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Introduction 1228 I. The Rise of Generative AI and the Current Legal Landscape 1232 A. Generative AI 1233 B. Copyrighted Architectural Works 1235 1. The Incorporation of Architectural Works in [...]

The article focuses on a court case in which Heather Andersen and Leslie Christian, along with seven other same sex couples, filed a suit against the state of Washington, challenging the constitutional validity of Washington's Defense of Marriage Act (DOMA), codified in the Revised Code of Washington (RCW) 26.04.010 and RCW 26.04.020(l)(c). The plaintiffs claimed that the statutes violated their rights under the privileges and immunities clause, the due process clause, and the Equal Rights Amendment (ERA) of the Washington Constitution. Superior Court Judge William L. Downing ruled that DOMA violated the privileges and immunities clause of the Washington Constitution, and that the statutory denial of plaintiffs' right to marry violated the state constitutional principles of substantive due process. Judge Downing refused to rule on the ERA argument due to the binding precedent of "Singer versus Hara," a 1974 decision by the Court of Appeals of Washington. The Superior Court of Washington held RCW 26.04.010 and RCW 26.04.020(1)(c) invalid under the Washington Constitution because their exclusion of same-sex couples from the status and privileges of civil marriage were not rationally related to any valid or compelling state interest.

Background: Currently, there are no reliable biomarkers for predicting treatment response in chronic inflammatory diseases (CIDs)., Objective: To determine whether serum microfibrillar-associated protein 4 (MFAP4) levels can predict the treatment response to biological therapy in patients with CIDs., Methods: The BELIEVE study was originally designed as a prospective, multi-center cohort study of 233 patients with either rheumatoid arthritis, psoriatic arthritis, psoriasis, axial spondyloarthritis, Crohn's disease, or ulcerative colitis, initiating treatment with a biologic agent (or switching to another). Clinical assessment and blood sample collection were performed at baseline and 14-16 weeks after treatment initiation. The primary analyses included participants with available blood samples at baseline; missing data were handled as non-responders. The patients were stratified into the upper tertile of serum MFAP4 (High MFAP4) versus a combined category of middle and lower tertiles (Other MFAP4). The primary outcome was the proportion of patients with clinical response to biologic therapy after 14-16 weeks., Results: 211 patients were included in the primary analysis population. The mean age was 43.7 (SD: 14.8) years, and 120 (59%) were female. Positive treatment response was observed in 41 (59%) and 69 (49%) for High MFAP4 and Other MFAP4, respectively. When adjusting for pre-specified variables (CID, age, sex, smoking status, and BMI), the adjusted OR was 2.28 (95% CI: 1.07 to 4.85) for a positive treatment outcome in the High MFAP4 group., Conclusion: A high MFAP4 status before initiating biological treatment is associated with a positive clinical response, when adjusting for confounding factors., (© 2024. The Author(s).)

Chronic inflammatory diseases (CIDs) pose a growing healthcare challenge, with a substantial proportion of patients showing inadequate response to biological treatment. There is renewed interest in dietary changes to optimize treatment regimens, with a growing body of evidence suggesting beneficial effects with adherence to a gluten-free diet. This study compared the likelihood of achieving clinical response to biological treatment after 14-16 weeks in patients with CID with high versus low-to-medium gluten intake. Secondary outcomes of interest included changes in disease activity, health-related quality of life and C-reactive protein. The study was a multicentre prospective cohort of 193 participants with a CID diagnosis (i.e. Crohn's Disease, Ulcerative Colitis, Rheumatoid Arthritis, Axial Spondyloarthritis, Psoriatic Arthritis or Psoriasis) who initiated biological treatment between 2017 and 2020. Participants were stratified based on their habitual gluten intake: the upper 33.3% (high gluten intake) and the remaining 66.6% (low-to-medium gluten intake). The proportion of patients achieving clinical response to biological treatment after 14-16 weeks was compared using logistic regression models. The median gluten intake differed significantly between groups (12.5 g/day vs. 5.9 g/day, standardized mean difference = 1.399). In total, 108 (56%) achieved clinical response to treatment, with no difference between 35 (55%) in the high gluten group and 73 (57%) in the medium-to-low gluten group (OR = 0.96 [0.51-1.79], p = 0.897). No differences were found with secondary outcomes. In conclusion, this study found no association between gluten intake and response to biological treatment in patients with CID., (© 2024 The Author(s). Scandinavian Journal of Immunology published by John Wiley & Sons Ltd on behalf of The Scandinavian Foundation for Immunology.)

