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Kuo PY, Chen PH, Tsai SF, Lin WL, Hung CT, Huang SM. Psychometric evaluation of an adult post-COVID-19 symptom tool: a development and validation study. Sci Rep 2024; 14:664. [PMID: 38182859 PMCID: PMC10770111 DOI: 10.1038/s41598-024-51287-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/03/2024] [Indexed: 01/07/2024] Open
Abstract
The objective of this study was aimed to develop and validate an instrument for post-COVID-19 symptoms in adults. Data were collected from adults with a previous COVID-19 diagnosis in Taiwan. We developed the initial instrument through systematic review and expert feedback. Its validity was tested using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and criterion-related validity, while its reliability was tested using Cronbach's alpha. In total, 310 adults participated in this study. Examination of the EFA clearly classified a five-factor model with 24 items (Kaiser-Meyer-Olkin = 0.903; Bartlett's test of sphericity: X2 = 5242.956, df = 276, p < 0.01). The goodness of fit indices of the CFA were as follows: chi-square = 635.172 (p < 0.01), normed chi-square = 2.669, standardized root mean square residual = 0.077, root mean square error of approximation = 0.073, comparative fit index = 0.922, and Tuker and Lewis index = 0.910. The value of Cronbach's alpha coefficient for the total items was 0.941, and the values for the subscales ranged from 0.813 to 0.924. The instrument exhibited acceptable psychometric properties, proving it to be a valuable tool for evaluating post-COVID-19 symptoms in patients at hospitals.
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Affiliation(s)
- Po-Yuan Kuo
- Taipei Medical University Hospital, Taipei, Taiwan
| | - Ping-Ho Chen
- Taipei Medical University Hospital, Taipei, Taiwan
| | - Shu-Feng Tsai
- Department of Nursing, MacKay Medical College, No. 46, Section 3, Zhongzheng Road, Sanzhi District, New Taipei City, 252, Taiwan
| | - Wan-Ling Lin
- Taipei Medical University Hospital, Taipei, Taiwan
| | - Chia-Tai Hung
- Department of Nursing, MacKay Medical College, No. 46, Section 3, Zhongzheng Road, Sanzhi District, New Taipei City, 252, Taiwan
| | - Sheng-Miauh Huang
- Department of Nursing, MacKay Medical College, No. 46, Section 3, Zhongzheng Road, Sanzhi District, New Taipei City, 252, Taiwan.
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Polastri M, Ciasca A, Nava S, Andreoli E. Two years of COVID-19: Trends in rehabilitation. Pulmonology 2024; 30:1-3. [PMID: 35190299 PMCID: PMC8856133 DOI: 10.1016/j.pulmoe.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 01/26/2022] [Accepted: 01/26/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- M Polastri
- Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, St Orsola University Hospital, Bologna, Italy.
| | - A Ciasca
- Health Professions Direction Service, IRCCS Azienda Ospedaliero-Universitaria di Bologna, St Orsola University Hospital, Bologna, Italy
| | - S Nava
- Department of Clinical, Integrated and Experimental Medicine (DIMES), University of Bologna, Bologna, Italy; Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, St Orsola University Hospital, Bologna, Italy
| | - E Andreoli
- Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, St Orsola University Hospital, Bologna, Italy
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Dezzani EO. Pneumological problems in surgical practice. Minerva Surg 2023; 78:469-480. [PMID: 37870534 DOI: 10.23736/s2724-5691.23.10122-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
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Patrucco F, Solidoro P, Gavelli F, Apostolo D, Bellan M. Idiopathic Pulmonary Fibrosis and Post-COVID-19 Lung Fibrosis: Links and Risks. Microorganisms 2023; 11:microorganisms11040895. [PMID: 37110318 PMCID: PMC10146995 DOI: 10.3390/microorganisms11040895] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/26/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is considered the paradigmatic example of chronic progressive fibrosing disease; IPF does not result from a primary immunopathogenic mechanism, but immune cells play a complex role in orchestrating the fibrosing response. These cells are activated by pathogen-associated or danger-associated molecular patterns generating pro-fibrotic pathways or downregulating anti-fibrotic agents. Post-COVID pulmonary fibrosis (PCPF) is an emerging clinical entity, following SARS-CoV-2 infection; it shares many clinical, pathological, and immune features with IPF. Similarities between IPF and PCPF can be found in intra- and extracellular physiopathological pro-fibrotic processes, genetic signatures, as well as in the response to antifibrotic treatments. Moreover, SARS-CoV-2 infection can be a cause of acute exacerbation of IPF (AE-IPF), which can negatively impact on IPF patients’ prognosis. In this narrative review, we explore the pathophysiological aspects of IPF, with particular attention given to the intracellular signaling involved in the generation of fibrosis in IPF and during the SARS-CoV-2 infection, and the similarities between IPF and PCPF. Finally, we focus on COVID-19 and IPF in clinical practice.
