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Purpose: To investigate the efficacy of using Ratings of Perceived Exertion (RPE) to prescribe and regulate a 4-week handcycle training intervention., Methods: Thirty active adults, untrained in upper body endurance exercise, were divided into three groups to complete a 4-week intervention: (i) RPE-guided training (n = 10; 2 female), (ii) power output (PO)-guided (n = 10; 2 female) training, or (iii) non-training control (n = 10; 4 female). Training groups performed three sessions of handcycling each week. Oxygen uptake ([Formula: see text]), heart rate (HR), and Feeling Scale (FS) rating were collected during training sessions. RPE-guided training was performed at RPE 13. PO-guided training was matched for percentage of peak PO per session, based upon that achieved by the RPE-guided training group., Results: There were no differences in percentage of peak [Formula: see text] (66 ± 13% vs 61 ± 9%, p = 0.22), peak HR (75 ± 8% vs 71 ± 6%, p = 0.11) or FS rating (1.2 ± 1.9 vs 0.8 ± 1.6, p = 0.48) between RPE- and PO-guided training, respectively. The average coefficient of variation in percentage of peak HR between consecutive training sessions was 2.8% during RPE-guided training, and 3.4% during PO-guided training., Conclusion: Moderate-vigorous intensity handcycling exercise can be prescribed effectively using RPE across a chronic training intervention, suggesting utility for practitioners in a variety of rehabilitation settings., (© 2023. The Author(s).)

Objectives: To evaluate the difference between healthcare professionals (HCPs) and adults with spinal cord injury (SCI) in Asia regarding knowledge and interpretation of 'exercise intensity' for aerobic exercise prescription., Methods and Study Design: A survey was distributed to practising HCP and adults with SCI. It was completed in participants' local language on topics related to the importance of exercise frequency, intensity, time and type; methods for monitoring and terms related to exercise intensity prescription. χ 2 analysis was used to detect differences in HCP or those with SCI., Results: 121 HCP and 107 adults with an SCI ≥1 years (C1-L4) participated. Responses revealed 61% of all HCP ranked 'intensity' being most important whereas only 38% respondents from the SCI group ranked it as high importance (p=0.008). For those with SCI, 'frequency' was most important (61%) which was significantly higher than the 45% selected by HCPs (p=0.030). Of the 228 respondents on average only 34% believed that the terms, 'moderate' and 'vigorous' provided enough information for aerobic exercise intensity prescription. HCP most often used HR methods compared with the SCI group (90% vs 54%; p<0.01). Both groups frequently used the subjective measures of exercise intensity, for example, Ratings of Perceived Exertion (8%3 vs 76% for HCP and SCI), HCP also frequently used speed (81%) and SCI also frequently relied on 'the affect' or feelings while exercising (69%)., Conclusions: These differences must be considered when developing clinical-practice exercise guidelines and health referral educational pathways for adults with SCI in Asia., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: To examine the efficacy of per-cooling via ice slurry ingestion (ICE) in wheelchair tennis players exercising in the heat., Method: Eight wheelchair tennis players undertook sprints (4 sets of 10 × 5 s over 40 min) in a hot environment (∼32 °C), interspersed by 3 boluses of 2.67 g·kg (6.8 g·kg total) ICE or drinking temperate water (control condition). Athletes performed an on-court test of repeated sprint ability (20 × 20 m) in temperate conditions immediately before and 20 minutes after the heat exposure, and time to complete each sprint as well as intermediate times were recorded. Gastrointestinal and weighted mean skin and forehead temperatures were collected throughout the heat exposure, as were thermal sensation, heart rate, and blood lactate concentration. Sweat rate was calculated from body mass changes and fluid/ice intakes., Results: Compared with the control condition, ICE resulted in a significantly lower gastrointestinal temperature (95% CI, 0.11-0.17 °C; P < .001), forehead temperature (0.58-1.06 °C; P < .001), thermal sensation (0.07-0.50 units; P = .017), and sweat rate (0.06-0.46 L·h-1; P = .017). Skin temperature, heart rate, and blood lactate concentration were not significantly different between conditions (P ≥ .598). There was no overall change preheating to postheating (P ≥ .114) or an effect of condition (P ≥ .251) on repeated sprint times., Conclusions: ICE is effective at lowering objective and subjective thermal strain when consumed between sets of repeated wheelchair sprints in the heat. However, ICE has no effect on on-court repeated 20-m sprint performance.

