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Vaughan P Nicholson, Mark R McKean, Brendan J Burkett School of Health and Sport Sciences, University of the Sunshine Coast, Sunshine Coast, QLD, Australia Purpose: The purpose of the study was to evaluate the effect of BodyBalance® training on balance, functional task performance, fear of falling, and health-related quality of life in adults aged over 55 years.Participants and methods: A total of 28 healthy, active adults aged 66±5 years completed the randomized controlled trial. Balance, functional task performance, fear of falling, and self-reported quality of life were assessed at baseline and after 12 weeks. Participants either undertook two sessions of BodyBalance per week for 12 weeks (n=15) or continued with their normal activities (n=13).Results: Significant group-by-time interactions were found for the timed up and go (P=0.038), 30-second chair stand (P=0.037), and mediolateral center-of-pressure range in narrow stance with eyes closed (P=0.017). There were no significant effects on fear of falling or self-reported quality of life.Conclusion: Twelve weeks of BodyBalance training is effective at improving certain balance and functional based tasks in healthy older adults. Keywords: postural control, yoga, tai chi, center of pressure, exercise

The gastrin-releasing peptide receptor (GRPr) has gained recognition as a promising target for both diagnostic and therapeutic applications in a variety of human cancers. This study aims to explore the primary tumor detection capabilities of [ 68 Ga] Ga-GRPr PET imaging, specifically in newly diagnosed intra-prostatic prostate cancer lesions (PCa). Following PRISMA-DTA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy Studies) guidelines, a systematic literature search was conducted using the Medline, Embase, Scopus, and Web of Science databases. Data regarding patient characteristics and imaging procedure details-including the type of radiotracer used, administered activity, image acquisition time, scanner modality, criteria, and detection rate of index test-were extracted from the included studies. The pooled patient-and lesion-based detection rates, along with their corresponding 95% confidence intervals (CI), were calculated using a random effects model. The final analysis included 9 studies involving 291 patients and 350 intra-prostatic lesions with [ 68 Ga] Ga-GRPr PET imaging in primary PCa. In per-patient-based analysis of [ 68 Ga] Ga-GRPr PET imaging, the pooled detection rates of overall and patients with Gleason score ≥ 7 were 87.09% (95% CI 74.98-93.82) and 89.01% (95% CI 68.17-96.84), respectively. In per-lesion-based analysis, the pooled detection rate [ 68 Ga] Ga-GRPr PET imaging was 78.54% (95% CI 69.8-85.29). The pooled detection rate mpMRI (multiparametric magnetic resonance imaging) in patient-based analysis was 91.85% (95% CI 80.12-96.92). The difference between the detection rates of the mpMRI and [ 68 Ga] Ga-GRPr PET imaging was not statistically significant (OR 0.90, 95% CI 0.23-3.51). Our findings suggest that [ 68 Ga] Ga-GRPr PET imaging has the potential as a diagnostic target for primary PCa. Future research is needed to determine the effectiveness of [ 68 Ga] Ga-GRPr PET in delivering additional imaging data and guiding therapeutic decisions., (© 2024. The Author(s) under exclusive licence to The Japanese Society of Nuclear Medicine.)

Background: The main objective is to discuss why treatment of non-prostate cancers with [ 177 Lu]Lu-PSMA-radioligand achieved only low tumor dose in most published cases, despite high uptake on PSMA PET. We use a patient with renal cell carcinoma as an illustrative example. Furthermore, we discuss how the problem with early washout and low tumor dose might be overcome by using a radionuclide with shorter half-life, matching the target binding residence time., Case Presentation: [ 68 Ga]Ga-PSMA-11 PET/CT of a 56-year old man with metastatic renal cell carcinoma showed high lesion uptake. One dose of 6.9 GBq [ 177 Lu]Lu-PSMA-I&T was administrated. Post-therapy dosimetry was performed with SPECT/CT and whole-body planar imaging after 5, 24 and 48 h. Doses to target lesions were only 0.2-0.5 Gy. No treatment effect was achieved., Conclusion: Rapid tumor washout of [ 177 Lu]Lu-PSMA-I&T and low tumor dose despite high uptake of [ 68 Ga]Ga-PSMA-11 are most likely caused by localization of PSMA-receptors on neovasculature rather than on the tumor cells, and unlike in prostate cancer cells, the PSMA-RL / PSMA-receptor complex is not internalized. To overcome the problem with early washout, the use of a radionuclide with shorter half-life matching the target binding residence time will be needed., (© 2024. The Author(s).)

Treatment with 177 Lu-prostate-specific membrane antigen (PSMA)-617 ( 177 Lu-vipivotide tetraxetan [Pluvicto]) prolongs both progression-free and overall survival in advanced PSMA-positive metastatic castration-resistant prostate cancer. Data examining specifically neurologic symptoms after 177 Lu-PSMA-617 treatment are scarce. In this study, we aimed to review the neurologic findings in a large cohort of metastatic castration-resistant prostate cancer patients undergoing 177 Lu-PSMA-617 therapy. Methods: The clinical records and imaging data of patients who received their initial dose of 177 Lu-PSMA-617 between March 2022 and November 2022 were retrospectively reviewed. All patients presenting for medical evaluation, regardless of specific specialty appointments, with new or worsening neurologic symptoms were included in the study. Results: A total of 185 patients underwent 177 Lu-PSMA-617 therapy. The median age was 70 y (range, 58-90 y). The mean follow-up time was 12.04 ± 2.87 mo. Fifty-five new or worsening neurologic symptoms were observed in 50 patients (27%, 50/185). Of these, 27 (11.9%, 27/185) reported altered taste. Eleven patients (6%, 11/185) experienced dizziness with no other clear etiology; 2 of these patients were admitted to the emergency department (ED). Paresthesia symptoms were reported in 6 patients (3.2%, 6/185). Five patients (2.7%, 5/185) reported headaches, 3 of these patients were admitted to the ED because of the severity of the symptoms. Two patients (1.08%, 2/185) presented with extremity weakness. Two patients (1.08%, 2/185) had an ischemic stroke and were admitted to the ED. One patient (0.05%, 1/185) exhibited gait disturbances. In total, 7 patients (3.78%, 7/185) were admitted to the ED because of neurologic symptoms. None of the patients discontinued or failed to complete the 177 Lu-PSMA-617 therapy because of neurologic symptoms. Conclusion: After 177 Lu-PSMA-617 treatment, the most common neurologic symptoms were dysgeusia and dizziness. In this study, our follow-up period and population size might not have been sufficient to detect delayed or uncommon neurologic symptoms. In patients without neurologic symptoms or central nervous system metastases before treatment, we found the development of severe neurologic problems to be rare and unlikely to require discontinuation of treatment., (© 2024 by the Society of Nuclear Medicine and Molecular Imaging.)

