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People with spinal cord injury (SCI) tend to be more sedentary and increase fat accumulation, which could have a negative influence on metabolic flexibility. The aim of this study was to investigate the capacity to oxidize fat in a homogenous sample of men with thoracic SCI compared with healthy noninjured men during an arm cycling incremental test. Forty-one men, 21 with SCI and 20 noninjured controls, performed an incremental arm cycling test to determine peak fat oxidation (PFO) and the intensity of exercise that elicits PFO (Fatmax). PFO was expressed in absolute values (g/min) and relative to whole-body and upper-body lean mass ([mg·min−1]·kg−1) through three different models (adjusting by cardiorespiratory fitness and fat mass). Gross mechanical efficiency was also calculated. PFO was higher in SCI than in noninjured men (0.27 ± 0.07 vs. 0.17 ± 0.07 g/min; 5.39 ± 1.30 vs. 3.29 ± 1.31 [mg·min−1]·kg−1 whole-body lean mass; 8.28 ± 2.11 vs. 5.08 ± 2.12 [mg·min−1]·kg−1 upper-body lean mass). Fatmax was found at a significantly higher percentage of VO2peak in men with SCI (33.6% ± 8.2% vs. 23.6% ± 6.4%). Differences persisted and even increased in the fully adjustment model and at any intensity. Men with SCI showed significantly higher gross mechanical efficiency at 35 and 65 W than the noninjured group. Men with SCI showed higher fat oxidation when compared with noninjured men at any intensity, even increased after full adjustment for lean mass, fat mass, and cardiorespiratory fitness. These findings suggest that SCI men could improve their metabolic flexibility and muscle mass for greater efficiency, not being affected by their fat accumulation.

During the Late Bronze Age, a complex network of economic interactions constituted of various semi-independent political entities, yet economically interdependent, existed in the Lower Qishon. We conducted a comparative analysis of plainwares from different sites along the Lower Qishon to identify how they interacted during the LBA. We also performed a comparative study of the maritime-imported ceramics to uncover the maritime connections of the network. We conclude that the Lower Qishon network linked the southern Akko/Haifa Bay with the northwestern Jezreel Valley. On land, the network was in contact with Tel Hazor and the Transjordan. At sea, it was directly connected with Syro-Lebanese and Cypriote coastal sites and indirectly with Egypt, coastal Anatolia, and the Aegean. Durante la Edad del Bronce Final, existía en el cauce bajo del rio Qishon una compleja red de interacciones económicas constituida por varias entidades políticas semiindependientes, pero económicamente interdependientes. Para identificar cómo los diferentes yacimientos arqueológicos situados a lo largo del bajo Qishon interactuaban entre ellos, realizamos un análisis comparativo de sus cerámicas de uso común. También realizamos un estudio comparativo de las cerámicas importadas de ultramar para descubrir las conexiones marítimas de los asentamientos del bajo Qishon. Concluimos que, la red comercial situada en el bajo Qishon conectaba el sur de la bahía de Akko/Haifa con el noroeste del valle de Jezreel. Por tierra, la red enlazaba con Tel Hazor y Transjordania. Vía el comercio marítimo, estaba conectada de forma directa con varios yacimientos costeros sirio-libaneses y chipriotas, y de forma indirecta con Egipto, la costa de Anatolia y el Egeo.

The exact pathophysiology of stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs) remains unknown. The aim of this report is to describe the case of a patient that suffered from a vertebrobasilar stroke in whom asymmetric SIRPIDs due to a large right thalamic and mesencephalic infarction were observed. This case can provide some data that allows us to understand the mechanisms that potentially could be implicated in the origin of this fascinating electroencephalographic phenomenon.

Introduction and purpose To examine the effect of cardiorespiratory fitness (CRF) and muscle power output (MPO) on bone mass of prepubertal and pubertal children using lean mass (LM) and percentage of fat mass (%FM) as mediator variables. The hypothesis was that both LM and %FM would be independent mediators of the relationships during the sexual maturation period. Methods We analyzed 200 children (88 boys and 112 girls [11.5 ± 2.0 yr]). Body composition was analyzed by bone densitometry, and indirect calorimetry and cycle ergometer were used to calculate V˙O2peak (mL·kg·min) and MPO (W) during an incremental exercise test. Sample was divided by pubertal status. Results In the prepubertal group, LM and %FM acted independently as mediators in the relationship between bone mass and CRF or MPO (22%-25% for LM and 37%-50% for %FM, respectively). In pubertal children, LM acted as mediator at 37%. Conclusions Although the independent mediator role of LM and %FM in the associations between CRF or MPO and bone mass was present during the prepubertal stage, only LM remain its mediator role in these associations during the postpubertal period. Therefore, with growth and sexual maturation, the full effect of LM seems to increase, whereas the influence of %FM seems to disappear.

