Publication date: August 2018
Source:Journal of Environmental Radioactivity, Volume 188
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Δευτέρα 19 Μαρτίου 2018
Editorial Board
Enrichment of naturally occurring radionuclides and trace elements in Yatagan and Yenikoy coal-fired thermal power plants, Turkey
Source:Journal of Environmental Radioactivity, Volume 188
Author(s): Banu Ozden, Erkan Guler, Taavi Vaasma, Maria Horvath, Madis Kiisk, Tibor Kovacs
Coal, residues and waste produced by the combustion of the coal contain naturally occurring radionuclides such as 238U, 226Ra, 210Pb, 232Th and 40K and trace elements such as Cd, Cr, Pb, Ni and Zn. In this work, coal and its combustion residues collected from Yatagan and Yenikoy coal fired thermal power plants (CPPs) in Turkey were studied to determine the concentrations of natural radionuclides and trace elements, and their enrichments factors to better understand the radionuclide concentration processes within the combustion system. In addition, the utilization of coal fly ash as a secondary raw material in building industry was also studied in terms of radiological aspects. Fly ash samples were taken at different stages along the emission control system of the thermal power plants. Activity concentrations of naturally occurring radionuclides were determined with Canberra Broad Energy Germanium (BEGe) detector BE3830-P and ORTEC Soloist PIPS type semiconductor detector. The particle size distribution and trace elements contents were determined in various ash fractions by the laser scattering particle size distribution analyzer and inductively coupled plasma (ICP-OES). From the obtained data, natural radionuclides tend to condense on fly ash with and the activity concentrations increase as the temperature drop in CPPs. Measured 210Pb and 210Po concentration varied between 186 ± 20–1153 ± 44 Bq kg−1, and 56 ± 5–1174 ± 45 Bq kg−1, respectively. The highest 210Pb and 210Po activity concentrations were determined in fly ash taken from the temporary storage point as 1153 ± 44 Bq kg−1 and 1174 ± 45 Bq kg−1, respectively. There were significant differences in the activity concentrations of some natural radionuclide and trace elements (Pb and Zn) contents in ash fractions among the sampling point inside both of the plants (ANOVA, p < 0.001). Coal and ash sample analysis showed an increase activity concentration and enrichment factors towards the electrostatic precipitators for both of the power plants. The enrichment factors for Zn follow a similar trend as Pb, increasing in value towards the end of the emission control system. The calculated activity indexes were above 1.0 value for both of the power plants, assuming the utilization of fly ash at 100%. It can be concluded that the reuse of fly ash as a secondary raw material may not be hazardous depending on the percentage of utilization of ash.
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Assessment of dose rate to terrestrial biota in the area around coal fired power plant applying ERICA tool and RESRAD BIOTA code
Publication date: August 2018
Source:Journal of Environmental Radioactivity, Volume 188
Author(s): Mirjana Ćujić, Snežana Dragović
This paper presents the environmental radiation risk assessment based on two software program approaches ERICA Tool (version 1.2) and RESRAD BIOTA (version 1.5) to estimate dose rates to terrestrial biota in the area around the largest coal fired power plant in Serbia. For dose rate assessment software's default reference animals and plants and the best estimated values of activity concentrations of 238U, 234U, 234Th, 232Th, 230Th, 226Ra, 210Pb, 210Po, 137Cs in soil were used. Both approaches revealed the highest contribution to the internal dose rate due to 226Ra and 210Po, while 137Cs contributed the most to the external dose rate. In the investigated area total dose rate to biota derived using ERICA Tool ranged from 0.3 to 14.4 μGy h−1. The natural radionuclides exhibited significantly higher contribution to the total dose rate than the artificial one. In the investigated area, only dose rate for lichens and bryophytes exceeded ERICA Tool screening value of total dose rate of 10 μGy h−1 suggested as confident that environmental risks are negligible. The assessed total dose rates for reference animals and plants using RESRAD BIOTA were found to be 7 and 3 μGy h−1, respectively. In RESRAD BIOTA - Level 3, 10 species (Lumbricus terrestris, Rana lessonae, Sciurus vulgaris, Anas platyrhynchos, Lepus europaeus, Vulpes vulpes, Capreolus capreolus, Suss crofa, Quercu srobur, Tilia spp.) representative for the study area were modeled. Among them the highest total dose rate (4.5 μGy h−1) was obtained for large mammals. Differences in the predicted dose rates to biota using the two software programs are the consequence of the difference in the values of transfer parameters used to calculate activity concentrations in biota. Doses of ionizing radiation estimated in this study will not exhibit deterministic effects at the population level. Thus, the obtained results indicate no significant radiation impact of coal fired power plant operation on terrestrial biota. This paper confirms the use ERICA Tool and RESRAD BIOTA softwares as flexible and effective means of radiation impact assessment.
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Programmable Single and Multiplex Base-Editing in Bombyx mori Using RNA-Guided Cytidine Deaminases
Genome editing using standard tools (ZFN, TALEN, and CRISPR/Cas9) rely on double strand breaks to edit the genome. A series of new CRISPR tools that convert cytidine to thymine (C to T) without the requirement for DNA double-strand breaks was developed recently and quickly applied in a variety of organisms. Here, we demonstrate that CRISPR/Cas9-dependent base editor (BE3) converts C to T with a high frequency in the invertebrate Bombyx mori silkworm. Using BE3 as a knock-out tool, we inactivated exogenous and endogenous genes through base-editing-induced nonsense mutations with an efficiency of up to 66.2%. Furthermore, genome-scale analysis showed that 96.5% of B. mori genes have one or more targetable sites that can be edited by BE3 for inactivation, with a median of 11 sites per gene. The editing window of BE3 reached up to 13 bases (from C1 to C13 in the range of gRNA) in B. mori. Notably, up to 14 bases were substituted simultaneously in a single DNA molecule, with a low indel frequency of 0.6%, when 32 gRNAs were co-transfected. Collectively, our data show for the first time that RNA-guided cytidine deaminases are capable of programmable single and multiplex base editing in an invertebrate model.
