(1) Background: This report examines the unique demands of off-road triathlon (XT) by presenting physiological, field, and race data from a national champion off-road triathlete using several years of laboratory and field data to detail training and race intensity. (2) Methods: Laboratory and field data were collected when the athlete was at near peak fitness and included oxygen consumption (VO2), heart rate (HR), power output (W), and blood lactate (BLC) during cycling and running, while HR, cycling W, and running metrics were obtained from training and race data files over a period of seven years. Intensity was described using % HR max zones (Z) 1 < 75%, 2 = 75 - 87%, and Zone 3 > 87%, and W. An ordinary least squares analysis was used to model differences between event types. (3) Results: Weather conditions were not different across events. XT events had twice the elevation change (p<0.01) and two-three times greater W’ (p< 0.001) than road triathlon (ROAD), but similar HR intensity profiles (max, avg, and zones); both events are predominately performed at > Z2 or higher intensity. Championship XT events were longer (p<0.01) , with higher kJ expenditure (p<0.001). OLS modelling suggested three variables were strongly related (R2 = 0.84; p < 0.0001) to cycling performance: event type (XT vs ROAD), total meters climbed, and total bike duration. Championship XT runs were slower than either regional (p<0.05) or ROAD (p<0.01) runs, but HR intensity profiles similar. OLS modelling indicates that slower running is linked to either greater total bike kJ expenditure (R2 = 0.57; p<0.001), or total meters gained (R2 = 0.52; p<0.001). Race simulation data support these findings but failed to produce meaningful differences in running. Conclusions: XT race demands are unique and mirror MTB and trail running demands. XT athletes must be mindful of developing anaerobic fitness, technical ability, and aerobic fitness, all of which contribute to off-road cycling economy. It is unclear whether XT cycling affects subsequent running performance different from ROAD cycling.

Cystatin F (CstF) is a protease inhibitor of cysteine cathepsins, including those involved in acti-vating the perforin/granzyme cytotoxic pathways. It is targeted to the endolysosomal pathway but can also be secreted to the extracellular milieu or endocytosed by bystander cells. CtsF was shown to be significantly increased in tuberculous pleurisy, and during HIV coinfection, pleural fluids display high viral loads. In human macrophages, we revealed a strong upregulation of CstF during infection with Mycobacterium tuberculosis (Mtb). CstF manipulation using RNA si-lencing led to increased proteolytic activity of lysosomal cathepsins, improving Mtb intracellular killing. Here, we investigate the impact of CstF depletion during coinfection of Mtb-infected mac-rophages with lymphocytes infected with HIV. Our results indicate that decreasing CstF released by phagocytes impacts the major pro-granzyme convertase cathepsin C of cytotoxic immune cells. Consequently, an observed increase of the granzyme B apoptotic effects leads to a significant re-duction in viral replication in HIV-infected lymphocytes. Overall, our results indicate a mecha-nism of Mtb/HIV evasion of the cytotoxic mediated pathogen killing driven by the ax-is CstF/ catC/granzymes contributing to this syndemic interaction. Ultimately, this knowledge can be crucial for developing new therapeutic approaches to control both pathogens based on manipulating CstF.

The study sought to determine the rate of discordant results between genotypic and phe-notypic tests for the diagnosis of drug resistant tuberculosis (DR-TB). Sputum samples and cultured isolates from suspected DR-TB patients were respectively analysed for My-cobacterium tuberculosis by Xpert® MTB/RIF (Cepheid, USA) and Line Probe Assays (LPA) (Hain, Germany). Discrepant Rifampicin (RMP) resistant results were confirmed using BACTEC MGIT960 (BD, USA). Of 224 RMP-resistant by Xpert MTB/RIF, 5.4% were suscep-tible to RMP by LPA. MGIT960 showed 75% agreement with LPA. Discrepancy was at-tributed to either heteroresistance or DNA contamination during LPA testing in 58.3% of cases. In 25% of samples showing agreement in RMP resistance between Xpert MTB/RIF and MGIT960, discrepancy was attributed to laboratory errors causing false RMP suscep-tible results with LPA. Of 16.7% of cases, discrepancy was attributed to false RMP suscep-tible results with Xpert MTB/RIF. Of 224 isolates, susceptibility to isoniazid (INH) by LPA was performed in 73.7% RMP resistant isolates, of which, 80.6% were resistant. All RMP resistant isolates by Xpert MTB/RIF were confirmed in 98.5% by LPA if TB isolates were resistant to INH, but only confirmed in 81.3% if TB isolates were INH susceptible (ρ < 0.001). In conclusion, Laboratory errors should be considered when investigating dis-cordant results.