Extensive patient heterogeneity is a challenge in the management of inflammatory bowel disease (IBD). Sex and gender, as well as the interaction of sex and gender with other social identities, referred to as intersectionality, contribute to this heterogeneity and might affect IBD outcomes. An interdisciplinary team of clinicians, researchers, patients, and sex and gender experts reviewed current literature on the effect of sex and gender dimensions on IBD outcomes. The team also investigated the role that stakeholders have in advancing sex-based and gender-based IBD knowledge, as comprehensive studies are scarce. Acknowledging and integrating sex and gender into the organisation and content of research (eg, study design, participant recruitment, data analysis, data interpretation, data dissemination, and impact evaluation) could enhance the validity, relevance, and applicability of research. Such gendered innovation has potential for advancing personalised medicine and improving the quality of life for people with IBD., Competing Interests: Declaration of interests JH has served as a speaker or advisory board member for AbbVie, Aqilion, Bristol Myers Squibb, Celgene, Celltrion, Eli Lilly, Ferring, Galapagos, Gilead, Hospira, Index Pharma, Janssen, Meda Pharmaceuticals, Medivir, Novartis, Pfizer, Prometheus Laboratories, Sandoz, Shire, Takeda, Thermo Fisher Scientific, Tillotts Pharma, Vifor Pharma, and Union Chimique Belge, and has received grant support from Janssen, Merck Sharpe & Dohme, and Takeda. VA has served as an advisory board member for Merck Sharpe & Dohme. MDJ has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Tillotts Pharma, Takeda, Norgine, and Olympus. MR reports consulting fees from Janssen as part of a half-day advisory meeting concerning the use of a medication in clinical gastroenterology and payment from AbbVie as compensation for one lecture during Swedish Gastro Week on quality management within IBD; compensation for both was administrated as part of his job as a consultant of gastroenterology and hepatology. JDF reports support for attending meetings and travel from Tillotts and the Danish Society for Gastroenterology and Hepatology. MC has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Vifor Pharma. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)

The aim of the study was to examine the effects of a 5-week dynamic finger flexor strength training program on bouldering performance and climbing-specific strength tests. Advanced to elite level boulderers (n = 31) were randomized to a dynamic finger strength training group (DFS) or a control group (CON). The DFS training program consisted of 3 weekly sessions (3-5 sets, 4-10 repetitions per session). Both groups continued bouldering training as usual throughout the intervention period. Pre- and post-intervention measures included bouldering performance, maximal dynamic finger strength, isometric finger strength (peak and average force), and rate of force development (RFD). The DFS demonstrated greater improvement in dynamic finger strength (11.5%, 3.9 kg) than the CON (5.3%, 1.7 kg; p = 0.075, ES = 0.90), but there were no differences between the groups in 1RM ( p = 0.075, ES = 0.67), bouldering performance ( p = 0.39, ES = 0.35), isometric finger strength ( p = 0.42-0.56, ES = 0.20-0.22) or RFD ( p = 0.30, ES = 0.46). The DFS improved dynamic ( p < 0.01, ES = 1.83) and isometric peak and average ( p < 0.01, ES = 0.98, and p < 0.01, ES = 0.75, respectively) finger strength, while the CON only increased dynamic finger strength ( p < 0.05, ES = 0.58). None of groups improved bouldering performance or RFD ( p = 0.07-0.58). In conclusion, 5 weeks of DFS training improving dynamic strength to a greater extent than bouldering alone in addition to improving isometric finger strength among advanced boulderers. Isolated bouldering improved dynamic finger flexor strength, but importantly, increased finger strength (dynamic or isometric) did not improve bouldering performance., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Saeterbakken, Bratland, Andersen and Stien.)

