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Study aim: This systematic review aimed to identify and analyze the available evidence about the effects of high-intensity interval training (HIIT) interventions on endurance performance in handball players.

The PPARD gene codes protein that belongs to the peroxisome proliferator-activated receptor (PPAR) family engaged in a variety of biological processes, including lipid metabolism in muscle cells. In this study, we assess the relationship between PPARD gene expression lipid metabolism parameters and the variation of the PPARD gene expression before (T1) and after 12 hours of training (T2) sessions in a group of football players. Peripheral blood lymphocytes were obtained from 22 football players (17.5±0.7 years, 178±0.7 cm, 68.05±9.18 kg). The PPARD gene expression, analyzed by quantitative polymerase chain reaction (qPCR), was significantly higher after T2 (p = 0.0006). Moreover, at the end of the training cycle, there was a significant decrease in relative fat tissue (FAT) (%) (p = 0.01) and absolute FAT (kg) (p = 0.01). A negative correlation was observed between absolute FAT (kg) and PPARD gene expression level in T2 (p = 0.03). The levels of cholesterol and triglyceride (TG) fractions were not significantly different (p >0.05) before and after training. No significant relationship between PPARD expression and cholesterol or TG levels was found. We found that physical training affects PPARD expression. Moreover, the negative correlation between PPARD expression and absolute FAT (kg) level may be indicative of the contribution of PPARD in metabolic adaptation to increased lipid uptake that can be used to control the body composition of athletes.

The paradoxical effects of contextual interference (CI) assume that high CI practices hinder performances during the acquisition phase of learning, while providing more permanent enhancement during the retention phase. This meta-analysis evaluates the possible generalizability of the CI phenomenon in physical education (PE) and sports contexts, with regard to the acute and relatively permanent gains in performance outcomes. A total of 933 records from five electronic databases were screened using the PICOS criteria, of which 36 studies were selected. Outcomes evaluating the performance changes ([dellta]) from pre-post, post-retention, and pre-retention tests were included. Out of 183 overall pooled outcomes, [delta] in only 37 performance outcomes (20%) agreed with the paradoxical CI effects on the acquisition or the relatively permanent gains. No statistically significant overall difference was detected for "[delta] pre-post" between low (blocked) (28.9 ± 59.5%) and high (random/serial) (27.9 ± 52.8%) CI (effect size (ES) = 0.1, p = 0.35). An overall significant difference (p = 0.001) in favor of high CI practice was detected in "[delta] post-retention." However, this difference was not large enough (ES = -0.35) to produce an overall greater long-term gain following high (24.56 ± 4.4%), compared to low (21.9 ± 9.8%) CI (ES = -0.13, p = 0.18). Out of 10 tested variables, only the age significantly moderated both CI effects (p < 0.0001 for both [delta] pre-post and [delta] pre-retention) and the female proportion significantly moderated only the first CI effect (p = 0.009 for [delta] pre-post). These findings found very limited evidence supporting the recommendation to employ high CI practices to gain a longer-term performance advantage, calling into question the generalization of the CI model to PE and sports practices. High-quality follow-up research evaluating alternative motor-learning models are therefore needed.

Although kindergarteners often are excited to share their mathematical ideas, they may not be sure how to explain the underlying reasoning that brought them to their answers. Teachers seeking to use literacy skills in mathematics to support kindergarteners' reasoning can use writing to provide each student an avenue to communicate their individual reasoning. Writing further broadens students' ways of communicating mathematically because this medium incorporates representations, including drawings, which are typical ways young students share their ideas. Developing writing during mathematics class has the potential to provide more insights into students' depth of understanding of the content while advancing key literacy skills. This article shares an approach to introducing and supporting kindergarteners in learning to write mathematically. The article then describes implementation and reflections. Finally, the authors share their plans for continuing this work based on their observations across the implementation.

A numerical cloud model with Lagrangian particles coupled to an Eulerian flow is adapted for distributed memory systems. Eulerian and Lagrangian calculations can be done in parallel on CPUs and GPUs, respectively. The fraction of time when CPUs and GPUs work simultaneously is maximized at around 80 % for an optimal ratio of CPU and GPU workloads. The optimal ratio of workloads is different for different systems because it depends on the relation between computing performance of CPUs and GPUs. GPU workload can be adjusted by changing the number of Lagrangian particles, which is limited by device memory. Lagrangian computations scale with the number of nodes better than Eulerian computations because the former do not require collective communications. This means that the ratio of CPU and GPU computation times also depends on the number of nodes. Therefore, for a fixed number of Lagrangian particles, there is an optimal number of nodes, for which the time CPUs and GPUs work simultaneously is maximized. Scaling efficiency up to this optimal number of nodes is close to 100 %. Simulations that use both CPUs and GPUs take between 10 and 120 times less time and use between 10 to 60 times less energy than simulations run on CPUs only. Simulations with Lagrangian microphysics take up to 8 times longer to finish than simulations with Eulerian bulk microphysics, but the difference decreases as more nodes are used. The presented method of adaptation for computing clusters can be used in any numerical model with Lagrangian particles coupled to an Eulerian fluid flow.

The World Health Organization's declaration of mpox (formerly known as monkeypox) as a public health emergency of international concern (PHEIC) in July 2022, followed by its resurgence in 2024, has sparked concerns about its potential impact on sports, especially contact sports such as football. Although mpox is not a pandemic (as of late September 2024), the coronavirus disease 2019 (COVID-19) experience offers valuable lessons for proactive planning in sports. Our conceptual framework has been designed to draw insightful lessons from the COVID-19 pandemic to assist sports organizations in planning for and preventing similar situations. We aimed to draw lessons from COVID-19 to help sports organizations enhance practical preparedness through effective planning and mitigation strategies. Accordingly, we sought to assess the potential impact of mpox on sports, with a focus on football (soccer), and to develop strategies for prevention, management, and preparedness based on epidemiological insights and lessons from COVID-19 pandemic experience. Here we review mpox's pathophysiology and possibility of transmission in sports settings and discuss tailored strategies, including risk assessments, testing protocols, hygiene measures, and return-to-play policies. This review highlights key differences between mpox and COVID-19 in transmission, incubation, and management, emphasizing the need for customized prevention and control measures in sports. We propose innovative risk assessment methods using global positioning system tracking and machine learning for contact analysis, alongside tailored testing and hygiene protocols. We emphasize the importance of proactive planning, noting improved preparedness in the sports community compared to the early days of COVID-19. In conclusion, our proposed framework provides sports organizations with practical tools to manage potential risks associated with mpox, ensuring the continuity of activities while prioritizing public health. [ABSTRACT FROM AUTHOR]