Objective: To analyze and summarize the effect of regulating exercise training interventions with subjective measures of intensity on cardiorespiratory fitness, measured by peak oxygen uptake (V̇O 2peak ) and peak power output (PO peak ) in adults with spinal cord injury (SCI)., Data Sources: Four databases (MEDLINE, Embase, PsycINFO, SPORTDiscus) were searched from inception up until September 1, 2020, and updated November 18, 2021., Study Selection: Searches combined keywords relating to the topics: SCI, subjective measures of exercise intensity, and exercise., Data Extraction: Two reviewers independently conducted eligibility screening, data extraction, and assessed the risk of bias. Nine studies were included in the systematic review and meta-analysis, resulting in the inclusion of data from 95 adults with SCI representing both sexes and a diverse range of age, time since injury, lesion level, and lesion completeness classifications., Data Synthesis: Data were extracted and added to summary tables with 3 outcomes: V̇O 2peak , PO peak , and Other. Mean and SD values for V̇O 2peak and PO peak were extracted from pre- and post-perceptually regulated exercise training., Conclusions: All studies used ratings of perceived exertion scale to prescribe exercise intensity. Seven of 8 studies concluded an improvement in V̇O 2peak , and 5 studies of 7 concluded an improvement in PO peak . In the outcome Other, 5 studies concluded an improvement, and 3 studies concluded no change. There was evidence for an improvement in cardiorespiratory fitness, measured by V̇O 2peak and PO peak after perceptually regulated exercise training in adults with SCI (Grading of Recommendations, Assessment, Development, and Evaluation ratings: Low) (mean difference [MD], 2.92mL/kg/min; 95% confidence interval [CI], 1.30-4.54; P=.0004 and MD, 9.8W; 95% CI, 5.5-14.3; P<.0001, respectively). This review provides critically appraised, cumulative evidence on the use of perceptually regulated exercise training in individuals with SCI., (Copyright © 2022 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Study Design: Cohort study., Objectives: To investigate and critique different methods for aerobic exercise intensity prescription in adults with spinal cord injury (SCI)., Setting: University laboratory in Loughborough, UK., Methods: Trained athletes were split into those with paraplegia (PARA; n = 47), tetraplegia (TETRA; n = 20) or alternate health condition (NON-SCI; n = 67). Participants completed a submaximal step test with 3 min stages, followed by graded exercise test to exhaustion. Handcycling, arm crank ergometry or wheelchair propulsion were performed depending on the sport of the participant. Oxygen uptake (V̇O 2 ), heart rate (HR), blood lactate concentration ([BLa]) and ratings of perceived exertion (RPE) on Borg's RPE scale were measured throughout. Lactate thresholds were identified according to log-V̇O 2 plotted against log-[BLa] (LT 1 ) and 1.5 mmol L -1 greater than LT 1 (LT 2 ). These were used to demarcate moderate (1 ), heavy (>LT 1 , < LT 2 ) and severe (>LT 2 ) exercise intensity domains., Results: Associations between percentage of peak V̇O 2 (%V̇O 2peak ) and HR (%HR peak ) with RPE differed between PARA and TETRA. At LT 1 and LT 2 , %V̇O 2peak and %HR peak were significantly greater in TETRA compared to PARA and NON-SCI (P < 0.05). The variation in %V̇O 2peak and %HR peak at lactate thresholds resulted in large variability in the domain distribution at fixed %V̇O 2peak and %HR peak ., Conclusions: Fixed %V̇O 2peak and %HR peak should not be used for aerobic exercise intensity prescription in adults with SCI as the method does not lead to uniform exercise intensity domain distribution., (© 2021. The Author(s).)

Study Design: Cross-sectional cohort study., Objectives: To compare ratings of perceived exertion (RPE) on Borg's 6-20 RPE scale and Category Ratio 10 (CR10) in able-bodied (AB) participants during upper and lower body exercise, and recreationally active participants with paraplegia (PARA) and athletes with tetraplegia (TETRA) during upper body exercise only., Setting: University and rehabilitation centre-based laboratories in UK and Netherlands., Methods: Twenty-four participants were equally split between AB, PARA, and TETRA. AB performed maximal tests using cycle (AB-CYC) and handcycle (AB-HC) ergometry. PARA and TETRA performed maximal handcycle and wheelchair propulsion tests, respectively. Oxygen uptake (V̇O 2 ) and blood lactate concentration were monitored throughout. RPE was rated each stage on Borg's RPE scale and CR10. Thresholds were identified according to log-V̇O 2 plotted against log-blood lactate (LT 1 ), and 1.5 mmol L -1 greater than LT 1 (LT 2 )., Results: RPE from both scales were best fit against each other using a quadratic model, with high goodness of fit between scales that was independent of exercise mode and participant group (range R 2 : 0.965-0.970, P < 0.005). Though percentage peak V̇O 2 was significantly greater in TETRA (P < 0.005), there was no difference in RPE at LT 1 or LT 2 between groups on Borg's RPE scale or CR10., Conclusion: Strong association between Borg's RPE scale and CR10 suggests they can be used interchangeably. RPE at lactate thresholds were independent of mode of exercise and level of spinal cord injury. However, inter-individual variation precludes from making firm recommendations about using RPE for prescribing homogenous exercise intensity., (© 2021. The Author(s).)

A fundamental aspect of classification systems in Paralympic sport is having valid and reliable measures of impairment. However, minimal consensus exists for assessing impaired strength, coordination and range of motion. This review aimed to systematically identify measures of upper body strength, coordination and range of motion impairments that meet the requirements for use in evidence-based classification systems in wheelchair sports. Three electronic databases were searched from 2003 until 31 August 2019 for studies that assessed upper body function of participants and used a measurement tool that assessed strength, coordination or range of motion. The body of evidence for each identified measure was appraised using the Grading of Recommendations Assessment, Development and Evaluation framework. Twenty-three studies were included: ten measured strength and coordination, and six measured range of motion. There was "moderate" confidence in using isometric strength for assessing strength impairment. Tapping tasks for the assessment of coordination impairment received a "low" confidence rating. All other identified measures of coordination and range of motion impairment received a "very low" confidence rating. Several potential measures were identified for assessing upper body strength, coordination and range of motion impairments. Further research is warranted to investigate their use for classification in Paralympic wheelchair sports.