Hemodialysis (HD) patients are at high risk of cardiovascular disease and death. Reliable biomarkers for risk stratification and detection of acute myocardial infarction (AMI) are therefore pivotal. Cardiac troponins (cTn) are the preferred biomarkers for AMI. It remains unclear, if cTn concentrations changes as a consequence of HD treatment itself during dialysis. In this study, cTn was compared with soluble urokinase plasminogen activator receptor (suPAR) and Beta-2-microglobulin (B2M). We performed a prospective study including 17 HD patients measuring high-sensitive cardiac troponin t (hs-cTnT), suPAR and B2M before and after a dialysis session and verified the results in a random subgroup of eight patients from the group by repeating their measurements before and after a dialysis session 15 weeks later. Biomarker concentrations after dialysis were adjusted according to hemodilution or concentration according to the hemoglobin concentration. The average hs-cTnT concentration decreased significantly by -9.9% after dialysis (95% CI: -13.6% to -6.2%). The average (paired) difference were - 6.7 ng/L ( p  = 0.0104) after dialysis comparing 25 HD treatment occasions. SuPAR was not significantly influenced by dialysis. B2M decreased by -58% after HD as an expected result from the molecular size of the biomarker. The hs-cTnT in average decreased by -9.9% after dialysis. This is a diagnostic challenge since the current guidelines suggest a 20% change in hs-cTnT in patients with acute myocardial infarction. Larger prospective studies investigating the different factors influencing hs-cTnT after HD are warranted. Adjusting biomarker concentrations according to hemodilution or concentration using the hemoglobin concentration, should be considered in future studies to determine more exact changes in concentrations of cTnT and other relevant biomarkers.

The prevalence and disease burden of chronic inflammatory diseases (CIDs) are predicted to rise. Patients are commonly treated with biological agents, but the individual treatment responses vary, warranting further research into optimizing treatment strategies. This study aimed to compare the clinical treatment responses in patients with CIDs initiating biologic therapy based on smoking status, a notorious risk factor in CIDs. In this multicentre cohort study including 233 patients with a diagnosis of Crohn's disease, ulcerative colitis, rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis or psoriasis initiating biologic therapy, we compared treatment response rates after 14 to 16 weeks and secondary outcomes between smokers and non-smokers. We evaluated the contrast between groups using logistic regression models: (i) a "crude" model, only adjusted for the CID type, and (ii) an adjusted model (including sex and age). Among the 205 patients eligible for this study, 53 (26%) were smokers. The treatment response rate among smokers (n = 23 [43%]) was lower compared to the non-smoking CID population (n = 92 [61%]), corresponding to a "crude" OR of 0.51 (95% CI: [0.26;1.01]) while adjusting for sex and age resulted in consistent findings: 0.51 [0.26;1.02]. The contrast was apparently most prominent among the 38 RA patients, with significantly lower treatment response rates for smokers in both the "crude" and adjusted models (adjusted OR 0.13, [0.02;0.81]). Despite a significant risk of residual confounding, patients with CIDs (rheumatoid arthritis in particular) should be informed that smoking probably lowers the odds of responding sufficiently to biological therapy. Registration: Clinical.Trials.gov NCT03173144., (© 2024 The Author(s). Scandinavian Journal of Immunology published by John Wiley & Sons Ltd on behalf of The Scandinavian Foundation for Immunology.)

Objective: The American Academy of Pediatrics recommends that pediatric practices help families make lifestyle changes to improve BMI, but provider time and access to treatment are limited. This study compared the effectiveness of two pediatric practice-based referral interventions in reducing BMI., Methods: In this cluster-randomized clinical trial, 20 pediatric primary care practices were randomized to telephonic coaching (Fitline Coaching) or mailed workbook (Fitline Workbook). Parents and their 8- to 12-year-old children with BMI ≥ 85th percentile completed assessments at baseline and at 6 and 12 months post baseline. Primary outcomes were 12-month BMI percentile and z score., Results: A total of 501 children and their parents received Fitline Coaching (n = 243) or Fitline Workbook (n = 258); 26.8% had overweight, 55.4% had obesity, and 17.8% had severe obesity. Mean (SD) age was 10.5 (1.4), and 47.5% were female. BMI percentile improved in both groups; 12-month decline in continuous BMI z score was not statistically significant in either group. However, 20.8% of telephonic coaching participants and 12.4% of workbook participants achieved a clinically significant reduction of at least 0.25 in BMI z score, a significant between-group difference (p = 0.0415)., Conclusions: Both low-intensity interventions were acceptable and produced modest improvements in BMI percentile. One in five children in the telephonic coaching condition achieved clinically meaningful BMI z score improvements. However, more research is needed before such a program could be recommended for pediatric primary care practice., (© 2024 The Obesity Society.)