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Pain: A Neglected Problem in the Low-Resource Setting
Approximately 80% of the world's population lives in countries with little or no access to pain management. These countries also have 74% of the world's deaths from cancer and human immunodeficiency virus. Appropriate use of oral opioids can control 80%–90% of cancer pain. However, only 6.7% of the world's medical opioids are available in these low-resource countries. With the Lancet Commission on Global Surgery calling for a significant expansion of surgical services, postoperative pain management will need to be an increasing focus of our attention. There are multiple barriers to providing effective pain management. These include the type and funding of the health care system, the size and educational level of the workforce, the ease of access to effective medications, and the expectations and knowledge base of the community. Some barriers can be addressed by education at the undergraduate level, postgraduate level, and community level. Others will require continued advocacy at government level. Only when we tackle these problems will the considerable neglect of access to effective pain treatment in low- and middle-income countries be lessened.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/2HNnSBm
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Strengthening the Anesthesia Workforce in Low- and Middle-Income Countries
The majority of the world's population lacks access to safe, timely, and affordable surgical care. Although there is a health workforce crisis across the board in the poorest countries in the world, anesthesia is disproportionally affected. This article explores some of the key issues that must be tackled to strengthen the anesthesia workforce in low- and lower-middle-income countries. First, we need to increase the overall number of safe anesthesia providers to match a huge burden of disease, particularly in the poorest countries in the world and in remote and rural areas. Through using a task-sharing model, an increase is required in both nonphysician anesthesia providers and anesthesia specialists. Second, there is a need to improve and support the competency of anesthesia providers overall. It is important to include a broad base of knowledge, skills, and attitudes required to manage complex and high-risk patients and to lead improvements in the quality of care. Third, there needs to be a concerted effort to encourage interprofessional skills and the aspects of working and learning together with colleagues in a complex surgical ecosystem. Finally, there has to be a focus on developing a workforce that is resilient to burnout and the challenges of an overwhelming clinical burden and very restricted resources. This is essential for anesthesia providers to stay healthy and effective and necessary to reduce the inevitable loss of human resources through migration and cessation of professional practice. It is vital to realize that all of these issues need to be tackled simultaneously, and none neglected, if a sustainable and scalable solution is to be achieved.
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Safe Surgery Globally by 2030: The Essential Role of Anesthesia, The View From Obstetrics
No abstract available
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Safe Surgery Globally by 2030: The View From Anesthesia
No abstract available
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Global Access to Safe Anesthesia: Addressing the Gap
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Management of Incidental Lung Nodules
Publication date: Available online 7 March 2018
Source:Radiologic Clinics of North America
Author(s): Jeffrey B. Alpert, Jane P. Ko
Teaser
Incidentally detected lung nodules are increasingly common in routine diagnostic computed tomography (CT) imaging. Formal management recommendations for incidental nodules, such as those outlined by the Fleischner Society, must therefore reflect a balance of malignancy risk and the clinical context in which nodules are discovered. Nodule size, attenuation, morphology, and location all influence the likelihood of malignancy and, thus, the necessity and timing of follow-up according to current Fleischner recommendations. As technological advancements in CT imaging continue, there may be greater reliance on advanced computerized analysis of lung nodule features to help determine the risk of clinically significant disease.from Radiology via xlomafota13 on Inoreader http://ift.tt/2u2Ep25
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Lung Cancer Biopsies
Publication date: Available online 7 March 2018
Source:Radiologic Clinics of North America
Author(s): Amita Sharma, Jo-Anne O. Shepard
Teaser
Image-guided percutaneous transthoracic needle biopsy (PTNB) is a well-established and minimally invasive technique for evaluating pulmonary nodules. Implementation of a national lung screening program and increased use of chest computed tomography have contributed to the frequent identification of indeterminate pulmonary nodules that may require tissue sampling. The advent of biomarker-driven lung cancer therapy has led to increased use of repeat PTNB after diagnosis. Percutaneous insertion of markers for preoperative localization of small nodules can aid in minimally invasive surgery and radiation treatment planning. This article discusses PTNB, patient selection, and biopsy technique, including minimizing and managing complications.from Radiology via xlomafota13 on Inoreader http://ift.tt/2FLJ3XH
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Missed Lung Cancer
Publication date: Available online 7 March 2018
Source:Radiologic Clinics of North America
Author(s): Rydhwana Hossain, Carol C. Wu, Patricia M. de Groot, Brett W. Carter, Matthew D. Gilman, Gerald F. Abbott
Teaser
The chest radiograph is one of the most commonly used imaging studies and is the modality of choice for initial evaluation of many common clinical scenarios. Over the last two decades, chest computed tomography has been increasingly used for a wide variety of indications, including respiratory illnesses, trauma, oncologic staging, and more recently lung cancer screening. Diagnostic radiologists should be familiar with the common causes of missed lung cancers on imaging studies in order to avoid detection and interpretation errors. Failure to detect these lesions can potentially have serious implications for both patients as well as the interpreting radiologist.from Radiology via xlomafota13 on Inoreader http://ift.tt/2u3kTT9
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MR Imaging of the Prostate
Publication date: March 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 2
Author(s): Aytekin Oto
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Staging Lung Cancer
Publication date: Available online 7 March 2018
Source:Radiologic Clinics of North America
Author(s): Girish S. Shroff, Chitra Viswanathan, Brett W. Carter, Marcelo F. Benveniste, Mylene T. Truong, Bradley S. Sabloff
Teaser
The updated eighth edition of the tumor, node, metastasis (TNM) classification for lung cancer includes revisions to T and M descriptors. In terms of the M descriptor, the classification of intrathoracic metastatic disease as M1a is unchanged from TNM-7. Extrathoracic metastatic disease, which was classified as M1b in TNM-7, is now subdivided into M1b (single metastasis, single organ) and M1c (multiple metastases in one or multiple organs) descriptors. In this article, the rationale for changes in the M descriptors, the utility of preoperative staging with PET/computed tomography, and the treatment options available for patients with oligometastatic disease are discussed.from Radiology via xlomafota13 on Inoreader http://ift.tt/2FPKRPx
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Contributors
Publication date: March 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 2
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CME Accreditation Page
Publication date: March 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 2
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Forthcoming Issues
Publication date: March 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 2
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REBOA bei der Körperstammblutung – die Bedeutung für den Anästhesisten
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 168-169
DOI: 10.1055/a-0577-0573
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
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Atemwegsmanagement – der schwierige Atemweg beim thoraxchirurgischen Patienten
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 187-197
DOI: 10.1055/s-0043-114679
Das Management des schwierigen Atemwegs bei thoraxchirurgischen Patienten ist in den gültigen Leitlinien kaum abgebildet und stellt insbesondere in der Thoraxanästhesie mit der notwendigen Seitentrennung der Atemwege durch einen Doppellumentubus oder Bronchusblocker eine Herausforderung dar. Die Definition des schwierigen Atemwegs mit erschwerter Maskenbeatmung, Laryngoskopie oder endotrachealer Intubation wird überwiegend durch Veränderungen der Anatomie der oberen Atemwege (schwieriger oberer Atemweg) charakterisiert. Pathologische Veränderungen in der tracheobronchialen Anatomie, die die Platzierung des Doppellumentubus oder anderer Atemwegshilfen erschweren (schwieriger unterer Atemweg; schwierige Seitentrennung), sind in die Definition miteinzubeziehen. Der vorliegende Artikel beschreibt die Identifikation von Risikopatienten, Techniken, Empfehlungen und Algorithmen für das Management bei erwartet und unerwartet schwierigem Atemweg. Darüber hinaus gibt er einen Überblick über die Auswahl verschiedener Verfahren und Hilfsmittel zur Seitentrennung der Lungen zur Etablierung einer Ein-Lungen-Ventilation.