This study examined the relationship between proximal arm strength and mobility performance in wheelchair rugby (WR) athletes and examined whether a valid structure for classifying proximal arm strength impairment could be determined. Fifty-seven trained WR athletes with strength impaired arms and no trunk function performed six upper body isometric strength tests and three 10 m sprints in their rugby wheelchair. All strength measures correlated with 2 m and 10 m sprint times (r ≥ -0.43; p ≤ 0.0005) and were entered into k-means cluster analyses with 4-clusters (to mirror the current International Wheelchair Rugby Federation [IWRF] system) and 3-clusters. The 3-cluster structure provided a more valid structure than both the 4-cluster and existing IWRF system, as evidenced by clearer differences in strength (Effect sizes [ES] ≥ 1.0) and performance (ES ≥ 1.1) between adjacent clusters and stronger mean silhouette coefficient (0.64). Subsequently, the 3-cluster structure for classifying proximal arm strength impairment would result in less overlap between athletes from adjacent classes and reduce the likelihood of athletes being disadvantaged due to their impairment. This study demonstrated that the current battery of isometric strength tests and cluster analyses could facilitate the evidence-based development of classifying proximal arm strength impairment in WR.

From the perspective of food categories, fresh produce are the leading sources of food loss and waste globally. Their highly perishable nature shortens their shelf-lives leading to high postharvest losses if not properly handled. Currently, these losses are estimated at sixty-six percent based on total weight. Reduction of these losses will ensure constant supply of food along the supply chain as well as economic empowerment of the rural poor. Hexanal which is a naturally occurring compound has been developed as an intervention to prolong shelf-life of delicate tropical fruits such as bananas while also maintaining their quality. However, empirical evidence is still required on the usefulness of hexanal to farmers. It is envisaged that such evidence would inform scaling up of the technology in Kenya. This study assessed willingness to pay for hexanal and the factors influencing WTP amounts among banana farmers in Meru County, Kenya. Primary data was collected from 130 respondents who were grouped into aware and not aware of Hexanal. Results indicate that farmers who are aware of hexanal had a higher mean WTP Ksh 466.47 (US $4.66) compared to those not aware Ksh 331.86 (US $3.32). Factors such as age and income influenced the WTP amounts between subsamples. The major key policy implication of the study is the importance of stakeholders investing in the dissemination of information on hexanal among farmers to enhance uptake., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2021 Jane N. Kahwai et al.)

Objectives: The purpose of this study was to examine the validity and test-retest reliability of a battery of single-joint isometric strength tests, to establish whether the tests could be used for evidence-based classification in wheelchair rugby (WR)., Design: Cross-sectional., Methods: Twenty male WR athletes with impaired arm strength and thirty able-bodied (AB) participants (15 male, 15 female) performed four isometric strength tests. Each test required three 5-s efforts and examined maximal isometric force for flexion and extension around the shoulder and elbow joint. Test validity was established by comparing differences (Cohen's effect sizes [d]) in strength between WR athletes and AB participants. Differences were also explored between male and female AB participants. Twenty AB participants returned for a second visit to establish the test-retest reliability of the test battery., Results: Significantly lower force values were observed for all isometric strength measures in WR athletes compared to AB participants (p≤0.0005; d≥2.14). Female AB participants also produced significantly less force than male AB participants for all joint actions (p≤0.0005; d≥1.93). No significant differences were identified between trials for any measure of strength, with acceptable levels of test-retest reliability reported (ICCs≥0.97, SEM≤19.3N and CV≤8.4%)., Conclusions: The current results demonstrated the validity of a battery of isometric strength tests, suggesting they can be used to reliably infer strength impairment in WR athletes, which is a pre-requisite when working towards evidence-based classification in Paralympic sport., (Copyright © 2019 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Purpose: CT myelography has been used since 1976 to diagnose neural compression in the axial skeleton. With the advent of routine MRI, its role in accurately diagnosing neural compression has been questioned as its normal appearances are not defined in the study. In this study, we examine a series of CT myelograms to define the normal appearances of the neural elements of the spine., Methods: The CT myelograms of patients with unilateral symptoms were examined by four independent physicians. The lateral extent of contrast was examined and recorded. Concordance between the recorded extents was assessed using kappa scores., Results: Thirty-six scans were reviewed. Kappa analysis shows that there is a fair agreement in the lateral extent of contrast at L1, L3 and L4. At L2 and L5, agreement is slight., Conclusion: The interpretation of CT myelography shows significant interobserver variability. As a result, the usefulness of this diagnostic tool can be questioned, and if misinterpreted, it could lead to questionable diagnoses and inadvertently erroneous management if used in isolation. These slides can be retrieved under Electronic Supplementary Material.