Camilla Rye,1,2 Katrine Hass Rubin,2 Frederik Trier Moller,3,4 Mette Julsgaard,5 Tine Jess,6 Vibeke Andersen1,2,7 1Research Unit for Molecular Diagnostics and Clinical Research, Institute for Regional Health Research-Center of Southern Jutland, University Hospital of Southern Denmark, Aabenraa, Denmark; 2OPEN - Open Patient Data Explorative Network, Department of Clinical Research, University of Southern Denmark and Odense University Hospital, Odense, Denmark; 3Department of Epidemiological Research, Statens Serum Institute, Copenhagen, Denmark; 4Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institute, Copenhagen, Denmark; 5Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark; 6Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; 7Institute of Molecular Medicine, University of Southern Denmark, Odense, DenmarkCorrespondence: Vibeke AndersenResearch Unit for Molecular Diagnostics and Clinical Research, University Hospital of Southern Denmark, Kresten Philipsens Vej 15, Aabenraa, DK-6200, DenmarkTel +45-21157790Email va@rsyd.dkPurpose: Inflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are chronic diseases. The aim was to validate diagnoses of IBD among patients aged 50+ years in the Danish National Patient Registry (NPR) by comparison with patient medical records.Patients and Methods: Men and women in the Diet, Cancer and Health (DCH) cohort were linked to NPR, and cases with a diagnosis of IBD and their respective hospital records were identified. Validation was performed by comparing patient medical records with information on discharge diagnoses of IBD from the NPR.Results: Of 57,053 individuals in the DCH-cohort, 339 were registered with an IBD diagnosis in NPR, with 277 (82%) records available for review. Among 277 patients, the positive predictive values (PPVs) of one CD or UC registration in NPR were 78% for IBD overall, 51% for CD and 54% for UC. One hundred fifty-seven patients had at least two CD and/or UC registrations with PPVs of 90% for IBD overall, 65% for CD and 73% for UC. One hundred and two patients had at least three registrations with PPVs of 97% for IBD overall, 75% for CD and 88% for UC. 96% were diagnosed at a specialized department. Other diagnoses coded as IBD mostly included microscopic colitis, irritable bowel syndrome and cancer.Conclusion: Validity of IBD diagnoses in the registry of individuals aged 50+ years increased with the number of registrations. It is recommended that these results are taken into consideration in future studies, especially in epidemiology research using NPR as a data source for patients diagnosed with IBD.Keywords: inflammatory bowel disease, Danish National Patient Registry, register study, diagnostic accuracy, diagnosis