Nutrition is vital for athletic performance, especially in ultra-endurance sports, which pose unique nutritional challenges. Despite its importance, there exist gaps in the nutrition knowledge among athletes, and emerging digital tools could potentially bridge this gap. The ULTRA-Q, a sports nutrition questionnaire adapted for ultra-endurance athletes, was used to assess the nutritional knowledge of ChatGPT-3.5, ChatGPT-4, Google Bard, and Microsoft Copilot. Their performance was compared with experienced ultra-endurance athletes, registered sports nutritionists and dietitians, and the general population. ChatGPT-4 demonstrated the highest accuracy (93%), followed by Microsoft Copilot (92%), Bard (84%), and ChatGPT-3.5 (83%). The averaged AI model achieved an overall score of 88%, with the highest score in Body Composition (94%) and the lowest in Nutrients (84%). The averaged AI model outperformed the general population by 31% points and ultra-endurance athletes by 20% points in overall knowledge. The AI model exhibited superior knowledge in Fluids, outperforming registered dietitians by 49% points, the general population by 42% points, and ultra-endurance athletes by 32% points. In Body Composition, the AI model surpassed the general population by 31% points and ultraendurance athletes by 24% points. In Supplements, it outperformed registered dietitians by 58% points and the general population by 55% points. Finally, in Nutrients and in Recovery, it outperformed the general population only, by 24% and 29% points, respectively. AI models show high proficiency in sports nutrition knowledge, potentially serving as valuable tools for nutritional education and advice. AI-generated insights could be integrated with expert human judgment for effective athlete performance optimization. [ABSTRACT FROM AUTHOR]

New training approaches have emerged advocating for the implementation of compensatory physical training. This approach aims to provide additional training that balances the load typically experienced by non-starters during a match. This may help maintain their readiness and ensures that their physical fitness is not compromised by the reduced exposure to match loads. Thus, this narrative review aims to describe the differences in external loads between starting and non-starting players and describe the studies conducted in compensatory training. Studies examining external load metrics such as total distances covered, high-speed running, and sprinting suggest that, adjusted for playing time, values are often higher in non-starting players. Although not standardized, there is an obvious decrease in exposure for these critical variables in non-starters. Additionally, internal load parameters such as perceived exertion and heart rate tend to be higher in starting players. Regarding the physical fitness impacts, evidence suggests differences observed between starters and non-starters in some aspects of physical performance, although the extent and significance of these differences can vary. The studies on compensatory training are limited, and the typical approach usually centres on running-based exercises and small-sided games, offering differing approaches to address the physical needs. The gap in research underscores the necessity for improved study designs that can shed light on the real impact of compensatory training. Presently, the practice of compensatory training has been adopted, yet a definitive understanding of its genuine influence, particularly in terms of enhancing physical fitness and mitigating injury risks, remains elusive. [ABSTRACT FROM AUTHOR]

There is a lack of randomized clinical trials (RCTs) exploring the outcomes of cardiopulmonary rehabilitation programmes (CPRPs) on submaximal aerobic capacity of long COVID-19 patients (LC19Ps). This RCT aimed to evaluate the effect of an ambulatory CPRP on the 6-min walk test (6MWT) data (main outcome: 6-min walk distance (6MWD)) of LC19Ps. Conducted as a single-blinded RCT, the study included Tunisian LC19Ps with persistent dyspnoea (i.e. modified medical research council (mMRC) level ≥2) at least three months postdiagnosis. LC19Ps were randomly assigned to the intervention (IG, n = 20) or control (CG, n = 10) groups. Pre- and post-CPRP evaluations included dyspnoea assessments (Borg and mMRC scales), anthropometric data, spirometry, and 6MWT. The CPRP (i.e. 18 sessions over six weeks) encompassed warm-up, aerobic training, resistance training, respiratory exercises, and therapeutic education. The CPRP significantly improved i) dyspnoea, i.e. IG exhibited larger reductions compared to the CG in Borg (-3.5 ± 2.0 vs. -1.3 ± 1.5) and mMRC (-1.5 ± 0.8 vs. -0.1 ± 0.3) scales, and ii) 6MWD, i.e. IG demonstrated larger improvements compared to the CG in 6MWD (m, %) (168 ± 99 vs. 5 ± 45 m, 28 ± 8 vs. 1 ± 8%, respectively), and resting heart rate (bpm, % maximal predicted heart rate) (-9 ± 9 vs. 1 ± 7 bpm; -5 ± 6 vs. 0 ± 4%, respectively), with small effect sizes. In the IG, the 1.5-point decrease in mMRC and the 168 m increase in 6MWD exceeded the recommended minimal clinical important differences of 1 point and 30 m, respectively. CPRP appears to be effective in enhancing the submaximal exercise capacity of LC19Ps, particularly in improving 6MWD, dyspnoea, and resting heart rate. RCT registration: www.pactr.org; PACTR202303849880222. [ABSTRACT FROM AUTHOR]

Objective: To examine case logs reported by general surgery residents and identify potential disparities in operative experience. Background: A recent study of 21 institutions noted significant differences between the number of cases reported during general surgery residency by trainees who are underrepresented in medicine (URiM) versus trainees who are not URiM (non-URiM). This study also identified differences between female residents and male residents. We partnered with the Accreditation Council for Graduate Medical Education to examine case logs reported from all accredited general surgery programs in the United States. This is the first time these data have been examined nationally. Methods: We examined total case logs submitted by graduating residents between 2017 and 2022. Group differences in mean reported case logs were examined using paired t tests for female versus male and URiM versus non-URiM overall case numbers. Results: A total of 6458 residents submitted case logs from 319 accredited programs. Eight-hundred fifty-four (13%) were URiM and 5604 (87%) were non-URiM. Over the 5-year study period, URM residents submitted 1096.95 (SD ± 160.57) major cases versus 1115.96 (±160.53) for non-URiM residents (difference = 19 cases, P = 0.001). Case logs were submitted by 3833 (60.1%) male residents and 2625 (39.9%) female residents over the 5-year study period. Male residents reported 1128.56 (SD ± 168.32) cases versus 1091.38 (±145.98) cases reported by females (difference = 37.18, P < 0.001). When looking at surgeon chief and teaching assistant cases, there was no significant difference noted between cases submitted by URiM versus non-URiM residents. However, male residents reported significantly more in both categories than their female peers (P < 0.001). Conclusions: Overall, URiM residents submitted fewer cases in the 5-year study period than their non-URiM peers. The gap in submitted cases between male and female residents was more pronounced, with male residents submitting significantly more cases than their female counterparts. This finding was consistent and statistically significant throughout the entire study period, in most case categories, and without narrowing of difference over time. A difference of 30 to 40 cases can amount to 1 to 3 months of surgical training and is a concerning national trend deserving the attention of every training program and our governing institutions. [ABSTRACT FROM AUTHOR]

