Cardiopulmonary exercise testing (CPET) is a methodology that has profoundly affected the approach to patients' functional evaluation, linking performance and physiological parameters to the underlying metabolic substratum and providing highly reproducible exercise capacity descriptors. This study provides professionals with an up-to-date review of the rationale sustaining the use of CPET for functional evaluation of cardiac patients in both the clinical and research settings, describing parameters obtainable either from ramp incremental or step constant-power CPET and illustrating the wealth of information obtainable through an experienced use of this powerful tool. The choice of parameters to be measured will depend on the specific goals of functional evaluation in the individual patient, namely, exercise tolerance assessment, training prescription, treatment efficacy evaluation, and/or investigation of exercise-induced adaptations of the oxygen transport/utilization system. The full potentialities of CPET in the clinical and research setting still remain largely underused and strong efforts are recommended to promote a more widespread use of CPET in the functional evaluation of cardiac patients.

Conventional leg prostheses do not convey sensory information about motion or interaction with the ground to aboveknee amputees, thereby reducing confidence and walking speed in the users that is associated with high mental and physical fatigue 1-4 . The lack of physiological feedback from the remaining extremity to the brain also contributes to the generation of phantom limb pain from the missing leg 5,6 . To determine whether neural sensory feedback restoration addresses these issues, we conducted a study with two transfemoral amputees, implanted with four intraneural stimulation electrodes 7 in the remaining tibial nerve (ClinicalTrials. gov identifier NCT03350061). Participants were evaluated while using a neuroprosthetic device consisting of a prosthetic leg equipped with foot and knee sensors. These sensors drive neural stimulation, which elicits sensations of knee motion and the sole of the foot touching the ground. We found that walking speed and self-reported confidence increased while mental and physical fatigue decreased for both participants during neural sensory feedback compared to the no stimulation trials. Furthermore, participants exhibited reduced phantom limb pain with neural sensory feedback. The results from these proof-of-concept cases provide the rationale for larger population studies investigating the clinical utility of neuroprostheses that restore sensory feedback.Despite advances in the development of lower-limb prosthetics 8 , the potential benefits of restoring sensory feedback from such devices to transfemoral (above-knee) or transtibial (below-knee) amputees has not been investigated. Most surgery techniques 9 and noninvasive methods 10-12 to restore sensory feedback have been tested only in transtibial amputations, which produce a less disabling clinical condition than transfemoral amputation 1,3 . Direct neural stimulation through transversal intrafascicular multichannel electrodes (TIMEs) 7 has enabled upper-limb amputees to feel touch sensations from the missing hand and to exploit them for long-term prosthesis control 13,14 . Only F.M.P. designed the study, developed the software and the overall system integration, performed and supervised the experiments, analyzed the data and wrote and reviewed the paper. M.B. performed the surgeries, was responsible for all the clinical aspects of the study and reviewed the manuscript. G.V. developed the software and the overall system integration, performed the experiments, analyzed the data and reviewed the manuscript. V.I. and S. Mazic collected and analyzed the metabolic measurements. P.M. and B.M. collected and analyzed the EEG measurements. P.C. and T.S. developed the TIME electrodes and delivered technical assistance during the implantation and explanation procedures. F.B. and D.B. developed the software and the overall system integration and performed the experiments. N.K. analyzed the data. D.G. and D.A. designed the hardware and embedded software (real-time control) for STIMEP. K.L. and A.A. participated in the experimental design...

The purpose of this study was to describe structural and functional characteristics of elite Serbian basketball players and to evaluate whether players in different positional roles have different physical and physiological profiles. Five men's basketball teams participated in the study and competed in the professional First National League. Physiological measurements were taken of 60 players during the final week of their preparatory training for competition. According to positional roles, players were categorized as guards (n = 20), forwards (n = 20), and centers (n = 20). Guards were older (p < 0.01) and more experienced (p < 0.01) as compared with both forwards and centers. Centers were taller and heavier than guards and forwards (p < 0.01), whereas forwards had significantly higher height and weight than guards (p < 0.01). Centers had more body fat (p < 0.01) as compared with forwards and guards. Also, centers had significantly lower estimated VO(2)max values (p < 0.01) compared with forwards and guards. In addition, the highest heart rate frequencies during the last minute of the shuttle run test were lower in guards (p < 0.01) as compared with forwards and centers. Vertical jump power was significantly higher in centers (p < 0.01) as compared with guards. The results of the present study demonstrate that a strong relationship exists between body composition, aerobic fitness, anaerobic power, and positional roles in elite basketball.

