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Abstract Background Online question banks are the most widely used education resource amongst medical students. Despite this there is an absence of literature outlining how and why they are used by students. Drawing on Deci and Ryan’s self-determination theory, our study aimed to explore why and how early-stage medical students use question banks in their learning and revision strategies. Methods The study was conducted at Newcastle University Medical School (United Kingdom and Malaysia). Purposive, convenience and snowball sampling of year two students were employed. Ten interviews were conducted. Thematic analysis was undertaken iteratively, enabling exploration of nascent themes. Data collection ceased when no new perspectives were identified. Results Students’ motivation to use question banks was predominantly driven by extrinsic motivators, with high-stakes exams and fear of failure being central. Their convenience and perceived efficiency promoted autonomy and thus motivation. Rapid feedback cycles and design features consistent with gamification were deterrents to intrinsic motivation. Potentially detrimental patterns of question bank use were evident: cueing, avoidance and memorising. Scepticism regarding veracity of question bank content was absent. Conclusions We call on educators to provide students with guidance about potential pitfalls associated with question banks and to reflect on potential inequity of access to these resources.

Neurofibromatosis type 1 (NF1) results from germline mutations in the tumor-suppressor gene NF1 and predisposes patients to developing nervous system tumors. Twenty percent of NF1 patients harbor nonsense mutations resulting in premature termination codons (PTCs). Nonsense suppression therapies can facilitate ribosomal readthrough of PTCs to restore full-length protein, but their potential in NF1 is underexplored. We developed a minipig model of NF1 carrying a PTC to test whether nonsense suppression could restore expression of the NF1-encoded protein neurofibromin in vitro and in vivo. Nonsense suppression did not reliably increase neurofibromin in primary NF1−/− Schwann cells isolated from minipig neurofibromas but could reduce phosphorylated ERK. Gentamicin in vivo produced a similar plasma pharmacokinetic profile to humans and was detectable in clinically relevant tissues, including cerebral cortex, sciatic nerve, optic nerve, and skin. In gentamicin-treated animals, increased neurofibromin expression was seen in the optic nerve. Nonsense-mediated decay (NMD) causes degradation of transcripts with PTCs, which could impede nonsense suppression therapies. Nonsense suppression in combination with NMD inhibition restored neurofibromin protein expression in primary NF1−/− Schwann cells isolated from minipig neurofibromas. Thus, the effectiveness of nonsense suppression therapies can be improved in NF1 by the concurrent use of NMD inhibitors.

Background: Resistance training has well-documented health benefits; however, participation and adherence remain overwhelmingly low. Supervision has been evidenced to improve adherence, and produce favourable adaptations compared to unsupervised resistance training. A recent exploratory systematic review and meta-analysis on supervision during resistance training noted a lack of clarity as to the purpose/intent of the supervisor within the body of literature. Methods: An online cross-sectional survey study was conducted in English and distributed primarily across social media platforms and through the authors’ personal and professional networks. The aim of the survey was to compare the perceptions of supervision between trainers and trainees. Secondary outcomes included exploratory analyses of the impact of training experience, sex of participant, and comparison based on supervision type. Results: 468 participants completed all elements of the survey (68% male, 32% female). Of which 236 were personal trainers/strength coaches, and 232 were trainees. In brief, descriptive data from the survey suggest that trainers perceived supervision as more important than trainees for the characteristics and variables measured. Females perceived supervision in resistance training as more important than males. Trainees who engage in supervised resistance training reported supervision to be more important compared to those training alone or with a training partner. Technical coaching was reported to be the most important characteristic of supervision. Finally, trainers and trainees engaging in supervised strength training reported lower injury rates compared to those strength training unsupervised or with a training partner. Qualitative data are presented regarding perceptions of how and why supervision should differ based on sex, age, and experience, as well as reporting injury experiences. Conclusion: Our data suggest that the perceived benefits of supervision vary based on population. We posit that the present data have implications for both trainers and trainees, which might serve to strengthen a relationship by aligning roles and realising goals in supervised resistance training. Further, this data might provide insight and prompt future research as to how to engage more people into resistance training.

