Background The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on practical activities and didactic teaching of residents and fellows. This survey aimed to propose long-term changes for ophthalmology training based on the changes experienced by trainees and their perception of new training opportunities. Methods An online survey was distributed to ophthalmology trainees in multiple countries. Descriptive statistics were used to analyse the data. Results A total of 504 analyzable responses were collected from 32 different countries. The current impact of COVID-19 pandemic was described as "severe" by most trainees (55.2%); however, the future perspective was more optimistic as demonstrated by the greater number of responses reporting a presumed "moderate" (37.3%), "mild" (14.1%) or "slight" (4.2%) long-term impact. The vast majority of trainees reported a decrease ≥50% of clinical activity (76.4%) and >75% of surgical activity (74.6%). Although an initial gap in didactic teaching has been experienced by many (55.4%), regular webbased teaching was reportedly attended by 67.7% of the respondents. A strong agreement was found regarding the worthwhile role of web-based case-presentations in clinical training (91.7%), web-based discussion of edited surgical videos (85.7%) and simulation-based practice (86.9%) in surgical training. Conclusions This survey, focusing on trainees' perspective, strongly reinforces the need to promptly include new technology-based training tools, such as web-based teaching, virtual surgical simulators, and telementoring, in long-term reorganisation of ophthalmology training to ensure its continuity and effectiveness, which would remain available even in the face of another unpredictable crisis within the health system.

Common methods to prescribe exercise intensity are based on fixed percentages of maximum rate of oxygen uptake (V˙O2max), peak work rate (WRpeak), maximal HR (HRmax). However, it is unknown how these methods compare to the current models to partition the exercise intensity spectrum. Purpose Thus, the aim of this study was to compare contemporary gold-standard approaches for exercise prescription based on fixed percentages of maximum values to the well-established, but underutilized, “domain” schema of exercise intensity. Methods One hundred individuals participated in the study (women, 46; men, 54). A cardiopulmonary ramp-incremental test was performed to assess V˙O2max, WRpeak, HRmax, and the lactate threshold (LT), and submaximal constant-work rate trials of 30-min duration to determine the maximal lactate steady-state (MLSS). The LT and MLSS were used to partition the intensity spectrum for each individual in three domains of intensity: moderate, heavy, and severe. Results V˙O2max in women and men was 3.06 ± 0.41 L·min−1 and 4.10 ± 0.56 L·min−1, respectively. Lactate threshold and MLSS occurred at a greater %V˙O2max and %HRmax in women compared with men (P < 0.05). The large ranges in both sexes at which LT and MLSS occurred on the basis of %V˙O2max (LT, 45%–74%; MLSS, 69%–96%), %WRpeak (LT, 23%–57%; MLSS, 44%–71%), and %HRmax (LT, 60%–90%; MLSS, 75%–97%) elicited large variability in the number of individuals distributed in each domain at the fixed-percentages examined. Conclusions Contemporary gold-standard methods for exercise prescription based on fixed-percentages of maximum values conform poorly to exercise intensity domains and thus do not adequately control the metabolic stimulus.

Coronavirus disease 2019 (COVID-19) vaccines can cause transient local and systemic post-vaccination reactions. The aim of this study was to report uveitis and other ocular complications following COVID-19 vaccination. The study included 42 eyes of 34 patients (20 females, 14 males), with a mean age of 49.8 years (range 18–83 years). The cases reported were three herpetic keratitis, two anterior scleritis, five anterior uveitis (AU), three toxoplasma retinochoroiditis, two Vogt-Koyanagi-Harada (VKH) disease reactivations, two pars planitis, two retinal vasculitis, one bilateral panuveitis in new-onset Behçet’s disease, three multiple evanescent white dot syndromes (MEWDS), one acute macular neuroretinopathy (AMN), five retinal vein occlusions (RVO), one non-arteritic ischemic optic neuropathy (NAION), three activations of quiescent choroidal neovascularization (CNV) secondary to myopia or uveitis, and one central serous chorioretinopathy (CSCR). Mean time between vaccination and ocular complication onset was 9.4 days (range 1–30 days). Twenty-three cases occurred after Pfizer-BioNTech vaccination (BNT162b2 mRNA), 7 after Oxford-AstraZeneca vaccine (ChAdOx1 nCoV-19), 3 after ModernaTX vaccination (mRNA-1273), and 1 after Janssen Johnson & Johnson vaccine (Ad26.COV2). Uveitis and other ocular complications may develop after the administration of COVID-19 vaccine.