[...]
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Intraoperatives Ketamin verhindert weder Delir, noch reduziert es postoperativen Schmerz
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 165-165
DOI: 10.1055/a-0577-0303
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
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Atemwegsmanagement in der Thoraxanästhesie
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 171-172
DOI: 10.1055/a-0577-4101
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
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Überwachung des Analgesieniveaus unter Allgemeinanästhesie
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 166-167
DOI: 10.1055/a-0577-0557
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
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Gastrointestinale Anastomoseninsuffizienz: operatives vs. konservatives Vorgehen
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 212-219
DOI: 10.1055/s-0042-120994
Eine Anastomoseninsuffizienz ist nach Resektionen und Rekonstruktionen im Gastrointestinaltrakt eine häufige Komplikation – ihre Folgen sind eine Verlängerung des stationären Aufenthaltes, eine schlechtere Prognose und eine erhöhte Letalität der betroffenen Patienten 1, 2. Der folgende Beitrag beleuchtet konservative und operative Therapieoptionen der Anastomoseninsuffizienz und zeigt Strategien zu ihrer Vermeidung und Früherkennung auf.
[...]
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Atemwegsmanagement in der Thoraxanästhesie mit dem Doppellumentubus
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 174-185
DOI: 10.1055/s-0043-114678
Die Seitentrennung der Lungen mit konsekutiver Ein-Lungen-Ventilation ist der zentrale Bestandteil des Atemwegsmanagements in der Thoraxanästhesie. Das Indikationsspektrum umfasst dabei die thoraxchirurgischen und prozedurbezogenen Notwendigkeiten wie auch die patientenspezifischen Faktoren. Von der Vielzahl der technischen Möglichkeiten der Separation der Lungenflügel bleiben routinemäßig nur die Anwendung des Doppellumentubus oder des Bronchusblockers übrig. Die ausgewiesene Kenntnis der tracheobronchialen Anatomie bis zur Segmentebene durch den Anästhesisten ist ebenso notwendig wie der standardmäßige Einsatz einer flexiblen Fiberoptik. Diese Arbeit gibt grundlegende Empfehlungen für die klinische Routine, stellt eine Übersicht zum derzeitigen Stellenwert im Atemwegsmanagement in der Thoraxanästhesie mit dem Doppellumentubus dar und berücksichtigt kontroverse Diskussionen zu Größe und Design.
[...]
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Infektionen durch Mycobacterium chimaera nach kardiochirurgischen Eingriffen
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 168-168
DOI: 10.1055/a-0577-0619
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
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Atemwegsmanagement in der Thoraxanästhesie mit dem Bronchusblocker
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 198-210
DOI: 10.1055/s-0043-114677
Bronchusblocker stellen für die Ein-Lungen-Ventilation eine Alternative zum Doppellumentubus dar – bei spezifischen Patientengruppen können sie sogar die einzige Option für die Lungenisolation sein. In diesem Beitrag werden Indikationen für Bronchusblocker gezeigt und die verfügbaren Modelle mit praktischen Hinweisen vorgestellt. Im Anschluss wird die klinische Anwendbarkeit der Bronchusblocker mit der des Doppellumentubus verglichen.
[...]
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Ungewöhnlicher Fall eines schweren Polytraumas beim Kleinkind – Happy End trotz Fallstricken
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 220-223
DOI: 10.1055/s-0043-109008
Ein 16 Monate alter Junge erleidet bei einem Verkehrsunfall ein schwerstes Polytrauma (dislozierte offene Beckenfraktur, pelvines Décollement und hämorrhagischer Schock). Die dabei auftretenden Besonderheiten und Fallstricke in der präklinischen und frühen klinischen Versorgung dieses schweren und seltenen Traumas bei pädiatrischen Patienten werden herausgearbeitet, wobei besonders auf die damit einhergehenden medizinisch-einsatztaktischen Schwierigkeiten eingegangen wird.
[...]
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Weniger postoperative Komplikationen nach individuellem Blutdruckmanagement
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 165-166
DOI: 10.1055/a-0576-9925
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
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Betweenness Centrality of Intracranial Electroencephalography Networks and Surgical Epilepsy Outcome
Epilepsy is a neurological disorder in which patients suffer from recurrent seizures. Pharmacologically resistant epilepsy patients have been increasingly referred for surgical options, but despite many advances in non-invasive pre-operative localization modalities, the rate of seizure freedom after epilepsy surgery has been relatively stagnant at 60-70% after the first year, and decreasing with post-operative follow-up.(Spencer et al., 2008, Bulacio et al., 2012) The goal of surgery is to identify discrete parts of the brain that give rise to seizures (frequently with intracranial EEG - iEEG) and resect them.(Luders et al., 2001) Surgical failures are most frequently attributed to either incomplete resection of a seizure focus or missed identification of additional foci.(Englot et al., 2014a; Englot et al., 2014b)
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Targeting high frequency oscillations in epilepsy
Human brain oscillations organize across multiple temporal scales that can be measured directly with EEG. Once considered inessential epiphenomena, recent work has highlighted cortical oscillations as primary phenomena that cause and direct essential brain processes. Pioneering work has shown that brain rhythms can be augmented by external manipulation with direct cognitive impact. For example, auditory enhancement of slow wave oscillations during NREM sleep improves declarative memory (Ngo et al., 2013).