The introduction of stool as a readily obtainable sample and the recently developed simple-one-step (SOS) stool processing method offer an opportunity for TB diagnosis in children. We conducted this study at secondary health facilities in Ethiopia which are the first level referral facilities for childhood TB diagnosis and treatment with the aim to determine if stool-based TB diagnosis can be performed with reasonable level of concordance with sputum tests in using Xpert MTB/RIF Ultra. Eligible children 0-14 years with presumptive pulmonary TB were asked to provide stools in addition to routinely requested sputum samples. We computed Cohen’s kappa statistic in SPSS to determine the level of agreement between stool and sputum test results. Of the 373 children included in the study, 61% were &lt;5 years of age and 56% were male. Thirty-six children (9.7%) were diagnosed with TB and all started treatment. The rate of concordance between stool and sputum was high with kappa value of 0.83 (P&lt;0.001). There were more Xpert ultra positive test results on stool (n=27 (7.2%)) than on sputum/NGA (n=23 (6.2%)). Laboratories in secondary hospitals can perform stool-based TB diagnosis in children with high concordance between stool and sputum test results reaffirming the applicability of the SOS method.

In the continued battle against one of the oldest enemies known to mankind, Mycobacterium tuberculosis (MTB), the emergence of drug resistance among children poses multiple challenges for early detection and treatment. Molecular diagnostics and newer drugs like bedaquiline and delamanid have strengthened the armamentarium and helped design convenient, safe and child-friendly therapeutic regimens against drug-resistant tuberculosis (TB). Preventive strategies like treatment of TB infection among children living in close contact with patients with drug-resistant TB and effective vaccines against TB are currently in the investigative stages of development and implementation. In addition to the implementation of recent novel diagnostics and treatment modalities, effective psychosocial and nutritional support, as well as dedicated monitoring for compliance and adverse effects, are crucial determinants for successful treatment outcomes in these children.

This article analyzes some available bike mobile applications for smartphones as an alternative to bike computers (Cycle Computers or speedometer or speed sensors). We have records of a large number of MTB (Mountain Bike) datasets, 219 datasets were recorded on 4 different routes. These applications create maps and profiles from geographic data. Inputs can be in GPS data (tracks and waypoints), driving routes, street addresses, or simple coordinates. Most applications estimate fields such as speed, heading, slope, distance, VMG (velocity made good) and pace (cadence). However, it is necessary to calculate the relationship between cadence and power in pedaling so that cyclists know the appropriate moment to apply power to their legs to improve the torque. This paper shows tables, comparative graphs, and performance evaluation of biking routes in four different cycling mobile applications.

Since certain Mycobacterium tuberculosis complex (MTBC) members, like M. bovis, are endemic in specific South African wildlife reserves and zoos, cases of clinically important nontuberculous mycobacteria (NTM) in wildlife may be neglected. Additionally, due to the inability of tests to differentiate between host responses to MTBC and NTM, the diagnosis of MTBC may be confounded by the presence of NTMs. This may hinder control efforts. These constraints highlight the need for enhanced rapid detection and differentiation methods for MTBC and NTM, especially in high MTBC burden areas. We evaluated the use of the GeneXpert MTB/RIF Ultra, the Hain CMdirect V1.0, and novel amplicon sequencing PCRs targeting the mycobacterial rpoB and ku gene targets, directly on antemortem respiratory samples from known MTBC-infected and NTM culture-positive African elephants (n=26 animals) and rhinoceros (n=23 animals). Our findings suggest that the Ultra is the most sensitive diagnostic test for MTBC DNA detection directly in raw antemortem respiratory specimens and that the rpoB PCR is ideal for Mycobacterium genus DNA detection and species identification through amplicon sequencing.