Vibeke Andersen,1– 3 Andreas Kristian Pedersen,1 Sören Möller,4 Anders Green4 1Focused Research Unit for Molecular Diagnostic and Clinical Research, University Hospital of Southern Denmark, Åbenrå, Denmark; 2Institute of Regional Research (IRS-Center Sonderjylland), University of Southern Denmark, Odense, Denmark; 3Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark; 4Open Patient Data Explorative Network (OPEN), Department of Clinical Research, Odense University Hospital and University of Southern Denmark, Odense, DenmarkCorrespondence: Vibeke AndersenFocused Research Unit for Molecular Diagnostic and Clinical Research, University Hospital of Southern Denmark, Aabenraa, Kresten Philipsens Vej 15, Åbenrå DK-6200, DenmarkEmail va@rsyd.dkBackground: Chronic inflammatory diseases (CIDs) may share aetiological factors across diseases. We used registry data to evaluate the risk of developing five common childhood CIDs dependent on the parents’ disease status.Methods: We performed a national population-based registry study by linking data from the national Danish health registers from January 1973 to March 2016 to evaluate any potential associations between parents’ disease and development of CIDs among the offspring. Results were adjusted for parental age at birth, the decade of birth, gender of the child, and type of birth. A cohort of 2,699,449 liveborn children was established for investigating the primary outcome measures: diabetes mellitus (DM), rheumatoid arthritis (RA), coeliac disease, Crohn’s disease (CD), and ulcerative colitis (UC) and all diseases combined (CID).Results: Children with one CID affected parent (Hazard ratio (HR), 95% confidence interval (95% CI)=1.75 (1.72– 1.79, p< 0.001)), one multiple CID affected parent (HR=2.23 (2.11– 2.34), p< 0.001), and both parents affected (HR=3.10 (2.98– 3.22), p< 0.001) were at higher risk than children without CID affected parents. Children with DM, RA, and COE affected parents were at increased risk of three specific diseases (DM, RA and COE), whereas children with CD and UC affected parents were at increased risk of two specific diseases (CD and UC).Conclusion: Children with CID affected parents were at increased risk of the same CID as their parents as well as other specific CIDs dependent on the parents’ CID. Future studies should address the aetiology underlying these findings to support the development of new strategies for prevention, treatment, and cure.Keywords: parents’ disease, population study, chronic inflammatory disease, inflammatory bowel diseases, rheumatoid arthritis, coeliac disease, diabetes mellitus

Abstract: Andersen, V, Paulsen, G, Stien, N, Baarholm, M, Seynnes, O, and Saeterbakken, AH. Resistance training with different velocity loss thresholds induce similar changes in strengh and hypertrophy. J Strength Cond Res 38(3): e135-e142, 2024-The aim of this study was to compare the effects of 2 velocity-based resistance training programs when performing resistance training with matched training volume. Ten resistance-trained adults volunteered (age, 23 ± 4.3 years; body mass, 68 ± 8.9 kg; and height, 171 ± 8 cm) with a mean resistance training experience of 4.5 years. A within person, between leg design was used. For each subject, the legs were randomly assigned to either low velocity loss (LVL) threshold at 15% or high velocity loss (HVL) threshold at 30% velocity loss. Leg press and leg extension were trained unilaterally twice per week over a period of 9 weeks. Before and after the intervention, both legs were tested in 1 repetition maximum (RM) (kg), maximal voluntary contraction (MVC) (N), rate of force development (N·s -1 ), average velocity (m·s -1 ), and power output (W) at 30, 45, 60, and 75% of 1 RM (all in unilateral leg press). Furthermore, muscle thickness (mm) of the vastus lateralis and rectus femoris, pennation angle (°) of the vastus lateralis, and the fascicle length (mm) of the vastus lateralis were measured using ultrasound imaging. The data were analyzed using mixed-design analysis of variance. No differences between the legs in any of the variables were found; however, both low and HVL were effective for increasing 1 RM (ES = 1.25-1.82), MVC (effect size [ES] = 0.42-0.64), power output (ES = 0.31-0.86), and muscle thickness (ES = 0.24-0.51). In conclusion, performing velocity-based resistance training with low and HVL with equal training volume resulted in similar effects in maximal and explosive strength in addition to muscular adaptations., (Copyright © 2021 National Strength and Conditioning Association.)