This study aimed to compare the effects of two elastic band 10-week training programmes on the athletic performance in adolescent female handball players. Participants aged 16.0 ± 0.5 years were randomly assigned to control (CNT, n = 12), standard elastic band (SEB, n = 12), or contrast elastic band (CEB, n = 12) programmes, each performed twice a week supplementing the regular training. The sprint (10 m and 20 m), modified Illinois change-of-direction test (COD), squat jump (SJ), countermovement jump (CMJ), standing long jump (SLJ), back extensor strength (BES), medicine ball throw (MBT), 1-RM bench press, 1-RM half squat, repeated sprint ability, and force-velocity (F-V) tests were measured before and after the intervention. Both CEB and SEB similarly improved sprint (p < 0.01 and p < 0.01) and COD (p < 0.001 and p < 0.01) when compared to CNT. Jumping performance improved significantly (SJ p < 0.01; CMJ p < 0.05) only in CEB, compared to CNT. Strength improved in both experimental groups (p < 0.01; ES: 0.73 < d < 1.59) compared to CNT, and there was a greater increase for CEB than SEB (p < 0.05) in the medicine ball throw (Table 3). Both CEB and SEB increased all RSA scores compared to CNT (p < 0.01; ES: 0.10 < d < 1.22), without significant difference between them. All F-V scores increased significantly in CEB and SEB compared to CNT (p < 0.01; ES: 0.45 < d < 2.47). In addition, CEB showed substantial gains in performance for PPabs, PPrel, and F0 (p < 0.001, p < 0.001 and p < 0.05, respectively) compared to SEB. Ten-week elastic band training conducted within the competitive season improved limb strength, power and F-V profile in female handball players, with a superior effect of the contrast elastic band training mode for upper-limb strength and F-V characteristics. [ABSTRACT FROM AUTHOR]

This study aimed to examine the impact of playing position (PP), match location (ML), and opposition standard (OS) on team and individual acceleration (ACC) and deceleration (DEC) efforts. Fifty professional football players were monitored across 24 English Premier Development League matches during the 2020/21 season. High-intensity ACC and DEC thresholds were set at > +3 m ⋅ s-2 and < -3 m ⋅ s-2, respectively. Players were divided into five PPs: centre backs (CB; n = 68), full-backs (FB; n = 24), centre midfielders (CM; n = 54), wide midfielders (WM; n = 15), centre forwards (CF; n = 27). Opposition standard was categorised as Top (1st-4th), Middle (5th-9th), and Bottom (9th-13th) based on final league ranking of the study season. Each match location was classified as Home or Away. One way analysis of variance (ANOVA) and a multivariate ANOVA analysed the independent effect of PP, ML and OS on ACC and DEC efforts, and the interaction of all contextual factors, respectively. Acceleration efforts were affected by PP and ML. FB performed 22% more ACC than WM. All players performed 6% more ACC actions during home matches compared to away fixtures. DEC efforts were only affected by PP, with FB and CM executing 26% and 32% greater DEC efforts than CB, respectively. When playing against top or middle teams at home, CB, CM, and CF tended to perform more high-intensity actions than when playing away. In contrast, when playing against top teams at home, FB and WM performed fewer high-intensity actions than when playing away. Playing position and ML affected ACC and DEC actions but not OS. [ABSTRACT FROM AUTHOR]

Skeletal muscle is a heterogenous and metabolically active tissue, the composition of which is associated with multiple traits. The aim of the study was to determine whether there are additional health and exercise-related traits associated with muscle fiber composition in athletes and non-athletes. This study recruited 164 Russian participants (51 endurance and 48 power athletes; 65 controls). Vastus lateralis muscle fiber composition was assessed by immunohistochemistry. Slow-twitch muscle fiber percentage (STMF%) was significantly greater in endurance than power athletes and non-athletes, and in non-athlete females than males. STMF% was positively associated with athletes’ training frequency, non-athletes’ and endurance athletes’ age, endurance athletes’ competition level and chest depth, and power athletes’ training age. STMF% was negatively associated with diastolic blood pressure in power athletes and with systolic blood pressure and reaction time in non-athletes. In all participants, STMF% was positively associated with age, tolerance to long distance exercise, chest depth and fracture incidence, and negatively with systolic blood pressure and resting heart rate. Age, sex and training frequency explained 10.6% and 13.2% of the variance in STMF% in endurance and power athletes, respectively. This is one of the most comprehensive studies involving athletes and untrained subjects and provides novel information concerning associations of increased STMF percentage with lower resting heart rate, better tolerance to long distances, faster reaction time and larger chest depth. On the other hand, the increased percentage of fast-twitch muscle fibers was associated with rare fracture incidence.

O presente artigo tem por objetivo examinar a noção de prazer (hedoné) enquanto télos da vida feliz (makários zén) em Epicuro. Compreendido como bem primeiro (agathòn prôton) e inerente ao ser humano, o prazer é apresentado como o princípio e o fim último (archê kai télos) da vida feliz. Com efeito, convém destacar que não são os prazeres do vulgo (os quais consistem no gozo imoderado dos sentidos) que Epicuro considera como télos da vida feliz, mas o prazer que é ausência de sofrimentos no corpo e na alma, o qual é nomeado por Epicuro de prazer catastemático (hedoné katastematiké) ou prazer estático/em repouso. São, neste sentido, duas as preocupações que orientam o presente trabalho: i) a de apresentar o prazer como télos da vida feliz; ii) a de expor o sentido estrito que o conceito de prazer assume na filosofia (especialmente na ética) epicurista, atentando-se para a distinção entre prazer em movimento e prazer em repouso. O presente estudo está pautado sobretudo em passagens da epístola a Meneceu, em algumas Máximas Principais e Sentenças Vaticanas, textos em que Epicuro expõe os fundamentos do seu hedonismo, bem como nos testemunhos de discípulos tardios, como Tito Lucrécio Caro, Diógenes Laércio e Diógenes de Enoanda.