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SLIDING WINDOW AVERAGING IN NORMAL AND PATHOLOGICAL MOTOR UNIT ACTION POTENTIAL TRAINS
The analysis of motor unit action potential (MUAP) is one of the fundamental tests in routine clinical neurophysiology. Electromyography (EMG) signals are recorded intramuscularly with conventional concentric needle electrodes. These signals usually contain several MUAP trains. Manual, semi or completely automatic techniques (Nandedkar, 2002; Merletti and Parker, 2004) are used for decompose EMG signals into different MUAP trains. From each MUAP train a representative waveform is formed (Malanda et al., 2015) and characterized with clinically useful parameters (Stålberg et al., 1986; Zalewska and Hausmanowa-Petrusewicz, 1995; Nandedkar, 2002; Kimura, 2002).
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Qualitative postural control differences in Idiopathic Parkinson’s Disease vs. Progressive Supranuclear Palsy with dynamic-on-static platform tilt
Progressive Supranuclear Palsy (PSP) and Idiopathic Parkinson's disease (IPD) are frequent neurodegenerative disabling movement disorders with postural instability and falls in the disease course.
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Biomechanical comparative study on stability of injectable pedicle screw with 1 different lateral holes augmented with different volumes of polymethylmethacrylate in osteoporotic lumbar vertebrae
Polymethylmethacrylate (PMMA) is widely used for pedicle screw augmentation in osteoporosis. Until now, there had been no studies of the relationship between screw stability and the distribution and volume of PMMA.
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Predicting survival for metastatic spine disease: a comparison of nine scoring systems
Despite advances in spinal oncology, research into patient-based prognostic calculators for metastatic spine disease is lacking. Much of the literature in this area investigates the general predictive accuracy of scoring systems in heterogeneous populations, with few studies considering the accuracy of scoring systems based on patient specifics such as type of primary tumor.
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In-hospital complication rate following microendoscopic versus open lumbar laminectomy: a propensity score-matched analysis
The incidence of postoperative complications after microendoscopic laminectomy (MEL) has not been compared with that of open laminectomy in a large study, so it is not clear whether MEL is a safer procedure.
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Paramedic Part Time - Dodge Center Ambulance
General Duties: The City of Dodge Center is accepting applications for the position of part-time Paramedic with Dodge Center Ambulance. This position is responsible for emergency response, treatment and transport of the sick and injured and will assist with the day to day operations of the ambulance service to include cleaning, stocking, training and education, mentoring, and public outreach.
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In Response
No abstract available
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The Role of the WFSA in Reaching the Goals of the Lancet Commission on Global Surgery
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Safe Surgery Globally by 2030: The View From Anesthesia
No abstract available
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Higher Operating Table for Optimal Needle-Entry Angle and Less Discomfort During Spinal Anesthesia
The aim of this study was to find the optimal table height to facilitate insertion of the spinal needle at a 90° angle and to reduce the anesthesiologist's discomfort. Sixty patients were randomly allocated according to landmarks on the anesthesiologist's body: umbilicus (group U), lowest rib margin (R), xiphoid process (X), and nipple (N). The coronal insertion angle between the patient's skin and the spinal needle was obtuse in groups U and R, and 90° in group X. We demonstrated that high operating tables at the xiphoid and nipple level facilitate more optimal needle entry angles while reducing the discomfort and joint flexion of anesthesiologists during spinal anesthesia.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/2u1bpb9
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Safe Surgery Globally by 2030: The View From Surgery
No abstract available
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Oxytocin Study Raises Concerns About Carbetocin Use
No abstract available
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Safe Surgery Globally by 2030: The Essential Role of Anesthesia, The View From Obstetrics
No abstract available
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Improving Anesthesia Safety in Low-Resource Settings
The safety of anesthesia characteristic of high-income countries today is not matched in low-resource settings with poor infrastructure, shortages of anesthesia providers, essential drugs, equipment, and supplies. Health care is delivered through complex systems. Achieving sustainable widespread improvement globally will require an understanding of how to influence such systems. Health outcomes depend not only on a country's income, but also on how resources are allocated, and both vary substantially, between and within countries. Safety is particularly important in anesthesia because anesthesia is intrinsically hazardous and not intrinsically therapeutic. Nevertheless, other elements of the quality of health care, notably access, must also be considered. More generally, there are certain prerequisites within society for health, captured in the Jakarta declaration. It is necessary to have adequate infrastructure (notably for transport and primary health care) and hospitals capable of safely carrying out the "Bellwether Procedures" (cesarean delivery, laparotomy, and the treatment of compound fractures). Surgery, supported by safe anesthesia, is critical to the health of populations, but avoidable harm from health care (including very high mortality rates from anesthesia in many parts of the world) is a major global problem. Thus, surgical and anesthesia services must not only be provided, they must be safe. The global anesthesia workforce crisis is a major barrier to achieving this. Many anesthetics today are administered by nonphysicians with limited training and little access to supervision or support, often working in very challenging circumstances. Many organizations, notably the World Health Organization and the World Federation of Societies of Anaesthesiologists, are working to improve access to and safety of anesthesia and surgery around the world. Challenges include collaboration with local stakeholders, coordination of effort between agencies, and the need to influence national health policy makers to achieve sustainable improvement. It is conceivable that safe anesthesia and perioperative care could be provided for essential surgical services today by clinicians with moderate levels of training using relatively simple (but appropriately designed and maintained) equipment and a limited number of inexpensive generic medications. However, there is a minimum standard for these resources, below which reasonable safety cannot be assured. This minimum (at least) should be available to all. Not only more resources, but also more equitable distribution of existing resources is required. Thus, the starting point for global access to safe anesthesia is acceptance that access to health care in general should be a basic human right everywhere.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/2u2JFCT
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Error: Blood Pressure and Irmageddon
No abstract availablefrom Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/2GJOMdZ
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Impact of Anesthetic Regimen on Remote Ischemic Preconditioning in the Rat Heart In Vivo
Remote ischemic preconditioning (RIPC) seems to be a promising cardioprotective strategy with contradictive clinical data suggesting the anesthetic regimen influencing the favorable impact of RIPC. This study aimed to investigate whether cardio protection by RIPC is abolished by anesthetic regimens. Male Wistar rats were randomized to 6 groups. Anesthesia was either maintained by pentobarbital (Pento) alone or a combination of sevoflurane (Sevo) and remifentanil or propofol (Prop) and remifentanil in combination with and without RIPC. RIPC reduced infarct size in Pento- and Sevo-anesthetized rats (Pento-RIPC: 30% ± 9% versus Pento-control [Con]: 65% ± 6%, Pfrom Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/2u2ijN9
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A Value-Based Revolution Afoot
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ABC of Clinical Leadership, 2nd ed
No abstract available
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Propofol Anesthesia and Remote Ischemic Preconditioning: An Unfortunate Relationship
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In Response
No abstract available
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GIK: The Cure We Have Been Waiting For?