Vibeke Andersen, 1–3 Sören Möller, 4 Peter Bjødstrup Jensen, 4 Frederik Trier Møller, 5, 6 Anders Green 4 1Focused Research Unit for Molecular Diagnostic and Clinical Research (MOK), Hospital of Southern Jutland, Åbenrå DK-6200, Denmark; 2Institute of Regional Research (IRS-Center Sonderjylland), University of Southern Denmark, Odense C DK-5000, Denmark; 3Institute of Molecular Medicine, University of Southern Denmark, Odense C DK-5000, Denmark; 4Open Patient data Explorative Network (OPEN), Department of Clinical Research, Odense University Hospital and University of Southern Denmark, Odense C DK-5000, Denmark; 5Department of Epidemiology Research, Statens Serum Institute, Copenhagen DK-2300, Denmark; 6Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institute, Copenhagen DK-2300, DenmarkCorrespondence: Vibeke Andersen Email va@rsyd.dkBackground: Chronic inflammatory diseases in childhood and early adult life share aetiological factors operating from birth and onwards. In this study, we use data from the national Danish health registers to evaluate the risk of developing four common, immune-mediated hospital-diagnosed childhood chronic inflammatory diseases.Methods: A national population-based registry study. Data from the Danish Medical Birth Registry and the Danish National Patient Registry from January 1973 to March 2016 were linked at a personal level to evaluate any potential associations between caesarean section and development of Inflammatory bowel diseases, rheumatoid arthritis, coeliac disease and diabetes mellitus among the offspring. A model adjusted for parental age at birth, decade of birth, gender of child, and parents’ chronic inflammatory disease status was used.Results: This register-based national cohort study of 2672708 children with information on delivery mode found an increased risk of diabetes, arthritis, coeliac disease, and inflammatory bowel disease for both girls and boys after caesarean section compared with vaginal delivery. The higher risk was present at least 40 years after delivery. In a subgroup analysis, both acute and elective caesarean section was associated with an increased risk of developing a chronic inflammatory disease.Conclusions: Being born by caesarean section leads to increased host susceptibility for chronic inflammatory diseases that last for decades. This finding should be further addressed in future studies with the aim to support the development of new strategies for prevention, treatment, and maybe even cure.Keywords: caesarean delivery, population study, vaginal birth, chronic inflammatory disease, inflammatory bowel diseases, rheumatoid arthritis, coeliac disease

Introduction: The absence of reliable prognostic markers poses a challenge to the management of inflammatory bowel disease (IBD). Patients with aggressive disease may not receive sufficient treatment with conventional 'step-up' therapy, whereas a top-down approach may expose patients with indolent disease to unnecessary treatment-related toxicity. The objective of the Nordic IBD treatment strategy trial (NORDTREAT) is to assess the feasibility of personalised therapy by stratifying patients according to a prognostic serum protein signature at diagnosis., Methods and Analysis: NORDTREAT is a multicentre, biomarker-strategy design, open-label controlled trial. After screening consent, eligible patients are randomised (1:1) into one of two groups: a group with access to the protein signature and a group without access. In the access to protein signature group, patients displaying a protein signature suggestive of an increased risk of an aggressive disease course will be treated in line with a top-down treatment algorithm (anti-tumour necrosis factor agent with/without an immunomodulator). In contrast, those with a protein signature indicative of indolent disease will be excluded from the trial. Patients not in the access group receive treatment based on clinical management. This traditional management involves a stepwise escalation of treatment as determined by the investigator after failure of first-line treatment. After 52 weeks, outcomes are assessed in the subgroup of patients with a protein profile indicating a potentially severe disease trajectory. The primary endpoint is a composite of the proportion of patients with corticosteroid-free clinical and endoscopic remission at week 52. Surgical intervention due to IBD during follow-up will be defined as treatment failure., Ethics and Dissemination: Ethical approval has been obtained, and recruitment is underway at sites in four participating Nordic countries (Denmark, Iceland, Norway and Sweden). Following trial completion and data analysis, the trial results will be submitted for publication in peer-reviewed journals and presented at international conferences., Trial Registration Number: NCT05180175; Pre-results. EudraCT number: 2019-002942-19., Competing Interests: Competing interests: MR has served as a speaker or advisory board member for Jansen and Abbvie. MH has received investigator-initiated research grants from Takeda, Pfizer, Tillotts, Ferring and Janssen and has served as a speaker or advisory board member for Takeda, Tillotts, Ferring, Janssen, Pfizer, Galapagos, MSD, Lilly, Celltrion and AbbVie. JH has served as a speaker or advisory board member for AbbVie, Aqilion, BMS, Celgene, Celltrion, Dr. Falk Pharma and the Falk Foundation, Ferring, Galapagos, Gilead, Hospira, Index Pharma, Janssen, MEDA, Medivir, Merck, MSD, Olink Proteomics, Novartis, Pfizer, Prometheus Laboratories Inc., Sandoz, Shire, Takeda, Thermo Fisher Scientific, Tillotts Pharma, Vifor Pharma and UCB and received grant support from Janssen, MSD and Takeda. JDF, LGD, AF, JDS, RC, VA, DR and JK: none., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