Scrub typhus is a poorly studied but life-threatening disease caused by the intracellular bacterium Orientia tsutsugamushi (Ot). Cellular and humoral immunity in Ot-infected patients is not long-lasting, waning as early as one-year post-infection; however, its underlying mechanisms remain unclear. To date, no studies have examined germinal center (GC) or B cell responses in Ot-infected humans or experimental animals. This study was aimed at evaluating humoral immune responses at acute stages of severe Ot infection and possible mechanisms underlying B cell dysfunction. Following inoculation with Ot Karp, a clinically dominant strain known to cause lethal infection in C57BL/6 mice, we measured antigen-specific antibody titers, revealing IgG2c as the dominant isotype induced by infection. Splenic GC responses were evaluated by immunohistology, co-staining for B cells (B220), T cells (CD3), and GCs (GL-7). Organized GCs were evident at day 4 post-infection (D4), but they were nearly absent at D8, accompanied by scattered T cells throughout splenic tissues. Flow cytometry revealed comparable numbers of GC B cells and T follicular helper (Tfh) cells at D4 and D8, indicating that GC collapse was not due to excessive death of these cell subtypes at D8. B cell RNAseq analysis revealed significant differences in expression of genes associated with B cell adhesion and co-stimulation at D8 versus D4. The significant downregulation of S1PR2 (a GC-specific adhesion gene) was most evident at D8, correlating with disrupted GC formation. Signaling pathway analysis uncovered downregulation of 71% of B cell activation genes at D8, suggesting attenuation of B cell activation during severe infection. This is the first study showing the disruption of B/T cell microenvironment and dysregulation of B cell responses during Ot infection, which may help understand the transient immunity associated with scrub typhus.

[This corrects the article DOI: 10.1371/journal.pntd.0010459.].

Abstract Background: Range of motion (ROM) during resistance training is of growing interest and is potentially used to elicit differing adaptations (e.g. muscle hypertrophy and muscular strength and power). To date, attempts at synthesising the data on ROM during resistance training have primarily focused on muscle hypertrophy in the lower body. Objective: Our aim was to meta-analyse and systematically review the effects of ROM on a variety of outcomes including hypertrophy, strength, sport, power and body-fat type outcomes. Following pre-registration and consistent with PRISMA guidelines, a systematic review of PubMed and SportsDISCUS was performed. Data was extracted and a Bayesian multi-level meta-analysis was performed. A range of exploratory sub-group and moderator analyses were performed. Results: The main model revealed a trivial SMD (0.12; 95% CI: –0.02, 0.26) in favour of full ROM compared to partial ROM. When grouped by outcome, SMDs all favoured full ROM, but SMDs were trivial to small (all between 0.05 to 0.2). Sub-group analyses suggested there may be a muscle hypertrophy benefit to partial ROM training at long muscle lengths compared to using a full ROM (–0.28; 95% CI: –0.81, 0.16). Analysis also suggested the existence of a specificity aspect to ROM, such that training in the ROM being tested as an outcome resulted in greater strength adaptations. No clear differences were found between upper- and lower-body adaptations when ROM was manipulated. Conclusions: Overall, our results suggest that using a full or long ROM may enhance results for most outcomes (strength, speed, power, muscle size, and body composition). Differences in adaptations are trivial to small. As such, partial ROM resistance training might present an efficacious alternative for variation and personal preference, or where injury prevents full-ROM resistance training.