Importance: Asymmetric oropharynx uptake on positron emission tomography (PET)/computed tomography (CT) is a common incidental finding and often prompts otolaryngology referral to rule out malignancy; however, the true risk of malignancy based on this finding is unknown., Objective: To identify the incidence of oropharynx cancer in patients with incidental asymmetric oropharynx PET uptake., Design, Setting, and Participants: In this retrospective cohort study, patients 18 years and older undergoing PET/CT scans at Mayo Clinic between January 2001 and December 2018 were included. Patients with a history or pretest suspicion of oropharynx cancer were excluded. Data were analyzed from March 2021 to December 2023., Exposure: Blinded radiologic review of imaging studies, including measurement of maximum standardized uptake values (SUVmax) of the ipsilateral side of concern and contralateral side. Retrospective medical record review for associated clinical data., Main Outcomes and Measures: The primary study outcome was the incidence of oropharynx cancer diagnosis in patients with asymmetric oropharynx PET uptake. The primary outcome was formulated before data collection., Results: Of the 1854 patients identified with asymmetric oropharynx PET uptake, 327 (17.6%) met inclusion criteria. Of these, 173 (52.9%) were male, and the median (range) age was 65.0 (24.8-90.7) years. The mean (SD) follow-up interval was 52.1 (43.4) months. A total of 18 of 327 patients (5.5%) were newly diagnosed with oropharynx cancer. The most common diagnosis was squamous cell carcinoma (n = 9), followed by lymphoma (n = 8), and sarcoma (n = 1). Patients with an incidental diagnosis of oropharynx cancer had higher mean (SD) ipsilateral SUVmax (8.7 [3.7] vs 5.3 [1.9]) and SUVmax ratio (3.0 [1.6] vs 1.6 [0.6]) compared with patients with normal examination findings. SUVmax ratio and difference were found to be good discriminators of oropharynx cancer, with areas under the receiver operating characteristic curve of 86.3% (95% CI, 76.4-94.6) and 85.8% (95% CI, 74.8-94.6), respectively. Patients with a new diagnosis of oropharynx cancer were more likely to have a corresponding CT abnormality than those with normal examination findings (6 of 18 [33%] vs 24 of 295 [8.1%]). Patients with concerning lesions on oropharynx palpation by an otolaryngology health care professional were significantly more likely to be diagnosed with oropharynx cancer compared with patients with normal examination findings (odds ratio, 28.4; 95% CI, 6.6-145.8)., Conclusions and Relevance: In this cohort study, while incidental asymmetric oropharynx PET uptake was common, a new diagnosis of oropharynx cancer was not and potentially results in a large volume of unnecessary referrals and work-up. Using SUVmax ratio, SUVmax difference, and CT correlation may increase the benefit of referral. Patients with a palpable oropharynx lesion and asymmetric oropharynx PET uptake should undergo confirmatory biopsy.

Background: Many patients use artificial intelligence (AI) chatbots as a rapid source of health information. This raises important questions about the reliability and effectiveness of AI chatbots in delivering accurate and understandable information., Purpose: To evaluate and compare the accuracy, conciseness, and readability of responses from OpenAI ChatGPT-4 and Google Bard to patient inquiries concerning the novel 177 Lu-PSMA-617 therapy for prostate cancer., Materials and Methods: Two experts listed the 12 most commonly asked questions by patients on 177 Lu-PSMA-617 therapy. These twelve questions were prompted to OpenAI ChatGPT-4 and Google Bard. AI-generated responses were distributed using an online survey platform (Qualtrics) and blindly rated by eight experts. The performances of the AI chatbots were evaluated and compared across three domains: accuracy, conciseness, and readability. Additionally, potential safety concerns associated with AI-generated answers were also examined. The Mann-Whitney U and chi-square tests were utilized to compare the performances of AI chatbots., Results: Eight experts participated in the survey, evaluating 12 AI-generated responses across the three domains of accuracy, conciseness, and readability, resulting in 96 assessments (12 responses x 8 experts) for each domain per chatbot. ChatGPT-4 provided more accurate answers than Bard (2.95 ± 0.671 vs 2.73 ± 0.732, p =0.027). Bard's responses had better readability than ChatGPT-4 (2.79 ± 0.408 vs 2.94 ± 0.243, p =0.003). Both ChatGPT-4 and Bard achieved comparable conciseness scores (3.14 ± 0.659 vs 3.11 ± 0.679, p =0.798). Experts categorized the AI-generated responses as incorrect or partially correct at a rate of 16.6% for ChatGPT-4 and 29.1% for Bard. Bard's answers contained significantly more misleading information than those of ChatGPT-4 ( p = 0.039)., Conclusion: AI chatbots have gained significant attention, and their performance is continuously improving. Nonetheless, these technologies still need further improvements to be considered reliable and credible sources for patients seeking medical information on 177 Lu-PSMA-617 therapy., 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 Belge Bilgin, Bilgin, Childs, Orme, Burkett, Packard, Johnson, Thorpe, Riaz, Halfdanarson, Johnson, Sartor and Kendi.)

Antiamyloid therapies for Alzheimer disease recently entered clinical practice, making imaging biomarkers for Alzheimer disease even more relevant to guiding patient management. Amyloid and tau PET are valuable tools that can provide objective evidence of Alzheimer pathophysiology in living patients and will increasingly be used to complement 18 F-FDG PET in the diagnostic evaluation of cognitive impairment and dementia. Parkinsonian syndromes, also common causes of dementia, can likewise be evaluated with a PET imaging biomarker, 18 F-DOPA, allowing in vivo assessment of the presynaptic dopaminergic neurons. Understanding the role of these PET biomarkers will help the nuclear medicine physician contribute to the appropriate diagnosis and management of patients with cognitive impairment and dementia. To successfully evaluate brain PET examinations for neurodegenerative diseases, knowledge of the necessary protocol details for obtaining a reliable imaging study, inherent limitations for each PET radiopharmaceutical, and pitfalls in image interpretation is critical. This review will focus on underlying concepts for interpreting PET examinations, important procedural details, and guidance for avoiding potential interpretive pitfalls for amyloid, tau, and dopaminergic PET examinations., (© 2024 by the Society of Nuclear Medicine and Molecular Imaging.)

The field of theranostics is rapidly advancing, driven by the goals of enhancing patient care. Recent breakthroughs in artificial intelligence (AI) and its innovative theranostic applications have marked a critical step forward in nuclear medicine, leading to a significant paradigm shift in precision oncology. For instance, AI-assisted tumor characterization, including automated image interpretation, tumor segmentation, feature identification, and prediction of high-risk lesions, improves diagnostic processes, offering a precise and detailed evaluation. With a comprehensive assessment tailored to an individual's unique clinical profile, AI algorithms promise to enhance patient risk classification, thereby benefiting the alignment of patient needs with the most appropriate treatment plans. By uncovering potential factors unseeable to the human eye, such as intrinsic variations in tumor radiosensitivity or molecular profile, AI software has the potential to revolutionize the prediction of response heterogeneity. For accurate and efficient dosimetry calculations, AI technology offers significant advantages by providing customized phantoms and streamlining complex mathematical algorithms, making personalized dosimetry feasible and accessible in busy clinical settings. AI tools have the potential to be leveraged to predict and mitigate treatment-related adverse events, allowing early interventions. Additionally, generative AI can be utilized to find new targets for developing novel radiopharmaceuticals and facilitate drug discovery. However, while there is immense potential and notable interest in the role of AI in theranostics, these technologies do not lack limitations and challenges. There remains still much to be explored and understood. In this study, we investigate the current applications of AI in theranostics and seek to broaden the horizons for future research and innovation., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Given the prevalence of dementia and the development of pathology-specific disease-modifying therapies, high-value biomarker strategies to inform medical decision-making are critical. In vivo tau-PET is an ideal target as a biomarker for Alzheimer's disease diagnosis and treatment outcome measure. However, tau-PET is not currently widely accessible to patients compared to other neuroimaging methods. In this study, we present a convolutional neural network (CNN) model that imputes tau-PET images from more widely available cross-modality imaging inputs. Participants (n = 1192) with brain T1-weighted MRI (T1w), fluorodeoxyglucose (FDG)-PET, amyloid-PET and tau-PET were included. We found that a CNN model can impute tau-PET images with high accuracy, the highest being for the FDG-based model followed by amyloid-PET and T1w. In testing implications of artificial intelligence-imputed tau-PET, only the FDG-based model showed a significant improvement of performance in classifying tau positivity and diagnostic groups compared to the original input data, suggesting that application of the model could enhance the utility of the metabolic images. The interpretability experiment revealed that the FDG- and T1w-based models utilized the non-local input from physically remote regions of interest to estimate the tau-PET, but this was not the case for the Pittsburgh compound B-based model. This implies that the model can learn the distinct biological relationship between FDG-PET, T1w and tau-PET from the relationship between amyloid-PET and tau-PET. Our study suggests that extending neuroimaging's use with artificial intelligence to predict protein specific pathologies has great potential to inform emerging care models., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Guarantors of Brain.)