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Affiliation(s)
- Filippo Patrucco
- Respiratory Diseases Unit, Medical Department, AOU Maggiore della Carità Hospital, 28100 Novara, Italy
- Correspondence:
| | - Paolo Solidoro
- Medical Sciences Department, University of Turin, 10126 Turin, Italy
- Respiratory Diseases Unit, Cardiovascular and Thoracic Department, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Francesco Gavelli
- Translational Medicine Department, University of Eastern Piedmont, 28100 Novara, Italy
- Emergency Medicine Department, Maggiore della Carità Hospital, 28100 Novara, Italy
| | - Daria Apostolo
- Translational Medicine Department, University of Eastern Piedmont, 28100 Novara, Italy
| | - Mattia Bellan
- Translational Medicine Department, University of Eastern Piedmont, 28100 Novara, Italy
- Division of Internal Medicine, Medical Department, AOU Maggiore della Carità di Novara, 28100 Novara, Italy
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5
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Li H, Xia J, Bennett D, Roque F, Bam RA, Tavares ABT, Gokhale M, Ida F, Rhee JJ, Soriano Gabarro M, Song Y. Long-COVID-19 clinical and health outcomes: an umbrella review. Ther Adv Infect Dis 2023; 10:20499361231198335. [PMID: 37720384 PMCID: PMC10501084 DOI: 10.1177/20499361231198335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/03/2023] [Indexed: 09/19/2023] Open
Abstract
Background A growing interest in long-term sequelae of COVID-19 has prompted several systematic literature reviews (SLRs) to evaluate long-COVID-19 effects. However, many of these reviews lack in-depth information on the timing, duration, and severity of these conditions. Objectives Our aim was to synthesize both qualitative and quantitative evidence on prevalence and outcomes of long-term effect of COVID-19 through an umbrella review. Design Umbrella review of relevant SLRs on long-COVID-19 in terms of prolonged symptoms and clinical conditions, and comprehensively synthesized the latest existing evidence. Data Sources and Methods We systematically identified and appraised prior systematic reviews/meta-analyses using MEDLINE, Embase, and Cochrane database of systematic review from 2020 to 2021 following the preferred reporting items for systematic reviews and meta-analyses guidance. We summarized and categorized all relevant clinical symptoms and outcomes in adults with COVID-19 using the Medical Dictionary for Regulatory Activities System Organ Class (MedDRA SOC). Results We identified 967 systematic reviews/meta-analyses; 36 were retained for final data extraction. The most prevalent SOC were social circumstances (40%), blood and lymphatic system disorders (39%), and metabolism and nutrition disorder (38%). The most frequently reported SOC outcomes within each MedDRA category were poor quality of life (59%), wheezing and dyspnea (19-49%), fatigue (30-64%), chest pain (16%), decreased or loss of appetite (14-17%), abdominal discomfort or digestive disorder (12-18%), arthralgia with or without myalgia (16-24%), paresthesia (27%) and hair loss (14-25%), and hearing loss or tinnitus (15%). Conclusion This study confirmed a high prevalence of several long COVID-19 outcomes according to the MedDRA categories and indicated that the majority of evidence was rated as moderate to low. Registration The review was registered at PROSPERO (https://www.crd.york.ac.uk/prospero/) (CRD42022303557).