Objective: To investigate the effect of 1) lockdown duration and 2) training intensity on sleep quality and insomnia symptoms in elite athletes.Methods: 1,454 elite athletes (24.1 ± 6.7 years; 42% female; 41% individual sports) from 40 countries answered a retrospective, cross-sectional, web-based questionnaire relating to their behavioral habits pre- and during- COVID-19 lockdown, including: 1) Pittsburgh sleep quality index (PSQI); 2) Insomnia severity index (ISI); bespoke questions about 3) napping; and 4) training behaviors. The association between dependent (PSQI and ISI) and independent variables (sleep, napping and training behaviors) was determined with multiple regression and is reported as semi-partial correlation coefficient squared (in percentage).Results: 15% of the sample spent < 1 month, 27% spent 1–2 months and 58% spent > 2 months in lockdown. 29% self-reported maintaining the same training intensity during-lockdown whilst 71% reduced training intensity. PSQI (4.1 ± 2.4 to 5.8 ± 3.1; mean difference (MD): 1.7; 95% confidence interval of the difference (95% CI): 1.6–1.9) and ISI (5.1 ± 4.7 to 7.7 ± 6.4; MD: 2.6; 95% CI: 2.3–2.9) scores were higher during-compared to pre-lockdown, associated (all p < 0.001) with longer sleep onset latency (PSQI: 28%; ISI: 23%), later bedtime (PSQI: 13%; ISI: 14%) and later preferred time of day to train (PSQI: 9%; ISI: 5%) during-lockdown. Those who reduced training intensity during-lockdown showed higher PSQI (p < 0.001; MD: 1.25; 95% CI: 0.87–1.63) and ISI (p < 0.001; MD: 2.5; 95% CI: 1.72–3.27) scores compared to those who maintained training intensity. Although PSQI score was not affected by the lockdown duration, ISI score was higher in athletes who spent > 2 months confined compared to those who spent < 1 month (p < 0.001; MD: 1.28; 95% CI: 0.26–2.3).Conclusion: Reducing training intensity during the COVID-19-induced lockdown was associated with lower sleep quality and higher insomnia severity in elite athletes. Lockdown duration had further disrupting effects on elite athletes’ sleep behavior. These findings could be of relevance in future lockdown or lockdown-like situations (e.g., prolonged illness, injury, and quarantine after international travel).

Background: Academic medical centers (AMCs) rely on clinical revenue to support the missions of research and education. Funds Flow model (FFM) is a financial model proposed to enhance the ability to do that. Some have argued the FFM has increased pressure for clinical productivity (CP), so we measured CP before and after implementation of a FFM. Methods: A FFM system was implemented in 2014. All Department of Surgery faculty with two years of practice prior to and after FFM initiation were included. The percentage of adjusted work relative value unit benchmarks met was compared between pre- and post-FFM using t-tests and ANOVA. Results: Fifty-one surgeons were included. There was no statistically significant difference in clinical productivity in the pre- and post-FFM periods. Thirteen surgeons (25%) had significantly lower CP after FFM implementation (p

Symptoms of psychological distress and disorder have been widely reported in people under quarantine during the COVID-19 pandemic; in addition to severe disruption of peoples’ daily activity and sleep patterns. This study investigates the association between physical-activity levels and sleep patterns in quarantined individuals. An international Google online survey was launched in April 6th, 2020 for 12-weeks. Forty-one research organizations from Europe, North-Africa, Western-Asia, and the Americas promoted the survey through their networks to the general society, which was made available in 14 languages. The survey was presented in a differential format with questions related to responses “before” and “during” the confinement period. Participants responded to the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the short form of the International Physical Activity Questionnaire. 5056 replies (59.4% female), from Europe (46.4%), Western-Asia (25.4%), America (14.8%) and North-Africa (13.3%) were analysed. The COVID-19 home confinement led to impaired sleep quality, as evidenced by the increase in the global PSQI score (4.37 ± 2.71 before home confinement vs. 5.32 ± 3.23 during home confinement) (p < 0.001). The frequency of individuals experiencing a good sleep decreased from 61% (n = 3063) before home confinement to 48% (n = 2405) during home confinement with highly active individuals experienced better sleep quality (p < 0.001) in both conditions. Time spent engaged in all physical-activity and the metabolic equivalent of task in each physical-activity category (i.e., vigorous, moderate, walking) decreased significantly during COVID-19 home confinement (p < 0.001). The number of hours of daily-sitting increased by ~2 hours/days during home confinement (p < 0.001). COVID-19 home confinement resulted in significantly negative alterations in sleep patterns and physical-activity levels. To maintain health during home confinement, physical-activity promotion and sleep hygiene education and support are strongly warranted.

Although recognized as effective measures to curb the spread of the COVID19 outbreak, social distancing and home confinement have generated a mental health burden with older adults who are considered to be more vulnerable to psychosocial strains. To date, the application of digital technologies in response to COVID-19 pandemic has been narrowed to public-health needs related to containment and mitigation. However, information and communications technology (ICT)-based initiatives directed toward prediction and prevention of psychosocial support are still limited. Given the power of digital health solutions to allow easy and accurate characterization and intervention for health and disease, as well as to flatten the COVID19 incidence curves in many countries, our ECLB-COVID19 consortium is highlighting the importance of providing innovative ICT-based solutions (ICT-COVID-Companion) to improve elderly physical and mental health, thereby preventing/dampening psychosocial strain during pandemics. Based on innovative approaches (e.g., emotional/social computing, open social platform, interactive coaching, gamification, fitness-tracker, internet of things) and smart digital solutions (smartwatch/smartphone), smart companions must provide safe personalised physical, mental and psychosocial health surveillance. Additionally, by delivering personalised multi-dimension crisis-oriented health recommendations, such innovative crisis-oriented solutions would help (i) facilitate a user’s adherence to active and healthy confinement lifestyle (AHCL), (ii) achieve a rapid psychosocial recovery in case of depression issues and (iii) enhance preparedness for eventual future pandemics.