Purpose: Dental amalgam contains mercury and is commonly used in dental restorations. The impact of MRI on mercury excretion from dental amalgam is not well understood across clinical field strengths, especially 7T. We investigated the effects of MRI exposure on mercury excretion using fresh, lab-created dental amalgam restorations and in extracted teeth with old, pre-existing restorations., Methods: Donated, unfilled human teeth (n = 120) were restored with amalgam before being stored in saline, artificial saliva, or a dry box prior to MRI scanning. The teeth were placed in individual tubes of fresh artificial saliva and scanned at 1.5T, 3T, or 7T or left unscanned as controls. Mercury concentrations were measured 24-30 h later. Donated teeth with pre-existing restorations (n = 40) were stored in artificial saliva, scanned at 7T or left unscanned as controls, and mercury concentration tested., Results: For teeth extracted and restored in a laboratory, no significant difference was found (F = 2.42, P = 0.072) between mean mercury concentrations of unscanned teeth (13.72 μg/L) and teeth scanned at 1.5T (10.88 μg/L), 3T (12.65 μg/L), or 7T (8.88 μg/L). For teeth extracted with previously placed restorations, no significant difference (P = 0.288) was found between unscanned controls (4.28 μg/L) and teeth scanned at 7T (6.63 μg/L)., Conclusion: MRI of dental amalgam does not significantly increase mercury excretion at 1.5T, 3T, or 7T compared to unscanned teeth. This holds true for controlled laboratory restorations as well as for those placed and lived with prior to extraction and scanning, demonstrating no added risk to the clinical patient or research subject., (© 2023 International Society for Magnetic Resonance in Medicine.)

Abstract: Leucine-rich glioma inactivated 1 autoimmune encephalitis is a treatable cause of autoimmune epilepsy associated with faciobrachial dystonic seizures-a rare form of epilepsy with frequent brief seizures primarily affecting the arm and face. We report a case with characteristic imaging findings. 18 F-FDG PET/CT demonstrated severe hypometabolism in the left basal ganglia, a regional abnormality associated with leucine-rich glioma inactivated 1 encephalitis., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: Congenital absence of the stapedial tendon is a rare entity with characteristic imaging findings, which can go unrecognized due the scarcity of the diagnosis and limited previous description in the imaging literature. We aim to characterize the imaging features of this entity., Methods: A series of 9 cases with surgical confirmation of stapedial tendon absence were retrospectively reviewed and the most common abnormalities on high resolution computed tomography (CT) of the temporal bone described., Results: Congenital fixation of the stapes footplate was present in nearly all cases of stapedial tendon absence (n = 8, 89%), a clinically important association because the stapes footplate abnormality was not detectable on preoperative CT. Absence or hypoplasia of the pyramidal eminence and aperture was identified in almost all cases (n = 8, 89%), which may be the sole imaging finding to suggest stapedial tendon absence and associated stapes footplate fixation prior to surgery., Conclusion: The most reliable indicator of stapedial muscle absence on temporal bone CT is the absence or hypoplasia of the pyramidal eminence and aperture. Importantly, most patients had congenital stapes footplate fixation confirmed intraoperatively with a normal stapes footplate on CT, meaning the pyramidal eminence/aperture abnormality was the only preoperative imaging finding that could have suggested the footplate fixation., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Amyotrophic lateral sclerosis (ALS) is a disease leading to progressive motor degeneration and ultimately death. It is a complex disease that can take a significantly long time to be diagnosed, as other similar pathological conditions must be ruled out for a definite diagnosis of ALS. Noninvasive imaging of ALS has shed light on disease pathology and altered biochemistry in the ALS brain. Other than magnetic resonance imaging (MRI), two types of functional imaging, positron emission tomography (PET) and single photon emission computed tomography (SPECT), have provided valuable data about what happens in the brain of ALS patients compared to healthy controls. PET imaging has revealed a specific pattern of brain metabolism through [ 18 F]FDG, while other radiotracers have uncovered neuroinflammation, changes in neuronal density, and protein aggregation. SPECT imaging has shown a general decrease in regional cerebral blood flow (rCBF) in ALS patients. This educational review summarizes the current state of ALS imaging with various PET and SPECT radiopharmaceuticals to better understand the pathophysiology of ALS., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Ayaan M. Jamali et al.)

Theranostics is the combination of two approaches-diagnostics and therapeutics-applied for decades in cancer imaging using radiopharmaceuticals or paired radiopharmaceuticals to image and selectively treat various cancers. The clinical use of theranostics has increased in recent years, with U.S. Food and Drug Administration (FDA) approval of lutetium 177 ( 177 Lu) tetraazacyclododecane tetraacetic acid octreotate (DOTATATE) and 177 Lu-prostate-specific membrane antigen vector-based radionuclide therapies. The field of theranostics has imminent potential for emerging clinical applications. This article reviews critical areas of active clinical advancement in theranostics, including forthcoming clinical trials advancing FDA-approved and emerging radiopharmaceuticals, approaches to dosimetry calculations, imaging of different radionuclide therapies, expanded indications for currently used theranostic agents to treat a broader array of cancers, and emerging ideas in the field. Keywords: Molecular Imaging, Molecular Imaging-Cancer, Molecular Imaging-Clinical Translation, Molecular Imaging-Target Development, PET/CT, SPECT/CT, Radionuclide Therapy, Dosimetry, Oncology, Radiobiology © RSNA, 2023.

