigability are increased compared with SL. The specific mechanisms contributing to impaired performance are dependent on the exercise paradigm and amount of muscle mass involved. Next, the effect of chronic exposure to high altitude (ie, acclimatization of ~7-28 days) will be considered. With acclimatization, supraspinal fatigability is restored to SL values, regardless of the amount of muscle mass involved, whereas peripheral fatigability remains greater than SL except when exercise involves a small amount of muscle mass (eg, knee extensors). Indeed, when whole-body exercise is involved, peripheral fatigability is not different to acute high-altitude exposure, due to competing positive (haematological and muscle metabolic) and negative (respiratory-mediated) effects of acclimatization on neuromuscular performance. In the final section, we consider evolutionary adaptations of native highlanders (primarily Himalayans of Tibet and Nepal) that may account for their superior performance at altitude and lesser degree of neuromuscular fatigability compared with acclimatized lowlanders, for both single-joint and whole-body exercise., (© 2022 The Authors. Acta Physiologica published by John Wiley & Sons Ltd on behalf of Scandinavian Physiological Society.)

COVID-19 containment measures hampered population cardiorespiratory fitness (which can be quantified as peak oxygen consumption (V.O 2peak )) and the possibility to assess it using laboratory-based techniques. Although it is useful to ascertain the V.O 2peak recovery after lockdowns, the community and most scientific institutions were unable to evaluate it. Wearable devices may provide the opportunity to estimate cardiorespiratory fitness outside of the laboratory, without breaking self-isolation; herein, we explore the feasibility of this approach. Fifteen healthy participants were tested every 2 weeks for 10 weeks during a reduction of containment measures after a strict lockdown. Physical activity levels were measured using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). V.O 2peak was estimated through a previously validated test based on the speed of a 60 m sprint run, the baseline-to-peak heart rate (HR) variation, and the velocity of HR decay after the sprint, and measured through a wearable HR monitor. Participants increased physical activity from the end of lockdown (1833 [917-2594] MET-min/week; median [1st quartile-3rd quartile]) until the end of follow-up (2730 [1325-3380] MET-min/week). The estimated V.O 2peak increased by 0.24 ± 0.19 mL/(min*kg*week) (regression coefficient ± standard error). Based on previous knowledge on the impact of inactivity on V.O 2peak , our study indicates that a 10-week period of reducing the stringency of containment measures may not be sufficient to counteract the detrimental effects of the preceding lockdown.

Body segments inertial parameters (or, more generally encompassing humans and animal species, inertial biometry), often necessary in kinetics calculations, have been obtained in the past from cadavers, medical 3D imaging, 3D scanning, or geometric approximations. This restricted the inertial archives to a few species. The methodology presented here uses commercial 3D meshes of human and animal bodies, which can be further re-shaped and 'posed', according to an underlying skeletal structure, before processing. The sequence of steps from virtually chopping the mesh to the estimation of inertial parameters of body segments is described. The accuracy of the method is tested by comparing the estimated results to real data published for humans (male and female), horses, and domestic cats. The proposed procedure opens the possibility of remarkably expanding biomechanics research when body size and shape change, or when external tools, such as prosthesis and sport material, take part in biological movement., Competing Interests: Competing interests The authors declare no competing or financial interests., (© 2022. Published by The Company of Biologists Ltd.)