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Affiliation(s)
- Hu Li
- Gilead Sciences Inc., 333 Lakeside Drive, Foster City, CA 94404, USA
| | - Jin Xia
- Takeda Development Center Americas, Inc., Cambridge, MA, USA
| | - Dimitri Bennett
- Takeda Development Center Americas, Inc., Cambridge, MA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Fatima Roque
- Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), Guarda, Portugal
| | | | | | - Mugdha Gokhale
- Pfizer Inc., New York, NY, USA
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | | | | | | | - Yiqing Song
- Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
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Oehler D, Bruno RR, Holst HT, Tudorache I, Aubin H, Sigetti D, Horn P, Akhyari P, Kelm M, Lichtenberg A, Westenfeld R, Boeken U. COVID-19 nach Herztransplantation: Erfahrungen eines deutschen Transplantationszentrums. ZEITSCHRIFT FUR HERZ THORAX UND GEFASSCHIRURGIE 2022; 36:406-413. [PMID: 35875599 PMCID: PMC9297270 DOI: 10.1007/s00398-022-00529-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/11/2022] [Accepted: 04/12/2022] [Indexed: 12/15/2022]
Abstract
Hintergrund Die durch SARS-CoV‑2 (Severe acute respiratory syndrome coronavirus type 2) verursachte Erkrankung gilt bei immunsupprimierten Patienten als besonders gefährlich. Patienten nach einer Herztransplantation zählen zu den Gruppen mit langjähriger, meist 3‑facher Immunsuppression. In der Literatur werden schwerwiegende klinische Verläufe beschrieben. Ziel der Arbeit (Fragestellung) In dieser Arbeit wird über unsere Erfahrungen mit COVID-19 (coronavirus disease 2019) bei herztransplantierten Patienten an einem deutschen Transplantationszentrum longitudinal über die bisherigen Pandemiewellen berichtet und es erfolgt eine Einordnung dieser in publizierte Erfahrungen anderer Zentren. Material und Methoden Alle adulten herztransplantierten Patienten unseres Zentrums, bei denen nach der Herztransplantation eine SARS-CoV-2-Infektion nachgewiesen wurde (n = 12), wurden eingeschlossen und retrospektiv analysiert. Ergebnisse Das Durchschnittsalter betrug 61,5 (49 bis 63) Jahre; die Mehrheit der Patienten war männlich (83 %). Die häufigsten Komorbiditäten waren Diabetes (42 %), arterielle Hypertonie (43 %) sowie chronische Niereninsuffizienz (67 %). Bei 50 % erfolgte bei Krankenhausaufnahme eine passive Immunisierung (Rekonvaleszenzplasma/monoklonale Antikörper). Eine Sauerstoffgabe war bei 33 % der Patienten notwendig; nur ein Patient erhielt eine nichtinvasive Ventilation (8 %). Kein Patient benötigte eine invasive Beatmung oder eine mechanische Herz-Kreislauf-Unterstützung (ECMO). Es fanden sich keine neuen kardiovaskulären oder thrombembolischen Ereignisse. Zusammenfassung In dieser Kohorte konnten wir longitudinal keine schweren Verläufe oder eine erhöhte Mortalität von COVID-19 in herztransplantierten Patienten detektieren. Prospektive Studien sind notwendig, um in Zukunft bessere Prognoseabschätzungen bei COVID-19 in (herz-)transplantierten Patienten treffen zu können.
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Affiliation(s)
- Daniel Oehler
- Klinik für Kardiologie, Pneumologie und Angiologie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Deutschland
| | - Raphael Romano Bruno
- Klinik für Kardiologie, Pneumologie und Angiologie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Deutschland
| | - Hans Torulv Holst
- Klinik für Herzchirurgie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Deutschland
| | - Igor Tudorache
- Klinik für Herzchirurgie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Deutschland
| | - Hug Aubin
- Klinik für Herzchirurgie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Deutschland
| | - Dennis Sigetti
- Klinik für Herzchirurgie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Deutschland
| | - Patrick Horn
- Klinik für Kardiologie, Pneumologie und Angiologie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Deutschland
| | - Payam Akhyari
- Klinik für Herzchirurgie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Deutschland
| | - Malte Kelm
- Klinik für Kardiologie, Pneumologie und Angiologie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Deutschland
| | - Artur Lichtenberg
- Klinik für Herzchirurgie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Deutschland
| | - Ralf Westenfeld
- Klinik für Kardiologie, Pneumologie und Angiologie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Deutschland
| | - Udo Boeken
- Klinik für Herzchirurgie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Deutschland
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Gramaglia C, Gattoni E, Gambaro E, Bellan M, Balbo PE, Baricich A, Sainaghi PP, Pirisi M, Binda V, Feggi A, Jona A, Marangon D, Prosperini P, Zeppegno P. Anxiety, Stress and Depression in COVID-19 Survivors From an Italian Cohort of Hospitalized Patients: Results From a 1-Year Follow-Up. Front Psychiatry 2022; 13:862651. [PMID: 35782424 PMCID: PMC9247238 DOI: 10.3389/fpsyt.2022.862651] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Abstract
Background Mental health-related symptoms can persist over time beyond the most common respiratory clinical features of COVID-19. A recent meta-analysis underlined that mental health sequalae may be relevant for COVID-19 survivors and reported the following prevalence rates: 20% for post-traumatic stress disorder, 22% for anxiety, 36% for psychological distress, and 21% for depression. In the context of a multi-disciplinary follow-up project, we already investigated the mid-term (4 months) psychiatric outcomes in a sample of COVID-19 survivors. Patients were re-assessed after 1-year since hospital discharge. Methods Follow-up conducted after 1 year involved 196 individuals recovered from COVID-19. Patients were assessed with a multi-disciplinary approach; including both a clinical interview performed by an experienced psychiatrist, trained in the use of the Mini-International Neuropsychiatric Interview (MINI) to assess the presence of anxiety, stress, and depressive symptoms and the following self-administered questionnaires: Beck Anxiety Inventory, Beck Depression Inventory-II, Resilience Scale for Adults, Impact of Event Scale, and COVID-19 Peritraumatic Distress Index (CPDI). Results Anxiety (p < 0.0001) and depressive (p < 0.0003) symptoms registered at the clinical interview showed a significant improvement from the 4 to 12-months follow-up. Logistic regression model showed that female gender (p = 0.006), arterial hypertension (p = 0.01), obesity (0.04), anxiety (p < 0.0001), and depressive (p = 0.02) symptoms at 4-months follow-up were associated with persistence of anxiety symptoms at 12 months. At logistic regression analysis female gender (p = 0.02) and depressive symptoms at 4-months follow-up (p = 0.01) were associated with depressive symptoms after 12 months. Conclusion Severity of the disease in the acute phase, in this study, was not a determining factor in identifying subjects at risk of developing clinically relevant anxiety and depression as a consequence of COVID-19 disease. Findings from the logistic regressions suggest that the factors most affecting depression and anxiety in COVID survivors after 12 months were female gender, the presence of anxiety and depression after 4 months and some physical symptoms, not necessarily COVID-related. Impact of infection and consequent hospitalization for COVID-19 did no longer represent a relevant issue for depressive symptoms, compared to other general factors.