Purpose: Determine the effects of skin temperature change on bench-pull power following a passive warm-up intervention with highly trained swimmers using multiple heated clothing garments., Methods: Using a crossover design, 8 high-performance swimmers (mean [SD]; age, 22.4 [4.4] y; body mass, 74.9 [8.1] kg; height, 1.79 [0.09] m; world record ratio, 107.3% [5.1%]) completed a pool-based warm-up followed by a 35-minute transition phase before completing 3 repetitions at 50% of 1-repetition maximum of the bench-pull exercise. During transition, swimmers wore either a warm (control) or a heated (heat) clothing condition., Results: Following heating, mean skin temperature was 0.7 °C higher in heat (P = .011), though no change was seen in tympanic temperature. Bench-pull mean and peak power improved by 4.5% and 4.7% following heating, respectively. A large repeated-measures correlation was observed between skin temperature and mean (r [90% CI] = .94 [.65 to .99], P < .01) and peak (r [90% CI] = .89 [.45 to .98], P < .01) power output. Thermal sensation and comfort at all regions were higher with heating (P ≤ .02)., Conclusion: Combined upper- and lower-limb passive heating can increase whole-body skin temperature and improve short-duration upper-limb power output during the bench-pull exercise. Improvements in power output were directly related to the skin temperature increase facilitated by the heated clothing.

In tau PET, a reliable method to detect early tau accumulation in the brain is crucial. Noise, artifacts, and off-target uptake impede detection of subtle true-positive ligand binding. We hypothesize that identifying voxels with stable activity over time can enhance detection of true-positive tau. Methods: In total, 339 participants in the clinical spectrum ranging from clinically unimpaired to Alzheimer disease dementia underwent at least 2 serial tau PET scans with flortaucipir. The overlap index (OI) method was proposed to detect spatially identical, voxelwise SUV ratio (SUVR) elevation when seen sequentially in serial tau PET scans. The association of OI with tau accumulation, clinical diagnosis, and cognitive findings was evaluated. Results: OI showed good dynamic range in the low-SUVR window. Only OI was able to identify subgroups with increasing tau PET signal in low-SUVR meta-region-of-interest (ROI) groups. OI showed improved association with early clinical disease progression and cognitive scores versus meta-ROI SUVR measures. Conclusion: OI was more sensitive to tau signal elevation and longitudinal change than standard ROI measures, suggesting it is a more sensitive method for detecting early, subtle deposition of neurofibrillary tangles., (© 2022 by the Society of Nuclear Medicine and Molecular Imaging.)

Abstract: PET imaging plays an essential role in achieving earlier and more specific diagnoses of dementia syndromes, important for clinical prognostication and optimal medical management. This has become especially vital with the recent development of pathology-specific disease-modifying therapy for Alzheimer disease, which will continue to evolve and require methods to select appropriate treatment candidates. Techniques that began as research tools such as amyloid and tau PET have now entered clinical use, making nuclear medicine physicians and radiologists essential members of the care team. This review discusses recent changes in the understanding of dementia and examines the roles of nuclear medicine imaging in clinical practice. Within this framework, multiple cases will be shown to illustrate a systematic approach of FDG PET interpretation and integration of PET imaging of specific molecular pathology including dopamine transporters, amyloid, and tau. The approach presented here incorporates contemporary understanding of both common and uncommon dementia syndromes, intended as an updated practical guide to assist with the sophisticated interpretation of nuclear medicine examinations in the context of this rapidly and continually developing area of imaging., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: In swimming, the period between the end of the swimming warmup and the beginning of competition is critical to performance, here termed the transition phase. Several options are available during this phase, necessitating a systematic review to understand if optimal strategies exist., Objectives: To synthesise and critically evaluate the current literature investigating land-based warmup interventions on subsequent performance in competitive swimmers., Methods: A search of three electronic databases (PubMed, EBSCO SPORTDiscus and Web of Science) was conducted to identify original studies until February 2022. Selection criteria dictated that (i) a control condition was used, (ii) participants were ≥ 15 years of age, (iii) a pool-based warmup was done prior to the land-based warmup. A total of 25 articles met the selection criteria., Results: Reducing the transition phase duration by at least half led to consistently faster time-trial times of between 1.1-1.5% for all included studies. Passive warmups using clothing interventions resulted in mostly faster time-trial's of 0.4-0.8% with increases in skin temperature frequent, though little change occurred in core temperature. The methodology of passive respiratory warmups were vastly different with positive time-trial's effects ranging between 0.9-1.1% for two studies, though one reported no meaningful difference. Active warmups led to consistently faster time-trial's between 0.7-0.9%, though the unpinning factors are not clear. Warmups which combined passive and active options frequently led to faster time-trial's between 0.8-3%. Upper and combined limb post-activation performance enhancement led to mostly unfavourable time-trial changes. Lower limb exclusive protocols results were inconsistent, with limited beneficial effects on time-trial or start performance reported following plyometric protocols. However, there does appear merit in heavier loaded lower limb protocols., Conclusion: Each of a reduced transition phase length, and passive, active or combination warmup have demonstrated improvements in swimming performance. Conversely, PAPE protocols should be used with caution, especially when including the upper limbs., Competing Interests: The authors have declared that no competing interests exist.

Brain aging is accompanied by patterns of functional and structural change. Alzheimer's disease (AD), a representative neurodegenerative disease, has been linked to accelerated brain aging. Here, we developed a deep learning-based brain age prediction model using a large collection of fluorodeoxyglucose positron emission tomography and structural magnetic resonance imaging and tested how the brain age gap relates to degenerative syndromes including mild cognitive impairment, AD, frontotemporal dementia and Lewy body dementia. Occlusion analysis, performed to facilitate the interpretation of the model, revealed that the model learns an age- and modality-specific pattern of brain aging. The elevated brain age gap was highly correlated with cognitive impairment and the AD biomarker. The higher gap also showed a longitudinal predictive nature across clinical categories, including cognitively unimpaired individuals who converted to a clinical stage. However, regions generating brain age gaps were different for each diagnostic group of which the AD continuum showed similar patterns to normal aging., (© 2022. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Since the relatively recent regulatory approval for clinical use in both Europe and North America, 7-Tesla (T) MRI has been adopted for clinical practice at our institution. Based on this experience, this article reviews the unique features of 7-T MRI neuroimaging and addresses the challenges of establishing a 7-T MRI clinical practice. The underlying fundamental physics principals of high-field strength MRI are briefly reviewed. Scanner installation, safety considerations, and artifact mitigation techniques are discussed. Seven-tesla MRI case examples of neurologic diseases including epilepsy, vascular abnormalities, and tumor imaging are presented to illustrate specific applications of 7-T MRI. The advantages of 7-T MRI in conjunction with advanced neuroimaging techniques such as functional MRI are presented. Seven-tesla MRI produces more detailed information and, in some cases, results in specific diagnoses where previous 3-T studies were insufficient. Still, persistent technical issues for 7-T scanning present ongoing challenges for radiologists.

Lutetium 177 ( 177 Lu) DOTA-0-Tyr3-Octreotate (DOTATATE) peptide receptor radionuclide therapy (PRRT) is an effective treatment for advanced gastroenteropancreatic neuroendocrine tumors. This review presents a clinical practice workflow that has been successful since 177 Lu DOTATATE PRRT was approved by the U.S. Food and Drug Administration. The workflow relies heavily on the input of a multidisciplinary team and involves a nuclear medicine consultation service, tumor board, and specific preparations in advance of therapy and day-of-therapy procedures. A systematic checklist designed to ensure appropriate selection of treatment candidates and identification of any concerns to address to safely administer PRRT is provided. All patients were evaluated with gallium 68 DOTATATE PET/CT, and in cases of high-grade tumors, they were also evaluated with fluorine 18 fluorodeoxyglucose PET/CT, with imaging findings reviewed as part of the systematic checklist before PRRT. Adverse effects are discussed and imaging follow-up regimens are reviewed, including alternative diagnostic contrast materials. Approaches to multiple challenging patient scenarios are illustrated through case examples. Finally, alternative theranostic radionuclides and treatment strategies are discussed., (© RSNA, 2020.)

