The TIRADS has allowed us to improve patient management and cost-effectiveness, avoiding unnecessary FNAB. In addition, we have established standard codes to be used both for radiologists and endocrinologists.

There is evidence from human twin and family studies as well as mouse and rat selection experiments that there are considerable interindividual differences in the response of cardiorespiratory fitness (CRF) and other cardiometabolic traits to a given exercise programme dose. We developed this consensus statement on exercise response variability following a symposium dedicated to this topic. There is strong evidence from both animal and human studies that exercise training doses lead to variable responses. A genetic component contributes to exercise training response variability.In this consensus statement, we (1) briefly review the literature on exercise response variability and the various sources of variations in CRF response to an exercise programme, (2) introduce the key research designs and corresponding statistical models with an emphasis on randomised controlled designs with or without multiple pretests and post-tests, crossover designs and repeated measures designs, (3) discuss advantages and disadvantages of multiple methods of categorising exercise response levels—a topic that is of particular interest for personalised exercise medicine and (4) outline approaches that may identify determinants and modifiers of CRF exercise response. We also summarise gaps in knowledge and recommend future research to better understand exercise response variability.

Eight weeks of ET-BFR can increase muscle strength and induce similar muscle hypertrophy responses to RT while V˙O2max responses also increased post-intervention even with a significantly lower work load compared to ET. Our findings provide new insight to some of the molecular mechanisms mediating adaptation responses with ET-BFR and the potential for this training protocol to improve muscle and cardiorespiratory capacity.

BackgroundRecent studies have begun to identify the molecular determinants of inter-individual variability of cardiorespiratory fitness (CRF) in response to exercise training programs. However, we still have an incomplete picture of the molecular mechanisms underlying trainability in response to exercise training.ObjectiveWe investigated baseline serum and skeletal muscle metabolomics profile and its associations with maximal power output (MPO) gains in response to 8-week of continuous endurance training (ET) and high-intensity interval training (HIIT) programs matched for total units of exercise performed (the TIMES study).MethodsEighty healthy sedentary young adult males were randomized to one of three groups and 70 were defined as completers (> 90% of sessions): ET (n = 30), HIIT (n = 30) and control (CO, n = 10). For the CO, participants were asked to not exercise for 8 weeks. Serum and skeletal muscle samples were analyzed by 1H-NMR spectroscopy. The targeted screens yielded 43 serum and 70 muscle reproducible metabolites (intraclass > 0.75; coefficient of variation < 25%). Associations of baseline metabolites with MPO trainability were explored within each training program via three analytical strategies: (1) correlations with gains in MPO; (2) differences between high and low responders to ET and HIIT; and (3) metabolites contributions to the most significant pathways related to gains in MPO. The significance level was set at P < 0.01 or false discovery rate of 0.1.ResultsThe exercise programs generated similar gains in MPO (ET = 21.4 ± 8.0%; HIIT = 24.3 ± 8.5%). MPO associated baseline metabolites supported by all three levels of evidence were: serum glycerol, muscle alanine, proline, threonine, creatinine, AMP and pyruvate for ET, and serum lysine, phenylalanine, creatine, and muscle glycolate for HIIT. The most common pathways suggested by the metabolite profiles were aminoacyl-tRNA biosynthesis, and carbohydrate and amino acid metabolism.ConclusionWe suggest that MPO gains in both programs are potentially associated with metabolites indicative of baseline amino acid and translation processes with additional evidence for carbohydrate metabolism in ET.

• TIRADS classification allows accurate selection of thyroid nodules requiring biopsy (TIRADS 4-5). • The recognition of benign/possibly benign patterns can avoid unnecessary procedures. • This classification and its sonographic patterns are validated using surgical specimens.

Obesity is associated with comorbidities related to metabolic disorders due to excess of adipose tissue. Physical exercise has a major role in the prevention of obesity. Combined training (CT), in particular, has been shown to improve markers of health. In this study, we used H NMR-based metabolomics to investigate changes in the metabolism of obese men after 24 weeks of CT. Twenty-two obese (body mass index 31 ± 1.4 kg/m), middle-aged men (48.2 ± 6.1 years) were randomly assigned to a control group (CG, n = 11) or CT group (n = 11). The CT was performed three times a week (resistance and aerobic training) for 24 weeks. Blood samples were collected before and after experimental period. There was an improvement in body composition and physical fitness indices after CT training. Multivariate PCA and PLS-DA models showed a distinct separation between groups. Twenty metabolites with importance for projection (VIP) >1.0 were identified, and four were classified as best discriminators (tyrosine, 2-oxoisocaproate, histidine, pyruvate). Some metabolites were correlated with strength, VO peak, fat and lean body mass, waist circumference, and insulin. In conclusion, 24 weeks of CT was effective for functional improvements and metabolic changes in obese middle-aged men.

This study investigated the autonomic and haemodynamic responses to different aerobic exercise loads, with and without blood flow restriction (BFR). In a crossover study, 21 older adults (8 males and 13 females) completed different aerobic exercise sessions: low load without BFR (LL) (40% VO), low load with BFR (LL-BFR) (40% VO + 50% BFR) and high load without BFR (HL) (70% VO). Heart rate variability and haemodynamic responses were recorded during rest and throughout 30 min of recovery. HL reduced R-R interval, the root mean square of successive difference of R-R intervals and high frequency during 30 min of recovery at a greater magnitude compared with LL and LL-BFR. Sympathetic-vagal balance increased the values for HL during 30 min of recovery at a greater magnitude when compared with LL and LL-BFR. Post-exercise haemodynamic showed reduced values of double product at 30 min of recovery compared to rest in LL-BFR, while HL showed higher values compared to rest, LL-BFR and LL. Reduced systolic blood pressure was observed for LL-BFR (30 min) compared to rest. Autonomic and haemodynamic responses indicate lower cardiovascular stress after LL-BFR compared to HL, being this method, besides the functional adaptations, a potential choice to attenuate the cardiovascular stress after exercise in older adults.

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