Orientia tsutsugamushi is an obligately intracellular bacterium with endothelial tropism and can cause mild to lethal scrub typhus in humans. No vaccine is available for this reemerging and severely neglected infection. Previous scrub typhus studies have utilized inbred mice, yet such models have intrinsic limitations. Thus, the development of suitable mouse models that better mimic human diseases is in great need for immunologic investigation and future vaccine studies. This study is aimed at establishing scrub typhus in outbred CD-1 mice and defining immune biomarkers related to disease severity. CD-1 mice received O. tsutsugamushi Karp strain via the i.v. route; major organs were harvested at 2-12 days post-infection for kinetic analyses. We found that for our given infection doses, CD-1 mice were significantly more susceptible (90-100% lethal) than were inbred C57BL/6 mice (0-10% lethal). Gross pathology of infected CD-1 mouse organs revealed features that mimicked human scrub typhus, including pulmonary edema, interstitial pneumonia, perivascular lymphocytic infiltrates, and vasculitis. Alteration in angiopoietin/receptor expression in inflamed lungs implied endothelial dysfunction. Lung immune gene profiling using NanoString analysis displayed a Th1/CD8-skewed, but Th2 repressed profile, including novel biomarkers not previously investigated in other scrub typhus models. Bio-plex analysis revealed a robust inflammatory response in CD-1 mice as evidenced by increased serum cytokine and chemokine levels, correlating with immune cell recruitment during the severe stages of the disease. This study provides an important framework indicating a value of CD-1 mice for delineating host susceptibility to O. tsutsugamushi, immune dysregulation, and disease pathogenesis. This preclinical model is particularly useful for future translational and vaccine studies for severe scrub typhus.

Abstract Background Over the last decade, the use of technology-enhanced learning (TEL) has rapidly expanded and diversified. Since the COVID-19 pandemic, there is a growing demand for distance and online learning strategies to support and even replace learning experiences previously afforded by clinical placements and clerkships. An intriguing but under-researched modality is the use of medical reality television to provide authentic experiences of patient care. This strategy does not feature in published medical educational literature, though promising research is emerging from other disciplines. Methodology A programme of learning using medical reality television clips to facilitate case-based learning was developed according to the principles of ‘anchored instruction’, a technology-based educational theory. Clips were taken from the UK television show ’24 hours in A&E’. Medical students’ learning experiences were investigated using a qualitative approach addressing the following research questions: - What is the perceived emotional experience of medical students when watching reality television in an educational context? - How do medical students relate their experience of watching reality television in a formal educational setting to their perceived learning needs in the clinical environment? A case study research methodology was adopted within the interpretivist paradigm. Data were triangulated from semi-structured interviews with students and non-participant observation of the teaching session. Field notes and transcripts were analysed through an inductive thematic analysis. Results In response to the medical reality television, a diverse range of emotions were expressed including: excitement, amusement, concern, nervousness, sadness and joy. Students identified gaps in their clinical knowledge such as interpreting results, practical aspects of prescribing and end of life care. Key themes were increased student engagement and a promotion of holistic care practices. Discussion Students perceived reality television as a highly realistic and relatable medium and an enjoyable, memorable way to contextualise learning from the classroom to real life, a finding mirrored in previous studies in other fields. The high degree of emotion expressed may explain the improved subjective memorability of the cases. Conclusion Medical reality television offers a unique means of engaging students by providing authentic experiences of patient care and should be valued alongside other technology-enhanced learning strategies.

Infection with Orientia tsutsugamushi, an obligate intracellular bacterium, can cause mild or severe scrub typhus. Some patients develop acute lung injury, multi-organ failure, and fatal infection; however, little is known regarding key immune mediators that mediate infection control or disease pathogenesis. Using murine models of scrub typhus, we demonstrated in this study the requirement of TNF-TNFR signaling in protective immunity against this infection. Mice lacking both TNF receptors (TNFR1 and TNFR2) were highly susceptible to O. tsutsugamushi infection, displaying significantly increased tissue bacterial burdens and succumbing to infection by day 9, while most wild-type mice survived through day 20. This increased susceptibility correlated with poor activation of cellular immunity in inflamed tissues. Flow cytometry of lung- and spleen-derived cells revealed profound deficiencies in total numbers and activation status of NK cells, neutrophils, and macrophages, as well as CD4 and CD8 T cells. To define the role of individual receptors in O. tsutsugamushi infection, we used mice lacking either TNFR1 or TNFR2. While deficiency in either receptor alone was sufficient to increase host susceptibility to the infection, TNFR1 and TNFR2 played a distinct role in cellular responses. TNF signaling through TNFR1 promoted inflammatory responses and effector T cell expansion, while TNFR2 signaling was associated with anti-inflammatory action and tissue homeostasis. Moreover, TNFRs played an intrinsic role in CD8+ T cell activation, revealing an indispensable role of TNF in protective immunity against O. tsutsugamushi infection.