Introduction: This study examines the utility of electroencephalography (EEG) in clinical decision making in acute ischemic stroke (AIS) patients in regards to the prescription of antiseizure medications., Methods: Patients were grouped as having positive EEG (+) for epileptiform activity or negative EEG (-). These studies were no more than 30 minutes in length. Patients' charts were retrospectively reviewed for antiepileptic drug (AED) use before, during, and on discharge from AIS hospitalization., Results: Of the 509 patients meeting inclusion criteria, 24 (4.7%) had a positive EEG. Patients did not significantly differ with respect to any demographic or baseline characteristics with the exception of prior history of seizure. In the EEG- group, AEDs were discontinued in only 3.5% of patients. In the EEG+ group, only 37.5% of patients had an initiation or change to their AED regimen within 36 hours of the study. 62.5% of the EEG+ group had a cortical stroke. Significance . Our results indicate that vascular neurologists are not using spot EEGs to routinely guide inpatient AED management. EEGs may have greater utility in those with a prior history of seizures and cortical strokes. Longer or continuous EEG monitoring may have better utility in the AIS population if there is clinical suspicion of seizure., Competing Interests: None of the authors has any conflict of interest to disclose., (Copyright © 2020 Rahul Rao et al.)

There are more than 3 million breast cancer survivors living in the United States of which a significant number have undergone mastectomy followed by breast and nipple-areolar complex (NAC) reconstruction. Current strategies for NAC reconstruction are dependent on nonliving or nonpermanent techniques, including tattooing, nipple prosthetics, or surgical nipple-like structures. Described herein is a tissue engineering approach demonstrating the feasibility of an allogeneic acellular graft for nipple reconstruction. Nonhuman primate (NHP)-derived NAC tissues were decellularized and their extracellular matrix components analyzed by both proteomic and histological analyses. Decellularized NHP nipple tissue showed the removal of intact cells and greatly diminished profiles for intracellular proteins, as compared with intact NHP nipple tissue. We further evaluated the biocompatibility of decellularized grafts and their potential to support host-mediated neovascularization against commercially available acellular dermal grafts by performing in vivo studies in a murine model. A follow-up NHP pilot study evaluated the host-mediated neovascularization and re-epithelialization of onlay engrafted decellularized NAC grafts. The murine model revealed greater neovascularization in the decellularized NAC than in the commercially available control grafts, with no observed biocompatibility issues. The in vivo NHP model confirmed that the decellularized NAC grafts encourage neovascularization as well as re-epithelialization. These results support the concept that a biologically derived acellular nipple graft is a feasible approach for nipple reconstruction, supporting neovascularization in the absence of adverse systemic responses. Impact statement Currently, women in the United States most often undergo a mastectomy, followed by reconstruction, after being diagnosed with breast cancer. These breast cancer survivors are often left with nipple-areolar complex (NAC) reconstructions that are subsatisfactory, nonliving, and/or nonpermanent. Utilizing an acellular biologically derived whole NAC graft would allow these patients a living and permanent tissue engineering solution to nipple reconstruction.

Purpose: To estimate the benefit of pelvic magnetic resonance (MR) imaging after routine pelvic ultrasound (US) in patients with pathologically or surgically proven endometriosis., Methods: Patients with surgically or pathologically proven endometriosis who had routine pelvic US followed by pelvic MR within 6 months prior to surgery were included. Patients were excluded if they had previously confirmed endometriosis, pregnancy, or surgery > 6 months after MR. The detection rate of endometriosis by pelvic US and MR was compared to the surgical/pathological reference standard., Results: 83 female patients (mean age 40 ± 9) met inclusion criteria and had surgical/pathological confirmation of endometriosis. The mean time interval between pelvic US and MR was 33 ± 43 days, with 64 ± 69 days between MR examination and surgery. US detected endometriosis in 22% (18/83) of patients compared to 61% (51/83) for MR (p < 0.0001). 51% (33/65) of patients with a negative pelvic US exam had a positive MR. MR identified additional sites or sequela in the majority of patients with a positive US (14/18; 78%), including extraovarian locations [e.g., fallopian tubes 7/18 (39%), uterus 7/18 (39%), uterine ligaments 6/18 (33%), posterior cul de sac 5/18 (28%), pelvic side walls 5/18 (28%), abdominal wall 1/18 (6%)] and sequela [ovarian tethering 5/18 (28%), 6/18 (33%) bowel adhesive disease, posterior cul de sac obliteration 2/18 (11%), hydrosalpinx 2/18 (11%), and hydronephrosis 1/18 (6%)]. 3 T MR detected endometriosis in 33/46 (72%) patients compared to 18/37 (49%) for 1.5 T MR (p = 0.03)., Conclusion: Pelvic MR imaging had a higher detection rate of surgically/pathologically proven endometriosis and provides more information about disease location and sequela compared to routine pelvic US.

Purpose: The aim of the study was to quantify the value of pre-operative magnetic resonance imaging (MRI) in guiding surgical management of women with endometriosis., Methods: Pre-operative discussion of patient management and review of imaging occurred for 136 patients with endometriosis in an MRI-based multidisciplinary conference co-directed by an abdominal radiologist and gynecologic surgeon. A tri-compartmental report template guided the systematic imaging review. Management changes made as a result of the conference were identified via retrospective chart review and classified as major, directly influencing the surgical procedure or approach, or minor, impacting the patient's medical management, therapies, or diagnostic evaluation., Results: Of the 136 patients discussed in conference, a management change was identified in 18.4% (25 patients). Major changes occurred in 8.1% (11 patients) and minor changes in 13.2% (18 patients). The sum of major and minor management changes exceeded the total, as both major and minor management changes were made for 4 patients., Conclusion: Our findings demonstrate the ability of an MRI-based multidisciplinary conference to result in pre-operative management changes in approximately 1 of 5 pre-operatively reviewed women with endometriosis. Importantly, systematic review of the MRI facilitated management changes beyond that of the dictated report alone, which was available to clinicians prior to the conference. The study reflects the value of multidisciplinary interaction, with radiologists serving more directly as clinical consultants to surgical services, and suggests an opportunity to optimize the role of MRI in endometriosis management with standardized reports emphasizing surgically pertinent findings.

This study examined the effect of water immersion on trunk and lower limb kinematics during squat exercises in older participants. A total of 24 active older adults (71.4 ± 5.4 years) performed squats and split squats on land and while partially submerged in water. Inertial sensors (100 Hz) were used to record trunk and lower body kinematics. Water immersion increased the squat depth (squat: p  = .028, d  = 0.63 and split squat: p  = .005, d  = 0.83) and reduced the trunk flexion range (squat: p  = .006, d  = 0.76 and split squat: p  < .001, d  = 1.35) during both exercises. In addition, water immersion increased the hip range of motion during the split squat ( p  = .002, d  = 0.94). Waveform analyses also indicated differences in the timing of the movements. These results showed that water-based exercise generates a different exercise outcome and appears to provide an alternative option for older adults, enabling exercisers to perform these tasks in a manner not possible on land.