This study evaluated the effects of a five-week period of practicing specific climbing movements using a system wall on motor skills and bouldering performance compared to self-regulated, conventional bouldering. Thirteen advanced female boulderers (age: 24.5 ± 3.6 years, height: 166.9 ± 3.4 cm, and body mass: 63.4 ± 8.0 kg) were divided into an experimental group ( n  = 7) and a control group ( n  = 6). Both groups continued their normal training routines during the intervention, but the experimental group dedicated 30 minutes of their climbing time twice per week to practicing specific motor skills on a system climbing wall. Before and after the intervention, the participants attempted two boulder problems on the same wall. The performance was registered as the number of attempts to complete the boulder problems and as the highest hold reached within four attempts. Video recordings of climbers' best attempts, capturing the highest hold reached from a perspective directly behind them, were analyzed by three independent experts. The analysis was conducted using a five-point scale across six categories of movement quality. Modest enhancements in certain motor skills and performance were evident in both groups, revealing no significant distinction between them. The results underscore the efficacy of incorporating system walls into the training routines of advanced female boulder climbers, but the absence of between-group differences highlights the significance of individual preferences when choosing between conventional and system wall bouldering., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2024 Nicolay Stien et al.)

Recent research has elucidated the effects of strength training on climbing performance. Although local muscular endurance training of the upper-limbs and finger flexors is frequently suggested, there is currently insufficient evidence to support its impact on climbing performance and climbing-specific strength. Furthermore, there is no evidence on climbers' experiences related to training and the likelihood of consistent engagement. In addition, the effects of more climbing-specific strength training on walls with built in lights and adjustable angles have yet to be examined. The low percentage of studies involving female subjects, additionally, demonstrates a significant gap in understanding the specific effects of strength training on women in the context of climbing. The aim of this study was thus to assess the effects of five-week on-, and off-the-wall climbing training on climbing performance, climbing-specific strength, and training experience. Thirty-one female lower-grade to advanced climbers were randomly assigned to either a control group, an off-the-wall training or an on-the-wall training group. Apart from the training regimen, all groups followed their usual climbing and bouldering routine. Subjects trained at least twice a week. Bouldering performance, and maximum strength and muscular endurance of the finger flexors and upper-limbs were assessed before and after the intervention. Furthermore, rate of perceived exertion and discomfort, exercise enjoyment, and exercise pleasure were assessed during the first and last training session, as well as after two and a half weeks of training. Intrinsic training motivation was assessed after the last training session. The results showed trends towards positive effects of off-the-wall training on climbing-specific strength, and on-the-wall training on climbing technique. Furthermore, our finding revealed high exercise enjoyment and intrinsic training motivation for both on- and off-the-wall training. Hence, lower-grade to advanced female climbers should rely on personal training preferences., Competing Interests: There were no professional relationships with companies or manufacturers that will benefit from the results of this study. There was no specific financial support for the preparation of this study. The authors have no potential conflicts of interest that are directly related to the study and the journal., (Copyright: © 2024 Langer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The objective of this meta-epidemiological study was to explore the impact of attrition rates on treatment effect estimates in randomised trials of chronic inflammatory diseases (CID) treated with biological and targeted synthetic disease-modifying drugs. We sampled trials from Cochrane reviews. Attrition rates and primary endpoint results were retrieved from trial publications; Odds ratios (ORs) were calculated from the odds of withdrawing in the experimental intervention compared to the control comparison groups (i.e., differential attrition), as well as the odds of achieving a clinical response (i.e., the trial outcome). Trials were combined using random effects restricted maximum likelihood meta-regression models and associations between estimates of treatment effects and attrition rates were analysed. From 37 meta-analyses, 179 trials were included, and 163 were analysed (301 randomised comparisons; n = 62,220 patients). Overall, the odds of withdrawal were lower in the experimental compared to control groups (random effects summary OR = 0.45, 95% CI, 0.41-0.50). The corresponding overall treatment effects were large (random effects summary OR = 4.43, 95% CI 3.92-4.99) with considerable heterogeneity across interventions and clinical specialties (I 2  = 85.7%). The ORs estimating treatment effect showed larger treatment benefits when the differential attrition was more prominent with more attrition in the control group (OR = 0.73, 95% CI 0.55-0.96). Higher attrition rates from the control arm are associated with larger estimated benefits of treatments with biological or targeted synthetic disease-modifying drugs in CID trials; differential attrition may affect estimates of treatment benefit in randomised trials., (© 2024 The Authors. Research Synthesis Methods published by John Wiley & Sons Ltd.)