This study determined the physical and technical demands of elite wheelchair tennis (WT) match-play, how the demands differed between divisions (Men, Women, Quad) and the effect that set result and score margin had on these demands. Seventeen WT players were monitored during a singles competition. Physical measures of performance were analysed using an indoor tracking system and inertial measurement units. Technical measures of performance were examined using video analysis. Physical measures of performance differed by division (Men > Women > Quad) for most parameters. Rallies were longer during Men's ( P = 0.027) and Women's ( P = 0.004) matches compared to Quad's and fewer shots were hit off 2 bounces in Men's matches compared to Women's and Quad's ( P ≤ 0.026). High-speed activity (HSA) increased during losing sets ( P = 0.043). Most physical measures of performance increased by moderate to large effects during sets with a small score margin (≤3 games differential). Mean speed and HSA were similar during losing sets, regardless of margin, but decreased (large effects) when winning by a large margin. This study demonstrated the physical and technical demands that elite WT players need to be prepared for and how situational factors can influence these demands.

Objectives: To investigate peripheral (RPE P ) and central (RPE C ) Ratings of Perceived Exertion during wheelchair propulsion in untrained able-bodied (AB) participants, and trained wheelchair rugby athletes with and without cervical spinal cord injury (CSCI)., Design: Cross-sectional study., Methods: 38 participants (AB: n=20; wheelchair rugby athletes with CSCI: n=9; without CSCI: n=9) completed an incremental wheelchair propulsion test to exhaustion on a motorised treadmill. Gas exchange measures and heart rate (HR) were collected throughout. RPE P and RPE C on the Category Ratio-10 were verbally recorded each minute. Blood lactate concentration ([BLa]) was determined post-test., Results: Between 50-100% peak oxygen uptake (V̇O 2peak ), RPE P was greater than RPE C in AB (p<0.05), but not in athletes with (p=0.07) or without (p=0.16) CSCI. RPE P was greater in AB compared to players with CSCI (Effect sizes: 1.24-1.62), as were respiratory exchange ratio (1.02±0.10 vs 0.82±0.11, p<0.05) and [BLa] peak (7.98±2.53 vs 4.66±1.57mmol·L -1 ). RPE C was greater in athletes without CSCI compared to those with CSCI (Effect sizes: 0.70-1.38), as were HR (166±20 vs 104±15 beats·min -1 , p<0.05) and ventilation (59.2±28.8 vs 35.1±16.6L·min -1 , p=0.01)., Conclusions: RPE P was dominant over RPE C during wheelchair propulsion for untrained AB participants. For athletes with CSCI, lower RPE P and RPE C were reported at the same %V̇O 2peak compared to those without CSCI. The mechanism for this remains to be fully elucidated., (Copyright © 2019 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

This study investigated the effect of prolonged familiarisation with ratings of perceived exertion (RPE) on the peripheral (RPE P ) and central (RPE C ) RPE responses to moderate-vigorous exercise in adults with spinal cord injury (SCI). RPE P and RPE C characterise the exertion of the working musculature and cardiorespiratory systems, respectively. Nineteen participants (age, 41.4 ± 11.4 years; peak oxygen uptake, 19.2 ± 7.2 mL·kg -1 ·min -1 ) with chronic SCI were randomly assigned to RPE-guided ( n = 11; EXP) or active control ( n = 8; CON) groups. EXP performed 16-weeks of RPE-guided, supervised aerobic training for 20 min, twice weekly, at RPE 3-6 (Category-Ratio 10 scale). CON had access to the same exercise equipment but received no specific advice on their exercise-training regime. Participants completed a graded exercise test, using an arm crank ergometer at pre- and post-training to determine peak oxygen uptake, with RPE P and RPE C recorded every minute throughout tests. Sixteen weeks training did not improve peak oxygen uptake. RPE decreased post-training at 50% ( p = 0.02) and 70% peak oxygen uptake ( p = 0.03), though there was no effect of group at either intensity ( p = 0.54, 0.42, respectively). At 70% peak oxygen uptake, RPE P was greater than RPE C (4.2 ± 1.7 vs 3.4 ± 1.8, p < 0.005). Training with RPE-guidance for 16 weeks had no additional effect on the differentiated RPE responses to moderate-vigorous exercise in adults with SCI. Novelty In adults with SCI, differentiated RPE responses were not different between those who did, and did not, perform 16 weeks of RPE-guided training. This challenges whether familiarisation with RPE is necessary to be an effective regulator of exercise intensity in this population.

Para Va'a is a new Paralympic sport in which athletes with trunk and/or leg impairment compete over 200 m. The purpose of this study was to examine the impact of impairment on kinematic and kinetic variables during Va'a ergometer paddling. Ten able-bodied and 44 Para Va'a athletes with impairments affecting: trunk and legs (TL), legs bilaterally (BL) or leg unilaterally (UL) participated. Differences in stroke frequency, mean paddling force, and joint angles and correlation of the joint angles with paddling force were examined. Able-bodied demonstrated significantly greater paddling force as well as knee and ankle flexion ranges of movement (ROM) on the top hand paddling side compared to TL, BL and UL. Able-bodied, BL and UL demonstrated greater paddling force and trunk flexion compared to TL, and UL demonstrated larger bottom hand paddling side knee and ankle flexion ROM compared to BL. Significant positive correlations were observed for both male and female athletes between paddling force and all trunk flexion angles and ROM in the trunk and pelvis rotation and bottom hand paddling side hip, knee and ankle flexion. The results of this study are important for creating an evidence-based classification system for Para Va'a.