Objectives: To evaluate the reliability of swimming-specific range of movement tests developed in order to permit evidenced-based classification in the sport of para swimming., Design: Test-retest intra- and inter-examiner reliability., Setting: International Swimming training camps and university exercise science departments., Participants: 42 non-disabled participants (mean age 23.2 years) and 24 Para swimmers (mean age 28.5 years)., Main Outcome Measures: Intra- and inter-examiner reliability of a battery of novel active range of motion tests., Results: Good to excellent intra-examiner reliability was found for the majority (32/34) of tests in non-disabled participants (ICC = 0.85-0.98). SEM values ranged from 1.18° to 6.11°. Similarly, good to excellent inter-examiner reliability was found for the majority (35/42) of tests in non-disabled participants (ICC = 0.85-0.98). SEM values range from 0.73° to 6.52°. Para swimmers exhibited significantly reduced range of motion compared to non-disabled participants., Conclusions: The large majority of ROM tests included in this novel battery were reliable both within and between examiners in non-disabled participants. The tests were found to differentiate between non-disabled participants and Para swimmers with hypertonia or impaired muscle power., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Effective re-endothelialization is critical for the use of decellularized scaffolds for ex vivo lung engineering. Current approaches yield insufficiently re-endothelialized scaffolds that haemorrhage and become thrombogenic upon implantation. Herein, gravity-driven seeding coupled with bioreactor culture facilitated widespread distribution and engraftment of endothelial cells throughout rat lung scaffolds. Initially, human umbilical vein endothelial cells were seeded into the pulmonary artery by either gravity-driven, variable flow perfusion seeding or pump-driven, pulsatile flow perfusion seeding. Gravity seeding evenly distributed cells and supported cell survival and re-lining of the vascular walls while perfusion pump-driven seeding led to increased cell fragmentation and death. Using gravity seeding, rat pulmonary artery endothelial cells and rat pulmonary vein endothelial cells attached in intermediate and large vessels, while rat pulmonary microvascular endothelial cells deposited mostly in microvessels. Combination seeding of these cells led to positive vascular endothelial cadherin staining. In addition, combination seeding improved barrier function as assessed by serum albumin extravasation; however, leakage was observed in the distal portions of the re-endothelialized tissue suggesting that recellularization of the alveoli is necessary to complete barrier function of the capillary-alveolar network. Overall, these data indicate that vascular recellularization of rat lung scaffolds is achieved through gravity seeding. Copyright © 2016 John Wiley & Sons, Ltd., (Copyright © 2016 John Wiley & Sons, Ltd.)

Background: The presence of pain during movement typically results in changes in technique. However, the physical properties of water, such as flotation, means that water-based exercise may not only reduce compensatory movement patterns but also allow pain sufferers to complete exercises that they are unable to perform on land. The purpose of this study was to assess bilateral kinematics during double-leg squats and single-leg squats on land and in water in individuals with unilateral anterior knee pain. A secondary aim was to quantify bilateral asymmetry in both environments in affected and unaffected individuals using a symmetry index., Methods: Twenty individuals with unilateral knee pain and twenty healthy, matched controls performed body weight double- and single-leg squats in both environments while inertial sensors (100 Hz) recorded trunk and lower body kinematics. Repeated-measures statistics tested for environmental effects on movement depths and peak angles within the anterior knee pain group. Differences in their inter-limb symmetry in each environments was compared to the control group using analysis of variance tests., Results: Water immersion allowed for greater movement depths during both exercises (double-leg squat: +7 cm, p  = 0.032, single-leg squat: +9 cm, p  = 0.002) for the knee pain group. The double-leg squat was symmetrical on land but water immersion revealed asymmetries in the lower body frontal plane movements. The single-leg squat revealed decreased hip flexion and frontal plane shank motions on the affected limb in both environments. Water immersion also affected the degree of lower limb asymmetry in both groups, with differences also showing between groups., Conclusions: Individuals with anterior knee pain achieved increased squat depth during both exercises whilst in water. Kinematic differences between the affected and unaffected limbs were often increased in water. Individuals with unilateral anterior knee pain appear to utilise different kinematics in the affected and unaffected limb in both environments., Competing Interests: This project was conducted in accordance to the approval by the Human Ethics Research Committee at the University of the Sunshine Coast, which approved the research protocol and data collection instruments (S/15/742). All participants signed a written informed consent prior to any data collection.A signed consent form was provided for the publication of Fig. 1.The authors declare no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Aquatic exercises can be used in clinical and sporting disciplines for both rehabilitation and sports training. However, there is limited knowledge on the influence of water immersion on the kinematics of exercises commonly used in rehabilitation and fitness programs. The aim of this study was to use inertial sensors to quantify differences in kinematics and movement variability of bodyweight squats, split squats, and single-leg squats performed on dry land and whilst immersed to the level of the greater trochanter. During two separate testing sessions, 25 active healthy university students (22.3±2.9 yr.) performed ten repetitions of each exercise, whilst tri-axial inertial sensors (100 Hz) recorded their trunk and lower body kinematics. Repeated-measures statistics tested for differences in segment orientation and speed, movement variability, and waveform patterns between environments, while coefficient of variance was used to assess differences in movement variability. Between-environment differences in segment orientation and speed were portrayed by plotting the mean difference ±95% confidence intervals (CI) throughout the tasks. The results showed that the depth of the squat and split squat were unaffected by the changed environment while water immersion allowed for a deeper single leg squat. The different environments had significant effects on the sagittal plane orientations and speeds for all segments. Water immersion increased the degree of movement variability of the segments in all exercises, except for the shank in the frontal plane, which showed more variability on land. Without compromising movement depth, the aquatic environment induces more upright trunk and shank postures during squats and split squats. The aquatic environment allows for increased squat depth during the single-leg squat, and increased shank motions in the frontal plane. Our observations therefore support the use of water-based squat tasks for rehabilitation as they appear to improve the technique without compromising movement depth.

