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BackgroundType 2 diabetes mellitus (T2D) is a common age-related disease, and is a major health concern, particularly in developed countries where the population is aging, including Europe. The multi-scale immune system simulator for the onset of type 2 diabetes (MISSION-T2D) is a European Union-funded project that aims to develop and validate an integrated, multilevel, and patient-specific model, incorporating genetic, metabolic, and nutritional data for the simulation and prediction of metabolic and inflammatory processes in the onset and progression of T2D. The project will ultimately provide a tool for diagnosis and clinical decision making that can estimate the risk of developing T2D and predict its progression in response to possible therapies. Recent data showed that T2D and its complications, specifically in the heart, kidney, retina, and feet, should be considered a systemic disease that is sustained by a pervasive, metabolically-driven state of inflammation. Accordingly, there is an urgent need (1) to understand the complex mechanisms underpinning the onset of this disease, and (2) to identify early patient-specific diagnostic parameters and related inflammatory indicators. ObjectiveWe aim to accomplish this mission by setting up a multi-scale model to study the systemic interactions of the biological mechanisms involved in response to a variety of nutritional and metabolic stimuli and stressors. MethodsSpecifically, we will be studying the biological mechanisms of immunological/inflammatory processes, energy intake/expenditure ratio, and cell cycle rate. The overall architecture of the model will exploit an already established immune system simulator as well as several discrete and continuous mathematical methods for modeling of the processes critically involved in the onset and progression of T2D. We aim to validate the predictions of our models using actual biological and clinical data. ResultsThis study was initiated in March 2013 and is expected to be completed by February 2016. ConclusionsMISSION-T2D aims to pave the way for translating validated multilevel immune-metabolic models into the clinical setting of T2D. This approach will eventually generate predictive biomarkers for this disease from the integration of clinical data with metabolic, nutritional, immune/inflammatory, genetic, and gut microbiota profiles. Eventually, it should prove possible to translate these into cost-effective and mobile-based diagnostic tools.

Introduction: Early increases in muscle strength following unilateral resistance training are typically accompanied by strength gains in the contralateral untrained muscles, a phenomenon known as cross-education. However, the specific motor unit adaptations responsible for this gain transfer remain poorly understood. To address this gap, we recorded myoelectrical activity from the biceps brachii using high-density electromyography. Methods: Nine participants performed 8-week unilateral resistance training and were compared to nine control individuals who did no intervention. Discharge characteristics of longitudinally tracked motor units were assessed during maximal voluntary contractions and isometric ramp contractions at 35% and 70% of the maximal voluntary force (MVF) at baseline (T0), 4 weeks (T1), and 8 weeks (T2) post-intervention. Results: MVF increased by 7% in untrained muscles at T1 and 10% at T2 (p < 0.05). These gains were accompanied by significant decreases in motor unit recruitment thresholds (p < 0.01) and higher net discharge rate (i.e., gain in discharge rate from recruitment to peak) following intervention (p < 0.05). Trained muscles presented greater MVF (+11%, T1; +19%, T2) with similar motor unit adaptations, including a lower recruitment threshold (p < 0.01) and a higher net discharge rate (p < 0.01). Discussion: Our findings indicate that higher strength in untrained muscles is associated with a higher net discharge rate, implying a greater spinal motoneuron output to muscles. The present results underscore the role of motor unit adaptations in the transfer of strength gains to non-trained muscles, offering novel insights into the neural mechanisms underlying cross-education. [ABSTRACT FROM AUTHOR]

Growing evidence suggests that respiratory frequency (fR) is a valid marker of effort during high-intensity exercise, including sports of an intermittent nature, like soccer. However, very few attempts have been made so far to monitor fR in soccer with unobtrusive devices. This study assessed the validity of three strain-based commercial wearable devices measuring fR during soccer-specific movements. On two separate visits to the soccer pitch, 15 players performed a 30 min validation protocol wearing either a ComfTech® (CT) vest or a BioharnessTM (BH) 3.0 strap and a Tyme WearTM (TW) vest. fR was extracted from the respiratory waveform of the three commercial devices with custom-made algorithms and compared with that recorded with a reference face mask. The fR time course of the commercial devices generally resembled that of the reference system. The mean absolute percentage error was, on average, 7.03% for CT, 8.65% for TW, and 14.60% for BH for the breath-by-breath comparison and 1.85% for CT, 3.27% for TW, and 7.30% for BH when comparison with the reference system was made in 30 s windows. Despite the challenging measurement scenario, our findings show that some of the currently available wearable sensors are indeed suitable to unobtrusively measure fR in soccer. [ABSTRACT FROM AUTHOR]