This study compares test-retest reliability and peak exercise responses from ramp-incremented (RAMP) and maximal perceptually-regulated (PRET max ) exercise tests during arm crank exercise in individuals reliant on manual wheelchair propulsion (MWP). Ten untrained participants completed four trials over 2-weeks (two RAMP (0-40 W + 5-10 W · min -1 ) trials and two PRET max . PRET max  consisted of five, 2-min stages performed at Ratings of Perceived Exertion (RPE) 11, 13, 15, 17 and 20). Participants freely changed the power output to match the required RPE. Gas exchange variables, heart rate, power output, RPE and affect were determined throughout trials. The V̇O 2peak  from RAMP (14.8 ± 5.5 ml · kg -1  · min -1 ) and PRET max  (13.9 ± 5.2 ml · kg -1  · min -1 ) trials were not different (P = 0.08). Measurement error was 1.7 and 2.2 ml · kg -1  · min -1  and coefficient of variation 5.9% and 8.1% for measuring V̇O 2peak  from RAMP and PRET max , respectively. Affect was more positive at RPE 13 (P = 0.02), 15 (P = 0.01) and 17 (P = 0.01) during PRET max . Findings suggest that PRET max  can be used to measure V̇O 2peak  in participants reliant on MWP and leads to a more positive affective response compared to RAMP.

Study Design: Retrospective radiographic review., Objectives: Our objectives were to (1) compare the ability of fulcrum bend radiographs and traction radiographs under general anesthesia to predict correction of adolescent idiopathic scoliosis (AIS) using pedicle screw only constructs and (2) compare the fulcrum bend correction index (FBCI) with a new measurement: the traction correction index (TCI)., Methods: This is a retrospective radiographic review of 80 AIS patients (62 female and 18 male), who underwent scoliosis correction with pedicle screw only constructs. The mean age at surgery was 14 years (range 9-20 years). Radiographic analysis was carried out on the preoperative and immediate postoperative posteroanterior standing radiographs and the preoperative fulcrum bend radiographs and traction radiographs under general anesthesia. FBCI is calculated by dividing the correction rate by the fulcrum flexibility and TCI is calculated by dividing the correction rate by the traction flexibility., Results: Preoperative mean Cobb angle of 63.9° was corrected to 25.8° postoperatively. The mean fulcrum bending Cobb angle was 37.6° and traction Cobb angle was 26.6°. The mean fulcrum flexibility was 41.1%, traction flexibility 58.4%, and correction rate 59.6%. The median FBCI was 137% and TCI was 104.3%., Conclusions: When comparing fulcrum bend and traction radiographs, we found the traction radiographs to be more predictive of curve correction in AIS using pedicle screw constructs. TCI takes into account the curve flexibility better than FBCI., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: To examine the effects of different small-sided games (SSGs) on physical and technical aspects of performance in wheelchair basketball (WB) players., Design: Observational cohort study., Methods: Fifteen highly trained WB players participated in a single 5v5 (24-s shot clock) match and three 3v3 SSGs (18-s shot clock) on a (1) full court, (2) half-court, and (3) modified-length court. During all formats, players' activity profiles were monitored using an indoor tracking system and inertial measurement units. Physiological responses were monitored via heart rate and rating of perceived exertion. Technical performance, that is, ball handling, was monitored using video analysis. Repeated-measures analysis of variance and effect sizes (ESs) were calculated to determine the statistical significance and magnitude of any differences between game formats., Results: Players covered less distance and reached lower peak speeds during half-court (P ≤ .0005; ES ≥ very large) compared with all other formats. Greater distances were covered, and more time was spent performing moderate- and high-speed activity (P ≤ .008; ES ≥ moderate) during full court compared with all other formats. Game format had little bearing on physiological responses, and the only differences in technical performance observed were in relation to 5v5. Players spent more time in possession, took more shots, and performed more rebounds in all 3v3 formats compared with 5v5 (P ≤ .028; ES ≥ moderate)., Conclusions: Court dimensions affect the activity profiles of WB players during 3v3 SSGs yet had little bearing on technical performance when time pressures (shot clocks) were constant. These findings have important implications for coaches to understand which SSG format may be most suitable for physically and technically preparing WB players.

Objective: To systematically synthesize and appraise research regarding test-retest reliability or criterion validity of subjective measures for assessing aerobic exercise intensity in adults with spinal cord injury (SCI)., Data Sources: Electronic databases (Pubmed, PsychINFO, SPORTDiscus, EMBASE, and CINAHL) were searched from inception to January 1, 2016., Study Selection: Studies involving at least 50% of participants with SCI who performed an aerobic exercise test that included measurement of subjective and objective intensity based on test-retest reliability or criterion validity protocols., Data Extraction: Characteristics were extracted on study design, measures, participants, protocols, and results. Each study was evaluated for risk of bias based on strength of the study design and a quality checklist score (COnsensus-based Standards for the selection of health Measurement INstruments [COSMIN])., Data Synthesis: The 7 eligible studies (1 for reliability, 6 for validity) evaluated overall, peripheral and/or central ratings of perceived exertion (RPE) on a scale of 6-20 (RPE 6-20). No eligible studies were identified for other subjective intensity measures. The evidence for reliability and validity were synthesized separately for each measure and were assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Overall, very low GRADE confidence ratings were established for reliability and validity evidence generalizable to the entire population with SCI and various upper-body and lower-body modalities. There was low confidence for the evidence showing that overall RPE 6-20 has acceptable validity for adults with SCI and high fitness levels performing moderate to vigorous-intensity upper-body aerobic exercise., Conclusions: Health care professionals and scientists need to be aware of the very low to low confidence in the evidence, which currently prohibits a strong clinical recommendation for the use of subjective measures for assessing aerobic exercise intensity in adults with SCI. However, a tentative, conditional recommendation regarding overall RPE 6-20 seems applicable, depending on participants' fitness level as well as the exercise intensity and modality used., Level of Evidence: NA., (Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.)

