Παρασκευή, 18 Μαρτίου 2016

Pancreatic cysts in general population on ultrasonography: Prevalence and development of risk score

Abstract

Background

Pancreatic cysts are related to the presence of ductal adenocarcinomas elsewhere in the pancreas, and are also associated with an increased risk of pancreatic adenocarcinoma in the future. Most of the previous studies that investigated the prevalence of pancreatic cysts focused on patients within a hospital or out-patient setting, which may not be representative of the general population. We investigated the prevalence and predictive factors for the presence of pancreatic cysts within a large number of subjects via general health examination.

Methods

Between December 2007 and December 2013, a total of 5198 subjects were enrolled that underwent ultrasonography (US) on general health examination. We established a scoring system for predicting the presence of one or more pancreatic cysts using a split-sample method.

Results

Among the enrolled subjects, the prevalence of a pancreatic cyst was 3.5 %. In multivariate analysis, the prevalence was significantly increased with older age, female sex, and the presence of gall bladder adenomyomatosis (GB-ADM). Based on multivariate analysis in the training sample (n = 2,599), we established the scoring system consisting of age, sex, and the presence of GB-ADM to predict the presence of pancreatic cysts. This scoring system was validated in the testing sample (n = 2,599) and produced an area under the curve of 0.711.

Conclusions

The prevalence of pancreatic cyst detected by US was 3.5 % in the general population, and increased with age, female sex, and the presence of GB-ADM. A new scoring system developed in the present study may help to identify better candidates for further examination when the pancreas is not visible by US.



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Cover Image, Volume 170A, Number 4, April 2016

Thumbnail image of graphical abstract

The cover image, by Karen G. Scheps et al., is based on the Research Article Multiple copy number variants in a pediatric patient with Hb H disease and intellectual disability, DOI: 10.1002/ajmg.a.37532.



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MicroRNA-379-5p inhibits tumor invasion and metastasis by targeting FAK/AKT signaling in hepatocellular carcinoma

Cancer Letters

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Spectrum of gene variants linked to cystic fibrosis in nonwhites



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The performance of vibration controlled transient elastography in a US cohort of patients with nonalcoholic fatty liver disease

The American Journal of Gastroenterology

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Association between allergic rhinitis and asthma symptoms in adults in Sudan

2016-03-18T10-31-54Z
Source: International Journal of Medical Science and Public Health
Aamir Ali Magzoub, Omer Abdelaziz Musa, Asma I Elsony, Ghada Elmahi, Azza O Alawad, Ogail Y Dawoud.
Background: Many published epidemiologic studies confirm a marked increase in the prevalence of asthma and allergic rhinitis (AR). Information is scarce regarding prevalence of AR and its association with asthma symptoms in Sudanese adults. Objective: To determine the prevalence of AR symptoms in the adults in Sudan and its relation with asthma symptoms and to identify the common trigger factors for allergy symptoms. Materials and Methods: A cross-sectional study was performed in Western, Northern, Eastern, and Central Sudan. An epidemiological questionnaire was distributed among the university students, academic staff, employees, and workers chosen randomly. The questionnaire included cardinal asthma symptoms and nasal symptoms in the past year when the subject did not have cold or flu, their seasonal occurrence, trigger factors, and the family history of asthma and AR. Result: A total of 3,974 respondents in the age group of 1867 years were included. Average prevalence of asthma symptoms in Sudanese adults was 10%. Prevalence of AR symptoms was 49% in the total sample with a significantly (p = 0.004) higher prevalence among patients with asthma (72.3%, n = 458) compared with patients without asthma (32.6%, n = 3516). There was a strong association between AR and asthma symptoms in all the sites (odds ratio: 2.914.52). Positive family history was a strong risk factor for AR in all the sites (odds ratio: 3.384.24). Symptoms of AR were more prevalent in winter season followed by summer and autumn. Home dust was found to be the most prevalent trigger factor for symptoms of AR in all the sites. Conclusion: There is a high prevalence of AR symptoms in Sudanese adults, which is significantly associated with asthma symptoms.


