Explore the vast range of titles available.

Less than 7% of the world's population live at an altitude above 1500 m. Yet, as many as 67% of medalists in the 2020 men's and women's Olympic marathon, and 100% of medalists in the 2020 men's and women's Olympic 5000 m track race may have been born or raised above this otherwise rare threshold. As a possible explanation, research spanning nearly a quarter of a century demonstrates that indigenous highlanders exhibit pulmonary adaptations distinct from their lowland counterparts. These adaptations may then promote endurance performance. Indeed, healthy indigenous highlanders often exhibit a larger aerobic exercise capacity compared to sea‐level residents who travel to high altitude. However, questions remain on whether high‐altitude birth is advantageous for sea‐level competitions. In this review, we ask whether being born at a high altitude generates an ergogenic advantage for endurance performance in the Summer Olympics—a venue that is generally held at sea level. In so doing, we distinguish between three groups of high‐altitude residents: (i) the indigenous highlander, (ii) the highland newcomer, and (iii) the highland sojourner. Concentrating specifically on altitude‐induced alterations to pulmonary physiology beginning in the perinatal period, we propose that if altitude‐related maladaptations are avoided, genomic and developmental alterations accompanying highland birth may present benefits for endurance competitions at sea level. What is the topic of this review? Whether being born at high altitude contributes to endurance exercise performance at sea level. Does highland birth set the stage for lowland success? What advances does it highlight? The physiological effects and ergogenic potential of highland birth, especially as it pertains to the respiratory system. Possible (mal)adaptations evoked by perinatal hypoxia in various groups of highlanders and the influence of these pulmonary‐related alterations on endurance performance at sea level, for example, in the Summer Olympics.

Background: Continuous blood pressure (BP) measurement in intensive care units is based on arterial line (AL) transducers, sometimes associated with clinical complications. Our objective was to evaluate continuous BP measurements obtained from a non-invasive, wireless photoplethysmography (PPG)-based device using two distinct configurations (wristwatch and chest-patch monitors) compared to an AL. Methods: In this prospective evaluation study, comparison of the PPG-based devices to the AL was conducted in 10 patients immediately following cardiac surgery. Pulse rate (PR), systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) were recorded using both the AL and the PPG-based devices simultaneously for an average of 432 ± 290 min starting immediately after cardiac surgery. Bland-Altman plots and Pearson's correlations were used to assess the accuracy and degree of agreement between techniques. Results: A total of ~4,000 data points were included in the final analysis. AL measurements for PR, SBP, DBP and MAP were significantly ( p < 0.001) and strongly correlated with both the wristwatch ( r = 0.99, r = 0.94, r = 0.93 and r = 0.96, respectively) and the chest-patch ( r = 0.99, r = 0.95, r = 0.93 and r = 0.95, respectively) monitors. Both configurations showed a marginal bias of <1 mmHg for BP measurements and <1 beat/min for PR [95% limits of agreement −3,3 beat/min; BP measurements: (−6)–(−10), 6–10 mmHg] compared to AL measurements. Conclusion: The PPG-based devices offer a high level of accuracy for cardiac-related parameters compared to an AL in post-cardiac surgery patients. Such devices could provide advanced monitoring capabilities in a variety of clinical settings, including immediate post-operative and intensive care unit settings. Clinical Trial Registration: www.clinicaltrials.gov , NCT03603860.

Background Clinical trial guidelines for assessing the safety of vaccines, are primarily based on self-reported questionnaires. Despite the tremendous technological advances in recent years, objective, continuous assessment of physiological measures post-vaccination is rarely performed. Methods We conducted a prospective observational study during the mass vaccination campaign in Israel. 160 participants >18 years who were not previously found to be COVID-19 positive and who received the BNT162b2 COVID-19 (Pfizer BioNTech) vaccine were equipped with an FDA-approved chest-patch sensor and a dedicated mobile application. The chest-patch sensor continuously monitored 13 different cardiovascular, and hemodynamic vitals: heart rate, blood oxygen saturation, respiratory rate, systolic and diastolic blood pressure, pulse pressure, mean arterial pressure, heart rate variability, stroke volume, cardiac output, cardiac index, systemic vascular resistance and skin temperature. The mobile application collected daily self-reported questionnaires on local and systemic reactions. Results We identify continuous and significant changes following vaccine administration in nearly all vitals. Markedly, these changes are observed even in presumably asymptomatic participants who did not report any local or systemic reaction. Changes in vitals are more apparent at night, in younger participants, and in participants following the second vaccine dose. Conclusion the considerably higher sensitivity of wearable sensors can revolutionize clinical trials by enabling earlier identification of abnormal reactions with fewer subjects. Plain language summary The safety of vaccines in clinical trials is primarily determined by participants completing self-reported questionnaires. We monitored various indicators of participant’s health using a chest-patch sensor in 160 participants before and after receiving the BNT162b2 COVID-19 (Pfizer BioNTech) vaccine. Participants were also asked to self-report their health via a mobile phone app. We observed significant changes in health indicators following vaccine administration. Changes were seen by chest patch sensor in both participants who did and did not report changes via the mobile phone app. Three days following vaccination, participant health indicators returned to the levels observed the day before vaccination in both groups. Using wearable sensors could potentially improve clinical trials by enabling earlier identification of abnormal reactions. Gepner et al. undertake a prospective observational study using a chest-patch sensor to monitor cardiovascular and hemodynamic vital signs following the BNT162b2 COVID-19 (Pfizer BioNTech) vaccine. Continuous and significant changes occurred in the vital signs, including in participants who did not report any reactions.