Melatonin has been proved to have positive effects on cellular damage and metabolic regulation. The aim of the study was to determine the effect of melatonin supplementation during an intensive training period on physical performance decline, oxidative stress and cellular damage state. The investigation was conducted on 20 soccer players who participated in an exhaustive six-day training schedule associated with daily 5 mg oral melatonin or placebo ingestion. Resting blood samples and physical performance were measured before and after the training period. The mixed 2-way ANOVA (group x training camp) showed that compared to placebo, melatonin intake prevented an increase in advanced oxidation protein products (p>0.05) and increased the antioxidant enzyme activity (i.e., superoxide dismutase; p0.05) and biomarkers of muscle (e.g., creatine kinase; p>0.05) and liver (e.g., gamma-glutamyltransferase; p>0.05) damage. Furthermore, melatonin alleviated the deterioration in physical performance (countermovement jump, five-jump test and 20-m sprint; p>0.05). In conclusion, the obtained data showed increased oxidative stress and renal, muscle and liver damage in professional soccer players during an exhaustive training schedule. Melatonin intake during the training period exerts beneficial effects on physical performance and protects tissues against the deleterious effects of reactive oxygen species and cellular damage.

Multicellular organisms maintain structure and function of tissues/organs through emergent, self-organizing behavior. In this report, we demonstrate a critical role for lung mesenchymal stromal cell (L-MSC) aging in determining the capacity to form three-dimensional organoids or ‘alveolospheres’ with type 2 alveolar epithelial cells (AEC2s). In contrast to L-MSCs from aged mice, young L-MSCs support the efficient formation of alveolospheres when co-cultured with young or aged AEC2s. Aged L-MSCs demonstrated features of cellular senescence, altered bioenergetics, and a senescence-associated secretory profile (SASP). The reactive oxygen species generating enzyme, NADPH oxidase 4 (Nox4), was highly activated in aged L-MSCs and Nox4 downregulation was sufficient to, at least partially, reverse this age-related energy deficit, while restoring the self-organizing capacity of alveolospheres. Together, these data indicate a critical role for cellular bioenergetics and redox homeostasis in an organoid model of self-organization and support the concept of thermodynamic entropy in aging biology.

Currently, there is limited evidence regarding various neurophysiological responses to strength exercise and the influence of the adopted practice schedule. This study aimed to assess the acute systemic effects of snatch training bouts, employing different motor learning models, on skill efficiency, electric brain activity (EEG), heart rate variability (HRV), and perceived exertion as well as mental demand in novices. In a within-subject design, sixteen highly active males (mean age: 23.13 ± 2.09 years) randomly performed snatch learning bouts consisting of 36 trials using repetitive learning (RL), contextual interference (blocked, CIb; and serial, CIs), and differential learning (DL) models. Spontaneous resting EEG and HRV activities were recorded at PRE and POST training bouts while measuring heart rate. Perceived exertion and mental demand were assessed immediately after, and barbell kinematics were recorded during three power snatch trials performed following the POST measurement. The results showed increases in alpha, beta, and gamma frequencies from pre- to post-training bouts in the majority of the tested brain regions (p values ranging from < 0.0001 to 0.02). The CIb model exhibited increased frequencies in more regions. Resting time domain HRV parameters were altered following the snatch bouts, with increased HR (p < 0.001) and decreased RR interval (p < 0.001), SDNN, and RMSSD (p values ranging from < 0.0001 to 0.02). DL showed more pronounced pulse-related changes (p = 0.01). Significant changes in HRV frequency domain parameters were observed, with a significant increase in LFn (p = 0.03) and a decrease in HFn (p = 0.001) registered only in the DL model. Elevated HR zones (> HR zone 3) were more dominant in the DL model during the snatch bouts (effect size = 0.5). Similarly, the DL model tended to exhibit higher perceived physical (effect size = 0.5) and mental exertions (effect size = 0.6). Despite the highest psycho-physiological response, the DL group showed one of the fewest significant EEG changes. There was no significant advantage of one learning model over the other in terms of technical efficiency. These findings offer preliminary support for the acute neurophysiological benefits of coordination-strength-based exercise in novices, particularly when employing a DL model. The advantages of combining EEG and HRV measurements for comprehensive monitoring and understanding of potential adaptations are also highlighted. However, further studies encompassing a broader range of coordination-strength-based exercises are warranted to corroborate these observations. [ABSTRACT FROM AUTHOR]

Natural language processing (NLP) has been studied in computing for decades. Recent technological advancements have led to the development of sophisticated artificial intelligence (AI) models, such as Chat Generative Pre-trained Transformer (ChatGPT). These models can perform a range of language tasks and generate human-like responses, which offers exciting prospects for academic efficiency. This manuscript aims at (i) exploring the potential benefits and threats of ChatGPT and other NLP technologies in academic writing and research publications; (ii) highlights the ethical considerations involved in using these tools, and (iii) consider the impact they may have on the authenticity and credibility of academic work. This study involved a literature review of relevant scholarly articles published in peer-reviewed journals indexed in Scopus as quartile 1. The search used keywords such as "ChatGPT," "AI-generated text," "academic writing," and "natural language processing." The analysis was carried out using a quasi-qualitative approach, which involved reading and critically evaluating the sources and identifying relevant data to support the research questions. The study found that ChatGPT and other NLP technologies have the potential to enhance academic writing and research efficiency. However, their use also raises concerns about the impact on the authenticity and credibility of academic work. The study highlights the need for comprehensive discussions on the potential use, threats, and limitations of these tools, emphasizing the importance of ethical and academic principles, with human intelligence and critical thinking at the forefront of the research process. This study highlights the need for comprehensive debates and ethical considerations involved in their use. The study also recommends that academics exercise caution when using these tools and ensure transparency in their use, emphasizing the importance of human intelligence and critical thinking in academic work. [ABSTRACT FROM AUTHOR]

Abstract Background In May 2015 the Malawian Ministry of Health (MOH) contacted the German Development Cooperation to seek technical assistance from the P4H Network for Social Health Protection for an “Assessment of the appropriateness and feasibility of National Health Insurance in Malawi” against two alternative options: continuing with a tax (and donor)-funded National Health Service, and introducing a purchaser-provider split without a revenue collection function. Methods A health financing benchmarking matrix was agreed with MOH, with six domains corresponding to six objectives: revenue mobilisation, technical efficiency, equity, financial risk protection, policy coordination, and health outcomes. The assessment comprised key informant interviews with Malawian stakeholders, a review of the relevant literature and datasets, rapid assessments of the Malawi Revenue Authority (MRA) and the Unified Beneficiary Registry (UBR), and projections of the National Health Insurance Scheme’s (NHIS) revenue collection costs and benefits. Results A key finding was that introducing NHIS in Malawi would increase revenues for health, but these would come predominantly from the formal sector and would be unlikely to cover the health sector funding gap. The performance of existing poverty identification and targeting mechanisms was not commensurate with the requirements of a NHIS. Incentives to enrol in NHI are insufficient to reach scale unless service fees be introduced, which would negatively affect equity and financial risk protection. The assessment identified the Purchaser Scenario as the most favourable reform model. Conclusions As ever more countries look towards implementing National Health Insurance, the proposed assessment framework can provide an orientation for evidence-based policy making in the area of health financing.