Introducción Varón de 27 años que ingresa en unidad de agudos por estado de agitación psicomotriz y episodio maniforme en probable relación con consumo de cocaína. Objetivo El objetivo de este caso es mostrar al airpiprazol inyectable 9.75 mg como tratamiento eficaz para la agitación psicomotriz y la manía aguda en un paciente consumidor de cocaína Metodología Presentación de caso y revisión de literatura Situacion actual El paciente acude a urgencias por episodio de alteración conductual en via publica. A su llegada presenta marcada agitación psicomotriz. Mantiene un discurso acelerado, taquipsíquico y con descarrilamiento en su discurso. El paciente no presenta antecedentes psiquiátricos. Reconoce un consumo elevado de cocaína desde hace 3 años con aumento en su consumo los últimos meses. Se administra aripiprazol 9.75 mg con diazepam 5 mg intramusculares con mejoría del estado de inquietud. Relata que desde hace una semana se encuentra con sensación de elevada energía junto con ideación delirante de contenido místico y megalomaníaco. Llevaba varios días sin ingerir alimentos, con un consumo diario de cocaína y con disminución importante de las horas de sueño. Se realiza exploración física con pruebas complementarias normales. Durante el ingreso se inicia aripiprazol intramuscular cada 8 horas durante 4 días para más tarde iniciar aripiprazol oral hasta 20 mg día. Los episodios de agitación fueron mitigándose y dándose con menor intensidad y reconducibles verbalmente. Progresivamente se fue organizando su discurso. Respecto al delirio fue distanciándose del contenido delirante pudiendo llegar a realizar crítica tanto de las ideas como del patrón de consumo. conclusión El aripirazol se ha mostrado como un fármaco eficaz para el manejo de episodios maniacos y de sintomatología psicótica. Su formulación intramuscular ha resultado una opción valida para el manejo de episodios de agitación psicomotriz y del tratamiento de sintomaotología maniforme.

Purpose: The present study aims to report the clinical evolution of a patient with AN, without another substance use disorder, who followed 90-day residential treatment with the 12 Steps Minnesota Model and its subsequent two-year follow-up, during which she regularly attends Overeaters Anonymous (OA) groups. Methods: This case report follows the treatment of a 20-year-old female with anorexia nervosa. After 3 months of multidisciplinary treatment, low-doses of venlafaxine and trazodone were initiated. She expressed her decrease in rigidness at mealtimes, increased her weight and had a resumption of menses. She was committed with treatment and maintained her weight gain despite a single binge/purge relapse episode in this 2-year of follow-up. Results: The results obtained in this case suggest that, although purgative and self-injurious behaviours stopped during admission, weight gain was poor during admission and the first year of follow-up, as well as the reporting of improvements in concerns about her weight: it is not until the second year of follow-up that the patient manages to reach weight indicators that can be considered within the range of the norm. Regarding body shape, even though at the end of the second year she refers to greater acceptance, it continues to be a problem. Conclusion: In the case of a patient with AN, without another substance use disorder, the main changes produced regarding to weight gain and body shape acceptance occurred in the second year of follow-up, during which the patient regularly attended OA groups.

