Block training periodization in alpine skiing: effects of 11-day HIT on VO2max and performance

Attempting to achieve the high diversity of training goals in modern competitive alpine skiing simultaneously can be difficult and may lead to compromised overall adaptation. Therefore, we investigated the effect of block training periodization on maximal oxygen consumption (VO2max) and parameters of exercise performance in elite junior alpine skiers. Six female and 15 male athletes were assigned to high-intensity interval (IT, N = 13) or control training groups (CT, N = 8). IT performed 15 high-intensity aerobic interval (HIT) sessions in 11 days. Sessions were 4 x 4 min at 90-95% of maximal heart rate separated by 3-min recovery periods. CT continued their conventionally mixed training, containing endurance and strength sessions. Before and 7 days after training, subjects performed a ramp incremental test followed by a high-intensity time-to-exhaustion (tlim) test both on a cycle ergometer, a 90-s high-box jump test as well as countermovement (CMJ) and squat jumps (SJ) on a force plate. IT significantly improved relative VO2max by 6.0% (P < 0.01; male +7.5%, female +2.1%), relative peak power output by 5.5% (P < 0.01) and power output at ventilatory threshold 2 by 9.6% (P < 0.01). No changes occurred for these measures in CT. tlim remained unchanged in both groups. High-box jump performance was significantly improved in males of IT only (4.9%, P < 0.05). Jump peak power (CMJ -4.8%, SJ -4.1%; P < 0.01), but not height decreased in IT only. For competitive alpine skiers, block periodization of HIT offers a promising way to efficiently improve VO2max and performance. Compromised explosive jump performance might be associated with persisting muscle fatigue.

Evidence, lack of evidence, controversy, and debate in the provision and performance of the surgery of acute type A aortic dissection

Acute type A aortic dissection is a lethal condition requiring emergency surgery. It has diverse presentations, and the diagnosis can be missed or delayed. Once diagnosed, decisions with regard to initial management, transfer, appropriateness of surgery, timing of operation, and intervention for malperfusion complications are necessary. The goals of surgery are to save life by prevention of pericardial tamponade or intra-pericardial aortic rupture, to resect the primary entry tear, to correct or prevent any malperfusion and aortic valve regurgitation, and if possible to prevent late dissection-related complications in the proximal and downstream aorta. No randomized trials of treatment or techniques have ever been performed, and novel therapies-particularly with regard to extent of surgery-are being devised and implemented, but their role needs to be defined. Overall, except in highly specialized centers, surgical outcomes might be static, and there is abundant room for improvement. By highlighting difficulties and controversies in diagnosis, patient selection, and surgical therapy, our over-arching goal should be to enfranchise more patients for treatment and improve surgical outcomes.

Use and Performance of In-Stream Structures for River Restoration: a Case Study from North Carolina

In-stream structures including cross-vanes, J-hooks, rock vanes, and W-weirs are widely used in river restoration to limit bank erosion, prevent changes in channel gradient, and improve aquatic habitat. During this investigation, a rapid assessment protocol was combined with post-project monitoring data to assess factors influencing the performance of more than 558 in-stream structures and rootwads in North Carolina. Cross-sectional survey data examined for 221 cross sections from 26 sites showed that channel adjustments were highly variable from site to site, but approximately 60 % of the sites underwent at least a 20 % net change in channel capacity. Evaluation of in-stream structures ranging from 1 to 8 years in age showed that about half of the structures were impaired at 10 of the 26 sites. Major structural damage was often associated with floods of low to moderate frequency and magnitude. Failure mechanisms varied between sites and structure types, but included: (1) erosion of the channel bed and banks (outflanking); (2) movement of rock materials during floods; and (3) burial of the structures in the channel bed. Sites with reconstructed channels that exhibited large changes in channel capacity possessed the highest rates of structural impairment, suggesting that channel adjustments between structures led to their degradation of function. The data question whether currently used in-stream structures are capable of stabilizing reconfigured channels for even short periods when applied to dynamic rivers.