Background: Coronavirus disease 2019 (COVID-19) has forced adolescents to adapt rapidly to a new reality of physical and social distancing, while introducing a range of new sources of stress and adversity. Our primary aim was to study the relationship between adolescents’ resilience and their participation in online sports programs during the COVID-19 pandemic lockdown period. Our secondary aims were to assess the associations between the organized sports programs’ determinants and resilience. Methods: Online surveys designed to examine resilience, lifestyle, psychosocial health and characteristics of the organized sports programs were administered to 473 adolescents who were enrolled in organized sports programs before the COVID-19 pandemic. Results: Adolescents who continued to participate in online structured programs during the lockdown period were significantly more resilient and physically active, had higher self-related health, satisfaction with life, and ability to cope during the pandemic, compared to those who did not participate. Relationships with the adult instructor and levels of physical activity were the most important factors of the programs that were associated with resilience. Conclusions: Participation of adolescents in sports programs is an important resource associated with higher levels of resilience. Youth programs should continue their activities during globally challenging times, such as the COVID-19 pandemic.

Accurate and continuous monitoring of critically ill patients is frequently achieved using invasive catheters, which is technically complex. Our purpose was to evaluate the validity and accuracy of a photoplethysmography (PPG)-based remote monitoring device compared to invasive methods of arterial line (AL) and Swan-Ganz (SG) catheters in a swine model of controlled hemorrhagic shock. Following a baseline phase, hemorrhagic shock was induced in 11 pigs by bleeding 35% of their blood volume, followed by a post-bleeding follow-up phase. Animals were monitored concomitantly by the PPG device, an AL and a SG catheter, for a median period of 447 min. Heart rate (HR), systolic and diastolic blood pressure (SBP and DBP, respectively), and cardiac output (CO) were recorded continuously. The complete data set consisted of 1312 paired observations. Correlations between the PPG-based technique and the invasive methods were significant ( p  < 0.001) during baseline, bleeding and follow-up phases for HR ( r  = 0.90–0.98), SBP ( r  = 0.90–0.94), DBP ( r  = 0.89–0.93), and CO ( r  = 0.76–0.90). Intraclass correlations for all phases combined were 0.96, 0.92, 0.93 and 0.87 for HR, SBP, DBP and CO, respectively. Correlations for changes in CO, SBP and DBP were significant ( p  < 0.001) and strong ( r  > 0.88), with concordance rates (determined by quadrant plots) of 86%, 66% and 68%, respectively. The novel PPG-based device was accurate and valid compared to existing invasive techniques and might be used for continuous monitoring in several clinical settings following further studies.

Previous investigations have demonstrated the therapeutic advantages of extremely low-frequency electromagnetic fields (ELF-EMFs) in mitigating inflammation and influencing biological processes. We aimed to shed light on the effects of ELF-EMF on recovery rate following high-intensity exercise. Nine male athletes (26.7 ± 6.0 years; 69.6 ± 7.7 kg, VO2peak 57.3 ± 6.8 mL/kg/min) completed five visits in a double-blinded crossover design, performing two consecutive testing days, following a ventilatory thresholds assessment. Following 62 min of high-intensity cycling, participants lay on an ELF-EMF mattress under active (A) and non-active (NA) conditions, immediately post protocol and during the night. Physical performance and blood markers were assessed at baseline and at 60 min (60 P) and 24 h (24 H) post-protocol. The A-condition demonstrated a notable reduction in interleukin-10 (IL-10) concentrations (mean difference = −88%, p = 0.032) and maximal isometric strength of the quadriceps muscles (mean difference = ~8%, p = 0.045) compared to the NA-condition between 60 P and 24 H. In a sensitivity analysis, the A-condition revealed that younger athletes who possessed lower fat mass experienced attenuated inflammation and biochemical responses and improved physical performance. In conclusion, ELF-EMF showed no significant overall effects on performance and inflammation after intense cycling among athletes. Post-hoc analysis revealed modest benefits of ELF-MLF, suggesting a context-dependent impact. Further research with a larger sample size and multiple sessions is needed to confirm the recovery potential of ELF-EMF.