No abstract available
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Education: The Heart of the Matter
There are inadequate numbers of anesthesia providers in many parts of the world. Good quality educational programs are needed to increase provider numbers, train leaders and teachers, and increase knowledge and skills. In some countries, considerable external support may be required to develop self-sustaining programs. There are some key themes related to educational programs in low- and middle-income countries: (1) Programs must be appropriate for the local environment—there is no "one-size-fits-all" program. In some countries, nonuniversity programs may be appropriate for training providers. (2) It is essential to train local teachers—a number of short courses provide teacher training. Overseas attachments may also play an important role in developing leadership and teaching capacity. (3) Interactive teaching techniques, such as small-group discussions and simulation, have been incorporated into many educational programs. Computer learning and videoconferencing offer additional educational possibilities. (4) Subspecialty education in areas such as obstetric anesthesia, pediatric anesthesia, and pain management are needed to develop leadership and increase capacity in subspecialty areas of practice. Examples include short subspecialty courses and clinical fellowships. (5) Collaboration and coordination are vital. Anesthesiologists need to work with ministries of health and other organizations to develop plans that are matched to need. External organizations can play an important role. (6) Excellent education is required at all levels. Training guidelines could help to standardize and improve training. Resources should be available for research, as well as monitoring and evaluation of educational programs.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/2u01faT
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SmartTots: Quo Vadis?
No abstract available
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Global Surgery System Strengthening: It Is All About the Right Metrics
Progress in achieving "universal access to safe, affordable surgery, and anesthesia care when needed" is dependent on consensus not only about the key messages but also on what metrics should be used to set goals and measure progress. The Lancet Commission on Global Surgery not only achieved consensus on key messages but also recommended 6 key metrics to inform national surgical plans and monitor scale-up toward 2030. These metrics measure access to surgery, as well as its timeliness, safety, and affordability: (1) Two-hour access to the 3 Bellwether procedures (cesarean delivery, emergency laparotomy, and management of an open fracture); (2) Surgeon, Anesthetist, and Obstetrician workforce >20/100,000; (3) Surgical volume of 5000 procedures/100,000; (4) Reporting of perioperative mortality rate; and (5 and 6) Risk rates of catastrophic expenditure and impoverishment when requiring surgery. This article discusses the definition, validity, feasibility, relevance, and progress with each of these metrics. The authors share their experience of introducing the metrics in the Pacific and sub-Saharan Africa. We identify appropriate messages for each potential stakeholder—the patients, practitioners, providers (health services and hospitals), public (community), politicians, policymakers, and payers. We discuss progress toward the metrics being included in core indicator lists by the World Health Organization and the World Bank and how they have been, or may be, used to inform National Surgical Plans in low- and middle-income countries to scale-up the delivery of safe, affordable, and timely surgical and anesthesia care to all who need it.from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/2u1yJFN
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Surveying the Literature: Synopsis of Recent Key Publications
No abstract available
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Ultrasound-Assisted Versus Fluoroscopic-Guided Lumbar Sympathetic Ganglion Block: A Prospective and Randomized Study
BACKGROUND: Fluoroscopy (FL)-guided lumbar sympathetic ganglion block (LSGB) is widely performed to diagnose and manage various diseases associated with sympathetically maintained pain. Recently, numerous ultrasound (US)-assisted procedures in pain medicine have been attempted, showing an advantage of low radiation exposure. This randomized, prospective trial compared the procedural outcomes and complications between FL-guided and US-assisted LSGBs. METHODS: Fifty LSGBs were randomly divided into 2 groups: FL-guided (FL group) or US-assisted (US group) LSGB group. Both groups received FL-guided or US-assisted LSGB with 10 mL of 0.25% levobupivacaine. The primary end point was the total procedure time. Secondary outcomes were success rate, imaging time, onset time (based on temperature rise), dosage of radiation exposure, other procedure-related outcomes, and complications. RESULTS: Total procedure time and success rate were not statistically different between the 2 groups, whereas imaging time of the US group was longer than that of the FL group (P = .012). The onset time was faster in the US group (P = .019), and bone touching during the procedure was less frequent in the US group (P = .001). Moreover, radiation exposure was significantly lower in the US group than in the FL group (Pfrom Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/2u0OYTk
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Mercury Medical announces new agreement with Henry Schein Medical to expand the EMS market distribution of airway management product lines
CLEARWATER, Fla. — Doug Smith, Mercury's VP of Sales & Marketing, is pleased to announce that Mercury Medical has signed an agreement with Henry Schein Medical, the U.S. medical division of Henry Schein, Inc., to represent the company's Airway Management Devices in the United States' Emergency Medical Services (EMS) market. Effective January 1, 2018, the EMS business of Henry ...