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Affiliation(s)
- Carla Gramaglia
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Eleonora Gattoni
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Eleonora Gambaro
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Mattia Bellan
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | | | - Alessio Baricich
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Pier Paolo Sainaghi
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Mario Pirisi
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Valeria Binda
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Alessandro Feggi
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Amalia Jona
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Debora Marangon
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | | | - Patrizia Zeppegno
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
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van Bakel BMA, van den Heuvel FMA, Vos JL, Rotbi H, Bakker EA, Nijveldt R, Thijssen DHJ, Eijsvogels TMH. High Levels of Sedentary Time in Patients with COVID-19 after Hospitalisation. J Clin Med 2022; 11:jcm11041110. [PMID: 35207383 PMCID: PMC8878400 DOI: 10.3390/jcm11041110] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 02/06/2023] Open
Abstract
Many patients with COVID-19 experience severe and even fatal disease. Survivors may have long-term health consequences, but data on physical activity and sedentary behaviour are scarce. Therefore, we objectively assessed physical activity (PA) patterns among post-hospitalised patients with COVID-19 and explored associations with patient characteristics, disease severity and cardiac dysfunction. We objectively assessed PA, sedentary behaviour and sleep duration for 24 h/day during 8 days at 3-6 months after COVID-19 hospitalisation. PA and sedentary time were compared across pre-defined subgroups based on patient and disease characteristics, cardiac biomarker release during hospitalisation, abnormal transthoracic echocardiogram at 3-6 months post-hospitalisation and persistence of symptoms post-discharge. PA and sedentary behaviour were assessed in 37 patients (60 ± 10 years old; 78% male). Patients spent 4.2 [3.2; 5.3] h/day light-intensity PA and 1.0 [0.8; 1.4] h/day moderate-to-vigorous intensity PA. Time spent sitting was 9.8 [8.7; 11.2] h/day, which was accumulated in 6 [5; 7] prolonged sitting bouts (≥30 min) and 41 [32; 48] short sitting bouts (<30 min). No differences in PA and sedentary behaviour were found across subgroups, but sleep duration was higher in patients with versus without persistent symptoms (9.1 vs. 8.3 h/day, p = 0.02). Taken together, high levels of sedentary time are common at 3–6 months after COVID-19 hospitalisation, whilst PA and sedentary behaviour are not impacted by patient or disease characteristics.
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Affiliation(s)
- Bram M. A. van Bakel
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; (B.M.A.v.B.); (H.R.); (E.A.B.); (D.H.J.T.)
| | - Frederik M. A. van den Heuvel
- Department of Cardiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; (F.M.A.v.d.H.); (J.L.V.); (R.N.)
| | - Jacqueline L. Vos
- Department of Cardiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; (F.M.A.v.d.H.); (J.L.V.); (R.N.)
| | - Hajar Rotbi
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; (B.M.A.v.B.); (H.R.); (E.A.B.); (D.H.J.T.)
| | - Esmée A. Bakker
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; (B.M.A.v.B.); (H.R.); (E.A.B.); (D.H.J.T.)
| | - Robin Nijveldt
- Department of Cardiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; (F.M.A.v.d.H.); (J.L.V.); (R.N.)
| | - Dick H. J. Thijssen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; (B.M.A.v.B.); (H.R.); (E.A.B.); (D.H.J.T.)
- Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool L3 5UX, UK
| | - Thijs M. H. Eijsvogels
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; (B.M.A.v.B.); (H.R.); (E.A.B.); (D.H.J.T.)
- Correspondence: ; Tel.: +31-(0)24-36-14273; Fax: +31-(0)24-3668340
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