Background: Since many people choose to perform resistance training unsupervised, and a lack of supervision within strength training is reported to result in inadequate workout quality, we aimed to compare outcomes for resistance training with and without supervision. Methods: A systematic review and meta-analysis were performed for performance/functional outcomes and/or body composition measurements. Results: 12 studies were included in the review; 301 and 276 participants were in supervised and unsupervised groups, respectively. The main model for all performance/function effects revealed a small, standardised point estimate favouring SUP (0.28 [95%CI = 0.02 to 0.55]). For sub-grouped outcome types, there was very poor precision of robust estimates for speed, power, function, and endurance. However, for strength there was a moderate effect favouring SUP (0.40 [95%CI = 0.06 to 0.74]). The main model for all body composition effects revealed a trivial standardised point estimate favouring SUP (0.07 [95%CI = -0.01 to 0.15]). Conclusions: Supervised resistance training, compared to unsupervised training, might produce a small effect on increases in performance/function, most likely in strength, but has little impact on body composition outcomes.

Orientia tsutsugamushi is an obligately intracellular bacterium and an etiological agent of scrub typhus. Human studies and animal models of scrub typhus have shown robust type 1-skewed proinflammatory responses during severe infection. Macrophages (MΦ) play a critical role in initiating such responses, yet mechanisms of innate recognition for O. tsutsugamushi remain unclear. In this study, we investigated whether Syk-dependent C-type lectin receptors (CLRs) contribute to innate immune recognition and the generation of proinflammatory responses. To validate the role of CLRs in scrub typhus, we infected murine bone marrow-derived MΦ with O. tsutsugamushi in the presence of selective Syk inhibitors and analyzed a panel of CLRs and proinflammatory markers via qRT-PCR. We found that Mincle/Clec4a and Clec5a transcription was significantly abrogated upon Syk inhibition at 6 h of infection. The effect of Syk inhibition on Mincle protein expression was validated via Western blot. Syk-inhibited MΦ had diminished expression of type 1 cytokines/chemokines (Il12p40, Tnf, Il27p28, Cxcl1) during infection. Additionally, expression of innate immune cytosolic sensors (Mx1 and Oas1-3) was highly induced in the brain of lethally infected mice. We established that Mx1 and Oas1 expression was reduced in Syk-inhibited MΦ, while Oas2, Oas3, and MerTK were not sensitive to Syk inhibition. This study reveals that Syk-dependent CLRs contribute to inflammatory responses against O. tsutsugamushi. It also provides the first evidence for Syk-dependent activation of intracellular defenses during infection, suggesting a role of pattern recognition receptor crosstalk in orchestrating macrophage-mediated responses to this poorly studied bacterium.

Hypertrophy can be operationally defined as an increase in the axial cross-sectional area of a muscle fiber or whole muscle, and is due to increases in the size of pre-existing muscle fibers. Hypertrophy is a desired outcome in many sports. For some athletes, muscular bulk and, conceivably, the accompanying increase in strength/power, are desirable attributes for optimal performance. Moreover, bodybuilders and other physique athletes are judged in part on their muscular size, with placings predicated on the overall magnitude of lean mass. In some cases, even relatively small improvements in hypertrophy might be the difference between winning and losing in competition for these athletes. This position stand of leading experts in the field synthesizes the current body of research to provide guidelines for maximizing skeletal muscle hypertrophy in an athletic population. The recommendations represent a consensus of a consortium of experts in the field, based on the best available current evidence. Specific sections of the paper are devoted to elucidating the constructs of hypertrophy, reconciliation of acute vs long-term evidence, and the relationship between strength and hypertrophy to provide context to our recommendations.