The cortisol (C) and testosterone (T) responses to experimental stress have been linked to sport and health outcomes several days to years later. Here we examined the utility of these biomarkers, taken across a simulated Olympic weightlifting (OWL) competition, as predictors of future competitive performance in young athletes. Seventy junior athletes (46 males, 24 females) participated in a talent identification and development programme that replicated an OWL competition. Performance was indexed by the total load lifted, relative to body mass, with serum changes in C (∆C) and (∆T) concentrations profiled. We identified each athlete’s best performance in real competitions over two subsequent years via online resources. Hierarchical regression was used to predict changes in competitive performance at

High mobility group box 1 (HMGB1) protein is a danger-signaling molecule, known to activate an inflammatory response via TLR4 and RAGE. HMGB1 can be either actively secreted or passively released from damaged alveolar epithelial cells. Previous studies hav

Trauma and sepsis are frequent causes of immunosuppression and risk of secondary bacterial infections and mortality among critically ill patients. Reduced activity of neutrophil NADPH oxidase 2 (NOX2) and impaired bacterial killing are among the major indices of immunosuppression. We hypothesize that NOX2-decoy peptides disrupt the inhibition of neutrophil NOX2 by plasma of patients with severe trauma and immunosuppression, thereby preserving the neutrophil respiratory burst that is a central antimicrobial mechanism. We demonstrate that plasma from trauma/hemorrhage (T/H) patients, but not healthy donors (HD), significantly reduced the activity of neutrophil NOX2 and impaired bacterial killing. The inhibitory action of plasma was associated with an increase in bacterial infections among trauma survivors. High Mobility Group Box 1 (HMGB1) is a mediator of lethality in trauma and sepsis and our mechanistic studies revealed that disulfide and oxidized forms of HMGB1 bind to the gp91phox subunit of NOX2, and thus decrease the neutrophil respiratory burst and bacterial killing. NOX2 decoy Anti-Immunosuppression (Ai) Peptides 1 and 3 effectively disrupted the immunosuppressive action of T/H plasma. HMGB1 selectively binds to Ai-Peptide 3, supporting the possibility for direct interaction between HMGB1 and the third external loop of gp91phox. In vivo, Ai-Peptides improved survival of mice subjected to lethal peritonitis. Taken together, plasma-dependent inhibition of neutrophil NOX2 appeared to be a suitable indicator of immunosuppression in patients with severe trauma. Given that gp91phox decoys protected the neutrophil respiratory burst, selected Ai-Peptides have therapeutic potential to reduce bacterial infections and end-organ injury associated with sepsis/trauma-induced immunosuppression.

The aim of the present study was to analyse VEGFA rs699947, rs1570360, and rs2010963 polymorphisms with susceptibility to anterior cruciate ligament rupture (ACLR) in a Polish population. The study included 412 physically active Caucasian participants. The study group consisted of 222 individuals with surgically diagnosed primary ACLR qualified for ligament reconstruction (ACLR group). The control group consisted of 190 apparently healthy participants without any history of ACLR (CON group). Three polymorphisms within the VEGFA (rs699947, rs1570360, and rs2010963) gene were chosen for investigation due to their significance in the angiogenesis signalling pathway and previous associations with risk of ACLRs. Both single-locus and haplotype-based analyses were conducted. No significant differences in the allele and genotype frequency distributions were noted for the rs699947 and rs1570360 polymorphisms. In contrast, rs2010963 was associated with risk of ACLR in the codominant (p=0.047) and recessive model (p=0.017). In the latter, the CC genotype was overrepresented among individuals with ACL rupture (23.4% vs 14.2%, OR=1.85 [1.11-3.08]). Two VEGFA haplotypes were associated with ACLR under the additive (global score=11.39, p=0.022) and dominant model (global score=11.61, p=0.020). The [C;G;G] haplotype was underrepresented in the ACLR group (52.2% vs. 60.3%), whereas the [C;G;C] haplotype was overrepresented (2.9% vs 0.5%). The results obtained suggest a potential correlation between the VEGFA rs2010963 polymorphism and ACLR risk, suggesting that harbouring this specific C allele may be an unfavourable risk factor for a knee injury in Caucasian participants from Poland.

Endothelial nitric oxide synthase (NOS3) generates nitric oxide in blood vessels and is involved in the regulation of vascular function, metabolism and muscle fibre type transformations. Evidence suggests that the NOS3 G894T (rs1799983) and -786T/C (rs2070744) polymorphisms are associated with athletic performance. The purpose of this study was to determine the association between the NOS3 G894T and -786T/C polymorphisms with elite swimmer status in Polish athletes. One hundred and ninety-seven Polish swimmers (104 males and 93 females), who competed in national and international events, and 379 healthy control subjects (222 males and 157 females) were recruited for this study. The swimmers were divided into two groups: short distance swimmers (SDS; n=147; 50-200 m) and long distance swimmers (LDS; n=49; more than 500 m). As expected, the frequencies of the -786T/C T allele (77.0 vs. 63.1%, p = 0.0085) and G-T haplotype (63.7 vs. 52.0, p=0.025) were significantly higher in the LDS group in comparison with controls. Compared with the -786T/C CC genotype, the chance of being a long distance swimmer was 8.49 times higher (CI=1.14-62.78, p=0.023) for the carriers of -786T/C T allele than in control subjects. On the other hand, the Asp allele frequency was significantly higher in the female SDS group compared with controls (34.3 vs. 18.5%, p=0.00043). In conclusion, our results demonstrate that the T allele and the G-T haplotype of the -786T/C and G894T polymorphisms may be beneficial for long distance swimmers.