Purpose Critical power (CP), and the finite capacity to perform work above CP ( W ′), can be determined using a 3-min “all-out” cycling test (3MT). This protocol requires two laboratory visits: an incremental exercise test, followed by a 3MT on a separate day. The purpose of this study was to establish whether an incremental exercise test and a 3MT performed during a single laboratory visit can be used to accurately determine CP and W ′. Methods Twelve participants completed two experimental protocols: (1) Combined protocol : an incremental exercise test followed by a 3MT, with 20 min of recovery between exercise bouts; and (2) Independent protocol : the conventional 3MT protocol, performed on a separate day. Results CP determined from the Combined (254 ± 117 W) and Independent (256 ± 118 W) protocols were not different ( p  = 0.40). Similarly, W ′ was not different ( p  = 0.96) between the Combined (13.7 ± 3.9 kJ) and Independent (13.7 ± 4.5 kJ) protocols. Linear regression revealed a strong level of measurement agreement between the protocols for CP and W ′, evidenced by high R 2 values (≥0.85) and marginal standard errors of the estimates (CP = 5 W; W ′ = 1.81 kJ). Conclusion A Combined protocol, consisting of an incremental exercise test followed by a 3MT, provides an accurate and valid method to determine an individual’s CP and, to a lesser extent, W ′. Furthermore, this protocol permits the measurement of the gas-exchange threshold and peak O 2 uptake and, consequently, the moderate, heavy, and severe exercise-intensity domains may be defined within a single exercise-testing session.

The relation between changes in respiratory quotient (RQ) following dietary interventions and clinical parameters and body fat pools remains unknown. In this randomized controlled trial, participants with moderate abdominal obesity or/and dyslipidemia (n = 159) were randomly assigned to a Mediterranean/low carbohydrate (MED/LC, n = 80) or a low fat (LF, n = 79) isocaloric weight loss diet and completed a metabolic assessment. Changes in RQ (measured by indirect calorimeter), adipose-tissue pools (MRI), and clinical measurements were assessed at baseline and after 6 months of intervention. An elevated RQ at baseline was significantly associated with increased visceral adipose tissue, hepatic fat, higher levels of insulin and homeostatic insulin resistance. After 6 months, body weight had decreased similarly between the diet groups (−6 ± 6 kg). However, the MED/LC diet, which greatly improved metabolic health, decreased RQ significantly more than the LF diet (−0.022 ± 0.007 vs. −0.002 ± 0.008, p = 0.005). Total cholesterol and diastolic blood pressure were independently associated with RQ changes (p = 0.045). RQ was positively associated with increased superficial subcutaneous-adipose-tissue but decreased renal sinus, pancreatic, and intramuscular fats after adjusting for confounders. Fasting RQ may reflect differences in metabolic characteristics between subjects affecting their potential individual response to the diet.

The hypoxic ventilatory response (HVR) could play an important role in mitigating performance declines in hypoxia. However, it is almost exclusively measured at rest (HVRREST) even when physiological responses to exercise are in question, and therefore an exercise HVR test (HVREX) may be of greater relevance for exercise performance. Purposes: 1) determine whether HVRREST and HVREX are comparable, 2) determine whether HVREX is related to the degree of performance impairment in acute hypoxia, and 3) identify factors that could explain the variance in cycling performance impairment with acute hypoxic exposure. Methods: Sixteen endurance-trained men (VO2max: 61.5 ± 5.9 ml˙kg-1˙min-) performed two poikilocapnic HVR tests while seated rested (HVRREST) and while cycling (HVREX). On two separate visits, subjects (n = 12) performed a 10km cycling time trial while breathing either room air or a hypoxic gas mixture (FIO2 = 0.16) in a randomized order. Degree of performance impairment was calculated as the percentage change in time to complete the time trial between normoxia and hypoxia (ΔTT). Results: HVREX was significantly (p < 0.001) greater than HVRREST (0.22 ± 0.14 and 1.51 ± 0.45 l·min-1,%-1, respectively), and the two measures were not correlated (r = -0.05, p = 0.84). ΔTT was not correlated with HVREX ( r = 0.36, p = 0.28), but was correlated with measures of an adequate hyperventilatory response to exercise, which explained 71% of the variance in ΔTT (p < 0.01). Conclusions: 1) HVRREST is not an appropriate measure to consider when studying the physiological responses to exercise and/or exercise performance, 2) ventilatory responsiveness during exercise may contribute little to the degree of performance impairment in hypoxia, and 3) (adequate) increases in exercise ventilation are likely essential for mitigating the expected hypoxia-induced impairments in performance, at least to some degree.

COVID-19 exerts deleterious cardiopulmonary effects, leading to a worse prognosis in the most affected. This retrospective multi-center observational cohort study aimed to analyze the trajectories of key vitals amongst hospitalized COVID-19 patients using a chest-patch wearable providing continuous remote patient monitoring of numerous vital signs. The study was conducted in five COVID-19 isolation units. A total of 492 COVID-19 patients were included in the final analysis. Physiological parameters were measured every 15 min. More than 3 million measurements were collected including heart rate, systolic and diastolic blood pressure, cardiac output, cardiac index, systemic vascular resistance, respiratory rate, blood oxygen saturation, and body temperature. Cardiovascular deterioration appeared early after admission and in parallel with changes in the respiratory parameters, showing a significant difference in trajectories within sub-populations at high risk. Early detection of cardiovascular deterioration of COVID-19 patients is achievable when using frequent remote patient monitoring.