Orientia tsutsugamushi is an obligately intracellular bacterium and the etiological agent of scrub typhus. The lung is a major target organ of infection, displaying type 1-skewed proinflammatory responses. Lung injury and acute respiratory distress syndrome are common complications of severe scrub typhus; yet, their underlying mechanisms remain unclear. In this study, we investigated whether the C-type lectin receptor (CLR) Mincle contributes to immune recognition and dysregulation. Following lethal infection in mice, we performed pulmonary differential expression analysis with NanoString. Of 671 genes examined, we found 312 significantly expressed genes at the terminal phase of disease. Mincle (Clec4e) was among the top 5 greatest up-regulated genes, accompanied with its signaling partners, type 1-skewing chemokines (Cxcr3, Ccr5, and their ligands), as well as Il27. To validate the role of Mincle in scrub typhus, we exposed murine bone marrow-derived macrophages (MΦ) to live or inactivated O. tsutsugamushi and analyzed a panel of CLRs and proinflammatory markers via qRT-PCR. We found that while heat-killed bacteria stimulated transitory Mincle expression, live bacteria generated a robust response in MΦ, which was validated by indirect immunofluorescence and western blot. Notably, infection had limited impact on other tested CLRs or TLRs. Sustained proinflammatory gene expression in MΦ (Cxcl9, Ccl2, Ccl5, Nos2, Il27) was induced by live, but not inactivated, bacteria; infected Mincle-/- MΦ significantly reduced proinflammatory responses compared with WT cells. Together, this study provides the first evidence for a selective expression of Mincle in sensing O. tsutsugamushi and suggests a potential role of Mincle- and IL-27-related pathways in host responses to severe infection. Additionally, it provides novel insight into innate immune recognition of this poorly studied bacterium.

We develop a finite random assignment model where players know either their cardinal or their ordinal preferences and may make cardinal or ordinal reports to an assignment mechanism. Under truthful reporting, we find that all mechanisms that disregard the cardinal information in players' reports (e.g., Deferred Acceptance and Probabilistic Serial) are utilitarian inefficient, as are classic mechanisms that make use of cardinal information (e.g., Pseudo-markets). Motivated by these negative results, we introduce a "Simple Mechanism" that makes use of cardinal information "in the right way." We establish that this mechanism is utilitarian efficient, treats equals equally, and makes truth-telling almost Bayesian incentive compatible.

Scrub typhus and spotted fever rickettsioses (SFR) are understudied, vector-borne diseases of global significance. Over 1 billion individuals are at risk for scrub typhus alone in an endemic region, spanning across eastern and southern Asia to Northern Australia. While highly treatable, diagnostic challenges make timely antibiotic intervention difficult for these diseases. Delayed therapy may lead to severe outcomes affecting multiple organs, including the central nervous system (CNS), where infection and associated neuroinflammation may be lethal or lead to lasting sequelae. Meningitis and encephalitis are prevalent in both scrub typhus and SFR. Additionally, case reports detailing focal neurological deficits have come to light, with attention to both acute and chronic sequelae of infection. Despite the increasing number of clinical reports outlining neurologic consequences of these diseases, relatively little research has examined underlying mechanisms of neuroinflammation. Animal models of scrub typhus have identified cerebral T-cell infiltration and vascular damage associated with endothelial infection and neuropathogenesis. Differential gene expression analysis of brain tissues during murine scrub typhus have revealed selective increases in CXCR3 ligands, proinflammatory and type-1 cytokines and chemokines, and cytotoxicity molecules, as well as alterations in the complement pathway. In SFR, microglial expansion and macrophage infiltration contribute to neurological disease progression. This narrative Review highlights clinical neurologic features of scrub typhus and SFR and evaluates our current understanding of basic research into neuroinflammation for both diseases in animal models. Further investigation into key mediators of neuropathogenesis may yield prognostic markers and treatment regimens for severe patients.