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A note from the Editor’s desk
Source:Arab Journal of Gastroenterology, Volume 19, Issue 1
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Editorial Board
Source:Arab Journal of Gastroenterology, Volume 19, Issue 1
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Congenital glaucoma and CYP1B1 : an old story revisited
Abstract
Primary congenital glaucoma is a trabecular meshwork dysgenesis with resultant increased intraocular pressure and ocular damage. CYP1B1 mutations remain the most common identifiable genetic cause. However, important questions about the penetrance of CYP1B1-related congenital glaucoma remain unanswered. Furthermore, mutations in other genes have been described although their exact contribution and potential genetic interaction, if any, with CYP1B1 mutations are not fully explored. In this study, we employed modern genomic approaches to re-examine CYP1B1-related congenital glaucoma. A cohort of 193 patients (136 families) diagnosed with congenital glaucoma. We identified biallelic CYP1B1 mutations in 80.8% (87.5 and 66.1% in familial and sporadic cases, respectively, p < 0.0086). The large family size of the study population allowed us to systematically examine penetrance of all identified alleles. With the exception of c.1103G>A (p.R368H), previously reported pathogenic mutations were highly penetrant (91.2%). We conclude from the very low penetrance and genetic epidemiological analyses that c.1103G>A (p.R368H) is unlikely to be a disease-causing recessive mutation in congenital glaucoma as previously reported. All cases that lacked biallelic CYP1B1 mutations underwent whole exome sequencing. No mutations in LTBP2, MYOC or TEK were encountered. On the other hand, mutations were identified in genes linked to other ophthalmic phenotypes, some inclusive of glaucoma, highlighting conditions that might phenotypically overlap with primary congenital glaucoma (SLC4A4, SLC4A11, CPAMD8, and KERA). We also encountered candidate causal variants in genes not previously linked to human diseases: BCO2, TULP2, and DGKQ. Our results both expand and refine the genetic spectrum of congenital glaucoma with important clinical implications.
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Molecular mechanisms driving transcriptional stress responses
Molecular mechanisms driving transcriptional stress responses
Molecular mechanisms driving transcriptional stress responses, Published online: 19 March 2018; doi:10.1038/s41576-018-0001-6
Recent studies have revealed the genome-wide reprogramming of gene expression upon exposure to stress, such as acute heat stress. Here, the authors review the molecular mechanisms that underlie stress-induced changes at promoters, enhancers and untranscribed loci.
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Correction to: Diagnostic significance of SPACE for PCIS
Abstract
In the original publication of the article, the first sentence of the listed point 2, in page 1 should read as "Advanced pancreatic cancer is diagnosed by pancreatic juice cytology in < 50% of cases."
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New treatment options for inflammatory bowel diseases
Abstract
The advent of anti-TNF agents has dramatically changed the treatment algorithms for IBD in the last 15 years, but primarily and more importantly secondary loss of response is often observed. Fortunately , new treatment options have been actively explored and some have already entered our clinical practice. In the class of anti-cytokine agents, the anti-IL12/IL23 monoclonal antibodies (mAbs) have entered clinical practice with the anti-p40 mAb ustekinumab in Crohn's disease (CD). Also, more selective anti-IL23 agents (anti-p19) have shown efficacy and are being further developed, in contrast to agents inhibiting IL-17 downstream which have failed in clinical trials despite their clear efficacy in psoriasis (Verstockt et al. in Expert Opin Biol Ther 17(1):31–47, 2017; Verstockt et al. in Expert Opin Drug Saf 16(7):809–821, 2017). Following up on the efficacy of the anti-adhesion molecule vedolizumab, etrolizumab (anti-beta-7 integrin) and PF-00547659, an anti-MadCam mAb, are being developed (Lobaton et al. in Aliment Pharmacol Ther 39(6):579–594, 2014). Oral anti-trafficking agents, such as ozanimod, targeting the S1P receptor responsible for the efflux of T-cells from the lymph nodes, have also shown efficacy in patients with ulcerative colitis (UC) (Sandborn et al. in N Engl J Med 374(18):1754–1762, 2016). Oral agents inhibiting cell signaling have been explored successfully in IBD. Tofacitinib, a non-selective oral Janus kinase (JAK) inhibitor, is effective in patients with UC and several other more or less selective Jak1, 2 and 3 inhibitors are being developed for the treatment of CD and UC (Sandborn et al. in N Engl J Med 376(18):1723–1736, 2017; Vermeire et al. in Lancet 389(10066):266–275, 2017; De Vries et al. in J Crohns Colitis 11(7):885–93, 2017). Finally, despite initial disappointing results with systemic administration of mesenchymal stem cells, Alofisel, adipose tissue derived, allogeneic mesenchymal stem cells, locally injected in perianal fistula tracts, induce long-lasting beneficial effects and the drug has been approved in Europe (Panes et al. in Gastroenterology, 2017). In summary, the quest for new treatment options in IBD is very active and justified by the high medical need and unresolved problems patients are facing.
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Behavioral and Neural Evidence of the Rewarding Value of Exercise Behaviors: A Systematic Review
Abstract
Background
In a time of physical inactivity pandemic, attempts to better understand the factors underlying the regulation of exercise behavior are important. The dominant neurobiological approach to exercise behavior considers physical activity to be a reward; however, negative affective responses during exercise challenge this idea.
Objective
Our objective was to systematically review studies testing the automatic reactions triggered by stimuli associated with different types of exercise behavior (e.g. physical activity, sedentary behaviors) and energetic cost variations (e.g. decreased energetic cost, irrespective of the level of physical activity). We also examined evidence supporting the hypothesis that behaviors minimizing energetic cost (BMEC) are rewarding.
Methods
Two authors systematically searched, screened, extracted, and analyzed data from articles in the MEDLINE database.
Results
We included 26 studies. Three outcomes of automatic processes were tested: affective reactions, attentional capture, and approach tendencies. Behavioral results show that physical activity can become attention-grabbing, automatically trigger positive affect, and elicit approach behaviors. These automatic reactions explain and predict exercise behaviors; however, the use of a wide variety of measures prevents drawing solid conclusions about the specific effects of automatic processes. Brain imaging results are scarce but show that stimuli associated with physical activity and, to a lesser extent, sedentary behaviors activate regions involved in reward processes. Studies investigating the rewarding value of behaviors driving energetic cost variations such as BMEC are lacking.