In a previous paper, as the first of a series of three on the importance of characteristics and modalities of physical activity (PA) and exercise in the management of cardiovascular health within the general population, we concluded that, in the population at large, PA and aerobic exercise capacity clearly are inversely associated with increased cardiovascular disease risk and all-cause and cardiovascular mortality and that a dose–response curve on cardiovascular outcome has been demonstrated in most studies. More and more evidence is accumulated that engaging in regular PA and exercise interventions are essential components for reducing the severity of cardiovascular risk factors, such as obesity and abdominal fat, high BP, metabolic risk factors, and systemic inflammation. However, it is less clear whether and which type of PA and exercise intervention (aerobic exercise, dynamic resistive exercise, or both) or characteristic of exercise (frequency, intensity, time or duration, and volume) would yield more benefit for each separate risk factor. The present paper, therefore, will review and make recommendations for PA and exercise training in the management of cardiovascular health in individuals with cardiovascular risk factors. The guidance offered in this series of papers is aimed at medical doctors, health practitioners, kinesiologists, physiotherapists and exercise physiologists, politicians, public health policy makers, and individual members of the public. Based on previous and the current literature overviews, recommendations from the European Association on Cardiovascular Prevention and Rehabilitation are formulated regarding type, volume, and intensity of PA and regarding appropriate risk evaluation during exercise in individuals with cardiovascular risk factors.

Apheresis with different procedures and devices are used for a variety of indications that may have different adverse events (AEs). The aim of this study was to clarify the extent and possible reasons of various side effects based on data from a multinational registry. The WAA-apheresis registry data focus on adverse events in a total of 50846 procedures in 7142 patients (42% women). AEs were graded as mild, moderate (need for medication), severe (interruption due to the AE) or death (due to AE). More AEs occurred during the first procedures versus subsequent (8.4 and 5.5%, respectively). AEs were mild in 2.4% (due to access 54%, device 7%, hypotension 15%, tingling 8%), moderate in 3% (tingling 58%, urticaria 15%, hypotension 10%, nausea 3%), and severe in 0.4% of procedures (syncope/hypotension 32%, urticaria 17%, chills/fever 8%, arrhythmia/asystole 4.5%, nausea/vomiting 4%). Hypotension was most common if albumin was used as the replacement fluid, and urticaria when plasma was used. Arrhythmia occurred to similar extents when using plasma or albumin as replacement. In 64% of procedures with bronchospasm, plasma was part of the replacement fluid used. Severe AEs are rare. Although most reactions are mild and moderate, several side effects may be critical for the patient. We present side effects in relation to the procedures and suggest that safety is increased by regular vital sign measurements, cardiac monitoring and by having emergency equipment nearby.

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The effect of intensive long-term physical activity on phospholipid fatty acid (FA) composition has not been studied thoroughly. We determined plasma and erythrocyte phospholipid FA status of professional basketball and football players. Our results showed differences in plasma FA profile not only between sportsmen and sedentary subjects, but also between two groups of sportsmen. Plasma FA profile in basketball players showed significantly higher proportion of n-6 FA (20:3, 20:4, and 22:4) and total polyunsaturated FA (PUFA) than controls, while football players had higher palmitoleic acid (16:1) than basketball players and controls. Total PUFA and 22:4 were also higher in basketball than in football players. Erythrocyte FA profile showed no differences between football players and controls. However, basketball players had higher proportion of 18:0 than controls, higher saturated FA and lower 18:2 than two other groups, and higher 22:4 than football players. These findings suggest that long-term intensive exercise and type of sport influence FA profile.

The aim of this study was to describe qualitatively and quantitatively dietary supplements (DS) and medication use in elite athletes. Athletes (n=912; age 23.9 ± 6 years; 72% male) reported medications and DSs taken within 3 days before doping control. We analyzed data collected from 2006 to 2008, identified and classified substances. Total of 74.6% athletes reported use of at least one substance, 61.2% took DS (3.17 per user) and 40.6% took medications. Among users, 21.2% reported the use of six and more different products, and one took 17 different products at the same time. Majority of medication users took non-steroidal anti-inflammatory drugs (NSAID) (24.7%), and 22.2% used more than one NSAID. We found no gender differences in DS use (P=0.83). Individual sport athletes used more DS (P<0.01). Our study showed widespread use of DS and drugs by elite athletes. Consumption of DS with no evident performance or health benefits, demonstrated the need for specific educational programs focused on DS use. Amount, quantity and combination of the reported products raised concern about the risk of potential side effects.