Background: The aim of the present study was to compare the effects of resistance training through full range of motion and static stretching (SS) of the hip and lower back extensors on flexibility and strength in healthy, physically active, adults., Methods: Eighteen participants (age: 24.2 ± 3.0 years, body mass: 71.3 ± 8.9 kg, height: 172.8 ± 7.5 cm) were randomly assigned to either a Resistance Training (RT) (n = 6), SS (n = 6), or control (CON) group (n = 6). The sit & reach (S&R) flexibility test and maximum isometric straight legged deadlift (ISLDL) at 95% and 50% range of motion (ROM) were tested pre- and post-intervention with significance set at p < 0.05. Both groups conducted four to eight sets per session. Within each set, the RT group performed eight repetitions each lasting four seconds, while the SS group stretched continuously for 32 s. The rest periods between each set were 60-90 s. Consequently training volume and rest times were matched between the groups., Results: The RT and SS groups achieved significant, large magnitude improvements in the S&R test compared to the CON group (p < 0.01 g = 2.53 and p = 0.01, g = 2.44), but no differences were observed between the RT and SS groups (p = 1.00). Furthermore, the RT group demonstrated a larger improvement in 50% and 95% ROM ISLDL compared to SS (p < 0.01, g = 2.69-3.36) and CON (p < 0.01, g = 2.44-2.57)., Conclusion: Resistance training through a full ROM was equally effective as SS for improving S&R flexibility, but improved hip- and lower back extensor strength more than SS and the CON. The authors recommend using large ROM resistance training to improve hip and lower back extensor flexibility and muscle strength., Trial Registration: ISRCTN88839251, registered 24. April 2024, Retrospectively registered., (© 2024. The Author(s).)

Background: Inflammatory bowel diseases (IBDs) are associated with high healthcare utilization. This systematic review aimed to summarize what is known about the impact of sex, income, and education on the likelihood of bowel surgery, hospitalization, and use of corticosteroids and biologics among patients with IBD., Methods: We used EMBASE, MEDLINE, CINAHL, and Web of Science to perform a systematic literature search. Pooled hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random effects meta-analysis for the impact of sex on the likelihood of surgery and hospitalization. In addition, we performed subgroup analyses of the effect of IBD type (Crohn's disease or ulcerative colitis) and age. Finally, meta-regression was undertaken for the year of publication., Results: In total, 67 studies were included, of which 23 studies were eligible for meta-analysis. In the main meta-analysis, male sex was associated with an increased likelihood of bowel surgery (HR 1.42 (95% CI 1.13;1.78), which was consistent with the subgroup analysis for UC only (HR 1.78, 95% CI 1.16; 2.72). Sex did not impact the likelihood of hospitalization (OR 1.05 (95% CI 0.86;1.30), although the subgroup analysis revealed an increased likelihood of hospitalization in CD patients (OR 1.42, 95% CI 1.28;1.58). In 9 of 10 studies, no significant sex-based differences in the use of biologics were reported, although in 6 of 6 studies, female patients had lower adherence to biologics. In 11 of 13 studies, no significant sex-based difference in the use of corticosteroids was reported. The evidence of the impact of income and education on healthcare utilization was sparse and pointed in different directions. The substantial heterogeneity between studies was explained, in part, by differences in IBD type and age., Conclusions: The results of this systematic review indicate that male patients with IBD are significantly more likely to have surgery than female patients with IBD but are not, overall, more likely to be hospitalized, whereas female patients appear to have statistically significantly lower adherence to biologics compared to male patients. Thus, clinicians should not underestimate the impact of sex on healthcare utilization. Evidence for income- and education-based differences remains sparse., Systematic Review Registration: PROSPERO CRD42022315788., (© 2024. The Author(s).)