Breast density has been shown to be a strong, independent risk factor for breast cancer. Unfortunately, mammography is less accurate on dense breast tissue compared to fattier breast tissue. Multiple studies suggest a solution to this by demonstrating the ability of supplemental screening ultrasound to detect additional malignant lesions in women with dense breast tissue but negative mammography. In particular, supplemental screening ultrasound may be beneficial to women with dense breast tissue and intermediate or average risk for breast cancer, women in specific ethnic populations with greater prevalence of dense breast tissue, and women living in resource-poor healthcare environments. Although magnetic resonance imaging is currently recommended for women with high risk for breast cancer, not all women can access or tolerate a magnetic resonance imaging examination. Notably, ultrasound does not require intravenous gadolinium and may be an alternative for women with socioeconomic or medical restrictions, which limit their access to magnetic resonance imaging. Limitations of supplemental screening ultrasound include a substantial rate of false-positives, increased cost, and limited resource availability, particularly in regard to the time required for image interpretation. Additional clinical experience with this application of ultrasound, improved patient selection criteria, and new technology, such as the promising results seen with automated whole breast ultrasound, may address these limitations. In light of recent legislation in some states that has called for discussing supplemental imaging with patients who have dense breast tissue, the optimal role for supplemental screening ultrasound merits further exploration., (Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Objectives: To evaluate research into the effectiveness of group-based sport and exercise programs targeting Indigenous adults on anthropometric, physiological and quality of life outcomes., Design: A systematic review with quality assessment of study design., Methods: A computer-based literature search of EBSCO, SPORTDiscus, CINAHL, Informit, Scopus, Web of Science, Medline, PubMed, Global Health, ProQuest and Discover databases was conducted. Methodological quality of individual articles was assessed using McMasters University Guidelines and Appraisal Forms for Critical Review for Quantitative Research. Results of the effectiveness of programs are then summarised., Results: Six articles were identified with critical appraisal scores ranging from 6 to 12 (from a possible 15 points), with a mean score of 9.6. Five articles were of moderate to good quality. Significant improvements were observed in anthropometric, physiological and quality of life outcomes across all studies. Elements of successful group-based exercise and sport programs corresponded to global recommendations on physical activity for health for 18 to 64 year olds, and were implemented over a period of time ranging from 12 to 24 weeks to exhibit results, plus community consultation in developing programs and nutrition education., Conclusions: Group-based programs that include nutrition, exercise and/or sport components are effective in producing short to intermediate term health outcomes among Indigenous adults. Further high quality research, specifically on group-based modified sport programs for Indigenous adults that are culturally appropriate and aim to improve quality of life are needed., (Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

An MRI of the brain and spine of an 11-year-old male revealed the following abnormality which is consistent with his chronic condition.

This study determined the physical fitness, match-activity profiles and physiological responses of representative tag football players and examined the relationship between physical fitness and the match-activity profile. Microtechnology devices and heart rate (HR) chest straps were used to determine the match-activity profiles of sixteen tag football players for five matches during the 2014 Australian National Championships. The relationships between lower body muscular power, straight line running speed and Yo-Yo intermittent recovery test level 2 (Yo-Yo IR2) and the match-activity profile were examined using Pearson's correlation coefficients. Outside players had greater lower body muscular power (ES = 0.98) and straight line running speed (ES = 1.03-1.18) than inside players, and also covered greater very high-speed running (VHSR) distance/min (ES = 0.67) and reached higher peak running speeds (ES = 0.95) during matches. Inside and outside players performed a similar number of repeated high-intensity effort (RHIE) bouts and reported similar mean and maximum efforts per RHIE bout. However, there were differences between playing positions for mean and maximal RHIE effort durations (ES = 0.69-1.15) and mean RHIE bout recovery (ES = 0.56). Inside and outside players also reported small to moderate differences (ES = 0.43-0.80) for times spent in each HR zone. There were a number of moderate to very large correlations between physical fitness measures and match-activity profile variables. This study found lower body muscular power, straight line running speed and Yo-Yo IR2 to be related to the match-activities of representative tag football players, although differences between inside and outside players suggest that athlete testing and training practices should be modified for different playing positions.

The purpose of this study was to: a) identify changes in jump height and perceived well-being as indirect markers of fatigue, b) determine the internal and external workloads performed by players, and c) examine the influence of Yo-Yo IR2 on changes in jump height, perceived well-being and internal and external workloads during a tag football tournament. Microtechnology devices combined with heart rate (HR) chest straps provided external and internal measures of match work-rate and workload for twelve male tag football players during the 2014 Australian National Championships. Jump height and perceived well-being were assessed prior to and during the tournament as indirect measures of fatigue. Changes in work-rate, workload and fatigue measures between high- and low-fitness groups were examined based on players' Yo-Yo IR2 score using a median split technique. The low- and high-fitness groups reported similar mean HR, PlayerloadTM/min, and distance/min for matches, however the low-fitness group reported higher perceived match-intensities (ES = 0.90-1.35) for several matches. Further, the high-fitness group reported higher measures of tournament workload, including distance (ES = 0.71), PlayerloadTM (ES = 0.85) and Edwards' training impulse (TRIMP) (ES = 1.23) than the low-fitness group. High- and low-fitness groups both showed large decreases (ES = 1.46-1.49) in perceived well-being during the tournament, although jump height did not decrease below pre-tournament values. Increased Yo-Yo IR2 appears to offer a protective effect against player fatigue despite increased workloads during a tag football tournament. It is vital that training programs adequately prepare tag football players for tournament competition to maximise performance and minimise player fatigue.

Objectives: To determine the effect of 26 weeks of low-load high-repetition resistance training (BodyPump™) on maximal strength, gait speed, balance and self-reported health status in healthy, active middle-aged and older adults., Design: Two-group randomised control trial., Methods: Sixty-eight apparently healthy, active adults aged over 55 years completed either 26 weeks of BodyPump™ training (PUMP) or served as control participants (CON). The BodyPump™ group (n = 32, age = 66 ± 4 years) trained twice per week for 26 weeks while the control group (n = 36, age = 66 ± 5 years) continued with their normal activities. Leg-press and Smith-machine bench-press one repetition maximum (1RM), gait speed, balance, and self-reported health status were all assessed at baseline and follow-up., Results: Significant group-by-time interactions in favour of the BodyPump™ group were found for leg-press 1RM (PUMP + 13%, CON + 3%, p = 0.007, partial eta(2) = 0.11), Smith-machine bench-press 1RM (PUMP + 14%, CON +5%, p = 0.001, partial eta(2) = 0.18), normal gait speed (PUMP + 23%, CON +9 %, p = 0.028, partial eta(2) = 0.08) and single leg balance right (PUMP + 24%, CON - 7%, p = 0.006, partial eta(2) = 0.12). There were no group-by-time interactions for health status measures. Three participants in the BodyPump™ group withdrew from training due to injury or fear of injury related to training., Conclusions: Low-load high-repetition resistance training in the form of BodyPump™ is effective at improving maximal strength, gait speed and some aspects of standing balance in adults over 55 years. The training was well tolerated by the majority of participants., (Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Purpose: To examine the neuromuscular and perceptual fatigue responses to consecutive tag football matches played on the same day and determine the relationship between fatigue and match running performance., Methods: Neuromuscular and perceptual fatigue responses of 15 national tag football players were assessed before and during the 2014 State of Origin tournament. Global positioning systems (GPS) provided data on players' match running performance, and a vertical-jump test and subjective questionnaire were used to assess players' neuromuscular and perceptual fatigue, respectively., Results: There were small to moderate reductions in the majority of match-running-performance variables over consecutive matches, including distance (ES=-0.81), high-speed-running (HSR) distance (ES=-0.51), HSR efforts (ES=-0.64), and maximal accelerations (ES=-0.76). Prematch vertical jump was initially below baseline values before the first match (ES=0.68-0.88). There were no substantial reductions in vertical-jump performance from baseline values over consecutive matches, although there was a small decline from after match 2 to after match 3 (3.3%; ES=-0.45±0.62). There were progressive reductions in perceived well-being scores after matches 1 (ES=-0.38), 2 (ES=-0.70), and 3 (ES=-1.14). There were small to moderate associations between changes in fatigue measures and match running performance., Conclusions: Perceptual fatigue accumulates over consecutive tag football matches, although there were only marginal increases in neuromuscular fatigue. However, both neuromuscular and perceptual fatigue measures were found to contribute to reduced match running performance in the final match.