In athletes, pain has diverse functions and a complex etiology. Its role is not limited to indicating the limits of the body, especially in areas that are exposed to maximal forces and stresses and consequently vulnerable to damage or injury. Several common single nucleotide polymorphisms (SNPs) have been recently associated with inter individual differences in pain perception. Among several other markers, catechol-O-methyltransferase ( COMT rs4680:G>A ) and the μ-opioid receptor ( OPRM1 rs1799971:A >G ) were proposed as key factors for pain perception. The aim of the current study was to investigate the potential association between COMT and OPRM1 genotypes and pain perception as well as the relation with elite athlete status. The study involved 395 healthy men, aged 18 to 28 years; 214 combat sports athletes comprised the experimental group and 181 non-athletes comprised the control group. DNA was extracted from buccal cells donated by the subjects, and genotyping for COMT rs4680 and OPRM1 rs1799971 was carried out using real-time PCR. Measurement of the pain threshold and pain tolerance was performed using an algometer and the cold pressor test. The genotype distribution of COMT and OPRM1 polymorphisms did not differ between combat athletes and the control group (p=0.500 and p=0.390). Pain threshold and pain tolerance as both quantitative and qualitative measures did not differ with respect to OPRM1 and COMT polymorphism in either the combat or the control group for any of the analysed genetic models.

The purpose of the study was to analyse the changes in muscle strength, power, and somatic parameters in elite volleyball players after a specific pre-season training programme aimed at improving jumping and strength performance and injury prevention. Twelve junior female volleyball players participated in an 8-week training programme. Anthropometric characteristics, isokinetic peak torque (PT) single-joint knee flexion (H) and extension (Q) at 60º/s and 180º/s, counter movement jump (CMJ), squat jump (SJ), and reactive strength index (RSI) were measured before and after intervention. Significant moderate effects were found in flexor concentric PT at 60º/s and at 180 º/s in the dominant leg (DL) (18.3±15.1%, likely; 17.8±11.2%, very likely) and in extensor concentric PT at 180º/s (7.4%±7.8%, very likely) in the DL. In the non-dominant leg (NL) significant moderate effects were found in flexor concentric PT at 60º/s and at 180º/s (13.7±11.3%, likely; 13.4±8.0%, very likely) and in extensor concentric PT at 180º/s (10.7±11.5%, very likely). Small to moderate changes were observed for H/QCONV in the DL at 60º/s and 180º/s (15.9±14.1%; 9.6±10.4%, both likely) and in the NL at 60º/s (moderate change, 9.6±11.8%, likely), and small to moderate decreases were detected for H/QFUNC at 180º/s, in both the DL and NL (-7.0±8.3%, likely; -9.5±10.0%, likely). Training-induced changes in jumping performance were trivial (for RSI) to small (for CMJ and SJ). The applied pre-season training programme induced a number of positive changes in physical performance and risk of injury, despite a lack of changes in body mass and composition. CITATION: Lehnert M, Sigmund M, Lipinska P et al. Training-induced changes in physical performance can be achieved without body mass reduction after eight week of strength and injury prevention oriented programme in volleyball female players. Biol Sport. 2017;34(2):205-213.

Proteoglycans are considered integral structural components of tendon and ligament and have been implicated in the resistance of compressive forces, collagen fibrillogenesis, matrix remodelling and cell signalling. Several sequence variants within genes encoding proteoglycans were recently implicated in modulating anterior cruciate ligament ruptures (ACLR). This study aimed to test the previously implicated variants in proteoglycan and vascular epithelial growth factor encoding genes with risk of ACLR in a population from Poland. A case control genetic association study was conducted using DNA samples from 143 healthy participants without a history of ACL injuries (99 male and 44 females) (CON group) and 229 surgically diagnosed ACLR participants (158 males and 71 females). All samples were genotyped for the ACAN: rs1516797, BGN: rs1042103, rs1126499, DCN: rs516115 and VEGFA: rs699947 variants. Main findings included the (i) ACAN rs1516797 G/T genotype which was underrepresented in the CON group (CON: 36%, n=52, ACLR: 49%, n=112, p=0.017, OR=1.68, 95% CI 1.09 to 2.57) when all participants were investigated and (ii) the BGN rs1042103 A allele was significantly under-represented in the male CON group compared to the male ACLR group (CON: 39%, n=78, ACLR: 49%, n=156, p=0.029, OR=1.5, 95% CI 1.05 to 2.15). Furthermore, BGN inferred haplotypes were highlighted with altered ACLR susceptibility. Although the study implicated the ACAN and BGN genes (combination of genotype, allele and haplotype) in modulating ACLR susceptibility, several differences were noted with previous published findings.

We describe a 36-year-old woman who presented to our facility after sustaining a gunshot wound to the epigastric region. The gunshot resulted in injury to the left lobe of the liver and the twelfth thoracic vertebral body as well as in a through-and-through injury to the abdominal aorta at the level of the celiac axis. The vascular injury was managed successfully by placement of a thoracic stent graft with coverage of the celiac axis. This case demonstrates the feasibility of managing this uncommon injury with endovascular techniques.

The 2022 FIFA World Cup (FIFA-WC) held in Qatar presented unique challenges, given the potential for rapid transmission of coronavirus disease 2019 (COVID-19) among over 1.4 million international fans attending the event. This study aimed to investigate the impact of the FIFA-WC 2022 on COVID-19 cases, deaths, and reproduction rate (R0) in Qatar. Additionally, it sought to understand the implications of hosting large-scale events during a pandemic without COVID-19 restrictive measures, providing critical insights for future decision-making. Data from "Our World in Data" were analysed for three distinct periods: one week before the FIFA-WC (week-preWC), the four weeks of the event (week-1WC to week-4WC), and one week after (week-postWC). The results revealed a significant increase in COVID-19 cases during week-3WC and week-4WC (compared to week-preWC) in Qatar, followed by a subsequent decrease during the week-postWC. Notably, Qatar experienced a more pronounced surge in positive cases than the global trend. Regarding COVID-19-related deaths, Qatar's peak occurred during week-2WC, while globally deaths peaked from week- 3WC to week-postWC. Nevertheless, Qatar's death toll remained relatively low compared to the global trend throughout the event. The findings highlight that the FIFA-WC 2022 in Qatar demonstrated the feasibility of organizing large-scale sporting events during a pandemic with appropriate measures in place. They emphasize the importance of high vaccination coverage, continuous monitoring, and effective collaboration between event organizers, healthcare authorities, and governments. As such, the event serves as a valuable model for future gatherings, underlining the significance of evidence-based decision-making and comprehensive public health preparedness. [ABSTRACT FROM AUTHOR]