Introducción: Varón de 50 años que ingresa en centro de deshabituación por consumo diario de alcohol y cocaína, intensificado en los últimos 8 meses. Objetivos: La presentación del caso pretende ilustrar como el consumo de sustancias puede formar parte de la historia de enfermedad del espectro bipolar y dificultar el diagnóstico y tratamiento. Metodología: Caso clínico y revisión bibliográfica Situación Actual: En tratamiento desde hace 10 meses con venlafaxina 75mg/día y clorazepato dipotásico 10mg/día, iniciado en CAID de area. Al ingreso psicopatológicamente estable, se incrementa clorazepato a 30mg/día para evitar abstinencia. A las 3 semanas de ingreso inicia cuadro de hipoprosexia, trato hiperfamiliar, insomnio, sensación de elevado bienestar, taquipsiquia. Se suspende venlafaxina y a los dos días presenta desorganización conductual, labilidad emocional, insomnio global, irritabilidad, comportamiento referencial con otros pacientes... Se traslada al paciente a urgencias hospitalarias donde se pauta Olanzapina en dosis creciente hasta 10mg. Regresa al centro y en pocos días se corrige el sueño y se resuelve el cuadro clínico. El paciente relata historial previo de un único episodio depresivo en su juventud tras una ruptura. Describe personalidad con tendencia al optimismo, elevada actividad, múltiples planes, desde su juventud ha creado y cerrado diversas empresas... El consumo de alcohol y cocaína ha estado presente de forma habitual desde hace años, incrementado en los últimos meses, coincidiendo con la pauta de antidepresivo. Conclusión: Por su relato el paciente parece tener lo que se denomina temperamento hipertímico en este caso asociado a consumo de sustancias. La pauta de tratamiento antidepresivo incrementa el consumo y parece que la abstinencia y el ingreso favorecen que se desencadene un episodio de hipomanía, también en probable relación con tratamiento antidepresivo. La evolución del paciente se verá favorecida por la pauta de un estabilizador de ánimo, pudiendo establecer diagnóstico dentro del espectro bipolar.

Spinal cord injury (SCI) derives in loss of bone mineral content (BMC) and bone mineral density (BMD). However, physical activity is an important determinant in bone mass acquisition, which is partially mediated through the lean mass (LM). The aim was to examine the effect of cardiorespiratory fitness (CRF) on BMD and BMC arms of adult males with SCI and able-bodied controls using the arm LM as a mediator variable. Thirty able-bodied men and thirty men with SCI participated. BMC and BMD were analysed by DXA, and indirect calorimetry was used to calculate VO

We describe the case of an elderly woman with an episode of ambulatory de novo absence status epilepticus of late onset (DNASLO) after oral treatment with cefuroxime. A high level of suspicion of DNASLO in cases of unexplained confusion in adults or elderly subjects taking cephalosporins is essential to prompt an emergency EEG and, in turn, rapidly achieve an appropriate diagnosis and enable optimal treatment.

Purpose: This study aims to analyze the effects of a 3-month vigorous physical activity (VPA) intervention on eating behavior and body composition in overweight and obese children and adolescents. Methods: Forty-seven participants (7–16 years) took part in the study: 28 were assigned to the intervention group (IG) (10 boys and 18 girls) and 19 in a control group (CG) (8 boys and 11 girls). Body composition (dual-energy X-ray absorptiometry), anthropometrics (body mass, height, and body mass index (BMI)), and eating behavior traits (Three-Factor Eating Questionnaire-R21C) were determined before and after the VPA intervention. Results: A decrease in the percentage of body fat and BMI (−2.8% and −1.8%, respectively), and an increase in most lean mass variables were found in the IG (all p ≤ 0.05). In relation to the eating behavior traits, IG subjects showed a 14% reduction in the Emotional Eating score (p = 0.04), while Cognitive Restraint score did not change after the VPA intervention. The baseline factors of the questionnaire predicted changes in body mass and fat mass variables only in the CG. Conclusion: A 3-month VPA intervention influenced eating behaviors of overweight or obese young, especially the Emotional Eating factor, in the presence of favorable body composition changes. Keywords: Appetite, Children, Exercise, Obesity, TFEQ-R21, Young

PurposeThe aim of this study was to analyze and compare the effects of different sports (swimming, football, basketball, and handball) on fat mass and lean mass in prepubertal and pubertal girls.MethodsTwo hundred girls (10.6 ± 1.5 years old, Tanner stages I–III) participated in the study and were divided into five groups: 40 swimmers, 40 football players, 40 basketball players, 40 handball players, and 40 controls. Fat and lean masses at whole body, arms, trunk, and legs were measured using dual-energy X-ray absorptiometry (DXA). Pubertal status was determined using Tanner test. Effects of different sports on fat and lean masses were assessed through analysis of covariance with height as covariates. Analyses were performed separately in two groups depending on the Tanner stage (prepubertal and pubertal).ResultsThe girls of the control group had less lean mass and more fat mass compared to the girls who play sports (p

Generalized tonic status epilepticus (TSE) is a rare epileptic condition. It occurs usually in the context of symptomatic generalized epilepsy, in particular, in subjects with a diagnosis of Lennox-Gastaut syndrome, atypical forms of idiopathic (genetic) generalized epilepsy, or as a paradoxical effect during treatment with diverse antiepileptic drugs. Herein, we describe the case of an elderly woman on chronic treatment with psychotropic drugs who developed an episode of generalized TSE. Motor manifestations were subtle and difficult to recognize as seizures, and a detailed video-EEG importantly contributed to accurate and prompt diagnosis. TSE was initially refractory to conventional anti-seizure drug therapy including levetiracetam and valproate but was finally controlled with lacosamide. Our case indicates a potential therapeutic effect of lacosamide on TSE in the elderly after treatment failure with first-line anti-seizure drugs. [Published with video sequence on www.epilepticdisorders.com].