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Precision medicine company takes aim at genetically based epilepsy



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Single-port laparoscopic surgery in acute appendicitis: retrospective comparative analysis for 618 patients

Surgical Endoscopy

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Prevalence and risk factors of anxiety among Saudi male secondary schools’ students in Madinah, Saudi Arabia

2016-03-18T10-31-54Z
Source: International Journal of Medical Science and Public Health
Mohammad Mater Al-Johani, Awad Mohammed Al-Qahtani.
Background: Anxiety disorders are frequent in adolescents and are associated with a clinically significant degree of severity and substantial psychosocial disability. Interventions that address their needs can save lives and foster a new generation of productive adults who can help their communities progress. Objective: To determine the prevalence and risk factors responsible for anxiety among male secondary schools students in Madinah. Materials and Methods: Cross-sectional study was conducted in Al-Madinah city in 2012. Only secondary school male students were included for study. Multistage sampling technique was used for students inclusion. The researcher used a self-administered questionnaire containing sociodemographic and medical data and Beck Anxiety Inventory. Fifteen students were given this questionnaire as a pilot study. All data have been entered and analyzed using SPSS version 17. Result: This study indicates the prevalence rates for symptoms of anxiety among Saudi secondary school boys of Al-Madinah city. 61.6% students showed symptoms of anxiety. About 3.4% students showed severe symptoms of anxiety whereas 58.2% of them showed mild to moderate symptoms of anxiety. The risk factors found were accidents, bronchial asthma, and hypertension. Conclusion: This study indicates the prevalence of anxiety among Saudi secondary school boys of Al-Madinah city, Kingdom of Saudi Arabia (KSA). A corelation has been found between symptoms of anxiety and chronic diseases such as hypertension, bronchial asthma, and history of accidents. No significant relation was found between the score of anxiety and the sociodemographic characteristics of the study participants and their parents.


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Publication schedule for 2016



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Pre-existence and persistence of resistant minority hepatitis C virus variants in genotype-1-infected patients treated with simeprevir/peginterferon/ribavirin

Open Forum Infectious Diseases

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Table of Contents, Volume 170A, Number 4, April 2016



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What is the risk of colorectal cancer after an episode of acute diverticulitis in conservatively treated patients?

Journal of Clinical Gastroenterology

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Healthy aging conceptualizations in Saudi Arabia: a systematic review

2016-03-18T10-31-54Z
Source: International Journal of Medical Science and Public Health
Tahani Altamimi.
The concepts of healthy aging have been growing in recent years. Based on searches of literature on aging, there are limited studies that address healthy aging issues for older population in Saudi Arabia. A systematic review of the healthy aging conceptualizations in Arab-Muslim cultures was conducted to identify gaps in the evidence base. A systematic review of healthy aging studies was conducted to critically evaluate the quality of the evidence by comparing it to the STROBE (Strengthening the Reporting of Observational studies in Epidemiology) statement checklist. In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis), specific databases were searched using key terms. Fifteen articles were selected for review. Few research studies address aging in Saudi Arabia and Arab-Muslim societies. Findings from many of the studies did not provide key information that could be used to draw valid conclusions about the concepts of healthy aging in Saudi Arabia or in Arabic culture. This review has underscored the different associations of sociodemographic background, health status, social and family network, religion, and social activity with satisfaction and well-being in old age. However, there is no existing research that has examined the older peoples perspective of healthy aging in Saudi Arabia. Thus, the subjective understanding of older population in Saudi Arabia should be considered to improve the quality of life of Saudi elders.


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In this issue



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High baseline bilirubin and low albumin predict liver decompensation and serious adverse events in HCV-infected patients treated with sofosbuvir-containing regimens

Journal of Viral Hepatitis

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Swallow Outcome in Three Female Siblings with Huntingtons Disease and Chorea

2016-03-18T09-21-19Z
Source: The Journal of Neurobehavioral Sciences
Thejaswi Dodderi, Chinju Micheal.
The present study focuses on describing characteristics of swallow among Huntingtons Disease (HD) with Chorea before and after dysphagia therapy. 3 female siblings of 21, 22 and 33 years having juvenile type onset of HD with chorea were included. The patients were evaluated comprehensively for swallowing using Manipal Manual for Swallow Abilities. Each patient was subjected to ingestion of solid, thin liquid and thick liquid of 5ml and 10 ml quantified using a standard measurable cup. Descriptive statistics was administered on the data using statistical package SPSS (Version 17). On observation, all 3 patients presented with sensory and motor issues in addition to posture instability with abrupt body movements, food spillage, piece meal deglutition, intra bolus retention, wet voice and cough. Following which cognitive approach and behavioural approach based intervention was initiated. The symptoms of intra bolus retention and cough decreased post therapy with no change in sensory aspects. The present study evidences three female siblings with severe cognitive deficits and dysphagia secondary to HD. Despite rehabilitation being provided, they could not completely waiver off the symptoms. These evidences highlight the importance of identifying and addressing swallow based treatment outcomes in HD with chorea.