Mesenchymal hamartoma of the chest wall is a rare condition seen in infants. This case describes a prenatally diagnosed rapidly growing bilateral chest wall masses, suspected to be a mesenchymal hamartoma. Prenatal MRI performed at 33 weeks gestation showed large bilateral lesions with substantial mass effect in the form of pulmonary compression and displacement of the mediastinal structures necessitating delivery at our tertiary care facility at 35 weeks. At 48 hours post-birth, CTA revealed bilateral chest wall masses consistent with mesenchymal hamartoma and secondary aneurysmal bone cyst formation. The large left-sided lesion compressed the left lung and severely hindered pulmonary function, and the neonate required increasing respiratory support. The left-sided lesion was completely resected on day of life 15, and the neonate was extubated shortly after surgery. At the time of surgery the chest wall was reconstructed with alloderm, vicryl mesh and a latissimus dorsi advancement flap. A CTA at 3 months of age showed resection of the left-sided lesion with no evidence of recurrence, but significant growth in the unresected right hemithorax lesion. The right-sided lesion was resected uneventfully 8 months later. The prenatal and postnatal images showing the symptomatic lesion growth are discussed in this report.

Abstract It is well known that physical activity and exercise is associated with a lower risk of a range of morbidities and all-cause mortality. Further, it appears that risk reductions are greater when physical activity and/or exercise is performed at a higher intensity of effort. Why this may be the case is perhaps explained by the accumulating evidence linking physical fitness and performance outcomes (e.g. cardiorespiratory fitness, strength, and muscle mass) also to morbidity and mortality risk. Current guidelines about the performance of moderate/vigorous physical activity using aerobic exercise modes focuses upon the accumulation of a minimum volume of physical activity and/or exercise, and have thus far produced disappointing outcomes. As such there has been increased interest in the use of higher effort physical activity and exercise as being potentially more efficacious. Though there is currently debate as to the effectiveness of public health prescription based around higher effort physical activity and exercise, most discussion around this has focused upon modes considered to be traditionally ‘aerobic’ (e.g. running, cycling, rowing, swimming etc.). A mode customarily performed to a relatively high intensity of effort that we believe has been overlooked is resistance training. Current guidelines do include recommendations to engage in ‘muscle strengthening activities’ though there has been very little emphasis upon these modes in either research or public health effort. As such the purpose of this debate article is to discuss the emerging higher effort paradigm in physical activity and exercise for public health and to make a case for why there should be a greater emphasis placed upon resistance training as a mode in this paradigm shift.

Scrub typhus is an understudied, potentially lethal disease caused by infection with Orientia tsutsugamushi. Despite causing an estimated 1 million cases per year and an increasing global presence, mechanisms of scrub typhus pathogenesis remain unclear. One of the most life-threatening conditions that can arise in scrub typhus patients is acute respiratory distress syndrome (ARDS). The development of ARDS is a complex process; some of its pathological hallmarks, including prolonged recruitment of inflammatory immune cells to the lung and vasculature damage, have been observed in humans and/or animal models of O. tsutsugamushi infection. Although different cell types and mechanisms may contribute to ARDS development during O. tsutsugamushi infection, this review highlights our current evidence of pulmonary endothelial activation and damage, the potential roles of neutrophils and macrophages in the lung, and the knowledge gaps in this field. Continued investigation of the lung microenvironment and cellular interactions will help elucidate disease pathogenesis and possible treatment during scrub typhus.