Purpose: To examine the reliability of a perceptually-regulated maximal exercise test (PRETmax) to measure peak oxygen uptake ([Formula: see text]) during handcycle exercise and to compare peak responses to those derived from a ramp-incremented protocol (RAMP)., Methods: Twenty recreationally active individuals (14 male, 6 female) completed four trials across a 2-week period, using a randomised, counterbalanced design. Participants completed two RAMP protocols (20 W·min-1) in week 1, followed by two PRETmax in week 2, or vice versa. The PRETmax comprised five, 2-min stages clamped at Ratings of Perceived Exertion (RPE) 11, 13, 15, 17 and 20. Participants changed power output (PO) as often as required to maintain target RPE. Gas exchange variables (oxygen uptake, carbon dioxide production, minute ventilation), heart rate (HR) and PO were collected throughout. Differentiated RPE were collected at the end of each stage throughout trials., Results: For relative [Formula: see text], coefficient of variation (CV) was equal to 4.1% and 4.8%, with ICC(3,1) of 0.92 and 0.85 for repeated measures from PRETmax and RAMP, respectively. Measurement error was 0.15 L·min-1 and 2.11 ml·kg-1·min-1 in PRETmax and 0.16 L·min-1 and 2.29 ml·kg-1·min-1 during RAMP for determining absolute and relative [Formula: see text], respectively. The difference in [Formula: see text] between PRETmax and RAMP was tending towards statistical significance (26.2 ± 5.1 versus 24.3 ± 4.0 ml·kg-1·min-1, P = 0.055). The 95% LoA were -1.9 ± 4.1 (-9.9 to 6.2) ml·kg-1·min-1., Conclusion: The PRETmax can be used as a reliable test to measure [Formula: see text] during handcycle exercise in recreationally active participants. Whilst PRETmax tended towards significantly greater [Formula: see text] values than RAMP, the difference is smaller than measurement error of determining [Formula: see text] from PRETmax and RAMP.

Background: Most cast materials mature and harden via an exothermic reaction. Although rare, thermal injuries secondary to casting can occur. The purpose of this study was to evaluate factors that contribute to the elevated temperature beneath a cast and, more specifically, evaluate the differences of modern casting materials including fiberglass and prefabricated splints., Methods: The temperature beneath various types (plaster, fiberglass, and fiberglass splints), brands, and thickness of cast material were measured after they were applied over thermometer which was on the surface of a single diameter and thickness PVC tube. A single layer of cotton stockinette with variable layers and types of cast padding were placed prior to application of the cast. Serial temperature measurements were made as the cast matured and reached peak temperature. Time to peak, duration of peak, and peak temperature were noted. Additional tests included varying the dip water temperature and assessing external insulating factors. Ambient temperature, ambient humidity and dip water freshness were controlled., Results: Outcomes revealed that material type, cast thickness, and dip water temperature played key roles regarding the temperature beneath the cast. Faster setting plasters achieved peak temperature quicker and at a higher level than slower setting plasters. Thicker fiberglass and plaster casts led to greater peak temperature levels. Likewise increasing dip-water temperature led to elevated temperatures. The thickness and type of cast padding had less of an effect for all materials. With a definition of thermal injury risk of skin injury being greater than 49 degrees Celsius, we found that thick casts of extra fast setting plaster consistently approached dangerous levels (greater than 49 degrees for an extended period). Indeed a cast of extra-fast setting plaster, 20 layers thick, placed on a pillow during maturation maintained temperatures over 50 degrees of Celsius for over 20 minutes., Conclusion: Clinicians should be cautious when applying thick casts with warm dip water. Fast setting plasters have increased risk of thermal injury while brand does not appear to play a significant role. Prefabricated fiberglass splints appear to be safer than circumferential casts. The greatest risk of thermal injury occurs when thick casts are allowed to mature while resting on pillow.

The results of intradermal testing with three commercial flea antigens and a serological test for IgE antibodies to flea antigens were compared with live flea challenge in cats. Eight control cats with no prior flea exposure had negative serological test and flea challenge results. By contrast, 17 out of 27 cats with previous flea exposure showed immediate reactivity to flea challenge; reactivity at 6, 24 and 48 h after flea exposure was noted in 12, 16 and 21 cats, respectively. Seventeen of these cats had positive serological test results. Seven cats showed immediate intradermal test reactions to the ARTU allergen, six reacted to the Biophady allergen, and six reacted to the Greer allergen. Intradermal test reactivity was less frequent at the other time points. Using the results of the flea challenge as the 'gold standard' for the presence or absence of sensitisation to fleas, the sensitivity and specificity of the serological test was 0.88 and 0.77, respectively. Sensitivities of the intradermal tests at the four time points ranged from 0 to 0.33, whereas the specificities ranged from 0.78 to 1.0. Live flea challenge is better able to detect cats with hypersensitivity to fleas than either intradermal or serological testing.