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Clinical and oncologic outcomes of totally robotic total mesorectal excision for rectal cancer: initial results in a center for minimally invasive surgery

International Journal of Colorectal Disease

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Analyzing of family healthcare centers usage

2016-03-18T09-54-22Z
Source: Balkan Military Medical Review
Yasin UZUNTARLA.
Introduction: Family healthcare centers are primary healthcare institutions in which people are examined, got treatment, referred to higher level health care institutions if necessary, and which deliver preventive health care. Objective: This study aimed at analyzing family healthcare centers usage and determining impression of individuals about these institutions. Methods: Data was collected by questionnaire method. The questionnaire used in this research comprised 13 questions including sociodemographic characteristic and individuals' attitudes related to family healthcare center usage. SPSS 21 software was used for statistical analyze. Frequencies and percentages indicated descriptive data. This study is cross-sectional type. Within this study, all 60 technical employees of a global electronic company were reached in Ankara/Turkey. Results: It was found of participants, 68.3% applied to doctor 2-5 times during last six months, 93.3% applied to family health care center once, almost three quarter chose private hospital in first. It was seen of technical employees, 31.7% didn't choose family healthcare centers, because of specialist absence, 51.7% chose these institutions for examining, being close to family health center was an affecting factor for 65.0% of technical employees. Conclusion: Effect of private healthcare insurances delivered by this company is seen on technical employees' healthcare choice. It is thought family health care centers have important role in delivering high quality, low cost and effective healthcare. This study, conducted on technical employees for the first time, is considered contributive to healthcare manager and policy makers.


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Alterations in the mucosa-associated bacterial composition in Crohn's disease: a pilot study

International Journal of Colorectal Disease

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Accuracy evaluation of the optical surface monitoring system on EDGE linear accelerator in a phantom study

Medical Dosimetry

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The differential effects of 1,25-dihydroxyvitamin D3 on Salmonella-induced interleukin-8 and human beta-defensin-2 in intestinal epithelial cells

Clinical and Experimental Immunology

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Hemobilia following laparoscopic cholecystectomy: computed tomography findings and clinical outcome of transcatheter arterial embolization

Acta Radiologica

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Anatomical predilection of intestinal metaplasia based on 78,335 endoscopic cases

Saudi Journal of Gastroenterology

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Tumor MGMT promoter hypermethylation changes over time limit temozolomide efficacy in a phase II trial for metastatic colorectal cancer

Annals of Oncology

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Albumin-bilirubin score for predicting the in-hospital mortality of acute upper gastrointestinal bleeding in liver cirrhosis: A retrospective study

The Turkish Journal of Gastroenterology

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Hand and Eye Dominance in Sport: Are Cricket Batters Taught to Bat Back-to-Front?

Abstract

Background

When first learning to bimanually use a tool to hit a target (e.g., when chopping wood or hitting a golf ball), most people assume a stance that is dictated by their dominant hand. By convention, this means that a 'right-handed' or 'left-handed' stance that places the dominant hand closer to the striking end of the tool is adopted in many sports.

Objective

The aim of this study was to investigate whether the conventional stance used for bimanual hitting provides the best chance of developing expertise in that task.

Methods

Our study included 43 professional (international/first-class) and 93 inexperienced (<5 years' experience) cricket batsmen. We determined their batting stance (plus hand and eye dominance) to compare the proportion of batters who adopted a reversed stance when batting (that is, the opposite stance to that expected based on their handedness).

Results

We found that cricket batsmen who adopted a reversed stance had a stunning advantage, with professional batsmen 7.1 times more likely to adopt a reversed stance than inexperienced batsmen, independent of whether they batted right or left handed or the position of their dominant eye.

Conclusion

Findings imply that batsmen who adopt a conventional stance may inadvertently be batting 'back-to-front' and have a significant disadvantage in the game. Moreover, the results may generalize more widely, bringing into question the way in which other bimanual sporting actions are taught and performed.



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The first-in-class anti-EGFR antibody mixture Sym004 overcomes cetuximab-resistance mediated by EGFR extracellular domain mutations in colorectal cancer

Clinical Cancer Research

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A real-world study focused on the long-term efficacy of mycophenolate mofetil as first-line treatment of autoimmune hepatitis

Alimentary Pharmacology and Therapeutics

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Micronutrient supplementation after biliopancreatic diversion with duodenal switch in the long term

Obesity Surgery

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Impact of the Fukushima accident on tritium, radiocarbon and radiocesium levels in seawater of the western North Pacific Ocean: A comparison with pre-Fukushima situation