Frequent and regular physical activity has significant benefits for health, including improvement of body composition and help in weight control. Consequently, promoting training programmes, particularly in those who are genetically predisposed, is a significant step towards controlling the presently increasing epidemic of obesity. Although the physiological responses of the human body to exercise are quite well described, the genetic background of these reactions still remains mostly unknown. This review not only summarizes the current evidence, through a literature review and the results of our studies on the influence of gene variants on the characteristics and range of the body’s adaptive response to training, but also explores research organization problems, future trends, and possibilities. We describe the most reliable candidate genetic markers that are involved in energy balance pathways and body composition changes in response to training programmes, such as FTO, MC4R, ACE, PPARG, LEP, LEPR, ADRB2, and ADRB3. This knowledge can have an enormous impact not only on individualization of exercise programmes to make them more efficient and safer, but also on improved recovery, traumatology, medical care, diet, supplementation and many other areas. Nevertheless, the current studies still represent only the first steps towards a better understanding of the genetic factors that influence obesity-related traits, as well as gene variant x physical activity interactions, so further research is necessary.

The aim of the study was to investigate the effects of eight weeks of regular physical education classes supplemented with high intensity interval cycle exercise (HIIE) or continuous cycle exercises of moderate intensity (CME). Forty-eight collegiate females exercising in two regular physical education classes per week were randomly assigned to two programmes (HIIE; n=24 or CME; n=24) of additional (one session of 63 minutes per week) physical activity for 8 weeks. Participants performed HIIE comprising 2 series of 6x10 s sprinting with maximal pedalling cadence and active recovery pedalling with intensity 65%–75% HRmax or performed CME corresponding to 65%-75% HRmax. Before and after the 8-week programmes, anthropometric data and aero- and anaerobic capacity were measured. Two-way ANOVA revealed a significant time main effect for VO2max (p

Study region: Harmful algal blooms (HABs) in the Western Basin (WB) of Lake Erie have been linked to nonpoint pollution from agricultural watersheds. The Maumee River watershed is the largest in the Great Lakes region and delivers the biggest sediment and nutrient load to Lake Erie. Study focus: Climate change could alter the magnitude and timing of sediment and nutrient delivery to Lake Erie's WB. Data from four Coupled Model Intercomparison Project Phase 5 (CMIP5) models were inputted into a calibrated Soil and Water Assessment Tool (SWAT) model of the Maumee River watershed to determine the effects of climate change on watershed yields. Tillage practices were also altered within the model to test the effectiveness of conservation practices under climate change scenarios. New hydrological insights for the region: Moderate climate change scenarios reduced annual flow (up to −24%) and sediment (up to −26%) yields, while a more extreme scenario showed smaller flow reductions (up to −10%) and an increase in sediment (up to +11%). No-till practices had a negligible effect on flow but produced 16% lower average sediment loads than scenarios using current watershed conditions. At high implementation rates, no-till practices could offset any future increases in annual sediment loads, but they may have varied seasonal success. Regardless of future climate change intensity, increased remediation efforts will likely be necessary to significantly reduce HABs in Lake Erie's WB.

Although various intrinsic and extrinsic risk factors for anterior cruciate ligament (ACL) rupture have been identified, the exact aetiology of the injury is not yet fully understood. Type III collagen is an important factor in the repair of connective tissue, and certain gene polymorphisms may impair the tensile strength. The aim of this study was to examine the association of the COL3A1 rs1800255 polymorphism with ACL rupture in Polish male recreational skiers. A total of 321 male Polish recreational skiers were recruited for this study; 138 had surgically diagnosed primary ACL ruptures (ACL-injured group) and 183 were apparently healthy male skiers (control group – CON) who had no self-reported history of ligament or tendon injury. Both groups had a comparable level of exposure to ACL injury. Genomic DNA was extracted from the oral epithelial cells. All samples were genotyped on a real-time polymerase chain reaction instrument. The genotype distribution in the ACL-injured group was significantly different than in CON (respectively: AA=10.1 vs 2.2%, AG=22.5 vs 36.1, GG=67.4 vs 61.8%; p=0.0087). The AA vs AG+GG genotype of COL3A1 (odds ratio (OR) = 5.05; 95% confidence interval (CI), 1.62-15.71, p = 0.003) was significantly overrepresented in the ACL-injured group compared with CON. The frequency of the A allele was higher in the ACL-injured group (21.4%) compared with CON (20.2%), but the difference was not statistically significant (p=0.72). This study revealed an association between the COL3A1 rs1800255 polymorphism and ACL ruptures in Polish skiers.

The purpose of this investigation is to estimate the global disease burden attributable to low physical activity (PA) in 204 countries and territories from 1990 to 2019 by age, sex, and Socio-Demographic Index (SDI). Detailed information on global deaths and disability-adjusted life years (DALYs) attributable to low PA were collected from the Global Burden of Disease Study 2019. The ideal exposure scenario of PA was defined as 3000-4500 metabolic equivalent minutes per week and low PA was considered to be less than this threshold. Age-standardization was used to improve the comparison of rates across locations or between time periods. In 2019, low PA seems to contribute to 0.83 million [95% uncertainty interval (UI) 0.43 to 1.47] deaths and 15.75 million (95% UI 8.52 to 28.62) DALYs globally, an increase of 83.9% (95% UI 69.3 to 105.7) and 82.9% (95% UI 65.5 to 112.1) since 1990, respectively. The age-standardized rates of low-PA-related deaths and DALYs per 100,000 people in 2019 were 11.1 (95% UI 5.7 to 19.5) and 198.4 (95% UI 108.2 to 360.3), respectively. Of all age-standardized DALYs globally in 2019, 0.6% (95% UI 0.3 to 1.1) may be attributable to low PA. The association between SDI and the proportion of age-standardized DALYs attributable to low PA suggests that regions with the highest SDI largely decreased their proportions of age-standardized DALYs attributable to low PA during 1990-2019, while other regions tended to have increased proportions in the same timeframe. In 2019, the rates of low-PA-related deaths and DALYs tended to rise with increasing age in both sexes, with no differences between males and females in the age-standardized rates. An insufficient accumulation of PA across the globe occurs together with a considerable public health burden. Health initiatives to promote PA within different age groups and countries are urgently needed. [ABSTRACT FROM AUTHOR]