A flea larval bioassay was developed by an international team of scientists to monitor the susceptibility of fleas (Ctenocephalides felis) to imidacloprid (Advantage, Bayer HealthCare). The assay was validated using laboratory and field isolates of C. felis. Flea eggs representing different field isolates of C. felis were collected by veterinarians in the United States, United Kingdom, and Germany. Of the 972 flea isolates obtained during the 5-year study, 768 contained sufficient numbers of eggs to conduct the larval bioassay. Greater than 5% survival occurred for only six of the field isolates evaluated. Further evaluation and analysis of these isolates demonstrated that they did not differ significantly in their susceptibility to imidacloprid from the reference strains used to develop the assay. Collections of field flea isolates will continue in an attempt to detect and document any change in the susceptibility of field flea populations to imidacloprid.

Analysis of larval Aedes aegypti midgut using scanning electron microscopy, nuclear and mitochondrial dyes, response to Bacillus thuringiensis israelensis CryIVB toxin, and electrophysiology is described. The anterior ventriculus ("stomach") region is found to have much lower mitochondrial densities than other midgut regions. The transitional region is distinguished by apical surface architecture, and by region-specific effects of CryIVB endotoxin. In this region CryIVB causes holes ranging from 1.0 to 7.0 microm in diameter (mean 3.3+/-0.53 microm, N=12), blisters 16.9+/-1.54 microm in diameter (N=10), and separation of adjacent cells. The holes are not consistent with damage due to the colloid osmotic lysis model of delta-endotoxin activity. The posterior ventriculus possesses a distinctive cellular architecture consisting of hemispherical, domed apical membranes surrounded by deep clefts. Functional and morphological heterogeneity is revealed within the posterior ventriculus, with the anterior end dominating the electrical profile of isolated, perfused preparations and showing the greatest response to serotonin. Hyperpolarization of the transepithelial potential by serotonin occurred in conjunction with a decrease in the space constant lambda, ruling out closure of ion channels as the mechanism of action of serotonin.

Study Design: A prospective in vivo animal study., Objectives: To determine whether infection in the juvenile spine influences spinal development., Summary of Background Data: Discitis is thought to occur in children when blood-borne infection penetrates the highly vascular immature disc. The condition generally resolves without apparent complication, but little is known about the long-term effects on the growing spine., Methods: Twenty-nine 6-week-old lambs underwent discography at multiple lumbar levels using radiographic contrast deliberately inoculated with Staphylococcus epidermidis. No antibiotics were given. Plain radiographs were taken at intervals up to 52 weeks after inoculation for morphometric analysis of the vertebral bodies and discs, and the lumbar spines were prepared for histology., Results: Sixteen of 44 inoculated discs showed radiological evidence of discitis between 2 and 6 weeks after inoculation. Disc height and disc area were significantly reduced from 2 weeks, and did not recover during the study period. Vertebral body dimensions and overall lumbar spine length were not significantly affected., Conclusion: Infection of juvenile ovine discs impedes disc development but has no significant effect on vertebral body growth.

A method is described for the quantitative determination of quinoxaline-2-carboxylic acid (QCA) and methyl-3-quinoxaline-2-carboxylic acid (MQCA), the metabolites that have been designated as the marker residues for the veterinary drugs, carbadox and olaquindox, respectively, in swine tissue. The method is suitable for use as a confirmatory method under EU National Surveillance Schemes. Porcine liver samples were subjected to protease digestion followed by liquid-liquid extraction. Further clean-up was performed by automated solid phase extraction (SPE) and was followed by a final liquid-liquid extraction step. Analysis was performed using a narrow bore column HPLC coupled to electrospray MS/MS, operated in positive ion mode. MS/MS product ions were monitored at m/z 102 and 75 amu for QCA, m/z 145 and 102 amu for MQCA and at m/z 106 and 152 amu for the d(4)-QCA and d(7)-MQCA internal standards, respectively. The method has been validated at 3.0, 10, 50 and 150 microg kg(-1) for both metabolites. The method performance characteristics-the decision limit (CCalpha) and the detection capability (CCbeta) have been determined for QCA at 0.4 and 1.2 microg kg(-1), respectively, and for MQCA at 0.7 and 3.6 microg kg(-1), respectively.

A method is described for the quantitative determination of the two feed additives carbadox and olaquindox in porcine feedingstuffs. The use of these agents in feedingstuffs was prohibited in the European Union as a result of concerns about their toxicity. Regulatory laboratories are required to have suitably validated analytical methods to ensure compliance with the ban. The analytes were extracted from finished feedingstuffs into acetonitrile:chloroform (1:1, v/v), and aliquots (1.0 ml) of the extract were dried down under a stream of nitrogen at 65 degrees C. All residues were re-dissolved in HPLC mobile phase containing acetonitrile/water/formic acid. Analysis was based on LC coupled to positive-ion electrospray MS-MS, with daughter ions for carbadox at m/z 231 and 90, and for olaquindox at m/z 212 and 143 being monitored. The method was validated by analysing feed samples fortified with carbadox and olaquindox at 0.5, 2.5 and 5 mg kg(-1) on three separate occasions. Sample preparation was simple, thus allowing the confirmation of these compounds in large numbers of samples.