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Publication date: Available online 17 March 2016
Source:Journal of Environmental Radioactivity
Author(s): P.P. Povinec, L. Liong Wee Kwong, J. Kaizer, M. Molnár, H. Nies, L. Palcsu, L. Papp, M.K. Pham, P. Jean-Baptiste
Tritium, radiocarbon and radiocesium concentrations in water column samples in coastal waters offshore Fukushima and in the western North Pacific Ocean collected in 2011–2012 during the Ka'imikai-o-Kanaloa (KoK) cruise are compared with other published results. The highest levels in surface seawater were observed for 134Cs and 137Cs in seawater samples collected offshore Fukushima (up to 1.1 Bq L−1), which represent an increase by about three orders of magnitude when compared with the pre-Fukushima concentration. Tritium levels were much lower (up to 0.15 Bq L−1), representing an increase by about a factor of 6. The impact on the radiocarbon distribution was measurable, but the observed levels were only by about 9% above the global fallout background. The 137Cs (and similarly 134Cs) inventory in the water column of the investigated western North Pacific region was (2.7 ± 0.4) PBq, while for 3H it was only (0.3 ± 0.2) PBq. Direct releases of highly contaminated water from the damaged Fukushima NPP, as well as dry and wet depositions of these radionuclides over the western North Pacific considerably changed their distribution patterns in seawater. Presently we can distinguish Fukushima labeled waters from global fallout background thanks to short-lived 134Cs. However, in the long-term perspective when 134Cs will decay, new distribution patterns of 3H, 14C and 137Cs in the Pacific Ocean should be established for future oceanographic and climate change studies in the Pacific Ocean.



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Effects of Pedal Speed and Crank Length on Pedaling Mechanics during Submaximal Cycling

imageDuring submaximal cycling, the neuromuscular system has the freedom to select different intermuscular coordination strategies. From both a basic science and an applied perspective, it is important to understand how the central nervous system adjusts pedaling mechanics in response to changes in pedaling conditions. Purpose: To determine the effect of changes in pedal speed (a marker of muscle shortening velocity) and crank length (a marker of muscle length) on pedaling mechanics during submaximal cycling. Methods: Fifteen trained cyclists performed submaximal isokinetic cycling trials (90 rpm, 240 W) using pedal speeds of 1.41 to 1.61 m·s−1 and crank lengths of 150 to 190 mm. Joint powers were calculated using inverse dynamics. Results: Increases in pedal speed and crank length caused large increases knee and hip angular excursions and velocities (P 0.05). Joint moments and joint powers were less affected by changes in the independent variables, but some interesting effects and trends were observed. Most noteworthy, knee extension moments and powers tended to decrease, whereas hip extension power tended to increase with an increase in crank length. Conclusions: The distribution of joint moments and powers is largely maintained across a range of pedaling conditions. The crank length induced differences in knee extension moments, and powers may represent a trade-off between the central nervous system's attempts to simultaneously minimize muscle metabolic and mechanical stresses. These results increase our understanding of the neural and mechanical mechanisms underlying multi-joint task performance, and they have practical relevance to coaches, athletes, and clinicians.

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Resistance Exercise Impacts Lean Muscle Mass in Women with Polycystic Ovary Syndrome

imagePurpose: This study investigated the effects of progressive resistance training (PRT) on lean muscle mass (LMM) in women with or without polycystic ovary syndrome (PCOS) and its effects on metabolic factors and concentrations of related steroid hormones. Design: This was a nonrandomized, therapeutic, open, single-arm study. Participants: All in all, 45 sedentary women with PCOS and 52 without (non-PCOS), 18–37 yr of age, with body mass indexes (BMI) of 18–39.9 kg·m−2 of all races and social status, performed PRT three times a week for 4 months. Before and after PRT, the concentrations of hormones and metabolic factors and waist circumference were measured. LMM and total body fat percentage were determined using dual-energy x-ray absorptiometry. Clinical characteristics, LMM, and fasting glucose were adjusted for confounding covariables and compared using general linear mixed models. Each patient's menstrual history was taken before study enrollment and after PRT. Results: PRT resulted in reduced plasma testosterone and fasting glucose levels. After PRT, the androstenedione concentration increased and the sex hormone-binding globulin concentration decreased in women with PCOS. The waist circumference was reduced (P

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Training Increases Muscle O2 Diffusing Capacity Intrinsic to the Elevated V˙O2max