Objective: To assess the relationship between fitness levels and components, sitting time and health-related quality of life (HRQoL), over time among community-dwelling older adults. Methods: Three different sitting trajectories were calculated: (i) no change; (ii) decrease; and (iii) increase in ST, between baseline and follow-up. Fitness was assessed using the aerobic capacity, upper and lower limb strength, and total fitness. Participants were classified into higher (75th percentile or above) or lower (below 75th percentile) fitness levels, using the fitness tests. HRQoL scores at follow-up were compared to the three different sitting time trajectories within and across both the higher and the lower fitness groups for each of the three fitness indexes. Results: Greater HRQoL scores were observed in those participants that decreased their ST as compared with those increasing their sitting time over time for participants classified in the lower end of their aerobic capacity or total fitness index. No differences were detected in HRQoL scores in people classified in the higher fitness level group for any of the fitness indexes. Participants that increased or did not change their sitting time and who were classified in the higher fitness end of aerobic capacity and total fitness index self-reported higher HRQoL scores when compared with those in the lower fitness end. Conclusion: Increased sitting time over time is associated with poorer HRQoL in older adults. Higher fitness levels could help attenuate the negative impact of sitting over time.

ResumenSe presenta el caso de un paciente que refiere un cuadro de dolor en el miembro inferior izquierdo, más acusado en zona pretibial, atraumático, desde hace 6 meses. El dolor, de características no mecánicas, era refractario al tratamiento, constante, impidiendo el descanso nocturno. Se realizaron estudios complementarios cuyo primer diagnóstico fue osteomielitis, iniciándose tratamiento antibiótico. Al no ceder el cuadro, fue evaluado nuevamente con el diagnostico final de acrometástasis en el miembro inferior izquierdo como primer signo clínico de un adenocarcinoma pulmonar.Acrometástasis en miembro inferior secundaria a un caso de adenocarcinoma pulmonar es infrecuente y suele proceder de cáncer colorrectal y/o tracto urogenital. En ocasiones puede inducir a una sospecha diagnostica errónea, con el consiguiente retraso en el diagnóstico.AbstractThe case is presented of a patient who referred to a clinical history of non-traumatic pain, of six months onset, in the left lower limb, which was more intensive in pretibial region. The pain was non-mechanical in character, treatment resistant, constant, and with night rest difficulty. Several tests were performed, with osteomyelitis being the primary diagnosis, and antibiotics were started. There was no improvement, and the patient was evaluated again, with the final diagnosis of left lower limb acrometastasis as the first clinical sign of lung adenocarcinoma.Acrometastasis in lower limbs due to lung adenocarcinoma is uncommon and usually arises from colorectal or urogenital cancer. Occasionally it may be lead to an erroneous suspicion resulting in a delay in diagnosis.

Aim The aim of this study was to determine the prognosis of 26 consecutive adults with alpha coma (AC), theta coma (TC) or alpha-theta coma (ATC) following CRA and to describe the clinical setting and EEG features of these patients. Methods We retrospective analyzed a prospectively collected cohort of adult patients diagnosed as having AC, TC or ATC after CRA between January 2008 and June 2016. None of patients included in this analysis underwent therapeutic hypothermia (TH). Neurological outcome was expressed as the best score 6 months after CRA using the five-point Glasgow-Pisttsburgh Cerebral Performance Categories (CPC) Results Twenty-six patients were identified with a diagnosis of postanoxic AC, TC or ATC coma. There were 20 (77%) men and 6 (23%) women. The mean age was 63?±?16?years. The most frequent EEG pattern was TC (21 patients, 80%), followed by AC (3 patients, 12%) and ATC (2 patients, 8%). The cardiac rhythm as primary origin of the CRA was ventricular fibrillation (VF) in 16 patients (61.5%), asystole in 8 patients (34.6%) and ventricular tachycardia (VT) in one patient (3.8%). The presence of EEG reactivity was present in 8 patients (30%). The mortality rate was 85%. Of the 4 surviving patients, two (3.8%) had moderate disability (CPC 2), one (3.8%) had severe disability (CPC 3) and one (3.8%) reached a good recovery. The age was significantly lower in survivors 46.2?±?10.8 versus nonsurvivors 63.3?±?15.5 (p?=?0.04). There was increased association of EEG reactivity with survival (p?=?0.07). Conclusion Hypoxic-ischemic AC, TC and ATC are associated with a poor prognosis and a high rate of mortality. In younger patients with AC, TC and ATC and incomplete forms showing reactivity on the EEG, there is a greater probability of clinical recovery.