Carbadox cannot be used in food-producing animals within the European Union following the adoption of Commission Regulation EC 2788/98/EC. Monitoring of the longest remaining residue--quinoxaline-2-car-boxylic acid (QCA)--is the most effective way of enforcing the prohibition on its use. The study was under taken to determine if QCA could be passed from pig to pig following the exposure of unmedicated animals to housing that had previously contained medicated animals. Drug-withdrawal studies were also carried out on medicated animals. Distinction between treated animals and those exposed to QCA might be required by competent national authorities to determine whether a positive result for QCA in tissue is truly 'violative'. Comparison of the ratio concentrations of QCA in tissues and body fluids was made to determine if they, could be used as criteria for discrimination between illegally treated animals and environmental contamination.

A method is described for the quantitative determination of quinoxaline-2-carboxylic acid (QCA), the marker residue for the veterinary drug carbadox, in swine liver. Tissue is subjected to alkaline hydrolysis followed by liquid-liquid extraction. QCA residues are cleaned up using automated solid phase extraction (SPE), before a final liquid-liquid extraction step. Analysis is based on LC coupled to positive ion electrospray MS-MS, monitoring product ions at m/z 129, 102 and 75 for QCA and at m/z 106 for the internal standard (d4-QCA). The method has been validated according to draft revised EU criteria for analysis of veterinary drug residues, and is suitable for monitoring tissues taken under national surveillance schemes. The method has been validated at 3, 10, 30, 100 and 300 microg kg(-1). The method performance characteristics, CCalpha (decision limit) and CCbeta (detection limit) were determined to be 0.16 and 0.27 microg kg(-1), respectively. The described method, which is relatively rapid and applicable to large sample numbers, correlates well (r2 = 0.9799) with a widely used GC-MS assay for QCA.

To investigate the persistence of flea larvicidal activity in the immediate environment of cats treated with imidacloprid, eggs of the cat flea Ctenocephalides felis felis Bouché (Siphonaptera: Pulicidae), from untreated donor cats, were incubated on samples of fleece blanket taken from the floor of cages used by treated or untreated cats for a total of 10 or 20 6-h periods over 2-4 weeks, respectively. Sufficient imidacloprid accumulated during these periods to reduce the emergence of adult fleas by 94.7-97.6% when the blankets were tested after 18 weeks' storage at room temperature. A typical laundry procedure (washing with detergent at 50 degrees C and low temperature tumble drying) removed this biological activity. Unwashed control blankets did not support the flea life-cycle as effectively as washed blankets or a sand substrate.

As the ferret, Mustela putorius furo L. (Carnivora: Mustelidae), is becoming increasingly popular as a pet animal and as it is susceptible to the cat-flea, Ctenocephalides felis felis Bouché (Siphonaptera: Pulicidae), an experimental model was established for evaluating insecticidal treatments on this host. A high establishment rate (76.7-91.8%) was recorded when 60 unfed adult C. felis were placed on ferrets. This provided an adequate infestation for chemotherapeutic evaluation without causing undue discomfort to the host. Twelve ferrets were allocated to two groups matched for sex and individual ability to sustain a flea population. One group was treated topically with an imidacloprid spot-on formulation at a dose rate of 10 mg/kg body-weight on Day 0. All ferrets were infested with C. felis on Days -1, 7, 14, 21 and 28, and flea counts were performed 8 and 24 h post-treatment and one day after each subsequent infestation. Fleas were removed at all but the 8 h count (when they were returned to their host). Flea burdens were reduced by 95.3% (P < 0.001) within 8 h of treatment and 100% efficacy was recorded at 24 h. At 1, 2, 3 and 4 weeks post-treatment, protection against re-infestation was 92.9% (P < 0.001), 55.7% (P < 0.02), 18.3% (NS) and 7.4% (NS), respectively. Thus, at this dose rate, imidacloprid gave excellent efficacy against a resident C. felis population and provided a high level of residual activity for at least one week after treatment.

Control strategies were evaluated over a 6-month period in a home simulation model comprising a series of similar carpeted pens, housing matched groups of six cats, in which the life-cycle of the flea Ctenocephalides felis felis Bouche (Siphonaptera: Pulicidae) had been established. Additional adult fleas were placed on the cats at intervals to mimic acquisition of extraneous fleas from outside the home. Treatment strategies included a single subcutaneous deposition of injectable lufenuron supported by initial treatments with a short-acting insecticidal spray, or monthly topical applications of imidacloprid or fipronil. An untreated control group indicated that conditions were suitable for flea replication and development. Controls had to be combed on 18 occasions to remove excessive flea burdens and two developed allergic reactions. Lufenuron cats were combed once and required two insecticidal treatments in the first month to achieve control. Even so, small flea burdens were constantly present thereafter. Imidacloprid and fipronil treatments appeared to give virtually complete control throughout. Single fleas were found on imidacloprid cats on two occasions, whereas none were recovered from fipronil cats at any time after the first treatment. Tracer cats were used to monitor re-infestation rates at the end of the trial period. Small numbers of host-seeking fleas were demonstrated in all treatment pens, indicating that total eradication had not been accomplished. It is concluded that the home environment simulation model incorporating tracer animals could provide a powerful tool for studying flea population dynamics under controlled conditions but improved techniques are needed for quantifying other off-host life-cycle stages.