No abstract available

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Muscle Activity during Rapid Wrist Extension in People with Lateral Epicondylalgia

imageBackground: Individuals with lateral epicondylalgia (LE) have delayed upper limb reaction time (RT); however, it is unknown if the mechanisms of this dysfunction are related to neural processing or the affected forearm muscles. The aim of this study was to examine the timing of processes that occur before and after forearm muscles are activated during the RT task. Methods: Eleven LE (42 ± 11 yr) and 11 healthy controls (42 ± 11 yr) performed rapid wrist extension in response to an audio cue. Intramuscular EMG was obtained from extensor carpi radialis brevis (ECRB), extensor digitorum communis (EDC), extensor carpi ulnaris (ECU), and anconeus. Premotor time (PMT) was the duration from an audio cue to the onset of muscle activity, and motor time (MT) was the onset of muscle activity to the onset of wrist extension. Standard clinical assessments of LE were also performed. Results: RT was significantly slower (33; 95% CI, 1–66 ms) in the LE group. There were no group differences in PMT and the order of muscle activation. Instead, the MT of ECRB (18; 95% CI, 6–31 ms), EDC (12; 95% CI, 1–23 ms), ECU (28; 95% CI, 9–46 ms), and anconeus (33; 95% CI, 11–56 ms) showed significant delay in LE group. Regression analyses revealed that the duration of LE could predict RT, ECRB, and anconeus PMT, whereas cold pain threshold predicted ECRB MT. Conclusions: Delayed RT in LE was predominantly caused by deficits in ECRB and EDC MT. This study provides preliminary evidence that in the people with longer LE symptoms, duration appeared to have faster RT, although confirmation of this finding is required before firm conclusions can be drawn.

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Similar Hemoglobin Mass Response in Hypobaric and Normobaric Hypoxia in Athletes

imagePurpose: To compare hemoglobin mass (Hbmass) changes during an 18-d live high–train low (LHTL) altitude training camp in normobaric hypoxia (NH) and hypobaric hypoxia (HH). Methods: Twenty-eight well-trained male triathletes were split into three groups (NH: n = 10, HH: n = 11, control [CON]: n = 7) and participated in an 18-d LHTL camp. NH and HH slept at 2250 m, whereas CON slept, and all groups trained at altitudes 0.08) and remained unchanged in CON (+0.2%, P = 0.89). Conclusion: HH and NH evoked similar Hbmass increases for the same hypoxic dose and after 18-d LHTL. The wide variability in individual Hbmass responses in HH and NH emphasizes the importance of individual Hbmass evaluation of altitude training.

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Oxidative Stress and Fitness Changes in Cancer Patients after Exercise Training

imageIntroduction: The purpose of this study was to determine the effect of an exercise intervention (EX) on muscular strength, cardiorespiratory fitness (CRF), and oxidative stress in cancer survivors compared with a nonexercising cancer control group (CON). Methods: Fifteen cancer patients and seven age-matched individuals with no history of cancer (NC) participated in this study. A blood draw and assessments of muscular strength and CRF were administered to cancer survivors within 6 wk of completing radiation or chemotherapy, and again 10 wk later. Eight cancer patients completed a 10-wk supervised exercise intervention, whereas seven continued standard care. Baseline oxidative stress was compared between cancer patients and the NC group. Changes in plasma protein carbonyls, 8-OHdG, and Trolox equivalent antioxidant capacity were compared between groups using repeated-measures ANOVA, and correlations between fitness and oxidative stress changes were evaluated. Results: Baseline antioxidant capacity was significantly lower, and plasma protein carbonyls were significantly higher in cancer patients compared with NC (P = 0.001). EX had a significant increase in antioxidant capacity (P

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Hemodynamic Responses to Resistance Exercise in Patients with Coronary Artery Disease

imagePurpose: Investigate hemodynamic responses of resistance exercise (RE) with moderate load (i.e., international guidelines for RE of patients) versus RE with high load in patients with coronary artery disease (CAD). Methods: Medically stable male (n = 11) and female patients (n = 4) treated with PCI or percutaneous coronary intervention, or coronary artery bypass surgery a minimum of 6 months before this study, performed three sets of 15RM and 4RM RE in a randomized order on separate days. Beat-to-beat systolic (SBP), diastolic (DBP) blood pressure, heart rate (HR), stroke volume (SV), cardiac output (CO), and systemic vascular resistance (SVR) were monitored at preexercise, and continuously during RE. Results: Compared with preexercise, SBP and DBP (mean of three sets) increased by 12% to 13% (both; P

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Effects of Sprint Interval Cycling on Fatigue, Energy, and Cerebral Oxygenation

imageIntroduction: Feelings of fatigue are reduced after a session of continuous exercise of low-to-moderate intensity lasting 20 min or more, but only when feelings of energy are increased. Feelings of fatigue and energy have not been described after fatiguing, high-intensity interval exercise. Cerebral oxygenation has been implicated as a central correlate of fatigability, but it has not been studied concurrent with perceived fatigue during or after exercise. Methods: Fifteen recreationally active participants (8 women, 7 men) completed bouts of sprint interval cycling (four, 30-s all-out sprints each followed by 4 min of active recovery) and a time- and work-matched bout of constant resistance cycling. Oxygenation (oxygenated hemoglobin [HbO2]) and deoxygenation (deoxygenated hemoglobin [HHb]) in the dorsolateral prefrontal cortex were measured using near-infrared spectroscopy. Fatigue ratings during each sprint and feelings of fatigue and energy during recovery were assessed. Results: Increases in HbO2 and HHb in frontal cortex were greater during sprint cycling than during constant resistance cycling (P = 0.001). Fatigability (decreased power output) increased over successive sprints (P = 0.001). About 95% of the increase in fatigue ratings across sprints (P