OBJECTIVE: The aim of this study was to examine the association of sedentary behaviour patterns with frailty in older people. SETTING: Clinical setting. DESIGN: Cross-sectional, observational study. PARTICIPANTS AND MEASUREMENTS: A triaxial accelerometer was used in a subsample from the Toledo Study for Healthy Aging (519 participants, 67-97 years) to assess several sedentary behaviour patterns including sedentary time per day, the number and duration (min) of breaks in sedentary time per day, and the proportion of the day spent in sedentary bouts of 10 minutes or more. Frailty was assessed using the Frailty Trait Scale (FTS). Regression analysis was used to ascertain the associations between sedentary behaviour patterns and frailty. RESULTS: Sedentary time per day and the proportion of the day spent in sedentary bouts of 10 minutes or more, were positively associated with frailty in the study sample. Conversely, the time spent in breaks in sedentary time was negatively associated with frailty. CONCLUSION: In summary, breaking up sedentary time and time spent in sedentary behaviour are associated with frailty in older people.

Introduction: While current exercise guidelines recommend progressive, high-intensity resistance training (RT) to promote muscle hypertrophy and strength gains, controversy exists regarding the efficacy of lighter-load RT. We compared 2 work-matched RT interventions that differed in training intensity. Methods: Fifteen women underwent 10 weeks of unilateral knee extensor RT. One leg was trained at increasing intensity (intensity leg, InL, 50–80% 1-repetition maximum [1-RM]), and training progression in the contralateral leg (volume leg, VoL, 50% 1-RM) was based on increasing training volumes. Quadriceps muscle size (ultrasound, dual energy X-ray absorptiometry) and strength (isokinetic dynamometry) were assessed on 4 occasions. Results: Both training programs induced significant, yet comparable increases in muscle size (InL: +4.6–12%, VoL: +3.1–11%) and strength (InL: +10–16%, VoL: +10–14%). Conclusions: Training at lower than commonly suggested intensities may be an equally effective alternative form of RT. Factors other than training intensity, such as the total mechanical work during training, may strongly affect the training response. Muscle Nerve 51: 92–101, 2015

The main aim of this study was to compare the bone mass of female football players with controls of different pubertal stages.Sixty five girls aged 8-14 years (10.14 ± 0.1, Tanner stages I-IV) participated in the study. Twenty participants were prepubertal (10 prepubertal control) and 45 peripubertal (15 peripubertal control). All footballers trained two days per week while the control group did not perform regular physical activity outside of school. Body composition was assessed by Dual-energy X-ray absorptiometry. Analysis of covariance was performed to evaluate differences in lean and bone masses.Significant differences in lower-body extremities lean mass (LLM) between peripubertal groups were found (P .05). Additionally, prepubertal footballers showed higher values of bone mineral content (BMC) at the femoral neck (P .05) while peripubertal footballers exhibited enhanced BMC at the whole-body, trochanter and Wards triangle area. Bone mineral density (BMD) was higher in footballers compared to their non-active peers at the femoral neck and intertrochanter (P .05, respectively) while in the peripubertal footballers higher BMD values were found in almost all of the studied body sites.Female footballers showed higher bone and lean masses compared to control counterparts; these differences are already detectable at prepubertal ages and more consistent after pubertal spurt.