This study determined the effect of 6 months of low-load very high-repetition resistance training on bone mineral density (BMD) and body composition in nonosteoporotic middle-aged and older women. Fifty healthy, active community-dwelling women aged 56-75 years took part in the two-group, repeated-measures randomized controlled trial. Participants either undertook 6 months of low-load very high-repetition resistance training in the form of BodyPump™ or served as control participants. Outcome measures included BMD at the lumbar spine, hip, and total body; total fat mass; fat-free soft tissue mass and maximal isotonic strength. Significant group-by-time interactions were found for lumbar spine BMD and maximal strength in favor of the BodyPump™ group. No favorable effects were found for hip BMD, total body BMD, total fat mass, or fat-free soft tissue mass. Three participants withdrew from the intervention group due to injury or fear of injury associated with training. Under the conditions used in this research, low-load very high-repetition resistance training is effective at attenuating losses in lumbar spine BMD compared to controls in healthy, active women aged over 55 years but did not influence hip and total body BMD or fat mass and fat-free soft tissue mass.

Australia has approximately 26,000 registered exercise professionals (REP), in comparison with 3,379 accredited practicing dietitians (APD). The REP workforce has the potential to reach more than 10% of the Australian population but there is limited data on their educational background and professional behaviors with regards to nutritional counseling of clients. The purpose of this research was to determine if REPs are working within their scope of practice and if their qualifications align with their practice, specifically as it relates to nutrition advice. Using a cross sectional descriptive study design, a self-administered online survey of REPs was conducted over 5 months. REPs were recruited through electronic and social media using a snowballing technique. The study focused on education, nutrition advice, and sources of information. A total of 286 respondents completed the survey, including 13 with tertiary dietetic qualifications i.e., APDs. The nationally recognized industry Certificate III/IV in Fitness was the most common qualification. The majority of REPs responding (88%) were working outside of their professional scope of practice, offering individual nutrition advice to clients across fitness and medical issues. This was despite 40% of REPs undertaking no further training in nutrition since graduating, and primarily basing advice on use of readily accessible sources of nutrition information. It is recommended the nutrition advice provided to REPs during training be limited to general nonmedical nutrition information in accordance with nationally endorsed evidence based guidelines and that issues pertaining to scope of practice be addressed with onward referral to other health professionals be advocated.

Memory acquisition and synaptic plasticity are accompanied by changes in the intrinsic excitability of CA1 pyramidal neurons. These activity-dependent changes in excitability are mediated by modulation of intrinsic currents which alters the responsiveness of the cell to synaptic inputs. The afterhyperpolarization (AHP), a major contributor to the regulation of neuronal excitability, is reduced in animals that have acquired several types of hippocampus-dependent memory tasks and also following synaptic potentiation by high frequency stimulation. BK channels underlie the fast AHP and contribute to spike repolarization, and this AHP is reduced in animals that successfully acquired trace-eyeblink conditioning. This suggests that BK channel function is activity-dependent, but the mechanisms are unknown. In this study, we found that blockade of BK channels with paxilline (10 μM) decreased I AHP amplitude and increased spike half-width and instantaneous frequency in response to a +100 pA depolarization. In addition, induction of long term potentiation (LTP) by theta burst stimulation (TBS) in CA1 pyramidal neurons reduced BK channel's contribution to I AHP, spike repolarization, and instantaneous frequency. This result indicates that BK channel activity is decreased following synaptic potentiation. Interestingly, blockade of mammalian target of rapamycin (MTORC1) with rapamycin (400 nM) following synaptic potentiation restored BK channel function, suggesting a role for protein translation in signaling events which decreased postsynaptic BK channel activity following synaptic potentiation.

Dry-land strength training is a fundamental component for elite kayak performance. The aims of this research were 3-fold: 1st, to determine the relationship between performance time and strength scores for elite kayakers; 2nd, to identify how strength changes (gains or losses) over 3 training y relate with changes in performance time for elite kayakers; and 3rd, to compare the progression in performance times for elite athletes with the top 3 performers from the national championships. The performance data for 15 elite male and 10 elite female kayakers were collected over 2 y. This group was reduced to 9 men and 8 women in the 3rd and final year. There were direct and significant correlations between strength scores and performance times across the 3 y. Bench-press 1RM increased by 34.8% for men and 42.3% for women. Over the 3 seasons, mean 1000-m time decreased by approximately 4.8%, 500-m times decreased by 7.3% (women), and 200-m times decreased by 9.1%. The women's 500-m changed from 11.9% difference from medalists to within 1.1% during the 3 y. During the 3 y of this study a change in 1-repetitionmaximum (1RM) bench press of 13% for men and 6.5% in women coincided with a change in performance times of 1%. For 1RM pull-up a change of 10% in men and 2.3% in women coincided with a change in performance times of 1%.

There are an insufficient number of donor organs available to meet the demand for lung transplantation. This issue could be addressed by regenerating functional tissue from diseased or damaged lungs that would otherwise be deemed unsuitable for transplant. Detergent-mediated whole-lung decellularization produces a three-dimensional natural scaffold that can be repopulated with various cell types. In this study, we investigated the decellularization and initial recellularization of diseased lungs using a rat model of monocrotaline-induced pulmonary hypertension (MCT-PHT). Decellularization of control and MCT-PHT Sprague-Dawley rat lungs was accomplished by treating the lungs with a combination of Triton X-100, sodium deoxycholate, NaCl, and DNase. The resulting acellular matrices were characterized by DNA quantification, Western blotting, immunohistochemistry, and proteomic analyses revealing that decellularization was able to remove cells while leaving the extracellular matrix (ECM) components and lung ultrastructure intact. Decellularization significantly reduced DNA content (∼30-fold in MCT-PHT lungs and ∼50-fold in the control lungs) and enriched ECM components (>60-fold in both the control and MCT-PHT lungs) while depleting cellular proteins. MicroCT visualization of MCT-PHT rat lungs indicated that the vasculature was narrowed as a result of MCT treatment, and this characteristic was unchanged by decellularization. Mean arterial vessel diameter of representative decellularized MCT-PHT and control scaffolds was estimated to be 0.152±0.134 mm and 0.247±0.160 mm, respectively. Decellularized MCT-PHT lung scaffolds supported attachment and survival of rat adipose-derived stem cells (rASCs), seeded into the airspace or the vasculature, for at least 2 weeks. The cells seeded in MCT-PHT lung scaffolds proliferated and underwent apoptosis similar to control scaffolds; however, the initial percentage of apoptotic cells was slightly higher in MCT-PHT lungs (2.79±2.03% vs. 1.05±1.02% of airway-seeded rASCs, and 4.47±1.21% vs. 2.66±0.10% of vascular seeded rASCs). The ECM of cell-seeded scaffolds showed no signs of degradation by the cells after 14 days in culture. These data suggest that diseased hypertensive lungs can be efficiently decellularized similar to control lungs and have the potential to be recellularized with mesenchymal stem cells with the ultimate goal of generating healthy, functional pulmonary tissue.