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Using Sit-to-Stand Workstations in Offices: Is There a Compensation Effect?

imagePurpose: Sit-to-stand workstations are becoming common in modern offices and are increasingly being implemented in sedentary behavior interventions. The purpose of this study was to examine whether the introduction of such a workstation among office workers leads to reductions in sitting during working hours, and whether office workers compensate for any reduction in sitting at work by increasing sedentary time and decreasing physical activity (PA) outside work. Methods: Office workers (n = 40; 55% female) were given a WorkFit-S, sit-to-stand workstation for 3 months. Participants completed assessments at baseline (before workstation installation), 1 wk and 6 wk after the introduction of the workstation, and again at 3 months (postintervention). Posture and PA were assessed using the activPAL inclinometer and ActiGraph GT3X+ accelerometer, which participants wore for 7 d during each measurement phase. Results: Compared with baseline, the proportion of time spent sitting significantly decreased (75% ± 13% vs 52% ± 16% to 56% ± 13%), and time spent standing and in light activity significantly increased (standing: 19% ± 12% vs 32% ± 12% to 37% ± 15%, light PA: 14% ± 4% vs 16% ± 5%) during working hours at all follow-up assessments. However, compared with baseline, the proportion of time spent sitting significantly increased (60% ± 11% vs 66% ± 12% to 68% ± 12%) and light activity significantly decreased (21% ± 5% vs 19% ± 5%) during nonworking hours across the follow-up measurements. No differences were seen in moderate-to-vigorous activity during nonworking hours throughout the study. Conclusion: The findings suggest that introducing a sit-to-stand workstation can significantly reduce sedentary time and increase light activity levels during working hours. However, these changes were compensated for by reducing activity and increasing sitting outside of working hours. An intervention of a sit-to-stand workstation should be accompanied by an intervention outside of working hours to limit behavior compensation.

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Cardiorespiratory Fitness, Sedentary Time, and Cardiovascular Risk Factor Clustering

imagePurpose: Prolonged sedentary time (ST) is associated with cardiovascular risk factors (CV-RF) independent of physical activity (PA). Whether a high level of cardiorespiratory fitness (CRF) can modify the deleterious health consequences related to high ST is not known. Methods: We performed a cross-sectional study of 12,274 men and 14,209 women (≥20 yr) without known cardiovascular disease. Self-reported ST measurements during a regular day were divided into three sex-specific equally sized groups (≤4, 5 to

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Sedentary Sphere: Wrist-Worn Accelerometer-Brand Independent Posture Classification

imageIntroduction: Access to raw acceleration data should facilitate comparisons between accelerometer outputs regardless of monitor brand. Purpose: To evaluate the accuracy of posture classification using the Sedentary Sphere in data from two widely used wrist-worn triaxial accelerometers. Methods: Laboratory: Thirty-four adults wore a GENEActiv and an ActiGraph GT3X+ on their nondominant wrist while performing four lying, seven sitting, and five upright activities. Free-living: The same participants wore both accelerometers on their nondominant wrist and an activPAL3 on their right thigh during waking hours for 2 d. Results: Laboratory: Using the Sedentary Sphere with 15-s epoch GENEActiv data, sedentary and upright postures were correctly identified 74% and 91% of the time, respectively. Corresponding values for the ActiGraph data were 75% and 90%. Free-living: Total sedentary time was estimated at 534 ± 144, 523 ± 143, and 528 ± 137 min by the activPAL, the Sedentary Sphere with GENEActiv data and with ActiGraph data, respectively. The mean bias, relative to the activPAL, was small with moderate limits of agreement (LoA) for both the GENEActiv (mean bias = −12.5 min, LoA = −117 to 92 min) and ActiGraph (mean bias = −8 min, LoA = −103 to 88 min). Strong intraclass correlations (ICC) were evident for the activPAL with the GENEActiv (0.93, 0.84–0.97 (95% confidence interval) and the ActiGraph (0.94, 0.86–0.97). Agreement between the GENEActiv and ActiGraph posture classifications was very high (ICC = 0.98 (0.94–0.99), mean bias = +3 min, LoA = −58 to 63 min). Conclusions: These data support the efficacy of the Sedentary Sphere for classification of posture from a wrist-worn accelerometer in adults. The approach is equally valid with data from both the GENEActiv and ActiGraph accelerometers.