Objective: The main purpose of the present study is to assess the factor structure and reliability of the Spanish ver sion of the 21-item Three Factor Eating Questionnaire (TFEQ-R21C) in children and adolescents and to analyze the relationships between eating behaviors, body composition and cardiovascular fitness. Subjects: A total of 192 children and adolescents took part in this study (89 boys and 103 girls; aged from 8.8 to 16.8 years old and with body mass index (BMI) ranging from 13.2 to 41.1 kg/m2 ). None of them had either a his tory of psychological or eating disorders. Measurements: Body composition (dual-energy X-ray absorptiometry-DXA), anthropometrics (body mass, height and BMI), cardiovascular fitness (cyclo-ergometer incremental test) and eating behaviors (TFEQ-R21C) were determined in all participants. Results: The confirmatory factor analysis corroborated the same three factors of the original TFEQ-R21: Uncon trolled Eating (UE), Emotional Eating (EE) and Cognitive Restraint (CR). The internal-consistency reliability (Cronbach's alpha coefficient) for the questionnaire was 0.73. Significant differences were found in BMI (F2,189 = 3.50, p = 0.032) and total fat mass (TFM) (F2,189 = 3.60, p = 0.029) between tertiles of the CR scale (children who had the lowest scores, also had lower BMI and fat mass). Cardiovascular fitness (measured by rel ative VO2 peak) differs depending on the UE and CR scores. The “healthy” group (those who were normal-weight and had also the highest relative VO2 peak) showed a significant lower CR (F3,160 = 3.07, p = 0.030) and higher UE (F3,160 = 3.86, p = 0.011) than the “unhealthy” group (those who were neither normal-weight nor had adequate relative VO2 peak). Conclusions: According to the psychometric analysis of the questionnaire, the TFEQ-R21C is a valid and useful tool to assess eating behaviors in Spanish child population. Further research is necessary to understand the links be tween eating behaviors and other health-related behaviors such as physical activity time or cardiovascular fitness.

This study aims to determine the reliability of assessment criteria used for a portfolio at the Andalusian Agency for Healthcare Quality (ACSA).all competences certification processes, regardless of their discipline.2010-2011. Three types of tests are used: 368 certificates, 17 895 reports and 22 642 clinical practice reports (N=3 010 candidates). The tests were evaluated in pairs by the ACSA team of raters using two categories: valid and invalid.The percentage agreement in assessments of certificates was 89.9%; for the reports of clinical practice, 85.1%; and for clinical practice reports, 81.7%. The inter-rater agreement coefficients (kappa) ranged from 0.468 to 0.711.The results of this study show that the inter-rater reliability of assessments varies from fair to good. Compared with other similar studies, the results put the reliability of the model in a comfortable position. Criteria were reviewed and progressive automation of evaluations was done.El objetivo de este estudio es analizar la fiabilidad inter-jueces de las calificaciones realizadas por el equipo de evaluadores, pertenecientes al programa de certificación de competencias profesionales de la Agencia de Calidad Sanitaria de Andalucía (ACSA). Se estudiaron todos los procesos de certificación de competencias profesionales durante el periodo 2010-2011, independientemente de su disciplina. Se han analizado tres tipos de pruebas: 368 certificados, 17.895 informes de reflexión y 22.642 informes de práctica clínica (N = 3.010 profesionales). El porcentaje de acuerdo en las evaluaciones de certificados fue de un 89,9% (k = 0,711); 85,1% para los informes de práctica clínica (k = 0,455); y 81,7% para los informes de reflexión (k = 0,468). Los resultados de este macro-estudio muestran que la fiabilidad inter-jueces de las evaluaciones varía de ajustada a buena. En comparación con otros estudios similares, los resultados sitúan la fiabilidad del modelo en una posición cómoda. Entre las mejoras incorporadas, se incluyen la revisión de criterios y una progresiva automatización de las evaluaciones.

Background and aims: Exercise training can improve health of patients with metabolic syndrome(MetS).However,whichMetS factors aremost responsive to exercise training remains unclear. We studied the time-course of changes in MetS factors in response to training and detraining. Methods and results: Forty eightMetS patients (52 8.8 yrs old; 33 4 BMI) underwent 4months (3 days/week) of supervised aerobic interval training (AIT) program. After 1 month of training, there were progressive increases in high density lipoprotein cholesterol (HDL-c) and reductions in waist circumference and blood pressure (12 3, 3.9 0.4, and 12 1%, respectively after 4 months; all P < 0.05). However, fasting plasma concentration of triglycerides and glucose were not reduced by training. Insulin sensitivity (HOMA), cardiorespiratory fitness (VO2peak) and exercisemaximal fat oxidation (FOMAx) also progressively improved with training ( 17 5; 21 2 and 31 8%, respectively, after 4months; all P < 0.05). Vastus lateralis samples fromseven subjects revealed that mitochondrial O2 flux was markedly increased with training (71 11%) due to increased mitochondrial content. After 1 month of detraining, the training-induced improvements in waist circumference and blood pressure were maintained. HDL-c and VO2peak returned to the values found after 1e2 months of training while HOMA and FOMAx returned to pre-training values. Conclusions: The health related variables most responsive to aerobic interval training in MetS patients arewaist circumference, blood pressure and the muscle and systemic adaptations to consume oxygen and fat. However, the latter reverse with detraining while blood pressure andwaist circumference are persistent to one month of detraining.