Training load (TL) is a widely used concept in training prescription and monitoring and is also recognized as as an important tool for avoiding athlete injury, illness, and overtraining. With the widespread adoption of wearable devices, TL metrics are used increasingly by researchers and practitioners worldwide. Conceptually, TL was proposed as a means to quantify a dose of training and used to predict its resulting training effect. However, TL has never been validated as a measure of training dose, and there is a risk that fundamental problems related to its calculation are preventing advances in training prescription and monitoring. Specifically, we highlight recent studies from our research groups where we compare the acute performance decrement measured following a session with its TL metrics. These studies suggest that most TL metrics are not consistent with their notional training dose and that the exercise duration confounds their calculation. These studies also show that total work done is not an appropriate way to compare training interventions that differ in duration and intensity. We encourage scientists and practitioners to critically evaluate the validity of current TL metrics and suggest that new TL metrics need to be developed. [ABSTRACT FROM AUTHOR]

Aims: To investigate the relationship between changes in physical fitness and cardiovascular risk factors and scores in patients with type 2 diabetes receiving either a behavioural counselling intervention to increase moderate‐to‐vigorous‐intensity physical activity (MVPA) and decrease sedentary‐time (SED‐time) or standard care. Materials and Methods: This is a pre‐specified ancillary analysis of the Italian Diabetes and Exercise Study_2, a 3‐year randomized clinical trial in which 300 physically inactive and sedentary patients were randomized 1:1 to receive either a one‐month theoretical and practical counselling each year or standard care. Mean changes from baseline throughout the 3‐year period in MVPA, SED‐time, cardiorespiratory fitness (VO2max), muscle strength, flexibility, cardiovascular risk factors and scores were calculated for study completers (n = 267) and considered irrespective of study arm. Results: Haemoglobin (Hb) A1c and coronary heart disease (CHD) risk scores decreased with quartiles of VO2max and lower body muscle strength changes. Multivariable linear regression analysis showed that increases in VO2max independently predicted decreases in HbA1c, blood glucose, diastolic blood pressure (BP), CHD and total stroke 10‐year risk and increases in HDL cholesterol, whereas increases in lower body muscle strength independently predicted decreases in body mass index (BMI), waist circumference, triglycerides, systolic BP, CHD and fatal stroke 10‐year risk. These associations remained after including changes in BMI, waist circumference, fat mass and fat‐free mass, or MVPA and SED‐time as covariates. Conclusions: Improvement in physical fitness predicts favourable changes in cardiometabolic risk profile, independent of changes not only in (central) adiposity or body composition but also in MVPA and SED‐time. Trial Registration: ClinicalTrials.gov; NCT01600937; URL https://clinicaltrials.gov/ct2/show/NCT01600937. [ABSTRACT FROM AUTHOR]

Purpose: Variables currently used in soccer training monitoring fail to represent the physiological demand of the player during movements like accelerations, decelerations, and directional changes performed at high intensity. We tested the hypothesis that respiratory frequency (fR) is a marker of physical effort during soccer-related high-intensity exercise. Methods: A total of 12 male soccer players performed a preliminary intermittent incremental test and 2 shuttle-run high-intensity interval training (HIIT) protocols, in separate visits. The 2 HIIT protocols consisted of 12 repetitions over 9 minutes and differed in the work-to-recovery ratio (15:30 vs 30:15 s). Work rate was self-paced by participants to achieve the longest possible total distance in each HIIT protocol. Results: Work-phase average metabolic power was higher (P < .001) in the 15:30-second protocol (31.7 [3.0] W·kg-1) compared with the 30:15-second protocol (22.8 [2.0] W·kg-1). Unlike heart rate and oxygen uptake, fR showed a fast response to the work--recovery alternation during both HIIT protocols, resembling changes in metabolic power even at supramaximal intensities. Large correlations (P < .001) were observed between fR and rating of perceived exertion during both 15:30-second (r = .87) and 30:15-second protocols (r = .85). Conclusions: Our findings suggest that fR is a good marker of physical effort during shuttle-run HIIT in soccer players. These findings have implications for monitoring training in soccer and other team sports. [ABSTRACT FROM AUTHOR]