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Physical Activity, Television Viewing Time, and 12-Year Changes in Waist Circumference

imagePurpose: Both moderate-to-vigorous physical activity (MVPA) and sedentary behavior can be associated with adult adiposity. Much of the relevant evidence is from cross-sectional studies or from prospective studies with relevant exposure measures at a single time point before weight gain or incident obesity. This study examined whether changes in MVPA and television (TV) viewing time are associated with subsequent changes in waist circumference, using data from three separate observation points in a large population-based prospective study of Australian adults. Methods: Data were obtained from the Australian Diabetes, Obesity, and Lifestyle study collected in 1999–2000 (baseline), 2004–2005 (wave 2), and 2011–2012 (wave 3). The study sample consisted of adults age 25 to 74 yr at baseline who also attended site measurement at three time points (n = 3261). Multilevel linear regression analysis examined associations of initial 5-yr changes in MVPA and TV viewing time (from baseline to wave 2) with 12-yr change in waist circumference (from baseline to wave 3), adjusting for well-known confounders. Results: As categorical predictors, increases in MVPA significantly attenuated increases in waist circumference (P for trend

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Fit To Be Well: Essential Concepts, 4th Edition

No abstract available

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Displacing Sedentary Time: Association with Cardiovascular Disease Prevalence

imagePurpose: Isotemporal substitution analysis offers new insights for public health but has only recently been applied to sedentary behavior research. We aimed to quantify associations between the substitution of 10 min of sedentary behavior with 10 min of light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) and the prevalence of cardiovascular disease (CVD). Age was also explored as a potential effect modifier. Methods: We completed a secondary analysis of data from 1477 adults from the Health Survey for England (2008). Sedentary time, LPA, and MVPA were measured using accelerometry. We applied isotemporal models to quantify the relationship with CVD prevalence of replacing 10 min of sedentary time with equivalent amounts of LPA or MVPA. Prevalence risk ratios (RR) with 95% confidence intervals (CI) are presented, adjusted for covariates. The role of age as an effect modifier was explored via age–MVPA and age–LPA interactions. CVD was defined as per the International Classification of Diseases. Results: The prevalence of CVD was 24%. The RR was 0.97 (95% CI, 0.96–0.99) for LPA and 0.88 (0.81–0.96) for MVPA. Substitution of approximately 50 min of LPA would be required for an association equivalent to 10 min of MVPA. The beneficial association of MVPA was attenuated with age, with a decrease in the relative risk reduction of approximately 7% per decade. Conclusions: Isotemporal substitution of sedentary time with LPA was associated with a trivial relative risk reduction for CVD, whereas the equivalent replacement with MVPA had a small beneficial relationship. With respect to CVD prevalence, MVPA might become decreasingly important in older individuals. Prospective studies are needed to investigate causality.

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Older Runners Retain Youthful Running Economy despite Biomechanical Differences

imagePurpose: Sixty-five years of age typically marks the onset of impaired walking economy. However, running economy has not been assessed beyond the age of 65 yr. Furthermore, a critical determinant of running economy is the spring-like storage and return of elastic energy from the leg during stance, which is related to leg stiffness. Therefore, we investigated whether runners older than 65 yr retain youthful running economy and/or leg stiffness across running speeds. Methods: Fifteen young and 15 older runners ran on a force-instrumented treadmill at 2.01, 2.46, and 2.91 m·s−1. We measured their rates of metabolic energy consumption (i.e., metabolic power), ground reaction forces, and stride kinematics. Results: There were only small differences in running economy between young and older runners across the range of speeds. Statistically, the older runners consumed 2% to 9% less metabolic energy than the young runners across speeds (P = 0.012). Also, the leg stiffness of older runners was 10% to 20% lower than that of young runners across the range of speeds (P = 0.002), and in contrast to the younger runners, the leg stiffness of older runners decreased with speed (P

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Effects of Oral Contraceptive Use on Anterior Cruciate Ligament Injury Epidemiology

imageIntroduction/Purpose: Anterior cruciate ligament injuries often incur major consequences for athletes. Elevated estrogen levels are likely increase the risk for injury. This risk may be partially or fully mitigated by the use of oral contraceptives. The purpose of this study was to determine if women undergoing anterior cruciate ligament surgical reconstruction were less likely to use oral contraceptives than matched noninjured population. Methods: This is a case–control study utilizing national insurance claims data from 2002 TO 2012. Participants included women age 15–39 yr. Cases were defined as those receiving surgical reconstruction of the anterior cruciate ligament between 2002 and 2012. Controls were matched 3/1 to cases. Exposure to oral contraceptives was defined as the presence of any prescription fill for oral contraceptives during the previous 12 months to index date. Conditional multivariate logistic regression was used to estimate adjusted odds ratios for the use of oral contraceptives. Results: Women age 15–19 yr undergoing surgical repair of the anterior cruciate ligament were 18% less likely to use oral contraceptives than matched controls (adjusted odds ratio, 0.82; 95% CI, 0.75–0.91; P