While current exercise guidelines recommend progressive, high-intensity resistance training (RT) to promote muscle hypertrophy and strength gains, controversy exists regarding the efficacy of lighter-load RT. We compared 2 work-matched RT interventions that differed in training intensity.Fifteen women underwent 10 weeks of unilateral knee extensor RT. One leg was trained at increasing intensity (intensity leg, InL, 50-80% 1-repetition maximum [1-RM]), and training progression in the contralateral leg (volume leg, VoL, 50% 1-RM) was based on increasing training volumes. Quadriceps muscle size (ultrasound, dual energy X-ray absorptiometry) and strength (isokinetic dynamometry) were assessed on 4 occasions.Both training programs induced significant, yet comparable increases in muscle size (InL: +4.6-12%, VoL: +3.1-11%) and strength (InL: +10-16%, VoL: +10-14%).Training at lower than commonly suggested intensities may be an equally effective alternative form of RT. Factors other than training intensity, such as the total mechanical work during training, may strongly affect the training response.

A formalism to deal with high-order perturbations of a general spherical background was developed in earlier work [D. Brizuela, J. M. Martín-García, and G. A. Mena Marugán, Phys. Rev. D 74, 044039 (2006); D. Brizuela, J. M. Martín-García, and G. A. Mena Marugán, Phys. Rev. D 76, 024004 (2007)]. In this paper, we apply it to the particular case of a perfect fluid background. We have expressed the perturbations of the energy-momentum tensor at any order in terms of the perturbed fluid’s pressure, density, and velocity. In general, these expressions are not linear and have sources depending on lower-order perturbations. For the second-order case we make the explicit decomposition of these sources in tensor spherical harmonics. Then, a general procedure is given to evolve the perturbative equations of motions of the perfect fluid for any value of the harmonic label. Finally, with the problem of a spherical collapsing star in mind, we discuss the high-order perturbative matching conditions across a timelike surface, in particular, the surface separating the perfect fluid interior from the exterior vacuum.

Penrose’s spinor calculus of four-dimensional Lorentzian geometry is extended to the case of five-dimensional Lorentzian geometry. Such fruitful ideas in Penrose’s spinor calculus as the spin covariant derivative, the curvature spinors, or the defi- nition of the spin coefficients on a spin frame can be carried over to the spinor calculus in five-dimensional Lorentzian geometry. The algebraic and differential properties of the curvature spinors are studied in detail, and as an application, we extend the well-known four-dimensional Newman–Penrose formalism to a five- dimensional spacetime., Gent University (Belgium)

17 pags. ; A-E Appendix, The Gerlach and Sengupta (GS) formalism of coordinate-invariant, first-order, spherical and nonspherical perturbations around an arbitrary spherical spacetime is generalized to higher orders, focusing on second-order perturbation theory. The GS harmonics are generalized to an arbitrary number of indices on the unit sphere and a formula is given for their products. The formalism is optimized for its implementation in a computer-algebra system, something that becomes essential in practice given the size and complexity of the equations. All evolution equations for the second-order perturbations, as well as the conservation equations for the energy-momentum tensor at this perturbation order, are given in covariant form, in Regge-Wheeler gauge., Financial support from the FPI program of the Regional Government of Madrid. J. M. M.-G. acknowledges the financial aid provided by the I3P framework of CSIC and the European Social Fund. This work was also supported by the Spanish MEC Project No. FIS2004-01912 and No. FIS2005-05736-C03-02.

The efficiency of the GHP formalism combined with the power of the computer system xAcT enables an exhaustive systematic analysis to be made of Petrov D vacuum spaces. This gives a complete involutive set of tables for the four GHP derivatives on each of the four GHP spin coefficients and the one Weyl tensor component. It follows directly from these results that the theoretical upper bound on the order of covariant differentiation of the Riemann tensor required for a Karlhede invariant classification of these spaces is reduced to two.