The oxygen uptake (V̇O2) at the respiratory compensation point (RCP) closely identifies with the maximal metabolic steady state. However, the power output (PO) at RCP cannot be determined from contemporary ramp-incremental exercise protocols. Purpose This study aimed to test the efficacy of a “step–ramp–step” (SRS) cycling protocol for estimating the PO at RCP and the validity of RCP as a maximal metabolic steady-state surrogate. Methods Ten heathy volunteers (5 women; age: 30 ± 7 yr; V̇O2max: 54 ± 6 mL·kg−1·min−1) performed in the following series: a moderate step transition to 100 W (MOD), ramp (30 W·min−1), and after 30 min of recovery, step transition to ~50% POpeak (HVY). Ventilatory and gas exchange data from the ramp were used to identify the V̇O2 at lactate threshold (LT) and RCP. The PO at LT was determined by the linear regression of the V̇O2 versus PO relationship after adjusting ramp data by the difference between the ramp PO at the steady-state V̇O2 from MOD and 100 W. Linear regression between the V̇O2–PO values associated with LT and HVY provided, by extrapolation, the PO at RCP. Participants then performed 30-min constant-power tests at the SRS-estimated RCP and 5% above this PO. Results All participants completed 30 min of constant-power exercise at the SRS-estimated RCP achieving steady-state V̇O2 of 3176 ± 595 mL·min−1 that was not different (P = 0.80) from the ramp-identified RCP (3095 ± 570 mL·min−1) and highly consistent within participants (bias = −26 mL·min−1, r = 0.97, coefficient of variation = 2.3% ± 2.8%). At 5% above the SRS-estimated RCP, four participants could not complete 30 min and all, but two exhibited non–steady-state responses in blood lactate and V̇O2. Conclusions In healthy individuals cycling at their preferred cadence, the SRS protocol and the RCP are capable of accurately predicting the PO associated with maximal metabolic steady state.

The dissociation between constant work rate of O2 uptake (V̇o2) and ramp V̇o2 at a given work rate might be mitigated during slowly increasing ramp protocols. This study characterized the V̇o2 dynamics in response to five different ramp protocols and constant-work-rate trials at the maximal metabolic steady state (MMSS) to characterize 1) the V̇o2 gain (G) in the moderate, heavy, and severe domains, 2) the mean response time of V̇o2 (MRT), and 3) the work rates at lactate threshold (LT) and respiratory compensation point (RCP). Eleven young individuals performed five ramp tests (5, 10, 15, 25, and 30 W/min), four to five time-to-exhaustions for critical power estimation, and two to three constant-work-rate trials for confirmation of the work rate at MMSS. G was greatest during the slowest ramp and progressively decreased with increasing ramp slopes (from ~12 to ~8 ml·min−1·W−1, P < 0.05). The MRT was smallest during the slowest ramp slopes and progressively increased with faster ramp slopes (1 ± 1, 2 ± 1, 5 ± 3, and 10 ± 4, 15 ± 6 W, P < 0.05). After “left shifting” the ramp V̇o2 by the MRT, the work rate at LT was constant regardless of the ramp slope (~150 W, P > 0.05). The work rate at MMSS was 215 ± 55 W and was similar and highly correlated with the work rate at RCP during the 5 W/min ramp ( P > 0.05, r = 0.99; Lin’s concordance coefficient = 0.99; bias = −3 W; root mean square error = 6 W). Findings showed that the dynamics of V̇o2 (i.e., G) during ramp exercise explain the apparent dichotomy existing with constant-work-rate exercise. When these dynamics are appropriately “resolved”, LT is constant regardless of the ramp slope of choice, and RCP and MMSS display minimal variations between each other. NEW & NOTEWORTHY This study demonstrates that the dynamics of V̇o2 during ramp-incremental exercise are dependent on the characteristics of the increments in work rate, such that during slow-incrementing ramp protocols the magnitude of the dissociation between ramp V̇o2 and constant V̇o2 at a given work rate is reduced. Accurately accounting for these dynamics ensures correct characterizations of the V̇o2 kinetics at ramp onset and allows appropriate comparisons between ramp and constant-work-rate exercise-derived indexes of exercise intensity.

These findings suggest the use of the proposed methodology as a valid alternative to other indirect approaches for 1RM prediction. The mathematical construct is simply based on the definition of the 1RM, and it is fed with subject's muscle strength capacities measured during a specific exercise. Its reliability is, thus, expected to be not affected by those factors that typically jeopardize regression-based approaches.

During ramp-incremental exercise, the mean response time (MRT) of oxygen uptake (V˙O2) represents the time delay for changes in muscle V˙O2 to be reflected at the level of the mouth and is generally calculated by linear (MRTLIN) and monoexponential (τ′) fitting of V˙O2 data. However, these methods yield MRT values that are highly variable from test-to-test. Purpose Therefore, we examined the validity and the reproducibility of a novel method to calculate the MRT. Methods On two occasions, 12 healthy men (age, 30 ± 10 yr; V˙O2max: 4.14 ± 0.47 L·min−1, 53.5 ± 7.3 mL·kg−1·min−1) performed a ramp-incremental cycling test (30 W·min−1) that was preceded by a step transition to 100 W. The ramp power output corresponding to the steady-state V˙O2 at 100 W was determined and the difference between that power output and 100 W was converted to time to quantify the MRT (MRTSS). Results The values of MRTLIN, τ′, and MRTSS were 28 ± 16 s, 27 ± 12 s, and 26 ± 11 s, respectively, which were not different (P > 0.05) from each other. However, compared to the MRT parameters derived from the fitting-based methods, MRTSS had a higher correlation coefficient (R = 0.87) and a smaller coefficient of variation (15% ± 9%) from test-to-test. Conclusions In conclusion, the novel method proposed in the current study was found to be valid and highly reproducible in a test-retest design. Therefore, we advocate the use of this approach when a precise and accurate determination of the MRT is needed to properly align the V˙O2 data with power output during ramp-incremental exercise.

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