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Maximizing Performance: Augmented Feedback, Focus of Attention, and/or Reward?

imagePurpose: Different approaches like providing augmented feedback (aF), applying an external focus of attention (EF), or rewarding participants with money (RE) have been shown to instantly enhance motor performance. So far, these approaches have been tested either in separate studies or directly against each other. However, there is no study that combined aF, EF, and/or RE to test whether this provokes additional benefits. The aim of the present study was therefore to identify the most powerful combination. Methods: Eighteen participants performed maximal countermovement jumps in six different conditions: neutral (NE), aF, RE, aF + EF, aF + RE, and aF + EF + RE. Results: Participants demonstrated the highest jump heights with aF + EF, followed by aF + EF + RE, aF + RE, aF, RE, and finally, NE. Activity of the M. rectus femoris differed significantly between conditions resulting in lower muscular activity in aF + EF and aF + EF + RE compared with NE. All other parameters, such as ground reaction forces and joint angles, were comparable across conditions. Conclusions: This is the first study showing superior performance when combining aF with EF. As reduced muscular activity was found only in conditions with EF, it is argued in line with the constrained action hypothesis that adopting an EF improves movement efficiency. In contrast, aF seems to rather enhance (intrinsic) motivation. However, monetary reward did not further amplify performance.

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Risk Factors for Knee Injuries in Children 8 to 15 Years: The CHAMPS Study DK

imageIntroduction: Knee injuries are frequent in children, with most studies reporting traumatic knee injuries. Evidence of risk factors for knee injuries in children is sparse. The purpose of this study was to report the extent of traumatic and overuse knee injuries in children and to evaluate intrinsic and extrinsic factors for risk of these injuries. Methods: Weekly musculoskeletal pain, sport participation, and sports type were reported by 1326 school children (8–15 yr). Knee injuries were classified as traumatic or overuse. Multinomial logistic regression was used for analyses. Results: During the study period, 952 (15% traumatic and 85% overuse) knee injuries were diagnosed. Period prevalence for traumatic and overuse knee injuries were 0.8/1000 and 5.4/1000 sport participations, respectively. Participation in tumbling gymnastics was a risk factor for traumatic knee injuries (OR, 2.14). For overuse knee injuries, intrinsic risk factors were sex (girls OR, 1.38) and previous knee injury (OR, 1.78), whereas participation in soccer (OR, 1.64), handball (OR, 1.95), basket (OR, 2.07), rhythmic (OR, 1.98), and tumbling gymnastics (OR, 1.74) were additional risk factors. For both injury types, sport participation above two times per week increased odds (OR, 1.46–2.40). Conclusions: Overuse knee injuries were the most frequent injury type. For traumatic knee injuries, participation in tumbling gymnastics was a risk factor. Risk factors for overuse knee injuries were being a girl; previous knee injury; and participation in soccer, handball, basket, and rhythmic and tumbling gymnastics. Further risk factors for both types of injury were participation in sports above two times per week. Although growth-related overuse knee injuries are a self-limiting condition, a major part of children are affected by these injuries with unknown short- and long-term consequences.

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Immediate Effects of Aerobic Exercise on Plasma/Serum Zinc Levels: A Meta-analysis

imageBackground: Zinc is involved in numerous metabolic roles, including energy metabolism, immunity, and antioxidative effects. Zinc losses during exercise, in particular through sweat, are well documented. However, conflicting results have been reported for changes in circulating and tissue zinc concentration as a result of exercise. The purpose of this article is to quantify the immediate effect of aerobic exercise on plasma or serum zinc levels, in healthy participants. Methods: We conducted a systematic review of peer-reviewed articles published up to December 20, 2014, to identify studies that investigated the acute effects of exercise on selected indices of zinc status. Meta-analyses were conducted to determine the change in serum zinc concentration immediately after a bout of aerobic exercise. Results: Forty-five studies were included in the systematic literature review. Of the included studies, sufficient data were available from 34 studies (providing 46 comparisons) to quantify the change in serum zinc concentration after exercise. Serum zinc concentration was significantly higher immediately after exercise (0.45 ± 0.12 μmol·L−1, P

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