Background: Despite efforts to increase coverage by two doses of measles vaccine in Italy, measles continues to circulate, with over 13 000 cases of disease since 2013. This study aimed to evaluate immunity to measles in Italian children and adolescents., Methods: A total of 378 serum samples from subjects aged 9 months-18 years were collected in Northern, Central and Southern regions of Italy between 2012 and 2016. Specific IgG antibodies against measles were measured by a commercial ELISA kit., Results: The frequency of IgG-positive samples ranged from 10.5% in infants under 1 year to 98.3% in children aged 6-7 years. The frequency of IgG was 72.2% in subjects aged 1-2 years, 85.6% in those aged 3-5 years and 88.3 and 86.8% in those aged 8-10 and 11-18 years, respectively. In Northern Italy, IgG prevalence was consistent with data on vaccination coverage, whereas some differences were observed in samples from subjects aged more than 8 years in Central and Southern Italy., Conclusions: Our findings confirm that a large proportion of children and adolescents in Italy are still susceptible to measles. While data on first- and second-dose measles vaccination are essential, they are not sufficient to identify susceptible population cohorts to be targeted by vaccination., (© The Author(s) 2020. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: It has been speculated that the SARS-CoV-2 was already widespread in western countries before February 2020., Methods: We gauged this hypothesis by analysing the nasal swab of infants with either bronchiolitis or a non-infectious disease admitted to the Ospedale Maggiore, Milan (one of the first epicentres of SARS-CoV-2 outbreak in Europe) from November 2019., Results: The SARS-CoV-2 RNA was never detected in 218 infants with bronchiolitis (95 females, median age 4.9 months) and 49 infants (22 females, median age 5.6 months) with a non-infectious disease between November 2019 and February 2020. On the contrary, two infants hospitalised for bronchiolitis between March and April 2020 tested positive for SARS-CoV-2., Conclusions: This study does not support the hypothesis that SARS-CoV-2 was already circulating among infants before the official outbreak of SARS-CoV-2 infection. However, it shows for the first time that SARS-CoV-2 might cause bronchiolitis requiring hospitalisation., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Quantifying prolonged low-frequency force depression (PLFFD) with the gold-standard 1-s trains presents challenges, so paired pulses have been used. Owing to greater impairment of high-frequency doublet than tetanic torque, paired pulses underestimate PLFFD. This study aimed to approximate the minimum number of high-frequency pulses needed to avoid such underestimation and assess the feasibility of modeling PLFFD from a limited number of experimental pulses. In 13 participants, a 1-s 10-Hz train and 100-Hz trains with 2, 4, 7, 12, 15, 25, 50, or 100 pulses were evoked before and after (15 min, 2, 4, and 7 days) eccentric exercise of the dorsiflexors. With ≤12 pulses, impairment of 100-Hz torque was greater than the 1-s train ( P ≤ 0.05; e.g., 12 vs. 100 pulses at 4 days: 97.8 ± 8.5% vs. 100.5 ± 8.2% baseline). Consequently, with ≤12 pulses, PLFFD was underestimated compared with the gold-standard measure ( P ≤ 0.05; e.g., 12 vs. 100 pulse 10:100-Hz torque ratio at 4 days: 86.8 ± 12.8% vs. 84.6 ± 13.5% baseline). Modeling reproduced 10:100-Hz ratios (PLFFD) with 95% limits of agreement of -13.6% to 16.7% of experimental values with ≥12 pulses. Our results indicate that a minimum of 13-25 pulses of 100 Hz are needed to accurately quantify PLFFD in the dorsiflexors. Although this may not be the minimum range for other muscles, a similar relationship with pulse number likely exists. Modeling may eventually provide an option to estimate PLFFD from experimental trains with relatively few pulses; however, further development is imperative to reduce variability. NEW & NOTEWORTHY Ideally, prolonged low-frequency force depression (PLFFD) is measured with 1-s trains of supramaximal stimuli; however, this induces considerable discomfort. We tested briefer trains to approximate the minimum number of high-frequency pulses needed to accurately determine PLFFD and the feasibility of modeling 1-s tetani with relatively few pulses. After eccentric exercise, 13-25 high-frequency pulses were needed to accurately measure PLFFD. Modeling reproduced mean experimental values but had considerable variability.

In biomechanics, kinematic and electromyographic data can be represented as one-dimensional (1D) waveforms and compared by using 1D hypothesis tests. These statistical techniques are increasingly applied in the study of locomotion. However, although widely agreed as a key step to obtain reliable and replicable findings, no a priori sample size estimation is usually conducted. This can also be done in 1D tests by calculating the statistical power - i.e., the probability of rejecting the null hypothesis when it is false - by using statistical parametric mapping. With the present study we characterised the parameters needed to estimate sample size in locomotion, and how they impact on statistical power in 1D tests. First, noise and signal in kinematics and electromyography were defined using experimental data on locomotion in physiological and pathological participants. Then, 1D power analysis was performed in representative conditions, and a dataset of tabulated sample sizes was generated. Kinematic and electromyographic data showed a smooth Gaussian noise, with amplitude and full-width-at-half-maximum depending on the physiological or pathological condition, and the considered joint or muscle. Given a certain noise, statistical power increased i) with greater signal amplitude and signal full-width-at-half-maximum, ii) when setting a region of interest and iii) when using a paired (vs. unpaired) study design. The present work provides initial benchmarks for appropriate sampling in 1D hypothesis testing, meant to evaluate statistical power in 1D tests and assists sample size estimation in studies on locomotion., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Unaccustomed eccentric (ECC) exercise induces muscle fatigue as well as damage and initiates a protective response to minimize impairments from a subsequent bout (i.e., repeated bout effect; RBE). It is uncertain if the sexes differ for neuromuscular responses to ECC exercise and the ensuing RBE. Twenty-six young adults (13 females) performed 2 bouts (4 weeks apart) of 200 ECC maximal voluntary contractions (MVCs) of the dorsiflexors. Isometric (ISO) MVC torque and the ratio of ISO torque in response to low- versus high-frequency stimulation (10:100 Hz) were compared before and after (2-10 min and 2, 4, and 7 days) exercise. The decline in ECC and ISO MVC torque and the 10:100 Hz ratio following bout 1 did not differ between sexes ( P > 0.05), with reductions from baseline of 31.5% ± 12.3%, 24.1% ± 15.4%, and 51.3% ± 12.2%, respectively. After bout 2, the 10:100 Hz ratio declined less (45.0% ± 12.4% from baseline) and ISO MVC torque recovered sooner compared with bout 1 but no differences between sexes were evident for the magnitude of the RBE ( P > 0.05). These data suggest that fatigability with ECC exercise does not differ for the sexes and adaptations that mitigate impairments to calcium handling are independent of sex. Novelty: One bout of 200 maximal eccentric dorsiflexor contractions caused equivalent muscle fatigue and damage for females and males. The repeated bout effect observed after a second bout 4 weeks later also had no sex-related differences. Prolonged low-frequency force depression is promoted as an indirect measure of muscle damage in humans.