Conclusion
Reward is an important factor in exercise behavior. The literature based on the investigation of automatic behaviors seems in line with the suggestion that physical activity is rewarding, at least for physically active individuals. Results suggest that sedentary behaviors could also be rewarding, although this evidence remains weak due to a lack of investigations. Finally, from an evolutionary perspective, BMEC are likely to be rewarding; however, no study has investigated this hypothesis. In sum, additional studies are required to establish a strong and complete framework of the reward processes underlying automatic exercise behavior.
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How to avoid the most common active shooter training mistakes
Great active shooter incident training takes a concerted effort to make exercises real, relevant, interesting and captivating for all participants
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How to avoid the most common active shooter training mistakes
Active shooter training exercises are becoming more commonplace across the country; which is a good thing. However, without proper planning, many of these well-meaning exercises leave the responders no better off than before or possibly even worse. A strong, multi-discipline exercise design team, a solid exercise plan and buy in from the responding disciplines are critical ingredients for success. Use ...
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EMS Pioneers: A Minnesota medic marks 40 years in EMS
When the Woodbury, Minn., fire department needed volunteers in 1978, John Dillon was ready to serve. "I grew up in the Johnny-and-Roy era," says Dillon, then a 17-year-old EMT. "'Emergency!'" was my introduction to EMS. I drank the Kool-Aid about saving lives and couldn't wait to get started." There was just one problem: John was still in high school ...
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Monogenic diseases in India
Publication date: Available online 17 March 2018
Source:Mutation Research/Reviews in Mutation Research
Author(s): Anila Venugopal, Manojkumar C., Nimmisha E., Soumya K.K., Sanuj C. Breezevilla, Balachandar V.
Studies on monogenic diseases are considered valuable because they give insights and expand our knowledge on gene function and regulation. Despite all the current advancement in science and technology, a deep understanding and knowledge as to why only those particular genes are affected in a disease is still vague. We also lack profound illumination as to why only certain mutations are seen in a disease. Though useful from a research perspective, a majority of these diseases are lethal resulting in death of the affected individual. Unfortunately, in the fast − growing land of India, the incidence of monogenic diseases is very high with few counter-measures in place. This article encompasses a list of all monogenic diseases ever to be reported in India with special focus on five diseases which has been stated to have the highest incidence in India. Here, we discuss about the limited research carried out in India on these high incidence monogenic diseases, the other diseases related to those genes, the range of treatments available for these diseases in India in contrast to its availability around the world and the need to develop treatment strategies to reduce the mortality and morbidity due to these rare but daunting diseases.
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Ampullary Carcinoma—A Genetic Perspective
Publication date: Available online 17 March 2018
Source:Mutation Research/Reviews in Mutation Research
Author(s): Jayaramayya Kaavya, Vellingiri Balachandar, Kumaran Sivanandan Santhy
Ampulla of vater carcinoma (AVC) is a rare gastrointestinal tumour that is associated with a high mortality rate and it's often diagnosed at later stages due to lack of clinical symptoms. Early diagnosis of this condition is essential to effectively treat patients for better prognosis. A significant amount of advancement has been made in understanding the molecular nature of cancer in the past decade. A substantial number of mutations and alterations have been detected in various tumors. Despite the occurrence of AVC across the globe, the number of studies conducted on this tumor type remains low; this is largely due to its rare occurrence. Moreover, AVC tissues are complex and contain mutations in oncogenes, tumour suppressors, apoptotic proteins, cell proliferation proteins, cell signaling proteins, transcription factors, chromosomal abnormalities and cellular adhesion proteins. The frequently mutated genes included KRAS, TP53 and SMAD4 and are associated with prognosis. Several molecules of the PI3K, Wnt signaling, TGF-beta pathway and cell cycle have also been altered in AVCs. This review comprises of all the genetic mutations, associated pathways and related prognosis that are involved in AVCs from the year 1989 to 2017. This report can be used as a stepping-stone to establish biomarkers for early diagnosis of AVC and to discover molecular targets for drug therapy.
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Cell cycle and apoptosis regulator 2 at the interface between DNA damage response and cell physiology
Publication date: Available online 19 March 2018
Source:Mutation Research/Reviews in Mutation Research
Author(s): Martina Magni, Giacomo Buscemi, Laura Zannini
Cell cycle and apoptosis regulator 2 (CCAR2 or DBC1) is a human protein recently emerged as a novel and important player of the DNA damage response (DDR). Indeed, upon genotoxic stress, CCAR2, phosphorylated by the apical DDR kinases ATM and ATR, increases its binding to the NAD+-dependent histone deacetylase SIRT1 and inhibits its activity. This event promotes the acetylation and activation of p53, a SIRT1 target, and the subsequent induction of p53 dependent apoptosis. In addition, CCAR2 influences DNA repair pathway choice and promotes the chromatin relaxation necessary for the repair of heterochromatic DNA lesions. However, besides DDR, CCAR2 is involved in several other cellular functions. Indeed, through the interaction with transcription factors, nuclear receptors, epigenetic modifiers and RNA polymerase II, CCAR2 regulates transcription and transcript elongation. Moreover, promoting Rev-erbα protein stability and repressing BMAL1 and CLOCK expression, it was reported to modulate the circadian rhythm. Through SIRT1 inhibition, CCAR2 is also involved in metabolism control and, suppressing RelB and p65 activities in the NFkB pathway, it restricts B cell proliferation and immunoglobulin production. Notably, CCAR2 expression is deregulated in several tumors and, compared to the non-neoplastic counterpart, it may be up- or down-regulated. Since its up-regulation in cancer patients is usually associated with poor prognosis and its depletion reduces cancer cell growth in vitro, CCAR2 was suggested to act as a tumor promoter. However, there is also evidence that CCAR2 functions as a tumor suppressor and therefore its role in cancer formation and progression is still unclear. In this review we discuss CCAR2 functions in the DDR and its multiple biological activities in unstressed cells.