Modern agricultural farming systems acidify the soil profile due to application of fertilisers with acidifying properties. In most parts of Australia, lime has been used to improve agricultural soil conditions and restore its productive potential. The observed response of crop yield to applied lime often varies with soil type, acidity profile and seasonal conditions, so it is difficult to specify the expected yield response in a given situation. We conducted a meta-analysis of 86 agricultural field trials from Western Australia (WA), New South Wales (NSW) and Victoria (VIC) where various rates of lime had been applied to the soil surface and crop yield (wheat, barley, canola, lupin or field pea) measured for a number of years after the initial application. Information from the meta-analysis was then paired with output from a crop simulation model, where the water-limited yield potential was estimated for both a neutral and acidified soil profile. The average increase in yield to applied lime across all locations and crops was 12%, but the response ranged from 0 to 185%. A trend was observed, where sites with topsoil pH (CaCl2) < 5 and subsoil pH < 4.5 had the greater benefit to liming. Soil type had little effect on the percentage yield increase. Overall, responses to applied lime were most likely when the yield of the trial site was at 50% of water-limited yield potential (or less), the quantity of lime applied was greater than 2.5 t ha−1 and the time since lime had been applied was greater than three years (with the maximum response occurring from four and sometimes up to eight years after liming). Therefore, soil pH measurements, combined with an assessment of actual yield relative to potential yield, provide the best guide to the response to surface applied lime and this response is likely to take more than four years to be realised.

Background The objective of the present study was to compare the effects of equal-volume resistance training (RT) performed with different training frequencies on muscle size and strength in trained young men. Methods Sixteen men with at least one year of RT experience were divided into two groups, G1 and G2, that trained each muscle group once and twice a week, respectively, for 10 weeks. Elbow flexor muscle thickness (MT) was measured using a B-Mode ultrasound and concentric peak torque of elbow extensors and flexors were assessed by an isokinetic dynamometer. Results ANOVA did not reveal group by time interactions for any variable, indicating no difference between groups for the changes in MT or PT of elbow flexors and extensors. Notwithstanding, MT of elbow flexors increased significantly (3.1%, P

The present study examined the effects of exercise utilising traditional resistance training (leg press) or ‘cardio’ exercise (recumbent cycle ergometry) modalities upon acute physiological responses. Nine healthy males underwent a within session randomised crossover design where they completed both the leg press and recumbent cycle ergometer conditions. Conditions were approximately matched for effort and duration (leg press: 4 × 12RM using a 2 s concentric and 3 s eccentric repetition duration controlled with a metronome, thus each set lasted 60 s; recumbent cycle ergometer: 4 × 60 s bouts using a resistance level permitting 80–100 rpm but culminating with being unable to sustain the minimum cadence for the final 5–10 s). Measurements included VO2, respiratory exchange ratio (RER), blood lactate, energy expenditure, muscle swelling, and electromyography. Perceived effort was similar between conditions and thus both were well matched with respect to effort. There were no significant effects by ‘condition’ in any of the physiological responses examined (all p > 0.05). The present study shows that, when both effort and duration are matched, resistance training (leg press) and ‘cardio’ exercise (recumbent cycle ergometry) may produce largely similar responses in VO2, RER, blood lactate, energy expenditure, muscle swelling, and electromyography. It therefore seems reasonable to suggest that both may offer a similar stimulus to produce chronic physiological adaptations in outcomes such as cardiorespiratory fitness, strength, and hypertrophy. Future work should look to both replicate the study conducted here with respect to the same, and additional physiological measures, and rigorously test the comparative efficacy of effort and duration matched exercise of differing modalities with respect to chronic improvements in physiological fitness.

‘Repetitions in Reserve’ (RIR) scales in resistance training (RT) are used to control effort but assume people accurately predict performance a priori (i.e. the number of possible repetitions to momentary failure (MF)). This study examined the ability of trainees with different experience levels to predict number of repetitions to MF. One hundred and forty-one participants underwent a full body RT session involving single sets to MF and were asked to predict the number of repetitions they could complete before reaching MF on each exercise. Participants underpredicted the number of repetitions they could perform to MF (Standard error of measurements [95% confidence intervals] for combined sample ranged between 2.64 [2.36–2.99] and 3.38 [3.02–3.83]). There was a tendency towards improved accuracy with greater experience. Ability to predict repetitions to MF is not perfectly accurate among most trainees though may improve with experience. Thus, RIR should be used cautiously in prescription of RT. Trainers and trainees should be aware of this as it may have implications for the attainment of training goals, particularly muscular hypertrophy.