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Differences in kinematics and energy cost between front crawl and backstroke below the anaerobic threshold
Abstract
Purpose
The purpose of this study was to determine kinematic and energetic differences between front crawl and backstroke performed at the same aerobic speeds.
Methods
Ten male competitive swimmers performed front crawl and backstroke at a pre-determined sub-anaerobic threshold speed to assess energy cost (through oxygen uptake measurement) and kinematics (using three-dimensional videography to determine stroke frequency and length, intra-cycle velocity fluctuation, three-dimensional wrist and ankle speeds, and vertical and lateral ankle range of motion). For detailed kinematic analysis, resultant displacement, the duration, and three-dimensional speed of the wrist during the entry, pull, push, and release phases were also investigated.
Results
There were no differences in stroke frequency/length and intra-cycle velocity fluctuation between the swimming techniques, however, swimmers had lower energy cost in front crawl than in backstroke (0.77 ± 0.08 vs 0.91 ± 0.12 kJ m−1, p < 0.01). Slower three-dimensional wrist and ankle speeds under the water (1.29 ± 0.10 vs 1.55 ± 0.10 and 0.80 ± 0.16 vs 0.97 ± 0.13 m s−1, both p < 0.01) and smaller ankle vertical range of motion (0.36 ± 0.06 vs 0.47 ± 0.07 m, p < 0.01) in front crawl than in backstroke were also observed, which indirectly suggested higher propulsive efficiency in front crawl.
Conclusion
Front crawl is less costly than backstroke, and limbs motion in front crawl is more effective than in backstroke.
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Impairment of exercise performance following cold water immersion is not attenuated after 7 days of cold acclimation
Abstract
Purpose
It is well-documented that severe cold stress impairs exercise performance. Repeated immersion in cold water induces an insulative type of cold acclimation, wherein enhanced vasoconstriction leads to greater body heat retention, which may attenuate cold-induced exercise impairments. The purpose of this study, therefore, was to investigate changes in exercise performance during a 7-day insulative type of cold acclimation.
Methods
Twelve healthy participants consisting of eight males and four females (mean ± SD age: 25.6 ± 5.2 years, height: 174.0 ± 8.9 cm, weight: 75.6 ± 13.1 kg) performed a 20 min self-paced cycling test in 23 °C, 40% humidity without prior cold exposure. Twenty-four hours later they began a 7-day cold acclimation protocol (daily 90 min immersion in 10 °C water). On days one, four, and seven of cold acclimation, participants completed the same cycling test. Measurements of work completed, core and skin temperatures, heart rate, skin blood flow, perceived exertion, and thermal sensation were measured during each cycling test.
Results
Successful insulative cold acclimation was observed. Work produced during the baseline cycling test (220 ± 70 kJ) was greater (p < 0.001) than all three tests that were performed following immersions (195 ± 58, 197 ± 60, and 194 ± 62 kJ) despite similar ratings of perceived exertion during each test, suggesting that cold exposure impaired cycling performance. This impairment, however, was not attenuated over the cold acclimation period.
Conclusions
Results suggest that insulative cold acclimation does not attenuate impairments in exercise performance that were observed following acute cold water immersion.
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De novo apparent loss-of-function mutations in PRR12 in three patients with intellectual disability and iris abnormalities
Abstract
PRR12 encodes a proline-rich protein nuclear factor suspected to be involved in neural development. Its nuclear expression in fetal brains and in the vision system supports its role in brain and eye development more specifically. However, its function and potential role in human disease has not been determined. Recently, a de novo t(10;19) (q22.3;q13.33) translocation disrupting the PRR12 gene was detected in a girl with intellectual disability and neuropsychiatric alterations. Here we report on three unrelated patients with heterozygous de novo apparent loss-of-function mutations in PRR12 detected by clinical whole exome sequencing: c.1918G>T (p.Glu640*), c.4502_4505delTGCC (p.Leu1501Argfs*146) and c.903_909dup (p.Pro304Thrfs*46). All three patients had global developmental delay, intellectual disability, eye and vision abnormalities, dysmorphic features, and neuropsychiatric problems. Eye abnormalities were consistent among the three patients and consisted of stellate iris pattern and iris coloboma. Additional variable clinical features included hypotonia, skeletal abnormalities, sleeping problems, and behavioral issues such as autism and anxiety. In summary, we propose that haploinsufficiency of PRR12 is associated with this novel multisystem neurodevelopmental disorder.
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Effects of low-volume high-intensity interval training in a community setting: a pilot study
Abstract
Purpose
High-intensity interval training (HIIT) is emerging as an effective and time-efficient exercise strategy for health promotion. However, most HIIT studies are conducted in laboratory settings and evidence regarding the efficacy of time-efficient "low-volume" HIIT is based mainly on demanding "all-out" protocols. Thus, the aim of this pilot study was to assess the feasibility and efficacy of two low-volume (≤ 30 min time-effort/week), non-all-out HIIT protocols, performed 2 ×/week over 8 weeks in a community-based fitness centre.
Methods
Thirty-four sedentary men and women were randomised to either 2 × 4-min HIIT (2 × 4-HIIT) or 5 × 1-min HIIT (5 × 1-HIIT) at 85–95% maximal heart rate (HRmax), or an active control group performing moderate-intensity continuous training (MICT, 76 min/week) at 65–75% HRmax.
Results
The exercise protocols were well tolerated and no adverse events occurred. 2 × 4-HIIT and 5 × 1-HIIT exhibited lower dropout rates (17 and 8 vs. 30%) than MICT. All training modes improved VO2max (2 × 4-HIIT: + 20%, P < 0.01; 5 × 1-HIIT: + 27%, P < 0.001; MICT: + 16%, P < 0.05), but the HIIT protocols required 60% less time commitment. Both HIIT protocols and MICT had positive impact on cholesterol profiles. Only 5 × 1-HIIT significantly improved waist circumference (P < 0.05) and subjective work ability (P < 0.05).
Conclusions
The present study indicates that low-volume HIIT can be feasibly implemented in a community-based setting. Moreover, our data suggest that practical (non-all-out) HIIT that requires as little as 30 min/week, either performed as 2 × 4-HIIT or 5 × 1-HIIT, may induce significant improvements in VO2max and cardiometabolic risk markers.
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